In the United States, “conversion therapy” for LGBTQ people has been widely condemned by major medical associations. Not only that, nearly half of the country has now banned the practice for minors.

But a new review of 16 investigations across six nations suggests conversion therapy is hardly a thing of the past.

On average, nearly one of every 10 LGBTQ individuals around the world say they have been exposed to the highly problematic practice at some point in their lives, researchers found.

Such practices “include organized attempts to deter someone from adopting or expressing an LGBTQ identity or a gender identity that differs from [their] sex assigned at birth,” explained study lead author Travis Salway. He is an assistant professor with the Simon Fraser University Centre for Gender and Sexual Health Equity, in Canada.

But “the vast majority of research on conversion practices to date demonstrates limited to no effectiveness, and substantial risk of harm, including depression, anxiety and, in some cases, suicide,” Salway added.

Nevertheless, after reviewing studies conducted in the United States, the United Kingdom, Australia, Canada, Colombia and South Korea, Salway’s team found “conversion practices remain prevalent, with approximately 8% of LGBTQ people having been exposed in their lifetime.”

That figure did vary considerably from country to country, rising to 13% in the United States, while falling to 7% across Canada. On average, 12% of transgender individuals said they had been subjected to the practice.

The findings were published online Oct. 4 in PLOS ONE.

“We are disheartened to find that conversion practices remain prevalent,” said Salway, “despite the enactment of laws to ban these harmful practices, as well as health professional statements denouncing them.”

State policies vary

Indeed, most major medication associations have come out against conversion therapy. In the United States, those include the American Medical Association, the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the American Psychiatric Association, the Gay and Lesbian Medical Association and the American Academy of Family Physicians.

Meanwhile, 22 states and Washington, D.C., have passed legislation banning conversion therapy for minors. Those states include California and New York. Another five states have partial bans on the books.

On the other hand, 19 states, including Texas, have no state law or policy limiting the practice. Three other states — including Florida — have bans that are blocked due to ongoing court battles, according to Family Equality.

The upshot: nearly 3 in 10 American LGBTQ youth between the ages of 13 and 17 reside in jurisdictions that permit the practice, according to the Family Equality Council.

One reason the practice has endured is that those bans cannot address the full scope of the problem, said Jason Cianciotto, vice president of communications and policy with Gay Men’s Health Crisis in New York City.

“It’s been very important for states and localities to pass these laws,” Cianciotto acknowledged. “But one of the big holes is that the majority of these therapies are being provided by religious-based lay counselors, ministers and church elders who are not licensed therapists or practitioners, which means they haven’t gone to school to get a psychology degree or medical school to get a psychiatry degree. If they have any credentials at all, it’s from a ministerial school.”

For the moment, there’s little legislation can do to address this loophole, he noted.

“These statewide bans would have included lay counselors if they could have, but they can’t. And you combine that with the fact that people under the age of 18 have very few rights,” Cianciotto added. “So, it’s very simple and easy for parents who have strong religious beliefs, and come from a homophobic place, to go somewhere and force their child to attend. And unless that child is being treated in a way that would meet the legal definition of abuse, there’s really no recourse.”

Personal journey

Cianciotto knows of what he speaks.

“I was 13 years old when I was first taken to a Christian lay counselor,” he recalled. “What was I going to do? Do I have the wherewithal at 13 to know to call the police and say I’m being abused here? Of course not.”

Raised primarily by a mother who embraced fundamentalist Christianity, Cianciotto said there was no pretense about what was happening.

“It was very clear that they were Christian counselors,” he stressed. “And religious dogma taught me that being gay was among the worst things you could do. And if I ‘chose’ to be a homosexual I would live a lonely life and get AIDS and die.”

Initially, Cianciotto played along with the process. “I was a smart kid. So, I pretty quickly realized that the best way to stop going to this place is to just go along with it, and agree with everything that they said,” he said. “Which I did.”

But when Cianciotto turned 16, he was forced back into “conversion therapy” for upwards of three more years.

“All the things I experienced then are very similar to what would be practiced today, meaning we would begin with a prayer,” he said. “And the world view I was subjected to was based on their interpretation of the Bible.”

College proved to be a turning point. There, he met other LGBTQ people and started to “develop a sense of agency,” Cianciotto said.

“I realized I don’t have to submit. I don’t have to do whatever my mother or the church thought I should do. But then of course I was kicked out of my home. I had to couch surf with friends. It was not until my father and brothers and sisters got involved that I had a home again,” he said.

“Today I have the life that my mother and my church told me that I was never going to have,” said Cianciotto, who recently celebrated the 20th anniversary of he and his husband’s first date. “I was very fortunate to have a couple of teachers in high school who helped me to see that a happy life is possible, who told me how valuable and special my life was, and how it was so worthwhile for me to fight and survive what I was going through, because when I get older I will thrive.”

Even so, “conversion therapy” left its mark, in the form of a lifelong struggle with depression, he added.

“I look at my husband, who grew up in a supportive family. He was teased in school a little, but nothing compared to what I went through,” Cianciotto said. “And I wonder what my life might have been like if conversion therapy had been a relic of the past, if these wounds hadn’t happened in the first place, and my heart aches for all those people who are still going through this.”

More information

There’s more on conversion therapy at Family Equality.

SOURCES: Travis Salway, PhD, assistant professor, Simon Fraser University, Centre for Gender and Sexual Health Equity, British Columbia Centre for Disease Control, Canada; Jason Cianciotto, vice president of communications and policy, Gay Men’s Health Crisis (GMHC), New York City; PLOS ONE, Oct. 4, 2023, online