The U.K. government will seek to ban “conversion therapy” aimed at LGBTQ people, Queen Elizabeth II announced in her annual address to the House of Lords.

Conversion therapy can refer to a wide range of efforts to alter a person’s sexual orientation, gender identity or gender expression.

Measures “will be brought forward to address racial and ethnic disparities and ban conversion therapy,” she said in her speech, which is written by the government to set out its agenda.

But the government is not expected to offer up legislation right away. It will first undertake consultations to examine how to “protect” professionals such as therapists and teachers and uphold religious freedom, according to the BBC’s Jessica Parker, who cited unnamed government sources.

The approach “will ensure medical professionals, religious leaders, teachers and parents can continue to be able to have open and honest conversations with people,” according to a government briefing document that accompanied the speech.

If passed, the measure would fulfill a promise made in 2018 by then-Prime Minister Theresa May, whose government announced a 75-point action plan that included a provision to bar conversion therapy, a slate of practices the government called “abhorrent.”

The pledge followed a national survey of more than 108,000 LGBTQ people in Britain in which 2 percent of respondents said they had participated in some form of conversion therapy and 5 percent said they had been offered it.

But government action stalled for more than two years. Prime Minister Boris Johnson, who banned the advertising of conversion therapy when he was mayor of London, said in July that the practice “has no place in a civilized society” and that the government would forbid it. But decrying a lack of concrete action on this and other LGBTQ issues, three members of the government’s LGBTQ advisory body quit in protest earlier this year.

Amid mounting pressure, Johnson’s government said in March that it would present a ban bill “shortly.” A U.N. official urged British politicians last month to follow through with a prohibition.

British LGBTQ rights organization Stonewall, which is part of a coalition pushing for a ban, on Monday hailed news of the queen’s planned announcement.

The organization added: “The UK Government must publish a full and comprehensive Bill that bans conversion practices in all forms, for all people and in all settings, including religious and faith-based settings, and that provides statutory support for victims and survivors.”

Legislation is likely to face opposition on a variety of fronts. In March, the Evangelical Alliance, a Christian group representing 3,500 churches across the United Kingdom, wrote to Johnson expressing concerns that a ban with “an expansive definition” of conversion therapy could restrict religious freedom.

LGBTQ rights advocates also worry that a growing anti-trans movement in Britain could stymie efforts to protect transgender people, who British government figures show undergo conversion therapy at the highest rate of any group.

Tuesday’s announcement positions the United Kingdom closer to joining only a handful of other countries with nationwide bans against conversion therapy. Here’s a look at where the practice stands globally.

What is ‘conversion therapy’ and where is it practiced?

In the late 19th century, sexualities and gender identities that diverged from the heterosexual, cisgender norm were pathologized — and conversion therapy soon became popular as treatment for these so-called illnesses, according to a 2020 report by ILGA World, an international federation of LGBT rights organizations that tracks conversion therapy measures worldwide.

The most extreme methods include electric shock therapy, hormone regimens, physical and sexual abuse, and internment. Psychotherapy and religious counseling aimed at changing someone’s gender or sexual identity also fall into the category of conversion therapy.

Medical and public opinion on such practices has shifted since the late 20th century. A 2017 Human Rights Watch report about gay conversion therapy in China said that “there is now a global consensus among professional medical bodies that conversion therapy with the intent to ‘cure’ homosexuality is ineffective, unethical, and potentially harmful.”

And a recent study of transgender adults in the United States found that exposure to gender identity conversion therapy was associated with increased odds of attempting suicide.

The World Health Organization has discredited the practice. But forms of conversion therapy persist throughout the world.

In the United States, about 700,000 LGBTQ adults have undergone some form, according to a 2019 report by the Williams Institute at the UCLA School of Law.

Almost one in five transgender teenagers in China reported being forced into conversion therapy in a 2019 survey. Political and religious leaders publicly promote it in Malaysia. Religious figures in France, Germany, Italy and Russia have carried out exorcisms. And in Indonesia, where LGBTQ activists have faced threats of “corrective rape,” a proposed bill would force LGBTQ people to undergo conversion therapy.

Lucas Ramón Mendos, research coordinator at ILGA World, estimates that some form of conversion therapy is practiced in “every single country.” Religious leaders and dogmas remain the principal drivers of these practices, the ILGA World report found.

More than 370 religious leaders from around the world have called for banning conversion therapy, however.

Which countries have banned it?

Very few.

Brazil became the first U.N. member to enact a nationwide restriction against conversion therapy in 1999, when its Federal Council of Psychology forbade psychologists from collaborating “with events and services that propose treatment and cure for homosexuality.” This prohibition was expanded to encompass efforts to change people’s gender identity in 2018. Conservative politicians and religious groups have tried to overturn the rules.

Ecuador has banned rehabilitation centers from offering conversion therapy and imposed more severe penalties on those found guilty of violence committed with the intention of modifying a person’s sexual orientation or gender identity.

In 2016, Malta became the first European country to ban conversion therapy — and the first to take a nationwide “comprehensive approach,” the ILGA said in its report.

Germany banned the advertising and practice of conversion therapy for minors last year, with lawbreakers facing up to a year in prison or a roughly $32,500 fine.

Ireland has also pledged to outlaw conversion therapy, and bills to ban the practice are wending their ways through legislatures in several other countries. Some regions of Australia, Canada and Spain also prohibit the practice.

Twenty U.S. states, plus Puerto Rico and D.C., ban conversion therapy for minors — but religious figures are often exempt from the provisions. Mendos said he thinks it would be difficult for a national prohibition to pass constitutional muster, given the United States’ broad interpretation of freedom of religion. New York City provides a cautionary tale: It passed a ban and then had to repeal it to thwart a potential Supreme Court challenge that could have complicated nationwide efforts to outlaw conversion therapy.

If the United Kingdom fulfills its pledge to enact a ban, it “will become one of the major players” on the global issue, Mendos said. “So we need to make sure the text of the law is a good one.”

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