Conversion therapy has long been a controversial subject, often regarded as being wholly unethical by critics. Over the last several decades there has been a powerful push to ban it, with publicity painting it as being abusive and harmful. But though like any practice there can be unethical conversion therapy, the facts of it are often misunderstood. This often leads to people being misled about the nature of conversion therapy and can undermine patient rights.
In reality, conversion therapy is nothing like how it is depicted by those opposed to it. Usually, it is rather mundane in practice, consisting of simple talk therapy and counseling to help individuals with unwanted feelings. Most therapists rely on the same techniques as any other type of therapy when offering conversion therapy.
This kind of talk therapy, more broadly known as psychotherapy, is by and far the most common form of mental health treatment for any problems people feel they might have. It involves primarily talking with individuals to work through their thoughts, emotions, and behaviors, and develop strategies to deal with stress or unwanted feelings. It is also a good way for individuals to explore difficult feelings in an emotionally supportive context, or face sources of discomfort or stress in their lives.1
While most debate centers around whether conversion therapy is harmful or helpful, that is not in fact it’s most pressing issue. Patient consent, though perhaps the most relevant aspect of it, is frequently ignored in favor of trying to undermine the entire practice of conversion therapy. Forced participation in any form of therapy is a terrible violation, and deeply unethical. Patients’ autonomy must always be a priority, and protecting the rights of those who want to seek such treatments goes hand in hand with stamping out involuntary practices.
The History of Conversion Therapy
Historically, homosexuality has often been viewed as an illness by medical and psychological communities. Many believed that it negatively impacted their life and ability to function in society. Conversion therapy, also known as Sexual Orientation Change Efforts (SOCE) was often endorsed and provided by medical professionals to help in this regard, and homosexuals often sought out therapy themselves in the hopes that it would improve their lives. Many others, however, were pressured or even forced into seeking treatment.
Conversion therapy through the 19th century ranged from offering support and simple counseling to patients to extreme and abusive methods. This included inducing vomiting in patients while they viewed homosexual images, administering electrical shocks, and attempting to make people associate homosexuality with disgust. Many patients of these methods described it as extremely degrading and inhumane.2
Thankfully, in the United States most conversion therapy has been more mundane than such examples. Exactly how often people were subjected to such abusive so-called therapy is unclear, but at least in modern settings such treatments are not practiced. Instead, talk therapy and pastoral counseling have made up almost all sexual orientation change efforts, and such therapy is far different than the ugly image that most people imagine.3
Today, many stories we hear of abuses rampant in conversion therapy within the United States are provably false or unverifiable. One notable example is that of Sam Brinton, who described torturous treatment at the hands of a therapist that does not appear to have happened. Indeed, even many LGBTQ+ organizations have labeled such stories as simply ‘too good to be true,’ which is perhaps an odd thing to say about recountings of vicious abuse.4
As a result of age-old abuses and exaggerated stories, people’s knowledge of SOCE is often filled with more misunderstandings than facts. Because of this, laws against conversion therapy are rarely designed to have any practical effect on it or protect patients’ freedoms. Instead, they seem to exist only to influence how it is perceived by the public, not as a solution to specific actual abuses.5
Why Would People Seek Out Conversion Therapy?
Many people don’t understand why someone would ever seek out conversion therapy. Often, those who struggle with unwanted sexual attraction are dismissed as simply homophobic or confused. Others are written off as bowing to societal pressure to conform. Because of this, many opponents of conversion therapy believe that those seeking it must be protected even from themselves.
In reality, the reasons why people seek out conversion therapy on their own are varied and poorly researched. Little attention is given to why people might want conversion therapy, as opposed to whether or not it is good for them.
What we do have suggests that pressure to conform is rarely why people seek SOCE. In one study of men, factors such as being married, feeling disconnected from other men, and difficulty expressing nonsexual affection were some of the most common factors. The study also found that these men did report positive changes to their attraction and psychological functioning from SOCE.6
The rest of what we know tends to come from individual accounts, either promoting or condemning SOCE. Generally, individuals seem to seek it because their feelings of homosexual attraction were unwanted or causing emotional or mental anguish in some way. Some do indeed seek treatment to make it easier to live in accordance with cultures or beliefs they value. Others do so to resolve mismatches between forms of attraction, overcome trauma, improve their attraction towards a desired sex, or many other personal reasons.
