So-Called "Conversion Therapy" and LGBTQ+ Youth Mental Health

GettyImages-1174493827.jpeg

Conversion therapy refers to a range of dangerous and discredited practices aimed at changing one’s sexual orientation or gender identity or expression.

So-called ‘conversion therapy,’ sometimes referred to as ‘reparative therapy’ or ‘sexual orientation change efforts’ (SOCE), are a range of dangerous and discredited practices aimed at changing one’s sexual orientation or gender identity or expression. These harmful practices are based on the false claim that being gay or transgender is a mental illness that should be cured. In fact, the American Psychiatric Association determined that homosexuality was not a mental illness, but a normal variant of human nature, in 1973. Unfortunately, young lesbian, gay, bisexual, transgender, and questioning (LGBTQ) people may be coerced and subject to these harmful practices, resulting in a range of negative outcomes including depression, anxiety, substance abuse, and suicidality.

Does conversion therapy work?

No. Conversion therapy has not been proven to change a person’s sexual orientation by any credible scientific study. In fact, Dr. Robert Spitzer, whose research had previously been misused to support conversion therapy, has retracted his original claims, stating that all data regarding conversion therapy has been misinterpreted, and that there is no conclusive evidence that it works. l A study published in 2002 found that 88% of participants in conversion therapy failed to achieve a sustained change in their sexual behavior with only 3% reporting becoming heterosexual. Of the 8 respondents (out of a sample of 202) who reported a change in sexual orientation, 7 worked as ex-gay counselors or group leaders.2

Is conversion therapy condoned by major medical organizations?

No. Conversion therapy is not condoned by the American Psychological Association, American Psychiatric Association, and The American School Counselor Association, The American Academy of Pediatrics, and the American Medical Association. The American Psychological Association, “advises parents, guardians, young people, and their families to avoid sexual orientation change efforts that portray homosexuality as a mental illness or developmental disorder…. 3 The American Medical Association, “opposes, the use of ‘reparative’ or ‘conversion’ therapy that is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her homosexual orientation.

 

Is conversion therapy harmful for LGBTQ+ young people?

Yes. The American Psychiatric Association has made clear that, “The potential risks of reparative therapy are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient.” 5 The Pan American Health Organization, a regional office of the World Health Organization, concluded that SOCE, “lack medical justification and represent a serious threat to the health and well-being of affected people.” 6 Furthermore, conversion therapy creates divisions between young people and their families, creating family rejection of young people’s sexual orientation.7

 

How do young people experience conversion therapy?

Young people experience conversion therapy as a form of family rejection. The American Academy of Child and Adolescent Psychiatry, warns that efforts by a therapist to change a minor’s sexual orientation “may encourage family rejection and undermine self-esteem, connectedness and caring, important protective factors against suicidal ideation and attempts.’

 

How does family acceptance or rejection affect LGBTQ young people?

Young people who experience family rejection based on their sexual orientation face especially serious health risks. 10 In one study, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, and 3.4 times more likely to use illegal drugs compared with peers from families that reported no or low levels of family rejection. ll Family acceptance is an important protective factor that has been shown to help prevent suicide behavior and mental health issues. In one study, fewer than half as many participants from highly accepting families reported suicidal thoughts in the past 6 months compared with those who reported low acceptance. Similarly, the prevalence of suicide attempts among participants who reported high levels of family acceptance was nearly half the rate of those who reported family acceptance.

 

How can I help a young person who has experienced conversion therapy?

Encourage the young person to seek help if they are suffering or feeling depressed. The Trevor Lifeline is free, confidential crisis intervention and suicide prevention lifeline, available 24/7 at 866-488-7386. Family acceptance of a youth’s sexuality or gender identity is another important way to reduce the risk of suicide or substance abuse for the youth. If the young person is experiencing anxiety or other symptoms of mental illness, psychotherapy by a licensed mental health practitioner is encouraged.

 

Should schools refer students to conversion therapy?

No. Schools may endanger LGBTQ students, foster a hostile atmosphere, and potentially open themselves to liability by referring students to conversion therapy or allowing conversion therapy-based programing. The American School Counselor Association has made clear that, “It is not the role of the professional school counselor to attempt to change a student’s sexual orientation/gender identity but instead to provide support to LGBTQ students to promote student achievement and personal well-being.’

 

Are there any laws to protect youth from conversion therapy?

Yes. In 2012 California passed SB 1172 protecting youth under 18 from conversion therapy, and in 2013 New Jersey passed similar legislation. Bills have also been introduced in numerous other states. At the federal level Rep. Jackie Speier introduced the Stop Harming our Kids Resolution (H.Con.Res.69), aimed at protecting LGBTQ youth from conversion therapy.

 

Do these bills to protect youth prevent religious counseling?

No. These bills are strictly designed to prevent licensed therapists from conducting conversion therapy upon minors. These bills do not affect ministers or persons conducting religious counseling; California Bill SB 1172 clarifies “this chapter shall not apply to any priest, rabbi, or minister of the gospel of any religious denomination when performing counseling services as part of his or her pastoral or professional duties”. 16 This only prevents ministers from practicing conversion therapy if they claim to be acting as a licensed therapist.

 

For more information about so-called “conversion therapy” and legislation which protects youth from this dangerous and discredited practice, please contact The Trevor Project Government Affairs Department at 202-204-4730 or by email at advocacy@thetrevorproject.org.

 

Ariel Shidlo & Michael Schroeder, SEXUAL CONVERSION THERAPY: ETHICAL, CLINICAL, AND RESEARCH PERSPECTIVES 135-150 (2002).

American Psychological Association, Resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts (2009).

American Medical Association, H-160.991 Health Care Needs of the Homosexual Population (1991).

American Psychiatric Association Position Statement, December 1998.

World Health Organization, “Therapies” to change sexual orientation lack medical justification and threaten health (May 2012), http://new.paho.org/hq/index.php?option=com_content&task=%20%20view&id=6803&ltemid=1926. See also Pitcherskaia v. I.N.S., 118 F.3d 641 (9th Cir.

1997).

Caitlin Ryan, et al., Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults, PEDIATRICS

346 (2009). 8 Id.

11 Caitlin Ryan, et al., Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults, PEDIATRICS

346 (2009).

Caitlin Ryan et al., Family Acceptance in Adolescence and the Health of LGBT Young Adults, 23 J. C. Adol. Psych. Nurs. 205 (Nov. 2010).
Id.
American School Counselor Association Position statement: Gay, lesbian, transgendered, and questioning_youth (2007), www.schoolcounselor.org/content.asp?contentid=217 15 2012 Cal A.L.S. 835
Cal. Bus. & Prof. Code S 4980.010)
2012 Cal A.L.S. 835; Cal. Bus. & Prof. Code S 4980.010)