Language is important. We are speaking of a term that technically does not exist—sexual orientation and gender identity are not pathologies, and therefore, are not in need of treatment. Conversion therapy is not validated nor empirically supported, and not taught as a method of treatment for LGBTQ individuals. Existing research suggests that conversion therapy is associated with many negative outcomes for LGBTQ clients, including increased level of depressive symptoms, frequent suicidal ideation and attempts, social isolation and anger toward family members, and decreased levels of self-worth.

These practices also fail to meet criteria for an empirically supported treatment. The American Psychological Association’s 1998 Resolution on Appropriate Therapeutic Responses to Sexual Orientation describes the lack of efficacy conversion therapy. In 2000, the American Psychiatric Association adopted an official position statement opposing the practice of conversion therapy or any therapy that is based on the belief that LGB sexual orientation is a mental illness. The Substance Abuse and Mental Health Services Administration (SAMHSA) also called for an end to the practice of conversion therapy for children and youth in 2015 with the support of the American Psychological Association. Also, the American Psychological Association disseminated guidelines for working with LGB clients, which encourages the use of accurate information on sexual orientation and sexuality.

Ethical guidelines call for scientific bases for professional judgments, benefit and harm, justice, and respect for people’s rights and dignity. We are all familiar with the Hippocratic Oath—First, do no harm. In 2015, the American Counseling Association Chief Executive Officer Richard Yep stated, “Our code of ethics is really grounded on ‘do no harm.’ Our feeling is that people who are exposed to sexual orientation change efforts are exposed to all sorts of harm.” Conversion approaches also conflict with several standards of the APA Ethics Code, which prohibits Unfair Discrimination, as well as Avoid of False or Deceptive Statements. In addition to those guidelines, scholars have argued that conversion therapy is unethical because it is intended to change a marginalized group into members of the dominant group—essentially forcing LGBTQ individuals to conform to societal norms based on heterosexist and heteronormative assumptions that idealize and solely validate a heterosexual sexual orientation.

How do we support LGBTQ children and adolescents? By supporting Affirmative Therapy—a culturally-informed, evidence-based approach that does not pathologize sexual orientation or gender identity. Instead this therapeutic approach promotes a healthy identity and authenticity in LGBTQ children and adolescents through a nurturing and supportive stance. LGBTQ youth are 6x more likely to report high levels of depression and 8x more likely to have an attempted suicide—Therefore, it is important for us to send a message that mental health providers can help them with these concerns rather than pathologize them for their sexual orientation and/or gender identity.

To date several states (Colorado, California, Delaware, Illinois, New Jersey, Oregon, Vermont) have passed laws preventing licensed mental health professionals from offering conversion therapy to minors. I hope Virginia will be next.