Uncovering the Flaws: Analysing the Data Behind Gender Identity Conversion Practices

With ongoing debate about conversion therapy legislation — including a private member’s bill in the House of Lords on Feb 9th — policymakers must understand the very serious flaws in the data purporting to demonstrate gender identity conversion practices. Here we outline the most serious problems with the surveys and evidence most commonly presented to support trans conversion therapy legislation

The Coventry Study 2021

This government research aimed to improve the understanding of so-called conversion therapy by addressing 4 questions:

  1. What forms does conversion therapy take?
  2. Who experiences conversion therapy and why?
  3. What are the outcomes of conversion therapy?
  4. What measures have been taken to end conversion therapy around the world?

The few examples of trans conversion cited refer to apparently legitimate psychotherapy e.g. “techniques such as looking for ‘causes’ by discussing childhood trauma and family relationships.” In 2022 the Minister for Equalities confirmed to Bayswater that this was NOT conversion therapy.

The authors acknowledge doubt over their own findings: “Whether or not these experiences constitute ‘conversion therapy’ may depend on the definition, but they were perceived to be so by the interviewees.” In short: what is being reported as ‘conversion’ may not be.

The authors confirm that no conclusions can be drawn about prevalence: “No robust data exists on the number of LGBT people who have had conversion therapy and which sections of the UK population are most likely to have it or be offered it.”

The limited data on trans conversion is clear, in that a 20-year literature review found just 5 articles, of which 4 were deemed useful for the review, and 2 of these were based on the same dataset. The accompanying qualitative study had just 6 trans or non-binary interviewees.

Notably, the Coventry study makes no reference to the experiences of desisters or detransitioners who have been harmed by the experience of believing in a cross-sex identity, thus offering only a partial understanding of the different outcomes for trans-identified individuals.

National LGBT Survey 2017

The National LGBT Survey Summary was published in July 2018, to report back the findings of the government survey to gather more information about the experiences of LGBT people in the UK.

As noted by the EHRC in 2022, there are “significant challenges in drawing conclusions from the survey” due to the “absence of a definition of conversion therapy in the survey question, meaning that the practices classified in this way by respondents are unclear

Although the report states “we did not provide a definition of conversion therapy in the survey”, it confidently concludes that conversion practices “can range from pseudo-psychological treatments to, in extreme cases, surgical interventions and ‘corrective’ rape.”

This was a self-selected convenience sample, with the survey promoted at LGBT events and online. As the Coventry study points out this “is not representative of all LGBT people in the UK”.

The Coventry study also points out that the National LGBT survey failed to ask how long ago the conversion therapy took place, hence: “some of the findings are based on older evidence and therefore may not be reflective of current practice.

Since the survey conflates sexual orientation and gender identity conversion, it is not clear whether the alleged higher rates among trans respondents were for alleged gender identity or sexual orientation conversion.

Scottish Government 2024 Consultation: Ending Conversion Practices in Scotland

Before moving forward with “progressive legislation” to end conversion practices in Scotland, the Scottish government launched a public consultation on its’ proposals in January 2024.

The Scottish consultation provides no data of its own, referring instead to the UK National LGBT 2017 survey and admitting “There is no international, universal definition of the term ‘conversion practices’” but nonetheless, recommends legislation to follow other countries.

The anecdotal evidence presented is drawn from the “Expert Advisory Group” (EAG), a panel that drew experiences from a selected group of respondents but makes no mention of detransitioners or of clinicians who are concerned about the medical model of treating gender dysphoria.

The EAG’s definition of gender identity states that it “may involve, if freely chosen, modification of bodily appearance and/or functions by medical, surgical or other means“. Under this definition, opposition to medicalisation might be framed as a conversion attempt.

However, the Scottish legislative proposals themselves are more cautious, offering protection for parents who resist medicalisation provided this isn’t ‘coercive’. Nonetheless, the EAG is not alone in regarding “gatekeeping access to healthcare” as potential conversion.

The lack of clarity around what might constitute conversion is also evident from the fact that the legislative drafters felt the need to include explicit protection for clinicians facilitating medical transition to ensure they cannot be accused of conversion.

Galop Survey 2023: Experiences of Conversion Practices

This YouGov survey was commissioned by the LGBT charity Galop to ask LGBT+ adults about their experiences of violence and abuse, as well as if they had been subjected to conversion therapy or practices.

