Conversion therapy poses a substantial risk of severe and lasting harm

Research from authoritative scientific studies concludes that conversion therapy poses significant risks of harm. Past studies (from 1960-2007) described in the 2009 APA Report indicate that the risks of harm to adults from both talk therapies that were non-aversive, as well as aversive approaches that are less common now, include feelings of distress, anxiety, depression, increased suicidal ideation and suicide attempts, increase in substance abuse, self-blame, guilt, and loss of hope, among other negative feelings, as well as disillusionment with religious faith, and harm to family relationships.

More recent research on adults who participated in conversion therapy since 2007 supports the reports of harm documented in the 2009 APA Report. One study found that 37% of all participants reported moderate and significant harms including those found in the APA Report, such as increased risk of suicidality, depression, self-blame, and disillusionment with faith. This is a high rate of harm relative to alternatives. In this same study, those who received therapy that encouraged identity exploration found such approaches beneficial and not harmful as compared to those in conversion therapy.

Research shows that conversion therapy also poses a significant risk of harm to gender diverse people, including individuals who have a gender identity different from their sex assigned at birth. The available research shows that conversion therapy forces gender conformity and reinforces stigma and discrimination toward gender diverse people. These practices are associated with poor psychosocial outcomes, such as heightened psychological distress, compromised overall wellbeing, and health disparities.

Families often seek out conversion therapy when distressed about their child’s sexual orientation and gender identity. In particular, gender nonconforming youth are more likely to be taken by their parents to receive conversion therapy to change their gender expression and identity. As noted above, unlike other therapies that help parents support their children’s unique developmental tasks, conversion therapy often encourages parents to engage in coercive, rejecting, and critical behaviors, based on false claims that these behaviors can change or influence a child’s gender identity or sexual orientation.

The rejection of an adolescent’s gender identity and expression is harmful as it is associated with poorer emotional, social and vocational outcomes, and gender identity change efforts are clear examples of rejection. The risks posed by conversion therapy are demonstrably dangerous for adolescents. Research published since the APA Report on young adults who experienced such efforts in adolescence shows that these types of practices pose very serious psychological risks.

Recent research published in 2018 on young adults who reported that they had been subjected to conversion therapy in adolescence revealed serious harms. These individuals were 3 times more likely to have attempted suicide and to have had suicidal ideation (thoughts of suicide) than LGBT adolescents who are not subjected to conversion therapy. Adolescents who had been subjected to conversion therapy reported being seriously depressed 3.5 times more often than those who had not. Beyond the negative short-term mental health effects, participants also experienced negative long-term effects such as lowered life satisfaction, less social support, lower socioeconomic status, and other serious difficulties in their young adulthood that could impact them over the long term.

Another 2009 study showed that conversio therapy applied during adolescence is one of several types of rejecting parental behaviors that increase the rates of depression, suicidal ideation and suicide attempts in young adults. In fact, those who have had these rejecting experiences are twice as likely to experience depression, suicidal ideation, and suicide attempts as those LGBT individuals who have not experienced rejecting behaviors and the rates of depression, suicidal ideation and suicide attempts increase as the amount of rejection increases.

The risk of harm to children and adolescents from conversion therapy is heightened by additional considerations. Therapeutic interventions for children and adolescents must account for their physical, emotional and cognitive immaturity relative to adults. It is therefore reasonable to be particularly concerned about the likelihood of serious risks to children where there is research demonstrating that conversion therapy also poses a serious risk of harm to adults. Children and adolescents are particularly in need of appropriate therapeutic interventions given their stage of psychological development.

Young people subjected to conversion therapy are delaying or being denied effective treatment for the psychological distress they are experiencing, thus potentially increasing the risk of life-threatening conditions such as suicidal ideation and suicide attempts. Indeed, for adolescents who are particularly vulnerable to hopelessness, being told you can change your sexual orientation or gender identity, and then discovering that such assurances lead to failure, only increases despair and hopelessness.

Due to these harms, sexual orientation and gender identity change efforts for children and adolescents are considered invalid. The US Substance Abuse and Mental Health Services of the Department of Health and Human Services has rejected conversion therapy for these populations and stated about gender identity change efforts:

“Directing the child or adolescent to conform to any particular gender expression or identity, or directing parents and guardians to place pressure on the child or adolescent to conform to specific gender expressions and/or identities, is inappropriate and reinforces harmful gender stereotypes.”

Roland Behm