I have spent lockdown analysing ~200 papers about conversion therapy (don't ask why, it was not a Good Idea). As the Gov't has apparently forgotten that in their 2018 AP they pledged to bring forward proposals to make it illegal based on a SURVEY I thought I'd share my findings.

Conversion therapy, also known as Sexual Reorientation Theory (not accurate) or Reparative Therapy (bleurgh). Is an extremely broad school of thought designed to change the sexual orientation, gender and behaviour of a wide variety of different communities.

We often talk about CT with a silent gay, as if this this the only person targeted. This is definitely not the case. Using the language of the research, CT has been directed towards homosexuals, transvestites, transsexuals, gender identity disordered persons, cross-dressing...

children, sadomasochists, fetishists, pedophiliacs, and general sexual deviants. Essentially anyone who does not fit the scientific definition of cisgender and heterosexual (though, the lit uses purely the term heterosexual, the cisgender is extremely implied).

(To be clear, I'm not implying here that sexual orientation or trans identities are fetishes etc. this is a historic misrepresentation and often deliberate way of undermining what it means to be LGBTQIA+. I'm also not trying to kink/fetish shame in this note.)

It is v. important that all CT conversations acknowledge this and especially the use of CT on trans communities because 1) it is still very much in general practice, espc. for young people and tiny children and 2) the motivations and methodologies are tied to strict gender norms.

The rest of the thread will follow this structure:
- a brief history of CT focusing predominantly on research from the US and the UK;
- a very short overview of why the scientific arguments on its efficacy should not be taken at face value;
- a grim detailing of the worst of it.

I will use "LGBTQIA+" throughout in acknowledgement that every incident of CT has a wide reaching impact on LGBTQIA+ communties regardless of the sexual orientation/gender identity of the victim because it is all predicated on the idea that cishet = normal and LGBTQIA+ = sick.

A brief history (CW explicit but not graphic descriptions of torture SA and anti-LGBTQIA+ prejudice)

There are 2 types of CT: behaviour therapy which treats your differences as a misfiring of standard bodily functions and attempts to retrain the way your body responds to stimuli

and psychoanalysis which argues that your difference is a result of an error in your sexual development* that can be fixed through, conveniently, psychoanalysis.

*historically, science has seen LGBQ+ as an extension of gender nonconformity and TQ+ as a type of sexuality.

Prior to the full development of these schools, there was the horror of the late 19th/early 20thC in which LGBTQIA+ folk were prescribed exercise regimes to exhaust them, hormones and surgeries to make them more masculine/feminine, and sex to, IDK, kickstart their engines.

As an aside, the history of CT is also the history of how women’s bodies have been instrumentalised to help men and why women should be subservient to men. In CT women have been forced to become men, required to help men and made to subjugate to men.

Women were held responsible for sexual deviance in the form of overbearing mothers, unwilling sexual partners and destructive feminists and often forced to give up their bodies to help cure men.

Ultimately, CT is built on the premise that men are better than women masculinity is

better than femininity and behaviour associated with women is a sign of weakness that must be fixed.

As an expected consequence the history of CT for those categorised as women (despite their actual gender) is much less well documented.

I think we really see CT formalise as a "science" in the 50's/60's, when we get the development of BT which, Clockwork Orange style, involved pairing deviant behaviours (arousal at someone of the same sex, cross dressing, expressing femininity/masculinity) with something bad and

pairing acceptable behaviours (arousal at someone of the appropriate sex, being repulsed by deviant behaviours, etc.) with something good.

Punishments include(d) electric shocks, noxious fumes, being asked to imagine something disgusting, being reprimanded and, for kids, being ignored or losing good behaviour tokens & rewards relief from the shocks/bad smells, praise and for kids, good behaviour tokens and biscuits.

In contrast, as the psychoanalytical framework argued that LGBTQIA+ identities are caused by some form of (traumatic) event, the cure was to identify the event and help the patient overcome it.

On the +ve side, this approach doesn't involve physical torture but on the -ve this connection between LGBTQIA+ identities and trauma featured heavily in the conversion therapy propaganda, particularly of the 90's & reenforced this idea that we were meant to be straight.

Now for the refutation of the CT science. This may seem unnecessary, given that the majority of scientists don't support CT practices, right?

It's true that CT for sexuality has fallen out of favour but that's not so much the case for gender nonconformity in kids.

Firstly a lot of the evidence is in the form of individual case studies with success measured by the researcher - obvious limitations. A key point is science's conflation between gender expression and sexuality/gender & biases held by researchers makes them very bad at this.

And, papers that rely on the testimonies of the patients themselves are also limited by the pressure likely felt by patients to claim success given that they were spending a lot of time with people who told them they were 1) sick and 2) to blame if they didn't get cured.

