There's a good Transgender Trend article on the problems with the MoU here.
During the time James Caspian was a trustee for the UK Council for Psychotherapy he acted as a consultant to the working group drawing up the MoU (Daily Mail article):
Everyone in the working group — including James — agreed conversion therapy should be banned.
James, however, wanted the memorandum to specifically accept that some people regret their transition and that there are patients who might have other underlying psychological issues.
Without spelling out these irrefutable facts, he feared health professionals could be prevented from exploring the potentially deeper reasons for a patient saying they wanted to change sex.
The committee, which included health professionals and representatives from the outspoken LGBTIQ (where 'I' stands for intersex and 'Q' for queer) group Pink Therapy and the Association of Christian Counsellors, eventually decided not to include James's recommendations.
The Memorandum of Understanding will take effect this month. Effectively, it could prevent a therapist, when presented with a person who wants to change sex, from exploring any possible ulterior reason behind their decision. This disturbs James greatly.
'Any ethical therapist wouldn't try to impose their view of how a client should be — but surely they should be able to explore if gender identity is truly the psychological issue,' he says.
'We need a framework that allows therapists to freely explore other underlying issues that may be present before they start gender reassignment treatment, without the fear of being accused of conversion therapy if they do so.
'The Memorandum of Understanding is saying we must accept whatever gender identity a client says they are without question.
'I was one of the few people involved who understood transition from a clinical perspective and was not a campaigner, so I had no axe to grind — just concern for the clients and the professionals,' he says.
'When I looked at the ban on conversion therapy, I said, 'If you're not careful, you're going to make people think they can't ever question what somebody coming to them is saying and that's dangerous'.
'Already counsellors have contacted me to say they're worried that if a young client — say a 16-year-old — comes to them with a number of mental health issues or a history of sexual abuse and says, 'I want to transition', that it won't be safe for them to say, 'Well, let's look at this sexual abuse you had.
Could that have anything to do with the way you feel about your body?', because that could be construed as conversion therapy.
'One psychotherapist who works with young people called me last night to say she is worried this memorandum could simplify things to a scary degree.
'She said: 'If all I did was affirm my patients were trans without exploring any mental health issues they might have, I don't think I'd be able to help them properly.'
'Equally, people are afraid it might not be safe to work with someone who wants to detransition, i.e. reverse their sex change.
'Let's say a trans female, who is no longer happy in their gender, goes to a counsellor to say they want to go back to living as a man. Could that counsellor be accused of conversion therapy if they help them?
'I kept arguing for specific wording to say, 'We do acknowledge some people do regret their transitions and reverse them, or change their minds.'
But every time I tried to put that wording in it was rejected.
'There are lots of activists within the LGBT community and I sensed that everyone was scared of them.
'One of them said to me on the phone, 'Are you going to block this memorandum?' Of course I didn't want to block it, but I wanted to make it safe for everybody.
'It was a long phone call and quite intimidating. I felt whatever I said was being interpreted as a threat.
I felt this person wasn't prepared to listen to anything I was saying. It literally made the hairs stand up on the back of my neck. That's really powerful that sort of fear.
'The problem is that the activists feel only they have any right to say anything and anyone who disagrees with them walks on eggshells for fear of being accused of being transphobic.
I had sleepless nights over the memorandum. I would wake up at 3am worrying about it.
'At that point, I honestly felt I was the only person in the world who was carrying the interests of people who had transitioned and regretted it. Nobody else involved knew what I knew about how these people were suffering, because I was researching them.'