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BMA meeting: Conversion therapy for homosexuals should not be funded by the NHS

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c3553 (Published 02 July 2010) Cite this as: BMJ 2010;341:c3553
  1. Deborah Cohen
  1. 1Brighton

    The NHS should not fund “discredited” conversion therapy for homosexual people, representatives at the BMA conference have voted.

    The BMA has called on the Department of Health to investigate cases where it seems that conversion therapy has been funded with NHS money to prevent it happening in future.

    Conversion therapy is treatment directed at helping gay and lesbian people modify their sexual orientation to heterosexuality.

    Speaking for the motion, junior doctor, Tom Dolphin said, “This isn’t about therapy designed to help reconcile people to their sexuality, which is laudable and appropriate. I’m talking about therapy aimed at changing that sexual orientation.

    “Conversion therapy does not work, and can be actively harmful. Sexual orientation is such a fundamental part of who someone is that to attempt to change it will just result in significant conflict and depression, and even sometimes suicide.”

    A 2009 survey of UK psychologists, psychotherapists, and psychiatrists published in the journal BMC Psychiatry showed that out of 1328 questionnaires analysed, 4% of therapists (55) reported that they would attempt to change a client’s sexual orientation if one consulted asking for such therapy and 17% (222) reported having assisted at least one patient to reduce or change his or her homosexual or lesbian feelings (BMC Psychiatry 2009, 9:11). Of those treated, 40% were on the NHS even though the Diagnostic and Statistical Manual of Mental Disorders IV does not list homosexuality as a mental illness.

    In August last year, the American Psychological Association conducted a systematic review that suggested there was insufficient evidence to support the use of psychological interventions to change sexual orientation. The review also concluded that none of the studies assessed the potential harms.

    Gareth Payne a clinical neurophysiologist from Cardiff, however, said that although he was sympathetic to the argument, to say that conversion therapy was discredited was not “evidence based.”

    “This motion makes the classic error of interpreting absence of evidence as evidence of absence,” he said.

    “In the absence of RCTs [randomised controlled trials], when faced with a patient expressing a clear preference for changing their sexual orientation, then surely we as clinicians should respect their right to self-determination?” he asked. He said more research was needed about how best to support people struggling with their sexuality.

    Tony Calland, chairman of the ethics committee, however, urged doctors to vote against a treatment of no proved value to treat conditions that are not a psychiatric condition.

    Notes

    Cite this as: BMJ 2010;341:c3553