Secondly, we have no real way of evaluating if CT works because not only do we have a pisspoor understanding of what sexuality/gender is, the idea that everyone under even the individual letters in the LGBTQIA+ acronym has the same experience of sexuality/gender is ludicrous and

so having a clear, objective ability to say your sexuality/gender has changed from X to Y is inconceivable. Instead, what we get is a mismatch of weird proxies that never measure what they say they're measuring.

I really want to share here an example of a child who, after CT, played with the "appropriate toys". When asked why, they explained that, in doing so, they knew they'd get a biscuit. Congrats, science you've observed a child's ability to suss you out.

Basically there are no papers that hold up to scientific scrutiny that show CT (in any form) is effective at actually changing someone's sexual orientation, gender, or gender expression (or, for that matter, fetish).

But, way more importantly than any actual results, CT should be considered scientifically unsound because its theoretical basis is entirely flawed - it's based on heterosexist beliefs about LGBTQIA+ identities, i.e. that cis-heterosexuality is the default and natural state.

I promise I'm nearly done, but let's finish with why CT is really very bad and why it is insulting, dangerous and terrifying that the Gov't is opening a discussion about it particularly in the wake of their decision to not move ahead with GRA reform.

(CW: more torture and death)

It is hard to measure the full impact of CT on patients – a lot of information is missing. This is in part due to the lack of formal documentation of side effects and harms within the lite. Scientists have basically failed in their responsibility to do this.

Here are the sideeffects that have been documented: anxiety, depression, nervous breakdowns, shame, guilt, loss of self, PTSD, paranoia, suicide, suicidal ideation, self-harm, self-mutilation, being trapped with urges and desires that fill you with negative emotions, burns,

asphyxiation, complications from surgery, headaches, dehydration, sexual dysfunction, and death.

The harms of CT are compounded by the extreme lack of consent. Patients were recruited directly from prison or offered CT as an alternative to prison, so many patients have been children (as young as 3 or 4), in Apartheid South Africa many military conscripts were forced to

undergo CT (including gender reassignment surgery) in order to be made fit for service, and so, so many patients who have sought out CT have done so in a truly prejudice environment that has made them feel as if this is preferable to living as LGBTQIA+.

Beyond the clear harms to patients the existence of CT says that LGBTQIA+ identities are a sickness because here is the cure It is fundamentally in antithesis of the right of LGBTQIA+ people to live equally in society & it represents a state sanctioned method of getting rid of us

In 2018 the Gov't said they would make a move to ban it They have done nothing In the time since the climate in the UK has grown ever more transphobic making the use of CT practices and principles in the name of "protecting" gender nonconforming and trans kids ever more palatable

Don't buy their bullshit, learn our history, reject conversion therapy in all its forms.

(I realise that, despite using LGBTQIA+ throughout, I have not explicitly mentioned intersex or asexual populations. This is completely my bad. These communities somewhat fall outside of the traditional CT literature but are nonetheless affected.)

Trans patients, especially children, were often screened for intersex varients prior to CT because the "solution" there is usually to go straight to surgery.

Forced surgery to "fix" intersex variations is an adjacent and extremely important issue plagued with an equally horrific and heterosexist history. Any energy you put into ending CT, I emplore you, also put into ending nonconsensual surgeries especially on intersex kids.

As for the asexual community, I don't want to say things are complicated but I would say the literature is more confused. Because of acephobia and erasure, much of the conversation sits in the literature that deals with sexual dysfunction and I haven't yet been able to extract it

The vibe, however, is that asexuality is barely considered an identity from the perspective of, e.g. the DSM (which in the US at least tells us what is and isn't a mental disorder). This, combined with the lack of positive information about asexuality in the mainstream means that

So many people may be approaching medical practioners because they think that their experience of sexual/romantic attraction means there is something wrong with them and being diagnosed with an arousal disorder and being given medication/modern forms of CT.

(The DSM does say that asexuality is not a sexuality disorder and so if a patient is ace they shouldn't be treated but this is only in the full, not the quick, guide AND removing a SOGE but keeping distress at having said SOGE as a mental disorder is the same trick that was used

for sexual orientation and for being trans and both times this has been used to justify CT (oh my patient needs it, they're very sad they're gay etc.).) It's irresponsible to practice therapy for sexual dysfunction if you can't distinguish it from an experience of asexuality.

OK, this thread was too long already but here is the main take away:
Any fight against CT needs to recognise that it hurts everyone LGBTQIA+ and fights against it should reflect that. Ending CT = ending it for LGBQ+ AND TQ+ AND A+ AND means ending forced intersex surgery.