The effectiveness of US bans on anti-LGBTQ ‘conversion therapy’ has been called into question after mental health professionals recommended by a prominent US religious conservative group offered to “remedy” an undercover reporter’s “unwanted same-sex attraction”.
Some 20 US states have introduced bans on ‘conversion therapy’ for minors – but an undercover investigation by openDemocracy found that two counsellors operating in states where the practice is prohibited advised a reporter posing as a 17-year-old lesbian to “suppress” her orientation, including by fasting.
The counsellors were described as offering treatment for “homosexuality issues” and “gender identity issues” on a US-wide list provided by Focus on the Family, a conservative Christian group that is pursuing similar anti-LGBTQ activities in Costa Rica, where its Latin America office is located, our investigation reveals.
In one instance, a counsellor operating in Virginia told our undercover reporter that LGBTQ people were “unhealthy”, and that our reporter should not eat until she reached the point of seeing herself “at the Cross with Christ [...] hanging, dying, bleeding” because “that’s life-changing”.
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A counsellor in Colorado promised to treat “unwanted same-sex attraction” – an expression frequently used to disguise ‘conversion therapy’ but rejected by LGBTQ communities.
Leading health and legal experts said that openDemocracy’s findings were “blatantly unethical” and “graphic” examples of ‘conversion therapy’ that broke local laws and raised concerns about the effectiveness of existing anti-’conversion therapy’ legislation.
‘Conversion therapy’ is defined in different ways in different US states, but a UN report described it as an umbrella term for “interventions of a wide-ranging nature” based on the belief that a person's sexual orientation and gender identity “can and should be changed or suppressed”, and aimed at changing them to heterosexual or cisgender. Experts call these practices ‘sexual orientation and gender identity change efforts’ (SOGICE).
International health bodies and human rights experts have condemned these practices as “harmful” and “ineffective”. A 2018 survey in the US found that LGBTQ youths undergoing these so-called ‘cures’ “were more than twice as likely to report having attempted suicide”.
Focus on the Family’s counselling network
The Christian Counselors Network, a US-wide list provided by Focus on the Family, a conservative religious group active since the 1970s, offers referrals to more than 100 licensed professionals who offer specific treatment for “homosexuality issues”, “gender identity issues” or both. Dozens of them also have children and adolescents as clients, including in states where ‘conversion therapy’ is banned.
Focus on the Family’s vetting system for the network requires practitioners to have a “state mental health credential” and to complete an application form in which they are asked to explain “what you understand the Bible teaches regarding homosexuality and gender identity” and what their “approach in counseling” on these issues will be. They also have to pay a $129 annual fee.
Applicants must also promise to uphold the organisation’s ‘Counseling for Sexual Identity Concerns’ statement, which says: “Regulatory bans against helping youths in any manner that does not comply with LGBT values and identity are advancing. At stake are religious freedoms sacred to families and American life, client autonomy, individual well-being, and parental rights.”
In response to our questions, Focus on the Family sent us a link to the same document, adding that it expresses the group’s “position regarding those seeking help for unwanted same-sex attraction”.
“We believe in and support the availability of professional counselling in matters of sexuality that is respectful, safe, ethical, and responsive to the client’s values and desires,” the statement says. It adds that LGBTQ people “often suffer stress, family strain and questions that are deeply perplexing”.
‘At the foot of the Cross’
openDemocracy’s reporter contacted two different professionals whose profiles were available on the group’s website, via its “find a counselor” search engine, which enables users to find practitioners by location.
Our reporter, claiming to be aged 17, had several online paid sessions with these two practitioners, who were operating in Virginia and Colorado, two of the 20 states where offering ‘conversion therapy’ to minors is banned.
Virginia and Colorado measures share the same definition of ‘conversion therapy’: any practice or treatment that “seeks”, “attempts” or “purports” “to change an individual's sexual orientation or gender identity, including efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender.”
Both prohibit healthcare providers or counsellors licensed by these states from using such treatment with any person “under 18 years of age”. Doing so constitutes “unprofessional conduct” and is grounds “for disciplinary action”, say both acts.
The first of the two professionals told openDemocracy’s reporter that he was currently based in Virginia – although he was listed on the website as being in another nearby state, where these practices are not restricted.
During the first session, this therapist told our reporter that she had to “suppress” homosexual desires, read the Bible and stay away from any Christian group that affirms gay sexuality.
“They're not going to tell you that your depression, your anxiety, all that, is not going to go away if you pursue the gay lifestyle,” he said.
The therapist also described LGBTQ communities as “unhealthy”, claiming that “the suicide rate is considerably higher than the national average.”
