Sexual orientation change efforts
Sexual orientation change efforts (SOCE) are methods that aim to change sexual orientation, used to try to convert homosexual and bisexual people to heterosexuality. They may include behavioral techniques, cognitive behavioral techniques, psychoanalytic techniques, medical approaches, religious and spiritual approaches, and, in some parts of the world, acts of sexual violence ("corrective rape"). There are no studies of adequate scientific rigor to conclude whether or not SOCE work to change sexual orientation. The longstanding consensus of the behavioral and social sciences, and the health and mental health professions, since the 1970s, is that homosexuality and bisexuality are per se normal and positive variations of human sexual orientation. The research consistently failed to provide any empirical or scientific basis for regarding homosexuality or bisexuality as a disorder or abnormality.
There is a large body of research evidence that indicates that being gay, lesbian or bisexual is compatible with normal mental health and social adjustment. Because of this, the major mental health professional organizations do not encourage individuals to try to change their sexual orientation from homosexual to heterosexual. Indeed, such interventions are ethically suspect because they can be harmful to the psychological well-being of those who attempt them; clinical observations and self-reports indicate that many individuals who unsuccessfully attempt to change their sexual orientation experience considerable psychological distress. For these reasons, no major mental health professional organization has sanctioned efforts to change sexual orientation and virtually all of them have adopted policy statements cautioning the profession and the public about treatments that purport to change sexual orientation. The Royal College of Psychiatrists shares the concern of both the American Psychiatric Association and the American Psychological Association that positions espoused by bodies like the National Association for Research & Therapy of Homosexuality (NARTH) in the United States are not supported by science and that so-called treatments of homosexuality as recommended by NARTH create a setting in which prejudice and discrimination can flourish.
SOCE has been controversial due to tensions between the values held by some right-wing faith-based organizations, on the one hand, and those held by LGBT rights organizations, human rights and civil rights organizations, and other faith-based organizations, as well as professional and scientific organizations, on the other. Some individuals and groups have, contrary to global scientific research and consensus, promoted the idea of homosexuality as symptomatic of developmental defects or spiritual and moral failings and have argued that SOCE, including psychotherapy and religious efforts, could alter homosexual feelings and behaviors. Such efforts are potentially harmful because they present the view that the sexual orientation of lesbian, gay, and bisexual youth is a mental illness or disorder, and they often frame the inability to change one’s sexual orientation as a personal and moral failure. Many of these individuals and groups appeared to be embedded within the larger context of conservative religious political movements that have supported the stigmatization of homosexuality on political or religious grounds.
There is a population that undergoes sexual orientation change efforts (SOCE) and tends to have strongly conservative religious views that lead them to seek to change their sexual orientation. Co-founder and other former Exodus International leaders issued a public and formal apology for their work as ex-gay leaders and the harm they caused to those they claimed to be helping.
Medical attempts to change homosexuality included surgical treatments such as hysterectomy, ovariectomy, clitoridectomy, castration, vasectomy, pudic nerve surgery, and lobotomy. Substance-based methods included hormone treatment, pharmacologic shock treatment, and treatment with sexual stimulants and sexual depressants. Other methods included aversion therapy, the reduction of aversion to heterosexuality, electroshock treatment, group therapy, hypnosis, and psychoanalysis.
Richard von Krafft-Ebing
Richard von Krafft-Ebing was a German-Austrian psychiatrist and one of the founders of scientific sexology. His first systematic work on sexual pathology was published in 1877 in a German psychiatric journal. His influential work, Psychopathia Sexualis was published in 1886. Numerous expanded German editions followed, and it was widely translated. Krafft-Ebing became a proponent of the sickness model of homosexuality.
Section IV of Psychopathia Sexualis, “General Pathology“, discussed homosexuality in “Diagnosis, Prognosis and Therapy of Antipathic Sexual Instinct.” Krafft-Ebing believed that homosexuality could be either innate or acquired. In his view, it could sometimes be treated through prevention of masturbation and cure of the neuroses “arising out of the unhygienic conditions of sexual life”, but these methods would work only in rare cases “where acquired antipathic sexual instinct has not progressed far”, and would therefore usually be ineffective even when homosexuality was not inborn. Krafft-Ebing believed that hypnosis was therefore the "only means of salvation" in most cases. He stated that he knew of only a single case in which self-hypnosis had proven successful, and that hypnotic suggestion by another person was usually necessary to change homosexuality.
Krafft-Ebing wrote about this method that "... the object of post-hypnotic suggestion is to remove the impulse to masturbation and homosexual feelings, and to encourage heterosexual emotions with a sense of virility". Krafft-Ebing described three cases in which he believed it had proved satisfactory, writing that they "seem to afford a proof that even the gravest cases of congenital sexual inversion may be benefited by the application of hypnotism". He warned however that "only when hypnotism produces deep somnambulism decided and lasting results may be hoped for".
He rejected castration as a cure for homosexuality, and the internment of gay people in asylums, except in cases involving sex crimes. Krafft-Ebing cautioned that the success or failure of treatments for homosexuality proved nothing about its causes. He defended the right of patients to receive such treatment. Krafft-Ebing criticised several objections to medical treatment of homosexuality, including the charges that it was ineffective and that it gave an opportunity "to tainted individuals to propagate their perversions". In his view, physicians had a duty to provide such treatment if it was requested.
He concluded his discussion of methods of curing homosexuality by remarking that “in the majority of cases, the patient is quite satisfied when he becomes sexually neutral, and under these circumstances medical skill has rendered a great service to both society and the individual himself.” Later editions of Psychopathia Sexualis included an increased number of autobiographies by gay people who made it clear that they did not wish to change their sexual orientation.
In the last two decades of the 19th century, a different view began to predominate in medical and psychiatric circles, judging such behavior as indicative of a type of person with a defined and relatively stable sexual orientation. In the late 19th and 20th centuries, pathological models of homosexuality were standard.
In 1992, the World Health Organization replaced its categorization of homosexuality as a mental illness with the diagnosis of ego-dystonic homosexuality. The UK Government followed suit in 1994, followed by the Ministry of Health in Russian Federation in 1999 and the Chinese Society of Psychiatry in 2001.
The trustees of the American Psychiatric Association (APA) had previously voted unanimously to remove homosexuality as a disorder from the Sexual Deviancy section of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-II in 1973. This decision was officially confirmed by 58% of the general APA membership in 1974, who voted to replace the diagnosis with a milder category of "sexual orientation disturbance", which was then replaced in the DSM-III with "ego-dystonic homosexuality" which, in 1986, was deleted from the DSM-III-R. The APA now classifies persistent and marked distress about one's sexual orientation under Sexual Disorders Not Otherwise Specified.
No major mental health professional organization has sanctioned efforts to change sexual orientation and virtually all of them have adopted policy statements cautioning the profession and the public about treatments that purport to change sexual orientation. These include the American Psychiatric Association, American Psychological Association, American Counseling Association, National Association of Social Workers in the USA, the Royal College of Psychiatrists, Australian Psychological Society, and the Pan American Health Organization.
Reasons why people seek to change sexual orientation
Christian right political groups have marketed sexual orientation change directly to consumers. In 1998, these groups, including the Family Research Council and the American Family Association spent $600,000 on advertising promoting conversion therapy.
A majority of people who attempt to change their sexual orientation come from conservative religious backgrounds. A study by Spitzer found that 79% of 200 men and women who said they changed their sexual orientation were motivated by religion, with 93% indicating that religion is "extremely" or "very" important. Others indicated their desire came from moral or social values, which may be independent of their religion. Many people also say they wish to remain faithful to a spouse, or wish to enter into an opposite-sex marriage. Spitzer's study indicated that 67% of the men and 35% of women listed this as a reason.
