Conversion therapy

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Conversion therapy
ClaimsOne's sexual orientation, romantic orientation, gender identity, or gender expression can be changed to fit heterosexual, heteroromantic, and cisgender norms.
Notable proponents Ex-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]

Contents

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. Stolperstein von Friedrich Paul von Groszheim.jpg
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 One by One booth.jpg
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 Curbin 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. .mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{} 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 Countries banning conversion therapy.svg
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

Related Research Articles

Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder. The International Classification of Diseases uses the term gender incongruence instead of gender dysphoria, defined as a marked and persistent mismatch between gender identity and assigned gender, regardless of distress or impairment.

The Alliance for Therapeutic Choice and Scientific Integrity (ATCSI), which until 2014 was known as the National Association for Research & Therapy of Homosexuality (NARTH), also known as the NARTH Institute, is a US organization that promotes conversion therapy, a pseudoscientific practice used in attempts to change the sexual orientation of people with same-sex attraction. NARTH was founded in 1992 by Joseph Nicolosi, Benjamin Kaufman, and Charles Socarides. Its headquarters were in Encino, California, at its Thomas Aquinas Psychological Clinic. NARTH has not been recognized by any major United States–based professional association.

<span class="mw-page-title-main">Homosexuality and psychology</span> Homosexuality as studied by the field of psychology

The field of psychology has extensively studied homosexuality as a human sexual orientation. The American Psychiatric Association listed homosexuality in the DSM-I in 1952 as a "sociopathic personality disturbance," but that classification came under scrutiny in research funded by the National Institute of Mental Health. That research and subsequent studies consistently failed to produce any empirical or scientific basis for regarding homosexuality as anything other than a natural and normal sexual orientation that is a healthy and positive expression of human sexuality. As a result of this scientific research, the American Psychiatric Association removed homosexuality from the DSM-II in 1973. Upon a thorough review of the scientific data, the American Psychological Association followed in 1975 and also called on all mental health professionals to take the lead in "removing the stigma of mental illness that has long been associated" with homosexuality. In 1993, the National Association of Social Workers adopted the same position as the American Psychiatric Association and the American Psychological Association, in recognition of scientific evidence. The World Health Organization, which listed homosexuality in the ICD-9 in 1977, removed homosexuality from the ICD-10 which was endorsed by the 43rd World Health Assembly on 17 May 1990.

The ex-gay movement consists of people and organizations that encourage people to refrain from entering or pursuing same-sex relationships, to eliminate homosexual desires and to develop heterosexual desires, or to enter into a heterosexual relationship. Beginning with the founding of Love In Action and Exodus International in the mid-1970s, the movement saw rapid growth in the 1980s and 1990s before declining in the 2000s.

<span class="mw-page-title-main">Joseph Nicolosi</span> American clinical psychologist (1947–2017)

Joseph Nicolosi was an American clinical psychologist who advocated and practised "reparative therapy", a form of the pseudoscientific treatment of conversion therapy that he claimed could help people overcome or mitigate their homosexual desires and replace them with heterosexual ones. Nicolosi was a founder and president of the National Association for Research and Therapy of Homosexuality (NARTH). Medical institutions warn that conversion therapy is ineffective and may be harmful, and that there is no evidence that sexual orientation can be changed by such treatments.

<span class="mw-page-title-main">LGBTQ rights in New Zealand</span>

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<span class="mw-page-title-main">Ego-dystonic sexual orientation</span> Psychiatric diagnosis

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<span class="mw-page-title-main">Homosexuality and the Church of Jesus Christ of Latter-day Saints</span>

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Gay affirmative psychotherapy is a form of psychotherapy for non-heterosexual people, specifically gay and lesbian clients, which focuses on client comfort in working towards authenticity and self-acceptance regarding sexual orientation, and does not attempt to "change" them to heterosexual, or to "eliminate or diminish" same-sex "desires and behaviors". The American Psychological Association (APA) offers guidelines and materials for gay affirmative psychotherapy. Affirmative psychotherapy affirms that homosexuality or bisexuality is not a mental disorder, in accordance with global scientific consensus. In fact, embracing and affirming gay identity can be a key component to recovery from other mental illnesses or substance abuse. Clients whose religious beliefs are interpreted as teaching against homosexual behavior may require some other method of integration of their possibly conflicting religious and sexual selves.

