What Conversion Therapy Actually Does to Your Mind

Conversion therapy is a scientifically discredited practice with no proven efficacy that actively causes documented psychological harm, including depression, PTSD, and suicidal ideation, through mechanisms like internalized shame and betrayal trauma, condemned by every major medical and mental health organization, while LGBTQ+-affirming, trauma-informed therapy provides survivors with a genuine, evidence-based path to healing.

Conversion therapy has never successfully changed a single person's sexual orientation or gender identity, but it has caused documented, lasting harm to thousands who underwent it. Every major medical and mental health organization in the world agrees. This article explains exactly how it works, what it does to the mind, and how survivors heal.

What is conversion therapy?

Conversion therapy is an umbrella term for any practice designed to change, suppress, or eliminate a person’s sexual orientation, gender identity, or gender expression. You may also see it called reparative therapy, sexual orientation change efforts (SOCE), or gender identity change efforts (GICE). Regardless of the label, the core premise is the same: that being LGBTQ+ is something to be fixed.

The roots of this practice run deep. For decades, homosexuality was classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the standard reference guide used by mental health professionals in the United States. That classification was not removed until 1973. Even after that landmark shift, change-oriented practices persisted, carried forward in both clinical offices and religious communities that continued to treat LGBTQ+ identities as pathological, meaning disordered or in need of treatment.

Conversion therapy does not target one narrow group. According to population-level data on the scope of conversion therapy, it affects LGBTQ+ individuals broadly, including a significant number of minors. It takes place across clinical, religious, and community settings, which means it is not confined to licensed practitioners. Research on conversion therapy among men who have sex with men also highlights a troubling pattern: many people who undergo these practices do not choose them freely, pointing to a coercive element that compounds the potential for lasting harm, including the kinds of traumatic disorders explored later in this article.

Conversion therapy is not a recognized clinical intervention by any mainstream medical or mental health organization. That consensus, and the evidence behind it, is what the rest of this article examines.

What conversion therapy looks like: techniques, settings, and rebranded practices

Conversion therapy is not a single method. It spans a wide range of practices, from formal clinical settings to informal family or faith-based pressure. Understanding what these practices actually look like, and how they disguise themselves, is one of the most practical ways to protect yourself or someone you care about.

Clinical and behavioral techniques

On the clinical side, conversion therapy has historically taken two broad forms. The first involves talk-based approaches: psychoanalytic models that treat same-sex attraction as a developmental failure, or cognitive reframing techniques designed to redirect desire toward heterosexuality. The second involves behavioral aversion methods, which are among the most harmful on record. These include covert sensitization, where a person is trained to associate LGBTQ+ feelings with imagined disgusting scenarios, and electroshock pairing, where physical pain is used to condition a negative response to same-sex attraction.

Today, overtly aversive techniques are less common in licensed settings, but talk-based versions remain widespread. Because they look superficially similar to legitimate counseling, they are often harder to identify and easier to dismiss as ordinary therapy.

Religious and community-based practices

Conversion therapy also happens entirely outside clinical offices. Religious and community-based interventions include exorcism rituals, structured prayer programs, and residential camps framed as spiritual formation or healing retreats. These settings operate with little to no oversight, and participants, especially minors, may have no meaningful ability to refuse. The harm in these environments is real and well-documented, even when no licensed professional is ever involved.

How to recognize conversion therapy when it is rebranded

Rebranding is one of the biggest obstacles to identifying and stopping these practices. Programs increasingly use language like “gender-exploratory therapy,” “unwanted same-sex attraction counseling,” or “identity-affirming ministry” to avoid legal scrutiny and sound credible. Knowing the red flags matters.

Be cautious if a therapist or program:

• Frames your LGBTQ+ identity as a symptom, disorder, or phase to be resolved
• Sets explicit goals around changing your sexual orientation or gender identity
• Uses religious texts as clinical rationale in a licensed therapeutic context
• Does not disclose that the practice lacks scientific support before you consent
• Operates without a license or outside the scope of a recognized mental health profession

Conversion therapy does not require a therapist’s office to cause harm. It can happen in a pastor’s study, at a family dinner table, or at a weekend retreat. Recognizing it by its intent and its effects, not just its label, is what matters most.