Many people may seek to change their sexual orientation as a way to avoid behaviors which they perceive as being associated with homosexuality, such as non-monogamy. As anal sex carries a higher risk of HIV-infection and some other sexually transmitted infections than vaginal sex, some men seek to change their sexual orientation to lower their chances of contracting a sexually transmitted infection.
An article in the American Medical Association's Journal of Ethics argues that clinicians who care for adolescents face a "common challenge" of parents seeking interventions to change the sexual orientation of their teenage children. The article states that adolescents are increasingly comfortable in revealing their same-sex attraction to their parents because of the "generational shift in views of sexual orientation" due in part to increasing acceptance of LGBT rights and same-sex marriage.
An APA task force found that people often sought out SOCE due to (a) a lack of other sources of social support; (b) a desire for active coping and (c) access to methods of sexual orientation identity exploration and reconstruction. The American Psychological Association states that harassment and abuse, as well as pressure from family, peers, and religious groups ignorant about and prejudiced against homosexuality, may cause high levels of emotional stress for LGB people. These pressures may lead people to feel forced into attempting to change their sexual orientation. Other researchers have found that social pressure plays a key role in a person's desire to change his or her sexuality.
Types of behavior therapy used to change sexual orientation include aversion therapy, covert sensitization and systematic desensitization. Aversion therapy associates negative stimuli with homoerotic pictures and positive stimuli with heteroerotic pictures. A series of 1966 experiments appeared promising, and the practice became popular, but when reports were shown to be flawed, it fell out of favour. Since 1994, the American Psychological Association has declared that aversion therapy is a dangerous practice that does not work, but it is still in use in some countries.
Bioenergetics is a therapeutic technique developed by Alexander Lowen and John Pierrakos, who were students of Wilhelm Reich. It has been used to attempt to convert gay people to heterosexuality by Richard Cohen, who has been called one of America's leading practitioners of conversion therapy. Cohen holds male patients in his lap with the patient curled into the fetal position, and also advocates methods involving shouting or slamming a pillow with a tennis racket.
The American Psychological Association defines conversion therapy or reparative therapy as therapy aimed at changing sexual orientation. The American Psychiatric Association states that conversion therapy or reparative therapy is a type of psychiatric treatment "based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that a patient should change his/her sexual homosexual orientation." Conversion therapy comprises efforts by mental health professionals to convert lesbians and gay men to heterosexuality, and that techniques include psychoanalysis, group therapy, reparative therapy, and involvement in ex-gay ministries such as Exodus International. Aversive conditioning involving electric shock or nausea-inducing drugs was practiced before 1973, as was sex therapy, though there are some reports of aversive treatments through unlicensed practice as late as the 1990s.
The ethics guidelines of major U.S. mental health organizations vary from cautionary statements about the safety, effectiveness, and dangers of prejudice associated with conversion therapy (American Psychological Association) to recommending that ethical practitioners refrain from using conversion therapy (American Psychiatric Association) or referring patients to others who do (American Counseling Association). It may be harmful if the client is egosyntonic and does not wish to change their sexual orientation.
In late 2012, an epigenetic model of homosexuality was proposed, which might explain the heritability of homosexuality in the absence of a "homosexual gene", and it has been assumed that epigenetic therapy might be used to change one's sexual orientation. Androgens are also suggested to play an important part in the formation of sexuality; therefore prenatal hormonal treatment of congenital adrenal hyperplasia may reduce the probability of homosexuality in fetuses.
A task force commissioned by the APA found that ex-gay groups act like support groups, in that they help counteract and buffer Minority Stress, marginalization, and isolation.
Most ex-gay groups focus on abstaining from homosexual relationships rather than a complete sexual orientation change from homosexual to heterosexual. Evergreen International taught that it is unlikely therapy can erase all homosexual feelings, and does not advocate any particular form of therapy.
People with a sexual relationship disorder have difficulty forming or maintaining a relationship because of their sexual orientation. A significant number of men and women experience conflict surrounding homosexual expression within a mixed-orientation marriage. People may turn to a marriage therapist for help to change their sexual orientation. Although a strong homosexual identity was associated with difficulties in marital satisfaction, viewing the same-sex activities as compulsive facilitated commitment to the marriage and to monogamy.
Some people with unwanted homosexual attractions turn to their faith for help. Some conservative Christians believe that homosexuality is a result of a broken world and that faith can change sexual orientation. Some report that their sexual orientation has been changed through the atonement of Jesus Christ.
Syntonic therapy, a method developed by Robert Kronemeyer, was based partly on the work of Wilhelm Reich.
Kronemeyer rejected some earlier methods that were used in attempts to change homosexuality, including lobotomy, electroshock treatment, and Aesthetic Realism.
During the Holocaust, an estimated 5,000 to 15,000 gay men were imprisoned in concentration camps on the grounds that male homosexuality was deemed incompatible with Nazism. Some imprisoned homosexuals faced human experimentation by Nazi doctors who sought to find a "medical cure" for homosexuality. No scientific knowledge has been yielded from these experiments.
At Buchenwald, Nazi doctor Carl Værnet conducted hormonal experiments on twelve gay men. He made incisions in their groin and implanted a metal tube that released testosterone over a prolonged period, as he believed that a lack of testorone was the cause of homosexuality. Although some of the men claimed to have become heterosexual, the results are largely unreliable as many are assumed to have stated they were "cured" in order to be released from the camp. Those who did not show improvement were determined to be "chronic" or "incurable" homosexuals.
Effects of SOCE
The American Psychological Association appointed the Task Force on Appropriate Therapeutic Responses to Sexual Orientation to review the available research. Ex-gay organizations expressed concerns about the lack of representation of pro-reparative-therapy perspectives on the task force, while alleging that anti-reparative-therapy perspectives were amply represented.
Recent studies of participants in Sexual Orientation Change Efforts (SOCE) identify a population of individuals who experience serious distress related to same sex sexual attractions. Most of these participants are Caucasian males who report that their religion is extremely important to them (Beckstead & Morrow, 2004; Nicolosi, Byrd, & Potts, 2000; Schaeffer, Hyde, Kroencke, McCormick, & Nottebaum, 2000; Shidlo & Schroeder, 2002, Spitzer, 2003). These individuals report having pursued a variety of religious and secular efforts intended to help them to change their sexual orientation. To date, the research has not fully addressed age, gender, gender identity, race, ethnicity, culture, national origin, disability, language, and socioeconomic status in the population of distressed individuals.
There are no studies of adequate scientific rigor to conclude whether or not recent SOCE do or do not work to change a person’s sexual orientation. Scientifically rigorous older work in this area (e.g., Birk, Huddleston, Miller, & Cohler, 1971; James, 1978; McConaghy, 1969, 1976; McConaghy, Proctor, & Barr, 1972; Tanner, 1974, 1975) found that sexual orientation (i.e., erotic attractions and sexual arousal oriented to one sex or the other, or both) was unlikely to change due to efforts designed for this purpose. Some individuals appeared to learn how to ignore or limit their attractions. However, this was much less likely to be true for people whose sexual attractions were initially limited to people of the same sex.
