Dr Hilary Cass: Conversion therapy ban risks 'frightening' clinicians off

Dr Hilary Cass said the idea of being a “test case” was making clinicians “even more anxious, potentially, about working in this area”. The Scottish Government previously consulted on plans to ban conversion practices, which are defined as attempts to change or suppress the gender identity or sexual orientation of another person.

This included potentially introducing new laws to criminalise "the most serious and harmful” examples, with jail sentences of up to seven years for the worst offenders.

Dr Cass was asked about the issue as she gave evidence to the Scottish Parliament’s health committee on Tuesday. She said: “This one is a big challenge, and all I can say is I’m glad I’m a doctor and not a litigator, because it is a really difficult problem. Everyone should be protected from conversion therapy – it’s a completely unacceptable practice.

"But because, thinking about the legislation, the issue has been about intent – and if a therapist engages with a young person and they change their views about their gender identity during the course of that therapeutic relationship, and then they subsequently say it was because the therapist had an intent to change their gender identity, that puts the therapist in a difficult position, because how can you legally determine intent?

"The anxiety that you may be the test case is making clinicians even more anxious, potentially, about working in this area, and we don’t want to do anything to frighten professionals off from working in this.

"So walking that path is very difficult. I guess the only thing I would say is that no credible professional body would support conversion therapy. So if any practitioner is deemed to be practising conversion therapy, it should in the first instance be a matter for their professional regulator before it would be a legislative issue.

"But I don’t know how we get that balance right of protecting people from conversion therapy and not frightening therapists who are just doing their job, and having an appropriate exploratory conversion with a young person.”

Dr Cass said “a very high percentage” of gender questioning young people were same-sex attracted, adding: “You can see how the two things could get conflated.”

She added: “This may have been naive, but one of the things I was surprised about in conducting this review is how much homophobia there still is, as well as transphobia. So we do have to support people in being able to express their, and understand their sexuality as well as their gender identity.”

The Cass Review’s final report, published last month, said children had been let down by a lack of research and evidence on the use of puberty blockers and hormones, in a debate it said had become exceptionally toxic.

Two Scottish health boards – one of which covers the only gender clinic in the country for young people – decided to pause the prescription of puberty blockers to new patients in the wake of the findings.

A Scottish Government spokesperson previously said the review was “a comprehensive and valid scientific document” and it was “considering all of the recommendations”.