Dangerous Truths About Conversion Therapy: Studies, Facts, And Research
Content Warning: This article mentions difficult topics, including suicide. If you or a loved one is in crisis or in danger of harming yourself, please reach out for help immediately. If anyone is in immediate danger, call 911. The National Suicide Prevention Hotline provides 24/7, free support, prevention, and crisis resources. It can be reached at 1-800-273-8255. The Lifeline hotline can connect anyone in crisis with a crisis counselor; text "HELLO" to 988.
Therapy can be a crucial and valuable resource for people living with mental health conditions. As society gains a better understanding of mental health, individuals may better recognize why therapy and types of therapeutic intervention can be helpful. As society gains more significant knowledge of sexual orientation, gender identity, and gender expression, acceptance, understanding, and inclusivity may grow.
If you are a loved one of someone who is LGBTQIA+, your acceptance and support may be imperative for your loved one's mental health. There are many positive, healthy ways to support the LGBT community, but there are also some dangerous practices.
One of these dangerous practices is called conversion therapy, which is not an officially recognized therapy nor a recognized psychiatric treatment. Conversion therapies lack scientific credibility and do not work regardless of sexual orientation, gender expression, gender identity, or other components of human sexuality and human development.
What Is Conversion Therapy?
"Conversion therapy" is an umbrella term for attempts to change the sexual orientation or gender identity of people who are LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, or another identity). Research on conversion therapy statistics shows that it is ineffective and potentially harmful.
The APA does not recognize conversion therapy as an effective or legitimate form of therapy. Conversion therapies are not researched-based behavioral health treatments or psychiatric treatments.
LGBTQIA+ youth may be encouraged to undergo conversion therapies under the misguided notion that they're still "in formation" and can adjust their sexual orientation or gender identity. However, young people aren't the only ones who might be targeted for conversion therapies. People of all ages may be urged to change their sexual orientation, gender identity, or pronouns.
Most psychological associations condemn conversion practices. The American Psychiatric Association issued a formal statement that opposes conversion therapy and interventions like conversation therapies.
The APA claims, "no credible evidence exists that any mental health intervention can reliably and safely change sexual orientation; nor, from a mental health perspective, does sexual orientation need to be changed."
Understanding Conversion Therapy
Conversion therapy refers to attempts to change an individual's sexual orientation, gender identity, or gender expression. For example, conversion therapy may involve efforts to change a person's sexual orientation from homosexual or bisexual to heterosexual.
Conversion therapy may also focus on changing a person's gender identity from transgender or non-binary to cisgender (the gender that matches the sex assigned at birth). These efforts to change sexual orientation, gender identity, and gender expression lack scientific credibility and can mentally harm LGBTQIA+ individuals.
Names For Conversion Therapy
Conversion therapy may be referred to by other names, such as:
Sexual orientation change efforts
Gender identity change efforts
Gender expression therapy
Religious purity-based therapy
Another common term for conversion therapy is "reparative therapy," viewed as trying to "repair" gender identity, sexual orientation, or gender expression.
A diverse identity is not a trait that needs to be changed or "repaired." Sexual orientation, gender expression, and gender identity are not mental health disorders and are not included in the Diagnostic and Statistical Manual of Mental Disorders.
Warnings About Conversion Therapy
Sometimes religious or other groups use different terms for conversion efforts. No matter what term is used for conversion therapies, research consistently shows that conversion therapy efforts do not work for changing sexual orientation, gender identity, or gender expression.
"Reparative therapy" (and other identity change efforts) can be significantly harmful. Aversion therapy can also be damaging when used for similar intentions.
In addition to the ineffectiveness and possible dangers of reparative therapies, these practices are not typically guided by licensed mental health professionals and often involve using unmonitored methods unsupported by evidence. Do not attend "therapy" with someone who does not have a degree and license to practice psychology.
The Strong Opposition And Rejection Of Conversion Therapy By Mental Health Professionals
The American Psychiatric Association and numerous other mental health, therapy, and medical associations have stated that no gender identity, sexual expression, or sexual orientation are mental health disorders, nor do they require conversion or repair. Similarly, diverse sexual orientations and gender identities are not included in the Diagnostic and Statistical Manual of Mental Disorders.
Conversion therapies are not recognized by the American Psychiatric Association, American Psychological Association, or the American Medical Association for anyone of any sexual orientation, gender identity, or gender expression. The Human Rights Campaign also warns against the lies and dangers of conversion therapy with supporting research.
Additionally, the US Department of Health and Human Services emphasizes that sexual orientation and gender identity are not mental illnesses and do not warrant mental health interventions or therapy. Many states and US jurisdictions have passed bills or resolutions to ban conversion therapy. Many other countries and municipalities also have laws that prohibit conversion therapy.
