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{{Short description|Pseudoscientific attempts to change sexual orientation or gender identity}}
{{Short description|Pseudoscientific attempts to change sexual orientation or gender identity}}
{{pp-pc}}
{{pp-semi-indef|small=yes}}
{{Use dmy dates|date=October 2020}}
{{Use dmy dates|date=October 2020}}
{{Infobox pseudoscience
{{Infobox pseudoscience
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{{LGBT rights sidebar}}
{{LGBT rights sidebar}}
{{Alternative medicine sidebar|fringe}}
{{Alternative medicine sidebar|fringe}}
{{Distinguish|Transgender hormone therapy}}


'''Conversion therapy''' is the [[pseudoscientific]]<!-- DO NOT remove or change to "scientific" without talk page consensus --> practice of attempting to change an individual's [[sexual orientation]], [[gender identity]], or [[gender expression]] to align with [[heterosexual]] and [[cisgender]] norms.<ref>{{Cite journal |last1=Fenaughty |first1=John |last2=Tan |first2=Kyle |last3=Ker |first3=Alex |last4=Veale |first4=Jaimie |last5=Saxton |first5=Peter |last6=Alansari |first6=Mohamed |date=January 2023 |title=Sexual Orientation and Gender Identity Change Efforts for Young People in New Zealand: Demographics, Types of Suggesters, and Associations with Mental Health |journal=Journal of Youth and Adolescence |language=en |volume=52 |issue=1 |pages=149–164 |doi=10.1007/s10964-022-01693-3 |pmid=36301377 |pmc=9813061 |issn=0047-2891}}</ref> Methods that have been used to this end include forms of [[brain surgery]], [[castration|surgical]] or [[chemical castration|hormonal castration]], [[Aversion therapy|aversive treatments]] such as electric shocks, nausea-inducing drugs, [[hypnosis]], counseling, spiritual interventions, visualization, [[psychoanalysis]], and arousal reconditioning.
'''Conversion therapy''' is the [[pseudoscientific]]<!-- DO NOT remove or change to "scientific" without talk page consensus --> practice of attempting to change an individual's [[sexual orientation]], [[romantic orientation]], [[gender identity]], or [[gender expression]] to align with [[heterosexual]] and [[cisgender]] norms.<ref>{{Cite journal |last1=Fenaughty |first1=John |last2=Tan |first2=Kyle |last3=Ker |first3=Alex |last4=Veale |first4=Jaimie |last5=Saxton |first5=Peter |last6=Alansari |first6=Mohamed |date=January 2023 |title=Sexual Orientation and Gender Identity Change Efforts for Young People in New Zealand: Demographics, Types of Suggesters, and Associations with Mental Health |journal=Journal of Youth and Adolescence |language=en |volume=52 |issue=1 |pages=149–164 |doi=10.1007/s10964-022-01693-3 |pmid=36301377 |pmc=9813061 |issn=0047-2891}}</ref> Methods that have been used to this end include forms of [[brain surgery]], [[castration|surgical]] or [[chemical castration|chemical (hormonal) castration]], [[aversion therapy]] treatments such as electric shocks, nausea-inducing drugs, [[hypnosis]], counseling, spiritual interventions, visualization, [[psychoanalysis]], and arousal reconditioning. There is a scientific consensus that conversion therapy is ineffective at changing a person's sexual orientation or gender identity and that it frequently causes significant long-term psychological harm.<ref name=":0" /> The position of current [[evidence-based medicine]] and clinical guidance is that [[homosexuality]], [[bisexuality]], and [[gender variance]] are natural and healthy aspects of [[human sexuality]].<ref name=":0" />{{sfn|Haldeman|2022|p=5}} An increasing number of jurisdictions around the world have passed [[laws against conversion therapy]].<ref name="Drescher" />


There is a scientific consensus that conversion therapy is ineffective at changing a person's sexual orientation or gender identity and that it frequently causes significant long-term psychological harm.<ref name=":0" /> The position of current [[evidence-based medicine]] and clinical guidance is that [[homosexuality]], [[bisexuality]] and [[gender variance]] are natural and healthy aspects of [[human sexuality]].<ref name=":0" />{{sfn|Haldeman|2022|p=5}} Historically, conversion therapy was the treatment of choice for individuals who disclosed same-sex attractions or exhibited gender nonconformity, which were formerly assumed to be [[pathologies]] by the medical establishment.{{sfn|Haldeman|2022|p=5}} When performed today, conversion therapy may constitute [[fraud]] and when performed on minors, a form of [[child abuse]]; it has been described by experts as [[torture]]; [[cruel, inhuman, or degrading treatment]]; and contrary to [[human rights]].
Historically, conversion therapy was the treatment of choice for individuals who disclosed same-sex attractions or exhibited gender nonconformity, which were formerly assumed to be [[pathologies]] by the medical establishment.{{sfn|Haldeman|2022|p=5}} When performed today, conversion therapy may constitute [[fraud]] and when performed on minors, a form of [[child abuse]]; it has been described by experts as [[torture]]; [[cruel, inhuman, or degrading treatment]]; and contrary to [[human rights]].

An increasing number of jurisdictions around the world have passed [[laws against conversion therapy]].<ref name="Drescher" />


==Terminology ==
==Terminology ==
Medical professionals and activists consider "conversion therapy" a [[misnomer]], as it does not constitute a legitimate form of [[therapy]].{{sfn|Haldeman|2022|p=4}} Alternative terms include sexual orientation change efforts (SOCE){{sfn|Haldeman|2022|p=4}} and gender identity change efforts (GICE){{sfn|Haldeman|2022|p=4}}—together, sexual orientation and gender identity change efforts (SOGICE).<ref name="SOGICESurvivor">{{cite web | author=Csabs, C., Despott, N., Morel, B., Brodel, A., Johnson, R. | url=http://socesurvivors.com.au/wp-content/uploads/2020/12/Survivor-Statement-A4-Doc-v1-2-Digital.pdf | title=The SOGICE Survivor Statement | archive-url=https://web.archive.org/web/20230405220718/https://socesurvivors.com.au/wp-content/uploads/2020/12/Survivor-Statement-A4-Doc-v1-2-Digital.pdf | archive-date=2023-04-05 | date=July 2020 | url-status=dead}}</ref>{{better source needed|date=February 2023}} According to researcher [[Douglas C. Haldeman]], SOCE and GICE should be considered together because both rest on the assumption "that gender-related behavior consistent with the individual's birth sex is [[normative]] and anything else is unacceptable and should be changed".{{sfn|Haldeman|2022|p=8}} "Reparative therapy" may refer to conversion therapy in general,{{sfn|Haldeman|2022|p=4}} or to [[#Reparative therapy|a subset thereof]].<ref name="Drescher1998"/>
Medical professionals and activists consider "conversion therapy" a [[misnomer]], as it does not constitute a legitimate form of [[therapy]].{{sfn|Haldeman|2022|p=4}} Alternative terms include sexual orientation change efforts (SOCE){{sfn|Haldeman|2022|p=4}} and gender identity change efforts (GICE){{sfn|Haldeman|2022|p=4}}—together, sexual orientation and gender identity change efforts (SOGICE).<ref name="SOGICESurvivor">{{cite web | vauthors=Csabs C, Despott N, Morel B, Brodel A, Johnson R | url=http://socesurvivors.com.au/wp-content/uploads/2020/12/Survivor-Statement-A4-Doc-v1-2-Digital.pdf | title=The SOGICE Survivor Statement | archive-url=https://web.archive.org/web/20230405220718/https://socesurvivors.com.au/wp-content/uploads/2020/12/Survivor-Statement-A4-Doc-v1-2-Digital.pdf | archive-date=2023-04-05 | date=July 2020 | url-status=dead}}</ref>{{better source needed|date=February 2023}} According to researcher [[Douglas C. Haldeman]], SOCE and GICE should be considered together because both rest on the assumption "that gender-related behavior consistent with the individual's birth sex is [[normative]] and anything else is unacceptable and should be changed".{{sfn|Haldeman|2022|p=8}} "Reparative therapy" may refer to conversion therapy in general,{{sfn|Haldeman|2022|p=4}} or to [[#Reparative therapy|a subset thereof]].<ref name="Drescher1998"/>


Advocates of conversion therapy do not necessarily use the term either, instead using phrases such as "healing from sexual brokenness"<ref>{{cite journal |id={{Gale|A586241649}} |last1=Lee |first1=Jin |title=Diversity or a flavor of diversity? |journal=Gateway Journalism Review |date=1 January 2019 |volume=47 |issue=352 |pages=34–35 }}</ref><ref>{{cite thesis |last1=Stephens |first1=John Bryant |date=1997 |title=Conflicts over homosexuality in the United Methodist Church: Testing theories of conflict analysis and resolution |id={{ProQuest|304408101}} |oclc=41964052 }}</ref> and "struggling with same-sex attraction".<ref>{{cite journal |last1=Creek |first1=S. J. |last2=Dunn |first2=Jennifer L. |title='Be Ye Transformed': The Sexual Storytelling of Ex-gay Participants |journal=Sociological Focus |date=2012 |volume=45 |issue=4 |pages=306–319 |doi=10.1080/00380237.2012.712863 |jstor=41633922 |s2cid=144699323 }}</ref>
Advocates of conversion therapy do not necessarily use the term either, instead using phrases such as "healing from sexual brokenness"<ref>{{cite journal |id={{Gale|A586241649}} |last1=Lee |first1=Jin |title=Diversity or a flavor of diversity? |journal=Gateway Journalism Review |date=1 January 2019 |volume=47 |issue=352 |pages=34–35 }}</ref><ref>{{cite thesis |last1=Stephens |first1=John Bryant |date=1997 |title=Conflicts over homosexuality in the United Methodist Church: Testing theories of conflict analysis and resolution |id={{ProQuest|304408101}} |oclc=41964052 }}</ref> and "struggling with same-sex attraction".<ref>{{cite journal |last1=Creek |first1=S. J. |last2=Dunn |first2=Jennifer L. |title='Be Ye Transformed': The Sexual Storytelling of Ex-gay Participants |journal=Sociological Focus |date=2012 |volume=45 |issue=4 |pages=306–319 |doi=10.1080/00380237.2012.712863 |jstor=41633922 |s2cid=144699323 }}</ref>
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Early [[social engineering (political science)|interventions]] were rooted in psychoanalytic hypotheses.{{sfn|Rivera|Pardo|2022|p=58}} [[Robert Stoller]] advanced the theory that [[gender variance|gender-nonconforming]] behavior and expression in children assigned male at birth (AMAB) was caused by being overly close to their mother. [[Richard Green (sexologist)|Richard Green]] continued his research; his methods for altering behavior included having the father spend more time with the child and mother less, expecting both to exhibit stereotypical [[gender roles]], and having them praise their child's masculine behaviors, and shame their feminine and gender-nonconforming ones. These interventions resulted in depression in the children and feelings of betrayal from parents that the treatments failed.{{sfn|Rivera|Pardo|2022|p=58}}
Early [[social engineering (political science)|interventions]] were rooted in psychoanalytic hypotheses.{{sfn|Rivera|Pardo|2022|p=58}} [[Robert Stoller]] advanced the theory that [[gender variance|gender-nonconforming]] behavior and expression in children assigned male at birth (AMAB) was caused by being overly close to their mother. [[Richard Green (sexologist)|Richard Green]] continued his research; his methods for altering behavior included having the father spend more time with the child and mother less, expecting both to exhibit stereotypical [[gender roles]], and having them praise their child's masculine behaviors, and shame their feminine and gender-nonconforming ones. These interventions resulted in depression in the children and feelings of betrayal from parents that the treatments failed.{{sfn|Rivera|Pardo|2022|p=58}}


In the 1970s, [[UCLA]] psychologist Richard Green recruited [[Ole Ivar Lovaas]] to adapt the techniques of [[ABA therapy]] to attempt to prevent children from becoming [[transsexual]].<ref name="silberman_2016_319">{{Cite book |last1=Silberman |first1=Steve |title=Neurotribes: The Legacy of Autism and the Future of Neurodiversity |date=2016 |publisher=Avery |location=New York City, NY |pages=319–321 |isbn=978-0399185618}}</ref> Deemed the "Feminine Boy Project", the treatments used [[operant conditioning]] to reward gender-conforming behaviors, and punish gender non-conforming behaviors.<ref name="silberman_2016_319"/>
In the 1970s, [[UCLA]] psychologist Richard Green recruited [[Ole Ivar Lovaas]] to adapt the techniques of [[Applied Behavior Analysis]] (ABA) therapy to attempt to prevent children from becoming [[transsexual]].<ref name="silberman_2016_319">{{Cite book |last1=Silberman |first1=Steve |title=Neurotribes: The Legacy of Autism and the Future of Neurodiversity |date=2016 |publisher=Avery |location=New York City, NY |pages=319–321 |isbn=978-0399185618}}</ref> Deemed the "Feminine Boy Project", the treatments used [[operant conditioning]] to reward gender-conforming behaviors, and punish gender non-conforming behaviors.<ref name="silberman_2016_319"/>


