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Straight, No Chaser: In the News – Gay Conversion Therapy

By Jeffrey Sterling, MD January 27, 2020

Straight, No Chaser previously reviewed the scientific basis for whether homosexuality is a choice. As was the case with this previous question, the issue of gay conversion therapy was brought prominently into the public eye politicized (i.e. via Marcus Bachmann, the husband of the former Minnesota congressperson). Just yesterday, The Iowa Senate approved a bill banning gay conversion therapy. This effort follows bans that have passed in California, New Jersey and the District of Columbia.
In this post, the questions surrounding gay conversion therapy are reviewed by answering five questions.


  1. What is gay conversion therapy? Gay conversion therapy is an effort to facilitate gays “overcoming” their homosexual attractions. These efforts are usually promoted by religious organizations, not the psychological/mental health or medical communities – none of which views homosexuality as a mental disorder.
  2. How is gay conversion therapy supposed to work? Given that it’s not an acknowledged medically- or psychologically-approved course of treatment, there’s no consensus approach to gay conversion therapy, and as such it’s often referred to as an attempt to “pray the gay away.” Prior efforts over the years weren’t as benign and included electric shock therapy (both as a means of negative reinforcement to gay thoughts and as a means to induce seizures and promote memory loss), psychoanalysis (“talk therapy”), coupling the administration of nausea-inducement while showing homosexual erotica, and estrogen therapy in men (presumably to reduce libido). It is of note that in the not-too-distant past, this so-called therapy was often court-mandated. It is of interest that Sigmund Freud railed against the need and predicted failure in any effectiveness of gay conversation therapy back in the 1920s. Even so, homosexuality was in fact classified as a mental disorder until 1973.
  3. Does gay conversation therapy work? No. The American Psychological Association (APA) performed a summary review of gay conversation therapy in 2009, reporting “These studies show that enduring change to an individual’s sexual orientation is uncommon.” Those undergoing gay conversation therapy generally continued to report same-sex attractions and denied higher levels of opposite-sex attractions.
  4. Is gay conversation therapy harmful? Obviously some past efforts such as electric shock therapy have physical consequences, but the real focus of this question is the damage to mental health. The entire premise of gay conversation therapy is a mental disorder exists, which hasn’t been demonstrated medically or in the behavioral health literature. As such, the entities left to presumed problems exist with homosexuality are religious entities or others inclined to be intolerant of these individuals and/or their lifestyles. The APA flatly states the real danger to the mental health of homosexuals are systemic pressure to conform and ongoing prejudice. Gay conversion therapy intensifies these pressures, and as such has specific adverse effects including anxiety, depression and suicidal thoughts and actions.
  5. Why do people presume gay conversion therapy works? In 2003 Dr. Robert Spitzer, a psychiatrist largely responsible for removal of homosexuality from the APA’s mental disorder list, reported that a review of conversion therapy suggested some people could change sexual orientation. Given the stature of Dr. Spitzer, this was quite the endorsement. Groups that promote conversion therapy often point to a single study to support their work. Less than ten years later, he retracted his comments based on the lack of scientific effort supporting his claim.

 conversion 2

There are currently lawsuits addressing gay conversation therapy. Those against it note its ineffectiveness and the consequences of having had it. In fact a New Jersey state court recently upheld the ban there on the basis that conversion therapy constitutes consumer fraud. The lawsuits supporting gay conversion therapy focus on freedom of speech concerns instead of any actual demonstrated benefit. The implication here is efforts at mind control are free speech instead of a psychiatric practice. 

Frankly, gay conversion therapy represents another example of measures that would be best dealt with be applying objective criteria to determine any effectiveness and let the chips fall where they may. To that end, there currently does not exist data that supports it’s effectiveness. Efforts to suggest otherwise are occurring with other considerations, if not agenda, in play.
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