However, 21 states in the US have not outlined a ban on conversion therapy, and these practices may still take place in those locations. If you are being put in conversion therapy against your will, LGBT resource pages may be able to help you.
Dangers Of Conversion Therapy
Research shows that conversion therapy is strongly linked to adverse mental health outcomes, including depression, increased substance abuse, attempts of suicide, and other serious concerns.
Additionally, people whose families or religious groups support conversion therapy and efforts to change someone's identity may feel rejected or hurt. When a person's community believes in conversion therapy, the belief may send a message that any gender identity, sexual orientation, or gender expression that is different from what the community views as "mainstream" are mental health disorders in need of treatment.
Being LGBT does not lead to mental health problems. However, homophobia, transphobia, and LGBT-related traumas may lead to substance abuse, depression, or other adverse mental health outcomes.
A person who is LGBTQIA+ may feel shame and a negative stigma about how they identify when their community sends them a message that they need to change or "be repaired." They may also experience fractured relationships or broken religious connections resulting from the non-acceptance of their identity and the pressure placed on them to undergo conversion therapy.
If Conversion Therapy Is Harmful, Why Does It Exist?
Conversion therapy still happens around the world. There is no clear justification for conversion therapy. Still, research shows that approximately 700,000 lesbian, gay, bisexual, and transgender adults have undergone conversion therapy at some point in their lives. There may be several reasons why this practice is still used worldwide.
The conversion therapy practice may occur because people are uncomfortable with gender identities, gender expressions, and sexual orientations that do not match their own. They may not understand why someone else would desire something they do not want, such as a same-sex relationship or a gender-affirming surgery.
Religion And Family
Research shows that some parents believe that the best way to help their children thrive and survive is to make them fit in with peers in the majority through conversion therapy.
Religion may be one of the top causes of conversion therapy. Studies show that religion-based trauma is common in conversion therapy. Religions may state that an individual's sexuality, gender identity, or identity is a "sin" or goes against religious texts or practices. However, there are some religious organizations and resources that support the LGBT community.
If you are LGBTQIA+, some people and groups recognize the ineffectiveness and harm of conversion therapies and similar practices.
The LGBTQIA+ National Hotline offers a safe space to support people of all ages and can be reached at 888-843-4564 and www.glbthotline.org. Your local mental health services administration may also have resources to help.
Understanding Gender Identity And Gender Expression
Some people or groups may believe conversion therapy can change those whose gender identity doesn't align with their birth gender. However, this practice will not change your gender identity or gender expression and can cause harm.
If you want to support a loved one who is gender non-conforming, it may help to gain a greater understanding of gender identity. Gender and human sexuality are multi-dimensional and may exist on a broad spectrum.
Gender identity is not the same as sexual orientation or gender expression. Gender identity is considered a social construct—an idea that each gender comes with expectations. For instance, gender identity associated with being male may come with the expectations of dressing, talking, feeling, and interacting like a "stereotypical" male according to society's expectations.
Society has defined gender roles related to gender identity—what it means to be female or male, a girl or boy, a man or woman, for instance. However, there are many ways that people may express gender identity and genders other than just male and female. Gender identity is a personal sense of what your gender is.
How To Support Gender Diversity
What can you do to be supportive of gender identity diversity? You may choose to show respect for others. For example, if someone has told you what pronouns they use, try to make every effort to use those pronouns. It may feel confusing at first but learning a new word or way of speaking can be possible, and studies show that using someone's pronouns correctly can improve their mental well-being.
You might also try paying attention, without judgment, to how they refer to themselves regarding sexual orientation and gender identity. For instance, do they call themselves a boy or a girl? Do they refer to themselves as trans, non-binary, or another label?
Make genuine efforts to avoid misgendering people. Misgendering can include using incorrect pronouns or forms of address for a person's gender identity. If you misgender mistakenly, sincerely apologize and try to be more mindful of respecting the person's gender identity in the future. Purposefully misgendering or making microaggressions regarding someone's gender identity or expression can be hurtful.
Remember that gender and human sexuality cannot always be seen. Someone's gender identity may be fluid, or they may not want to specify a gender identity. Some individuals may be intersex or trans, and you may not know. Gender identity can be personal.
Keep trying to learn more. Your local mental health services administration or a local LGBT task force may have helpful resources for best practices to support people who identify as minorities. You might also try to spread understanding and best practices by joining a task force or group to promote the inclusivity of LGBTQIA+ people.
Your school, workplace, or community may have a group, or you could spearhead forming one. A safety-related task force can also help promote a safe environment. The Human Rights Campaign also offers resources and information regarding educating and supporting LGBTQIA+ individuals, their loved ones, and their greater community.