{{Anchor|Living in your own skin model}}
[[Kenneth Zucker]] at [[Centre for Addiction and Mental Health|CAMH]] adopted Richard Green's methods, but narrowed the scope to attempting to prevent the child from identifying as transgender. His model used the same interventions as Green with the addition of [[psychodynamic therapy]].{{sfn|Rivera|Pardo|2022|p=58}} In January 2015, members of Rainbow Health Ontario, a provincial health promotion and navigation organization, approached CAMH expressing their concerns regarding Zucker's clinic.<ref name="howthefight">{{cite news |last=Singal |first=Jesse |date=7 February 2016 |title=How the Fight Over Transgender Kids Got a Leading Sex Researcher Fired |url=https://www.thecut.com/2016/02/fight-over-trans-kids-got-a-researcher-fired.html |work=New York Magazine |access-date=30 October 2022}}</ref> Rainbow Health Ontario submitted a review of academic literature and clinical practices for [[transgender youth]], and expressed concern that the gender identity clinic was not following accepted practices.<ref name="ashley_2022_4">{{Cite book |title=Banning Transgender Conversion Practices: A Legal and Policy Analysis |last1=Ashley |first1=Florence |publisher=University of British Columbia Press |location=Vancouver, BC |date=2022 |isbn=978-0774866958 |page=4}}</ref> Others linked the Gender Identity Clinic's practices to [[suicide]] of transgender youth caused by conversion therapy, and referenced the high-profile case of [[Leelah Alcorn]], a transgender teen from [[Ohio]].<ref name="howthefight"/> In November 2015, an external review of the clinic was published.<ref name="gic-review">{{Cite web |url=https://www.transadvocate.com/wp-content/uploads/GIC-Review-26Nov2015-TA1.pdf |title=External Review of the Gender Identity Clinic of the Child, Youth and Family Services in the Underserved Populations Program at the Centre for Addiction and Mental Health |publisher=CAMH |date=26 November 2015 |access-date=5 March 2023}}</ref> The review noted numerous strengths of the clinic, but also described it as an insular entity with an approach dissimilar from other clinics and described it as being out of step with current best practices, including [[Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People#Version 7|WPATH SOC Version 7]].<ref name="gic-review"/> After the review, CAMH shut down the clinic and fired Zucker. [[Kwame McKenzie]], medical director of CAMH's child, youth, and family services, said "We want to apologize for the fact that not all of the practices in our childhood gender identity clinic are in step with the latest thinking" and that Zucker is, "no longer at CAMH."<ref name="ubelacker_20151215">{{cite news|last1=Ubelacker|first1=Sheryl|title=CAMH to 'wind down' controversial gender identity clinic services|url=https://www.theglobeandmail.com/news/toronto/camh-to-wind-down-controversial-gender-identity-clinic-services/article27766580/|access-date=15 December 2015|agency=Canadian Press|newspaper=The Globe and Mail|date=December 15, 2015}}</ref>
[[Kenneth Zucker]] at the [[Centre for Addiction and Mental Health]] adopted Richard Green's methods, but narrowed the scope to attempting to prevent the child from identifying as transgender by modifying gender behavior and presentation to conform to the expectations of the assigned gender at birth, which he dubbed the "living in your own skin" model. His model used the same interventions as Green with the addition of [[psychodynamic therapy]].{{sfn|Rivera|Pardo|2022|p=58}}<ref name="forcier_2020_177">{{Cite book |last1=Chung |first1=Kathleen |last2=Rhoads |first2=Sarah |last3=Rolin |first3=Alicia |last4=Sackett-Taylor |first4=Andrew C. |last5=Forcier |first5=Michelle |editor-last1=Forcier |editor-first1=Michelle |editor-last2=Van Schalkwyk |editor-first2=Gerrit |editor-last3=Turban |editor-first3=Jack L. |date=2020 |title=Pediatric Gender Identity: Gender-affirming Care for Transgender & Gender Diverse Youth |publisher=Springer |chapter=Treatment Paradigms for Prepubertal Children |page=177 |isbn=978-3030389086}}</ref><ref name="Hart">{{Cite book |title=Banning 'conversion therapy': legal and policy perspectives |date=2023 |publisher=Hart |year=2023 |isbn=978-1-5099-6117-7 |editor-last=Trispiotis |editor-first=Ilias |location=Oxford London New York New Delhi Sydney |pages=134 |editor-last2=Purshouse |editor-first2=Craig}}</ref><ref name="ashley_2022_4">{{Cite book |last1=Ashley |first1=Florence |title=Banning Transgender Conversion Practices: A Legal and Policy Analysis |date=2022 |publisher=University of British Columbia Press |isbn=978-0774866958 |location=Vancouver, BC |pages=4–6}}</ref>


==Motivations==
==Motivations==
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As [[societal attitudes toward homosexuality]] have become more tolerant over time, the most harsh conversion therapy methods such as aversion have been reduced. Secular conversion therapy is offered less often due to reduced medical pathologization of homosexuality, and religious practitioners have become more dominant.<ref>{{cite journal |last1=Andrade |first1=G. |last2=Campo Redondo |first2=M. |title=Is conversion therapy ethical? A renewed discussion in the context of legal efforts to ban it |journal=Ethics, Medicine and Public Health |date=2022 |volume=20 |pages=100732 |doi=10.1016/j.jemep.2021.100732 }}</ref>
As [[societal attitudes toward homosexuality]] have become more tolerant over time, the most harsh conversion therapy methods such as aversion have been reduced. Secular conversion therapy is offered less often due to reduced medical pathologization of homosexuality, and religious practitioners have become more dominant.<ref>{{cite journal |last1=Andrade |first1=G. |last2=Campo Redondo |first2=M. |title=Is conversion therapy ethical? A renewed discussion in the context of legal efforts to ban it |journal=Ethics, Medicine and Public Health |date=2022 |volume=20 |pages=100732 |doi=10.1016/j.jemep.2021.100732 }}</ref>


===Aversion therapy and behaviorism===
===Aversion therapy===
{{see also|Behavior modification}}
{{see also|Behavior modification}}


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===Brain surgery===
===Brain surgery===


In the 1940s and 1950s, U.S. neurologist [[Walter Jackson Freeman II|Walter Freeman]] popularized the [[Lobotomy#Transorbital lobotomy|ice-pick lobotomy]] as a treatment for homosexuality. He personally performed as many as 3,439<ref>{{cite news |last1=Day |first1=Elizabeth |title=He was bad, so they put an ice pick in his brain... |url=https://www.theguardian.com/science/2008/jan/13/neuroscience.medicalscience |work=The Observer |date=13 January 2008 }}</ref> lobotomy surgeries in 23 states, of which 2,500 used his ice-pick procedure,<ref>{{cite web|title=Top 10 Fascinating And Notable Lobotomies|url=http://listverse.com/2009/06/24/top-10-fascinating-and-notable-lobotomies/|date=24 June 2009|website=listverse.com|access-date=26 December 2013}}</ref> despite the fact that he had no formal surgical training.<ref name="rowland">{{cite journal|last=Rowland|first=Lewis|date=April 2005|title=Walter Freeman's Psychosurgery and Biological Psychiatry: A Cautionary Tale|journal=Neurology Today|volume=5|issue=4|pages=70–72|doi=10.1097/00132985-200504000-00020}}</ref>
In the 1940s and 1950s, U.S. neurologist [[Walter Jackson Freeman II|Walter Freeman]] popularized the [[Lobotomy#Transorbital lobotomy|ice-pick lobotomy]] as a treatment for homosexuality. He personally performed as many as 3,439<ref>{{cite news |last1=Day |first1=Elizabeth |title=He was bad, so they put an ice pick in his brain... |url=https://www.theguardian.com/science/2008/jan/13/neuroscience.medicalscience |work=The Observer |date=13 January 2008 |access-date=16 November 2017 |archive-date=20 October 2013 |archive-url=https://web.archive.org/web/20131020075415/http://www.theguardian.com/science/2008/jan/13/neuroscience.medicalscience |url-status=live }}</ref> lobotomy surgeries in 23 states, of which 2,500 used his ice-pick procedure,<ref>{{cite web|title=Top 10 Fascinating And Notable Lobotomies|url=http://listverse.com/2009/06/24/top-10-fascinating-and-notable-lobotomies/|date=24 June 2009|website=listverse.com|access-date=26 December 2013|archive-date=27 December 2013|archive-url=https://web.archive.org/web/20131227024430/http://listverse.com/2009/06/24/top-10-fascinating-and-notable-lobotomies/|url-status=live}}</ref> despite the fact that he had no formal surgical training.<ref name="rowland">{{cite journal|last=Rowland|first=Lewis|date=April 2005|title=Walter Freeman's Psychosurgery and Biological Psychiatry: A Cautionary Tale|journal=Neurology Today|volume=5|issue=4|pages=70–72|doi=10.1097/00132985-200504000-00020}}</ref>


In West Germany, a type of brain surgery usually involving destruction of the [[ventromedial nucleus of the hypothalamus]] was done to some homosexual men. The practice was criticized by sexologist [[Volkmar Sigusch]].<ref>{{cite journal |last1=Rieber |first1=Inge |last2=Sigusch |first2=Volkmar |date=1979 |title=Psychosurgery on sex offenders and sexual "deviants" in West Germany |url=https://link.springer.com/article/10.1007/BF01541419 |journal=Archives of Sexual Behavior |language=en |volume=8 |issue=6 |pages=526 |doi=10.1007/BF01541419 |issn=1573-2800 |pmid=391177 |s2cid=41463669}}</ref>
In West Germany, a type of brain surgery usually involving destruction of the [[ventromedial nucleus of the hypothalamus]] was done to some homosexual men during the 1960s and 1970s. The practice was criticized by sexologist [[Volkmar Sigusch]].<ref>{{cite journal |last1=Rieber |first1=Inge |last2=Sigusch |first2=Volkmar |date=1979 |title=Psychosurgery on sex offenders and sexual "deviants" in West Germany |url=https://link.springer.com/article/10.1007/BF01541419 |journal=Archives of Sexual Behavior |language=en |volume=8 |issue=6 |pages=526 |doi=10.1007/BF01541419 |issn=1573-2800 |pmid=391177 |s2cid=41463669 |access-date=20 June 2023 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070658/https://link.springer.com/article/10.1007/BF01541419 |url-status=live }}</ref>


===Castration and transplantation===
===Castration and transplantation===
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{{Main|Ex-gay}}
{{Main|Ex-gay}}


Ex-gay ministries are religious groups that attempt to use religion to eliminate or change somebody's sexual orientation.<ref name="APA">{{citation |url=http://www.apa.org/pi/lgbt/resources/just-the-facts.pdf |title=Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel |access-date=14 May 2010 |year=1999 |publisher=Just the Facts Coalition}}</ref><ref name="DrescherandZucker">{{Harvnb|Drescher|Zucker|2006|pp=126, 175}}</ref><ref>{{Harvnb|Haldeman|1991|pp=149,156–159}}</ref><ref name="JonesandYarhouse">{{Harvnb|Jones|Yarhouse|2007|p=374}}</ref> The ex-gay umbrella organization [[Exodus International]] in the United States ceased activities in June 2013, and the three member board issued a statement which repudiated its aims and apologized for the harm their pursuit has caused to [[LGBT]] people.<ref>{{Cite web |last=Burnett |first=John |date=20 June 2013 |title=Group That Claimed To 'Cure' Gays Disbands, Leader Apologizes |url=https://www.npr.org/2013/06/20/193965227/group-that-claimed-to-cure-gays-disbands-leader-apologizes |website=NPR}}</ref><ref name="Change">{{citation |url=http://exodusinternational.org/2013/06/i-am-sorry |first=Alan |last=Chambers |archive-url=https://web.archive.org/web/20130623013409/http://exodusinternational.org/2013/06/i-am-sorry |archive-date=23 June 2013 |title=I Am Sorry |access-date=22 June 2013 |publisher=Exodus International}}</ref> Ex-trans organizations often overlap and portray being trans as inherently sinful or against God's design, or pathologize gender variance as due to trauma, social contagion, or "[[gender ideology]]."<ref>{{cite journal |last1=Robinson |first1=Christine M. |last2=Spivey |first2=Sue E. |title=Ungodly Genders: Deconstructing Ex-Gay Movement Discourses of 'Transgenderism' in the US |journal=Social Sciences |date=17 June 2019 |volume=8 |issue=6 |pages=191 |doi=10.3390/socsci8060191 |doi-access=free }}</ref><ref>{{cite journal |last1=Jones |first1=Tiffany |last2=Jones |first2=Timothy W. |last3=Power |first3=Jennifer |last4=Pallotta-Chiarolli |first4=Maria |last5=Despott |first5=Nathan |title=Mis-education of Australian Youth: exposure to LGBTQA+ conversion ideology and practises |journal=Sex Education |date=3 September 2022 |volume=22 |issue=5 |pages=595–610 |doi=10.1080/14681811.2021.1978964 |s2cid=241018465 |doi-access=free |hdl=10536/DRO/DU:30156953 |hdl-access=free }}</ref>
Ex-gay ministries are religious groups that attempt to use religion to eliminate or change somebody's sexual orientation.<ref name="APA">{{citation |url=http://www.apa.org/pi/lgbt/resources/just-the-facts.pdf |title=Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel |access-date=14 May 2010 |year=1999 |publisher=Just the Facts Coalition |archive-date=22 April 2018 |archive-url=https://web.archive.org/web/20180422101943/http://www.apa.org/pi/lgbt/resources/just-the-facts.pdf |url-status=live }}</ref><ref name="DrescherandZucker">{{Harvnb|Drescher|Zucker|2006|pp=126, 175}}</ref><ref>{{Harvnb|Haldeman|1991|pp=149,156–159}}</ref><ref name="JonesandYarhouse">{{Harvnb|Jones|Yarhouse|2007|p=374}}</ref> The ex-gay umbrella organization [[Exodus International]] in the United States ceased activities in June 2013, and the three member board issued a statement which repudiated its aims and apologized for the harm their pursuit has caused to [[LGBT]] people.<ref>{{Cite web |last=Burnett |first=John |date=20 June 2013 |title=Group That Claimed To 'Cure' Gays Disbands, Leader Apologizes |url=https://www.npr.org/2013/06/20/193965227/group-that-claimed-to-cure-gays-disbands-leader-apologizes |website=NPR |access-date=27 January 2024 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070613/https://www.npr.org/2013/06/20/193965227/group-that-claimed-to-cure-gays-disbands-leader-apologizes |url-status=live }}</ref><ref name="Change">{{citation |url=http://exodusinternational.org/2013/06/i-am-sorry |first=Alan |last=Chambers |archive-url=https://web.archive.org/web/20130623013409/http://exodusinternational.org/2013/06/i-am-sorry |archive-date=23 June 2013 |title=I Am Sorry |access-date=22 June 2013 |publisher=Exodus International}}</ref> Ex-trans organizations often overlap and portray being trans as inherently sinful or against God's design, or pathologize gender variance as due to trauma, social contagion, or "[[gender ideology]]."<ref>{{cite journal |last1=Robinson |first1=Christine M. |last2=Spivey |first2=Sue E. |title=Ungodly Genders: Deconstructing Ex-Gay Movement Discourses of 'Transgenderism' in the US |journal=Social Sciences |date=17 June 2019 |volume=8 |issue=6 |pages=191 |doi=10.3390/socsci8060191 |doi-access=free }}</ref><ref>{{cite journal |last1=Jones |first1=Tiffany |last2=Jones |first2=Timothy W. |last3=Power |first3=Jennifer |last4=Pallotta-Chiarolli |first4=Maria |last5=Despott |first5=Nathan |title=Mis-education of Australian Youth: exposure to LGBTQA+ conversion ideology and practises |journal=Sex Education |date=3 September 2022 |volume=22 |issue=5 |pages=595–610 |doi=10.1080/14681811.2021.1978964 |s2cid=241018465 |doi-access=free |hdl=10536/DRO/DU:30156953 |hdl-access=free }}</ref>