Although sound data on the safety of SOCE are extremely limited, some individuals reported being harmed by SOCE. Distress and depression were exacerbated. Belief in the hope of sexual orientation change followed by the failure of the treatment was identified as a significant cause of distress and negative self-image (Beckstead & Morrow, 2004; Shidlo & Schroeder, 2002).Although there is insufficient evidence to support the use of psychological interventions to change sexual orientation, some individuals modified their sexual orientation identity (i.e., group membership and affiliation), behavior, and values (Nicolosi, Byrd, & Potts, 2000). They did so in a variety of ways and with varied and unpredictable outcomes, some of which were temporary (Beckstead & Morrow, 2004; Shidlo & Schroeder, 2002). Based on the available data, additional claims about the meaning of those outcomes are scientifically unsupported.
Position of professional organizations on SOCE
The World Health Organization's ICD-10, which is widely used internationally outside of North America (where DSM-IV-TR is used), states that "sexual orientation by itself is not to be regarded as a disorder". It lists ego-dystonic sexual orientation as a disorder instead, the diagnosis for which is when "the gender identity or sexual preference (heterosexual, homosexual, bisexual, or prepubertal) is not in doubt, but the individual wishes it were different because of associated psychological and behavioural disorders, and may seek treatment in order to change it."
In 2012, the Pan American Health Organization (the North and South American branch of the World Health Organization) released a statement cautioning against "services that purport to 'cure' people with non-heterosexual sexual orientations" as they "lack medical justification and represent a serious threat to the health and well-being of affected people", and noted that "there is a professional consensus that homosexuality is a normal and natural variation of human sexuality and cannot be regarded as a pathological condition". The organization further called "on governments, academic institutions, professional associations and the media to expose these practices and to promote respect for diversity." They further noted that adolescents have sometimes been forced to attend these therapies involuntarily, being deprived of their liberty and sometimes kept in isolation for several months, and that these findings were reported by several United Nations bodies. Additionally, the organization recommended that such malpractices be denounced and subject to sanctions and penalties under national legislation, as they constitute a violation of the ethical principles of health care and violate human rights that are protected by international and regional agreements.
The American Psychiatric Association "affirms that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality regardless of sexual orientation identity; reaffirms its position that homosexuality per se is not a mental disorder and opposes portrayals of sexual minority youths and adults as mentally ill due to their sexual orientation; concludes that there is insufficient evidence to support the use of psychological interventions to change sexual orientation; encourages mental health professionals to avoid misrepresenting the efficacy of sexual orientation change efforts by promoting or promising change in sexual orientation when providing assistance to individuals distressed by their own or others’ sexual orientation; concludes that the benefits reported by participants in sexual orientation change efforts can be gained through approaches that do not attempt to change sexual orientation; concludes that the emerging knowledge on affirmative multiculturally competent treatment provides a foundation for an appropriate evidence-based practice with children, adolescents and adults who are distressed by or seek to change their sexual orientation; advises parents, guardians, young people, and their families to avoid sexual orientation change efforts that portray homosexuality as a mental illness or developmental disorder and to seek psychotherapy, social support and educational services that provide accurate information on sexual orientation and sexuality, increase family and school support, and reduce rejection of sexual minority youth; encourages practitioners to consider the ethical concerns outlined in the 1997 APA Resolution on Appropriate Therapeutic Response to Sexual Orientation, in particular the following standards and principles: scientific bases for professional judgments, benefit and harm, justice, and respect for people’s rights and dignity; encourages practitioners to be aware that age, gender, gender identity, race, ethnicity, culture, national origin, religion, disability, language, and socioeconomic status may interact with sexual stigma, and contribute to variations in sexual orientation identity development, expression, and experience; opposes the distortion and selective use of scientific data about homosexuality by individuals and organizations seeking to influence public policy and public opinion and will take a leadership role in responding to such distortions; supports the dissemination of accurate scientific and professional information about sexual orientation in order to counteract bias that is based in lack of knowledge about sexual orientation; and encourages advocacy groups, elected officials, mental health professionals, policy makers, religious professionals and organizations, and other organizations to seek areas of collaboration that may promote the wellbeing of sexual minorities."
The American Psychiatric Association also states: "It is possible to evaluate the theories which rationalize the conduct of "reparative" and conversion therapies. Firstly, they are at odds with the scientific position of the American Psychiatric Association which has maintained, since 1973, that homosexuality per se, is not a mental disorder. The theories of "reparative" therapists define homosexuality as either a developmental arrest, a severe form of psychopathology, or some combination of both. In recent years, noted practitioners of "reparative" therapy have openly integrated older psychoanalytic theories that pathologize homosexuality with traditional religious beliefs condemning homosexuality. The earliest scientific criticisms of the early theories and religious beliefs informing "reparative" or conversion therapies came primarily from sexology researchers. Later, criticisms emerged from psychoanalytic sources as well. There has also been an increasing body of religious thought arguing against traditional, biblical interpretations that condemn homosexuality and which underlie religious types of "reparative" therapy."
Mainstream health organizations critical of attempts to change sexual orientation include the American Medical Association, American Psychiatric Association, the American Psychological Association, the American Counseling Association, the National Association of Social Workers, the American Academy of Pediatrics, the American Association of School Administrators, the American Federation of Teachers, the National Association of School Psychologists, the American Academy of Physician Assistants, and the National Education Association.
In the United Kingdom, the Royal College of Psychiatrists states: "The Royal College shares the concern of both the American Psychiatric Association and the American Psychological Association that positions espoused by bodies like the National Association for Research and Therapy of Homosexuality (NARTH) in the United States are not supported by science. There is no sound scientific evidence that sexual orientation can be changed. Furthermore so-called treatments of homosexuality as recommended by NARTH create a setting in which prejudice and discrimination can flourish. The Royal College of Psychiatrists holds the view that lesbian, gay and bisexual people should be regarded as valued members of society who have exactly similar rights and responsibilities as all other citizens."
In Australia, the Australian Psychological Society states: "Even though homosexual orientation is not a mental illness and there is no scientific reason to attempt conversion of lesbians or gays to heterosexual orientation, some individuals may want to change their own sexual orientation or that of another individual (for example, parents seeking therapy for their child). Some therapists who undertake this kind of therapy report that they have changed their client's sexual orientation (from homosexual to heterosexual) in treatment. Close scrutiny of these reports shows that many of the claims come from organisations with an ideological perspective on sexual orientation rather than from mental health researchers. Also, the treatments and their outcomes are poorly documented and the length of time that clients are followed up after the treatment is sometimes too short to be a true reflection of the outcome. In other cases it has been shown that individuals can be assisted to live a heterosexual lifestyle, but that their sexual orientation remains unchanged. In other words, their pattern of arousal to members of the same sex does not alter. The Australian Psychological Society acknowledges the lack of scientific evidence for the usefulness of conversion therapy, and notes that it can in fact be harmful for the individual."
In China, Western psychiatry and psychology were imported during a "Westernization Movement" in the late 19th century. At that time, the West viewed homosexuality as a mental disorder, and that became the prevailing view in China as well. During this period, homosexual sexual behavior was grounds for persecution, a marked change from the attitude of general (but not total) acceptance found in pre-19th-century China. These views lasted throughout the 1970s, despite changed theoretical models of sexuality orientation in the West, during a period when the Chinese government held a "closed-door" policy on information about human sexuality. After 1980, information became more available, and views began to change. In 2000 and under pressure from both the APAs and the ACA, the Chinese Classification of Mental Disorders (CCMD-III) declassified homosexuality, but added a diagnosis resembling ego-dystonic sexual orientation. Attempts to change sexual orientation are rare in China.
In India, psychiatry and psychology scholars have "preserved an almost complete silence on the subject of homosexuality". One paper discusses behavior modification methods used to treat the sexual orientation of thirteen gay patients. They use the WHO classification of egodystonic sexual orientation, but the People's Union for Civil Liberties reports that doctors will often diagnosis the patient as egodystonic even if the patient really is egosyntonic.
