Conversion therapy is a range of practices that claim to change or suppress a person’s sexual orientation or gender identity. In the United States, an estimated 698,000 LGBTQ+ adults have received some form of conversion therapy, with roughly half reporting that it occurred during adolescence.

Every major American medical and psychological organization concluded that the practice is harmful, and the United Nations described it in 2020 as a form of torture. Despite those findings, conversion therapy continues to be practiced in some settings.

A History of the Practice

Conversion therapy is the umbrella term for any practice that attempts to change a person’s sexual orientation, gender identity, or gender expression to match heterosexual and cisgender norms.

Clinical literature refers to the orientation version as “sexual orientation change efforts” and the gender version as “gender identity change efforts.” Conversion therapy is the more widely recognized term in public discussion.

The modern practice originated in aversion methods developed in licensed clinical settings during the late 1950s and early 1960s. These methods paired electric shocks or induced nausea with same-sex erotic stimuli. Aversion-therapy programs spread through academic psychology departments and clinical settings during the 1960s and early 1970s before largely disappearing from licensed practices by the 1980s.

Joseph Nicolosi co-founded the National Association for Research and Therapy of Homosexuality in 1992 to formalize a psychoanalytic approach he branded reparative therapy. Religious organizations like Exodus International grew from the 1980s through the 1990s to more than 250 ministries.

Many of those organizations and their founders are no longer active. Exodus International closed in June 2013 after its president, Alan Chambers, issued a public apology, telling the press that 99.9% of the people he met in such programs had not changed their orientation. John Smid, longtime director of Love in Action and one of the practice’s longest-tenured public faces, came out publicly years after leaving the organization and is now married to a man.

McKrae Game, founder of Hope for Wholeness, came out in 2019 and disavowed his own work, saying he had “harmed generations of people.” David Matheson, a co-founder of the Journey Into Manhood retreat program, left in 2019 and announced that he intended to date men. Both later publicly rejected the premises that had guided their work in conversion therapy.

Inside a Conversion Therapy Session

Much of the conversion therapy practiced in the United States today is delivered as one-on-one talk therapy through a religious lens. Sessions claim to uncover root causes of same-sex attraction or transgender identity.

A theory associated with Sandor Rado in the 1940s and Joseph Nicolosi in the 1990s holds that male homosexuality stems from a distant or hostile father and an over-close mother. In contrast, female homosexuality results from inadequate maternal bonding. Sessions encourage clients to reinterpret their family history through that lens.

One exercise used in some Christian conversion-therapy programs is the genogram, a family tree that participants annotate with relatives’ sins. Letters and symbols are used, such as AB for abortion, a dollar sign for gambling, and H for homosexuality. The exercise supports the belief that a participant’s orientation is the inherited consequence of generational sin.

Other exercises included a 12-step moral inventory modeled on Alcoholics Anonymous, rules governing dress and posture, and exercises intended to uncover supposed trauma. In his memoir Boy Erased, Garrard Conley described being required to scream at imagined versions of his parents as part of that process.

Mathew Shurka, who underwent conversion therapy as a teenager and later advocated for legal bans, said his counselor instructed him to cut off contact with his mother and sisters for three years. The program attributed his orientation to female family members. He spent years rebuilding the relationships it told him to sever.

Behavioral techniques peaked from the late 1950s through the 1970s and were later abandoned in licensed clinical settings, although some unlicensed programs continued to use them. Historical methods included pairing same-sex erotic imagery with electric shocks or nausea-inducing drugs, then pairing opposite-sex imagery with relief.

Masturbatory reconditioning, developed in sexology during the 1960s and 1970s, instructed participants to masturbate to opposite-sex stimuli in an effort to redirect arousal. A documented Brigham Young University study conducted around 1975 and 1976 used a plethysmograph and electrodes attached to the bicep to deliver electric shocks during exposure to same-sex images.

Religious programs add prayer-based techniques, deliverance prayer, group testimony evenings, accountability partners, and gender-conformity coaching. The Journey Into Manhood weekend retreat, run by Brothers on a Road Less Traveled, includes touch-and-hold exercises between men. Program materials describe these exercises as a way to repair what participants are told are father-deficit wounds.

Residential conversion programs for minors and adults are now largely defunct in the United States. Online programs, weekend retreats, religious counseling, and unlicensed coaching continue to operate.

