Conversion therapy
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. Conversion therapy is ineffective at changing a person's sexual orientation or gender identity and frequently causes significant long-term psychological harm. 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 and gender identity.
When performed today, conversion therapy may constitute fraud; when performed on minors, it is considered to be a form of child abuse. It has been described by experts as torture; cruel, inhuman, or degrading treatment; and contrary to human rights. Many jurisdictions around the world have passed laws against conversion therapy.
Conversion therapy often consists of methods that involve, but are not limited to: talk therapy, aversion therapy, brain surgery, chemical castration, surgical castration, hypnosis, psychoanalysis, corrective rape, and various religious practices, including prayer and exorcism.
Terminology
Medical professionals and activists consider "conversion therapy" a misnomer, as it does not constitute a legitimate form of therapy. Alternative terms include "sexual orientation change efforts" and "gender identity change efforts". Together, and more commonly referred to as "sexual orientation and gender identity change efforts", or "sexual orientation and gender identity or expression change efforts".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". The American Psychological Association stated in a 2021 resolution that some parts of SOCE also met their definition of GICE, and "intense focus" on gender-normative "conformity is a frequent characteristic of SOCE".
"Reparative therapy" may refer to conversion therapy in general, or to [|a subset thereof]. Some sources prefer the term "conversion practices" to "conversion therapy", on the grounds that the practices in question are not actually therapeutic.
Advocates of conversion therapy do not necessarily use the term either, instead using phrases such as "healing from sexual brokenness" and "struggling with same-sex attraction".
Evolving phraseology
A common term found throughout conversion therapy practices is "same-sex attraction" with various phrases or words connected to it.The term "same-sex attraction disorder", or sometimes "same-sex attachment disorder" was coined by Richard Fitzgibbon in the 1990s as a replacement for the term gay and the "ex-gay movement" and subsequently popularized in the 2000s by Richard A. Cohen who authored the book Coming Out Straight in which he details the phrase and invented "diagnosis" that tried to pathologize homosexuality as a condition, concluding that "Homosexuality is a Same-Sex Attachment Disorder." The term was picked up by the ex-gay movement in scripts such as "I used to be gay, but I don't think of myself as gay anymore. Now I just experience same-sex attraction."
A 2020 report by ILGA tracking bans on conversion therapy worldwide explained that in many countries where "conversion therapy" has been banned, "proponents had to reshape and adapt the way in which they present and offer their 'treatment'." The report further explains that many proponents of "conversion therapy" now try to expressly distance themselves from the term "conversion therapy" or saying they support homosexuality or gender variance and referring to their alternative terminology as being something different. The report describes this effort to "make these pseudo-scientific practices 'a constant moving target'."
The report listed a series of currently common terms used by proponents of "conversion therapy" for their "services" to provide assistance with "unwanted same-sex attraction"; promoting a "healthy sexuality", addressing "sexual brokenness"; helping clients explore their "gender confusion".
In 2022, the Global Project Against Hate and Extremism began tracking terms related to conversion therapy online in a report titled Conversion Therapy Online: The Ecosystem.
The report documents practices, techniques and phraseology used by groups providing "conversion therapy" under various names to refer to the practice itself, as well as common phrases such as "same-sex attracted" in relation to conversion therapy targeted at LGBTQ people, in particular gay men and transgender people.
In January 2024, GPAHE published an updated report for 2023, highlighting that many social media platforms and search engines are still serving a lot of content related to conversion therapy. Listing examples, using the search term "overcoming same-sex attraction" on YouTube led to results from religious and non-religious groups serving videos targeting gay and transgender people, such as videos titled "Former LGBTQers Testify: If You No Longer Want to be Gay or Transgender, You Don't Have to Be."
In 2022, GPAHE also started creating an ongoing tracking project on organizations connected to the promotion of "conversion therapy" practices online titled Conversion Therapy Online: The Players to document the actors involved in these activities and show the interconnectedness.
The report highlights some larger groups at the center of these efforts such as London-based International Federation for Therapeutic and Counseling Choice, chaired by Mike Davidson, founder of related Core Issues Trust and several other organizations involved. IFTCC has been hosting annual conferences since its inception in 2015 with the purpose to connect individuals "seeking help with 'same-sex attraction' and 'gender confusion'" with therapists.
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. 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". 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.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. 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, and Spitzer later repudiated his own study.
Gender identity change efforts (GICE)
Gender Identity Change Efforts 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. Western medical-model narratives have historically favored a binary gender model and pathologizing gender diversity and non-conformity. This aided the development and proliferation of GICE.Early interventions were rooted in psychoanalytic hypotheses. Robert Stoller advanced the theory that gender-nonconforming behavior and expression in children assigned male at birth 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.
In the 1970s, UCLA psychologist Richard Green recruited Ole Ivar Lovaas to adapt the techniques of applied behavior analysis to attempt to prevent children from becoming transsexual. Deemed the "Feminine Boy Project", the treatments used operant conditioning to reward gender-conforming behaviors, and punish gender non-conforming behaviors.
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.
Bans on conversion therapy
In 2020, the United Nations Independent Expert on sexual orientation and gender identity published a Report on conversion therapy, which documented global practices on conversion therapy against LGBTQ individuals.In the report, the UN IESOGI called for a global ban on "conversion therapy", as an umbrella term describing various interventions practiced to "cure" people, and to "convert" them from non-heterosexual to heterosexual, and from trans or gender diverse to cisgender. The report highlighted a 2015 US court case from New Jersey, "Ferguson v JONAH'", in which a jury unanimously found the defendants guilty of fraud, claiming they were providing "services that could significantly reduce or eliminate same-sex attraction."