Conversion-therapy bans and talking therapy

Do bans on conversion practices criminalise exploratory psychotherapy for gender-questioning minors?

“Conversion therapy” originally described attempts to make lesbian, gay or bisexual people heterosexual, often through aversion techniques, religious pressure or psychotherapy founded on the premise that same-sex attraction was disordered. There is a strong ethical and policy consensus that coercive efforts to alter sexual orientation are harmful and should not be practised. The harder legal question is what happens when legislation uses the same framework for gender identity, particularly where a child or adolescent is uncertain, distressed or has multiple relevant difficulties.

Background

“Conversion therapy” originally described attempts to make lesbian, gay or bisexual people heterosexual, often through aversion techniques, religious pressure or psychotherapy founded on the premise that same-sex attraction was disordered. There is a strong ethical and policy consensus that coercive efforts to alter sexual orientation are harmful and should not be practised. The harder legal question is what happens when legislation uses the same framework for gender identity, particularly where a child or adolescent is uncertain, distressed or has multiple relevant difficulties.

The distinction matters because talking therapy can serve very different purposes. Therapy may seek to impose a predetermined outcome: for example, making a young person identify as cisgender, or suppressing a declared transgender identity. It may instead help a young person describe and understand distress, family circumstances, sexuality, puberty, neurodevelopmental differences, trauma, mental health, social pressures and their own wishes, without requiring a particular conclusion. The first is a change-or-suppression project; the second is what clinicians generally mean by exploratory or assessment-led psychotherapy.

The UK Government’s An assessment of the evidence on conversion therapy for sexual orientation and gender identity found no robust evidence that conversion therapy changes sexual orientation or gender identity and reported consistent associations with self-reported harm. However, it also recorded major evidence limitations. Of the 46 studies identified, only four focused exclusively on gender identity, and there was no study specifically focused on gender-identity conversion therapy in the UK (Government Equalities Office, 2021). That is important context: evidence of harm from coercive, goal-directed practices should not be casually treated as evidence against every form of neutral psychotherapy.

What the documents say

The current UK proposal

As of 11 September 2026, England and Wales do not have an enacted, trans-inclusive conversion-practices ban. The Government published a draft Conversion Practices Bill on 25 June 2026 for pre-legislative scrutiny. The distinction is not technical: a draft Bill creates no criminal offence unless Parliament passes it and it receives Royal Assent.

The draft defines a conversion practice as conduct intended to cause a person to have, not have, or believe that they have or do not have a sexual orientation or transgender identity. But clause 1(3) contains a significant safeguard. Conduct performed while providing healthcare services to the individual is not a conversion practice unless the practitioner acts in a way that falls far below the standards reasonably expected of someone in that position. “Healthcare services” expressly includes mental as well as physical healthcare (Draft Conversion Practices Bill, 2026).

The draft’s principal offence has further thresholds. It applies only where an abusive conversion practice causes serious physical or mental harm, or serious alarm or distress that substantially adversely affects normal day-to-day activities. Courts must assess abuse on all the facts, including whether conduct was sexual, violent, threatening, controlling, coercive, economically pressuring, or psychologically or emotionally pressuring. The maximum sentence on conviction on indictment would be five years (Draft Conversion Practices Bill, 2026).

On its text, therefore, the draft Bill does not criminalise properly delivered exploratory psychotherapy merely because it discusses whether a minor’s gender-related distress has more than one possible meaning. It does, however, make professional standards central. A therapist who presented coercive identity suppression as “exploration”, or whose practice fell far below expected standards, could not rely on the healthcare provision.

Canada, New Zealand and Queensland

Canada provides the clearest statutory answer. Its Criminal Code defines prohibited conversion therapy as a practice, treatment or service designed to change a person’s sexual orientation to heterosexual, gender identity to cisgender, or to repress non-heterosexual attraction, non-cisgender identity or non-conforming gender expression. It then expressly states that the definition does not include exploration or development of an integrated personal identity, including services relating to gender transition, provided they are not based on an assumption that one sexual orientation, gender identity or expression is preferable to another (Criminal Code, Canada, 2021).