Kenneth J. Zucker is an American-Canadian psychologist and sexologist known for the living in your own skin model, a form of conversion therapy aimed at preventing pre-pubertal chidren from growing up transgender by modifying their gender identity and expression.

Jack Drescher is an American psychiatrist and psychoanalyst known for his work on sexual orientation and gender identity.

Sexual fluidity is one or more changes in sexuality or sexual identity. Sexual orientation is stable for the vast majority of people, but some research indicates that some people may experience change in their sexual orientation, and this is slightly more likely for women than for men. There is no scientific evidence that sexual orientation can be changed through psychotherapy. Sexual identity can change throughout an individual's life, and does not have to align with biological sex, sexual behavior, or actual sexual orientation.

<span class="mw-page-title-main">Sexual relationship disorder</span> Medical condition

Sexual relationship disorder was listed in the tenth edition of the World Health Organization's (WHO) International Classification of Diseases, the ICD-10, the most widely used diagnostic manual by psychiatrists and psychologists worldwide. It was described as a disorder where a person has difficulties forming or maintaining a sexual relationship because of their gender identity or sexual orientation. In 2014, it was determined that there was no justification for the existence of this mental disorder category, and the diagnosis was not included in the ICD-11, which went into effect in January 2022.

<span class="mw-page-title-main">Sexual maturation disorder</span> Medical condition

Sexual maturation disorder was listed in the tenth edition of the World Health Organization's (WHO) International Classification of Diseases, the ICD-10, the most widely used diagnostic manual by psychiatrists and psychologists worldwide. It was described as a disorder of anxiety or depression related to an uncertainty about one's gender identity or sexual orientation. In 2014, it was determined that there was no justification for the existence of this mental disorder category, and the diagnosis was not included in the ICD-11, which went into effect in January 2022.

The Aversion Project was a medical torture programme in South Africa led by Aubrey Levin during apartheid. The project identified gay soldiers and conscripts who used drugs in the South African Defence Forces (SADF). Victims were forced to submit to "curing" their homosexuality because the SADF considered homosexuality to be subversive, and those who were homosexual were subject to punishment. In 1995, the South African Medical Association issued a public apology for past wrongdoings.

Homosexuality was classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) beginning with the first edition, published in 1952 by the American Psychiatric Association (APA). This classification was challenged by gay rights activists during the gay liberation following the 1969 Stonewall riots, and in December 1973, the APA board of trustees voted to declassify homosexuality as a mental disorder. In 1974, the DSM was updated and homosexuality was replaced with a new diagnostic code for individuals distressed by their homosexuality, termed ego-dystonic sexual orientation. Distress over one's sexual orientation remained in the manual, under different names, until the DSM-5 in 2013.

<span class="mw-page-title-main">Sexual orientation change efforts and the Church of Jesus Christ of Latter-day Saints</span>

Because of its ban against same-sex sexual activity and same-sex marriage the Church of Jesus Christ of Latter-day Saints has a long history of teaching that its adherents who are attracted to the same sex can and should attempt to alter their feelings through righteous striving and sexual orientation change efforts. Reparative therapy is the pseudoscientific practice of attempting to change an individual's sexual orientation from homosexual or bisexual to heterosexual, or their gender identity from transgender to cisgender using psychological, physical, or spiritual interventions. There is no reliable evidence that such practices can alter sexual orientation or gender identity, and many medical institutions warn that conversion therapy is ineffective and potentially harmful.

Many health organizations around the world have denounced and criticized sexual orientation and gender identity change efforts. National health organizations in the United States have announced that there has been no scientific demonstration of conversion therapy's efficacy in the last forty years. 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.

The history of conversion therapy can be divided broadly into three periods: an early Freudian period; a period of mainstream approval of conversion therapy, when the mental health establishment became the "primary superintendent" of sexuality; and a post-Stonewall period where the mainstream medical profession disavowed conversion therapy.

References

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