Thankfully, “conversion therapy” is much less common than it used to be. But a ban proposed by Britain's government is muddled—and potentially harmful for patients
Psychologists, psychiatrists and quacks have been trying to “cure” homosexuality for at least a century. These days, thankfully, “conversion therapy” is much less common than it used to be. Partly that is because it does not work. Mainly, though, it is because society has changed. Although homophobia still exists, people across the West increasingly see same-sex attraction as something normal and unremarkable. But Britain’s government wants to clamp down onall the same.
That would be a bad idea. There is little evidence that the affirmative approach relieves gender dysphoria—the misery of feeling at odds with one’s biological sex. Key to medicine’s 20th-century transformation from guesswork to science was the notion that doctors should prescribe treatments only when there is good reason to think they work. Yet the evidence base for the affirmative approach is thin. The drugs it uses were not clinically tested for this kind of therapy.
Starting puberty blockers often begins what doctors call a “treatment cascade”. Data from European clinics suggest the vast majority of those prescribed puberty blockers go on to take cross-sex hormones. The drugs are powerful, and so have powerful side effects. Puberty blockers may stunt growth and weaken bones. Cross-sex hormones produce irreversible changes, including the growth of facial hair and a deep voice in women, and the growth of breasts in men. Long-term use can affect fertility.
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