Is change possible?

Insight
News
Is change possible?
The social media response to the tragic death by suicide
of 17-year-old transgender teenager Leelah Alcorn in
Ohio, USA, has stirred up a storm of vitriolic blame
and anger, beyond the conﬁnes of the lesbian, gay,
bisexual, and transgender (LGBT) community. The
outpouring of grief and rage is understandable, as is
the resulting entrenchment of ﬁrmly held opinions.
But this risks clouding or overriding the complexities of
transphobia—experienced at home, school, work, and in
the community—which is so ingrained in society that it
permeates every facet of life.
Calls for a ban on the controversial so-called conversion
or reparative therapies that attempt to “cure” same-sex
attraction or those who do not conform to gender-binary
types have been re-awakened. In the USA, California
and New Jersey are the only states that have enacted a
bill banning the therapy. In the UK, major professional
bodies are uniﬁed in discouraging this treatment as nonevidence-based and unethical. Even if prohibition was
achieved, how might it prevent those exercising their
rights under religious freedom not to practise it in less
overt ways?
The American Psychiatric Association (APA) issued a
position statement on August 16, 2012, that supports
access to care and civil rights for transgender individuals.
The statement refers to the insuﬃcient access to health
care and medical intervention, widespread discrimination,
fear of hate-crime, and unique social challenges faced by
transgender individuals, points out alarmingly high rates
of death by suicide, and calls on more laws to protect their
www.thelancet.com/psychiatry Vol 2 February 2015
civil liberties. Unquestionably, all these inequalities and
disadvantages qualify for immediate and eﬀective redress,
but one signiﬁcant question remains, how does this really
help adolescents who are supposedly led to believe that to
live as a transgendered individual is unattainable?
Ohio rates poorly in LGBT equality, as presented in a
state-by-state comparative analysis by the Transgender
Law Centre. TransOhio, a support and advocacy group
for transgender communities and individuals provides
signposting for crisis intervention organisations, such as The
Trevor Project and The Trans Lifeline. However, accessing
such organisations might be a problem, especially for young
people facing painful choices that risk alienating them from
their communities and loved ones.
Family and society undoubtedly have a responsibility to
promote a culture of acceptance, but pointing the ﬁnger
at individuals is shortsighted. Strong opinions about the
damage of fundamentalist religious morality need to be
addressed, particularly for those who might experience
opposition, intolerance, and denial of a personal identity
that they themselves could be struggling to understand.
Is dialogue between the medical profession, transgender
advocates, and the religious communities who advocate
re-orientation possible? What role should the law have
in protecting mental wellbeing, and how much does this
collide with religious freedom? There are no easy answers,
but the least health-care professionals and advocates can
do is keep asking tough questions.
For more on the petition from
the Transgender Human Rights
Institute to ban genderconversion therapy see https://
www.change.org/p/barackobama-enact-leelah-s-law-toban-transgender-conversiontherapy/u/9190451
For statements on conversion
therapy from professional UK
bodies see http://www.ukcp.org.
uk/UKCP_Documents/policy/
Conversion%20therapy.pdf
For the American Psychiatric
Association position statement
see http://www.psychiatry.org/
advocacy--newsroom
For the Transgender Law Centre
equality map see http://
transgenderlawcenter.org/
equalitymap
For TransOhio see http://www.
transohio.org/wordpress
For more on The Trevor Project
see http://www.thetrevorproject.
org
For more on The Trans Lifeline
see http://www.translifeline.org
Jules Morgan
e4

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