Why Conversion Therapy is Unethical - LGBTQIA Healthcare Guild

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Beyond Ex-Gay: An Online Community for Those who have Survived Ex-Gay Experiences

Beyond Ex-Gay is an online community and resource for those of us who have survived ex-gay experiences. So often healing comes through community and through sharing our stories and experiences with each other.  We believe that ex-gay experiences cause more harm than good. Certain people who currently identify as ex-gay say they are content as such. We don’t seek to invalidate their experience. For us such a lifestyle was not possible nor healthy.

Why Conversion Therapy is an Unethical Practice

The American Psychological Association created a nation-wide Task Force on Appropriate Therapeutic Responses to Sexual Orientation and issued a resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts in 2009, which states: “The American Psychological Association advises parents, guardians, young people, and their families to avoid sexual orientation change efforts...” 

The task force conducted a systematic review of the peer-reviewed journal literature on sexual orientation change efforts (SOCE) and concluded that efforts to change sexual orientation are unlikely to be successful and involve some risk of harm, contrary to the claims of SOCE practitioners and advocates.

The American Psychological Association assigned a task force to assess the effectiveness of SOCE and released a report in 2009 titled, Appropriate Therapeutic Responses to Sexual Orientation. Practitioners were cautioned not to use conversion therapy because: a) such treatments do not have adequate scientific evidence demonstrating their effectiveness, b) overlook established scientific understanding of human sexuality, c) mischaracterizes homosexuality as being a pathological or developmental disorder, and d) are more likely to cause harm due to the distress associated with self-rejection and social stigmatization.  The report suggested that practitioners should accept and support clients dealing with struggles surrounding their sexual orientation.  This includes a clinical focus on identity development and exploration, active coping skills development, and enhanced social support building, without directing the client towards a specific sexual orientation identity outcome.

Human Rights Campaign - Dangers of Reparative Therapy

There is ample evidence that societal prejudice causes significant medical, psychological and other harms to LGBT people. For example, research on the issue of family acceptance of LGBT youth conducted at San Francisco State University found that "compared with LGBT young people who were not rejected or were only a little rejected by their parents and caregivers because of their gay or transgender identity, highly rejected LGBT young people were.

Ex-Gay Proponents Take Advantage of Clients

Ex-gay proponents take advantage of clients’ desire to change their sexual orientation by reinforcing it, essentially sacrificing professional perspective in the process by giving clients’ desired outcomes priority over reality. Then, they place sexual orientation and religious beliefs on a false equal footing, suggesting that sexual orientation might be easier to change if the client’s religious affiliation is more “stable.” This ignores that research has repeatedly demonstrated there is an enduring biological component to sexual orientation, whereas religious beliefs are simply ideas that many people change throughout their lives....
Therapy is not like consumer economics where “the customer is always right.” Rather than help clients work through the conflict they’re experiencing because of their sexual orientation, ex-gay profiteers attempt to milk that conflict by reinforcing it and promising change that will never actually be accomplished. That they defend this strategy by claiming to be less biased by research shows that they care more about profiting off their assumptions than actually helping clients achieve wellness.

Southern Poverty Law Center - Map of Therapists Advertising Conversion Therapy Practices

This map illustrates the pervasiveness of conversion therapy practitioners across the United States. Nearly 70 therapists currently advertise they practice conversion therapy in 20 states and the District of Columbia. We will continue to build this map with your help. As part of Southern Poverty Law Center’s (SPLC) investigation of these harmful practices, we're asking people who have attempted such therapy, especially in recent years, to share their story of survival.

International Academy of Sex Research - Advocates Promoting Conversion Therapy Often Intertwine Gender, Sexual, and Cultural Identities

Homosexuality is thus seen as a‘‘condition’’or addiction that results when a child does not receive sufficient love or role modeling from the same-sex parent (Nicolosi, 1991). This creates an estrangement towards same-sex others that theoretical causes the individual to sexualize same-sex emotional needs: "A confusion of the emotional needs of the non-adult with the physiological desires of the adult" (Moberly, 1983, p. 21). Nicolosi (1993) labeled this process of estrangement as‘‘defensive detachment,’’ which is the focus of his ‘‘reparative’’ efforts. Along these lines, Abbott and Byrd (2010) proposed that the‘‘normal neural pathway" leading to heterosexuality‘‘ is short circuited’’and that heterosexuality can be‘‘encouraged’’and homosexuality is preventable or treatable through‘‘brain training’’ (p. 53), which theoretically occurs through reinforcing traditional gender roles and nonsexual same-sex relationships.

Current change methods include (1) telling clients the cause of their attractions (e.g., due to abuse, parental and peer neglect and rejection, gender role deficits); (2) reframing homoerotic attractions as unmet needs and admiration; (3) reducing homosexual behaviors through avoidance; (4) developing non-sexual, same-sex relationships; (5) utilizing support groups for accountability, validation, and role modeling; and (6) using religious methods (e.g., praying, repenting, and focusing on God and doctrines) to provide answers, miracles, and support (Ponticelli, 1999; Wolkomir, 2001; Yarhouse, Burkett, & Kreeft, 2002). Other current religious methods involve exorcisms to eradicate homosexual demons from the supposed innately heterosexual person (Hamill, 2009).

* Beckstead, A. L.  (2012).  Can we change sexual orientation? Archives of Sexual Behavior, 41(1), 121-134.


Human Rights Campaign - Mental Health Organizations Warn Against Reparative Therapy or Conversion Therapy

American Academy of Pediatrics

"Confusion about sexual orientation is not unusual during adolescence. Counseling may be helpful for young people who are uncertain about their sexual orientation or for those who are uncertain about how to express their sexuality and might profit from an attempt at clarification through a counseling or psychotherapeutic initiative. Therapy directed specifically at changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation."
Homosexuality and Adolescence, Pediatrics.