A self-selected sample responding to a survey conducted by an LGBT+ charity (via YouGov) which is “run by and for LGBT+ people”. Risk of bias from the results of this survey is high. The disability/health condition rate of 40% (UK figures around 24%) suggests this sample is not representative.

The survey questions are framed in such a way as to exclude those who do not describe themselves as having a gender identity at all. Thus responses from detransitioners or desisters are unlikely to be reflected in the data.

A lack of clarity over what constitutes ‘conversion therapy’ also undermines the data. The broad range of behaviours include ‘clandestine’ coercion into the ‘cis norm’ and the authors admit it can be difficult even for respondents “to identify their experiences as attempts at conversion”.

Claims about the consequences of ‘conversion’ (including depression, post-traumatic stress, suicidal ideation, suicide attempts) could in fact reflect a vulnerable cohort with complex psychological and neurodevelopmental difficulties that are not resolved by transition.

Stonewall Conversion Therapy and Gender Identity Survey 2020

Compiled by ‘Independent Research Monitor’ Richard Matousek, this survey looked at the effects of so-called ‘Gender Identity Conversion Therapy’. Matousek states that the data generated is ‘demonstrative rather than…statistically robust‘.

The survey collected 1504 responses, of which 418 were excluded via ‘quality control’, i.e. 28% of responses were discarded due to: location (not UK), age (<16), or ‘bad faith’ data (including ‘transphobia’). No figures are given on how many were in the latter category.

Two examples of ‘bad faith’ responses are given, one talks about ‘transing the gay away’ thus echoing concerns expressed by GIDS whistleblowers, the other describes discrimination against lesbians who describe their sexual orientation in terms of sex not gender identity.

The entire framework for the survey assumes respondents are happy to define their ‘gender’ as either matching or not matching their ‘sex assigned at birth’. Anyone who does not subscribe to this belief system and says as much will likely have had their response discarded.

The author admits the results are not indicative of the prevalence of trans conversion (due to non-randomised small sample), yet the study is cited by the Ozanne Foundation to claim conversion is “more widespread and often more violent than has previously been understood.

The attested higher rates of mental health issues post ‘conversion’ attempts are interpreted as showing the ‘harms’ of conversion but could equally indicate that those with existing poor mental health are likely to be encouraged to resolve those issues before transitioning.

Contrary to the claim that ‘conversion’ doesn’t work, even in this skewed sample 19% of respondents believed that trans conversion therapy ‘had successfully made them cis‘.

The study reports a negative impact of gender identity conversion therapy on people’s lives, but fails to mention that a not insignificant number of respondents reported either ‘no impact’ or even that they felt ‘better’ or ‘much better’ following the ‘conversion’.

The percentage of survey responses reporting ‘no impact, better, or much better’ following ‘gender identity conversion therapy’ (as found on p15 of the report):

  • mental health 31%
  • physical health 56%
  • family relationships 40%
  • peer relationships 56%
  • community relationships 47%
  • romantic relationships 36%

Perhaps these surprisingly positive outcomes are due to the broad definition of ‘conversion’ used in the study, designed to be ‘the most inclusive of various forms of conversion’ to the extent that even respondents did not necessarily know they were experiencing conversion.

The lack of clarity about what ‘conversion’ might involve is clear in several of the survey responses: “I didn’t realise I was being subjected to ‘conversion therapy’, it was gradual drip/suggestion/gaslighting” (asexual agender person, 55 – 64).

Another respondent (a ‘gender diverse woman’) describes being sent to an all-boys school despite articulating a cross-sex identity from a young age. The author notes this “may not be considered by some to be ‘conversion therapy’ ” but it is nonetheless recorded as such here.

Summary

Perhaps the most salient theme is the subjective nature of gender identity ‘conversion’. Most concerningly, there may be little overlap between conduct described as conversion in surveys and the practices policymakers believe they should be seeking to outlaw.

Convenience sampling likely offers a skewed perspective and this too must be factored into any interpretation of the survey results.

What is clear is that we need precise definitions of what exactly is meant by gender identity/trans conversion and credible evidence that these practices are occurring before proceeding with any legislation.

In short: the first hurdle for any prospective legislation to clear is to provide evidence of the harm it is seeking to outlaw. The trans/gender identity conversion therapy proposals have thus far stumbled at this very first hurdle.