According to the American Psychiatric Association, gender expression expresses one's gender identity through appearance, behaviors, and personality styles. It is different from sexual orientation and gender identity.
The expression of gender (such as clothing or make-up, for instance) is often defined by society as feminine or masculine. A specific sexual orientation, however, is not always something that can be seen through gender expression.
Someone who is transgender or non-binary may decide to utilize gender-affirming surgery or hormones to change their body, which may be part of gender expression. They may also use androgynous, feminine, or masculine styles.
Someone who is transgender or non-binary does not necessarily have an average "look." People may dress or express themselves differently depending on their preferences. Social fashions or fads may exist within the LGBT community. However, stereotypes can be harmful.
If a person is experiencing gender dysphoria, they may benefit from the support of a licensed mental health professional. The American Psychiatric Association describes gender dysphoria as psychological distress resulting from one's gender identity not matching the sex assigned at birth.
Someone experiencing dysphoria may experience the following:
Discomfort looking at their body
A feeling of not having the "right" genitals
A feeling that their body is "bad" or "wrong"
A feeling that they want to remove or hide a part of their body to feel more comfortable
A desire to look like someone else of a different gender
A knowingness that their body or assigned gender does not match their true gender
Conversion therapy attempts are often not helpful for gender dysphoria, but helping clients explore their feelings and experiences of gender identity and gender expression through talk therapy may be.
Understanding Sexual Orientation
If your sexual orientation or gender identity varies from what is considered heteronormative, you are not experiencing a mental health condition due to this.
According to the American Psychological Association, sexual orientation is an "enduring pattern of emotional, romantic, or sexual attraction to men, women, or both sexes." Sexual orientation may also refer to a person's sense of identity based on those patterns.
Sexual orientation is often spoken of in labels. Some common sexual orientations include:
Heterosexuality: Romantic or sexual interest in genders other than your own
Bisexuality: Romantic or sexual interest in the same gender as your own and genders other than your own
Homosexuality: Romantic or sexual interest in the same gender as your own
Asexuality: Not experiencing sexual attraction (may experience sexual desire or romantic attraction)
Queer: Some individuals choose to identify with the umbrella label of "queer" to mean someone who identifies as a sexual or gender minority.
Others: Many individuals identify with a label not on this list
Sexual orientation can involve feelings and identity; a person's particular sexual orientation may not be visible through gender expression or actions.
Many aspects may contribute to a person's sexual orientation, identity, and expression. For instance, many experts say that sexual orientation may be determined by environmental, emotional, hormonal, and biological factors.
According to experts, sexual orientation cannot be voluntarily changed. Some individuals might try to hide their sexual orientation. They may have been taught to feel shame or been exposed to homophobia as a child. Conversion therapy may reinforce this shame and harm their mental health.
Special Consideration: Supporting The Mental Health of LGBTQIA+ Youth And Young Adults
Teens and young adults identifying as a sexual or gender minority may be at a greater risk of developing a mental health disorder. For example, research shows that LGBTQIA+ youth engage in substance abuse at higher rates than their heteronormative and gender-normative peers.
The adolescent stage of human development is often when LBGTQ youth (and others) question their sexual orientation or gender identity. They may want to learn more about homosexual and bisexual issues, topics, identities, and personal feelings.
Families or religious groups may feel they can "form" or influence a young person's particular sexual orientation or sway one's gender identity. They may attempt to use the practice of conversion therapy to try to intervene as LGBTQ youth explore or express their identity.
Acceptance and support at school may benefit LGBTQ youth who do not receive help at home. Inclusive school and after-school programs may open the doors to more children. Many schools have established a task force to develop inclusive, welcoming, and safe measures. Some schools have a GSA (gay-straight alliance) club to allow LGBT children to discuss LGBT matters at school.
Promoting The Mental Health Of LGBTQIA+ Individuals Through Acceptance And Support
If the goal is to support the mental and physical health of those who identify as LGBTQIA+, there are many ways to achieve that goal without conversion therapy, sexual orientation change efforts, reparative therapy, or similar interventions. Satisfying interpersonal relationships, for example, may support emotional health and well-being.
Additionally, therapy methods that are research-based and offered by a licensed mental health professional may be beneficial. These mental health services are not necessary for someone based on their sexual orientation, gender identity, or gender expression. Still, they can be very effective and favorable for supporting mental health and treating existing mental health disorders.
An individual's LGBT identity does not mean they have or will have a mental disorder. However, some people who are LGBTQIA+ may face increased challenges that can harm their mental health. For example, they may experience the following:
Abuse (verbal, emotional, or physical)
Fear of hate crimes or being harmed for their identity
Conversion therapy, reparative therapy, and attempts to change sexual orientation may not stop these dangers but reinforce them. However, there are legitimate, positive ways to support the safety of people whose identity differs from what is heteronormative.
