A number of states (Queensland, Victoria) and territories (ACT) are introducing legislation to outlaw conversion therapies that aim to force individuals to change sexual orientation or gender preference. None of these methods have been used in the medical profession for many decades. Unfortunately, in relation to gender matters in young persons, the various ‘conversion therapies’ legislation more or less forces doctors to dismiss exploring for underlying causes or explanations of gender dysphoria (the mood) or gender incongruence (the cognition).
The legislation endorses one approach to gender dysphoria/incongruence – that is ‘affirmation’ then puberty blockers/cross-sex hormones and follow-up sex reassignment surgery, as if there is no other way of treating this condition. Doctors (or other healthcare workers) who look for underlying psychological, psychiatric, family or social origins of gender identity difficulties and then treat them are discouraged from doing this because they will fear their efforts will be captured by the legislation as ‘conversion therapy’ because this type of intervention will not have as its primary goal the transitioning of the young person to the desired gender.
Governments trying to impose this legislation are mandating the type of medical care provided for a complex clinical condition without taking into account the particular circumstances of the individual case. This seems a very unusual development. This will limit the availability of professional help for young persons who need assistance in dealing with gender identity issues. Perhaps an analogy would be for government legislation to mandate only ECT for depressive illness irrespective of the individual clinical situation. And then prohibit psychological therapies for this condition by naming them ‘conversion therapies’.
Doctors with concerns about this legislation should contact members of the ACT Legislative Assembly. NAPP has made a submission to the ACT government outlining our concerns with the legislation.