What is “conversion therapy?”
Conversion therapy refers to any of several dangerous and discredited practices aimed at changing an individual’s sexual orientation or gender identity. For example, that could mean attempting to change someone’s sexual orientation from lesbian, gay, or bisexual to straight or their gender identity from transgender or nonbinary to cisgender. And it could include efforts to change a person’s gender expression (to make a person act more stereotypically masculine or feminine, for example), or to reduce or eliminate sexual or romantic attraction or feelings toward a person of the same gender.
“Conversion therapy” can come in many forms and is sometimes known by other names, including:
- “gender critical therapy”
- “reparative therapy”
- “ex-gay ministries”
- “sexual orientation and gender identity change efforts”
Conversion therapy can be performed by licensed professionals, unlicensed ministries, or life coaches; it can be done one-on-one in an office or in groups at retreats or conferences; and it can be done for money or for free. Faith-based conversion therapy can be found across a wide range of religious traditions; faith communities have also played an important and growing role in protecting LGBTQ youth from conversion therapy.
While some conversion therapists continue to use physical methods, including painful aversive conditioning, the most common techniques in the United States today include “talk therapies” that licensed or unlicensed practitioners use in attempt to “treat” a person’s sexual orientation or gender identity. They may falsely claim that a person’s sexual orientation or gender identity is a result of abuse and childhood trauma, or otherwise a result of the person’s environment and upbringing. Part of the reason for the vast diversity in experiences of change efforts is due to the fact that modern science has so thoroughly rejected the practice, so there is no accredited training for mental health professionals on how to attempt to change a person’s sexual orientation or gender identity. That also means there is no ethical standard of care for doing so.
Especially for faith-based providers, conversion therapy often involves teachings pulled from religious texts, prayer, spiritual discipline, and practices modeled off of twelve-step programs targeting “sexual brokenness,” “unwanted same-sex attractions,” or “gender confusion.”
Importantly, “conversion therapy” does not include counseling that helps a person to find social support or explore their identity. Laws against conversion therapy also do not prevent people from providing treatment for sexual assault, harassment, and abuse.
Does conversion therapy work?
No. Conversion therapy is based on the outdated and false notion that being LGBTQ is a mental illness that should be cured, despite all major medical associations’ agreement that LGBTQ identities are a normal variant of human nature. The American Psychiatric Association has not treated homosexuality as a mental illness since 1973, and being transgender is no longer treated as a mental illness since “gender identity disorder” was removed from psychological diagnostic manuals in 2013.
No credible scientific study has ever supported the claims of conversion therapists to actually change a person’s sexual orientation. A 2009 report by an American Psychological Association Task Force found that “results of scientifically valid research indicate that it is unlikely that individuals will be able to reduce same-sex attractions or increase other-sex sexual attractions through [sexual orientation change efforts].”
In recent years, many former ex-gay leaders have come out to declare that conversion therapy is not effective and never was.
Is conversion therapy harmful?
Yes. The risks of conversion therapy extend far beyond its ineffectiveness, and the time and money wasted on “therapies” that don’t work. Conversion therapy is strongly associated with negative mental health outcomes and greater rates of attempting suicide.
According to The Trevor Project’s 2020 National Survey on LGBTQ Youth Mental Health, 10% of LGBTQ youth reported undergoing conversion therapy, with 78% reporting it occurred when they were under age 18. Youth who reported undergoing conversion therapy reported more than twice the rate of attempting suicide in the past year compared to those who did not.
Furthermore, a peer-reviewed study published by The Trevor Project in the American Journal of Public Health found that LGBTQ youth who underwent conversion therapy were more than twice as likely to report having attempted suicide and more than 2.5 times as likely to report multiple suicide attempts in the past year.
That’s why conversion therapy is widely opposed by prominent professional medical associations including the American Medical Association, the American Psychological Association, and the American Academy of Pediatrics.
“[T]he potential risks of reparative therapy are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient.”
—American Psychiatric Association
“[Conversion therapy] lack[s] medical justification and represent[s] a serious threat to the health and well-being of affected people.”
—Pan American Health Organization – WHO
The American Psychological Association Task Force found that conversion therapy, in addition to being ineffective, can have a wide range of harmful side effects to participants, including:
- Loss of faith
- Decreased self-esteem
- Increased self-hatred
- Social withdrawal
- Feeling dehumanized and untrue to self
- Increased substance abuse
- High-risk sexual behaviors
Conversion therapy as a form of family rejection
Conversion therapy amplifies the shame and stigma so many LGBTQ young people already experience. Parents who attempt to change their child’s sexual orientation or gender identity instill feelings of family rejection and risk, which can seriously fracture their relationship with their child. A 2018 study by The Family Acceptance Project found that:
- Rates of attempted suicide by LGBT young people whose parents tried to change their sexual orientation were more than double (48%) the rate of LGBT young adults who reported no conversion experiences (22%).
- Suicide attempts nearly tripled for LGBT young people who reported both home-based and out-of-home efforts to change their sexual orientation (63%).
- High levels of depression more than doubled (33%) for LGBT young people whose parents tried to change their sexual orientation compared with those who reported no conversion experiences (16%) and more than tripled (52%) for LGBT young people who reported both home-based and out-of-home efforts to change their sexual orientation.
- Sexual orientation change experiences during adolescence by both parents/caregivers and externally by therapists and religious leaders were associated with lower young adult socioeconomic status, less educational attainment, and lower weekly income.
Is it still happening?
Yes. The Trevor Project regularly hears from LGBTQ youth affected by conversion therapy across our 24/7 crisis services. This includes young survivors of conversion therapy and youth who are afraid to come out to their families because of the fear that their relatives will force them to go to conversion therapy. Other LGBTQ youth contact The Trevor Project because they are in conversion therapy, it is not working, and their feelings of isolation and failure contribute to suicidal thoughts and behaviors.
Every year, more conversion therapy survivors are coming forward to tell their stories, with documentaries, media, and a growing body of research demonstrating the real and ongoing harm from these discredited practices across the United States and the globe. Far from being a relic of the past, conversion therapy may actually be on the rise again, especially as proponents rebrand and shift their focus to “treating” transgender and nonbinary youth.
According to studies by the UCLA Williams Institute, more than 700,000 LGBTQ people have been subjected to the horrors of conversion therapy, and an estimated 80,000 LGBTQ youth will experience this unprofessional conduct in coming years, often at the insistence of well-intentioned but misinformed parents or caretakers.
Conversion therapy is still legal in 30 states across the United States. You can see which states still allow this dangerous and discredited practice on our Progress Map.
For journalists looking to learn more about how to cover the issue of conversion therapy, here is a guide on best practices.