Whatever their motive, the underlying feelings or experiences of these individuals should not be dismissed. To not offer, let alone forbid, desired professional care does not protect an individual. It only removes their options and limits their ability to seek help.
Does Conversion Therapy Work?
Many people claim that it is not possible to change someone’s sexual orientation, no matter how they might try or what they might want. This idea is often repeated by many major institutions out there, including mainstream mental health organizations. However, it’s not actually supported by the evidence. To the contrary, many studies support the idea that SOCE may work to change people’s sexual orientation and produce positive changes in their lives as well.
Many studies, for example, demonstrate that a change of homosexual orientation is absolutely possible. In one, individuals pursuing SOCE with various Christian ministries demonstrated substantial changes in their attraction. Moreover, the study showed that psychological distress does not on average increase by any metric for most people trying to change their sexuality.7
Other surveys of those who have received SOCE generally tend to report a positive change as well by most participants. The majority state that they experienced a change from a predominantly or exclusively homosexual orientation to one that was predominantly heterosexual. The research also explores whether these individuals are creating self-deceptive narratives of their own conversion, concluding that this is not the case, and that their reports of their own feelings are credible.8
Similar evidence is found when one looks at a patient’s subsequent mental well-being. Almost all patients that undergo SOCE report large improvements in their psychological, interpersonal, and spiritual well-being. Those that reported doing worse even on a minority of mental health indicators made up less than 10% of the survey size.9
Ultimately, SOCE may not work for everyone, but it absolutely does seem to help the majority of people that seek it. The idea that it is ineffective is disputed by the evidence, if not outright wrong. Those who receive it generally tend to be happy with it and find themselves doing better even if it didn’t ultimately help them change their orientation.
Can Conversion Therapy Be Harmful?
Because of its controversy, significant effort has been made to prove that conversion therapy may cause harm. This is particularly true among the many people who were involuntarily forced into therapy and rightfully resent it. But the oft-repeated statements that there is a scientific consensus that conversion therapy is bad, or that conversion therapy has “the potential to harm” those who receive it, are misleading. There is a potential for harm in all health services, but for that to mean anything one would need to show that a particular form of care is notably worse than others, or worse than not providing options for such care at all.10
Many studies do indeed show that conversion therapy may be associated with harm. In terms of how many studies show this, this conclusion may even be in the majority. As an example, one recent study showed that LGBT individuals who underwent conversion therapy were more likely to report having attempted suicide than those who did not. Another has shown that it is associated with emotional or mental harm.11; 12
This data, however, isn’t perfect. While these studies help shed a little light on the mental health of those seeking conversion therapy, most don’t actually tell us much about conversion therapy itself. Almost all research showing harm suffers from not knowing whether worsened mental health was a result of therapy or a cause of it. This is not an oversight, but simply a lack of data. Studies that have reexamined other studies data while attempting to account for this often find contrary results. For example, in one paper performing the same study but accounting for previous suicide attempts, conversion therapy was shown to reduce suicide, not increase it.13
Additionally, research does not always distinguish between therapy sought voluntarily and therapy that was forced. Some even use language that implies they are studying only those involuntarily compelled to undergo conversion therapy. What we do know, however, is that adults that sought out conversion therapy voluntarily report generally positive results.
The best studies have suggested that when voluntarily sought out by those seeking to change, individuals report feeling improvements in their psychological, interpersonal, and spiritual well-being. They also report significant reductions in their unwanted attraction, thoughts, and fantasies. This contrast with the many studies finding worsened mental health likely indicates that the larger issue is that therapy is being forced on those that don’t want it, and that conversion therapy itself can be healthy for those who desire it.14
This is not a conclusive subject. There are many different studies claiming to show harm, and many showing positive results. But there is no rigorous proof showing that conversion therapy is worse than any other form of psychotherapy. Just more controversial.
Should Conversion Therapy Be Allowed for Minors?
One of the most controversial aspects of conversion therapy is whether to allow it for minors. For many parents SOCE can seem like a fantastic tool to help struggling kids, especially given evidence showing that it can help with psychological well-being. If conversion therapy can be a healthy kind of care for anyone, then barring minors from accessing it is depriving them of a potentially valuable mental health tool.