In Italy, little research has been conducted in the mental health community on homosexuality. Early work tended to describe homosexuality as a pathology or a developmental arrest. More recently, attitudes have begun to change: "with a lag of about ten years, Italy has followed ... the attitudes of American mental health professions toward homosexuality".
In Germany, the psychiatry, psychology, and sexology establishment from the early 20th century viewed homosexuality as pathological. However, following the increased visibility of the homosexual community during the AIDS epidemic of the late 1980s and the declassification of homosexuality as a mental disorder in the ICD-10, non-pathological, rather than pathological, models of homosexuality became mainstream.
Japan's psychiatric body removed homosexuality from its list of psychiatric disorders in 1995.
In Norway, a country known for its strong LGBT rights legislation, the shift from a pathological to non-pathological understanding of homosexuality began in the 1970s, following the APA's declassification in 1973. In 2000, the General Assembly of the Norwegian Psychiatric Association overwhelmingly voted for the following position statement on sexual orientation change therapy:
Homosexuality is no disorder or illness, and can therefore not be subject to treatment. A ‘treatment’ with the only aim of changing sexual orientation from homosexual to heterosexual must be regarded as ethical malpractice, and has no place in the health system.
Changing sexuality has become highly politicized, and the ensuing debates "have obscured the scientific data by calling into question the motives and even the character of individuals on both sides of the issue." The ethics, efficacy, benefits, and potential for harm of SOCE are under extensive debate, both in the professional literature and the popular media. Concerns have been expressed about forcing people to undergo SOCE against their will, blocking people who are seeking to change their sexual orientation from attempting to do so, and concern over the way SOCE is being promoted affects LGB rights.
Chuck Bright wrote that refusing to endorse a procedure that "has been deemed unethical and potentially harmful by most medical and nearly every professional psychotherapy regulating body cannot be justifiably identified as prohibiting client self-determination." Some commentators, recommending a hard stand against the practice, have found therapy inconsistent with a psychologist's ethical duties because "it is more ethical to let a client continue to struggle honestly with her or his identity than to collude, even peripherally, with a practice that is discriminatory, oppressive, and ultimately ineffective in its own stated ends." They argue that clients who request it do so out of social pressure and internalized homophobia, pointing to evidence that rates of depression, anxiety, alcohol and drug abuse and suicidal feelings are roughly doubled in those who undergo therapy.
Until the 1970s, homosexuality was considered a mental illness and homosexuals were forced by the government to undergo treatment. Famous cases include Alan Turing. This practice is outlawed in most of the world, but human right groups have complained that in some parts of the world, treatment is still being forced upon unwilling patients.
In one of the few published U.S. cases dealing with conversion therapy, the Ninth Circuit addressed the topic in the context of an asylum application. A Russian citizen "had been apprehended by the Russian militia, registered at a clinic as a 'suspected lesbian,' and forced to undergo treatment for lesbianism, such as 'sedative drugs' and hypnosis." The Ninth Circuit held that the conversion treatments to which Pitcherskaia had been subjected constituted mental and physical torture. The court rejected the argument that the treatments to which Pitcherskaia had been subjected did not constitute persecution because they had been intended to help her, not harm her, stating that "human rights laws cannot be sidestepped by simply couching actions that torture mentally or physically in benevolent terms such as 'curing' or 'treating' the victims."
There have been few, if any, medical malpractice lawsuits filed on the basis of conversion therapy. Laura A. Gans suggested in an article published in The Boston University Public Interest Law Journal that this is due to an "historic reluctance of consumers of mental health services to sue their care givers" and "the difficulty associated with establishing the elements of... causation and harm... given the intangible nature of psychological matters." Gans also suggested that a tort cause of action for intentional infliction of emotional distress might be sustainable against therapists who use conversion therapy on patients who specifically say that his or her anxiety does not arise from his or her sexuality.
Another concern is unwilling patients, particularly children, being forced into SOCE. Children experience significant pressure to conform with sexual norms, particularly from their peers, and often lack adequate legal protection from coercive treatment.
In 2005, Love In Action, an ex-gay ministry based in Memphis, was investigated by the Tennessee Department of Health and the Tennessee Department of Mental Health and Developmental Disabilities for providing counseling and mental health care without a license, and for treating adolescents without their consent. There have been reports that teenagers have been forcibly treated with conversion therapy on other occasions. Several legal researchers argue that parents who force their children into aggressive conversion therapy programs are committing child abuse under various state statutes.
Some advocates of SOCE (such as NARTH) have spoken in favor of a patient's right to reject SOCE and embrace a lesbian, gay or bisexual identity. Richard A. Cohen, an advocate of conversion therapy, has said, "If someone wants to live a gay life, that needs to be respected. If someone wants to change and come out straight, that too needs to be respected. Let us practice true tolerance, real diversity, and equality for all."
Gregory M. Herek, a professor of psychology at the University of California, Davis, wrote:
Few would dispute that some people’s sexual orientation changes during their lifetime. Indeed, many lesbians and gay men report living as a heterosexual before recognizing or developing their homosexual orientation. The question at issue is not whether sexual orientation can change but whether interventions can be designed to bring about such change.
Position of SOCE advocates
Positive Alternatives to Homosexuality, a coalition of ex-gay groups, supports the right for individuals to pursue a non-homosexual identity if they so choose, the right to know information the coalition provides to make informed decisions, and the right of those conflicted by their homosexual attraction to self-determine their own goals in therapy. They advocate compassion and respect specifically for ex-homosexuals and those on that path, and policy neutrality in creating laws that would inhibit freedom of speech to discuss SOCE. They claim equal access to public forums to state their viewpoint, share their experiences, and to raise awareness of ways to reject a gay identity.
Promotion of SOCE
The American Psychological Association and the Royal College of Psychiatrists expressed concerns that the positions espoused by NARTH and Focus on the Family are not supported by the science and create an environment in which prejudice and discrimination can flourish. The Just the Facts Coalition, consisting of the American Academy of Pediatrics, American Association of School Administrators, American Counseling Association, American Federation of Teachers, American Psychological Association, American School Counselor Association, American School Health Association, Interfaith Alliance Foundation, National Association of School Psychologists, National Association of Secondary School Principals, National Association of Social Workers, National Education Association, and the School Social Work Association of America, in 2008 released Just the Facts About Sexual Orientation and Youth. In it, they expressed concern that the advancement of SOCE may cause social harm by disseminating inaccurate views about sexual orientation.
The National Gay and Lesbian Task Force has described the recent support for sexual orientation change efforts as "the Christian Right repackag[ing] its anti-gay campaign in kinder, gentler terms. Instead of simply denouncing homosexuals as morally and socially corrupt, the Christian Right has now shifted to a strategy of emphasizing ... the ex-gay movement. Behind this mask of compassion, however, the goal remains the same: to roll back legal protections for lesbian, gay, bisexual and transgender people ..."
Psychologist John Gonsiorek said the way in which the Christian right promoted SOCE was hypocritical. He wrote "some conservative Christian institutions actively foster social conditions to maximize distress for such clients about their sexual orientations, and these institutions simultaneously promote conversion therapy as the solution to this distress." Prominent ex-gay Joe Dallas, while opposing gay sex, called Christians to repent of their hostility toward homosexuals and reach out to them: "I find to this day that there is a certain wrath Christians often express towards this sin that they do not express towards other sins – both sexual and non-sexual. And that's a problem. It's an imbalance."
