Conversion therapy, sometimes referred to as “reparative therapy,” is any of several dangerous and discredited practices aimed at changing an individual’s sexual orientation or gender identity. Conversion therapists use a variety of shaming, emotionally traumatic or physically painful stimuli to make their victims associate those stimuli with their LGBTQ identities. 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 premised on the 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. In fact, the American Psychiatric Association determined that homosexuality was not a mental illness in 1973.

In addition to its flawed foundation, no credible scientific study has ever supported the claims of conversion therapists  to actually change a person’s sexual orientation. On the contrary, a 2007 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 fact, Dr. Robert Spitzer, whose research had previously been misused to support conversion therapy, has retracted his original claims, stating that data regarding conversion therapy had been misinterpreted and that there is no conclusive evidence for its effectiveness.

The risks of conversion therapy extend far beyond its ineffectiveness, and the time and money wasted on “therapies” that don’t work. The American Psychiatric Association has clarified that “the 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.” The Pan American Health Organization, a regional office of the World Health Organization, concluded that conversion therapy, “lack[s] medical justification and represent[s] a serious threat to the health and well-being of affected people.”

Conversion therapy amplifies the shame and stigma so many LGBTQ young people already experience. Parents who send their child to conversion therapy instill feelings of family rejection and disappointment and risk seriously fracturing their relationship with their child. In a study by San Francisco State University, lesbian, gay and bisexual youth who were rejected by their families and caregivers due to their identities were nearly six times more likely to report high levels of depression and more than eight times more likely to have attempted suicide when compared to youth from accepting and affirming families and caregivers. Another recent study found that conversion therapy efforts on transgender youth increase the odds that they will attempt suicide by 400%. A similar pattern of high suicide attempt rates in lesbian and gay youth subjected to conversion therapy has been found in other studies. Few practices hurt LGBTQ youth more than attempts to change their sexual orientation or gender identity. All youth deserve a climate in which they are loved and embraced.

Indeed, ever major professional medical and mental health organization in the US has found that conversion therapy is harmful, ineffective, and unethical. 

American Academy of Child and Adolescent Psychiatry, The AACAP Policy on “Conversion Therapies” (2018), available at https://www.aacap.org/aacap/policy_statements/2018/Conversion_Therapy.aspx.

"The American Academy of Child and Adolescent Psychiatry finds no evidence to support the application of any “therapeutic intervention” operating under the premise that a specific sexual orientation, gender identity, and/or gender expression is pathological. Furthermore, based on the scientific evidence, the AACAP asserts that such “conversion therapies” (or other interventions imposed with the intent of promoting a particular sexual orientation and/or gender as a preferred outcome) lack scientific credibility and clinical utility. Additionally, there is evidence that such interventions are harmful. As a result, “conversion therapies” should not be part of any behavioral health treatment of children and adolescents."

American Academy of Pediatrics, Homosexuality and Adolescence, 92 Pediatrics 631 (1993), available at http://pediatrics.aappublications.org/content/92/4/631.full.pdf.

“Therapy directed at specifically changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation.”

American Association for Marriage and Family Therapy, AAMFT Position on Couples and Families (2009), available athttp://www.aamft.org/imis15/content/about_aamft/position_on_couples.aspx.

“[T]he association does not consider homosexuality a disorder that requires treatment, and as such, we see no basis for [reparative therapy]. AAMFT expects its members to practice based on the best research and clinical evidence available.”

American College of Physicians, Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians, Ann Intern Med. Published Online (2015), available at http://annals.org/article.aspx?articleid=2292051.

“8. The College opposes the use of “conversion,” “reorientation,” or “reparative” therapy for the treatment of LGBT persons.

Available research does not support the use of reparative therapy as an effective method in the treatment of LGBT persons. Evidence shows that the practice may actually cause emotional or physical harm to LGBT individuals, particularly adolescents or young persons. Research done at San Francisco State University on the effect of familial attitudes and acceptance found that LGBT youth who were rejected by their families because of their identity were more likely than their LGBT peers who were not rejected or only mildly rejected by their families to attempt suicide, report high levels of depression, use illegal drugs, or be at risk for HIV and sexually transmitted illnesses. The American Psychological Association literature review found that reparative therapy is associated with the loss of sexual feeling, depression, anxiety, and suicidality.”

