Erasing identity does not heal: that is the conclusion pointed to by the largest systematic review assembled to date on so-called “conversion therapies,” the practices that seek to force a person to give up their sexual orientation or gender identity. The meticulous work, published in American Psychologist, the official journal of the American Psychological Association, documents with data from 130 studies a consistent association between exposure to these interventions and harm.
What are conversion therapies?
They are heterogeneous interventions that seek to make a person conform to heterosexual and cisgender norms: that is, to abandon non-mainstream forms of desire or identity. They have been given many names —reparative, reorientation, “birth identity” affirmation— but they all share the same underlying goal: to change something that medicine and science regard as a natural variation of the human condition, not an illness.
The study reviews the empirical literature published on these practices and classifies it into two broad groups: prospective studies, which followed people while they underwent these change efforts (mean publication year 1974), and retrospective studies, which years later asked those affected about their exposure (mean publication year 2012).
Nine in ten prospective studies detect harm
Of the 86 studies that closely followed exposed individuals, at least one type of harm was present in 77.91% of them (roughly eight in ten). The authors systematically looked for five kinds of harm: use of aversive techniques; lack of informed consent or outright coercion; increased psychopathology; negative changes in life functioning and quality of life; and deterioration of personal relationships.
The picture the data draw is clear. Aversive techniques —from electrostimulation to nausea conditioning— are not a relic of the last century: they keep appearing in the reviewed literature. Coercion, family or religious pressure, and the absence of truly informed consent are repeatedly documented.
In the other group, the retrospective one, 68.18% of the studies (almost seven in ten) found a statistically significant association between having gone through these change efforts and suffering harm: more anxiety, more depression, more suicidal thoughts, a worse relationship with oneself and with others.
Relevance to gender dysphoria
The paper has a direct reading for the transgender population. People with gender dysphoria are precisely one of the groups most often subjected to these efforts: the popularly called “gender conversion therapy” is sometimes disguised as psychological support when it in fact seeks to suppress an identity that the scientific evidence recognizes as legitimate.
The authors stress that the reviewed research is abundant in the field of sexual orientation, while specific material on gender identity and gender expression remains scarcer. That gap should not be read as proof that these practices are harmless: the logic of harm and the mechanisms of pressure are shared, and the existing data point in the same direction.
A conclusion backed by 6,309 screened articles
In total, the team examined 6,309 publications and selected 130 that met strict criteria: documenting exposure to these practices and quantitatively measuring the intended change or the associated harm. It is the broadest picture of the available science on the matter.
Far from confirming any therapeutic usefulness, the review establishes the state of the art: exposure is consistently associated with suffering, and there is no evidence that changing a person’s identity brings any benefit. The message emerging from the most influential journal in world psychology is forceful and, at the same time, serene: identity is not repaired, it is accompanied.
