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Conversion therapy: How it harms mental health

Reviewed by Brooks Baer, LCPC, CMHP

A Progress Pride flag rippling in the wind

What is conversion therapy?

Conversion therapy is a set of harmful practices aimed at changing a person’s sexual orientation or gender identity. It’s also called “reparative therapy,” “gender critical therapy,” or “sexual reorientation.”

The goal of conversion therapy is to change the sexual orientation of LGBTQIA+ individuals to heterosexual. It also seeks to make transgender or nonbinary people identify with their birth-assigned gender (cisgender).

It’s important to note that so-called conversion “therapy” is dangerous, deeply damaging, and unsupported by scientific evidence. The American Psychological Association refers to conversion therapy as “sexual orientation change efforts (SOCE)” or “gender identity change efforts (GICE)” to separate it from accepted, evidence-based forms of therapy.

As of December 2023, there are over 1,300 conversion therapy practitioners across the United States.1 Because conversion therapy is often promoted and practiced secretively, the true number may be much larger.

What happens in conversion therapy?

Conversion therapy methods can be physical or non-physical.2 Physical methods involve disturbing practices such as physical or sexual abuse, kidnapping and imprisonment, electroconvulsive therapy, hormone treatments, and aversion therapy.

Non-physical methods usually take the form of talk therapy, peer counseling, or pastoral counseling. This may include enforcing gender stereotypes, urging recipients to cut family ties, or advocating for celibacy.

A therapist or person who practices conversion therapy may hold what they truly believe are positive intentions. For instance, they may want to help someone fit into their family or religious community. However, regardless of their intentions or therapeutic approach, conversion therapy is ineffective and harmful to both mental and physical health.3

The impact of conversion therapy on mental health

Conversion therapy is associated with an increased risk for mental health concerns including depression and internalized homophobia.4 A study found that LGBTQIA+ youth who experienced conversion therapy had a suicide attempt rate over double that of those who did not undergo the therapy.5

Professional medical and human rights associations strongly oppose conversion therapy practices, as overwhelming evidence shows it is both harmful and ineffective.6,7 Organizations that stand against conversion therapy include the American Academy of Child and Adolescent Psychiatry, the American Psychological Association, and the American Psychiatric Association, among many others.

Why conversion therapy is harmful

Conversion therapy is a shame-based practice. It undermines a person’s sense of self and discredits their sexual orientation or gender identity. It doesn’t help LGBTQIA+ people explore their identity or find support. Instead, it encourages them to suppress and feel ashamed of who they truly are.

Along with shame, conversion therapy can result in:8

  • Suicidal behavior
  • Depressive symptoms
  • Feelings of anger
  • Feelings of grief
  • Loss of sense of identity
  • Substance abuse
  • Dissociation
  • Emotional numbness
  • Lower levels of life satisfaction

Is being LGBTQIA+ harmful?

Identifying as LGBTQIA+ isn’t harmful. It also isn’t a mental disorder or illness. All major psychological associations agree it’s a normal part of human sexuality and gender expression.

The history of conversion therapy is rooted in the belief that being LGBTQIA+ is a mental illness or disorder. In the past, variations in sexual orientation and gender identity were not seen as natural or healthy aspects of human diversity.

Unfortunately, depathologizing the spectrum of human sexuality and gender identity has taken many decades. The American Psychiatric Association finally removed homosexuality from its diagnostic manual in 1973 and “gender identity disorder” was only eliminated in 2013.9,10

While identifying as LBGTQIA+ isn’t a mental illness, members of this community are at higher risk for depression, anxiety, substance use disorders, and other mental health concerns.11 The harm associated with being LGBTQIA+ comes from social stigma and lack of support, not the identity itself.

Societal oppression and discrimination put LGBTQIA+ people at an increased risk for mental health struggles, homelessness, and violence. They may also experience trauma from family and religious rejection, pressure around coming out, and inadequate physical and mental health care.

Can your sexuality or gender identity change?

Your sexual orientation and gender identity are determined through self-discovery. This means you may identify as one gender or sexual orientation and discover later that a different identity feels more suited to your internal experience. 

Your sexual identity and gender identity can’t be changed by external forces or pressure. These efforts may cause you to feel shame and change how you express your identity, but they can’t change you internally. 

Currently there is no federal law preventing conversion therapy in the United States. A bill designed to limit the practice was proposed in June 2023, but has not yet been passed.12

A growing number of US states have issued conversion therapy bans. States that have banned conversion therapy for minors include:

  • California
  • Colorado
  • Connecticut
  • Delaware
  • Hawaii
  • Illinois
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • Oregon
  • Rhode Island
  • Utah
  • Vermont
  • Virginia
  • Washington

As it stands today, conversion therapy remains legal in the majority of states. According to an estimate from June of 2019, 16,000 young people in the US will undergo conversion therapy before they turn 18.13 

Mental health resources

Exploring your sexual orientation and gender identity is a normal and healthy part of life. And it’s not unusual to be overwhelmed by the experience. 

If you’re struggling to understand or fully express your sexual or gender identity, help is available. A licensed mental health professional can work with you to address past trauma, understand your identity, and help you live a healthier, more authentic life. Search for an LGBTQIA+-affirming therapist near you today. 

If you’re in crisis and need help now, call or text one of the following helplines for free, confidential support, 24/7: 

About the author

The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.