Many right-wing religious groups promote the concept that an individual can change his or her sexual orientation, either through prayer or other religious efforts, or through so-called “reparative” or “conversion” therapy. The limited research on such efforts has disproven their efficacy, and also has indicated that they can be affirmatively harmful. Beyond studies focused solely on reparative therapy, broader research clearly demonstrates the significant harm that societal prejudice and family rejection has on lesbian, gay, bisexual and transgender (LGBT) people, particularly youth. Furthermore, there is significant anecdotal evidence of harm to LGBT people resulting from attempts to change their sexual orientation. Based on this body of evidence, every major medical and mental health organization in the United States has issued a statement condemning the use of reparative therapy.
Psychiatrist Dr. L. Spitzer, who once offered a study on reparative therapy, has since denounced the practice and has apologized for endorsing the practice. Read more here.
“Herman Cain’s opinion that being gay is a choice has no basis in current scientific thinking,” said Dr. Jack Drescher, MD, a Distinguished Fellow of the American Psychiatric Association and a member of the DSM-5 Workgroup on Sexual and Gender Identity Disorders. “Not only is homosexuality ‘not a choice,’ as most efforts to try and change a person’s sexual orientation fail, but some attempts to change can cause harm and damage to an individual’s well-being.”
Dr. Drescher also served as a past chair of APA’s Committee on GLB Issues.
Research on the Impacts of Reparative Therapy, Harms Caused by Societal Prejudice
In 2007, a task force of the American Psychological Association undertook a thorough review of the existing research on the efficacy of reparative therapy. Their report noted that there was very little methodologically sound research on sexual orientation change efforts (SOCEs) and that the “results of scientifically valid research indicate that it is unlikely that individuals will be able to reduce same-sex attractions or increase other-sex sexual attractions through SOCE.” In addition, the task force found that “there are no methodologically sound studies of recent SOCE that would enable the task force to make a definitive statement about whether or not recent SOCE is safe or harmful and for whom.” Read the full report.
In short, there is clear evidence that reparative therapy does not work, and some significant evidence that it is also harmful to LGBT people.
In contrast, there is ample evidence that societal prejudice causes significant medical, psychological and other harms to LGBT people. For example, research on the issue of family acceptance of LGBT youth conducted at San Francisco State University found that “compared with LGBT young people who were not rejected or were only a little rejected by their parents and caregivers because of their gay or transgender identity, highly rejected LGBT young people were:
Organizational Positions on Reparative Therapy
American Academy of Pediatrics
“Confusion about sexual orientation is not unusual during adolescence. Counseling may be helpful for young people who are uncertain about their sexual orientation or for those who are uncertain about how to express their sexuality and might profit from an attempt at clarification through a counseling or psychotherapeutic initiative. Therapy directed specifically at changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation.”
Homosexuality and Adolescence, Pediatrics.
American Association for Marriage and Family Therapy
“The American Association for Marriage and Family Therapy takes the position that same sex orientation is not a mental disorder. Therefore, we do not believe that sexual orientation in and of itself requires treatment or intervention.”
Statement on Nonpathologizing Sexual Orientation.
American Counseling Association
“The American Counseling Association opposes portrayals of lesbian, gay, and bisexual youth and adults as mentally ill due to their sexual orientation; and supports the dissemination of accurate information about sexual orientation, mental health, and appropriate interventions in order to counteract bias that is based on ignorance or unfounded beliefs about same-gender sexual orientation.”
Resolution, as reported in the American Psychological Association’s publication, “Just the Facts about Sexual Orientation and Youth.”
American Medical Association
“Our AMA… opposes, the use of ‘reparative’ or ‘conversion’ therapy that is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her homosexual orientation.”
H-160.991, Health Care Needs of the Homosexual Population.
