What Are Some Examples of Conversion Therapy?
In the past, some mental health professionals resorted to extreme measures such as institutionalization, castration, and electroconvulsive shock therapy to try to stop people from being lesbian, gay, bisexual, or transgender (LGBT). Today, while some counselors still use physical treatments like aversive conditioning, the techniques most commonly used include a variety of behavioral, cognitive, psychoanalytic, and other practices that try to change or reduce same-sex attraction or alter a person’s gender identity. While these contemporary versions of conversion therapy are less shocking and extreme than some of those more frequently used in the past, they are equally devoid of scientific validity and pose serious dangers to patients—especially to minors, who are often forced to undergo them by their parents or legal guardians, and who are at especially high risk of being harmed.
According to a 2009 report of the American Psychological Association, the techniques therapists have used to try to change sexual orientation and gender identity include inducing nausea, vomiting, or paralysis while showing the patient homoerotic images; providing electric shocks; having the individual snap an elastic band around the wrist when aroused by same-sex erotic images or thoughts; using shame to create aversion to same-sex attractions; orgasmic reconditioning; and satiation therapy. Other techniques include trying to make patients’ behavior more stereotypically feminine or masculine, teaching heterosexual dating skills, using hypnosis to try to redirect desires and arousal, and other techniques—all based on the scientifically discredited premise that being LGBT is a defect or disorder.
The current practice guidelines for the National Association for Research & Therapy of Homosexuality (NARTH), which is a group of therapists who endorse and practice conversion therapy in the United States, encourage its members to consider techniques that include hypnosis, behavior and cognitive therapies, sex therapies, and psychotropic medication, among others.
What Do Mainstream Mental Health Professionals Say About Conversion Therapy?
All of the nation’s leading professional medical and mental health associations have rejected conversion therapy as unnecessary, ineffective, and dangerous. These groups have cautioned that the practices do not work and have warned patients that they may be harmful. For example, 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.”
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.”
The American Academy of Pediatrics has stated: “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.”
The Pan American Health Organization, a regional office of the World Health Organization, has stated that these practices “lack medical justification and represent a serious threat to the health and well-being of affected people.”
Can Any Type of Therapy Change a Person’s Sexual Orientation or Gender Identity?
No. In 2009, the American Psychological Association conducted a comprehensive review of the published literature on these practices and concluded that they are not supported by any reliable evidence. In fact, the APA found that the opposite was true: “The results of scientifically valid research indicate that it is unlikely that individuals will be able to reduce same-sex sexual attractions or increase other-sex attractions through SOCE.”
Similarly, in 2000, the American Psychiatric Association published a statement concluding that: “In the last four decades, ‘reparative’ therapists have not produced any rigorous scientific research to substantiate their claims of cure.”
How Bad is Conversion Therapy?
Conversion therapy can be extremely dangerous and, in some cases, fatal. In 2009, the APA issued a report concluding that the reported risks of the practices include: depression, guilt, helplessness, hopelessness, shame, social withdrawal, suicidality, substance abuse, stress, disappointment, self-blame, decreased self-esteem and authenticity to others, increased self-hatred, hostility and blame toward parents, feelings of anger and betrayal, loss of friends and potential romantic partners, problems in sexual and emotional intimacy, sexual dysfunction, high-risk sexual behaviors, a feeling of being dehumanized and untrue to self, a loss of faith, and a sense of having wasted time and resources.
The risks are even greater for youth. Minors who experience family rejection based on their sexual orientation or gender identity face especially serious health risks. Research shows that lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were more than eight times more likely to report having attempted suicide, more than five times more likely to report high levels of depression, more than three times more likely to use illegal drugs, and more than three times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection.
In one highly publicized case from the early 1970s, psychologist George Rekers treated a five-year-old boy named Kirk Murphy, who had exhibited stereotypically feminine behavior such as a preference for girls’ toys. Rekers instructed Murphy’s parents to reward him for exhibiting “masculine” behavior and to punish him (by ignoring or even spanking him) when he displayed “feminine” behavior. Rekers claimed this treatment would prevent the boy from becoming gay. Later, Rekers published an article citing his treatment of Murphy as a success story, which Rekers and other proponents of these practices continue to use to deceive other parents and entrap other clients struggling with the stigma and discrimination faced by LGBT people. In fact, however, Murphy was gay in adulthood, and struggled with the severe psychological distress caused by Rekers’s “treatments” throughout his life. Murphy attempted to take his own life when he was about 17, and died by suicide at the age of 38.
