The Memorandum of Understanding on Conversion Therapy was originally a document rightly created in order to prevent conversion therapy for sexual orientation. However this document was updated in 2017 to include gender identity and it has been signed by many pro-trans institutions, by several psychotherapy bodies and also by the NHS. It regards all gender identities as of equal value and validity and states that no gender identity is to be preferred to any other. Attempts to help change or suppress a gender identity are seen as conversion therapy, unethical and potentially harmful. In practice this means that girls who believe they are boys are to be affirmed in that belief. Similarly boys who believe they are girls are to be affirmed in that belief. This limits the ability of clinicians to help children with these beliefs to be reconciled to their natal sex. If a clinician tries to challenge a child's misguided belief or explore its causes with a view to alleviating gender/sex confusion they run the risk of being accused of conversion therapy. This pressurises clinicians to adopt an affirmative approach to the beliefs of children and young people, affirming the gender they believe they are.