Are you an Accidental Conversion Therapist?

I have represented the College of Sexual and Relationship Therapists (COSRT) on the Coalition Against Conversion Therapy Group for four years now. This national level group is responsible for the development and implementation of the Memorandum of Understanding on Conversion Therapy V2, which was published in October 2017, with the primary aim of ending the practice of conversion therapy in the UK.

’Conversion therapy’ is an umbrella term for a therapeutic approach that attempts to change a client’s sexual orientation or gender identity. All of the major UK counselling professional bodies, including COSRT, are signatories to the MoU 2. This means that their members are bound by the MoU’s requirements to ensure that conversion therapy, whether in relation to sexual orientation or gender identity, is not practiced.

None of us want to be very well-intentioned, accidental conversion therapists.

I imagine that it is pretty obvious to most sex and relationship therapists that attempting to change a person’s sexuality or gender identity would be immoral, harmful and, essentially, ineffective. It goes without saying that diversity training and awareness of heteronormativity are obviously essential for safe sex and relationship therapy practice.  Simply believing that we are inclusive or thinking we don’t need specialist training because we don’t work with LGBTQ+ clients really isn’t good enough. Everyone has a relationship to sexuality and gender identity, even cis-gendered heterosexual people, and biases can be hidden in our blind spots, unconscious, beyond awareness and, therefore, a risk to safe therapeutic practice.

There are specific client groups, however, who may be at risk of accidental conversion therapy by qualified sex and relationship therapists.

Desire discrepancy is a common sex therapy theme, where people present to therapy with mis-matched levels of sexual desire in their relationship. A typical approach to this presentation is to find a way to help the ‘low desire’ person connect to their sexual desire and/or improve the quality of the relationship so that a regular sex life can be established. Although this is often an appropriate approach, what if the low desire person is actually a-sexual, grey-sexual or demi-sexual? In that scenario, self and sensate focus exercises, for instance, could easily be interpreted as conversion attempts. Attempting to make a non-sexual person sexual is a breach of the MoU2, which specifically protects a-sexual people. I wonder how many ‘sex aversion’ or ‘sex phobia’ clients are actually sex or body repulsed a-sexual people?

And what about the way we work with kinks? The talking therapy profession does not have a great track record in the treatment of people with atypical sexual preferences, with legal and consensual activities still meeting diagnostic criteria for ‘disorders’. When clients present in therapy with kink preferences that are consensual and lawful, but feel compulsive or ‘out of control’, a standard approach is to work towards stopping the sexual practice. If we replaced the word ‘kink’ with ‘lesbian’ in this scenario, I doubt we would be as quick to apply abstinence programmes. Specific Kink Awareness training is essential to prevent pathologising consensual sexual practices.

I have learnt in my time working in the Coalition group that adhering to the MoU 2 is not just a case of ensuring we are sufficiently trained in gender and sexual diversity so that we can avoid practicing conversion therapy. It is also about really examining the assumptions that inform some of the standard sex and relationship therapy protocols and widening our awareness of models that can help us to work sensitively with the full range of diversities. Models like Dr Betty Martin’s Wheel of Consent can be invaluable when working with desire discrepancy and Braun-Harvey’s Out of Control Sexual Behaviour gives us a sex positive approach to sexual compulsivity for example.

Afterall, none of us want to be very well-intentioned, accidental conversion therapists.

Need help with a sex or relationship issue?

- Visit the COSRT website for a list of qualified specialist therapists.
- Visit the Pink Therapy website for a list of queer friendly and diversity trained therapists.
- If you live in Hertfordshire visit Sex Therapy Herts website for details on how to access specialist sex and relationship therapy.

Blog Post written by:
Julie Sale
CICS Course Director and Psychosexual Psychotherapist