June is Pride Month. While many parades and festivities have been postponed this year, it remains imperative to celebrate the LGBTQ+ community. In the past decade, LGBTQ+ individuals have notched several major victories including the right to marry, the repeal of Don’t Ask, Don’t Tell, and the striking down of the Defense of Marriage Act. Most recently, the US Supreme Court expanded the reach of the Civil Rights Act to include protections against workplace discrimination due to sexual orientation or gender identity. Amid this heady progress, it’s easy to assume that all ills affecting this community have been eradicated. But there is still far to go, and one particularly insidious form of harm — one that we as physicians, residents, and medical students are uniquely suited to fight — continues to hurt the health of LGBTQ+ people. In the state of Ohio, conversion therapy is still a legally accepted “medical therapy” for LGBTQ+ minors.
In simple terms, conversion therapy, reparative therapy, or reorientation therapy is the attempt to change another’s sexual orientation based on the erroneous notion that alternate expressions of sexuality and sexual identity are aberrant and should be remedied. Talk therapy has become the method of choice for reorientation therapists. However, some employ more blatantly medieval tactics such as aversion, wherein patients are subjected to noxious stimuli (e.g. electric shock, inducing nausea/vomiting etc.) in response to erotic same-sex thoughts or arousal. Both tactics are wrong and harmful.
The American Psychiatric Association strongly opposes such practices. They argue that conversion and reparative therapy, “represent a significant risk of harm by subjecting individuals to forms of treatment which have not been scientifically validated.” They continue, “no credible evidence exists that any mental health intervention can reliably and safely change sexual orientation; nor, from a mental health perspective does sexual orientation need to be changed.” The American Medical Association, the American College of Physicians, the American Academy of Pediatrics, the American Psychological Association, and others echo those sentiments – conversion therapy is dangerous and unethical. Recent data show that conversion therapy is associated with increased measures of depression, suicidal thoughts, suicide attempts, lower educational attainment, and lower weekly income.
20 states have outlawed conversion therapy for minors. As for Ohio and others that have not yet followed, staggering recent estimates warn that licensed health care professionals alone will subject 20,000 young people of the LGBTQ+ community to conversion therapy before they reach the age of 18. A bipartisan group of lawmakers in the Ohio Statehouse has introduced legislation that would ban the practice. However, the bill was not assigned to committee and has not gained traction, thus preventing subsequent hearings on this life-saving intervention.
Throughout medical school and training we are taught to follow principles of evidence-based medicine. Further, anyone familiar with the field of medicine has heard of the exhortation, “first do no harm.” With that perspective, how could we stand by as fellow healthcare practitioners peddle in debunked and harmful therapies on vulnerable populations? I call on any medical professional to immediately cease this discredited practice and adhere to accepted gold standard treatments. To my colleagues elsewhere, I implore you to raise your voices against this injustice and advocate for its swift abolishment. Finally, I urge our state leaders to institute a statewide ban on conversion “therapy” for LGBTQ+ minors, ensuring that Ohio becomes a safer and more welcoming place for all.