Review of research underscores harms of conversion therapy and importance of family affirmation

So-called “conversion therapy” or “reparative therapy” for children and teens within the LGBTQ community is “harmful and should never be provided,” according to new research released by the U.S. Substance Abuse and Mental Health Services Administration.

The terms refer to attempts to change a person’s identity from LGBTQ to heteronormative.

“Although the terms ‘conversion therapy’ and ‘reparative therapy’ are commonly used to describe efforts to repress or change someone’s sexual orientation or gender identity, these efforts are not therapeutic, and using these terms reinforces disinformation that sexual- and gender-diverse people need repair or conversion,” the report’s executive summary states. “Efforts to change or suppress a person’s sexual orientation or gender identity are grounded in the belief that being LGBTQ is abnormal. They are dangerous, discredited and ineffective practices.”

Such practices — often undertaken by Christian counselors affiliated with churches — “are not supported by credible evidence and have been disavowed as harmful by behavioral health experts and scientific professional associations.”

The document, titled “Moving Beyond Change Efforts: Evidence and Action to Support and Affirm LGBTQI+ Youth,” reports on a scholarly review of two decades of research on the social and mental health of LGBTQ children and youth.

“Research over the past 20 years has underscored the importance of family and community support to the health of LGBTQ youth,” the summary explains. “Family and community negativity toward sexual diverse sexual orientation and/or gender identity, especially family rejection and school bullying and harassment, can cause harm to the behavioral health of this population.”

The review panel confirmed:

Rejection and lack of social and emotional support from families and caregivers, schools and communities negatively affects the health of sexual and gender minority youth. Such behaviors can cause harm, particularly family rejection of the youth’s sexual and/or gender diversity.
Policies that stigmatize, restrict or exclude sexual or gender minority youth are harmful to children and adolescents.
Legal prohibitions on gender-affirming care (including medical treatment) are harmful to LGBTQ children and adolescents.

“As we continue to defend LGBTQ young people, especially trans young people, against a record number of political attacks at the state level, we are grateful to the federal government for sending a powerful message to every LGBTQ young person that they should be proud of who they are and deserve access to affirming environments and care,” said Kasey Suffredini, vice president for advocacy and government affairs with the Trevor Project.

Added Matthew Shurka, co-founder of Born Perfect, an organization that advocates against conversion therapy: “Both as a survivor who was subjected to conversion therapy for five years as a minor and as an advocate on this issue, I am grateful to HHS for compiling this important report and for providing this critical information to families, providers and policymakers. It is past time for these deadly practices to end.”

Some of the research cited in the report includes:

A 2020 peer-reviewed study published in the American Journal of Public Health found youth who reported undergoing conversion therapy were more than twice as likely to report having attempted suicide and more than 2.5 times as likely to report multiple suicide attempts in the past year.
A 2020 peer-reviewed study published in the Journal of Adolescent Health found transgender and nonbinary youth were 2 to 2.5 times as likely to experience depressive symptoms, seriously consider suicide and attempt suicide compared to their cisgender LGBTQ peers.
A 2020 peer-reviewed study published in the Journal of Adolescent Health, found transgender and nonbinary youth who report experiencing discrimination based on their gender identity had more than double the odds of attempting suicide in the past year compared to those who did not experience discrimination based on their gender identity.
A 2021 peer-reviewed study published in LGBTQ Health found LGBTQ youth who reported high levels of sexual orientation acceptance from any adult had nearly 40% lower odds of a past-year suicide attempt compared with LGBTQ peers with little to no acceptance.
A 2021 peer-reviewed study published in Transgender Health found transgender and nonbinary youth who reported gender identity acceptance from adults and peers had significantly lower odds of attempting suicide in the past year.
A 2021 peer-reviewed study published in the Journal of Adolescent Health found gender-affirming hormone therapy is significantly related to lower rates of depression, suicidal thoughts and suicide attempts among transgender and nonbinary youth.
A 2022 peer-reviewed study published in JAMA Pediatrics found the practice of conversion therapy on LGBTQ youth, and its associated harms — such as substance abuse and negative mental health outcomes, including depression, anxiety and suicide attempts — cost the U.S. an estimated $9.23 billion annually.