Ego Dystonic Homosexual Orientation
Reference: 25-26039
Date response sent: 06/05/2025
Details of enquiry
Persons who experience exclusive sexual attraction to the same sex are commonly known as ‘homosexual’ and/or ‘gay’ and they are described as having a ‘homosexual orientation’. There are persons who experience profound distress on account of their unwanted homosexual orientation and these people sometimes seek psychotherapeutic treatment. Such persons were formerly described as having ‘ego dystonic homosexuality’, but I understand that this term is no longer or uncommonly used by clinicians. My FOI contains four questions:
- Do such persons have a right to be referred for treatment to the Tavistock?
2. What form would this treatment take?
3. How does the Tavistock treat patients who are deeply religious and who believe that homosexual acts are immoral and will not accept so-called gay affirmative therapies?
4. Does the trust accept referrals for ego dystonic homosexuality from parts of the UK outside of Greater London
Response sent
- Do such persons have a right to be referred for treatment to the Tavistock?
Under the NHS Right to Referral, every NHS patient who is entitled to free treatment has the right to choose to which NHS hospital or service they are referred.
The Tavistock and Portman NHS Foundation Trust do not offer treatments for the conditions you describe.
We can confirm that every referral received by the Trust is assessed on merit of suitability for a treatment that the Trust offers.
The list of treatments we provide is listed on our website, reached via the following link: Services – Tavistock and Portman There you will see a listing of links to all the services the Trust offers, and each of these links will reveal a description of the treatment offered and details on how to access the Service.
2. What form would this treatment take?
Not applicable. See our response to Q1 above – The Trust does not offer treatment for the conditions you describe above.
3. How does the Tavistock treat patients who are deeply religious and who believe that homosexual acts are immoral and will not accept so-called gay affirmative therapies?
We would work with patients who have such beliefs, as we are always open to and guided by what our patient seeks and what it is that bothers them, which would include a patient wishing to discuss sex, sexual orientation, sexual identity or any other aspects of their bio-psycho-social experience as part of their overall mental health presentation, but our Trust would not be the referral pathway for these issues as a presenting condition.
4. Does the trust accept referrals for ego dystonic homosexuality from parts of the UK outside of Greater London
The Trust does not offer a service to treat ego dystonic homosexuality or its current nomenclature of “persistent and marked distress about one’s sexual orientation”, irrespective of the patient’s UK provenance. The Trust would not accept referrals for which it had no suitable treatment.
We may consider referrals for this difficulty IF, after consultation or liaison with the referrer and/or the patient, they were open to thinking, reflecting and being demonstrably curious about the psychological reasons behind their request rather than concretely seeking ‘conversion’ which we do not offer support with.
We would only offer an assessment and potentially treatment to an individual where this was an element of their presentation in the context of wider mental health difficulties or experiences of trauma rather than the sole presentation.
Our intention would be to reduce psychological distress or mental pain by supporting the person to understand their psychological conflicts better – if indeed there is a conflict. To be clear , this would never be in the service of so called conversion but to reduce the risk of a deterioration in mental health which might also adversely effect other areas of life