Ending conversion practices in Scotland: consultation

Part 3: Background

Policy context

12. The Scottish Government is committed to tackling marginalisation and discrimination in Scotland. This Bill sits within a programme of Scottish Government policies that seeks to ensure that the rights of everyone in Scotland are respected, protected and fulfilled. We continue to promote equality and human rights and support strong communities that are inclusive, empowered, resilient, and safe, where human rights are respected. This, of course, includes the rights of LGBTQI+ people.

13. Conversion practices are harmful to individuals subjected to them. They are promoted within an ideology that views LGBTQI+ identities as wrong and believes that they can be changed. Their existence contributes to this way of thinking even further. This legislation specifically aims to protect people from the harm of conversion practices and, in doing so, contributes to the broader protection of human rights and respect for the dignity of LGBTQI+ people.

Throughout this document, we have chosen to use the term LGBTQI+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, plus) except when referencing the work of others where different terminology has been used.

14. The Scottish Government is committed to ensuring that this legislation also upholds all existing rights protected in our law including freedom of thought, conscience, and religion; freedom of expression; and the right to family and private life. Further detail on the protection of these rights is provided in Part 12 below.

Growing international momentum to tackle conversion practices

15. A number of countries and regions have passed laws to outlaw conversion practices, or aspects thereof. The first country to introduce legislation of this type was Brazil, as early as 1999. Over the last decade international momentum has grown, with laws passed in Malta, Ecuador, Germany, Spain, France, Greece, Cyprus, Belgium, Iceland, New Zealand, and Canada, as well as several states and territories in Australia, Mexico, and the USA.

16. The Welsh Government announced in April 2022 that it intends to establish a dedicated campaign to address conversion practices. In Northern Ireland, a Stormont Assembly debate in April 2021 resulted in a 59-24 vote in favour of banning ‘conversion therapy’. Additionally, in the Republic of Ireland, the Minister for Children, Equality, Disability, Integration and Youth, Roderic O’Gorman, announced in January 2023 that the Irish Government is committed to bringing forward a ban on the use of ‘conversion therapy’ and legislation is being prepared, with priority drafting in Autumn 2023.

Timeline

17. The timeline below sets out the journey so far, which has led the Scottish Government to this consultation.

October 2017

The Memorandum of Understanding (MOU) on Conversion Therapy (2017) which is a commitment to end the practice of conversion therapy in the UK was published. This was signed by 25 health, counselling and psychotherapy organisations. The MOU makes it clear that conversion therapy in relation to gender identity and sexual orientation is unethical, potentially harmful and is not supported by evidence.

July 2018

The UK Government committed to ending conversion therapy in its LGBT Action Plan (2018) with a UK-wide proposal: “We will bring forward proposals to end the practice of conversion therapy in the UK”. The Action Plan stated that “commitments, for example on ending conversion therapy, will require a UK-wide approach”.

July 2018

The UK Government undertook a UK-wide, self-selecting ‘LGBT Survey’ in 2017 and received over 100,000 responses. It provided some useful statistics regarding the prevalence of conversion ‘therapy’ in the UK.

June 2020

The United Nations (UN) Independent Expert on Sexual Orientation and Gender Identity called for a global ban.

August 2020

Petition PE1817: End Conversion Therapy was launched, “Calling on the Scottish Parliament to urge the Scottish Government to ban the provision or promotion of LGBT+ conversion therapy in Scotland”.

June 2021

The Scottish Parliament’s Equalities, Human Rights and Civil Justice (EHRCJ) Committee agreed to undertake an Inquiry on the Petition to End Conversion Therapy in Scotland.

November 2021

The Cabinet Secretary for Social Justice, Housing and Local Government announced the formation of The Expert Advisory Group on Ending Conversion Practices.

December 2021

The UK Government launched its public consultation, Banning Conversion Therapy.

January 2022

The EHRCJ Committee published its report on Petition PE1817: End Conversion Therapy which concluded that conversion practices should be banned and that current protective legislation is insufficient.