Does conversion therapy work? What the evidence shows

The short answer is no. Not a single peer-reviewed, methodologically sound study has demonstrated that conversion therapy can change a person’s sexual orientation or gender identity. This is not a matter of ongoing scientific debate. The evidence base has been examined thoroughly, and the conclusion is consistent.

The most comprehensive review to date comes from the APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation, published in 2009. Researchers systematically analyzed decades of studies claiming that sexual orientation change efforts produced results. What they found was a pattern of serious methodological failures across the board. Early studies relied entirely on self-report, included no control groups, and excluded participants who dropped out, which skews results significantly. Many studies also confused behavioral compliance, such as choosing celibacy, with an actual shift in attraction. Those are not the same thing.

The premise of conversion therapy is also scientifically unfounded at its core. Sexual orientation and gender identity are not pathological conditions, meaning they are not disorders, deficits, or problems requiring a cure. Treating them as such contradicts established consensus across psychiatry, psychology, and medicine.

A rigorous randomized controlled trial, the gold standard for testing any intervention, could not ethically be conducted here. Deliberately exposing participants to a practice already documented to cause serious psychological harm is not something any ethical review board would approve. The absence of high-quality trial data is not a gap in the science. It is a reflection of how harmful the practice is known to be.

How conversion therapy damages mental health: the five pathways of harm

Conversion therapy does not simply fail to work. It actively harms the people subjected to it through specific, identifiable psychological mechanisms. Understanding how the damage occurs matters, because it explains why the effects persist long after the practice ends and why they are so difficult to treat. The following five pathways map the causal routes from conversion therapy exposure to documented mental health outcomes.

Internalized stigma and shame loops

Conversion therapy is built on a single premise: that a person’s sexual orientation or gender identity is disordered, sinful, or in need of correction. When that message is delivered repeatedly by authority figures, it does not stay external. It gets absorbed into a person’s core self-concept, creating what researchers call internalized homophobia or transphobia. The individual stops hearing “your identity is wrong” from others and starts generating that verdict from within. This internal shame loop is self-sustaining, which is why it persists long after exposure to conversion practices ends. It is consistently associated with depression, low self-esteem, and elevated suicidal ideation.

Minority stress amplification

Psychologist Ilan Meyer’s minority stress model establishes that LGBTQ+ people already carry a chronic stress burden from navigating stigma, prejudice, and discrimination in daily life. Conversion therapy does not reduce it. Instead, it intensifies every proximal stressor the model identifies: expectations of rejection, the felt need to conceal one’s identity, and internalized stigma. A cross-sectional study published in The Lancet Psychiatry found measurable associations between conversion practice exposure and depression, anxiety, PTSD, and suicidal behavior across sexual and gender minority populations, directly reflecting this compounding effect.

Betrayal trauma in parental and religious contexts

When conversion therapy is initiated by a parent, a pastor, or another trusted authority figure, it produces what trauma researchers call betrayal trauma: harm inflicted by someone the individual depends on for safety and survival. This dynamic is especially damaging for minors, who cannot leave the home or the religious community and who may suppress their awareness of the betrayal in order to preserve the attachment relationship they need. Research published in JAMA Pediatrics found that parent-initiated conversion efforts were associated with depression, suicidal ideation, and compounding harms in LGBT youth, outcomes consistent with PTSD recovery literature on chronic relational trauma.

Identity fragmentation during adolescence

Erik Erikson’s foundational work on human development identifies adolescence as the critical window for identity consolidation. During this period, a young person is actively working out who they are. Conversion therapy intervenes in that process by demanding the individual reject a core aspect of self, not a behavior or a preference, but a fundamental dimension of identity. The result is chronic identity confusion, a fragmented sense of self that can manifest as dissociation and a persistent difficulty forming stable adult relationships. The developmental window, once disrupted, cannot simply be reopened.

Shame-based cognitive distortion

Repeated exposure to messaging that one’s desires, feelings, or identity are fundamentally wrong produces cognitive distortions rooted in shame. These are not situational thoughts like “I made a mistake.” They are identity-level beliefs: “I am broken,” “I am unlovable,” “Something is wrong with me at my core.” This pattern closely mirrors what clinicians observe in complex trauma. These distortions are resistant to standard cognitive behavioral therapy (CBT) approaches because CBT targets situational thinking, while shame-based distortions operate at the level of self-concept and require more specialized trauma-informed care.