The Scientific and Survivor Consensus

Major medical and psychological organizations have opposed conversion therapy for more than 15 years. The American Psychological Association’s 2009 task force reviewed 83 peer-reviewed studies covering 1960 to 2007 and concluded there was insufficient evidence to support psychological interventions intended to change sexual orientation.

The APA’s 2021 resolution strengthened that position, naming SOCE as unsupported by credible evidence, associated with serious risk of harm, and opposed across all age groups. The American Medical Association, the American Academy of Pediatrics, the World Psychiatric Association, the World Medical Association, the National Association of Social Workers, and the Pan American Health Organization issued similar positions.

A 2019 Trevor Project survey found that LGBTQ+ youth who had undergone conversion therapy attempted suicide at more than twice the rate of LGBTQ+ youth who had not. The Williams Institute estimated in 2018 that roughly 698,000 LGBTQ+ adults in the United States had received conversion therapy at some point in their lives, about half of them as adolescents.

The United Nations Independent Expert on protection against violence based on sexual orientation and gender identity described conversion therapy in a 2020 report as a form of torture and called for global bans.

Survivor accounts frequently use terms such as “torture,” “brainwashing,” and “spiritual abuse,” regardless of the program involved.

McKrae Game’s comments after leaving Hope for Wholeness offer a perspective from someone who once promoted conversion therapy. In interviews since 2019, he has said that he “never encountered anyone who had reoriented their sexuality” during his years leading the organization. He has also said that the teachings he promoted “harmed generations of people.”

Legal Status as of 2026

As of mid-2025, 23 states, the District of Columbia, and Puerto Rico banned licensed practitioners from performing conversion therapy on minors:

• France, nationwide ban enacted in January 2022.
• Germany, partial ban enacted in 2020.
• Mexico, constitutional ban affecting minors enacted in 2024.
• Canada, nationwide ban enacted in January 2022.
• Israel, ban on licensed providers enacted in 2022, although rabbinical conversion practices continue in some Orthodox communities.
• New Zealand, national ban enacted in 2022.
• India, National Medical Commission warning issued in 2022.

On March 31, 2026, the U.S. Supreme Court ruled 8–1 in Chiles v. Salazar that Colorado’s ban on conversion therapy by licensed counselors for minors violated First Amendment protections.

The ruling did not strike down existing state bans, although it raised questions about their future. Justice Ketanji Brown Jackson was the sole dissenter. The United Kingdom’s May 2026 King’s Speech identified a trans-inclusive Draft Conversion Practices Bill as a legislative priority for the new session, although the legislation has not yet been enacted.

The practice continues in settings that fall outside many legal restrictions. Religious conversion practices conducted outside the licensed-counselor system are excluded from some state bans. Unlicensed coaches, prayer-based ministries, and online programs continue to operate in jurisdictions that have banned conversion therapy by licensed practitioners.

After Conversion Therapy

Survivor accounts often place less emphasis on the most visible aspects of conversion therapy, such as electric shocks, screaming exercises, or dehumanizing language. Instead, they frequently describe the lasting impact of being told repeatedly that they were broken and needed to be changed.

Long-term effects continue after the program ends. Some report spending years working through those experiences, often with support from affirming therapists or peer networks. Survivor accounts frequently describe that process as more difficult than the coming-out process itself.

Survivors often rely on several resources, including:

• Survivor support groups, in person and online.
• Queer-affirming therapy directories.
• The Trevor Project’s TrevorLifeline and TrevorChat for younger survivors.
• Beyond Ex-Gay and similar peer networks for adult survivors.

The Living Truth letter, signed in July 2014 by nine former ex-gay leaders, including Michael Bussee and John Smid, remains an important document for survivors. The signatories acknowledged that the framework they once promoted was harmful and ineffective.

Legal protections do not affect sessions that have already taken place, and the closure of major organizations does not erase their impact on former participants. Recovery may involve therapy, peer support, or other forms of assistance as survivors work through beliefs and experiences shaped by those programs.

Frequently Asked Questions About Conversion Therapy

What is conversion therapy?

Conversion therapy is the umbrella term for any practice that attempts to change a person’s sexual orientation, gender identity, or gender expression to match heterosexual and cisgender norms. Clinical literature refers to the orientation version as “sexual orientation change efforts” and the gender version as “gender identity change efforts.” Every major American medical and psychological organization concluded that the practice is harmful, and the United Nations describes it as a form of torture.

Does conversion therapy work?

