‘Protect trans kids’: calls to bar Cape Town doctor from psychiatric practice

The University of Cape Town (UCT) says that an “internal process” is underway to deal with claims that one of its psychiatry students has advocated for transgender conversion therapy; a dangerous and internationally discredited practice.

On 19 October, Dr Marion Stevens, director of the Sexual and Reproductive Justice Coalition, wrote to Professor Dan Stein, head of UCT’s Department of Psychiatry and Mental Health, to lodge a complaint against a Dr Sybrand de Vaal.

According to Stevens, who also wrote in her capacity as part of a group of concerned parents, de Vaal is currently completing this training at UCT. She accuses him of perpetuating dangerous misinformation and practices about transgender issues and speaking on behalf of a fundamentalist anti-trans Christian lobby group, FOR SA (Freedom of Religion South Africa).

Stevens said that de Vaal, who works at Lentegeur Hospital in Cape Town, participated in a meeting called by the Western Cape Education Department to finalise the Guidelines on Gender Identity and Sexual Orientation for Public Schools on 16 October.

He was reportedly introduced by Nadine Badenhorst, the legal counsel of FOR SA, as an “independent expert” with expertise in “psychiatry and gender”.

Stevens expressed her concern that de Vaal’s presentation was biased and “poorly informed by clinical and research evidence” and that he appeared to be “advocating for a framing of a version of reparative therapy or ‘conversion therapy'”.

She said that “while he argued this was not conversion therapy, this is essentially semantics as he was suggesting that gender diversity is a choice and can be addressed therapeutically to cure it”.

Stevens, who also filed a complaint with the Health Professions Council of South Africa (HPCSA) against De Vaal, added: “These practices are well known to be harmful to children and have been banned in many parts of the world.”

Stevens alleges that De Vaal further stated that gender affirmative therapy in the form of hormones for transgender teenagers (which the World Professional Association for Transgender Health (WPATH ) supports in its best practice guidelines), is not based on scientific evidence but on ideology.

“The WPATH guidelines are evidenced-based research and it is disturbing that a doctor, who allows himself to be referred to as an ‘independent expert’ can publicly deny this,” said Stevens. “This can lead to confusion in the public and ultimately lead to transgender youth not getting the support and services they badly need.”

Stevens disputes that Dr de Vaal is entitled to speak as an expert in the area of gender as he has not yet qualified as a psychiatrist, has not published extensive research in the field and has not practised in UCT-affiliated gender clinics.

She called on UCT to “examine his competency to practice as a registered health professional” and to “affirm that he should not be consulted in relation to gender identity or sexual orientation and [should not] offer ‘conversion therapy'”.

An online petition created to “protect trans kids” by barring De Vaal from psychiatric practice has been signed by more than 2,000 people.

Triangle Project, the Cape Town-based LGBTIQ+ rights group, which attended the same meeting in which De Vaal gave his presentation, has backed the petition and urged the HPCSA and UCT to “act against Dr de Vaal and any other health professionals who promote or practice harmful discriminatory approaches”.

De Vaal’s lawyer, Ryan Smit, told the Sunday Times that his client denied making the comments he’d been accused of and was preparing a statement to clarify his stance. This would include conclusions from “academic and medical research studies on the clinical disorder, gender dysphoria, and the best clinical care response”.

(It is important to note that gender nonconformity is no longer recognised as a disorder in itself. As of 2019, the World Health Organization (WHO) also removed “gender identity disorder” from its International Classification of Diseases guidelines.)

Smit also confirmed that De Vaal has to still write his final exams to qualify as a psychiatrist, and did not consider himself to be an expert on transgender issues.

In a statement to MambaOnline, UCT applauded “the bravery of the individuals who have raised awareness about the specific needs of the trans community in the health care sector”.

It said that “UCT’s inclusivity policy requires that all health science students in the university are introduced to curriculum that provides knowledge about the medical care and support for sexually diverse and gender diverse communities”.

Concerning Stevens’ letter and the allegations against De Vaal, UCT Media Liaison Nombuso Shabalala commented that “UCT takes these claims seriously and will respond directly to Dr Stevens as soon as we have concluded our internal process”.

The HPCSA did not respond to MambaOnline’s query. The Society of South African Psychiatrists (SASOP), however, said that while De Vaal is not a member and it is not a regulatory body, it supports the HPCSA and UCT “in their investigation to the allegations made against Dr de Vaal”.

It also reiterated the society’s stance “that sexual orientation and gender identity is not a conscious choice and that we as SASOP reject any discrimination including clinical practices based on naturally occurring differences in sexual orientation and gender identity.”