=== Hypnosis ===
=== Hypnosis ===
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===Reparative therapy===
===Reparative therapy===


The term "reparative therapy" has been used as a synonym for conversion therapy generally, but according to [[Jack Drescher]] it properly refers to a specific kind of therapy{{clarify|date=July 2022}} associated with the psychologists [[Elizabeth Moberly]] and [[Joseph Nicolosi]].<ref name="Drescher1998">{{Harvnb|Drescher|2000|p=152}}</ref> After California banned conversion practices, Nicolosi argued that "reparative therapy" didn't attempt to directly change sexual orientation but instead encourage exploration into its underlying causes, which he believed was often childhood trauma.<ref name="ashley_202209" /> The term ''reparative'' refers to Nicolosi's postulate that same-sex attraction is a person's unconscious attempt to "self-repair" feelings of inferiority.<ref name="Hicks_1999">{{cite journal |last1=Hicks |first1=Karolyn A. |title='Reparative' Therapy: Whether Parental Attempts to Change a Child's Sexual Orientation Can Legally Constitute Child Abuse |journal=American University Law Review |volume=49 |issue=2 |date=December 1999 |pages=505–547 |url=https://digitalcommons.wcl.american.edu/aulr/vol49/iss2/4/ }}</ref><ref name="Bright">{{Harvnb|Bright|2004|pp=471–481}}</ref>
The term "reparative therapy" has been used as a synonym for conversion therapy generally, but according to [[Jack Drescher]] it properly refers to a specific kind of therapy{{clarify|date=July 2022}} associated with the psychologists [[Elizabeth Moberly]] and [[Joseph Nicolosi]].<ref name="Drescher1998">{{Harvnb|Drescher|2000|p=152}}</ref>
For example, he wrote:
:. . . the pursuit of fulfillment through same-sex eroticism is spurred by the fearful anticipation that their masculine self-assertion will inevitably fail and result in humiliation.<ref>{{cite web |last=Nicolosi |first=Joseph |title=The Traumatic Foundation of Male Homosexuality|
url=https://crisismagazine.com/opinion/traumatic-foundation-male-homosexuality}}</ref>
The term ''reparative'' refers to Nicolosi's postulate that same-sex attraction is a person's unconscious attempt to "self-repair" feelings of inferiority.<ref name="Hicks_1999">{{cite journal |last1=Hicks |first1=Karolyn A. |title='Reparative' Therapy: Whether Parental Attempts to Change a Child's Sexual Orientation Can Legally Constitute Child Abuse |journal=American University Law Review |volume=49 |issue=2 |date=December 1999 |pages=505–547 |url=https://digitalcommons.wcl.american.edu/aulr/vol49/iss2/4/ |access-date=10 June 2023 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070611/https://digitalcommons.wcl.american.edu/aulr/vol49/iss2/4/ |url-status=live }}</ref><ref name="Bright">{{Harvnb|Bright|2004|pp=471–481}}</ref>

After California banned conversion practices, Nicolosi argued that "reparative therapy" didn't attempt to directly change sexual orientation but instead encourage exploration into its underlying causes, which he believed was often childhood trauma.<ref name="ashley_202209" />


===Marriage therapy===
===Marriage therapy===
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=== Gender exploratory therapy ===
=== Gender exploratory therapy ===
Gender exploratory therapy (GET) is a form of conversion therapy<ref name="WPATH-NHS">{{Cite web |date=November 25, 2022 |title=WPATH, ASIAPATH, EPATH, PATHA, and USPATH Response to NHS England in the United Kingdom (UK) |url=https://www.wpath.org/media/cms/Documents/Public%20Policies/2022/25.11.22%20AUSPATH%20Statement%20reworked%20for%20WPATH%20Final%20ASIAPATH.EPATH.PATHA.USPATH.pdf?_t=1669428978 |website=[[WPATH]]}}</ref><ref name="Bharat">{{Cite journal |last1=Bharat |first1=Bharat |last2=Dopp |first2=Alex |last3=Last |first3=Briana |last4=Howell |first4=Gary |last5=Nadeem |first5=Erum |last6=Johnson |first6=Clara |last7=Stirman |first7=Shannon Wiltsey |title=OSF |url=https://osf.io/gz5mk/ |journal=The Behavior Therapist |publisher=Association for Behavioral and Cognitive Therapies |publication-date=October 2023 |volume=46 |issue=7 |doi=10.31234/osf.io/gz5mk}}</ref><ref name="Lawson">{{Cite journal |last1=Lawson |first1=Zazie |last2=Davies |first2=Skye |last3=Harmon |first3=Shae |last4=Williams |first4=Matthew |last5=Billawa |first5=Shradha |last6=Holmes |first6=Ryan |last7=Huckridge |first7=Jaymie |last8=Kelly |first8=Phillip |last9=MacIntyre-Harrison |first9=Jess |last10=Neill |first10=Stewart |last11=Song-Chase |first11=Angela |last12=Ward |first12=Hannah |last13=Yates |first13=Michael |date=October 2023 |title=A human rights based approach to transgender and gender expansive health |url=https://explore.bps.org.uk/lookup/doi/10.53841/bpscpf.2023.1.369.91 |journal=Clinical Psychology Forum |language=en |volume=1 |issue=369 |pages=91–106 |doi=10.53841/bpscpf.2023.1.369.91 |issn=1747-5732 |s2cid=265086908}}</ref><ref name="Amery">{{Cite journal |last=Amery |first=Fran |date=2023-12-11 |title=Protecting Children in 'Gender Critical' Rhetoric and Strategy: Regulating Childhood for Cisgender Outcomes |url=https://www.digest.ugent.be/article/id/85309/ |journal=DiGeSt - Journal of Diversity and Gender Studies |volume=10 |issue=2 |doi=10.21825/digest.85309 |issn=2593-0281 |doi-access=free}}</ref><ref name="Caraballo">{{Cite journal |last=Caraballo |first=Alejandra |date=December 2022 |title=The Anti-Transgender Medical Expert Industry |url=https://www.cambridge.org/core/journals/journal-of-law-medicine-and-ethics/article/antitransgender-medical-expert-industry/25EFFECB8F71CA9A37F9F089E13BC41E |journal=Journal of Law, Medicine & Ethics |language=en |volume=50 |issue=4 |pages=687–692 |doi=10.1017/jme.2023.9 |issn=1073-1105 |pmid=36883410}}</ref> characterized by requiring mandatory extended talk therapy attempting to find pathological roots for gender dysphoria while simultaneously delaying social and medical transition and viewing it as a last resort.<ref name="WPATH-NHS" /><ref name="Lawson" /><ref name="Amery" /><ref name="ashley_202209">{{Cite journal |last=Ashley |first=Florence |date=6 September 2022 |title=Interrogating Gender-Exploratory Therapy |journal=Perspectives on Psychological Science |volume=18 |issue=2 |pages=472–481 |doi=10.1177/17456916221102325 |pmc=10018052 |pmid=36068009 |s2cid=252108965}}</ref><ref name="MacKinnon">{{Cite journal |last1=MacKinnon |first1=Kinnon R. |last2=Gould |first2=Wren Ariel |last3=Enxuga |first3=Gabriel |last4=Kia |first4=Hannah |last5=Abramovich |first5=Alex |last6=Lam |first6=June S. H. |last7=Ross |first7=Lori E. |date=2023-11-29 |title=Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada |journal=PLOS ONE |language=en |volume=18 |issue=11 |pages=e0293868 |bibcode=2023PLoSO..1893868M |doi=10.1371/journal.pone.0293868 |issn=1932-6203 |pmc=10686467 |pmid=38019738 |doi-access=free}}</ref> Practitioners of GET often view medical transition as a last resort and propose their patient's dysphoria is caused by factors such as homophobia, social contagion, sexual trauma, and autism.<ref name="Lawson" /><ref name="Caraballo" /> Some practitioners of GET avoid using their patients' chosen names and pronouns while questioning their identification.<ref name="MacKinnon" /> Commenting on gender exploratory therapy in 2022, bioethicist [[Florence Ashley]] argued that its framing as an undirected exploration of underlying psychological issues bore similarities to gay conversion practices such as "[[Conversion therapy#Reparative therapy|reparative]]" therapy.<ref name="ashley_202209" /> States that have banned gender-affirming care for minors in the United States have called expert witnesses to argue that exploratory therapy should be the alternative treatment.<ref name="Pauly">{{Cite news |last=Pauly |first=Madison |last2=Carnell |first2=Henry |date=July 2024 |title=First they tried to "cure" gayness. Now they're fixated on "healing" trans people. |url=https://www.motherjones.com/politics/2024/05/conversion-therapy-lgbtq-anti-trans-gay-gender-affirming-care/ |access-date=2024-06-05 |work=Mother Jones |language=en-US}}</ref>
Gender exploratory therapy (GET) is a form of conversion therapy<ref name="WPATH-NHS">{{Cite web |date=November 25, 2022 |title=WPATH, ASIAPATH, EPATH, PATHA, and USPATH Response to NHS England in the United Kingdom (UK) |url=https://www.wpath.org/media/cms/Documents/Public%20Policies/2022/25.11.22%20AUSPATH%20Statement%20reworked%20for%20WPATH%20Final%20ASIAPATH.EPATH.PATHA.USPATH.pdf?_t=1669428978 |website=[[WPATH]] |access-date=2 January 2024 |archive-date=30 November 2022 |archive-url=https://web.archive.org/web/20221130183416/https://www.wpath.org/media/cms/Documents/Public%20Policies/2022/25.11.22%20AUSPATH%20Statement%20reworked%20for%20WPATH%20Final%20ASIAPATH.EPATH.PATHA.USPATH.pdf?_t=1669428978 |url-status=live }}</ref><ref name="Bharat">{{Cite journal |last1=Bharat |first1=Bharat |last2=Dopp |first2=Alex |last3=Last |first3=Briana |last4=Howell |first4=Gary |last5=Nadeem |first5=Erum |last6=Johnson |first6=Clara |last7=Stirman |first7=Shannon Wiltsey |title=OSF |url=https://osf.io/gz5mk/ |journal=The Behavior Therapist |publisher=Association for Behavioral and Cognitive Therapies |publication-date=October 2023 |volume=46 |issue=7 |doi=10.31234/osf.io/gz5mk |access-date=1 January 2024 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070611/https://osf.io/gz5mk/ |url-status=live }}</ref><ref name="Lawson">{{Cite journal |last1=Lawson |first1=Zazie |last2=Davies |first2=Skye |last3=Harmon |first3=Shae |last4=Williams |first4=Matthew |last5=Billawa |first5=Shradha |last6=Holmes |first6=Ryan |last7=Huckridge |first7=Jaymie |last8=Kelly |first8=Phillip |last9=MacIntyre-Harrison |first9=Jess |last10=Neill |first10=Stewart |last11=Song-Chase |first11=Angela |last12=Ward |first12=Hannah |last13=Yates |first13=Michael |date=October 2023 |title=A human rights based approach to transgender and gender expansive health |url=https://explore.bps.org.uk/lookup/doi/10.53841/bpscpf.2023.1.369.91 |journal=Clinical Psychology Forum |language=en |volume=1 |issue=369 |pages=91–106 |doi=10.53841/bpscpf.2023.1.369.91 |issn=1747-5732 |s2cid=265086908 |access-date=1 January 2024 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070719/https://explore.bps.org.uk/content/bpscpf/1/369/91 |url-status=live }}</ref><ref name="Amery">{{Cite journal |last=Amery |first=Fran |date=2023-12-11 |title=Protecting Children in 'Gender Critical' Rhetoric and Strategy: Regulating Childhood for Cisgender Outcomes |url=https://www.digest.ugent.be/article/id/85309/ |journal=DiGeSt - Journal of Diversity and Gender Studies |volume=10 |issue=2 |doi=10.21825/digest.85309 |issn=2593-0281 |doi-access=free |access-date=1 January 2024 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070616/https://www.digest.ugent.be/article/id/85309/ |url-status=live }}</ref><ref name="Caraballo">{{Cite journal |last=Caraballo |first=Alejandra |date=December 2022 |title=The Anti-Transgender Medical Expert Industry |url=https://www.cambridge.org/core/journals/journal-of-law-medicine-and-ethics/article/antitransgender-medical-expert-industry/25EFFECB8F71CA9A37F9F089E13BC41E |journal=Journal of Law, Medicine & Ethics |language=en |volume=50 |issue=4 |pages=687–692 |doi=10.1017/jme.2023.9 |issn=1073-1105 |pmid=36883410 |access-date=1 January 2024 |archive-date=1 March 2024 |archive-url=https://web.archive.org/web/20240301135428/https://www.cambridge.org/core/journals/journal-of-law-medicine-and-ethics/article/antitransgender-medical-expert-industry/25EFFECB8F71CA9A37F9F089E13BC41E |url-status=live }}</ref> characterized by requiring mandatory extended talk therapy attempting to find pathological roots for gender dysphoria while simultaneously delaying social and medical transition and viewing it as a last resort.<ref name="WPATH-NHS" /><ref name="Lawson" /><ref name="Amery" /><ref name="ashley_202209">{{Cite journal |last=Ashley |first=Florence |date=6 September 2022 |title=Interrogating Gender-Exploratory Therapy |journal=Perspectives on Psychological Science |volume=18 |issue=2 |pages=472–481 |doi=10.1177/17456916221102325 |pmc=10018052 |pmid=36068009 |s2cid=252108965}}</ref><ref name="MacKinnon">{{Cite journal |last1=MacKinnon |first1=Kinnon R. |last2=Gould |first2=Wren Ariel |last3=Enxuga |first3=Gabriel |last4=Kia |first4=Hannah |last5=Abramovich |first5=Alex |last6=Lam |first6=June S. H. |last7=Ross |first7=Lori E. |date=2023-11-29 |title=Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada |journal=PLOS ONE |language=en |volume=18 |issue=11 |pages=e0293868 |bibcode=2023PLoSO..1893868M |doi=10.1371/journal.pone.0293868 |issn=1932-6203 |pmc=10686467 |pmid=38019738 |doi-access=free}}</ref> Practitioners of GET often view medical transition as a last resort and propose their patient's dysphoria is caused by factors such as homophobia, social contagion, sexual trauma, and autism.<ref name="Lawson" /><ref name="Caraballo" /> Some practitioners of GET avoid using their patients' chosen names and pronouns while questioning their identification.<ref name="MacKinnon" /> Commenting on gender exploratory therapy in 2022, bioethicist [[Florence Ashley]] argued that its framing as an undirected exploration of underlying psychological issues bore similarities to gay conversion practices such as "[[Conversion therapy#Reparative therapy|reparative]]" therapy.<ref name="ashley_202209" /> States that have banned gender-affirming care for minors in the United States have called expert witnesses to argue that exploratory therapy should be the alternative treatment.<ref name="Pauly">{{Cite news |last=Pauly |first=Madison |last2=Carnell |first2=Henry |date=July 2024 |title=First they tried to "cure" gayness. Now they're fixated on "healing" trans people. |url=https://www.motherjones.com/politics/2024/05/conversion-therapy-lgbtq-anti-trans-gay-gender-affirming-care/ |access-date=2024-06-05 |work=Mother Jones |language=en-US}}</ref>