New Zealand’s Conversion Practices Prohibition Legislation Act 2022 also uses an intention-based definition: a practice must be directed at someone because of sexual orientation, gender identity or gender expression and be intended to change or suppress it. Its exclusions specifically cover health practitioners acting on reasonable professional judgement while complying with legal, professional and ethical standards; identity exploration; social support; and assistance with transition or gender expression. The Act creates an offence for conversion practices performed on under-18s or people lacking decision-making capacity, but the statutory exclusions remain part of the definition (Conversion Practices Prohibition Legislation Act, 2022).

Queensland’s health-sector prohibition is also instructive. Official Queensland Health guidance says reasonable, evidence-based clinical practice is not prohibited even if it does not proactively affirm a person’s identity. Its examples of permitted practice include evaluating underlying psychological factors, investigating a patient’s gender-identity experience as part of assessment and diagnosis, discussing treatment risks, and delaying or declining treatment where a clinician reasonably judges it unsafe or contraindicated (Queensland Health, 2020).

The positions

Advocates of broad trans-inclusive bans argue that gender-questioning young people can be harmed by therapists who begin from the assumption that a transgender identity is pathological, false or must be removed. In this view, apparently neutral “exploration” can conceal a predetermined aim, especially where a clinician repeatedly challenges only transition-related possibilities, frames identity as a symptom to be cured, or makes acceptance conditional on becoming comfortable with the sexed body. The 2024 UK Memorandum of Understanding on Conversion Therapy defines conversion therapy as therapy that assumes some sexual orientations or gender identities are inferior and seeks to change or suppress them on that basis (BACP, 2024).

Those concerned about overbroad bans make a different point. They argue that children with gender distress deserve the same careful, open-ended clinical assessment offered to children with other complex presentations. The Cass Review described a population with substantial co-occurring needs and recommended a holistic assessment including mental health, neurodevelopmental and family factors. It also reported that some practitioners feared being accused of conversion therapy for offering psychological care that did not simply affirm an asserted identity (Cass Review, 2024).

Both concerns can be genuine. A ban should protect minors from coercion, shame and identity-directed treatment. Equally, safeguarding should not mean that a clinician is forbidden to ask clinically ordinary questions, assess risk, address anxiety or trauma, explore sexuality, discuss the consequences of social or medical transition, or allow uncertainty to remain uncertainty.

Interpretation

Beyond Gender’s reading is that the answer is no, not necessarily: bans do not inherently criminalise exploratory psychotherapy. Canada, New Zealand and Queensland demonstrate that legislatures can expressly preserve identity exploration, reasonable clinical judgement and standards-compliant care. The UK’s 2026 draft similarly places ordinary healthcare outside the definition unless the practitioner’s conduct falls far below professional standards.

But this protection depends on precise drafting and fair implementation. A legal definition based only on a claimed outcome, rather than intention, method, coercion and professional standards, could create a chilling effect. If a clinician reasonably fears that asking whether distress may relate to puberty, sexuality, family conflict, autism, trauma, depression or social influence will be treated as attempted “suppression”, children may receive less thoughtful care. That would be particularly concerning for minors, for whom diagnostic uncertainty and developmental change are normal.

The crucial boundary should be clear: therapy must not have the predetermined purpose of making a child accept a particular identity, whether cisgender or transgender. Genuine exploration permits more than one possible endpoint. It listens without humiliation, does not promise to change identity, does not use coercion, and does not make access to compassionate support contingent on reaching a politically preferred answer.

Open questions

The UK draft Bill’s healthcare safeguard is broad, but future parliamentary scrutiny should test its practical limits. Does “healthcare services” clearly include independent counsellors and psychotherapists as well as NHS clinicians? How will courts distinguish robust but respectful clinical questioning from psychological pressure? What professional standards will be used where professional bodies disagree about affirmative and exploratory approaches?

There is also a wider evidence question. The Government Equalities Office’s 2021 assessment found limited direct evidence on gender-identity conversion practices, especially in the UK. Policymakers should not use that limitation to minimise survivors’ accounts of coercive treatment. Nor should they use it to collapse all non-affirmative or exploratory talking therapy into abuse. Better research should distinguish therapeutic intent, method, duration, consent, patient experience, clinical outcomes and whether the intervention was genuinely open-ended.

On the timeline

Episodes on this idea

He Helped Ban Conversion Therapy. Now He Regrets It