Some jurisdictions have made it illegal or are considering to make it illegal to engage in sexual orientation change efforts.
Since 1999 Brazil has banned pathologization or attempted treatment of sexual orientation by mental health professionals through the national ethical code (though proper professional register cancelling as a punishment only tends to be upheld in cases involving minors or non-consenting people).
Attempts by Marco Feliciano, an Evangelical preacher elected as the President of the Commission of Human Rights of the Chamber of Deputies to overturn the judicial institutionalization of same-sex marriage in Brazil as a right to all citizens, as well as support for a bill that would have overturned the ban (what was then known as the "gay cure" bill) were met with strong public objection in the wave of the 2013 protests in Brazil. This debate followed the 2007–2009 one caused by the Rozangela Justino affair in which an Evangelical Rio de Janeiro-based psychologist that suffered official sanction in the form of "public censorship" after promising to cure homosexuality compared the LGBT rights/social movements to Nazism and said that its militants are making alliances with the heads of the psychologist association of the country in its attempt to implant a "gay dictatorship" in the country, what sparked support of or common grounds with several religious and paleoconservative voices in the country (some of which, even saying that the country has 'heterophobic' policies, saying that Brazil lacks actual relevant homophobia, or comparing homosexuality to zoophilia).
As of 2013, only 50% of Brazilians do not support same-sex marriage being legal and 57% of them support the legality of same-sex couples' right to adoption in the country, while as of 2008 over 70% supported the expansion of a Constitutional amendment being discussed in the Senate that can explicitly ban all discrimination based on sexual orientation, all of which a wide number of the publicly voicing people who were/are in favor of allowing sexual orientation change efforts – often under a civil/individual rights discourse – had [often strongly] voiced against.
In May 2015, Manitoba became the first province within Canada to outlaw conversion therapy on LGBT minors.
Ontario was the second province within Canada to outlaw conversion therapy on LGBT minors. The Affirming Sexual Orientation and Gender Identity Act, 2015 was given royal assent, on 4 June 2015, with immediate force, banning the practice.
In November 2011, an Ecuadorean activist group, called Fundación Causana, began a petition on Change.org to entreat the Ecuadorean minister of health to close down more than 200 illegal "ex-gay clinics". The group claimed that the clinics abuse and torture patients in an effort to "cure homosexuality". The clinics primarily targeted lesbians and operated under the guise of being drug rehabilitation centers. At least one pair of parents discovered the abuse and asked for the clinic to release their daughter, Paola Ziritti, but were denied. Ziritti was eventually released after two years of confinement and was the first to press a formal complaint against the clinics.
On 23 January 2012, the Change.org petition was closed and marked as a success with 113,761 international signatures. The petition also was updated with a statement from Fundacion Causana reading,
After ten years of outcry, the nation of Ecuador - through the Ministry of Public Health - has entered into a commitment with civic organizations and society in general to deconstruct the belief that homosexuality is an illness and root out the use of torture in these clinics. We extend our thanks to all the men and women who signed our petition. It has been invaluable to have this support in starting to change this reality.
Carina Vance Mafla's ministry of health shortly thereafter raided three clinics in the vicinity of Quito and rescued dozens of women.
On 16 June 2015, Civil Liberties Minister Helena Dalli announced that the government plans to introduce a bill to ban sexual orientation and gender identity conversion therapy on minors. The bill had its first reading on 15 December 2015. If approved Malta would become the first country in Europe to outlaw conversion therapy on LGBT minors. The bill has not moved forward in months, despite the Nationalist Party (Malta) opposition supporting the bill.
In August 2012, the California State Legislature approved legislation prohibiting mental health providers from engaging in sexual orientation change efforts with minors, which Governor Jerry Brown signed into law on September 29, 2012. It applies to transgender minors, defining "sexual orientation change efforts" to include "efforts to change behaviors or gender expressions". Opponents challenged the law in federal court, and on December 21, 2012, in the case of Pickup v. Brown, the Ninth Circuit issued an emergency injunction barring enforcement. On August 29, 2013, the Ninth Circuit upheld the statute. On June 30, 2014, the Supreme Court refused to hear an appeal in the case.
In June 2013, the New Jersey Legislature passed legislation signed into law by Governor Chris Christie in August 2013, which makes it illegal to engage in sexual orientation change efforts with minors. The law, meant to apply to transgender minors, defines "sexual orientation change efforts" to include "efforts to change behaviors, gender identity, or gender expressions". In November 2013, a federal judge upheld the law.
We recognize the legitimacy and efficacy of counseling, which offers reparative therapy and treatment for those patients seeking healing and wholeness from their homosexual lifestyle. No laws or executive orders shall be imposed to limit or restrict access to this type of therapy.
On June 25, 2015 a New Jersey jury found the Jewish conversion therapy organization, JONAH, guilty of consumer fraud for promising to be able to change its clients' sexual urges and determined its commercial practices to be unconscionable.
On June 8, 2016, Miami Beach voted to ban conversion therapy. The ban was sponsored by Commissioner John Elizabeth Alemàn and was unanimously approved by the city commission. Miami Beach thus became the first city in Florida to ban the use of conversion therapy on LGBT minors.
On August 1, 2016 Seattle voted unanimously by all nine commissioners to ban conversion therapy on minors. The third city in the United States to do so.
- LGBT rights opposition
- Homosexuality and psychology
- Christianity and homosexuality
- Joel 2:25 International
- Restored Hope Network
- Joseph Nicolosi
- American Psychological Association: Resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts
- Judith M. Glassgold, PsyD, Chair; Lee Beckstead, PhD; Jack Drescher, MD; Beverly Greene, PhD; Robin Lin Miller, PhD; Roger L. Worthington, PhD; Clinton W. Anderson, PhD, Staff Liaison (August 2009). "Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation" (PDF). APA.org. American Psychological Association. Archived from the original (PDF) on 15 May 2010. Retrieved 28 July 2015.
- ""Therapies" to change sexual orientation lack medical justification and threaten health". Pan American Health Organization (PAHO). Retrieved 26 May 2012. archived here.
- Brief of Amici Curiae American Psychological Association; Maine Psychological Association; National Association of Social Workers; National Association of Social Workers, Maine Chapter; Maine Association of Psychiatric Physicians; Child Welfare League of America; Maine Children’s Alliance; Maine Medical Association; American Academy of Pediatrics, Maine Chapter; Evan B. Donaldson Adoption Institute; Kids First; and Community Counseling Center, In Support of Appellants (October 12, 2006)
- Royal College of Psychiatrists: Submission to the Church of England’s Listening Exercise on Human Sexuality.
- Expert affidavit of Gregory M. Herek, Ph.D., United States District Court for the State of Massachusetts.
- Royal College of Psychiatrists: Statement from the Royal College of Psychiatrists’ Gay and Lesbian Mental Health Special Interest Group
- Australian Psychological Society: Sexual orientation and homosexuality
- "Statement of the American Psychological Association" (PDF). APA.org. American Psychological Association. 10 August 2006. Archived from the original (PDF) on 6 August 2011. Retrieved 28 July 2015.
- American Psychological Association: Just the Facts about Sexual Orientation & Youth: A Primer for Principals, Educators, & School Personnel
- YouTube: Former Ex-Gay Leaders Apologize
- Katz, Jonathan (1976). Gay American history: lesbians and gay men in the U.S.A.: a documentary anthology. New York: Crowell. p. 129. ISBN 0-690-00510-5.
- Daniel, F.E. (1893). "Castration of Sexual Perverts". Texas Medical Journal. 9: 255–71.