There are no known empirical studies examining psychosocial or medical outcomes following GET.<ref name="MacKinnon" /><ref name="Leising">{{Cite journal |last=Leising |first=Julie |date=September 2022 |title=Gender-affirming care for youth—separating evidence from controversy |url=https://bcmj.org/sites/default/files/BCMJ_Vol64_No7-premise-corrected%20%28ID%202375120%29.pdf |journal=Bc Medic al Journal |volume=64 |issue=7}}</ref> Concerns have been raised that by not providing an estimated length of time for the therapy, the delays in medical interventions may compound mental suffering in trans youth,<ref name="Lawson" /><ref name="MacKinnon" /> while [[gender-affirming care|gender-affirming model of care]] already promotes gender identity exploration without favoring any particular identity, and individualized care.<ref name="MacKinnon" /> GET proponents deny this.<ref name="Santoro">{{Cite news |last=Santoro |first=Helen |date=2023-05-02 |title=How Therapists Are Trying to Convince Children That They're Not Actually Trans |url=https://slate.com/technology/2023/05/gender-exploratory-therapy-trans-kids-what-is-it.html |access-date=2024-01-01 |work=Slate |language=en-US |issn=1091-2339}}</ref>
There are no known empirical studies examining psychosocial or medical outcomes following GET.<ref name="MacKinnon" /><ref name="Leising">{{Cite journal |last=Leising |first=Julie |date=September 2022 |title=Gender-affirming care for youth—separating evidence from controversy |url=https://bcmj.org/sites/default/files/BCMJ_Vol64_No7-premise-corrected%20%28ID%202375120%29.pdf |journal=Bc Medic al Journal |volume=64 |issue=7}}</ref> Concerns have been raised that by not providing an estimated length of time for the therapy, the delays in medical interventions may compound mental suffering in trans youth,<ref name="Lawson" /><ref name="MacKinnon" /> while [[gender-affirming care|gender-affirming model of care]] already promotes gender identity exploration without favoring any particular identity, and individualized care.<ref name="MacKinnon" /> GET proponents deny this.<ref name="Santoro">{{Cite news |last=Santoro |first=Helen |date=2023-05-02 |title=How Therapists Are Trying to Convince Children That They're Not Actually Trans |url=https://slate.com/technology/2023/05/gender-exploratory-therapy-trans-kids-what-is-it.html |access-date=2024-01-01 |work=Slate |language=en-US |issn=1091-2339 |archive-date=21 January 2024 |archive-url=https://web.archive.org/web/20240121062936/https://slate.com/technology/2023/05/gender-exploratory-therapy-trans-kids-what-is-it.html |url-status=live }}</ref>


Multiple groups exist worldwide to promote GET and have been successful in influencing legal discussions and clinical guidance in some regions.<ref name="Amery" /> The Gender Exploratory Therapy Association (GETA) asserts that "psychological approaches should be the first-line treatment for all cases of gender dysphoria", that medical interventions for transgender youth are "experimental and should be avoided if possible", and that [[social transitioning|social transition]] is "risky".<ref name="Santoro" /> All of GETA's leaders are members of [[Genspect]], a "[[gender-critical]]" group that promotes GET and argues that gender-affirming care should not be available to those under 25.<ref name="Santoro" /> In late 2023, GETA changed their name to "Therapy First".<ref name="Pauly" />
Multiple groups exist worldwide to promote GET and have been successful in influencing legal discussions and clinical guidance in some regions.<ref name="Amery" /> The [[Gender Exploratory Therapy Association]] (GETA) asserts that "psychological approaches should be the first-line treatment for all cases of gender dysphoria", that medical interventions for transgender youth are "experimental and should be avoided if possible", and that [[social transitioning|social transition]] is "risky".<ref name="Santoro" /> All of GETA's leaders are members of [[Genspect]], a "[[gender-critical]]" group that promotes GET and argues that gender-affirming care should not be available to those under 25.<ref name="Santoro" /> In late 2023, GETA changed their name to "Therapy First".<ref name="Pauly" />


GETA also shares a large overlap with the [[Society for Evidence-Based Gender Medicine]] (SEGM), which promotes GET as first-line treatment for those under 25.<ref name="splc-defining-pseudoscience">{{Cite web |title=Group dynamics and division of labor within the anti-LGBTQ+ pseudoscience network |url=https://www.splcenter.org/captain/defining-pseudoscience-network |access-date=2024-01-01 |website=Southern Poverty Law Center |language=en}}</ref> GETA co-founder Lisa Marchiano stated U.S. President Joe Biden's executive order safeguarding trans youth from conversion therapy would have a "chilling effect" on GET practices.<ref name="Santoro" /><ref name="Reed">{{Cite news |last=Reed |first=Erin |date=2023-01-13 |title=Unpacking 'gender exploratory therapy,' a new form of conversion therapy |url=https://xtramagazine.com/health/gender-exploratory-therapy-243833 |access-date=2024-01-01 |work=Xtra Magazine |language=en-CA}}</ref> GETA also opposed Biden's Title IX changes protecting trans students from discrimination, stating allowing trans youth in restrooms would harm the mental health of their peers.<ref name="Reed" /> The [[American College of Pediatricians]], a small group aligned with the Christian Right and not to be confused with the [[American Academy of Pediatrics]], has cited numerous studies from SEGM to claim GET is necessary to restore transgender people's "biological integrity".<ref name="splc-defining-pseudoscience" /> In November 2023, Michelle Cretella, a board member of the pro conversion therapy group [[Alliance for Therapeutic Choice and Scientific Integrity]] (ATCSI, formerly NARTH), gave a speech at an ATCSI conference which endorsed GET and argued it "truly is very similar to how the Alliance has always approached unwanted same-sex attraction".<ref name="Pauly" />
GETA also shares a large overlap with the [[Society for Evidence-Based Gender Medicine]] (SEGM), which promotes GET as first-line treatment for those under 25.<ref name="splc-defining-pseudoscience">{{Cite web |title=Group dynamics and division of labor within the anti-LGBTQ+ pseudoscience network |url=https://www.splcenter.org/captain/defining-pseudoscience-network |access-date=2024-01-01 |website=Southern Poverty Law Center |language=en}}</ref> GETA co-founder Lisa Marchiano stated U.S. President Joe Biden's executive order safeguarding trans youth from conversion therapy would have a "chilling effect" on GET practices.<ref name="Santoro" /><ref name="Reed">{{Cite news |last=Reed |first=Erin |date=2023-01-13 |title=Unpacking 'gender exploratory therapy,' a new form of conversion therapy |url=https://xtramagazine.com/health/gender-exploratory-therapy-243833 |access-date=2024-01-01 |work=Xtra Magazine |language=en-CA}}</ref> GETA also opposed Biden's Title IX changes protecting trans students from discrimination, stating allowing trans youth in restrooms would harm the mental health of their peers.<ref name="Reed" /> The [[American College of Pediatricians]], a small group aligned with the Christian Right,<ref group="Note">not to be confused with the [[American Academy of Pediatrics]]</ref> has cited numerous studies from SEGM to claim GET is necessary to restore transgender people's "biological integrity".<ref name="splc-defining-pseudoscience" /> In November 2023, Michelle Cretella, a board member of the pro conversion therapy group [[Alliance for Therapeutic Choice and Scientific Integrity]] (ATCSI, formerly NARTH), gave a speech at an ATCSI conference which endorsed GET and argued it "truly is very similar to how the Alliance has always approached unwanted same-sex attraction".<ref name="Pauly" />


==Effects==
==Effects==
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There is a scientific consensus that conversion therapy is ineffective at changing a person's sexual orientation.<ref name=":0"/> Advocates of conversion therapy rely heavily on testimonials and retrospective self-reports as evidence of effectiveness. Studies purporting to validate the effectiveness of efforts to change sexual orientation or gender identity have been criticized for methodological flaws.{{sfn|Haldeman|2022|p=7}} After conversion therapy has failed to change someone's sexual orientation or gender identity, participants often feel increased shame that they already felt over their sexual orientation or gender identity.{{sfn|Haldeman|2022|p=9}}
There is a scientific consensus that conversion therapy is ineffective at changing a person's sexual orientation.<ref name=":0"/> Advocates of conversion therapy rely heavily on testimonials and retrospective self-reports as evidence of effectiveness. Studies purporting to validate the effectiveness of efforts to change sexual orientation or gender identity have been criticized for methodological flaws.{{sfn|Haldeman|2022|p=7}} After conversion therapy has failed to change someone's sexual orientation or gender identity, participants often feel increased shame that they already felt over their sexual orientation or gender identity.{{sfn|Haldeman|2022|p=9}}


Conversion therapy can cause significant, long-term psychological harm.<ref name=":0">{{cite journal |last1=Higbee |first1=Madison |last2=Wright |first2=Eric R. |last3=Roemerman |first3=Ryan M. |title=Conversion Therapy in the Southern United States: Prevalence and Experiences of the Survivors |journal=Journal of Homosexuality |date=2022 |volume=69 |issue=4 |pages=612–631 |doi=10.1080/00918369.2020.1840213|pmid=33206024 |s2cid=227039714 }}</ref> This includes significantly higher rates of [[Major depressive disorder|depression]], [[substance abuse]], and other mental health issues in individuals who have undergone conversion therapy than their peers who did not,<ref>{{Cite web |last=Christensen |first=Jen |date=2022-03-08 |title=Conversion therapy is harmful to LGBTQ people and costs society as a whole, study says |url=https://www.cnn.com/2022/03/07/health/conversion-therapy-personal-and-financial-harm/index.html |access-date=2022-11-05 |website=CNN |language=en}}</ref><ref name=":1" /> including a suicide attempt rate nearly twice that of those who did not.<ref>{{Cite web |last=thisisloyal.com |first=Loyal {{!}} |title=LGB people who have undergone conversion therapy almost twice as likely to attempt suicide |url=https://williamsinstitute.law.ucla.edu/press/lgb-suicide-ct-press-release/ |access-date=2022-11-05 |website=Williams Institute |language=en-US}}</ref> Modern-day practitioners of conversion therapy—primarily from a conservative religious viewpoint—disagree with current [[evidence-based medicine]] and clinical guidance that does not view [[homosexuality]] and [[gender variance]] as unnatural or unhealthy.<ref name=":0" />{{sfn|Haldeman|2022|p=5}}
Conversion therapy can cause significant, long-term psychological harm.<ref name=":0">{{cite journal |last1=Higbee |first1=Madison |last2=Wright |first2=Eric R. |last3=Roemerman |first3=Ryan M. |title=Conversion Therapy in the Southern United States: Prevalence and Experiences of the Survivors |journal=Journal of Homosexuality |date=2022 |volume=69 |issue=4 |pages=612–631 |doi=10.1080/00918369.2020.1840213|pmid=33206024 |s2cid=227039714 }}</ref> This includes significantly higher rates of [[Major depressive disorder|depression]], [[substance abuse]], and other mental health issues in individuals who have undergone conversion therapy than their peers who did not,<ref>{{Cite web |last=Christensen |first=Jen |date=2022-03-08 |title=Conversion therapy is harmful to LGBTQ people and costs society as a whole, study says |url=https://www.cnn.com/2022/03/07/health/conversion-therapy-personal-and-financial-harm/index.html |access-date=2022-11-05 |website=CNN |language=en |archive-date=1 December 2022 |archive-url=https://web.archive.org/web/20221201070406/https://www.cnn.com/2022/03/07/health/conversion-therapy-personal-and-financial-harm/index.html |url-status=live }}</ref><ref name=":1" /> including a suicide attempt rate nearly twice that of those who did not.<ref>{{Cite web |last=thisisloyal.com |first=Loyal {{!}} |title=LGB people who have undergone conversion therapy almost twice as likely to attempt suicide |url=https://williamsinstitute.law.ucla.edu/press/lgb-suicide-ct-press-release/ |access-date=2022-11-05 |website=Williams Institute |language=en-US}}</ref> Modern-day practitioners of conversion therapy—primarily from a conservative religious viewpoint—disagree with current [[evidence-based medicine]] and clinical guidance that does not view [[homosexuality]] and [[gender variance]] as unnatural or unhealthy.<ref name=":0" />{{sfn|Haldeman|2022|p=5}}


