Healthcare providers are ethically bound to serve the needs of their patients and provide care based on the best available evidence. Conversation therapy has been thoroughly debunked in terms of efficacy and has actually been found to swing so far in the other direction into directly harming patients. Knowingly providing substandard care is bad enough but providing care known to be harmful is an egregious breach of medical ethics. If a provider does not feel comfortable delivering care that meets standards of best practices, all they have to do is make a referral to a provider who is competent in LGBT care. In fact, they are ethically bound to do so. Patients do not seek care to be at the mercy of a provider's personal beliefs. They come to get help with the expectation that they will be treated with dignity and respect.