Psychotherapists are avoiding challenging children who want to be transgender because they fear being accused of conversion therapy by the NHS.
Children as young as six are expressing the desire to change their gender, several psychotherapists have told the Telegraph, and many feel unable to question young patients because they “could be accused of breaking the code of ethics”.
One psychotherapist who spoke to this newspaper said they have faced accusations of practicing conversion therapy for refusing to affirm any child who says they want to be transgender.
The widely accepted definition of conversion therapy - which traditionally focused exclusively on sexual orientation - was changed in 2017 when the NHS signed a new memorandum that included “gender identity”.
Psychotherapists have said the move has created “unintended consequences”.
“The 2017 memorandum is preventing NHS staff from giving children proper treatment,” Marcus Evans, the former governor of the UK’s only gender dysphoria clinic, said.
“The moment a young person goes to see someone and says they have gender dysphoria, clinicians often don't want to get involved.
“The children and their families can be very fixed in their beliefs and this leaves the clinician feeling worried that they might upset the child if they try to look at things from different points of view.
“It has become a political hot potato and you could be accused of breaking your code of ethics.”
Mr Evans, who resigned from The Tavistock in 2019, said he has been approached by numerous parents over the past year concerned at the care their children are receiving in the NHS.
“They are worried that the services are pushing their child down a particular path,” he said.
“The services often adopt an affirmation model, so if a female child says I’m a boy then you have to affirm that. There isn't enough support for a proper exploration of the issues driving the underlying belief system either in the child or in the family.
“The politicization of this area has interfered with good clinical care.”
Bob Withers, a psychotherapist for 35 years, has faced written threats to report him to his governing body, the UKCP, if he does not publicly endorse the new memorandum on conversation therapy.
“Conversion therapy is obviously an abhorrent practice for sexuality, but gender identity is not the same thing,” he said.
“I have been accused of practicing conversion therapy because I believe if someone, particularly a young child, wants medical treatment which could change their body forever, I think it’s important to explore the psychological reasons behind their desire to transition before hand.
“I am not saying that people should not medically transition if it’s the right decision for them and they know what they are doing. But it concerns me that you can’t get a tattoo before 18 even with your parent’s permission, but you can get puberty blockers.”
Puberty blocking drugs are prescribed to children experiencing gender dysphoria to temporarily stop their bodies developing by suppressing hormones.
In June this year, the NHS quietly changed its website to admit that “little is known” about the long-term side effects of the drugs after previously claiming that they are “considered to be fully reversible”.
Kirsty Entwistle, a former psychologist at the NHS’s Gender Identity Development Service (Gids), said she has heard of numerous colleagues who have been accused of conversion therapy.
Ms Entwistle left her role in the NHS within a year because she felt unable to speak out against the speed at which some children were being prescribed puberty blockers.
“I found it so disturbing working there,” she said. “I had a lot of conflict with a colleague who I worked closely with because they wanted to refer a lot of the children straight for puberty blockers when I didn’t really feel like there was clear indication that was needed.
“It was really obvious to me that the management was very anxious about challenging the affirmation approach.”
An NHS spokesman said: “The representative body of psychotherapists and numerous other expert organisations all signed the memorandum which makes clear that conversion therapy is unethical and can actively harm patients.
“The NHS has specialist clinics that offer any child or adult with gender dysphoria a range of evidence based services including therapy sessions to ensure the individual fully considers the decision they are making.”