No. The American Psychological Association’s 2009 task force reviewed 83 peer-reviewed studies and found insufficient evidence that conversion therapy changes sexual orientation. The APA’s 2021 resolution reaffirmed and strengthened that position. Former leaders of major conversion-therapy organizations, including Exodus International president Alan Chambers, later said they had not seen participants change their sexual orientation.

Is conversion therapy legal?

It depends on the jurisdiction. As of mid-2025, 23 states, the District of Columbia, and Puerto Rico banned licensed practitioners from performing conversion therapy on minors. The U.S. Supreme Court’s March 2026 ruling in Chiles v. Salazar raised questions about the future of those laws after finding that Colorado’s ban violated First Amendment protections. Religious conversion practices and services provided outside the licensed-counselor system often fall outside the scope of those bans.

What happens during conversion therapy?

Most contemporary conversion therapy involves one-on-one talk therapy delivered through a religious lens. Sessions often encourage participants to reinterpret their family history and view their sexual orientation or gender identity as the result of family relationships or childhood experiences. Programs have used genograms, 12-step moral inventories, dress and posture rules, deliverance prayer, and group testimony. Historical aversion methods involving electric shocks or induced nausea were largely abandoned in licensed settings by the 1980s.

Is conversion therapy banned worldwide?

No. Conversion therapy is banned in some countries, restricted for minors in others, and still practiced in many parts of the world. The United Nations called for global bans in 2020. Laws vary by jurisdiction and often exclude religious conversion practices conducted outside licensed clinical settings.

How harmful is conversion therapy?

The Trevor Project’s 2019 survey found that LGBTQ+ youth who had undergone conversion therapy attempted suicide at more than twice the rate of LGBTQ+ youth who had not. The Williams Institute estimated that 698,000 LGBTQ+ adults in the U.S. had received conversion therapy at some point in their lives, about half as adolescents. Survivor accounts frequently describe lasting psychological effects, including shame, self-stigma, and difficulty accepting their sexual orientation or gender identity.

What are the techniques of conversion therapy?

Contemporary conversion therapy often takes the form of one-on-one talk therapy delivered through a religious lens. Reported techniques include genograms annotated with relatives’ perceived sins, 12-step moral inventories, dress and posture rules, deliverance prayer, accountability partners, gender-conformity coaching, group testimony, and weekend retreats featuring touch-and-holding exercises between men. Historical methods included electric shocks, nausea-inducing drugs, masturbatory reconditioning, and ice baths. Aversion-based techniques were largely abandoned in licensed clinical settings by the 1980s.

How do you recover from conversion therapy?

Recovery varies by the person. Survivor accounts frequently describe seeking support from affirming therapists, peer networks, or support groups after leaving conversion therapy. Resources may include queer-affirming therapy directories, the Trevor Project’s TrevorLifeline and TrevorChat for younger survivors, and organizations such as Beyond Ex-Gay. Many survivors describe recovery as a gradual process of working through beliefs and experiences shaped by conversion-therapy programs.

Which countries banned conversion therapy?

Several countries have enacted national bans on conversion therapy, including France, Canada, and New Zealand in 2022. Germany introduced a partial ban in 2020, while Mexico amended its constitution in 2024 to prohibit the practice for minors. Israel banned licensed providers from practicing conversion therapy in 2022, although some rabbinical conversion practices continue outside the licensed system. As of mid-2026, the United Kingdom has draft legislation under consideration, and India’s National Medical Commission has issued a warning against the practice.

Is conversion therapy still happening today?

Yes. Although many of the largest conversion-therapy organizations have closed, religious programs and services provided outside the licensed-counselor system continue to operate in many jurisdictions. Current forms include online programs, weekend retreats, prayer-based ministries, and unlicensed coaching. In 2018, the Williams Institute estimated that roughly 16,000 LGBTQ+ youth ages 13 to 17 in the United States would receive conversion therapy from a licensed health professional before turning 18.

How many people have undergone conversion therapy?

The Williams Institute estimated in 2018 that 698,000 LGBTQ+ adults in the United States had received conversion therapy at some point in their lives, including roughly 350,000 who underwent it as adolescents. The estimate is limited to the United States and relies on survey responses from participants willing to disclose their experiences. Comparable global estimates are not available.

Who started conversion therapy?

There is no single founder of conversion therapy. The modern practice developed from several sources, including aversion-therapy research in the 1950s and 1960s, mid-20th-century psychoanalytic theories, and the religious ex-gay movement that gained prominence in the late 1970s. Joseph Nicolosi’s founding of NARTH in 1992 helped formalize the psychoanalytic “reparative therapy” model.