Conversion Therapy Remains Far Too Common, Study Finds

Conversion therapy, designed to change a person’s sexual orientation or gender identity, has been condemned by major medical and mental health groups, but it remains far too prevalent, especially for transgender people, according to a new study.

The study, published Wednesday in the journal PLOS One, looked at previous surveys of LGBTQ+ people on whether they’d experienced what the authors call “conversion practices,” or CP. Mental health professionals consider these practices not only ineffective but harmful, contributing to depression and other negative consequences, including suicide.

The authors, affiliated with a variety of universities, examined 14 surveys of patients conducted between 2011 and 2020, plus two studies of mental health care providers. The patient surveys were drawn from the U.S., Canada, and Australia, Colombia, South Korea, and U.K. Six of the surveys were conducted in the U.S., four in Canada, and one in each of the other locales.

Across the literature, the median proportion of cisgender LGBQ+ people who’d been subjected to conversion therapy was 4 percent, while for trans people the median was 12 percent. “This finding is likely attributable to the longer history of health professionals denouncing CP targeting sexual orientation, as compared to the more recent denouncements of CP targeting gender identity, not to mention the slower improvements in affirming attitudes, social policies and legal protection regarding transgender people (as compared to cis gay and lesbian people),” the authors wrote.

Among both cis and trans people, conversion therapy was more common among those who were assigned male at birth. “While interpretation of this gradient requires nuance, it may at least partially reflect a broad and unjust societal preference for or privileging of masculinity over femininity (i.e., sexism),” the authors noted. They added, “Amid overlapping contexts of sexism, gender binarism, and cisheteropatriarchy, penalties for violating gender norms and expectations of masculinity may in this case be greater than those rendered for violating gender norms and expectations of femininity.”

The highest prevalence of conversion therapy was among young adults. Smaller numbers of both youth and older adults reported having gone through the therapy. Twenty-one states in the U.S. have laws barring licensed therapists from subjecting minors to conversion therapy, and many cities and counties do as well. But unlicensed counselors, such as those affiliated with churches, aren’t covered by such laws. Canada has banned the practice for both youth and adult patients, with a law that took effect in 2022.

In the surveys of U.S. patients, the median proportion that reported having experienced the therapy was 13 percent, while that in Canada was 7 percent. This may be due to Canada having “more affirming social environments” and “stronger legal protections” for LGTBQ+ people than the U.S., the authors wrote.

In any case, conversion therapy is still too common, the researchers said. “We’re disheartened to find that these practices remain prevalent,” lead author Travis Salway, an assistant professor of health sciences at Simon Fraser University in Vancouver, Canada, told NBC News.

The study called for more research, especially on the people most affected by conversion therapy, such as trans people, Indigenous populations, and certain other racial groups. But public policy addressing conversion therapy “need not wait for more evidence,” the authors wrote. Their study “should motivate concerted action on the part of governments and civil society groups,” they said, adding that it is important for bans “to cover gender identity and expression.”

Beyond bans, they said, it’s crucial to enforce professional and regulatory standards for therapists; promote an affirming culture in health care and other parts of society, such as religious groups; and offer “broad, public education about the persistence of [conversion therapy] and its harms.”

“Should this review be repeated in the future, we hope that prevalence will have abated; if not, these prevention strategies must be revisited,” they concluded.