- Talbot, E.S.; Ellis, Havelock (1896). "A Case of Developmental Degenerative Insanity, with Sexual Inversion, Melancholia, Following Removal of Testicles, Attempted Murder and Suicide". Journal of Mental Science. 42: 341–44. doi:10.1192/bjp.42.177.340.
- "Results of Castration in Sexual Abnormalities". Urologic & Cutaneous Review. 33: 351. 1929.
- Sharp, Harry Clay (1908). "The Sterilization of Degenerates". National Christian League for Promotion of Purity.
- "The Gentleman Degenerate. A Homosexualist's Self-Description and Self-Applied Title. Pudic Nerve Section Fails Therapeutically". Alienist & Neurologist. 25: 68–70. 1904.
- Friedlander, Joseph; Banay, Ralph S. (1948). "Psychosis Following Lobotomy in a Case of Sexual Psychopathology; Report of a Case". Archives of Neurology & Psychiatry. 59: 303–11, 315, 321. doi:10.1001/archneurpsyc.1948.02300380031003.
- Rosenzweig, Saul; Hoskins, R.G. (1941). "A Note on the Ineffectualness of Sex-Hormone Medication in a Case of Pronounced Homosexuality". Psychosomatic Medicine. 3: 87–89.
- LeVay 1996
- Owensby, Newdigate M. (1940). "Homosexuality and Lesbianism Treated with Metrazol". Journal of Nervous & Mental Disease. 92: 65–66. doi:10.1097/00005053-194007000-00009.
- Cautela, Joseph R. (1967). "Covert Sensitization". Psychology Report. 20: 464–65. doi:10.2466/pr0.1922.214.171.1249.
- Rutner, Ivan T. (1970). "A Double-Barrel Approach to Modification of Homosexual Behavior". Psychology Report. 26 (2): 256–58. doi:10.2466/pr0.19126.96.36.1995. PMID 5486305.
- McConaghy, Nathaniel; Armstrong, Michael S.; Blaszczynsky, Alex (1981). "Controlled Comparison of Aversive Therapy and Covert Sensitization in Compulsive Homosexuality". Behavior Response & Therapy. 19 (5): 425–34. doi:10.1016/0005-7967(81)90132-7. PMID 7316919.
- Max, Louis William (1935). "Breaking Up a Homosexual Fixation by the Condition Reaction Technique: A Case Study". Psychological Bulletin. 32: 734. doi:10.1037/h0052493.
- Liebman, Samuel (1967). "Homosexuality, Transvestism, and Psychosis: Study of a Case Treated with Electroshock". Journal of Nervous & Mental Disease. 99: 945–57. doi:10.1097/00005053-194406000-00008.
- Duberman, Martin (1992). Cures: A Gay Man's Odyssey. New York: Plume. pp. 93–115, 118–24. ISBN 0-452-26780-3.
- Harms, Ernest (1953). "Homo-Anonymous". Diseases and the Nervous System. 14 (10): 318–19. PMID 13095274.
- Hadden, Samuel B. (1957). "Attitudes Toward and Approaches to the Problem of Homosexuality". Pennsylvania Medical Journal. 6 (9): 1195–98. PMID 13465269.
- Smith, Alexander B.; Bassin, Alexander (1959). "Group Therapy with Homosexuals". Journal of Social Therapy. 5: 227, 231–32.
- Quackenbos, John Duncan (1899). "Hypnotic Suggestion in the Treatment of Sexual Perversions and Moral Anaesthesia: A Personal Experience". Transactions of the New Hampshire Medical Society. 108: 69, 72, 75, 78–80.
- Miller, Michael M. (1963). "Hypnotic-Aversion Treatment of Homosexuality". Journal of the National Medical Association. 55 (5): 411–13, 415. PMC 2642357. PMID 14049556.
- Brill, A.A. (1913). "The Conception of Homosexuality". JAMA. 61: 335–40. doi:10.1001/jama.1913.04350050017008.
- Stekel, Wilhelm (1930). "Is Homosexuality Curable?". Psychoanalytic Review. 17: 443, 447–48.
- Yoshino, Kenji (January 2002). "Covering". Yale Law Journal. 111 (4): 179 et seq. doi:10.2307/797566.
- Rosario 1997, pp. 67–88
- Krafft-Ebing 1965, p. 299
- Krafft-Ebing 1965, p. 300
- Krafft-Ebing 1965, p. 308
- Krafft-Ebing 1965, p. 306
- Krafft-Ebing 1965, p. 307
- Drescher, J (2010). "Queer diagnoses: Parallels and contrasts in the history of homosexuality, gender variance, and the Diagnostic and Statistical Manual (DSM)". Archives of Sexual Behavior. 39: 427–460. doi:10.1007/s10508-009-9531-5. PMID 19838785.
- "China More Tolerant Toward Gays". CBS News. BEIJING. March 7, 2001.
- "The Sexes: An Instant Cure". Time. April 1, 1974.
- "Homosexuality and Mental Health". ucdavis.edu.
- Jonathan Merritt (15 Apr 2015). "How Christians Turned Against Gay Conversion Therapy". The Atlantic.
- "Ex-Ex-Gay Pride". Newsweek. 1 May 2014.
- Nicolosi, Byrd, & Potts, 2000; Schaeffer, Hyde, Kroencke, McCormick, & Nottebaum, 2000; Schaeffer, Nottebaum, Dech, & Drawczyk, 2000; Spitzer, 2001a).
- Spitzer, 2001a
- Rosik CH (January 2003). "Motivational, ethical, and epistemological foundations in the treatment of unwanted homoerotic attraction". J Marital Fam Ther. 29 (1): 13–28. doi:10.1111/j.1752-0606.2003.tb00379.x. PMID 12616795.
- Courtenay-Smith, Natasha (2005-08-08). "The gay man who wants to go straight". The Independent (Online Edition). Retrieved 2007-08-28.
- Zachariah P; Blaschke GS; Weddle M (2014). "A request for "conversion therapy".". Virtual Mentor. 16 (11): 877–83. doi:10.1001/virtualmentor.2014.16.11.ecas2-1411. PMID 25397646.
- "In U.S., Record-High Say Gay, Lesbian Relations Morally OK". Gallup. 20 May 2013.
- Resolution on Appropriate Therapeutic Responses to Sexual Orientation. American Psychological Association. 1997-08-14. Retrieved 2007-08-28.
- Shidlo, Ariel; Schroeder, Michael (2002). "Changing Sexual Orientation: A Consumers' Report". Professional Psychology: Research and Practice. 33 (3): 249–259. doi:10.1037/0735-7028.33.3.249.
- Beckstead, A. Gay is not me: Seeking Congruence Through Sexual Reorientation Therapy. (Unpublished master's thesis, University of Utah, 1999).
- Niraj Ahuja (30 July 2006). A Short Textbook of Psychiatry (illustrated ed.). Jaypee Brothers Publishers. ISBN 9788180618710.
- Seligman, p. 156
- Chandran, Vinay (February 2006). "Prayer, punishment or therapy? Being a homosexual in India". InfoChange News & Features. Archived from the original on 30 November 2006. Retrieved 2007-08-28.
While social attitudes are slowly changing [in India] and the anti-sodomy law is being challenged, mental health professionals in many places still offer therapy to homosexuals.
- Transcript of "USA - Gay Conversion, ABC TV Foreign Correspondent, 08-22-2006. Retrieved 04-07-2007.
- Cohen 2000, p. 152,176
- Answers to Your Questions: For a Better Understanding of Sexual Orientation and Homosexuality (PDF). American Psychological Association. February 2008. Retrieved 2008-02-14.
