conversion practices

Conversion practices, also called conversion therapy or reparative therapy, are a wide-ranging set of medical and psychological procedures aimed at changing a person’s gender identity to that traditionally associated with their sex assigned at birth or converting their sexual orientation to heterosexuality. Conversion practitioners commonly believe that sexual orientations or gender identities that are not heterosexual or cisgender, respectively, are unnatural and symptomatic of mental disorders that can and should be treated. Religious practitioners may also regard nonheterosexual orientations or non-cisgender identities as immoral or otherwise inconsistent with their religious beliefs. Conversion practices are opposed by leading medical and mental health associations, including international organizations, which contend that such treatments are not genuinely based on scientific evidence and are inconsistent with ethical principles observed by qualified caregivers.

Types of conversion practices

Conversion practices performed by some health care providers include psychological or behavioral therapies as well as medical treatments of individuals or groups. Some practices have also involved aversive conditioning (such as electric shocks and chemically induced nausea), hypnosis, biofeedback, and “masturbation reconditioning,” or working to change sexual arousal patterns. Religious leaders may use prayer, pastoral counseling, and even exorcism as conversion practices.

People undergoing conversion practices

According to a report issued in 2020 by the United Nations independent expert on protection against violence and discrimination based on sexual orientation and gender identity (IESOGI), a position created by the United Nations Human Rights Council in 2016, most people undergoing conversion practices are 24 years old or younger, and about half of that group consists of people under 18. Critics generally attribute the age distribution of conversion practices to the fact that younger people are understandably influenced by (and legally and financially dependent upon) their parents, who may wish to change their children’s sexual orientations and gender identities to something they consider normal or morally correct.

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Most people subjected to conversion practices experience negative effects, including depression, anxiety, low self-esteem, and social isolation, as well as substance use and other self-destructive behaviors. Some even die by suicide.

Opposition to conversion practices

Conversion practices are opposed by many multinational health organizations, including the World Psychiatric Association and the Pan American Health Organization, a regional arm of the World Health Organization that has stated that “purported therapies aimed at changing sexual orientation lack medical justification and are ethically unacceptable.” The United Nations IESOGI has called for a global ban on conversion practices. Such practices have also been opposed by many American health organizations, including the American Psychological Association, the American Psychiatric Association, the American Academy of Pediatrics, and the American Medical Association, which has called these practices “clinically and ethically inappropriate.”

As of May 2026, conversion practices were directly or indirectly banned in 25 countries and partially banned in 3 others. Although there is no countrywide ban on conversion practices in the United States, practices for minors are prohibited or restricted in 27 states and Puerto Rico, and practices for both minors and adults are banned in Washington, D.C. Six other U.S. states have state laws, budgets, or court rulings that effectively prohibit or deter local-level laws that ban conversion practices for youth.

Chiles v. Salazar

On March 31, 2026, the U.S. Supreme Court ruled in Chiles v. Salazar that a Colorado state law prohibiting counselors or therapists from performing gender conversion therapy for children should have been subject to “strict scrutiny” under the First Amendment, requiring that its limitation of free speech serve a compelling governmental interest and be narrowly tailored to achieve that goal. The resulting reassessment of the law made it likely that similar laws in other states would also be subject to strict scrutiny.

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