Catherine Jackson: Igi, you chair the group of professional psy associations, including BACP, UKCP and BPS, who are committed to a ban on conversion therapy in the UK.1 Can you briefly summarise what conversion therapy is and what forms it takes?

Igi Moon: For the organisations in the Memorandum of Understanding (MoU) Coalition, that term means any therapeutic approach, particular model or individual viewpoint that a therapist or counsellor may have that suggests or demonstrates an assumption that any sexual orientation or gender identity is inherently preferable to any other, or that seeks to bring about a change of sexual orientation or gender identity, or tries to suppress an individual’s expression of their sexual orientation or gender identity.

CJ: What do you think explains the Government’s apparent reluctance to go for a legal ban on conversion therapy when all the main psy professional bodies have taken a stand and declared it actively harmful and have banned their members from practising it?

IM: Practically speaking, it does take a bit of time to set up a law that will be effective. It takes a while to get the wording right and it’s worse to have a badly worded ban than not to have a ban at all. That would be playing into the hands of critics, who would just tear it apart. The state of Victoria in Australia has recently brought in a ban that we think is a very good round-up of what we need to cover.

We would like to see more enthusiasm from senior Government ministers in working with LGBT people. However, Alicia Kearns, the Conservative backbencher, has been magnificent in her support of our call for a legislative ban and in putting together the wording for such a law.2 We are hopeful that the Government will deliver on their pledge to bring in a legislative ban, and there is cross-party support. Till then, that throws the issue back on the professional associations to make sure their members abide by the MoU.

CJ: How prevalent is it? Is this just a scattering of maverick individual practitioners or is it something more widespread and systemic?

IM: Of the 108,000 responses to the national LGBT survey that was conducted by the Government Equalities Office in 2018, two per cent had undergone conversion therapy and five per cent had been offered it. That sounds quite low but you are still talking about thousands of individuals. And we also know that this isn’t just something that happened in the past: in the survey, 10% of the cisgendered people offered it were aged 65 and older, but eight per cent were aged 16 to 17 and seven per cent were 18 to 34 years old.

However, the survey also tells us that they had been offered or undergone conversion therapy mainly by faith organisations – 53% and 51% respectively. Likewise, people with religious belief were more likely to have undergone or been offered it – most commonly Muslim people at 19%, compared with just six per cent of those with no religion/belief system.

That’s the largest grouping. Nineteen per cent said that the conversion therapy had been conducted by healthcare providers or medical professionals, and 16% said that it had been conducted by their parents, guardians or other family members. We don’t have any specific statistics as regards therapists. But it is worrying that so many people encountered it in healthcare organisations, which suggests therapists or psychologists were involved. A much higher proportion of trans respondents than cisgender respondents who were given conversion therapy said that it had been conducted by healthcare providers or medical professionals, and not just in specialist and gender identity clinic settings.

Clearly, we need to be thinking about how we work with people from these communities in healthcare settings. Stonewall has done some research with practitioners in healthcare settings and we hear back from them that some feel they just do not know enough – they don’t know what questions to ask, how to ask those questions and what issues people may present with.

CJ: There has been some anxiety about the finding that there is most risk of conversion therapy being practised among particular faith communities. These tend to be the more fundamentalist religions. How do we call that out without allowing the debate to be hijacked by racist lobbies?

IM: Yes, clearly there are issues around conversion therapy within the black British and Muslim communities, and in the Jewish and Hindu communities. That, to me, is an invitation to work with faith organisations around this. There are people from all the main faith organisations who see the need for a ban and are open to people being able to live as they choose. But we have to be incredibly sensitive to the faith context. Within every faith, as within every therapeutic approach, there are individuals who have their own opinions and faith can become a vehicle for their opinions. We can’t dodge the fact that we, as a whole society, have a lot of work to do. In particular, we can help young people understand how conversion therapy can take place so they know when it is happening and where they can go to get help.

Hatred of anyone being homosexual or transgender goes beyond faith; it’s also a reflection of the society we live in. But yes, faith has a lot to say in this and it underpins the way a lot of therapists practise, and if that clashes with the commitment they have signed up to in the MoU, then we would expect their professional organisation to have something to say about it.

CJ: What about therapists whose religious faith condemns same-sex relationships? Should they be working as therapists at all?

IM: When I hear people saying that, it makes me wonder what they’ve been doing in their training. Have they been doing anything to shift them out of their comfort zone? First of all, every therapist needs to be very honest with themself about how they feel about lesbians and gay men and people who are transgender, in the same way that we all need to think about how we feel about working with people from any range of difference – people who are white, black, brown, people with a disability and in terms of religion or class. All these issues that have been shoved into an area of training that has received relatively very little attention are now pushing at the door saying, ‘Actually we are not demographics, we are not just boxes to be ticked, we are part of lived experience.’

My brother was a pilot and he used to say, when you’re in the cockpit, you have all the buttons and dials in front of you telling you what you need to be doing to fly your plane, but you are always aware that, out there, there are other planes flying at 300mph, and if you aren’t always keeping an eye on what’s going on out there as well, it could be disastrous. We need the textbooks and to do the exams and learn the skills, but we need to be aware of what’s going on out there in the social world.

