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Conversion Therapy
Conversion therapy is a pseudoscientific and discredited practice that attempts to force LGBTQ+ individuals to change their sexual orientation or gender identity and instead identify as heterosexual or cisgender. Because it is now understood that sexual orientation is not a choice or something that can be changed, so-called conversion therapy—sometimes called reparative therapy, ex-gay therapy, or sexual reorientation therapy—is not only ineffective, it is often actively harmful. Research has consistently found undergoing conversion therapy to be associated with negative mental health outcomes such as depression, substance abuse, and an increased risk of suicidality.
In recent years, governments around the world have taken steps to limit or ban conversion therapy, though the practice persists in some places. What’s more, LGBTQ-affirmative therapy—which validates the identities of sexual- and gender-diverse clients—has become increasingly available as societal acceptance of LGBTQ+ identities has become more widespread.
So-called conversion therapy is arguably among the more shameful parts of psychology’s past. In the U.S., homosexuality was considered a mental illness until 1973; before that, many psychologists, psychoanalysts, and psychiatrists around the world openly shamed or attempted to convert their queer clients. The form of "treatment" varied; some practitioners used hypnosis or aversion therapy tactics—for example, pairing homosexual stimuli with electric shocks—to “correct” a patient’s orientation; faith-based treatment was also common and may have included prayer or even, in extreme cases, attempted exorcisms. Extensive research has confirmed that such tactics are ineffective, cruel, and strongly associated with long-lasting psychological harm; conversion therapy has even been described as torture or a violation of human rights.
Many adverse events are associated with conversion therapy. One large study found that LGBTQ+ individuals who underwent conversion therapy were significantly more likely than their peers to experience depression, substance abuse, or other forms of severe psychological distress; 58 percent had attempted suicide. The same study also found that conversion therapy had a significant economic cost for society at large, both in terms of increased mental health care costs and in terms of lost productivity.
Yes, research has consistently found a link between undergoing conversion therapy and heightened suicidality. A 2020 study found that, compared to LGBTQ+ individuals who had never experienced conversion therapy, those who did were 92 percent more likely to experience suicidal ideation and 75 percent more likely to plan a suicide attempt.
It depends on the jurisdiction. In some countries, including Canada and France, it is illegal for anyone to perform conversion therapy on another person, regardless of their age; in other countries, such as New Zealand, the bill only applies to conversion therapy performed on minors. The practice has also been made illegal in many U.S. states, including California, New York, Maine, and others. In many states, however, no laws pertaining to conversion therapy currently exist.
Sadly, yes. The practice remains prevalent in many countries where homosexuality and/or gender diversity remains stigmatized, and has not been fully eradicated even in locations where LGBTQ+ identities are accepted—including the United States. A 2020 study of about 500 LGBTQ+ individuals in Southern U.S. states found that nearly 8 percent had been sent to conversion therapy. A 2023 report identified more than 1,300 practitioners of conversion therapy in the U.S., despite the fact that all major psychological organizations, including the American Psychological Association and the American Psychiatric Association, condemn the practice. Some studies have found that, in recent years, it has become more common for transgender and gender-nonconforming people to be subject to conversion therapy than gay, lesbian, or bisexual individuals.
The opposite of conversion therapy is LGBTQ+ affirmative therapy, often simply called affirmative therapy. Therapists who practice affirmative therapy know that being LGBTQ+ is nothing to be ashamed of and will validate and support clients’ sexual orientation or gender expression. Affirmative therapists are also keenly aware of the biases that many LGBTQ+ clients still face in their day-to-day lives and are prepared to help clients navigate and cope with these challenges and any mental health concerns that arise as a result. In many cases, someone who has undergone conversion therapy in the past may wish to seek an affirmative therapist to heal from the process and develop a healthy, positive relationship with their sexual orientation or gender identity.
Affirmative therapy provides a safe space for someone to explore their gender identity or sexuality without fear that they will be shamed, judged, or misunderstood. Individuals who have undergone affirmative therapy report feeling safe and supported during sessions and able to speak freely about navigating life as an LGBTQ+ person.
Research has found that, after undergoing conversion therapy, LGBTQ+ individuals were best able to recover if they had strong social support, especially from other queer individuals and communities; thus, prioritizing relationships with the people in your life who support and validate your identity—or finding people who do—is key. Seeing an LGBTQ+ affirmative therapist was also found to be a critical step toward healing.
Even LGBTQ+ individuals who have not undergone conversion therapy may struggle with shame and poor self-esteem, often related to the lingering effects of homophobia, transphobia, and related societal biases. Addressing this painful feeling directly, with the help of a therapist if necessary, can help someone finally come to terms with their identity and begin to cultivate an inner sense of self-acceptance.
