On first consideration, an attempt to ban so-called “conversion therapy” for people struggling with homosexual and transgender issues appears to have failed last week in the Queensland Parliament. Tucked in the middle of a number of a number of apparently inconsequential amendments to the Health and Other Legislation Amendments Bill (No. 2) 2019, the modified legislation passed easily in the unicameral parliament.

The intention to criminalise “conversion therapy”, conveyed in the original Bill of November 2019, been had been so opposed by a coalition of lesbians, feminists, psychologists, psychiatrists, paediatricians and Christians, that the Government had withdrawn it for “clarification”, doubtless with an eye on the October 31 election.  

The new version still declares “A person who is a health service provider must not perform conversion therapy on another person”, with a penalty of up to 18 months incarceration for anyone who breaks the law.

But it also seems to suggest exemption for doctors and psychologists who counsel people for gender dysphoria if they believe it to be “clinically appropriate” — and some of the Bill’s opponents have breathed a sigh of relief.

I, however, am not optimistic.

The Bill contains an ambiguity concerning “conversion therapy” that should not be overlooked by those supporting the right for a person troubled by unwanted sexual pre-occupations to seek and receive help, and by those seeking to prevent gender-confused children from being introduced to a pathway of hormonal and surgical “affirmation” in pursuit of an identity incongruent with chromosomes.

The basic intent of the original Bill is unaltered:  the draconian prohibition of “practice that attempts to change or suppress a person’s sexual orientation or gender identity”.

Its “in your face” intimidation has, however, been mollified by what might be interpreted as a contradictory exclusion: conversion therapy does not include practice “that, in the provider’s reasonable professional judgement” is “part of the clinically appropriate assessment, diagnosis or treatment” and is provided “in a manner that is safe and appropriate”.

The impact of the legislation, then, depends on the meaning of the words “reasonable”, “appropriate” and “safe”, and such meaning must be sought within the context of the ideology of gender fluidity which is promoting the legislation. This pseudo-religion believes there is no binary entity of boys and girls — gender is something you feel. The mind transcends the body’s chromosomes.

Therefore, if a child or an adult “feels” they might be of the opposite sex, it is not “reasonable” to try to persuade them otherwise. It will not be “appropriate” to deny them hormonal therapy in their attempt to make body congruent with mind. Indeed, it will not be “safe” to deny them an opportunity for “affirmation”. If thwarted, the mind could turn upon the body, leading to mental distress and even suicide.

In a medical tribunal, given the demonstrated support of leaders in the profession for the hormonal “affirmation” of children, how will the “reasonableness” of non-hormonal “watchful waiting” psychotherapy be defended?

As in the Family Court, given the proclivity of judges to accept declarations of “safety” for hormones and “risk of suicide” without them, how will “professional judgement” against their use be considered “appropriate”? This is especially the case when prosecutors come armed with officious “standards of care” and “guidelines” promulgated by gender clinics in the “best” of institutions.

Even the legislation’s examples of “conversion therapy” contain ambiguities.

At first sight, everyone would rush to concur with its condemnation of suppressing “sexual orientation or gender identity” by inducing “inducing nausea, vomiting or paralysis” (paralysis? – that’s a new one!), or by other varieties of coercive aversion therapy.

But what about “other techniques” that encourage an LGBTI person to believe their condition is a “defect or disorder”? How will a counsellor approach the situation in which a child is confused over gender? Or if an adult is disturbed by unwanted sexual pre-occupation?

Although the fact that they have sought counselling is an admission of disorder, if the counsellor tries to reduce the tension, would he or she not have colluded with, if not encouraged, the patient’s self-assessment?

The effect of the ambiguities in the amendment will be the likelihood of withdrawal of counsellors from the fray, leaving the confused to an increasing “consensus” in favour of gender fluidity.

It will be much less dangerous for a paediatrician to refer a confused child to a gender clinic than to recommend and practice “watchful waiting” in expectation of natural congruence of gender with chromosomes through puberty. Why risk being drawn into court to prove “reasonableness”?

It will be tricky for a psychiatrist to help someone with unwanted sexual pre-occupations without admitting that there is some kind of disorder.

Given support for “affirmation” by various medical colleges, could indemnity insurance be expected? Given the Australian Health Practitioner Regulation Agency is likely to issue a new Code of Conduct which would deem unprofessional practice contrary to “standards”, why risk de-registration?

This Bill, therefore, may not represent the withdrawal of parliament from a commitment to ban “conversion therapy”. It could be a sleight of hand which promises freedom of medical practice even as it undermines it through medico-legal vulnerability.

John Whitehall

John Whitehall is Professor of Paediatrics at Western Sydney University. His 50 year career began at Sydney University, continued through developing countries and western Sydney as a general paediatrician,...