Historically, some mental health professionals used methods such as electroconvulsive shock therapy, chemical castration, and institutionalization in an attempt to prevent people from being LGBTQ or suppress attractions and expressions of gender identity that they considered inappropriate. Conversion therapy is still used on LGBTQ youth today. It involves practices known as “reparative therapy,” “ex-gay therapy,” sexual orientation change efforts (SOCE), and psychological abuse.
In some cases, counselors today use aversive conditioning to try to influence gender identity or sexual orientation. This means they may use hypnosis or attempt to induce nausea or paralysis in connection with homoerotic images or try to trigger shame that is intended to cause an aversion to same-sex attraction. Although leading medical and mental health professionals reject conversion therapy as dangerous, psychologically harmful, and ineffective, the National Association for Research & Therapy of Homosexuality is a group of counselors who endorse conversion therapy.
No scientific evidence supports conversion therapy, and The American Psychiatric Association opposes conversion therapy. The American Psychological Association also reviewed the published literature on conversion therapy practices in 2009 and found no reliable evidence to support them.
Risks associated with conversion therapy include suicidal thoughts or actions, depression, stress, self-blame, helplessness, shame, social withdrawal, increased self-hatred, hostility, and high-risk sexual behaviors. LGBTQ youth who go through conversion therapy as a result of family pressure or force are especially at risk. Research shows that if LGBTQ youth are rejected by their families during adolescence, they are eight times more likely to have attempted suicide compared with their peers who have minimal or no levels of family rejection.
Recognizing the risks of conversion therapy associated with LGBTQ youth, some states have passed laws prohibiting its use. These health care laws aim to protect minors from being forced or coerced to undergo the therapy. In many states, state-licensed practitioners prey on parents and guardians who don’t know that the practices are dangerous and harmful. The laws are directed at licensed health care providers to ensure they follow professional standards of competence and avoid the use of non-scientific practices that can cause long-term damage to youth who are still emotionally developing.
California was the first state to protect youth from conversion therapy by prohibiting state-licensed therapists from trying to change the sexual orientations or gender identities of minors under age 18. The states of New Jersey, Illinois, Oregon, Vermont, New Mexico, Connecticut, Rhode Island, Nevada, Washington, Hawaii, Maryland, New Hampshire, and the District of Columbia followed suit with laws prohibiting state-licensed therapists from using dangerous practices to try to change an LGBTQ minor’s sexual orientation or gender identity. This includes efforts to alter a minor’s behaviors or gender expression, and to eliminate or reduce their sexual or romantic attraction to someone of the same sex.
These laws describe the practices as SOCE. They also include statements that the laws do not include practices that provide acceptance, understanding, or facilitation of LGBTQ clients’ coping, exploration, or development. This means efforts that are neutral with respect to sexual orientation that prevent or address unsafe sexual practices or are directed at preventing unlawful conduct are permissible. Therapy designed to help an individual transition from one gender to another are expressly exempted from these laws. The National Center for Lesbian Rights (NCLR) is advocating for similar legislation in numerous other states.
In California, two anti-LGBTQ groups challenged the law prohibiting conversion therapy on the grounds that it violated their constitutional rights to freedom of religion and speech and was constitutionally vague. A United States Court of Appeals panel unanimously ruled that the law was valid, and the Supreme Court declined to review the case. The Supreme Court has also declined to review a challenge to the New Jersey law prohibiting conversion therapy, which was upheld at the federal district court and appellate levels.
Mental health professionals are regulated by different state licensing boards. If you find that a mental health professional in a state that has a law prohibiting conversion therapy for minors is engaging in conversion therapy with a minor, you can contact the licensing board, as well as NCLR.
National LGBTQ organizations have filed a complaint with the United States Federal Trade Commission accusing a conversion therapy organization of engaging in fraud. The complaint asks the FTC to stop the organization from all forms of business and to investigate any other practitioners making similar claims. If successful, the complaint could work to end conversion therapy throughout the nation.
