Kemi Badenoch, the women and equalities minister, was warned about the risks of a planned ban on conversion practices by the doctor who reviewed gender identity services for under-18s.
Leading paediatrician Dr Hilary Cass said she had been “really clear” with the cabinet minister that any plans for a change in the law would have to avoid creating problems for professionals.
Badenoch is now drawing up legislation to ban conversion practices, which are defined by the British Psychological Society as an attempt to change someone’s sexual orientation or gender identity.
But the plan has been delayed repeatedly amid splits in the Conservative party, with reports that a draft bill could now be pushed beyond the general election. Campaigners have called for the ban to be brought in quickly to prevent lives being ruined by attempts to “cure” LGBTQ+ people “of being themselves”.
Any bill would be expected to include protection for teachers, doctors and parents, who some Tory MPs believe could face criminal action if they advise children against changing their gender.
In an interview with the Guardian, Cass said that she had been “really clear with the government that any legislation would have to take inordinate care to not make workforce problems worse than they are”.
Her review, published on Wednesday, found that medical professionals had expressed concerns about “potential accusations of conversion practice”, noting they were also concerned about the “interpretation of potential legislation on conversion practices”.
Cass said she had urged Badenoch to ensure care is taken not to “make professional fearfulness worse than it already is”, citing concerns among some medics over “being called transphobic if you take a more cautious approach”.
In her review, Cass said professionals supporting young people with gender incongruence or distress were “overshadowed by an unhelpfully polarised debate around conversion practices”.
She noted that some medics were afraid of being accused of conducting “conversion therapy if, again, they take a cautious or exploratory approach” and some clinicians expressed “fearfulness about what colleagues might say if they speak up and express an opinion that is not consistent with theirs”.
She added that framing the legislation was crucial when it came to ascribing intent. “If you have no intent to make somebody change their gender, and as a result of your therapy, or your interaction with them, they do happen to change their gender – and then they say that you were doing that deliberately.
“That’s what people are afraid of. How you legislate that I have absolutely no idea but all I can say is you absolutely have to avoid anything that’s going to frighten people more.
“If you can set in legislation a way of doing that without exposing people to that fear and that risk, then that’s all fine, but I just don’t know how you would define the law to do that. So I’m just glad I’m a doctor and not a lawyer.”
Cass’s review set out that no LGBTQ+ group should be forced to undergo a conversion practice.
Research published last year revealed more than 400,000 people who are gay, transgender or non-binary had been subjected to someone trying to change, “cure” or suppress their sexual orientation or gender identity.
Rishi Sunak has acknowledged the Cass findings highlight the need to “exercise extreme caution” in this area.
He said: “We care above all about the wellbeing of children and it’s clear that these things are not neutral acts, whether that’s social transitioning, any kind of medical intervention, we simply do not know the long-term effects of these things.
“And that’s why anyone involved in considering these issues, of course, has to treat people with sensitivity and compassion, but also have to be extremely cautious when it comes to taking any action.”
A government source said: “The Cass review shows again how important it is that the government takes its time to get this right. Cass found that doctors have been too scared to have those critical conversations with gender-questioning children, with disastrous results. So we need to make sure any ban on conversion practices has no unintended consequences, and that is the work that’s being done.”