In and of itself, there is no reason why minors should not be allowed to seek SOCE. It may be something many would find healthy and helpful. The problem is, in most cases minors are not choosing such therapy, but being forced into it. There is very little good data, but surveys from around the world suggest that about 75% of those under 18 who receive conversion therapy state that it was coerced, not voluntary. This may be notably lower in developed countries, but it’s absolutely still an issue. Particularly given the legal and moral ambiguity of minors’ capacity to consent to or refuse treatment, it is difficult to imagine any way by which we could ensure that minors are not being forced by parents or family members in this regard.15
For many minors, conversion therapy isn’t something they seek out to help them with unwanted feelings. It is an external pressure to change for the world around them. Even when not forced, the desire to feel loved and accepted by one’s parents can lead many to feel like they have no other choice. Given how many children state that they felt coerced, and how violating non-consensual therapy can be, this is particularly dangerous.
Better protections need to be implemented for any minors receiving conversion therapy. The startling rates of coerced therapy in many countries show that what we are doing now clearly isn’t enough. In the US though, outright bans on conversion therapy are likely counterproductive in actually protecting minors from involuntary therapy. Most laws banning conversion therapy only impact licensed mental health practitioners, when most conversion therapy currently is practiced by counselors and lay ministers. As a result, it only serves to further push the practice into potentially less professional spaces where fewer protections can be ensured. Allowing for professional conversion therapy serves to both help prevent abuse and provide quality access to care.16
Beyond how we deal with this matter legally, it is even more important that we get it right in our personal lives. For Catholic parents of children with same sex attraction, it can be as confusing for us as it undoubtedly is for our children. Many parents may not know how to proceed or feel panic. For those whose children express no desire to change they may feel that it is necessary to pressure their children to seek conversion therapy, even if it is unwanted. It is our job, as parents, to treat our children as gifts from God, and part of that is teaching them our beliefs. But we cannot force anyone to change if they do not want to, and though we might encourage it, conversion therapy should never be something we pressure them into.
Treat your children with love, no matter what. They are no less our children because of their attraction, and no less worthy of our love. If you are feeling unsure, take the time to educate yourself and review Church guidelines and advice for how to talk to your children in a healthy manner about same sex attraction.17
What About Those Who Don’t Want to Change?
The involuntary aspect of a substantial portion of conversion therapy around the world is often overshadowed by the outlandish exaggeration and demonization of SOCE as a whole. This is deeply unfortunate, as it more than anything should be the focus. Instead, very little research even looks into just what portion of SOCE is nonconsensual, as opposed to its effects. What we have, though, suggests that over 60% conversion therapy around the world is coerced in some way.18
Forcing anyone to undergo conversion therapy is deeply wrong, undermining both their freedom and person. Such willful violation of another individual is also unlikely to ever lead to anything other than harm for the person in question. It is entirely unacceptable, and individuals should be careful in encouraging others to seek SOCE to avoid pressuring them into anything they do not want.
Putting a stop to involuntary conversion therapy should be a priority of both proponents and opponents of SOCE. Perhaps through such a middle ground, we can work together to ensure that patient rights are protected, and their freedom of choice preserved.
Beyond the matter of conversion therapy, it’s important to recognize that everyone deserves to be treated with dignity. The Church teaches that those who experience same-sex attraction should be accepted with respect, compassion, and sensitivity. That is important to remember in all aspects of how we treat others, whether someone wants to change or not.
Conclusion
Conversion therapy is a controversial topic. There are real issues with it, most particularly with patients’ consent. However, such issues are often obscured by activists seeking to undermine SOCE as a whole, instead of focusing on rooting out actual abuses.
Ethical SOCE can help many people with their mental and psychological health. There is no reason to believe SOCE is a particularly bad form of therapy, and there is good reason to allow access to those who desire it. No one should be prohibited from exploring it as a way to help their mental and emotional well-being.
There is no reason that patient protections should come at the expense of access to care. By sticking to the facts, we can accomplish both, protecting children and adults from being forced into it while ensuring access for those that want it.
Endnotes
[1] “Psychotherapies.” National Institute of Mental Health, February 2024. https://www.nimh.nih.gov/health/topics/psychotherapies#:~:text=Psychotherapy%20.
[2] Chenier, Elise. “Aversion Therapy.” GLBTQ. Accessed November 15, 2024. http://www.glbtqarchive.com/ssh/aversion_therapy_S.pdf.
[3] “Conversion Therapy: An Evidence Assessment and Qualitative Study.” GOV.UK. Accessed November 15, 2024. https://www.gov.uk/government/publications/conversion-therapy-an-evidence-assessment-and-qualitative-study/conversion-therapy-an-evidence-assessment-and-qualitative-study.