American Association for Marriage and Family Therapy

"The American Association for Marriage and Family Therapy takes the position that same sex orientation is not a mental disorder. Therefore, we do not believe that sexual orientation in and of itself requires treatment or intervention."
Statement on Nonpathologizing Sexual Orientation.

American Counseling Association

"The American Counseling Association opposes portrayals of lesbian, gay, and bisexual youth and adults as mentally ill due to their sexual orientation; and supports the dissemination of accurate information about sexual orientation, mental health, and appropriate interventions in order to counteract bias that is based on ignorance or unfounded beliefs about same-gender sexual orientation."
Resolution, as reported in the American Psychological Association's publication, "Just the Facts about Sexual Orientation and Youth."

American Medical Association

"Our AMA… 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."
H-160.991, Health Care Needs of the Homosexual Population.

American Psychiatric Association

"Psychotherapeutic modalities to convert or 'repair' homosexuality are based on developmental theories whose scientific validity is questionable. Furthermore, anecdotal reports of "cures" are counterbalanced by anecdotal claims of psychological harm. In the last four decades, "reparative" therapists have not produced any rigorous scientific research to substantiate their claims of cure. Until there is such research available, [the American Psychiatric Association] recommends that ethical practitioners refrain from attempts to change individuals' sexual orientation, keeping in mind the medical dictum to first, do no harm.

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. Many patients who have undergone reparative therapy relate that they were inaccurately told that homosexuals are lonely, unhappy individuals who never achieve acceptance or satisfaction. The possibility that the person might achieve happiness and satisfying interpersonal relationships as a gay man or lesbian is not presented, nor are alternative approaches to dealing with the effects of societal stigmatization discussed.

Therefore, the American Psychiatric Association opposes any psychiatric treatment, such as reparative or conversion therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her sexual homosexual orientation."
Position Statement on Therapies Focused on Attempts to Change Sexual Orientation (Reparative or Conversion Therapies).

American Psychoanalytic Association

"Same-gender sexual orientation cannot be assumed to represent a deficit in personality development or the expression of psychopathology. As with any societal prejudice, anti-homosexual bias negatively affects mental health, contributing to an enduring sense of stigma and pervasive self-criticism in people of same-gender sexual orientation through the internalization of such prejudice.

As in all psychoanalytic treatments, the goal of analysis with homosexual patients is understanding. Psychoanalytic technique does not encompass purposeful efforts to "convert" or "repair" an individual's sexual orientation. Such directed efforts are against fundamental principles of psychoanalytic treatment and often result in substantial psychological pain by reinforcing damaging internalized homophobic attitudes."
Position Statement on Reparative Therapy.

American Psychological Association

"THEREFORE, BE IT RESOLVED, That the American Psychological Association affirms that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality regardless of sexual orientation identity;

BE IT FURTHER RESOLVED, That the American Psychological Association reaffirms its position that homosexuality per se is not a mental disorder and opposes portrayals of sexual minority youths and adults as mentally ill due to their sexual orientation;

BE IT FURTHER RESOLVED, That the American Psychological Association concludes that there is insufficient evidence to support the use of psychological interventions to change sexual orientation;

BE IT FURTHER RESOLVED, That the American Psychological Association encourages mental health professionals to avoid misrepresenting the efficacy of sexual orientation change efforts by promoting or promising change in sexual orientation when providing assistance to individuals distressed by their own or others' sexual orientation…"
Resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts.

American School Counselor Association

"Lesbian, gay, bisexual, transgendered and questioning (LGBTQ) youth often begin to experience self-identification during their pre-adolescent or adolescent years, as do heterosexual youth. These developmental processes are essential cognitive, emotional and social activities, and although they may have an impact on student development and achievement, they are not a sign of illness, mental disorder or emotional problems nor do they necessarily signify sexual activity.

The professional school counselor works with all students through the stages of identity development and understands this development may be more difficult for LGBTQ youth. 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."
The Professional School Counselor and LGBTQ Youth.

National Association of Social Workers

"People seek mental health services for many reasons. Accordingly, it is fair to assert that lesbians and gay men seek therapy for the same reasons that heterosexual people do. However, the increase in media campaigns, often coupled with coercive messages from family and community members, has created an environment in which lesbians and gay men often are pressured to seek reparative or conversion therapies, which cannot and will not change sexual orientation. Aligned with the American Psychological Association's (1997) position, NCLGB [NASW's National Committee on Lesbian and Gay Issues] believes that such treatment potentially can lead to severe emotional damage. Specifically, transformational ministries are fueled by stigmatization of lesbians and gay men, which in turn produces the social climate that pressures some people to seek change in sexual orientation. No data demonstrate that reparative or conversion therapies are effective, and in fact they may be harmful."
Position Statement, "Reparative" and "Conversion" Therapies.

Pan American Health Organization (PAHO): Regional Office of the World Health Organization

Services that purport to "cure" people with non-heterosexual sexual orientation lack medical justification and represent a serious threat to the health and well-being of affected people, the Pan American Health Organization (PAHO) said in a position statement launched on 17 May, 2012, the International Day against Homophobia. The statement calls on governments, academic institutions, professional associations and the media to expose these practices and to promote respect for diversity.

Statement, "Therapies" to change sexual orientation lack medical justification and threaten health

  1. *from The Lies and Dangers of Reparative Therapy.  https://www.hrc.org/resources/entry/the-lies-and-dangers-of-reparative-therapy

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