American Counseling Association, Ethical Issues Related to Conversion or Reparative Therapy (2013), available athttp://www.counseling.org/news/updates/2013/01/16/ethical-issues-related-to-conversion-or-reparative-therapy.

“The belief that same-sex attraction and behavior is abnormal and in need of treatment is in opposition to the position taken by national mental health organizations, including ACA. The ACA Governing Council passed a resolution in 1998 with respect to sexual orientation and mental health. This resolution specifically notes that ACA opposes portrayals of lesbian, gay and bisexual individuals as mentally ill due to their sexual orientation. . . . In 1999, the Governing Council adopted a statement ‘opposing the promotion of reparative therapy as a cure for individuals who are homosexual.’ . . .

[T]he ACA Ethics Committee strongly suggests that ethical professional counselors do not refer clients to someone who engages in conversion therapy or, if they do so, to proceed cautiously only when they are certain that the referral counselor fully informs clients of the unproven nature of the treatment and the potential risks and takes steps to minimize harm to clients. . . . This information also must be included in written informed consent material by those counselors who offer conversion therapy despite ACA’s position and the Ethics Committee’s statement in opposition to the treatment. To do otherwise violates the spirit and specifics of the ACA Code of Ethics.”

American Medical Association, Health Care Needs of Gay Men and Lesbians in the United States, 275 J. Am. Med. Ass’n 1354 (1996), available at http://jama.jamanetwork.com/article.aspx?articleid=401656.

“Aversion therapy (a behavioral or medical intervention which pairs unwanted behavior, in this case, homosexual behavior, with unpleasant sensations or aversive consequences) is no longer recommended for gay men and lesbians. Through psychotherapy, gay men and lesbians can become comfortable with their sexual orientation and understand the societal response to it.”

American Medical Association, H-160.991 Health Care Needs of the Homosexual Population, (reaffirmed 2012), available at http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee/ama-policy-regarding-sexual-orientation.page.

“Our AMA: (c) opposes, the use of ‘reparative’ or ‘conversion’ therapy that is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her homosexual orientation.”

American Psychiatric Association, Position Statement on Therapies Focused on Attempts to Change Sexual Orientation (Reparative or Conversion Therapies) (2000), available at http://www.psychiatry.org/File%20Library/Advocacy%20and%20Newsroom/
Position%20Statements/ps2000_ReparativeTherapy.pdf.

“Psychotherapeutic modalities to convert or ‘repair’ homosexuality are based on developmental theories whose scientific validity is questionable. Furthermore, anecdotal reports of ‘cures’ are counterbalanced by anecdotal claims of psychological harm. In the last four decades, ‘reparative’ therapists have not produced any rigorous scientific research to substantiate their claims of cure. Until there is such research available, [the American Psychiatric Association] recommends that ethical practitioners refrain from attempts to change individuals’ sexual orientation, keeping in mind the medical dictum to first, do no harm.

The 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. Many patients who have undergone reparative therapy relate that they were inaccurately told that homosexuals are lonely, unhappy individuals who never achieve acceptance or satisfaction. The possibility that the person might achieve happiness and satisfying interpersonal relationships as a gay man or lesbian is not presented, nor are alternative approaches to dealing with the effects of societal stigmatization discussed.

Therefore, the American Psychiatric Association opposes any psychiatric treatment such as reparative or conversion therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that a patient should change his/her sexual homosexual orientation.”

American Psychoanalytic Association, Position Statement on Attempts to Change Sexual Orientation, Gender Identity, or Gender Expression (2012), available at http://www.apsa.org/content/2012-position-statement-attempts-change-sexual-orientation-gender-identity-or-gender.

“As with any societal prejudice, bias against individuals based on actual or perceived sexual orientation, gender identity or gender expression negatively affects mental health, contributing to an enduring sense of stigma and pervasive self-criticism through the internalization of such prejudice.

Psychoanalytic technique does not encompass purposeful attempts to ‘convert,’ “repair,” change or shift an individual’s sexual orientation, gender identity or gender expression. Such directed efforts are against fundamental principles of psychoanalytic treatment and often result in substantial psychological pain by reinforcing damaging internalized attitudes.”

American Psychological Association, Resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts (2009), available athttp://www.apa.org/about/policy/sexual-orientation.pdf.