Do Any States Protect Youth From Conversion Therapy?
In 2012, California became the first state to protect LGBT youth from dangerous and scientifically discredited efforts by state-licensed therapists to change their sexual orientation or gender identity. This law (Senate Bill 1172) prohibits therapists who are licensed by the State of California from trying to change the sexual orientation or gender identity of people under 18. In 2013, New Jersey enacted a second law (Assembly Bill 3371), and, in 2014, Washington, D.C. enacted a third. Today, NCLR is involved in passing similar legislation in dozens of other states.
What Do These Laws Do?
Laws passed in California, New Jersey, and Washington, D.C., as well as bills introduced in many other states, prohibit state-licensed therapists from engaging in scientifically discredited and dangerous practices that try to change a young person’s sexual orientation or gender identity.
The laws describe these practices as “sexual orientation change efforts” (SOCE), which is the scientific term used by the American Psychological Association and other groups that have warned patients about these dangerous practices. These laws provide that state-licensed mental health providers may not engage in sexual orientation change efforts with a patient under 18 years of age.
The laws define “sexual orientation change efforts” to include any practices by mental health providers that seek to change an individual’s sexual orientation or gender identity. This includes efforts to change behaviors or gender expression, or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same sex.
The laws also state that the regulated practices do not include therapies that provide acceptance, support, and understanding of clients or the facilitation of clients’ coping, social support, and identity exploration and development, including sexual orientation-neutral efforts to prevent or address unlawful conduct or unsafe sexual practices. They specifically exempt therapy designed to aid a person in a transition from one gender to another.
Why Are These Laws Needed?
These laws are needed to ensure that therapists who are licensed by the state are providing competent care and are not harming patients. Before 1973, many mental health organizations inaccurately considered same-sex attraction to be a mental illness. In 1973, the American Psychiatric Association removed “homosexuality” from its official list of mental disorders. For decades, the American Psychiatric Association has recognized that being lesbian, gay, or bisexual is not a mental illness and that trying to change a person’s sexual orientation or gender identity is ineffective and dangerous. Despite this consensus, some therapists continue to engage in these discredited and unsafe practices.
These laws are especially needed to protect minors, who are almost always forced or coerced to undergo conversion therapy. These state-licensed practitioners frequently prey on well-intentioned parents and legal guardians who do not understand that they are putting their children at risk of serious harm.
The state has a strong interest in ensuring that licensed health care providers follow professional standards of competence and do not engage in dangerous practices that have no scientific basis and put patients at risk of severe and long-lasting damage.
After California Governor Jerry Brown signed California’s bill into law, two anti-LGBT groups filed lawsuits claiming that it violates their constitutional rights to freedom of speech and religion and is unconstitutionally vague. These claims have no merit. Many laws regulate the conduct of licensed therapists when dealing with patients, and these laws are just as valid as other regulations that require licensed professionals to provide safe, competent care and protect patients from harm and abuse. A panel of the United States Court of Appeals unanimously ruled that the California law is valid, and the Supreme Court of the United States declined review. The same anti-LGBT groups then filed challenges to the law in New Jersey, where a federal district court upheld it as well. That case is currently on review before the Supreme Court of the United States.
What Can I Do if I Find Out that a California, New Jersey, or Washington, D.C. Licensed Mental Health Care Provider Is Practicing Conversion Therapy?
Different licensing boards regulate different types of mental health professionals. If you discover that a California, New Jersey, or Washington, D.C. mental health provider is engaging in these practices with a minor, please contact NCLR.
How Can I Help Enact a Similar Law in my State?
NCLR is providing support and assistance to advocates who are seeking to enact such laws across the country. If you would like to help enacting a similar law in your state, please contact #BornPerfect Campaign Coordinator & Staff Attorney Samantha Ames at BornPerfect@NCLRights.org.