In 2020, [[ILGA|ILGA world]] published a world survey and report ''Curbin Deception'' listing consequences and life-threatening effects by associating specific public testimonies with different types of methods used to practice conversion therapies.<ref>{{Cite journal |last=Craig |first=Elaine |date=2021 |title=The Legal Regulation of Sadomasochism and the So-Called 'Rough Sex Defence' |url=http://dx.doi.org/10.2139/ssrn.4082097 |journal=SSRN Electronic Journal |doi=10.2139/ssrn.4082097 |s2cid=248256272 |issn=1556-5068}}</ref>
In 2020, [[ILGA|ILGA World]] published a world survey and report ''[[ILGA#Curbing Deception|Curbing Deception]]'' listing consequences and life-threatening effects by associating specific public testimonies with different types of methods used to practice conversion therapies.<ref>{{Cite web|url=https://ilga.org/resources/conversion-therapy-global-research-ilga-world-curbing-deception-february-2020/|title=Curbing deception A world survey of legal restrictions of so-called 'conversion therapies'|first=Lucas Ramón |last=Mendos|website=ILGA World}}</ref>


A 2022 study estimated that conversion therapy of youth in the United States cost $650.16 million annually with an additional $9.5 billion in associated costs such as increased suicide and substance abuse.<ref name=":1">{{cite journal |last1=Forsythe |first1=Anna |last2=Pick |first2=Casey |last3=Tremblay |first3=Gabriel |last4=Malaviya |first4=Shreena |last5=Green |first5=Amy |last6=Sandman |first6=Karen |title=Humanistic and Economic Burden of Conversion Therapy Among LGBTQ Youths in the United States |journal=JAMA Pediatrics |date=2022 |volume=176 |issue=5 |pages=493–501 |doi=10.1001/jamapediatrics.2022.0042|pmid=35254391 |pmc=8902682 |s2cid=247252995 }}</ref> Youth who undergo conversion therapy from a religious provider have more negative mental health outcomes than those who had consulted a licensed healthcare provider.{{sfn|Haldeman|2022|p=9}}
A 2022 study estimated that conversion therapy of youth in the United States cost $650.16 million annually with an additional $9.5 billion in associated costs such as increased suicide and substance abuse.<ref name=":1">{{cite journal |last1=Forsythe |first1=Anna |last2=Pick |first2=Casey |last3=Tremblay |first3=Gabriel |last4=Malaviya |first4=Shreena |last5=Green |first5=Amy |last6=Sandman |first6=Karen |title=Humanistic and Economic Burden of Conversion Therapy Among LGBTQ Youths in the United States |journal=JAMA Pediatrics |date=2022 |volume=176 |issue=5 |pages=493–501 |doi=10.1001/jamapediatrics.2022.0042|pmid=35254391 |pmc=8902682 |s2cid=247252995 }}</ref> Youth who undergo conversion therapy from a religious provider have more negative mental health outcomes than those who had consulted a licensed healthcare provider.{{sfn|Haldeman|2022|p=9}}
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A 2020 survey carried out on US adults found majority support for banning conversion therapy for minors.<ref>{{cite journal |last1=Flores |first1=Andrew R. |last2=Mallory |first2=Christy |last3=Conron |first3=Kerith J. |title=Public attitudes about emergent issues in LGBTQ rights: Conversion therapy and religious refusals |journal=Research & Politics |date=2020 |volume=7 |issue=4 |pages=205316802096687 |doi=10.1177/2053168020966874|s2cid=229001894 |doi-access=free }}</ref>
A 2020 survey carried out on US adults found majority support for banning conversion therapy for minors.<ref>{{cite journal |last1=Flores |first1=Andrew R. |last2=Mallory |first2=Christy |last3=Conron |first3=Kerith J. |title=Public attitudes about emergent issues in LGBTQ rights: Conversion therapy and religious refusals |journal=Research & Politics |date=2020 |volume=7 |issue=4 |pages=205316802096687 |doi=10.1177/2053168020966874|s2cid=229001894 |doi-access=free }}</ref>


A 2022 [[YouGov]] poll found majority support in England, Scotland, and Wales for a conversion therapy ban for both sexual orientation and gender identity, with opposition ranging from 13 to 15 percent.<ref>{{cite web |title=The majority of Welsh people support a ban on trans conversion therapy in Wales {{!}} YouGov |url=https://yougov.co.uk/topics/politics/articles-reports/2022/05/03/majority-welsh-people-support-ban-trans-conversion |website=yougov.co.uk |access-date=30 June 2022 |language=en-gb}}</ref>
A 2022 [[YouGov]] poll found majority support in England, Scotland, and Wales for a conversion therapy ban for both sexual orientation and gender identity, with opposition ranging from 13 to 15 percent.<ref>{{cite web |last=Kirk |first=Isabelle |date=3 May 2022 |title=The majority of Welsh people support a ban on trans conversion therapy in Wales |url=https://yougov.co.uk/topics/politics/articles-reports/2022/05/03/majority-welsh-people-support-ban-trans-conversion |access-date=30 June 2022 |website=[[YouGov]] |language=en-gb |archive-date=30 June 2022 |archive-url=https://web.archive.org/web/20220630035322/https://yougov.co.uk/topics/politics/articles-reports/2022/05/03/majority-welsh-people-support-ban-trans-conversion |url-status=live }}</ref>


==Legal status==
==Legal status==
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{{legend|Navy|Criminal prohibition against conversion therapy on the basis of sexual orientation and gender identity}}
{{legend|Navy|Criminal prohibition against conversion therapy on the basis of sexual orientation and gender identity}}
{{legend|#0000ff|Only medical professionals are banned from performing conversion therapy}}
{{legend|#0000ff|Only medical professionals are banned from performing conversion therapy}}
{{legend|Gold|Ban on conversion therapy pending or proposed}}
{{legend|LightGrey|No ban on conversion therapy}}]]
{{legend|LightGrey|No ban on conversion therapy}}]]
Some jurisdictions have criminal bans on the practice of conversion therapy, including Canada, Ecuador, France,<ref>{{Cite web |title=France Passed Law To Protect LGBTQ People From "Conversion Therapy" |url=https://lqioo.com/europe-news/france-passed-law-to-protect-lgbtq-people-from-conversion-therapy |access-date=2023-02-24 |website=LQIOO |date=3 February 2022 |language=en-US}}</ref> Germany, Malta, Mexico and Spain.<ref>{{Cite web |last=Branch |first=Legislative Services |date=2022-01-10 |title=Consolidated federal laws of canada, An Act to amend the Criminal Code (conversion therapy) |url=https://laws.justice.gc.ca/eng/annualstatutes/2021_24/page-1.html |access-date=2022-07-06 |website=laws.justice.gc.ca}}</ref> In other countries, including Albania, Brazil, Chile, Vietnam and Taiwan, medical professionals are barred from practicing conversion therapy.<ref name=Trispiotis/>
Some jurisdictions have criminal bans on the practice of conversion therapy, including Canada, Ecuador, France,<ref>{{Cite web |date=3 February 2022 |title=France Passed Law To Protect LGBTQ People From 'Conversion Therapy' |url=https://lqioo.com/europe-news/france-passed-law-to-protect-lgbtq-people-from-conversion-therapy |access-date=2023-02-24 |website=LQIOO |language=en-US}}</ref> Germany, Malta, Mexico and Spain.<ref>{{Cite web |last=Legislative Services Branch |date=2022-01-10 |title=Consolidated federal laws of canada, An Act to amend the Criminal Code (conversion therapy) |url=https://laws.justice.gc.ca/eng/annualstatutes/2021_24/page-1.html |access-date=2022-07-06 |website=laws.justice.gc.ca |archive-date=11 February 2023 |archive-url=https://web.archive.org/web/20230211034855/https://laws.justice.gc.ca/eng/annualstatutes/2021_24/page-1.html |url-status=live }}</ref> In other countries, including Albania, Brazil, Chile, Vietnam and Taiwan, medical professionals are barred from practicing conversion therapy.<ref name=Trispiotis/>


In some states, lawsuits against conversion therapy providers for [[fraud]] have succeeded, but in other jurisdictions those claiming fraud must prove that the perpetrator was intentionally dishonest. Thus, a provider who genuinely believes conversion therapy is effective could not be convicted.<ref>{{cite journal |last1=Purshouse |first1=Craig |last2=Trispiotis |first2=Ilias |title=Is 'conversion therapy' tortious? |journal=Legal Studies |date=2022 |volume=42 |issue=1 |pages=23–41 |doi=10.1017/lst.2021.28 |s2cid=236227920 |doi-access=free }}</ref>
In some states, lawsuits against conversion therapy providers for [[fraud]] have succeeded, but in other jurisdictions those claiming fraud must prove that the perpetrator was intentionally dishonest. Thus, a provider who genuinely believes conversion therapy is effective could not be convicted.<ref>{{cite journal |last1=Purshouse |first1=Craig |last2=Trispiotis |first2=Ilias |title=Is 'conversion therapy' tortious? |journal=Legal Studies |date=2022 |volume=42 |issue=1 |pages=23–41 |doi=10.1017/lst.2021.28 |s2cid=236227920 |doi-access=free }}</ref>


Conversion therapy on minors may amount to [[child abuse]].<ref name=irct/><ref>{{cite journal |last1=Canady |first1=Valerie |title=New report calls for an end to 'conversion therapy' for youth |journal=The Brown University Child and Adolescent Behavior Letter |date=2015 |volume=31 |issue=12 |pages=3–4 |doi=10.1002/cbl.30088}}</ref><ref>{{cite journal |last1=Lee |first1=Cory |title=A Failed Experiment: Conversion Therapy as Child Abuse |journal=Roger Williams University Law Review |date=2022 |volume=27 |issue=1 |url=https://docs.rwu.edu/rwu_LR/vol27/iss1/3/ }}</ref>
Conversion therapy on minors may amount to [[child abuse]].<ref name=irct/><ref>{{cite journal |last1=Canady |first1=Valerie |title=New report calls for an end to 'conversion therapy' for youth |journal=The Brown University Child and Adolescent Behavior Letter |date=2015 |volume=31 |issue=12 |pages=3–4 |doi=10.1002/cbl.30088}}</ref><ref>{{cite journal |last1=Lee |first1=Cory |title=A Failed Experiment: Conversion Therapy as Child Abuse |journal=Roger Williams University Law Review |date=2022 |volume=27 |issue=1 |url=https://docs.rwu.edu/rwu_LR/vol27/iss1/3/ |access-date=4 July 2022 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924072750/https://docs.rwu.edu/rwu_LR/vol27/iss1/3/ |url-status=live }}</ref>