Across all five pathways, the documented outcomes converge: depression, anxiety, PTSD, substance use, suicidal ideation, and suicide attempts. These are not rare edge cases. Survivor studies consistently show elevated prevalence of each outcome among people with conversion therapy exposure, and the mechanisms described above explain why the harm is so durable and so difficult to reverse.

Every major professional body that condemns conversion therapy

The condemnation of conversion therapy is not a political stance. It is a scientific consensus that spans medicine, psychiatry, psychology, counseling, social work, pediatrics, and international public health. Organizations across disciplines and continents have reviewed the same body of evidence and reached the same conclusion. That evidence includes peer-reviewed research documenting depression, PTSD, and suicidality in people who underwent these practices. The condemnation rests on three pillars: there is no credible evidence that conversion therapy works, there is substantial evidence that it causes serious harm, and its core premise is scientifically invalid because LGBTQ+ identities are not disorders requiring treatment.

Below is a comprehensive list of major professional and health organizations that have issued formal condemnations.

• American Psychiatric Association (1998, reaffirmed 2000): One of the earliest major bodies to formally oppose conversion therapy, stating it poses significant risks and is based on the false premise that homosexuality is a mental disorder.
• American Psychological Association (2009): Conducted a comprehensive review of the research and concluded there is insufficient evidence of efficacy and significant evidence of harm.
• American Psychoanalytic Association (2012): Declared attempts to change sexual orientation are not supported by evidence and are potentially harmful.
• Pan American Health Organization (2012): Called conversion therapy a serious threat to health and well-being and urged governments to take action against it.
• World Medical Association (2013): Condemned the practice and called on physicians worldwide to refuse to perform it under any circumstances.
• American Counseling Association (2013): Prohibits its members from engaging in conversion therapy and recognizes the serious harm it causes clients.
• Royal College of Psychiatrists (2014): Stated that sexual orientation is not a disorder and that attempts to change it are not ethical medical practice.
• SAMHSA (2015): Concluded that conversion therapy is a scientifically unsupported practice that causes significant harm, particularly to youth.
• National Association of Social Workers (2015, reaffirmed): Opposes any intervention that treats LGBTQ+ identities as conditions requiring change.
• British Psychological Society (2017): Determined that conversion therapy is harmful and that no reliable evidence supports its effectiveness.
• American Academy of Pediatrics (2018): Warned that conversion therapy increases the risk of depression, anxiety, and suicidal ideation in children and adolescents.
• American Academy of Child and Adolescent Psychiatry (2018): Stated that conversion therapy has no scientific support and causes measurable psychological harm to young people.
• American Medical Association (reaffirmed 2019): Calls conversion therapy a public health crisis and supports legislative bans at state and federal levels.
• World Health Organization (multiple statements): Has consistently classified conversion therapy as a threat to health and a violation of medical ethics.
• American Association for Marriage and Family Therapy (2009): Opposes therapeutic interventions that treat LGBTQ+ identities as pathological or in need of change.

The breadth of this list matters. These are not fringe voices or advocacy groups. They represent the governing bodies of every major health discipline, including organizations that once held neutral or ambivalent positions. The direction of movement across all organizations has been consistent: as research accumulated, condemnation replaced silence. Not a single major medical or mental health body has moved in the opposite direction.

Conversion therapy vs. affirmative therapy

Understanding the difference between conversion therapy and affirmative therapy is more than an academic exercise. It can help you protect yourself or someone you care about when evaluating a therapist or program.

How the two approaches differ

The contrast between these two approaches starts with the most fundamental question in therapy: what is the goal?

Conversion therapy operates from the premise that LGBTQ+ identities are disorders that need to be corrected. Its goal is to change a person’s sexual orientation or gender identity using techniques like aversion conditioning, reorientation exercises, or suppression strategies. No credible research supports its effectiveness, every major professional body condemns it, and its documented outcomes include depression, anxiety, PTSD, and increased suicidality.

Affirmative therapy starts from an entirely different foundation. It treats LGBTQ+ identities as normal human variations, not problems to fix. The goal is to support whatever identity the client determines for themselves. Therapists use established, evidence-based modalities, including cognitive behavioral therapy (CBT), psychodynamic therapy, and humanistic approaches, applied with cultural competence. Research supports its use, professional bodies endorse it, and clients consistently report improved mental health and greater self-acceptance.