He continued: “The sexual assault rate, the crime rate, all that is higher. The transmitted diseases, those numbers are higher in the gay community [...] All those numbers are out there [...] Focus on Family has done those kinds of studies.”
The therapist also claimed that in their lifetime gay men have on average 1,000 partners and lesbians 500.
Manipulation through dissemination of inaccurate or unscientific information [...] is blatantly unethical
Responding to these comments, Douglas Haldeman, a psychology professor and former president of the California Psychological Association, told openDemocracy that “for a therapist to attempt such manipulation through dissemination of inaccurate or unscientific information [...] including incorrect information about the LGBT community and baseless predictions about one’s future as a gay person, is blatantly unethical.”
Describing same-sex attraction to an under-age patient as a “gay lifestyle” (as the therapist did) is “insulting”, said Lisa Linsky, a leading New York lawyer who has won awards for her work on LGBTQ issues.
Shannon Minter, legal director of the National Center for Lesbian Rights, said: “This is graphic ‘conversion therapy’.” But he warned that practitioners engaged in such activities very rarely tell their patients: ‘You’re gay, and I’m going to change this.’
Linsky, a member of the American Bar Association litigation section’s diversity committee, pointed out that people “phrase things in such a way that you don't ever see the term ‘conversion therapy’ [...]. They have gotten much more sophisticated and surreptitious in the ways they bring young people in to change them [...] and that's scary.”
The therapist also suggested fasting as a “remedy” to homosexuality. “It would be wonderful [...] When you deny yourself food and drink […] you’re relying totally on the sustaining power of Christ […] as you’re praying and doing that, you can see yourself at the Cross with him, with him up there, hanging, dying, bleeding, and then with you at the foot of the Cross, weeping and crying. It’s life-changing.”
After two sessions, this mental health professional sent our reporter four emails insisting on meeting again.
Commenting on the exchanges between the reporter and the therapist, psychology professor Haldeman said that “using the leverage of the power differential in the therapeutic relationship and bullying a questioning client is reprehensible, and clear evidence why we need anti-conversion therapy laws on the books in all 50 states.”
For legal expert Minter, “this conduct violates the law.”
‘Talking with God’
The second counsellor, based in Colorado, emphasised the importance of praying and “talking with God” about fears and desires, instead of sharing feelings with family members and other loved ones, despite the reporter saying that she tended to isolate herself for days when feeling depressed.
“God’s issues are not going to come up because he doesn’t have any. Other people, their issues, will come up and that's going to be hard to manage. So there will be a place and a time for that, but, right now, start with you and God,” this counsellor told our reporter during a session.
When our reporter said she was afraid of being judged by others for her sexual orientation, the counsellor said: “If you have a lot of judgment, a lot of shame about yourself [...] you can be, even unintentionally, looking for shame that validates the shame that you feel about yourself.”
Despite warning that he primarily counselled men with “unwanted same-sex attraction”, he showed willingness to provide a similar service to our female reporter.
He said he was licensed to provide counselling in Colorado, but, as our reporter was located in a different state, he offered her ‘coaching sessions’ instead – which are not legally defined or regulated. He even suggested cutting his hourly rate in half if needed, because his business, he said, had plenty of “generous donors”.
We asked both therapists for comments. Neither replied to our request.
Currently, 20 US states plus the District of Columbia ban mental health professionals from providing ‘conversion therapy’ to minors, as do at least 90 cities, counties and other municipalities in the country.
Amie Bishop, from the global LGBTIQ rights group OutRight Action International, said: “OpenDemocracy’s findings highlight the pressing need to ensure that existing state bans against ‘conversion’ practices are enforced.”
Such practices are also at “egregious odds” with mental health professions’ ethics and regulations, she added.
Others argue that these bans do little to actually prevent activities that should be criminalised.
However, there are other ways to legally confront these practices, according to Mathew Shurka, a survivor of and prominent campaigner against ‘conversion therapy’.
“We represented a young woman in Berkeley, California who sued her conversion therapist and won. We are also currently representing survivors who are filing complaints to state licensing boards,” said Shurka, who runs the National Center for Lesbian Rights’s Born Perfect campaign, which litigates and advocates for laws against these practices.
According to Shurka, consumer fraud and malpractice are areas where providers are vulnerable. For example, a 2015 ruling against the group Jews Offering New Alternatives for Healing (JONAH) found it guilty of consumer fraud for offering services that claimed to change people’s sexual orientation or gender identity, and ordered it to shut down operations immediately.
But Bishop, from OutRight, observed that “bans, alone, will not suffice to end so-called conversion therapy”. She thinks the demand for such practices will persist “until LGBITQ+ people are fully embraced by their families, their faiths, and their communities.”
Additional reporting by Dánae Vílchez
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