===Human rights===
===Human rights===
In 2020, the [[International Rehabilitation Council for Torture Victims]] released an official statement that conversion therapy is torture.<ref name=irct>{{cite web |title=Conversion Therapy is Torture |url=https://irct.org/media-and-resources/latest-news/article/1027 |website=International Rehabilitation Council for Torture Victims |access-date=31 May 2021 |language=en |archive-date=7 January 2021 |archive-url=https://web.archive.org/web/20210107053543/https://irct.org/media-and-resources/latest-news/article/1027 |url-status=dead }}</ref> The same year, UN Independent Expert on sexual orientation and gender identity, [[Victor Madrigal-Borloz]], said that conversion therapy practices are "inherently discriminatory, that they are [[cruel, inhuman and degrading treatment]], and that depending on the severity or physical or mental pain and suffering inflicted to the victim, they may amount to torture". He recommended that it should be banned across the world.<ref>{{cite web |url=https://www.ohchr.org/EN/NewsEvents/Pages/ConversionTherapy_and_HR.aspx |title='Conversion therapy' Can Amount to Torture and Should be Banned says UN Expert |date=July 13, 2020 |website=United Nations Human Rights: Office of the High Commissioner |access-date=July 20, 2021}}</ref> In 2021, Ilias Trispiotis and Craig Purshouse argue that conversion therapy violates the prohibition against degrading treatment under [[Article 3 of the European Convention on Human Rights]], leading to a state obligation to prohibit it.<ref name=Trispiotis>{{cite journal |last1=Trispiotis |first1=Ilias |last2=Purshouse |first2=Craig |title='Conversion Therapy' As Degrading Treatment |journal=Oxford Journal of Legal Studies |date=2021 |volume=42 |issue=1 |pages=104–132 |doi=10.1093/ojls/gqab024|pmid=35264896 |pmc=8902017 |doi-access=free }}</ref><ref>{{cite journal |last1=Nugraha |first1=Ignatius Yordan |title=The compatibility of sexual orientation change efforts with international human rights law |journal=Netherlands Quarterly of Human Rights |date=2017 |volume=35 |issue=3 |pages=176–192 |doi=10.1177/0924051917724654|s2cid=220052834 |doi-access=free }}</ref> In February 2023 [[Commissioner for Human Rights]], [[Dunja Mijatović]], qualified those practices as “irreconcilable with several guarantees under the European Convention on Human Rights" and having no place in a human rights-based society urging the Member States of the Council of Europe to ban them for both adults and minors,<ref>{{Cite web |title=Nothing to cure: putting an end to so-called "conversion therapies" for LGBTI people - Commissioner for Human Rights - www.coe.int |url=https://www.coe.int/en/web/commissioner/-/nothing-to-cure-putting-an-end-to-so-called-conversion-therapies-for-lgbti-people |access-date=2023-07-22 |website=Commissioner for Human Rights |language=en-GB}}</ref> later in July 2023 she advocated for clear actions during a public hearing at the [[European Parliament]] studying different approaches to legally ban "conversion therapies" in the [[European Union]].<ref>{{Cite web |date=2023-07-17 |title='Conversion therapies' in the EU: MEPs discuss potential ban with experts {{!}} News {{!}} European Parliament |url=https://www.europarl.europa.eu/news/en/press-room/20230717IPR03013/conversion-therapies-in-the-eu-meps-discuss-potential-ban-with-experts |access-date=2023-07-22 |website=www.europarl.europa.eu |language=en}}</ref>
In 2020, the [[International Rehabilitation Council for Torture Victims]] released an official statement that conversion therapy is torture.<ref name=irct>{{cite web |title=Conversion Therapy is Torture |url=https://irct.org/media-and-resources/latest-news/article/1027 |website=International Rehabilitation Council for Torture Victims |access-date=31 May 2021 |language=en |archive-date=7 January 2021 |archive-url=https://web.archive.org/web/20210107053543/https://irct.org/media-and-resources/latest-news/article/1027 |url-status=dead }}</ref> The same year, UN Independent Expert on sexual orientation and gender identity, [[Victor Madrigal-Borloz]], said that conversion therapy practices are "inherently discriminatory, that they are [[cruel, inhuman and degrading treatment]], and that depending on the severity or physical or mental pain and suffering inflicted to the victim, they may amount to torture". He recommended that it should be banned across the world.<ref>{{cite web |url=https://www.ohchr.org/EN/NewsEvents/Pages/ConversionTherapy_and_HR.aspx |title='Conversion therapy' Can Amount to Torture and Should be Banned says UN Expert |date=July 13, 2020 |website=United Nations Human Rights: Office of the High Commissioner |access-date=July 20, 2021}}</ref> In 2021, Ilias Trispiotis and Craig Purshouse argue that conversion therapy violates the prohibition against degrading treatment under [[Article 3 of the European Convention on Human Rights]], leading to a state obligation to prohibit it.<ref name=Trispiotis>{{cite journal |last1=Trispiotis |first1=Ilias |last2=Purshouse |first2=Craig |title='Conversion Therapy' As Degrading Treatment |journal=Oxford Journal of Legal Studies |date=2021 |volume=42 |issue=1 |pages=104–132 |doi=10.1093/ojls/gqab024|pmid=35264896 |pmc=8902017 |doi-access=free }}</ref><ref>{{cite journal |last1=Nugraha |first1=Ignatius Yordan |title=The compatibility of sexual orientation change efforts with international human rights law |journal=Netherlands Quarterly of Human Rights |date=2017 |volume=35 |issue=3 |pages=176–192 |doi=10.1177/0924051917724654|s2cid=220052834 |doi-access=free }}</ref> In February 2023 [[Commissioner for Human Rights]], [[Dunja Mijatović]], qualified those practices as “irreconcilable with several guarantees under the European Convention on Human Rights" and having no place in a human rights-based society urging the Member States of the Council of Europe to ban them for both adults and minors,<ref>{{Cite web |title=Nothing to cure: putting an end to so-called "conversion therapies" for LGBTI people - Commissioner for Human Rights - www.coe.int |url=https://www.coe.int/en/web/commissioner/-/nothing-to-cure-putting-an-end-to-so-called-conversion-therapies-for-lgbti-people |access-date=2023-07-22 |website=Commissioner for Human Rights |language=en-GB}}</ref> later in July 2023 she advocated for clear actions during a public hearing at the [[European Parliament]] studying different approaches to legally ban "conversion therapies" in the [[European Union]].<ref>{{Cite web |date=2023-07-17 |title='Conversion therapies' in the EU: MEPs discuss potential ban with experts {{!}} News {{!}} European Parliament |url=https://www.europarl.europa.eu/news/en/press-room/20230717IPR03013/conversion-therapies-in-the-eu-meps-discuss-potential-ban-with-experts |access-date=2023-07-22 |website=www.europarl.europa.eu |language=en |archive-date=22 July 2023 |archive-url=https://web.archive.org/web/20230722140351/https://www.europarl.europa.eu/news/en/press-room/20230717IPR03013/conversion-therapies-in-the-eu-meps-discuss-potential-ban-with-experts |url-status=live }}</ref> In September 2024 it was reported that the European Union is considering banning "conversion therapies" across its Member States,<ref>{{Cite web |last=Ramsay |first=Max |date=2024-09-17 |title=EU to Pursue Ban on Conversion Therapy in New LGBTQ Strategy |url=https://www.bnnbloomberg.ca/business/politics/2024/09/17/eu-to-pursue-ban-on-conversion-therapy-in-new-lgbtq-strategy/?utm_source=substack&utm_medium=email |access-date=2024-10-05 |website=BNN Bloomberg |language=en}}</ref> while a [[European Citizens' Initiative]] that started collecting signatures in May 2024 is also calling on the [[European Commission]] to outlaw such practices.<ref>{{Cite web |title=Initiative detail {{!}} European Citizens' Initiative |url=https://citizens-initiative.europa.eu/initiatives/details/2024/000001_en |access-date=2024-10-05 |website=citizens-initiative.europa.eu}}</ref>


==In media==
==In media==


Efforts to change sexual orientation have been depicted and discussed in popular culture and various media. More recent examples include: ''[[Boy Erased]]'', ''[[The Miseducation of Cameron Post (film)|The Miseducation of Cameron Post]]'', [[The Book of Mormon (musical)|''Book of Mormon'' musical]], ''[[Ratched (TV series)|Ratched]]'', and documentary features ''[[Pray Away]], Homotherapy: A Religious Sickness.''<ref>{{Cite web |title=MEDIAWAN - HOMOTHERAPY, A RELIGIOUS SICKNESS (2019) |url=https://rights.mediawan.com/world-catalogue/documentary/program/4397 |access-date=2023-07-22 |website=rights.mediawan.com}}</ref><ref>{{Cite news |date=2019-11-26 |title=" Homothérapies " sur Arte : le scandale des " conversions " sexuelles forcées |language=fr |work=Le Monde.fr |url=https://www.lemonde.fr/culture/article/2019/11/26/homotherapies-sur-arte-le-scandale-des-conversions-sexuelles-forcees_6020634_3246.html |access-date=2023-07-22}}</ref>
Efforts to change sexual orientation have been depicted and discussed in popular culture and various media. More recent examples include: ''[[Boy Erased]]'', ''[[The Miseducation of Cameron Post (film)|The Miseducation of Cameron Post]]'', [[The Book of Mormon (musical)|''Book of Mormon'' musical]], ''[[Ratched (TV series)|Ratched]]'', and documentary features ''[[Pray Away]], Homotherapy: A Religious Sickness.''<ref>{{Cite web |title=MEDIAWAN - HOMOTHERAPY, A RELIGIOUS SICKNESS (2019) |url=https://rights.mediawan.com/world-catalogue/documentary/program/4397 |access-date=2023-07-22 |website=rights.mediawan.com |archive-date=22 July 2023 |archive-url=https://web.archive.org/web/20230722140353/https://rights.mediawan.com/world-catalogue/documentary/program/4397 |url-status=live }}</ref><ref>{{Cite news |date=2019-11-26 |title=" Homothérapies " sur Arte : le scandale des " conversions " sexuelles forcées |language=fr |work=Le Monde.fr |url=https://www.lemonde.fr/culture/article/2019/11/26/homotherapies-sur-arte-le-scandale-des-conversions-sexuelles-forcees_6020634_3246.html |access-date=2023-07-22 |archive-date=22 July 2023 |archive-url=https://web.archive.org/web/20230722140350/https://www.lemonde.fr/culture/article/2019/11/26/homotherapies-sur-arte-le-scandale-des-conversions-sexuelles-forcees_6020634_3246.html |url-status=live }}</ref>


==Medical views==
==Medical views==
{{main|Medical views of conversion therapy}}
{{main|Medical views of conversion therapy}}


National health organizations around the world have uniformly denounced and criticized sexual orientation and gender identity change efforts.<ref name="Lambda">{{cite news|title=Health and Medical Organization Statements on Sexual Orientation, Gender Identity/Expression and 'Reparative Therapy'|url=https://www.lambdalegal.org/publications/health-and-med-orgs-stmts-on-sex-orientation-and-gender-identity|newspaper=Lambda Legal}}</ref><ref name="HRC">{{cite web|title=Policy and Position Statements on Conversion Therapy|url=http://www.hrc.org/resources/policy-and-position-statements-on-conversion-therapy|website=Human Rights Campaign|access-date=12 April 2017}}</ref><ref>{{Cite web |date=December 2021 |title=Memorandum of Understanding on Conversion Therapy in the UK |url=https://www.psychotherapy.org.uk/media/cptnc5qm/mou2.pdf |publisher=[[United Kingdom Council for Psychotherapy]]}}</ref> They state that there has been no scientific demonstration of "conversion therapy's" efficacy.<ref name="APA"/><ref name="APA-Answers">{{cite web | url=http://www.apa.org/topics/lgbt/orientation.aspx | title=Answers to Your Questions: For a Better Understanding of Sexual Orientation and Homosexuality | publisher=American Psychological Association | date=2008 | access-date=31 January 2015}}</ref><ref name =APA_Position/><ref name="PsychNews">{{citation |title=APA Maintains Reparative Therapy Not Effective |url=http://www.psychiatricnews.org/pnews/99-01-15/therapy.html |publisher=Psychiatric News (news division of the American Psychiatric Association) |date=15 January 1999 |access-date=28 August 2007}}</ref> They find that conversion therapy is ineffective, risky and can be harmful. Anecdotal claims of cures are counterbalanced by assertions of harm, and the American Psychiatric Association, for example, cautions ethical practitioners under the [[Hippocratic oath]] to do no harm and to refrain from attempts at conversion therapy.<ref name=APA_Position>{{cite web|url=http://www.psych.org/Departments/EDU/Library/APAOfficialDocumentsandRelated/PositionStatements/200001a.aspx |title=Therapies Focused on Attempts to Change Sexual Orientation |publisher=Psych.org |access-date=18 July 2011 |url-status=dead |archive-url=https://web.archive.org/web/20080910045820/http://www.psych.org/Departments/EDU/Library/APAOfficialDocumentsandRelated/PositionStatements/200001a.aspx |archive-date=10 September 2008 }}</ref> Furthermore, they state that conversion therapy is harmful and that it often exploits individual's guilt and anxiety, thereby damaging self-esteem and leading to depression and even suicide.<ref name="nytconversion">{{citation |last=Luo |first=Michael |title=Some Tormented by Homosexuality Look to a Controversial Therapy |url=https://www.nytimes.com/2007/02/12/nyregion/12group.html |work=The New York Times |page=1 |date=12 February 2007 |access-date=28 August 2007}}</ref> There is also concern in the mental health community that the advancement of conversion therapy can cause social harm by disseminating inaccurate views about gender identity, sexual orientation, and the ability of LGBT people to lead happy, healthy lives.<ref name="HRC" /> Various medical bodies prohibit their members from practicing conversion therapy.<ref>{{cite news |title=Albania becomes third European country to ban gay 'conversion therapy' |url=https://www.france24.com/en/20200516-albania-becomes-third-european-country-to-ban-gay-conversion-therapy |access-date=30 June 2022 |work=France 24 |date=16 May 2020 |language=en}}</ref>
National health organizations around the world have uniformly denounced and criticized sexual orientation and gender identity change efforts.<ref name="Lambda">{{cite news|title=Health and Medical Organization Statements on Sexual Orientation, Gender Identity/Expression and 'Reparative Therapy'|url=https://www.lambdalegal.org/publications/health-and-med-orgs-stmts-on-sex-orientation-and-gender-identity|newspaper=Lambda Legal|access-date=16 December 2017|archive-date=15 June 2017|archive-url=https://web.archive.org/web/20170615154255/https://www.lambdalegal.org/publications/health-and-med-orgs-stmts-on-sex-orientation-and-gender-identity|url-status=live}}</ref><ref name="HRC">{{cite web|title=Policy and Position Statements on Conversion Therapy|url=http://www.hrc.org/resources/policy-and-position-statements-on-conversion-therapy|website=Human Rights Campaign|access-date=12 April 2017|archive-date=27 April 2017|archive-url=https://web.archive.org/web/20170427021742/http://www.hrc.org/resources/policy-and-position-statements-on-conversion-therapy|url-status=dead}}</ref><ref>{{Cite web |date=December 2021 |title=Memorandum of Understanding on Conversion Therapy in the UK |url=https://www.psychotherapy.org.uk/media/cptnc5qm/mou2.pdf |publisher=[[United Kingdom Council for Psychotherapy]] |access-date=31 May 2023 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924072651/https://www.psychotherapy.org.uk/media/cptnc5qm/mou2.pdf |url-status=live }}</ref> They state that there has been no scientific demonstration of "conversion therapy's" efficacy.<ref name="APA"/><ref name="APA-Answers">{{cite web | url=http://www.apa.org/topics/lgbt/orientation.aspx | title=Answers to Your Questions: For a Better Understanding of Sexual Orientation and Homosexuality | publisher=American Psychological Association | date=2008 | access-date=31 January 2015 | archive-date=20 January 2019 | archive-url=https://web.archive.org/web/20190120024548/https://www.apa.org/topics/lgbt/orientation.aspx | url-status=live }}</ref><ref name =APA_Position/><ref name="PsychNews">{{citation |title=APA Maintains Reparative Therapy Not Effective |url=http://www.psychiatricnews.org/pnews/99-01-15/therapy.html |publisher=Psychiatric News (news division of the American Psychiatric Association) |date=15 January 1999 |access-date=28 August 2007 |archive-date=20 August 2008 |archive-url=https://web.archive.org/web/20080820042149/http://www.psychiatricnews.org/pnews/99-01-15/therapy.html |url-status=dead }}</ref> They find that conversion therapy is ineffective, risky and can be harmful. Anecdotal claims of cures are counterbalanced by assertions of harm, and the American Psychiatric Association, for example, cautions ethical practitioners under the [[Hippocratic oath]] to do no harm and to refrain from attempts at conversion therapy.<ref name=APA_Position>{{cite web|url=http://www.psych.org/Departments/EDU/Library/APAOfficialDocumentsandRelated/PositionStatements/200001a.aspx |title=Therapies Focused on Attempts to Change Sexual Orientation |publisher=Psych.org |access-date=18 July 2011 |url-status=dead |archive-url=https://web.archive.org/web/20080910045820/http://www.psych.org/Departments/EDU/Library/APAOfficialDocumentsandRelated/PositionStatements/200001a.aspx |archive-date=10 September 2008 }}</ref> Furthermore, they state that conversion therapy is harmful and that it often exploits individual's guilt and anxiety, thereby damaging self-esteem and leading to depression and even suicide.<ref name="nytconversion">{{citation |last=Luo |first=Michael |title=Some Tormented by Homosexuality Look to a Controversial Therapy |url=https://www.nytimes.com/2007/02/12/nyregion/12group.html |work=The New York Times |page=1 |date=12 February 2007 |access-date=28 August 2007 |archive-date=20 April 2019 |archive-url=https://web.archive.org/web/20190420120908/https://www.nytimes.com/2007/02/12/nyregion/12group.html |url-status=live }}</ref> There is also concern in the mental health community that the advancement of conversion therapy can cause social harm by disseminating inaccurate views about gender identity, sexual orientation, and the ability of LGBT people to lead happy, healthy lives.<ref name="HRC" /> Various medical bodies prohibit their members from practicing conversion therapy.<ref>{{cite news |title=Albania becomes third European country to ban gay 'conversion therapy' |url=https://www.france24.com/en/20200516-albania-becomes-third-european-country-to-ban-gay-conversion-therapy |access-date=30 June 2022 |work=France 24 |date=16 May 2020 |language=en |archive-date=24 May 2020 |archive-url=https://web.archive.org/web/20200524174458/https://www.france24.com/en/20200516-albania-becomes-third-european-country-to-ban-gay-conversion-therapy |url-status=live }}</ref>