[4] Besen, Wayne. “Has Sam Brinton’s Story Always Been Too Good to Be True?” LGBTQ Nation, December 7, 2022. https://www.lgbtqnation.com/2022/12/sam-brintons-story-always-good-true/.
[5] George, Marie-Amélie. “Expressive Ends: Understanding Conversion Therapy Bans.” Alabama Law Review, 2018. https://doi.org/https://williamsinstitute.law.ucla.edu/wp-content/uploads/Expressive-Ends-Understanding-Conversion-Therapy-Bans.pdf.
[6] Karten, Elan Y., and Jay C. Wade. “Sexual Orientation Change Efforts in Men: A Client Perspective.” The Journal of Men’s Studies 18, no. 1 (January 1, 2010). https://doi.org/10.3149/jms.1801.84.
[7] Jones, Stanton L., and Mark A. Yarhouse. 2011. “A Longitudinal Study of Attempted Religiously Mediated Sexual Orientation Change.” Journal of Sex & Marital Therapy 37 (5): 404–27. doi:10.1080/0092623X.2011.607052.
[8] Spitzer, Robert L. “Can Some Gay Men and Lesbians Change Their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation.” National Library of Medicine 32, no. 5 (October 2003). https://doi.org/10.1023/a:1025647527010.
[9] Nicolosi, J., Byrd, A. D., & Potts, R. W. (2000). Retrospective Self-Reports of Changes in Homosexual Orientation: A Consumer Survey of Conversion Therapy Clients. Psychological Reports, 86(3_suppl), 1071-1088. https://doi.org/10.2466/pr0.2000.86.3c.1071
[10] Sutton, Philip M. “Professional Care for Unwanted Same-Sex Attraction: What Does the Research Say?” National Library of Medicine 82, no. 4 (2015). https://doi.org/10.1179/0024363915z.000000000147a.
[11] Green, Amy E., Myeshia Price-Feeney, Samuel H. Dorison, and Casey J. Pick. “Self-Reported Conversion Efforts and Suicidality among US LGBTQ Youths and Young Adults, 2018.” American Journal of Public Health 110, no. 8 (August 2020). https://doi.org/10.2105/ajph.2020.305701.
[12] Independent Forensic Expert Group. “Statement on Conversion Therapy.” Science Direct 72 (May 2020). https://doi.org/10.1016/j.jflm.2020.101930.
[13] Sullins, D. Paul. “Sexual Orientation Change Efforts Do Not Increase Suicide: Correcting a False Research Narrative.” National Library of Medicine 51, no. 7 (September 6, 2022). https://doi.org/10.1007/s10508-022-02408-2.
[14] Nicolosi, Joseph, A. Dean Byrd, and Richard W. Potts. “Retrospective Self-Reports of Changes in Homosexual Orientation: A Consumer Survey of Conversion Therapy Clients.” Psychological Reports 86, no. 3_part_2 (June 2000). https://doi.org/10.2466/pr0.2000.86.3c.1071.
[15] Outright International. “Harmful Treatment: The Global Reach of So-Called Conversion Therapy.” Outright International, August 2019. https://outrightinternational.org/sites/default/files/2023-09/092523_Outright_Conversion2023%20(1).pdf.
[16] George, Marie-Amélie. “Expressive Ends: Understanding Conversion Therapy Bans.” Alabama Law Review, 2018. https://doi.org/https://williamsinstitute.law.ucla.edu/wp-content/uploads/Expressive-Ends-Understanding-Conversion-Therapy-Bans.pdf.
[17] Ciancio, Susan. “Responding to Same-Sex Attraction as a Catholic Parent.” Human Life International, March 18, 2022. https://www.hli.org/resources/responding-to-same-sex-attraction-as-catholic-parent/.
[18] Outright International. “Harmful Treatment: The Global Reach of So-Called Conversion Therapy.” Outright International, August 2019. https://outrightinternational.org/sites/default/files/2023-09/092523_Outright_Conversion2023%20(1).pdf.
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William has worked as a professional writer for pro-life organizations since 2018, including Human Life International, Celebrate Life Magazine, and Pro-Life Utah. He has also written for the Bipartisan Press and edited for several blogs and websites. William is the founder and president of the Lifeguard Initiative, a pro-life group that informs the public, helps pregnant women in need, and works for pro-life legislation in many states.