New study of “conversion therapy” exposes causes, as well as deep harms to LGBT people

OutRight Action International (OAI), an international LGBTQ human rights NGO, has published the first-ever global study on “conversion therapy,” which reveals the global reach of the discriminatory practice against LGBTQ people, as well as its major root causes that serve to sanction and encourage stigma, violence, and discrimination against LGBTQ people.

“Conversion therapy,” as OAI defines it in Harmful Treatment: The Global Reach of So-Called Conversion Therapy, is the “process of cis-gender, heteronormative indoctrination — that is, attempting to change, suppress, or divert one’s sexual orientation,” gender identity, or gender expression.

The study, based on survey results from approximately 500 LGBTIQ people (lesbian, gay, bisexual, transgender, intersex, queer/questioning) in 80 countries and 19 in-depth interviews, pinpoints the common global influences that drive this harmful practice. The two most frequently cited reasons for the practice are religion and the family (“family pressures”) — the primary patriarchal institutions that not only demand and reify gender and sexual conformity, but also create and perpetuate hateful rhetoric about LGBTQ people that, like a deadly cycle, fuels the desire for the practice. That is, the desire — to condemn LGBTQ people as evil, or poisonous, or curable — produces the demand for “conversion therapy.”

According to OAI’s study, “‘conversion therapy’ is a manifestation of the scourge of both societal and internalized homophobia and transphobia and is fueled by the messages that being LGBTIQ is pathological, disordered, and unacceptable. Such myths converge in a perfect storm of rejection and condemnation, leading to an ongoing demand for ‘conversion therapy,’ both by LGBTIQ people themselves as well as by their families, communities, and broader society.”

These myths or beliefs about LGBTQ people have had both a societal permeability and a social transmissibility — they are pervasive in society, and the myths are communicated and adopted by other societies — such that it is not unusual for LGBTQ people to seek out conversion therapy themselves. Notably, of the 22% of survey respondents who had undergone some form of conversion therapy in their lives, 33.5% said that they voluntarily sought out treatment. However, as the study observes, “every major medical and mental health association in the United States, Canada, Australia, and countries of the European Union (EU), as well as in many other countries, has condemned the practice of ‘conversion therapy.’” The Pan American Health Organization called it a “fraudulent practice,” and the World Psychiatric Association released a statement saying that “so-called treatments of homosexuality can create a setting in which prejudice and discrimination flourish, and they can potentially be harmful. The provision of any intervention purporting to ‘treat’ something that is not a disorder is wholly unethical.”

The language of “conversion therapy,” the study asserts, “hijack[s] human rights language to promote [conversion therapy providers’] services.” The medical jargon of “therapy” or “treatment” implies not only that there is a “cure” for homosexuality or nonconforming gender identity, but that these practices are necessary for a person’s well-being, as forms of self-care.

The social transmissibility of conversion therapy practices mirrors the West’s exportation of Christianity through colonization, particularly in Africa, Latin America, and the Caribbean, the study suggests. Of OAI’s survey respondents, 51% said that they “had received treatment from faith groups.” In Africa, 75% of survey respondents cited religion as the reason for conversion therapy. The study explains that “the export of so-called conversion therapy based on ex-gay models to African countries started in earnest in 1998, at the Lambeth Conference, a decennial assembly of bishops of the Anglican Communion …where African Bishops and other leaders were told that homosexuality could be cured.” According to Dr. Kapya Kaoma, a Zambian scholar and Anglican priest cited in the study, the Anglican Church’s position on homosexuality drives LGBTIQ criminalization in Africa and “prevents governments and psychological associations from cracking down on their ‘religious liberty’ to help those suffering from unwanted same-sex attraction.”

In fact, “religious liberty” is cited as a significant reason why conversion therapy has not been outlawed in most countries around the world. “As of mid-2019,” the study indicates, “only four countries had banned conversion therapy: Brazil, Ecuador, Malta, and Taiwan.” In the United States, conversion therapy has been banned only in 18 states, Washington, D.C., and Puerto Rico. OAI’s study cites “competing rights such as freedom of religion and freedom of speech, which have been used to defend such practices.”

While religion is “the reason most frequently cited, with religious leaders or institutions being primary promoters and perpetrators, especially in Africa and LAC [Latin America and the Caribbean],” the family is also a significant reason driving the desire for and belief in conversion therapy. The reasons are family demands for social conformity, along with pressure to “protect family honor.” As the OAI study notes, “respondents cited protection of family honor and cultural reasons as the main justifications for ‘conversion therapy.’ When analyzed by region [Asia, Africa, and LAC, where the responses were the highest], religious and cultural factors and a need to protect family honor are, by far, the leading reasons cited by African respondents” as well as for LAC respondents. “In contrast,” and perhaps indicative of the role of religion and Christianity in particular, “Asian respondents cited family honor and culture, as well as medical reasons, as the main justifications for performing ‘conversion therapy.’”

Based on OAI’s findings, the study includes a list of 11 recommendations for courses of action to end the practice of conversion therapy. These recommendations place responsibility on government and the social sector, and especially the medical field, to adopt laws and policies not only to outlaw the practice but to upend the harmful myths and discriminatory beliefs that support the institutions that allow and promote conversion therapy. These include calling upon medical licensing boards to “revoke medical licenses of health professionals who offer ‘conversion therapy’” and encouraging “faith leaders and religious institutions” to “publicly condemn the use of ‘conversion therapy’ and dispel the harmful, religiously-based myths which drive negative attitudes and exclusion of LGBTIQ people.”

Hopefully the first of many studies of its kind, OAI’s Harmful Treatment raises much-needed visibility about the pernicious global reach of conversion therapy. In documenting the reasons driving such a hateful practice, the study reveals the main patriarchal institutions that propagate the myths, laws, policies, and social and psychological pressures at work to maintain the heteronormative society.