- Position Statement on Therapies Focused on Attempts to Change Sexual Orientation (Reparative or Conversion Therapies) (PDF). American Psychiatric Association. May 2000. Retrieved 2007-08-28.
- Gonsiorek 1991, pp. 149–160
- Yoshino, Kenji (2002). "Covering". Yale Law Journal. 111 (4).
- Wareham, Hannah Clay. "Survivor: MIT grad student Samuel Brinton remembers 'ex-gay' therapy". lgbtqnation.com. Retrieved 6 May 2015.
- Ocamb, Karen. "Shannon Minter on NARTH Lawsuit Against Psychological Child Abuse Law". www.bilerico.com. The Bilerico Project. Retrieved May 2015. Check date values in:
- Nicolosi, Joseph; Byrd, A. Dean; Potts, Richard W. (June 2000). "Retrospective self-reports of changes in homosexual orientation: A consumer survey of conversion therapy clients". Psychological Reports. 86: 1071–88. doi:10.2466/pr0.2000.86.3c.1071.
- Richards, Sabrina. "Can Epigenetics Explain Homosexuality?" The Scientist 1 January 2013.
- Tim Spector (February 18, 2014). "Why Does the Search for a Gay Gene Freak Everyone Out?". Slate.
- Shari Roan (August 15, 2010). "Medical treatment carries possible side effect of limiting homosexuality". Los Angeles Times.
- PATH: Positive Alternatives To Homosexuality
- Lucy Bannerman (7 October 2008). "The camp that 'cures' homosexuality". The Times Online. Archived from the original on 6 January 2010. Retrieved 28 July 2015.
- "The Five Goals". couragerc.net. Archived from the original on 14 December 2010. Retrieved 28 July 2015.
- "Five Truths About Same-sex Attraction", EvergreenInternational.org, Evergreen International, archived from the original on 2012-07-29
- Park, Jason (2007), "Therapy", EvergreenInternational.org, Evergreen International, archived from the original on 2012-07-24
- "Myths", EvergreenInternational.org, Evergreen International, archived from the original on 2012-07-24
- Wolf TJ (1987). "Group psychotherapy for bisexual men and their wives". J Homosex. 14 (1–2): 191–9. doi:10.1300/J082v14n01_14. PMID 3655341.
- Schneider JP; Schneider BH (1990). "Marital satisfaction during recovery from self-identified sexual addiction among bisexual men and their wives". J Sex Marital Ther. 16 (4): 230–50. doi:10.1080/00926239008405460. PMID 2079706.
- Lauren Gregory (28 December 2008). "Faith said to change sexual orientation". Chattanooga Times Free Press. Archived from the original on 9 July 2009. Retrieved 28 July 2015.
- Lillian Kwon (10 July 2007). "Skepticism Over Validity of Ex-Gay Story Prompts 'Confessions'". Christian Post.
- Kronemeyer 1980, p. 87
- "Persecution of Homosexuals in the Third Reich". USHMM. Retrieved August 1, 2016.
- Tamagne, Florence (2004). A History of Homosexuality in Europe Vol. II: Berlin, London, Paris, 1919-1939. Algora Publishing. p. 290. ISBN 0875863574.
- Austin, Ben. "Homosexuals & the Holocaust: Background & Overview". Jewish Virtual Library. Retrieved August 1, 2016.
- Gay reparative therapy under scrutiny, New York: Washington Times, July 11, 2007, retrieved 2009-02-15
- "ICD-10, Chapter V: Mental and behavioural disorders: Disorders of adult personality and behaviour". World Health Organization. 2007. Retrieved 2007-08-28.
- American Psychiatric Association: Therapies Focused on Attempts to Change Sexual Orientation (Reparative or Conversion Therapies) - Position statement
- American Medical Association policy regarding sexual orientation. American Medical Association. 2007-07-11. Retrieved 2007-07-30.
- Barbara L. Frankowski, MD, MPH; Committee on Adolescence. "CLINICAL REPORT: Sexual Orientation and Adolescents" (PDF). American Academy of Pediatrics. Archived from the original on 6 January 2012. Retrieved 28 July 2015.
- "Homosexuality and Adolesence" (PDF). Pediatrics, Official Journal of the American Academy of Pediatrics. 92 (4): 631–634. 1993. Retrieved 2007-08-28.
|last1=in Authors list (help)
- "Physician Assistants vote on retail clinics, reparative therapy". SpiritIndia.com. Retrieved 2007-08-28.
- Wu, Jin (2003). "From Long Yang and Dui Shi to Tongzhi: Homosexuality in China". Journal of Gay & Lesbian Psychotherapy. Haworth Medical Press. 7 (1/2): 117–143. doi:10.1300/J236v07n01_08.
- "Homosexuality Depathologized in China". Chinese Society for the Study of Sexual Minorities News Digest. 2001-03-05. Retrieved 2007-08-28.
- Parekh, Suresh (2003). "Homosexuality in India: The Light at the End of the Tunnel". Journal of Gay & Lesbian Psychotherapy. Haworth Medical Press. 7 (1/2): 153. doi:10.1300/J236v07n01_09.
- Pradhan, P.V.; Ayyar, K.S.; Bagadia, V.N. (1982). "HOMOSEXUALITY : TREATMENT BY BEHAVIOUR MODIFICATION". Indian Journal of Psychiatry. 24 (1): 80–83. PMC 3012889. PMID 21965890.
- "Human rights violations against sexuality minorities in India" (PDF). People's Union for Civil Liberties. February 2001.
- Capozzi, Paola; Lingiardi, Vittorio (2003). "Happy Italy? The Mediterranean Experience of Homosexuality, Psychoanalysis, and the Mental Health Professions". Journal of Gay & Lesbian Psychotherapy. Haworth Medical Press. 7 (1/2): 93–116. doi:10.1300/J236v07n01_07.
- Stakelbeck, Falk; Udo, Frank (2003). "From Perversion to Sexual Identity: Concepts of Homosexuality and Its Treatment in Germany". Journal of Gay & Lesbian Psychotherapy. Haworth Medical Press. 7 (1/2): 23–46. doi:10.1300/J236v07n01_03.
- "China More Tolerant Toward Gays: Psychiatric Association No Longer Views It As A Mental Illness". Associated Press. 2001-03-07. Retrieved 2008-08-28.
- Kjær, Reider (2003). "Look to Norway? Gay Issues and Mental Health Across the Atlantic Ocean". Journal of Gay & Lesbian Psychotherapy. Haworth Medical Press. 7 (1/2): 55–73. doi:10.1300/J236v07n01_05.
- Glassgold, Judith; Lee Beckstead; Jack Drescher; Beverly Greene; Robin Lin Miller; Roger L. Worthington; Clinton W. Anderson (2009). "Appropriate Therapeutic Responses to Sexual Orientation" (PDF). Retrieved 20 November 2009.
- Bright, Chuck (December 2004). "Deconstructing Reparative Therapy: An Examination of the Processes Involved When Attempting to Change Sexual Orientation". Clinical Social Work Journal. 32 (4): 471–481. doi:10.1007/s10615-004-0543-2.
- Tozer, Erinn E.; McClanahan, Mary K. (1999). "Treating the Purple Menace: Ethical Considerations of Conversion Therapy and Affirmative Alternatives". The Counseling Psychologist. 27 (5): 722–742. doi:10.1177/0011000099275006.
- Gans, Laura A. (Winter 1999). "Inverts, Perverts, and Converts: Sexual Orientation Conversion Therapy and Liability". The Boston University Public Interest Law Journal. 8.