== See also ==
== See also ==


* [[Christianity and homosexuality]]
* [[Christianity and homosexuality]]
* [[Corrective rape]]
* [[Recovering from Religion]]
* [[Recovering from Religion]]
* [[Sexual orientation change efforts and the LDS Church]]
* [[Sexual orientation change efforts and the LDS Church]]

== Notes ==
{{Reflist|group=Note}}


==References==
==References==
Line 176: Line 184:
*{{cite book |last1=Weindling |first1=Paul|author-link=Paul Weindling |title=Victims and Survivors of Nazi Human Experiments: Science and Suffering in the Holocaust |date=2015 |publisher=[[Bloomsbury Academic]] |isbn=978-1-4411-7990-6 |language=en}}
*{{cite book |last1=Weindling |first1=Paul|author-link=Paul Weindling |title=Victims and Survivors of Nazi Human Experiments: Science and Suffering in the Holocaust |date=2015 |publisher=[[Bloomsbury Academic]] |isbn=978-1-4411-7990-6 |language=en}}
*{{cite book |last1=Whisnant |first1=Clayton J.|author-link=Clayton J. Whisnant |title=Queer Identities and Politics in Germany: A History, 1880–1945 |date=2016 |publisher=[[Columbia University Press]] |isbn=978-1-939594-10-5 |language=en}}
*{{cite book |last1=Whisnant |first1=Clayton J.|author-link=Clayton J. Whisnant |title=Queer Identities and Politics in Germany: A History, 1880–1945 |date=2016 |publisher=[[Columbia University Press]] |isbn=978-1-939594-10-5 |language=en}}
*{{citation |last=Yoshino |first=Kenji |title=Covering |year=2002 |journal=Yale Law Journal |volume=111 |issue=4 |pages=769–939 |url=http://www.yalelawjournal.org/article/covering |doi=10.2307/797566 |jstor=797566 |hdl=20.500.13051/9392 }}
*{{citation |last=Yoshino |first=Kenji |title=Covering |year=2002 |journal=Yale Law Journal |volume=111 |issue=4 |pages=769–939 |url=http://www.yalelawjournal.org/article/covering |doi=10.2307/797566 |jstor=797566 |hdl=20.500.13051/9392 |access-date=7 May 2015 |archive-date=25 October 2015 |archive-url=https://web.archive.org/web/20151025034757/http://www.yalelawjournal.org/article/covering |url-status=live }}
* {{cite journal |last1=Zinn |first1=Alexander |title='Das sind Staatsfeinde' Die NS-Homosexuellenverfolgung 1933–1945|trans-title="They are enemies of the state": The Nazi persecution of homosexuals 1933–1945|journal=Bulletin des Fritz Bauer Instituts|pages=6–13|date=2020b|url=https://www.fritz-bauer-institut.de/fileadmin/editorial/publikationen/einsicht/Einsicht-2020_Einzelseiten.pdf |archive-url=https://ghostarchive.org/archive/20221009/https://www.fritz-bauer-institut.de/fileadmin/editorial/publikationen/einsicht/Einsicht-2020_Einzelseiten.pdf |archive-date=2022-10-09 |url-status=live|issn= 1868-4211|language=de}}
* {{cite journal|last1=Zinn|first1=Alexander|title='Das sind Staatsfeinde' Die NS-Homosexuellenverfolgung 1933–1945|trans-title="They are enemies of the state": The Nazi persecution of homosexuals 1933–1945|journal=Bulletin des Fritz Bauer Instituts|pages=6–13|date=2020b|url=https://www.fritz-bauer-institut.de/fileadmin/editorial/publikationen/einsicht/Einsicht-2020_Einzelseiten.pdf|archive-url=https://ghostarchive.org/archive/20221009/https://www.fritz-bauer-institut.de/fileadmin/editorial/publikationen/einsicht/Einsicht-2020_Einzelseiten.pdf|archive-date=2022-10-09|url-status=live|issn=1868-4211|language=de}}
{{refend}}
{{refend}}


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{{DEFAULTSORT:Conversion Therapy}}
{{DEFAULTSORT:Conversion Therapy}}
[[Category:Alternative medicine]]
[[Category:Conversion therapy| ]]
[[Category:Conversion therapy| ]]
[[Category:Gender identity]]
[[Category:Gender identity]]
[[Category:Human rights abuses]]
[[Category:Human rights abuses]]
[[Category:Medical controversies]]
[[Category:Medical controversies]]
[[Category:Pseudoscience]]
[[Category:Religion and mental health]]
[[Category:Religion and mental health]]
[[Category:Religion and science]]
[[Category:Religion and science]]
[[Category:Sexual orientation and medicine]]
[[Category:Sexual orientation and medicine]]
[[Category:Violence against LGBT people]]
[[Category:Violence against LGBTQ people]]
[[Category:Anti-LGBT sentiment]]
[[Category:Anti-LGBTQ sentiment]]
[[Category:Homophobia]]
[[Category:Homophobia]]
[[Category:Transphobia]]
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[[Category:Abuse]]
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[[Category:Torture]]
[[Category:Torture]]
[[Category:Romantic orientation]]

Latest revision as of 23:47, 2 December 2024

Conversion therapy
ClaimsOne's sexual orientation, romantic orientation, gender identity, or gender expression can be changed to fit heterosexual, heteroromantic, and cisgender norms.
Notable proponentsEx-gay movement
(Overview of pseudoscientific concepts)

Conversion therapy is the pseudoscientific practice of attempting to change an individual's sexual orientation, romantic orientation, gender identity, or gender expression to align with heterosexual and cisgender norms.[1] Methods that have been used to this end include forms of brain surgery, surgical or chemical (hormonal) castration, aversion therapy treatments such as electric shocks, nausea-inducing drugs, hypnosis, counseling, spiritual interventions, visualization, psychoanalysis, and arousal reconditioning. There is a scientific consensus that conversion therapy is ineffective at changing a person's sexual orientation or gender identity and that it frequently causes significant long-term psychological harm.[2] The position of current evidence-based medicine and clinical guidance is that homosexuality, bisexuality, and gender variance are natural and healthy aspects of human sexuality.[2][3] An increasing number of jurisdictions around the world have passed laws against conversion therapy.[4]

Historically, conversion therapy was the treatment of choice for individuals who disclosed same-sex attractions or exhibited gender nonconformity, which were formerly assumed to be pathologies by the medical establishment.[3] When performed today, conversion therapy may constitute fraud and when performed on minors, a form of child abuse; it has been described by experts as torture; cruel, inhuman, or degrading treatment; and contrary to human rights.

Terminology

Medical professionals and activists consider "conversion therapy" a misnomer, as it does not constitute a legitimate form of therapy.[5] Alternative terms include sexual orientation change efforts (SOCE)[5] and gender identity change efforts (GICE)[5]—together, sexual orientation and gender identity change efforts (SOGICE).[6][better source needed] According to researcher Douglas C. Haldeman, SOCE and GICE should be considered together because both rest on the assumption "that gender-related behavior consistent with the individual's birth sex is normative and anything else is unacceptable and should be changed".[7] "Reparative therapy" may refer to conversion therapy in general,[5] or to a subset thereof.[8]

Advocates of conversion therapy do not necessarily use the term either, instead using phrases such as "healing from sexual brokenness"[9][10] and "struggling with same-sex attraction".[11]

History

Sexual orientation change efforts (SOCE)

The term homosexual was coined by German-speaking Hungarian writer Karl Maria Kertbeny and was in circulation by the 1880s.[12][4] Into the middle of the twentieth century, competing views of homosexuality were advanced by psychoanalysis versus academic sexology. Sigmund Freud, the founder of psychoanalysis, viewed homosexuality as a form of arrested development. Later psychoanalysts followed Sandor Rado, who argued that homosexuality was a "phobic avoidance of heterosexuality caused by inadequate early parenting".[4] This line of thinking was popular in psychiatric models of homosexuality based on the prison population or homosexuals seeking treatment. In contrast, sexology researchers such as Alfred Kinsey argued that homosexuality was a normal variation in human development. In 1970, gay activists confronted the American Psychiatric Association, persuading the association to reconsider whether homosexuality should be listed as a disorder. The APA delisted homosexuality in 1973, which contributed to shifts in public opinion on homosexuality.[4]

Despite their lack of scientific backing, some socially or religiously conservative activists continued to argue that if one person's sexuality could be changed, homosexuality was not a fixed class such as race. Borrowing from discredited psychoanalytic ideas about the cause of homosexuality, some of these individuals offered conversion therapy.[4] In 2001, conversion therapy attracted attention when Robert L. Spitzer published a non-peer-reviewed study asserting that some homosexuals could change their sexual orientation. Many researchers made methodological criticisms of the study, which Spitzer later repudiated.[4]

Gender identity change efforts (GICE)

Gender Identity Change Efforts (GICE) refer to practices of healthcare providers and religious counselors with the goal of attempting to alter a person's gender identity or expression to conform to social norms. Examples include aversion therapy, cognitive restructuring, and psychoanalytic and talk therapies.[13] Western medical-model narratives have historically institutionalized transphobia: systemically favoring a binary gender model and pathologizing gender diversity and non-conformity.[14] This aided the development and proliferation of GICE.[15]

Early interventions were rooted in psychoanalytic hypotheses.[16] Robert Stoller advanced the theory that gender-nonconforming behavior and expression in children assigned male at birth (AMAB) was caused by being overly close to their mother. Richard Green continued his research; his methods for altering behavior included having the father spend more time with the child and mother less, expecting both to exhibit stereotypical gender roles, and having them praise their child's masculine behaviors, and shame their feminine and gender-nonconforming ones. These interventions resulted in depression in the children and feelings of betrayal from parents that the treatments failed.[16]

In the 1970s, UCLA psychologist Richard Green recruited Ole Ivar Lovaas to adapt the techniques of Applied Behavior Analysis (ABA) therapy to attempt to prevent children from becoming transsexual.[17] Deemed the "Feminine Boy Project", the treatments used operant conditioning to reward gender-conforming behaviors, and punish gender non-conforming behaviors.[17]

Kenneth Zucker at the Centre for Addiction and Mental Health adopted Richard Green's methods, but narrowed the scope to attempting to prevent the child from identifying as transgender by modifying gender behavior and presentation to conform to the expectations of the assigned gender at birth, which he dubbed the "living in your own skin" model. His model used the same interventions as Green with the addition of psychodynamic therapy.[16][18][19][20]

Motivations

A frequent motivation for adults who pursue conversion therapy is their religious beliefs, especially evangelical Christianity and Orthodox Judaism, that disapprove of same-sex relations. These adults prioritize maintaining a good relationship with their family and religious community.[21] Adolescents who are pressured by their families into undergoing conversion therapy also typically come from a conservative religious background.[21] Youth from families with low socioeconomic status are also more likely to undergo conversion therapy.[22]

Theories and techniques

As societal attitudes toward homosexuality have become more tolerant over time, the most harsh conversion therapy methods such as aversion have been reduced. Secular conversion therapy is offered less often due to reduced medical pathologization of homosexuality, and religious practitioners have become more dominant.[23]

Aversion therapy

Aversion therapy used on homosexuals included electric shock and nausea-inducing drugs during presentation of same-sex erotic images. Cessation of the aversive stimuli was typically accompanied by the presentation of opposite-sex erotic images, with the objective of strengthening heterosexual feelings.[24] Another method used was the covert sensitization method, which involves instructing patients to imagine vomiting or receiving electric shocks, writing that only single case studies have been conducted, and that their results cannot be generalized. Haldeman writes that behavioral conditioning studies tend to decrease homosexual feelings, but do not increase heterosexual feelings, citing Rangaswami's "Difficulties in arousing and increasing heterosexual responsiveness in a homosexual: A case report", published in 1982, as typical in this respect.[25]

Other methods of aversion therapy in addition to electric shock included ice baths, freezing, burning via metal coils, and hard labor. The intent was for the subject to associate homosexual feelings with pain and thus result in them being reduced. These methods have been concluded to be ineffective.[26]

Aversion therapy was developed in Czechoslovakia between 1950 and 1962 and in the British Commonwealth from 1961 into the mid-1970s. In the context of the Cold War, Western psychologists ignored the poor results of their Czechoslovak counterparts, who had concluded that aversion therapy was not effective by 1961 and recommended decriminalization of homosexuality instead.[27] Some men in the United Kingdom were offered the choice between prison and undergoing aversion therapy. It was also offered to a few British women, but was never the standard treatment for either homosexual men or women.[28]

In the 1970s, behaviorist Hans Eysenck was one of the main advocates of counterconditioning with malaise-inducing drugs and electric shock for homosexuals. He wrote that this type of therapy was successful in nearly 50% of cases. However, his studies were disputed.[29] Behavior therapists, including Eysenck, used aversive methods. This led to a protest against Eysenck by gay activist Peter Tatchell in a London Medical Group Symposium in 1972. Tatchell said that the therapy promoted by Eysenck was a form of torture.[29] Tatchell denounced Eysenck's form of behavioral therapy as inducing depression and suicide among gay men who were subjected to it.[30]

Brain surgery

In the 1940s and 1950s, U.S. neurologist Walter Freeman popularized the ice-pick lobotomy as a treatment for homosexuality. He personally performed as many as 3,439[31] lobotomy surgeries in 23 states, of which 2,500 used his ice-pick procedure,[32] despite the fact that he had no formal surgical training.[33]

In West Germany, a type of brain surgery usually involving destruction of the ventromedial nucleus of the hypothalamus was done to some homosexual men during the 1960s and 1970s. The practice was criticized by sexologist Volkmar Sigusch.[34]

Castration and transplantation

Friedrich-Paul von Groszheim (1908–2006) was spared from a concentration camp after agreeing to castration under pressure in 1938.