To support the mental health of those who are LGBTQIA+, the National Alliance on Mental Illness has several helpful suggestions. Loved ones, families, friends, and allies in the community can play a critical, positive role in supporting the mental wellness of people who are LGBTQIA+.
First, respecting and affirming sexual orientation, gender identity, and gender expression can offer a positive sense of acceptance. Being publicly supportive can also be helpful, as can using respectful language and terminology regarding sexual orientation and gender identity.
Rejecting harmful practices, such as conversion therapies and other efforts to change an individual's sexual orientation and gender identity, can show LGBTQIA+ individuals that you care about their safety, well-being, and human rights.
Knowing the signs of a mental health disorder may help you support LGBTQIA+ loved ones. Symptoms of mental illness may include:
Feeling excessively sad
Prolonged feelings of irritation or anger
Difficulties relating to others
Changes in sleep patterns
Difficulty understanding reality
Changes in eating habits
Changes in libido
Excessive worry or fear
Thinking about suicide
How To Get Help
If you are concerned with your mental health or someone else's, help is available. Your healthcare team may be a valuable resource to connect you with support. You can also reach out to your local mental health services administration or mental health organization. Many communities offer mental health services and behavioral health treatment allied with the LGBTQIA+ community. You may find support through an LGBT resource list.
Some therapists may add that they support the LGBT community on their profile, website, or office door. Therapists may offer those who identify as a sexual or gender minority support without judgment. The American Psychological Association encourages mental health professionals to recognize the positive aspects of being educated about best practices for working with and supporting LGBTQ+ individuals.
Getting Help For A Loved One
If a loved one is living with a mental illness, there are steps you can take to support them. You may ask potential therapists about working with LGBTQIA+ clients to ensure they do not support conversion therapy. If you are working with a psychiatrist, you might talk to them about their experience and background.
With the understanding that sexual orientation and gender identity are not mental disorders, recognizing that LGBTQ individuals may be more prone to mental health concerns may be beneficial. Expressing your concern, support, and reassurance that you care about your loved one can be a source of strength, as can reassuring them that effective treatments are available for mental health disorders.
There are valuable resources available for learning how to speak about mental health concerns and finding help for mental illness. There are also hotlines and websites available to specifically help and support people who are LGBTQIA+ and to offer information to their allies.
Your local mental health services administration, behavioral health treatment center, or LGBTQIA+ task force may also have helpful resources. You might also try starting or joining a regional task force to promote LGBTQIA+ inclusion and respect.
Finding The Right Licensed Mental Health Professional If You Identify As LGBTQIA+
Whatever your sexual orientation is, finding a therapist who is a good fit for you can be an essential step in addressing your mental health concerns. The National Alliance on Mental Health (NAMI) has suggestions for finding a therapist who is a good fit. Many therapists are part of the LGBTQ community and may understand your struggles.
You can look for information in the following locations:
On the NAMI website
Your insurance company's website
A local mental health services administration
A trusted healthcare provider
A local LGBTQIA+ task force
A trusted referral
When looking for a therapist, you might ask if they have experience working with those who are LGBTQIA+. They may identify as part of the community themselves, which could benefit you.
NAMI suggests that if you are concerned that a therapist might use a potentially harmful, ineffective form of therapy resembling conversion therapies, it can be helpful to ask before you partake in a session. If the therapist acts in homophobic or transphobic ways towards you, you can report them to your state's psychology board.
Online Therapy For LGBTQ Individuals
Online therapy may be a practical, positive experience for people seeking support and mental healthcare. Research has found online therapy effective for treating various issues, including anxiety, depression, trauma, self-esteem concerns, and relationship problems. These studies also found no difference in patient satisfaction between those who utilized in-person therapy and those who used online therapy.
If you're interested in finding an LGBTQ-accepting therapist, you might try online platforms like BetterHelp, which have large databases of therapists specializing in many different areas. Accredited online therapists should not offer conversion therapy. Therapy for LGBTQ individuals may be focused on non-related mental health concerns or related concerns to being a minority.
Sexual orientation, gender identity, and gender expression can make up who you are. If you are considering conversion therapy or are urged to consider it, know that there is no scientific evidence supporting its effectiveness, with ample evidence showing how it can cause significant harm to mental health.
Reputable, licensed mental health professionals may respect your identity, orientation, and expression and work with you to find mental health solutions that work for you.
If you're ready to try non-conversion therapy, such as counseling from home, take the first step by reaching out to a counselor.