October 2022

The Expert Advisory Group (EAG) on Ending Conversion Practices published its report and recommendations. The group found that “conversion practices infringe upon the human rights of individuals, in particular the victims’ freedom from discrimination and freedom from non-consensual medical treatment”.

What are conversion practices?

18. There is no international, universal definition of the term “conversion practices”, which is sometimes referred to as “conversion therapy”, “sexual orientation and gender identity change efforts”, “reparative therapy” or “gay cure therapy”.

19. The United Nations Independent Expert on protection against violence and discrimination based on Sexual Orientation and Gender Identity report states that “conversion therapy” is used as an umbrella term to describe interventions of a wide-ranging nature, all of which have the common belief that a person’s sexual orientation or gender identity (SOGI) can and should be changed. Such practices aim (or claim to aim) at changing people from gay, lesbian or bisexual to heterosexual, and from trans or gender diverse to cisgender.

20. The Expert Advisory Group (EAG) on Ending Conversion Practices defined conversion practices as “any treatment, practice or effort that aims to change, suppress and/or eliminate a person’s sexual orientation, gender identity and/or gender expression”.

21. Our specific proposal for defining conversion practices for the purposes of this legislation is set out below in Part 5.

What is the scale of conversion practices in Scotland?

22. Due to the often-private nature of conversion practices, evidence is often based on self-reporting. While there is currently no established figure on the size of the LGBTQI+ population in Scotland, the Office of National Statistics (ONS) found that, in the UK, an estimated1.8 million people aged 16 years and over (3.3% of the UK population) identified as lesbian, gay or bisexual in 2022. In the 2019 Scottish Surveys Core Questions 2019 (SSCQ), 2.7% of respondents self-identified as lesbian, gay, bisexual or other. Data collection on other sexual and gender minorities is currently insufficient to characterise the number of trans and non-binary people in Scotland.

23. Studies, surveys, reports, and qualitative evidence from individuals with lived experience provide some helpful data and information to support analysis of the types of conversion practices that exist, and the damage and trauma that such practices cause to individuals and society.

24. The UK Government’s National LGBT Survey, conducted in 2017, gives us a picture of the prevalence of conversion practices in the UK. The survey found that 5% of respondents had been offered so called ‘conversion’ or ‘reparative’ ‘therapy’ (but did not take it up) and a further 2% had undergone it. These figures were higher for trans respondents (9% of trans men been offered it and 4% had undergone it).

25. The survey also found that while older cisgender respondents were more likely to have undergone ‘conversion therapy’ than those in younger age groups, there was a relatively consistent pattern in the proportions of respondents who had undergone, or been offered, ‘conversion therapy’ amongst all of those aged 16-64. This suggests that it is a live issue, and not just one that affected older generations. Ten per cent of those aged 65 or above said that they had undergone or been offered ‘conversion therapy’, compared to 8% of 16-17-year-olds and 7% of 18-34-year-olds.

26. In terms of sexual orientation, bisexual respondents were the least likely to have undergone or been offered conversion therapy (5%), and asexual respondents the most likely (10%).

Transgender/trans refers to people whose sense of personal identity and gender does not correspond with the sex assigned to them at birth.

Cisgender refers to a person whose sense of personal identity and gender does correspond with the sex assigned to them at birth.

Bisexual refers to a person who is sexually or romantically attracted to more than one gender.

Asexual describes a person who does not experience sexual attraction.

27. The National LGBT Survey identified that, in Scotland, 7% of ‘LGBT’ respondents had either undergone or been offered ‘conversion therapy’. Transgender people were targeted the most with 10% of transgender respondents in Scotland having either undergone or been offered conversion therapy.

28. Across the UK, faith organisations were the most likely group to have conducted ‘conversion therapy’ (51%), followed by healthcare professionals (19%). Other people identified as carrying out ‘conversion therapy’ included ‘parent, guardian, other family members’ (16%), ‘person from my community’ (9%), ‘any individual or organisation not listed’ (14%), and ‘prefer not to say’ (11%). Respondents could select multiple responses.

