Change the Mind or Change the Body
PACE’s Conversion Practices Ban Risks Criminalising Psychotherapy
A proposed resolution on so-called conversion practices, due to be voted on by the Parliamentary Assembly of the Council of Europe (PACE) this Thursday, 29 January, should trouble anyone who cares about mental health, clinical ethics, or the inappropriate medicalisation of gender-nonconforming individuals. This is yet another attempt by trans activists to impose an ideological framework onto clinical practice, and it is likely to do considerable harm to same-sex attracted and autistic young people. Thanks to the extraordinary work of Athena Forum and founder Faika El-Nagashi, this resolution has been brought to public attention and Europeans are taking action.
At the heart of the resolution is a fundamental category error. The proposed ban bundles together abusive practices and ordinary psychotherapy, and treats them as if they are ethically indistinguishable. Standard therapeutic work is recast as inherently coercive unless it delivers a pre-approved outcome. These so-called ‘conversion therapy bans’ reveal a striking lack of understanding of psychotherapy as a discipline.
If you feel alienated from your sexed body, should you attempt to change your mind or change your body? It is an important question. Moving rapidly toward medicalisation of the body while asking few questions is the hallmark of the gender-affirming approach. It is not careful. It is fast and simplistic, and it presumes that medical transition is the best option for people who feel uncomfortable in their own bodies.
Psychotherapy is not an exercise in persuasion, nor is it a tool for steering people toward predetermined identities. It is, by design, slow, reflective, and tolerant of uncertainty. Ethical psychotherapy makes room for ambivalence, developmental change, and the possibility that initial self-understandings may evolve. It is careful, exploratory, and rooted in respect for the unconscious. It focuses on how we can manage psychological distress and come to terms with bitter reality.
When this kind of work is misunderstood and then framed as dangerous or suspect, clinicians inevitably retreat. The cost of that retreat means that fewer conventional clinicians work with gender dysphoric individuals and instead they are funnelled toward “gender-affirming care”, a new approach that is unsupported by long-term evidence and already shows signs of causing harm. “Gender-affirming care” is anti-psychological in that it disregards the unconscious in favour of promoting medical pathways that alter the body rather than addressing the mind.
This resolution was put forward by British Labour MP Kate Osborne while most people working in this field were focused on the ongoing debacle surrounding the forthcoming puberty blockers trial. From a clinical standpoint, the resolution’s definition of conversion practices is deeply flawed. It substitutes ideological certainty for therapeutic nuance. Any form of psychological exploration that does not immediately affirm a declared identity is implicitly treated as hostile or coercive. For young people experiencing gender dysphoria, this is particularly damaging. Ethical mental health care depends on careful assessment, attention to comorbidities, differential diagnosis, and, above all, therapeutic neutrality. A blanket ban erodes these foundations and replaces professional judgment with political orthodoxy.
The chilling effect of this approach is already visible. I know many experienced therapists who have withdrawn from this area of work. One such clinician, a friend of mine whom I will call Bernadette, has decades of experience supporting vulnerable adolescents. She is thoughtful, conscientious, and deeply committed to ethical practice. Yet she will not work with gender dysphoria. Not because she lacks skill or compassion, but because the field has become so legally and professionally precarious that a single complaint could jeopardise her career. Vexatious complaints based on spurious concepts create an administrative nightmare and months, if not years, of stress and worry for clinicians. Faced with that risk, she refuses to work in this field. There are countless other therapists like Bernadette who also refuse to work with gender dysphoria, not because of any lack of understanding, but because of the damaging impact of trans activism on clinical practice.
If PACE were genuinely interested in protecting same-sex attracted young people, it would direct its attention to the roots of their distress. Why are so many experiencing shame about their sexual orientation, and how can this be addressed safely and ethically without imposing irreversible medical interventions on their bodies?
Likewise, if PACE were sincerely concerned with protecting therapeutic practice, it would focus on strengthening mental health care rather than restricting it. This would mean championing evidence-based, developmentally informed approaches, defending therapeutic neutrality and robust informed consent, and addressing the long-standing lack of regulation around professional titles. Clear distinctions between counselling and psychotherapy should be established, with reliable and transparent standards of training, competence, and accountability across Europe.
PACE could also draw principled distinctions between abusive practices and legitimate psychotherapy, while investing in long-term outcome research rather than moral panics. Safeguarding requires higher standards, not prohibitions that fundamentally misunderstand the nature of psychotherapy.
Should this resolution pass, it is likely to be seized upon by trans activists across Europe as a mandate for further action. We can expect national legislation, regulatory guidance, and professional rules that extend well beyond the resolution’s original intent. Complaints mechanisms will proliferate, clinicians will practise defensively, and the range of acceptable therapeutic approaches will narrow further. The result will not be better care for vulnerable people.