So how do we explore that in therapy? I know what my beliefs are in relation to disability, to working with people from the LGBT community, people who are white or black or brown. I am not saying I always get it right but I try to work with as much openness as I can, and outside the clinical sessions I am constantly reading stuff about decolonisation and transgender and disability studies. I try to be up-to-date with the latest models that are around, to read the journals that seek to make you think about bodies and the social world in a very different way. That means that when I go into a session with someone, I’m not thinking, ‘I don’t know what to do, I don’t know what to say.’ This notion that we don’t know if we are actually doing conversion therapy comes from a failure to do the work. If, in our training, we have sat with our own feelings about our sexuality, our own whiteness or blackness or brownness, our own physical ableness or disabled body, they don’t frighten us anymore. But that exploration starts with ourselves.

I’m disabled and when I go to therapy, I don’t want to meet a therapist who doesn’t want to talk about my disability – I want them to do the thinking, as well as me, and that means doing the training about bodies, embodiment, our own personal discomfort with bodies and what we are really afraid of.

CJ: How would a client know the difference, that what’s happening isn’t supportive exploration, it’s the therapist’s agenda and they need to stop the therapy and maybe report their concerns?

IM: What the client needs to know is that the practitioner’s professional organisation takes a clear stand, that it has a clear statement of equality saying we expect all therapists to provide a space where you, the client, will feel safe. Also, when I start with a therapist, I would hope to hear them say, ‘This is a space where you should feel safe, where we can explore painful things together. If you don’t feel safe, I hope you can let me know, but here is what you can do if you don’t. And if you want to go to another therapist or if there are areas where you feel I can’t help, I can suggest other places you could go to.’

Professional organisations also need to keep informing the public about what is and is not good therapy, and in particular let young people in schools know that we want to build a world of therapy that is safe, and that this is what safety looks like and if you feel unsafe, you can approach us and talk to us. The fact is that a lot goes on in the one-to-one space, and ultimately it’s down to the therapist to know what is ethical.

CJ: What about people who are unhappy about their feelings of same-sex attraction and are coming to therapy wanting genuinely to ‘get rid of’ their feelings of discomfort, confusion and distress about their sexuality or their gender and to be ‘made normal’?

IM: I think the first step is to find out how much the person knows about therapy, what it can offer, how we work with clients by offering a space where they can explore their feelings and really dig deep, so that from the outset they know what therapy is about. We can open the space for them to explore what it means to say, ‘I want to be normal’. Conversion therapy is when the therapist agrees the person is fundamentally not normal, that there is something not OK about them.

CJ: The MoU was revised in 2017 specifically to include gender. Again, I think a lot of therapists are worried about how they can work safely and ethically with someone who comes wanting to discuss trans issues. Does the MoU effectively bind them to affirmative practice?

IM: The MoU does not require anyone to affirm anything. The MoU asks, first of all, that the therapist is very clear within themselves what their belief structure is. If a therapist really believes that affirmation of a gendered identity is a problem, I have to point out that we have been affirming a cisgendered identity without question for millennia. What the MoU does is ask us to explore our own understanding of our own gender and sexuality and get to grips with the possibly frightening aspects of what that might mean, and then work with our clients to explore rather than deny or exclude those feelings from the therapeutic space.

So, what do we mean by gender? For some of us, it’s essentially phenomenological – it’s about how people feel. And that is what we all work with in therapy – this very nebulous area that we call feelings. We can name them – anger, sadness and so forth – but it’s what these feelings are about that is one of the challenges of our work. We don’t just say someone’s feelings don’t exist. We don’t just cling to our two-sex model, male or female, and that’s all there is, because it isn’t.

How I feel in my body is to do with my experience of being in the world and how others respond to me. The debate about gender is asking us all to think about what it means for our body and for our concepts of masculinity or femininity. There are very different versions of masculinity among cisgendered men and very different versions of femininity among cisgendered women. It isn’t just about genitalia; it’s far more than that – it’s about how we feel as well.

I think therapy needs to find our voice in this debate. We need to start advocating our work and our phenomenological take on the world and be unafraid to say that feelings matter, that how we feel is important. We need to stand up and say, ‘Hang on a minute, we work in a very different world to the world of those who want everything neatly labelled and sealed off.’ We work with people whose lives have profoundly changed and when they share this with us at such a deep level, our lives are changed too. That is why I am so proud about the work we do.

CJ: Have the professional associations done enough? They’ve signed up to the MoU but should they do more to guide and lead their members?

IM: We need to know very clearly how organisations will deal with anyone who is complained about in relation to offering conversion therapy or who make it very clear that they do not support the MoU. If all our professional organisations are supporting the MoU and expect their 200,000-odd members to adhere to it and someone is saying publicly that they don’t agree with it, that is damaging for clients and their professional associations need to act. If our training is ethical and inclusive, most therapy trainees won’t feel afraid of the MoU. It is there to help them check out what they are thinking.

CJ: You are saying the professional organisations should require the same standards of adherence to the MoU as they would of their ethical framework or code of professional practice?

IM: I would argue that the MoU needs to be locked into an ethical framework in a much more integral way, rather than an add-on. It is beyond me to understand people who disagree with a ban on conversion therapy. Are they essentially saying, ‘I want to work with people but only with the right sort of people, and if you are the wrong sort of person, you can be harmed’? How can that be OK? What does that say about the work they are doing with clients?

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