In early twentieth century Germany experiments were carried out in which homosexual men were subjected to unilateral orchiectomy and testicles of heterosexual men were transplanted. These operations were a complete failure.[35]

Surgical castration of homosexual men was widespread in Europe in the first half of the twentieth century.[36] SS leader Heinrich Himmler ordered homosexual men to be sent to concentration camps because he did not consider a time-limited prison sentence was sufficient to eliminate homosexuality.[37] Although theoretically voluntary, some homosexuals were subject to severe pressure and coercion to agree to castration. There was no age limit; some boys as young as 16 were castrated. Those who agreed to castration after a Paragraph 175 conviction were exempted from being transferred to a concentration camp after completing their legal sentence.[38] Some concentration camp prisoners were also subjected to castration.[39] An estimated 400 to 800 men were castrated.[40]

Endocrinologist Carl Vaernet attempted to change homosexual concentration camp prisoners' sexual orientations by implanting a pellet that released testosterone. Most of the victims, non-consenting prisoners at Buchenwald, died shortly thereafter.[41][42]

An unknown number of men were castrated in West Germany and chemical castration was used in other Western countries, notably against Alan Turing in the United Kingdom.[43]

Ex-gay/ex-trans ministries

OneByOne booth at a Love Won Out conference

Ex-gay ministries are religious groups that attempt to use religion to eliminate or change somebody's sexual orientation.[44][45][46][47] The ex-gay umbrella organization Exodus International in the United States ceased activities in June 2013, and the three member board issued a statement which repudiated its aims and apologized for the harm their pursuit has caused to LGBT people.[48][49] Ex-trans organizations often overlap and portray being trans as inherently sinful or against God's design, or pathologize gender variance as due to trauma, social contagion, or "gender ideology."[50][51]

Hypnosis

Hypnosis was used in conversion therapy since the 19th century by Richard von Krafft-Ebing and Albert von Schrenck-Notzing. In 1967, Canadian psychiatrist Peter Roper published a case study of treating 15 homosexual (some of which would probably be considered bisexual by modern standards) people with hypnosis. Allegedly, 8 showed "marked improvement" (they reportedly lost sexual attraction towards the same sex altogether), 4 mild improvements (decrease of "homosexual tendencies"), and 3 no improvement after hypnotic treatment; he concluded that "hypnosis may well produce more satisfactory results than those obtainable by other means", depending on the hypnotic susceptibility of the subjects.[52][better source needed]

Psychoanalysis

Haldeman writes that psychoanalytic treatment of homosexuality is exemplified by the work of Irving Bieber et al. in Homosexuality: A Psychoanalytic Study of Male Homosexuals. They advocated long-term therapy aimed at resolving the unconscious childhood conflicts that they considered responsible for homosexuality. Haldeman notes that Bieber's methodology has been criticized because it relied upon a clinical sample, the description of the outcomes was based upon subjective therapist impression, and follow-up data were poorly presented. Bieber reported a 27% success rate from long-term therapy, but only 18% of the patients in whom Bieber considered the treatment successful had been exclusively homosexual to begin with, while 50% had been bisexual. In Haldeman's view, this makes even Bieber's unimpressive claims of success misleading.[53]

Haldeman discusses other psychoanalytic studies of attempts to change homosexuality. Curran and Parr's "Homosexuality: An analysis of 100 male cases", published in 1957, reported no significant increase in heterosexual behavior. Mayerson and Lief's "Psychotherapy of homosexuals: A follow-up study of nineteen cases", published in 1965, reported that half of its 19 subjects were exclusively heterosexual in behavior four and a half years after treatment, but its outcomes were based on patient self-report and had no external validation. In Haldeman's view, those participants in the study who reported change were bisexual at the outset, and its authors wrongly interpreted capacity for heterosexual sex as change of sexual orientation.[54]

Reparative therapy

The term "reparative therapy" has been used as a synonym for conversion therapy generally, but according to Jack Drescher it properly refers to a specific kind of therapy[clarification needed] associated with the psychologists Elizabeth Moberly and Joseph Nicolosi.[8] For example, he wrote:

. . . the pursuit of fulfillment through same-sex eroticism is spurred by the fearful anticipation that their masculine self-assertion will inevitably fail and result in humiliation.[55]

The term reparative refers to Nicolosi's postulate that same-sex attraction is a person's unconscious attempt to "self-repair" feelings of inferiority.[56][57]

After California banned conversion practices, Nicolosi argued that "reparative therapy" didn't attempt to directly change sexual orientation but instead encourage exploration into its underlying causes, which he believed was often childhood trauma.[58]

Marriage therapy

Previous editions of the World Health Organization's ICD included "sexual relationship disorder", in which a person's sexual orientation or gender identity makes it difficult to form or maintain a relationship with a sexual partner. The belief that their sexual orientation has caused problems in their relationship may lead some people to turn to a marriage therapist for help to change their sexual orientation.[59] Sexual orientation disorder was removed from the most recent ICD, ICD-11, after the Working Group on Sexual Disorders and Sexual Health determined that its inclusion was unjustified.[60]

Gender exploratory therapy

Gender exploratory therapy (GET) is a form of conversion therapy[61][62][63][64][65] characterized by requiring mandatory extended talk therapy attempting to find pathological roots for gender dysphoria while simultaneously delaying social and medical transition and viewing it as a last resort.[61][63][64][58][66] Practitioners of GET often view medical transition as a last resort and propose their patient's dysphoria is caused by factors such as homophobia, social contagion, sexual trauma, and autism.[63][65] Some practitioners of GET avoid using their patients' chosen names and pronouns while questioning their identification.[66] Commenting on gender exploratory therapy in 2022, bioethicist Florence Ashley argued that its framing as an undirected exploration of underlying psychological issues bore similarities to gay conversion practices such as "reparative" therapy.[58] States that have banned gender-affirming care for minors in the United States have called expert witnesses to argue that exploratory therapy should be the alternative treatment.[67]

There are no known empirical studies examining psychosocial or medical outcomes following GET.[66][68] Concerns have been raised that by not providing an estimated length of time for the therapy, the delays in medical interventions may compound mental suffering in trans youth,[63][66] while gender-affirming model of care already promotes gender identity exploration without favoring any particular identity, and individualized care.[66] GET proponents deny this.[69]

Multiple groups exist worldwide to promote GET and have been successful in influencing legal discussions and clinical guidance in some regions.[64] The Gender Exploratory Therapy Association (GETA) asserts that "psychological approaches should be the first-line treatment for all cases of gender dysphoria", that medical interventions for transgender youth are "experimental and should be avoided if possible", and that social transition is "risky".[69] All of GETA's leaders are members of Genspect, a "gender-critical" group that promotes GET and argues that gender-affirming care should not be available to those under 25.[69] In late 2023, GETA changed their name to "Therapy First".[67]

GETA also shares a large overlap with the Society for Evidence-Based Gender Medicine (SEGM), which promotes GET as first-line treatment for those under 25.[70] GETA co-founder Lisa Marchiano stated U.S. President Joe Biden's executive order safeguarding trans youth from conversion therapy would have a "chilling effect" on GET practices.[69][71] GETA also opposed Biden's Title IX changes protecting trans students from discrimination, stating allowing trans youth in restrooms would harm the mental health of their peers.[71] The American College of Pediatricians, a small group aligned with the Christian Right,[Note 1] has cited numerous studies from SEGM to claim GET is necessary to restore transgender people's "biological integrity".[70] In November 2023, Michelle Cretella, a board member of the pro conversion therapy group Alliance for Therapeutic Choice and Scientific Integrity (ATCSI, formerly NARTH), gave a speech at an ATCSI conference which endorsed GET and argued it "truly is very similar to how the Alliance has always approached unwanted same-sex attraction".[67]

Effects

There is a scientific consensus that conversion therapy is ineffective at changing a person's sexual orientation.[2] Advocates of conversion therapy rely heavily on testimonials and retrospective self-reports as evidence of effectiveness. Studies purporting to validate the effectiveness of efforts to change sexual orientation or gender identity have been criticized for methodological flaws.[72] After conversion therapy has failed to change someone's sexual orientation or gender identity, participants often feel increased shame that they already felt over their sexual orientation or gender identity.[21]

Conversion therapy can cause significant, long-term psychological harm.[2] This includes significantly higher rates of depression, substance abuse, and other mental health issues in individuals who have undergone conversion therapy than their peers who did not,[73][74] including a suicide attempt rate nearly twice that of those who did not.[75] Modern-day practitioners of conversion therapy—primarily from a conservative religious viewpoint—disagree with current evidence-based medicine and clinical guidance that does not view homosexuality and gender variance as unnatural or unhealthy.[2][3]

In 2020, ILGA World published a world survey and report Curbing Deception listing consequences and life-threatening effects by associating specific public testimonies with different types of methods used to practice conversion therapies.[76]

A 2022 study estimated that conversion therapy of youth in the United States cost $650.16 million annually with an additional $9.5 billion in associated costs such as increased suicide and substance abuse.[74] Youth who undergo conversion therapy from a religious provider have more negative mental health outcomes than those who had consulted a licensed healthcare provider.[21]

Public opinion

A 2020 survey carried out on US adults found majority support for banning conversion therapy for minors.[77]

A 2022 YouGov poll found majority support in England, Scotland, and Wales for a conversion therapy ban for both sexual orientation and gender identity, with opposition ranging from 13 to 15 percent.[78]

Map of jurisdictions that have bans on sexual orientation and gender identity change efforts with minors.
  Criminal prohibition against conversion therapy on the basis of sexual orientation and gender identity
  Only medical professionals are banned from performing conversion therapy
  No ban on conversion therapy

Some jurisdictions have criminal bans on the practice of conversion therapy, including Canada, Ecuador, France,[79] Germany, Malta, Mexico and Spain.[80] In other countries, including Albania, Brazil, Chile, Vietnam and Taiwan, medical professionals are barred from practicing conversion therapy.[81]

In some states, lawsuits against conversion therapy providers for fraud have succeeded, but in other jurisdictions those claiming fraud must prove that the perpetrator was intentionally dishonest. Thus, a provider who genuinely believes conversion therapy is effective could not be convicted.[82]

Conversion therapy on minors may amount to child abuse.[83][84][85]

Human rights

In 2020, the International Rehabilitation Council for Torture Victims released an official statement that conversion therapy is torture.[83] The same year, UN Independent Expert on sexual orientation and gender identity, Victor Madrigal-Borloz, said that conversion therapy practices are "inherently discriminatory, that they are cruel, inhuman and degrading treatment, and that depending on the severity or physical or mental pain and suffering inflicted to the victim, they may amount to torture". He recommended that it should be banned across the world.[86] In 2021, Ilias Trispiotis and Craig Purshouse argue that conversion therapy violates the prohibition against degrading treatment under Article 3 of the European Convention on Human Rights, leading to a state obligation to prohibit it.[81][87] In February 2023 Commissioner for Human Rights, Dunja Mijatović, qualified those practices as “irreconcilable with several guarantees under the European Convention on Human Rights" and having no place in a human rights-based society urging the Member States of the Council of Europe to ban them for both adults and minors,[88] later in July 2023 she advocated for clear actions during a public hearing at the European Parliament studying different approaches to legally ban "conversion therapies" in the European Union.[89] In September 2024 it was reported that the European Union is considering banning "conversion therapies" across its Member States,[90] while a European Citizens' Initiative that started collecting signatures in May 2024 is also calling on the European Commission to outlaw such practices.[91]

In media

Efforts to change sexual orientation have been depicted and discussed in popular culture and various media. More recent examples include: Boy Erased, The Miseducation of Cameron Post, Book of Mormon musical, Ratched, and documentary features Pray Away, Homotherapy: A Religious Sickness.[92][93]

Medical views

National health organizations around the world have uniformly denounced and criticized sexual orientation and gender identity change efforts.[94][95][96] They state that there has been no scientific demonstration of "conversion therapy's" efficacy.[44][97][98][99] They find that conversion therapy is ineffective, risky and can be harmful. Anecdotal claims of cures are counterbalanced by assertions of harm, and the American Psychiatric Association, for example, cautions ethical practitioners under the Hippocratic oath to do no harm and to refrain from attempts at conversion therapy.[98] Furthermore, they state that conversion therapy is harmful and that it often exploits individual's guilt and anxiety, thereby damaging self-esteem and leading to depression and even suicide.[100] There is also concern in the mental health community that the advancement of conversion therapy can cause social harm by disseminating inaccurate views about gender identity, sexual orientation, and the ability of LGBT people to lead happy, healthy lives.[95] Various medical bodies prohibit their members from practicing conversion therapy.[101]

See also

Notes

  1. ^ not to be confused with the American Academy of Pediatrics

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Bibliography

Further reading

  • Haldeman, Douglas C. (2021). Sexual Orientation and Gender Identity Change Efforts: Evidence, Effects, and Ethics. Columbia University Press. ISBN 978-1-939594-36-5.