Download PDFPDF

Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g.
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests


  • Responses are moderated before posting and publication is at the absolute discretion of BMJ, however they are not peer-reviewed
  • Once published, you will not have the right to remove or edit your response. Removal or editing of responses is at BMJ's absolute discretion
  • If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patient's written consent to publication and send them to the editorial office before submitting your response [Patient consent forms]
  • By submitting this response you are agreeing to our full [Response terms and requirements]

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Response to Trans Conversion Therapy Doesn’t Call Itself Conversion Therapy
    • Talen Wright, Research Assistant Division of Psychiatry, UCL; Public Health, Environments, and Society, London School of Hygiene and Tropical Medicine
    • Other Contributors:
      • Michael King, Professorial Research Associate
      • Bridget Candy, Principal Research Associate

    We would like to take the opportunity to thank the author for their correspondence and critique of our paper.

    In response to our conclusion about the “rarity” of the practice, the correspondence may be misleading. Our paper states “We found limited evidence in the research literature of the use of conversion therapies that aimed solely at suppressing or modifying what was considered by the therapist as abnormal gender identity”. Of course (as is the case for reviews of research into conversion treatments for LGB people), this does not presume that practices are not occurring in a wider context.

    We would like to further state that as in all systematic reviews, the search strategy must be agreed before the search begins. We spent considerable effort in discussing search terms, and based our search on previous reviews of LGB people and conversion/reparative approaches. This basis did not dictate the only search terms used however; we also used further terms which we believed would increase the yield in papers, these included “reparative” “non-affirming” and “repair”. We also included terms such as “barring” to account for covert attempts at hindering transition.

    We disagree that systematic reviews are counterproductive. Our aim was to assess how often and in what form conversion/reparative treatments for transgender and gender diverse people had been studied. We sought to examine critically any claims for effectiveness as well as understand the consequenc...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Trans Conversion Therapy Doesn’t Call Itself Conversion Therapy

    Wright, Candy, and King (2018)’s recent systematic review of transgender conversion therapies searched for articles which contained variants of the terms “conversion” and “transgender”. The review only identified four studies on conversion therapy, concluding that the practice was uncommon and reassuring.

    I believe that the article severely underestimates the breadth of the conversion therapy literature and of its practice. This is due to the inadequacy of the search strategy, which seeks articles involving variants of the term “conversion”, whereas proponents of reparative practices rarely conceive themselves in those terms. The search strategy was derived from “those used in previous reviews of LGB conversion therapy”. The decision to mirror terms of LGB conversion therapy should have been subjected to greater scrutiny. By the 1990s, the term “conversion therapy” was struck with infamy and associated with religious approaches, creating a pressure to disidentify with the term among secular practitioners who sought to discourage transitude, even if their clinical approaches were very similar to the approach of famous conversion therapists such as George Rekers.

    Many articles can be identified which sought to alter the patient’s gender identity or prevent trans outcomes but were not captured by the systematic review. The first author of one of the reviewed articles, Dr. Zucker, is a prolific writer who has written a lot about his approach, which is further de...

    Show More
    Conflict of Interest:
    None declared.