- David Williams. "About Ex-Gay Ministries". Retrieved 2008-09-14.
- Melzer, Eartha (2005-07-01). Tenn. opens new probe of ‘ex-gay’ facility: Experts say children should not be forced into counseling. Washington Blade. Retrieved 2007-08-28.
- Popper, Ben (2006-02-10). Love in Court: Gay-to-straight ministry and the state go to court. Memphis Flyer. Retrieved 2007-08-28.
- Talbot, T. (2006). "Reparative therapy for homosexual teens: the choice of the teen should be the only choice discussed". Journal of Juvenile Law.
- Cohan, J. (2002). "Parental Duties and the Right of Homosexual Minors to Refuse "Reparative" Therapy". Women's Law Journal (67).
- "NARTH Institute Position Statements". NARTH Institute.
- Cohen, Richard (2007-07-20). "Born gay? No way!". New Statesman. Retrieved 2007-08-27.
- Diverse Coalition Forms to Support People Seeking 'Non-Gay' Alternatives to Unwanted Homosexuality
- Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel. Just the Facts Coalition. 1999. Retrieved 2007-08-28.
- "Challenging the ex-gay myth: an information packet" (PDF). Political Research Associates, National Gay and Lesbian Task Force, Equal Partners in Faith. 1998. Retrieved 2007-08-28.
- Gonsiorek, John (2004). "Reflections From the Conversion Therapy Battlefield". The Counseling Psychologist. The Counseling Psychologist. 32 (5): 751. doi:10.1177/0011000004267621.
- Foust, Michael (December 4, 2003). "Love 'boldly,' expert says of homosexual outreach". Baptist Press.
- Homosexuality is not deviant - Federal Council of Psychologists of Brazil (Portuguese)
- Psychiatrist Jairo Bouer talks about the "collateral effects" of "gay cure" bill (Portuguese)
- Jonathan Watts (5 April 2013). "Head of Brazil's equality body accused of homophobia and racism". the Guardian. Rio de Janeiro, Brazil.
- The end of the Bill - Gay Cure (Portuguese)
- "Entrevista: Rozângela Alves Justino - Edição 2125 - Revista VEJA" (in Portuguese). veja.abril.com.br. Retrieved 2010-06-21.
- "Psicóloga que realiza 'tratamento' para homossexualidade pode ter registro profissional cassado, informa Folha de S.Paulo" [Psychologist realizing 'treatment' for homosexuality might have her professional register shot down, informs Folha de S. Paulo] (in Portuguese). Agência de Notícias da Aids. 2009-07-14. Retrieved 01/08/2009. Check date values in:
- ""Rozangela Justino foi punida pelos heterofóbicos", diz bispo anglicano" [Rozangela Justino was punished by the heterophobes, says Anglican bishop] (in Portuguese). A Capa. 04/08/2009. Retrieved 2009-08-08. Check date values in:
- The 1930s at our door: Gays, spinach and goats of Revista Veja (Portuguese)
- Almost half of Brazilian internet users support gay marriage – The Christian Post in Portuguese (Portuguese)
- National Research: Criminalization of prejudice or discrimination against homosexuals, DataSenado (2008) (Portuguese)
- Manitoba bans conversion therapy
- "Conversion therapy for LGBTQ youth to be banned in Ontario". CBC.ca. 2015-06-05. Retrieved 2015-06-19.
- "Lesbian Torture Clinics in Ecuador- Claiming to "Cure" Them". Hispanically Speaking News. Hispanically Speaking News. 5 November 2011. Retrieved 17 January 2013.
- "Why 200 Lesbian Torture Clinics Are Still Operating in Ecuador". The Huffington Post. The Huffington Post. 11 November 2011. Retrieved 17 January 2013.
- "Lesbians Escape From Ecuador's "Ex-Gay" Torture Centers". The Advocate. The Advocate. 7 October 2011. Retrieved 17 January 2013.
- "Rights groups hail Ecuador's crackdown on lesbian 'torture clinics'". MSNBC. 25 January 2012.
- Diacono, Tim (16 June 2015). "Gay 'conversion therapy' could become a criminal offence". Malta Today. Archived from the original on 17 June 2015.
- Malta could become first country in Europe to ban ‘gay cure’ therapy
- "Gay teen forced into therapy 'cure' by Christian community". The Local. 14 March 2016.
- (French) «L’Etat doit tout faire pour interdire ces pratiques»
- "TUC and Unison urge government to ban gay conversion therapy as petition heads to Parliament". PinkNews. July 12, 2013.
- Wyatt Buchanan (September 29, 2012). "State bans gay-repair therapy for minors". San Francisco Chronicle. Retrieved October 1, 2012.
- https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120SB1172 Bill Text, California Senate Bill No. 1172
- Stapleton, AnneClaire (December 22, 2012). "California law banning gay 'conversion therapy' put on hold". CNN. Retrieved December 23, 2012.
- "Federal appeals court stops California ban on gay-conversion therapy from taking effect". NBC News. Retrieved December 23, 2012.
- http://www.therepublic.com/view/story/a30d58ca60ba4c20a4dda80f7d80e31d/US-Gay-Therapy-Ban. Retrieved August 29, 2013. Missing or empty
- Joachim, David (2014-07-01). "Supreme Court Declines Case Contesting Ban on Gay 'Conversion Therapy'". New York Times.
- "N.J. Senate sends bill banning gay-to-straight 'conversion therapy' to Christie". NJ.com. June 27, 2013.
- "Chris Christie Signs Ban On Gay Conversion Therapy". Huffington Post. August 19, 2013.
- http://www.njleg.state.nj.us/2012/Bills/A3500/3371_I1.HTM Bill Text, Assembly, No. 3371, State of New Jersey, 215th Legislature
- "Court upholds N.J. ban on 'ex-gay' therapy". Washington Blade. November 9, 2013.
- Republican Party of Texas, Report of Permanent Committee on Platform and Resolutions As Amended and Adopted by the 2014 State Convention of theRepublican Party of Texas.
- Martin, Brittany (June 20, 2014). "Texas Republicans' backing puts spotlight on therapy for gays". Dallas Morning News.
- Livio, Susan K. "Group claiming to turn gay men straight committed consumer fraud, N.J. jury says". NJ.com True Jersey. New Jersey On-Line LLC. Retrieved 23 September 2015.
- "Vermont Senate approves ban on anti-gay therapy". KSL.com. March 16, 2016.
- Derek de Koff (August 20, 2015). "Illinois Republican governor signs two more pro-equality bills". LGBTQ Nation. Retrieved 21 August 2015.
- "Bill to ban conversion therapy for LGBT youth sent to Kate Brown's desk". Oregon Live. May 7, 2015.
- HB2307, Oregon Legislature
- "Oregon, Iowa lawmakers vote to ban sexual orientation conversion therapy". jurist.org.
- "ACA Advocacy Efforts Help Pass "Conversion Therapy" Ban in Oregon". American Counseling Association. 8 May 2015.
- Davis, Aaron C. (December 2, 2014). "D.C. bans gay conversion therapy of minors". The Washington Post.
- Cincinnati bans gay 'conversion' therapy
- Cincinnati Approves 'Ex-Gay' Therapy Ban
- Council votes to ban gay 'conversion' therapy in Cincinnati
- "Miami Beach says no more conversion therapy for youths under 18". Miami Herald. June 8, 2016.
- Ramos, Lisann (June 10, 2016). "Miami Beach Bans Conversion Therapy For Minors". Health News Florida.