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The Many Guises of Conversion Therapy

Beware of conversion therapy; it can be covert.

Key points

  • Conversion therapy is the harmful practice of attempting to change someone's sexuality.
  • Conversion therapy can be practiced in different guises, some intentional and some unintentional.
  • LGBTQ+ populations are at particular risk of being offered conversion therapy, especially within religious settings.
  • Asexual people and those with compulsive sexual behaviours may also be at risk from unintentional versions of conversion therapy.
Nik Shuliahin/Unsplash
Source: Nik Shuliahin/Unsplash

Conversion therapy is the harmful practice of attempting to turn someone who is gay into being heterosexual. The belief of those who promote conversion therapy is that heterosexuality is the only valid sexuality and that being gay or transgender is a pathology or disease caused by being defective or by past trauma.

In fact, being gay is a natural part of the wide diversity of sexual orientations. Being trans is not a pathology either; it is the expression of wanting to be in the physical body that is psychologically felt.

Conversion therapy doesn’t work, and forcing someone to repress their innate sexuality causes great harm. Research shows that living with your authentic sexuality and gender has great well-being benefits, and, conversely, repressing them has major negative psychological and emotional impact, including self-harm, severe depression, and suicidal ideation.

Conversion therapy is practiced widely across the globe, and especially in countries with high religiosity. Only a few countries have banned the practice. Here in the UK, conversion therapy is deemed to be unethical but it is not yet illegal (despite the government promising a ban since 2018), which means that people can continue to be legally exploited and damaged by the practice. Conversion therapy mostly occurs within religious settings (a counsellor associated with a church or faith, for example), and the podcast Thinking Straight has brought to light how widely conversion therapy is practiced under the radar in the UK.

Conversion therapy may be offered under different guises, such as ‘reparative therapy’, ‘gay cure,’ or sometimes it's hidden even more covertly under the label ofy ‘psychotherapy’ or ‘counselling’ to help people ‘explore their sexuality’. Even though there is nothing wrong with wanting to explore sexuality in therapy, it is unethical if the agenda has the primary goal of finding ‘wrongness’ in someone’s life to justify why their sexual orientation is a disease or pathology.

Apart from conversion therapy that is intentional but covert, a number of therapies may unintentionally practice conversion therapy, due to poor training or lack of knowledge in contemporary sexology. Even if it may be unintentional, it is still harmful.

Following are several ways that conversion therapy can happen, from intentional to unintentional

1. Intentional conversion therapy: “Pray the gay away." This type of conversion therapy is the one most talked about, as explained above. It is usually practiced in religious settings. It is an attempt to turn people heterosexual as that is deemed the only natural and valid sexual orientation.

2. Unintentional conversion therapy: Sex therapy gone bad. A sex therapist who has not updated their knowledge in sexuality diversity may think that a client/patient coming for help because of the absence of sexual desire has a pathology and will work toward getting that person to feel sexual desire. If the client is in a romantic relationship, the sex therapist might even suggest a programme to help the client have sex with their partner. In fact, the client may not have a dysfunction; they may be on the asexuality spectrum, which is as valid an orientation as any other. Working toward making an asexual person have sex is a form of conversion therapy and it can be harmful.

3. Unintentional conversion therapy: A vanilla-based therapy. Some clients may seek therapy because they have a sexual desire, arousal, or behaviours that worry them. For example, they only feel sexual in the presence of a particular object (fetish) or with a particular relational dynamic (for example, Dominant/Submissive). They think that they have a problem because they do not get turned on with ‘normal stuff’ (a partner looking lovingly into their eyes, for example). A therapist who is uninformed about kink and/or who is vanilla-based, may collude with the idea of the client having a problem, and may guide the client in identifying some childhood trauma that made them that way and attempt to change their turn ons. In fact, research has shown that for some people, kink and fetish are ‘serious leisure activities,’ but for others it is their ‘erotic orientation’. Attempting to turn a kinky person into a vanilla person may constitute conversion therapy.

4. Unintentional conversion therapy: The monogamous therapy. Some people are naturally monogamous; others are not. One's intimate relationship set-up can be a choice for some and a romantic/relational orientation for others. If a therapist believes that the gold-standard of relationships is monogamy, and that being nonmonogamous means that they are trying to avoid something, or are hiding from something, then they might want to find a problem where there is none, and imply, either overtly or covertly, that their client should try to be monogamous. Shaming polyamorous clients into monogamy can be conversion therapy.

5. Intentional conversion therapy. Many people misunderstand trans people. It is a hot political and moral debate that divides people. Some misinformed people believe that the politically correct agenda is to push people who question their gender to become trans. But this is not the case at all. Affirming someone’s feelings around their gender, and listening to someone’s struggles about their gender without judgment does not do harm, nor does it push people to become trans. However, some people questioning their gender feel that they’re not in the body that they psychologically feel, and a process of transition to make the body congruent with their mind promotes significant well-being. Telling a trans person it is ‘only a phase’, or that it is God’s plan to stay with their sex assigned at birth, or shaming them for wanting to transition, is conversion therapy.

6. Unintentional conversion therapy: ‘Sex addiction/porn addiction’ therapy. Most therapists specialising in ‘sex addiction’ are well-meaning but may have received poor training with a significant lack of understanding of contemporary sexology. Many 12-step programmes follow heteronormative (and/or religious) thinking about the sexual behaviours they deem ‘healthy’ and those they think are ‘unhealthy’. Many of the behaviours they deem ‘unhealthy’ are actually normative, functional, and a part of sexuality and romantic diversities. Some 12-step programmes and so-called ‘sex addiction’ therapists employ aversion techniques to stop people from having sexual urges (or even sexual fantasies). Sure, people who constantly cheat on their partner and breach their trust are not exhibiting good behaviour and it is extremely hurtful for their partners, but attempting to turn them monogamous or into 'good spouses’ without robust knowledge (and therefore solid grounds for assessment) based on contemporary sexology may lead a therapist to practice unintentional conversion therapy.

Be aware of the different guises of conversion therapy. Only you can identify what your sexual and romantic attractions are and only you can self-identify with what you feel and experience. A therapist can help you explore your sexuality and get to know your erotic mind but they can’t tell you what you are or are not. If you feel that a therapist has a particular agenda or belief about ‘healthy’ and ‘unhealthy’ sexuality that bothers you, you are probably right. It's your right to ask your therapist if they have knowledge of contemporary sexology, and to ask them what they know about it. It's also OK to change your therapist.

To find a therapist, visit the Psychology Today Therapy Directory.