29. As the above evidence indicates, conversion practices often happen in religious, community and family settings. This makes it even harder to obtain information on their prevalence as individuals may be reluctant to criticise their family or community members. However, through the collection of anecdotal evidence and engagement with key organisations, we know that LGBTQI+ people in Scotland are affected by harmful conversion practices and that they need to be addressed through legislation, alongside other measures.

Experiences of LGBTQI+ racialised minorities

30. The National LGBT survey found that, within the UK, there was a substantial variation by ethnic group amongst cisgender respondents. For example, Black/African/Caribbean/Black British (13%) and Asian/Asian British (14%) respondents, and respondents belonging to an ‘other’ ethnic group (15%), were up to twice as likely to be offered, or to have undergone, ‘conversion therapy’ than White (7%) respondents.

31. The survey report also noted that “there are legitimate concerns and feelings of apprehension around reporting of conversion practices where people belong to communities which have experienced historical prejudice and discrimination within the criminal justice system”.

32. The EAG’s specific report on ‘LGBT+ POC & Minority Ethnic Faith Experiences of Conversion Practices’ noted that conversion practices in many racialised minorities often take the form of coercing someone into suppressing their identity. It was also noted that in some racialised minorities, people were more likely to ‘self-refer’ to conversion practices because of anti-LGBTQI+ sentiment within communities. Victimisation from immediate and extended family members and the involvement of the broader community in conversion and suppression efforts was also highlighted.

33. The report also emphasised that many LGBTQI+ people in the UK have roots in other countries where conversion practices and other psychological therapeutic practices are the norm. The report found this to be significant in people’s experiences.

34. The Scottish Government has taken into account how an individual’s culture and race may play a part in their experience of conversion practices. The EAG recieved advice from a range of organisations during the development of its report to ensure cultural considerations were understood.

What harm do conversion practices cause?

35. Conversion practices are inherently harmful. They deny people’s right to be themselves and send a message to the LGBTQI+ community as a whole that their identity is wrong and can and should be fixed or suppressed.

36. The impact of conversion practices on people can be lifelong. Often, the harm is not immediately apparent. People who have experienced conversion practices have reported severe mental health consequences, including suicidal ideation, depression, and anxiety. As pointed out in the EAG report, undergoing these practices can result in feelings of shame, self-loathing and a crisis of identity. Survivors have also reported a negative impact on their relationships, work and career. The EAG report stressed that this negative impact can affect every aspect of life, stating that “survivors have difficulty building a life after conversion practices”.

37. Research from Australia has found complex forms of post-traumatic stress disorder (PTSD) can result from the internalised conflicts between, on the one hand, sexual orientation and gender identity and, on the other hand, attempts by family, faith, or other close communities to change or suppress that orientation or identity. The research outlines the following harm that can result from conversion practices:

• major anxiety and depression, including suicidal ideation
• difficulties forming and maintaining relationships
• difficulty with sexual function
• guilt, shame and grief
• deep spiritual harm at being rejected by their families, communities or losing their faith
• financial impact from costs of ‘conversion’ practices, lost earnings and opportunities, and later recovery
• significant delays in pursuing a career or vocation

38. A report from the United Nations Independent Expert on protection against violence and discrimination based on Sexual Orientation and Gender Identity (IESOGI), titled ‘Report on Conversion Therapy’, highlights that “all practices attempting conversion are inherently humiliating, demeaning and discriminatory. The combined effects of feeling powerless and extreme humiliation generate profound feelings of shame, guilt, self-disgust, and worthlessness, which can result in a damaged self-concept and enduring personality changes.”

39. Testimonies provided to the EHRCJ committee by individuals with lived experience of conversion practices describe PTSD, nightmares, bulimia, self-harm, shame, and panic attacks as some of the long-term effects caused by being subjected to conversion practices.

40. The trauma associated with conversion practices can present itself at different times for each person. Often, trauma can appear in adulthood despite the practices happening in childhood. In taking a trauma-informed approach we are mindful of where an individual may be affected by trauma, and the need to respond in ways which minimise distress and support recovery through a safe and compassionate response. We are also mindful of the importance of not re-traumatising those who have suffered harm from conversion practices or expecting them to denounce their families, communities or loved ones.