“Therefore be it resolved that the American Psychological Association affirms that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality regardless of sexual orientation identity;

Be it further resolved that the American Psychological Association reaffirms its position that homosexuality per se is not a mental disorder and opposes portrayals of sexual minority youths and adults as mentally ill due to their sexual orientation;

Be it further resolved that the American Psychological Association concludes that there is insufficient evidence to support the use of psychological interventions to change sexual orientation;

Be it further resolved that the American Psychological Association encourages mental health professionals to avoid misrepresenting the efficacy of sexual orientation change efforts by promoting or promising change in sexual orientation when providing assistance to individuals distressed by their own or others’ sexual orientation;

Be it further resolved that the American Psychological Association concludes that the benefits reported by participants in sexual orientation change efforts can be gained through approaches that do not attempt to change sexual orientation;

. . .

Be it further resolved that the American Psychological Association advises parents, guardians, young people, and their families to avoid sexual orientation change efforts that portray homosexuality as a mental illness or developmental disorder and to seek psychotherapy, social support and educational services that provide accurate information on sexual orientation and sexuality, increase family and school support, and reduce rejection of sexual minority youth;

Be it further resolved that the American Psychological Association encourages practitioners to consider the ethical concerns outlined in the 1997 APA Resolution on Appropriate Therapeutic Response to Sexual Orientation (American Psychological Association, 1998), in particular the following standards and principles: scientific bases for professional judgments, benefit and harm, justice, and respect for people’s rights and dignity[.]”

American School Counselor Association, The Professional School Counselor and LGBTQ Youth (2014), available at http://www.schoolcounselor.org/school-counselors-members/about-asca-%281%29/position-statements.

“The professional school counselor works with all students through the stages of identity development and understands this may be more difficult for LGBTQ youth. It is not the role of the professional school counselor to attempt to change a student’s sexual orientation or gender identity. Professional school counselors do not support efforts by licensed mental health professionals to change a student’s sexual orientation or gender as these practices have been proven ineffective and harmful (APA, 2009). School counselors provide support to LGBTQ students to promote academic achievement and personal/social development. Professional school counselors are committed to the affirmation of all youth regardless of sexual orientation, gender identity and gender expression and work to create safe and affirming schools.” 

American School Health Association, Quality Comprehensive Sexuality Education (2007).

“[T]he American School Health Association . . . expects that comprehensive sexuality education in schools will be scientifically accurate and based on current medical, psychological, pedagogical, educational and social research . . . [and recommends] that teachers be well-trained and competent to teach sexuality education as defined by . . . insight into and acceptance of their own personal feelings and attitudes concerning sexuality topics so personal life experiences do not intrude inappropriately into the educational experience.”

National Association of Social Workers, “Reparative” or “Conversion” Therapies for Lesbians and Gay Men (2000), available at http://www.naswdc.org/diversity/lgb/reparative.asp.  

“[P]roponents of reparative and conversion therapies, such as the most commonly cited group NARTH, claim that their processes are supported by scientific data; however, such scientific support is replete with confounded research methodologies. . . . [Reparative and conversion therapies] cannot and will not change sexual orientation. Aligned with the American Psychological Association’s (1997) position, NCLGB believes that such treatment potentially can lead to severe emotional damage.” (emphasis in original)

National Association of Social Workers, Policy Statement: Lesbian, Gay, and Bisexual Issues (2005), available at https://www.socialworkers.org/LinkClick.aspx?fileticket=yH3UsGQQmYI%3d&portalid=0
.pdf.

“Taken to the extreme, homophobia in social workers and other practitioners can lead to the use of conversion or reparative therapies, which are explicitly condemned by NASW. . . . NASW reaffirms its stance against reparative therapies and treatments designed to change sexual orientation or to refer practitioners or programs that claim to do so.”

Promoting public health represents a compelling government interest, and preventing suicide in vulnerable groups of youth absolutely meets this criteria. The state of Virginia also has a compelling interest in prohibiting medical and mental health practices practices which are ineffective, and harmful to children. There is no debate among experts in this field that these practices have no value, and are actively harmful to youth. Thus, I strongly urge the passage of regulations banning the professional practice of attempting to change the sexual orientation, gender identity, or gender expression of people under the age of 18.