Could new legislation that would ban conversion therapy be misused, targeting health-care professionals who advise against major interventions for children confused about their gender identity?
Some think it could.
“However well intended, the legislation unfortunately conflates sexual orientation with gender identity,” James Cantor, a psychologist who opposes the new legislation, said in an e-mail exchange.
Many children who identify as transgender change their minds upon reaching puberty, he said. In such cases, “watchful waiting” may be the best therapy. But he believes that under the legislation, such an approach could be labeled as conversion therapy for not permitting the child to transition, making it a crime.
“It is not clear to what extent laws intended to block ineffective treatment for sexual orientation will get used to block appropriate treatment for gender identity," he said. He believes laws on conversion therapy should target sexuality but not gender identity.
Kristopher Wells, Canada Research Chair for the Public Understanding of Sexual and Gender Minority Youth at MacEwan University in Edmonton, emphatically disagrees.
“If a person is not starting from an anti-trans ideology, there’s nothing to worry about,” he said in an interview.
This could get very complicated.
Virtually everyone agrees that so-called therapies to convert homosexuals to heterosexuals are bogus and dangerous. Bill C-8, introduced on Monday, would make it a crime to peddle such snake oil, and a crime to force it upon minors.
But C-8 addresses gender identity as well as sexual orientation. It defines conversion therapy as any practice “designed to change a person’s sexual orientation to heterosexual or gender identity to cisgender.” Trying to force someone to accept their biological gender even if they identify otherwise could be seen as conversion therapy.
If a prepubescent child identifies as a gender other than their biological gender, treatment can range from counselling to puberty-blocking drugs and sexual reassignment surgery.
Dr. Cantor advises against permanent measures "until we can be confident that the new role will be stable, and the evidence indicates that is not possible until after puberty.”
But "some activists are misrepresenting watchful waiting to count as a conversion therapy that should be included in the ban,” he believes. He would have legislation focus on sexual orientation, but not gender identity.
But Prof. Wells believes the legislation provides ample protection for any qualified therapist of good will.
“Lots of checks and balances are required,” he observed. “Nobody gets diagnosed and begins a medically supported transition overnight.”
He warns that failing to properly treat a transgender minor could place that child’s mental health at risk, which could include an elevated risk of attempted suicide.
Julia Ehrt, director of programs for ILGA, a consortium of more than 1,600 LGBTQ organizations around the world, agrees with Prof. Wells. While acknowledging that “there is a debate among medical professionals” about the best treatment for trans-identifying youth, what matters, she said, is to support and respect the child.
“Minors need to be protected,” she said in an interview. “Minors, as well, have a right to experience and explore their own gender identity.”
David Lametti, the Justice Minister, insists the new legislation poses no threat to therapists or anyone else of good will.
“No one should be told that who they are or who they love is wrong, and in need of repair,” he said in a statement to The Globe and Mail. He believes the law would not interfere with medical practitioners, family members, faith leaders or anyone else offering counselling, provided the child’s gender identity is respected. “Each case will be unique, different and personal.”
Does the bill, as worded, immunize qualified therapists who advise against hormonal or surgical intervention in a gender-dysphoric child, while allowing police and prosecutors to target transphobic charlatans? Or could it be exploited by ideologues to target therapists they disagree with? This is what Parliament’s justice committee will have to decide when it studies the legislation.
Transgender youth need protection from religious authorities, abusive parents or so-called therapists who deny the reality of transgender. But good-faith efforts to support a child while not rushing into hormonal or surgical interventions should not be a crime.
This is an important bill. Parliament should take the time to get it right.