Affirmative therapy also welcomes identity exploration. If you are questioning your orientation or gender identity, that process belongs in therapy. The difference is that affirmative care supports exploration without pushing toward a predetermined outcome, while conversion therapy imposes one from the start.

How to evaluate a therapist

Before working with any therapist, you can ask yourself a few straightforward questions:

• Does this therapist affirm my identity as it is right now?
• Am I the one setting the goals for my care?
• Does the therapist treat my orientation or gender identity as something to be fixed?
• Are they licensed and bound by a professional ethical code?

A therapist practicing affirmative care will answer the first two questions with a clear yes, and the third with a clear no. If you are unsure, asking directly is always appropriate.

If you are looking for a licensed therapist who practices affirmative care, you can create a free ReachLink account and browse therapist profiles at your own pace, with no commitment required.

Where conversion therapy is banned, and where it is still legal

The legal landscape around conversion therapy has shifted significantly in recent years, but protections remain uneven and full of gaps. Internationally, countries including Canada, Germany, France, Brazil, Malta, and parts of Australia have enacted full or partial bans. The trend is clear: major democracies are increasingly treating conversion therapy as a public health harm rather than a protected practice.

In the United States, no federal ban exists. Instead, protections are patchwork, enacted state by state and city by city. According to the Movement Advancement Project’s conversion therapy law tracker, more than 20 states plus Washington, D.C. have enacted some form of prohibition. The scope of those bans matters enormously.

Most U.S. bans apply only to licensed mental health professionals working with minors. That leaves three significant groups uncovered: adults of any age, unlicensed practitioners, and religious or pastoral counselors. As the Williams Institute has documented, this structural gap means tens of thousands of young people remain exposed to the practice through faith-based settings and informal networks, even in states with protective laws on the books.

Enforcement adds another layer of difficulty. Practitioners who rebrand conversion therapy under softer language, such as “sexual wholeness” or “unwanted attractions counseling,” can operate with little scrutiny. Some bans have also faced legal challenges on religious freedom grounds, further narrowing their reach in practice.

Recovery and support for conversion therapy survivors

If you have experienced conversion therapy, the harm you carry is not your fault. These practices were imposed on you, and the damage they caused reflects the failure of those who subjected you to them, not any flaw in who you are. Recovery is possible, and many survivors do find their way to a fuller, more grounded sense of self.

Qualitative research on recovery pathways for conversion therapy survivors identifies affirming therapy, LGBTQ+ community support, and intentional management of relationships with those who initiated the practice as meaningful evidence-based pathways forward. Trauma-informed therapy is especially valuable for survivors dealing with betrayal trauma or complex PTSD, which are common outcomes. Healing often also involves grieving: lost time, strained relationships, and a suppressed identity that never had space to develop.

When looking for a therapist, seek someone who is both LGBTQ+-affirming and trauma-informed. These are distinct competencies, and survivors benefit most from a professional who brings both. Psychotherapy with a qualified provider can offer the structured, compassionate space that recovery often requires.

Several organizations offer dedicated survivor support, including:

• The Trevor Project (crisis support for LGBTQ+ youth)
• Born Perfect (an NCLR campaign focused on banning conversion therapy)
• GLAAD (advocacy and survivor resources)
• Conversion Therapy Survivors network
• Local LGBTQ+ community centers, which often connect survivors with peer support groups

ReachLink connects you with licensed, affirming therapists who specialize in trauma-informed care. You can sign up for free and explore your options with no pressure or commitment.

What You Went Through Has a Name, and It Was Not Your Fault

If you came to this article already knowing something felt wrong about what you or someone you love experienced, that instinct was right. What conversion therapy does to mental health is not subtle: it works against a person’s sense of self at the most foundational level, and the pain that follows is real, documented, and taken seriously by every major medical and mental health body in the world. You are not alone in carrying this, and you do not have to make sense of it by yourself.

Healing from these experiences often means finding a therapist who is both affirming and trauma-informed, someone who understands not just what happened, but how it shaped you. If you are ready to explore that at your own pace, you can create a free ReachLink account and browse licensed, affirming therapists with no commitment required. The iOS app is also available on the App Store and the Android app on Google Play whenever you are ready.