How Conversion Therapy Bans Cause Irreversible Harm
“Conversion therapy” originally referred to the abusive methods once used to try to change a person’s sexual orientation, such as the administration of electric shocks, lobotomies, castration, and the surgical implantation of “heterosexual” testicles without the patient's consent. These unethical and harmful practices were egregious and rightfully banned.
However, today's "conversion therapy" bans prohibit much more than abusive practices. They prevent therapists from helping children who identify as transgender or nonbinary with non-invasive therapy. They prevent therapists from alleviating children’s distress with time-tested counseling techniques. As a result, they lead to invasive and unnecessary procedures that cause serious bodily harm to young people.
"Conversion therapy” bans currently in effect in nineteen states, the District of Columbia, and many municipalities throughout the US require therapists to affirm the “gender identities” of minor children. Similar bills have been introduced in many other states. A bill to ban "conversion therapy" nationwide has been introduced in the House (H.R. 3570) and the Senate (S.2008), the Therapeutic Fraud Prevention Act of 2019.
These “conversion therapy” bans prevent therapists from examining underlying psychosocial issues to help children understand and accept their bodies, identities, and feelings. They impede therapists from doing their job as responsible professionals and pose an unconstitutional restriction on their right to free speech.
Most concerning of all: ”conversion therapy” bans prevent therapists from helping children accept their bodies and lead to body-altering hormonal and surgical interventions.
People who identify as transgender deserve compassionate support. Their discomfort is real. But the causes are complicated, poorly understood, and under-researched. While mature adults should be free to make their own informed healthcare decisions, young people must be protected from interventions that are not based on sound science. No child or teenager should be given powerful drugs, hormones, or invasive surgeries that are not supported by rigorous research. They deserve evidence-based care, not experimental medicine.
Research points to many underlying factors that are likely fueling these new identities in young people. There is an especially high correlation with Autism Spectrum Disorder, as reported in replicated published research and observed in clinics around the world. In the UK, for example, nearly half of all children seeking Gender Identity Disorder Services displayed autistic traits. Other causal factors include mental health issues, ADHD, trauma, and same-sex attraction.
Despite evidence of psychosocial influences, most major professional psychological and medical associations promote an “affirmative care” model, while incorrectly asserting that this protocol is evidence-based and reflects “best practices”:
When transgender children get support affirming their gender identities, their mental health difficulties go down; when they don’t get support, they go up. American Psychological Association, Continuing Education materials
Many anatomical inconsistencies now can be corrected surgically or chemically to align with the experienced true self. A medical diagnosis for transgender individuals, whose self-experienced gender does not match the sex assigned at birth and who require medical services to align the body with the experienced self, is more appropriate and consistent with research and best practices than a mental health diagnosis. National Association of Social Workers
School counselors recognize that the responsibility for determining a student’s gender identity rests with the student rather than outside confirmation from medical practitioners, mental health professionals or documentation of legal changes. Position Statement from the American School Counselor Association
Not only does the “affirmative care” model discourage therapists from considering underlying psychosocial issues, but its practice often leads to drastic medical interventions. The hormonal treatments on children are experimental. The medical literature on the health effects of hormonal interventions “in the pediatric/adolescent population is completely lacking.” The drugs used are based on low-quality evidence, or no evidence at all. The consequences of these hormonal treatments include potential sterility, sexual dysfunction, thromboembolic and cardiovascular disease, and malignancy
These health consequences might well be irreversible. The full extent of the harms to young developing brains and bodies remains unknown. And yet the practice of treating young people with powerful puberty-blocking drugs, hormones, and irreversible surgeries is growing rapidly.
“Gender identities” are quickly and irreversibly medicalized at increasingly younger ages. Irreversible and invasive surgeries, such as mastectomies, hysterectomies, and vaginoplasties, are performed on minor children. Parent consent is not always required.
Children should not receive body-altering interventions on the basis of feelings, self-diagnosis, and unprovable identities. Ironically, "conversion therapy" bans that purport to prevent harm to children actually promote it by leading them to irreversible body-altering treatments -- some of whom, if left alone, may grow up to be healthy gay, lesbian, or bisexual adults.
These harms are not theoretical. Thousands of young people currently expressing tragic regret over irrreversible surgeries and hormones that they agreed to when they were teenagers. "Conversion therapy" bills that prohibit therapists from providing non-invasive support to these young people must be stopped.