Conversion Therapy Harm & Finding LGBTQIA+ Affirming Therapy

Just like everyone else, LGBTQIA+ folks grow up in an environment full of subtle messages about “how we’re supposed to act.” As people born with marginalized identities, we often don’t see ourselves represented in the same spaces where others are socialized, and when we do, it’s rarely in empowering ways. Without positive representation in our social learning, we instead internalize the message that we don’t belong.

Coming-of-age stories for LGBTQIA+ teens often center around trauma, sometimes lightened by the comedic tone typical of the genre. As a non-binary individual, one of my favorites growing up was But I’m a Cheerleader! It tells the story of a young woman who is assumed to be a lesbian, despite her strong belief that she’s not, leading her parents to send her to a conversion therapy camp. Over time, she comes to realize she is, in fact, a lesbian and embraces her new identity. Unfortunately, for many others, this happy ending is far from the reality of experiences with conversion therapy.

What is Conversion Therapy?

Conversion therapy encompasses a range of dangerous and discredited practices that falsely claim to change a person’s sexual orientation, gender identity or expression. What many therapists now consider to be archaic and barbaric practices were once used in the therapeutic setting. Some of the most extreme forms of conversion therapy included violent and invasive procedures, including coerced heterosexual sex activity and aversion therapy. As a society, we have largely condemned the overt and violent forms of conversion; the more covert forms, however, can still make their way into the therapy suite – the place you enter full of vulnerability and looking for help. 

Some types of conversion therapy, often referred to as reparative therapy, use traditional therapeutic techniques such as cognitive behavioral therapy, dialectical behavior therapy, exposure therapy, and talk therapy to convince patients that their sexual orientation or gender identity is a result of personal dysfunction. These practices often point to issues like strained relationships with parents, childhood trauma, or social insecurities as the root cause. Underlying these methods is a rigidly heteronormative and gender-binary framework, which falsely asserts that each gender is fixed with natural traits that must be perfected to be “well.” It suggests that conforming to these narrow gender roles will “heal” a person, making them heterosexual and cisgender.

The Ongoing Influence of Conversion Therapy

Just two and a half years ago, the governor of Pennsylvania signed an executive order that discouraged the practice of conversion therapy within state-based agencies. The order also ended state funding for conversion therapies and required state agencies to publicly report practitioners licensed through the state who were using such practices.

While conversion therapy has been rejected by every mainstream medical and mental health organization for decades, due to continuing discrimination and societal bias against LGBTQIA+ people, some psychotherapy practitioners continue to conduct conversion therapy under the guise of traditional therapy modalities, without labeling them as conversion or reparative therapy. 

Unfortunately, many religious leaders continue to endorse conversion therapy as a spiritually cleansing practice, reinforcing a persistent and harmful link between conversion and religious trauma. Additionally, we must acknowledge that due to the historically harmful use of religious and political frameworks which characterize much of our social learning, many practitioners do not recognize how their personal beliefs and biases may influence their treatment style.

Creating a Safe and Affirming Therapeutic Space

Feeling safe with your therapist is the most important factor in benefiting from therapy. As a member of the LGBTQIA+ community, and as a fellow human being, I want you to know that you deserve to heal. You deserve to feel heard and understood in your therapy sessions. It’s important to ask yourself these questions to assess whether your therapist is truly supportive of your identity:

• Can I tell my therapist my coming out story?
• Do I feel comfortable telling them my pronouns?
• Do I feel like I can talk to my therapist about my sex life? 
• Do I code switch/mask with my therapist?
• Does my therapist ask or say positive things about my community?
• Does my therapist seem aware of the way my community is portrayed inappropriately, and how that impacts me? 
• Does my therapist seem aware that other pieces of my identity influence, or are influenced by, my LGBTQIA+ identity?
• Does my therapist ask questions about my identity that feel inappropriate/unrelated to the session?
• Does my therapist blame my identity, rather than the way it is perceived by others, for my mental health experiences?

Creating a Safe and Affirming Therapeutic Space

At Counseling and Wellness Center of Pittsburgh, we support and welcome all members of the LGBTQIA+ community. We denounce the intentional use of conversion therapies, and we continue to educate our practitioners in the use of LGBTQIA+ affirming and trauma-informed treatments to best serve you. If your current therapist makes you feel judged as a member of the LGBTQIA+ community, consider taking a new look for someone who can better meet your needs.

Here at Counseling and Wellness Center of Pittsburgh, we are actively accepting non-binary and LGBTQIA+ patients for all of our service offerings and are actively hiring LGBTQIA+ therapists and psychiatric providers to join our inclusive team. We will continue to be a safe place for you, and we hope to see you soon.

Written by Ang Scotto (they/them), LCSW. They are accepting new patients. Call us at 412-856-WELL or contact us here to make an appointment.