American Psychiatric Association
“Psychotherapeutic modalities to convert or ‘repair’ homosexuality are based on developmental theories whose scientific validity is questionable. Furthermore, anecdotal reports of “cures” are counterbalanced by anecdotal claims of psychological harm. In the last four decades, “reparative” therapists have not produced any rigorous scientific research to substantiate their claims of cure. Until there is such research available, [the American Psychiatric Association] recommends that ethical practitioners refrain from attempts to change individuals’ sexual orientation, keeping in mind the medical dictum to first, do no harm.
The potential risks of reparative therapy are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient. Many patients who have undergone reparative therapy relate that they were inaccurately told that homosexuals are lonely, unhappy individuals who never achieve acceptance or satisfaction. The possibility that the person might achieve happiness and satisfying interpersonal relationships as a gay man or lesbian is not presented, nor are alternative approaches to dealing with the effects of societal stigmatization discussed.
Therefore, the American Psychiatric Association opposes any psychiatric treatment, such as reparative or conversion therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her sexual homosexual orientation.”
Position Statement on Therapies Focused on Attempts to Change Sexual Orientation (Reparative or Conversion Therapies).
American Psychoanalytic Association
“Same-gender sexual orientation cannot be assumed to represent a deficit in personality development or the expression of psychopathology. As with any societal prejudice, anti-homosexual bias negatively affects mental health, contributing to an enduring sense of stigma and pervasive self-criticism in people of same-gender sexual orientation through the internalization of such prejudice.
As in all psychoanalytic treatments, the goal of analysis with homosexual patients is understanding. Psychoanalytic technique does not encompass purposeful efforts to “convert” or “repair” an individual’s sexual orientation. Such directed efforts are against fundamental principles of psychoanalytic treatment and often result in substantial psychological pain by reinforcing damaging internalized homophobic attitudes.”
Position Statement on Reparative Therapy.
American Psychological Association
“THEREFORE, BE IT RESOLVED, That the American Psychological 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;
BE IT FURTHER RESOLVED, That the American Psychological Association 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;
BE IT FURTHER RESOLVED, That the American Psychological Association concludes that there is insufficient evidence to support the use of psychological interventions to change sexual orientation;
BE IT FURTHER RESOLVED, That the American Psychological Association 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…”
Resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts.
American School Counselor Association
“Lesbian, gay, bisexual, transgendered and questioning (LGBTQ) youth often begin to experience self-identification during their pre-adolescent or adolescent years, as do heterosexual youth. These developmental processes are essential cognitive, emotional and social activities, and although they may have an impact on student development and achievement, they are not a sign of illness, mental disorder or emotional problems nor do they necessarily signify sexual activity.
The professional school counselor works with all students through the stages of identity development and understands this development may be more difficult for LGBTQ youth. It is not the role of the professional school counselor to attempt to change a student’s sexual orientation/gender identity but instead to provide support to LGBTQ students to promote student achievement and personal well-being.”
The Professional School Counselor and LGBTQ Youth.
National Association of Social Workers
“People seek mental health services for many reasons. Accordingly, it is fair to assert that lesbians and gay men seek therapy for the same reasons that heterosexual people do. However, the increase in media campaigns, often coupled with coercive messages from family and community members, has created an environment in which lesbians and gay men often are pressured to seek reparative or conversion therapies, which cannot and will not change sexual orientation. Aligned with the American Psychological Association’s (1997) position, NCLGB [NASW's National Committee on Lesbian and Gay Issues] believes that such treatment potentially can lead to severe emotional damage. Specifically, transformational ministries are fueled by stigmatization of lesbians and gay men, which in turn produces the social climate that pressures some people to seek change in sexual orientation. No data demonstrate that reparative or conversion therapies are effective, and in fact they may be harmful.”
Position Statement, “Reparative” and “Conversion” Therapies.
Pan American Health Organization (PAHO): Regional Office of the World Health Organization
Services that purport to “cure” people with non-heterosexual sexual orientation lack medical justification and represent a serious threat to the health and well-being of affected people, the Pan American Health Organization (PAHO) said in a position statement launched on 17 May, 2012, the International Day against Homophobia. The statement calls on governments, academic institutions, professional associations and the media to expose these practices and to promote respect for diversity.