State Department to Combat Trans ‘Conversion Therapy’: Report

The State Department might soon launch an international campaign against conversion therapies for trans-identifying individuals, according to a leaked memo obtained last week by Manhattan Institute fellow Leor Sapir. This effort fits into the Biden administration’s overarching efforts to promote what it calls gender-affirming health care.

Sapir’s report, published in City Journal, suggests that State will soon note various countries’ handling of certain gender-identity-related treatments in its congressionally mandated assessments on human rights in various nations. Diplomatic outposts around the world, per the wording of the memo reported on by Sapir, will “submit robust information on the so-called ‘conversion therapy’ practices” of different countries “as part of the annual Human Rights Reports.” The office of Jessica Stern, the State Department’s special envoy on LGBTQI+ issues, will then launch an “action plan to combat the practice across foreign policy and foreign assistance lines of effort.”

Sapir writes that the memo, which was issued by Secretary of State Antony Blinken, also defines conversion therapy as efforts to “suppress or change an individual’s . . . gender identity.” While the Blinken memo says that such therapies include “electric shock” and “corrective rape,” it also includes “talk therapy” in the same category.

Sapir argues that this wrongly conflates two distinct things. “Using psychotherapy to help a child in distress about her changing body feel more comfortable in it rather than undergo expensive, risky, and irreversible hormonal and surgical interventions is, according to the State Department, no different from electrocuting gays and lesbians in order to ‘liberate’ them from their innate sexual attractions,” he writes.

In addition, Sapir identifies a number of potential diplomatic problems with that plan, arguing, in essence, that State has targeted a more or less innocuous practice used by several Western countries with well-regarded human-rights records. “Is the U.S. State Department about to classify Sweden, Finland, and the U.K. as human rights abusers?” he asks. Sapir provides the following context about those countries’ approach to gender-related health care:

The problem, for countries like Sweden, Finland, and the U.K., is that medical authorities in these places have concluded over the past two years that the evidence for pediatric “gender affirming care” is extremely weak and that, as a result, hormonal and surgical interventions are (as Finland’s COHERE put it) “experimental.” Sweden and Finland are now instructing clinicians who deal with minors to utilize an approach that emphasizes talk therapy as the first line of defense and “affirming” drugs only in extreme situations, if ever. Sweden has banned gender surgeries for minors—surgeries that are practiced in the United States, notwithstanding the repeated gaslighting of gender clinics and left-of-center media outlets. . . .

Other implications of the new “human rights” policy are anyone’s guess. Will the United States use its long financial arm to pressure Sweden, Finland, and the U.K. to restore “affirmative care,” against the judgment of experts in those countries that—unlike here—have conducted systemic evidentiary reviews? Will economic and cultural cooperation between the U.S. and other Western nations be made contingent on these countries demonstrating that a sufficient number of teenagers every year are medically transitioned? (Bureaucrats like to define objectives and measure outcomes numerically.) Or will the harm be largely symbolic and reputational, underscoring the extent to which American elites are willing to sacrifice reason and common sense to the ever-proliferating and increasingly destructive demands of wokeness?

That said, it seems less likely that Washington would punish those U.S. allies with financial penalties than that it would mention the countries’ stances in State’s annual report on human rights, with Stern raising the issue in diplomatic meetings with officials from those countries and at U.N.-sponsored and other multilateral events.

Still, even a softer State Department advocacy campaign on gender-affirming care could well carry consequences that erode Washington’s standing in the world. As Sapir argues:

Making “gender affirming care” a foreign policy requirement will dilute the moral authority of America’s broader commitment to human rights. Are foreign leaders now to believe that China’s persecution of its Uyghur minority, Venezuela’s use of arbitrary detentions and torture against regime dissidents, and the Taliban’s systematic oppression of women and girls are all on par with, say, Sweden urging its psychologists to help kids feel comfortable in their own bodies? Transgender activists will argue that ending “conversion therapy” and pushing back against other state-sponsored abuses are not mutually exclusive, but of course they are—and pretending otherwise will empower critics of the United States to argue that our understanding of human rights is absurd.

State’s reported work on gender-affirming care reflects the sharp turn that the department has taken to promote progressive conceptions of gender identity over the past year and a half. This followed a move to add a third gender marker, “X,” for “unspecified or another gender identity,” to passports starting in 2021. The department’s approach has been reflected in other communications, such as Foggy Bottom’s celebration of “International Pronouns Day” in a tweet that promoted an article discussing certain pronouns used by non-binary people, such as “ze/zir/zirs.”

Internally, too, State, which did not respond to National Review’s request for comment on Sapir’s report, adopted the language favored by gender-identity-focused activists throughout 2021, as NR reported last month:

In May of that year, in guidance on sensitivity to transgender employees, the department urged officials to “consider a shift in language to avoid making assumptions that can be offensive to transgender and gender nonconforming employees.” Officials were encouraged to use “words like everyone, colleagues, and esteemed guests rather than ladies and gentlemen.”

The document included a warning to those who don’t get with the times: “Persistent misuse of any employee’s name, pronoun, and/or honorific may be considered harassment.” The Family Liaison Office, which supports diplomats’ families, was renamed the “Global Community Liaison Office” in order to “better reflect and include diverse individuals and family types.”

In short, State’s reported move on gender-affirming care is consistent with the policy that it has advanced under the Biden administration. As the White House makes a series of further bold moves on this issue, State is likely to be a critical part of that effort, reshaping American diplomacy in noteworthy yet barely recognized ways and potentially pitting the U.S. against some of its allies on the finer points of gender ideology.