The Supreme Court will soon issue its ruling in Chiles v. Salazar, a case that could overturn the bans on conversion therapy for minors currently in place in 27 states. But while some people are familiar with the case, others are asking, “What is conversion therapy?” in order to learn more about the practice and how it became so controversial.

This explainer provides an overview that explains what conversion therapy is, its methods, its harmful effects, the state laws against it, and its key supporters and opponents.

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Conversion therapy is abuse & torture. It should never be legal.

What is conversion therapy?

Conversion therapy (aka. reparative therapy, ex-gay/ex-trans therapy, exploratory therapy) is the widely debunked, ineffective, and abusive pseudoscientific practice of trying to change a person’s sexual orientation or gender identity to fit heterosexual and cisgender social norms.

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Conversion therapy has been described by experts as a needless, cruel, inhuman form of psychological and physical torture that (when applied to minors) constitutes child abuse and violates basic human rights.

Conversion therapy has existed in various forms for over a century, with its roots tracing back to the late 19th century. Early methods, rooted in viewing homosexuality as a pathology, began appearing around 1886.

What methods are used in conversion therapy?

The key method of conversion therapy mostly involves “aversion therapy” — getting people to associate their same-sex attraction with painful, sickening, or humiliating stimuli, usually in the form of electric shocks, nausea-inducing drugs, or mockery from the “therapist.” Another popular “treatment” involves work camps — abusive labor farms where some kids literally get worked to death.

• Redirecting sexual desire onto members of the opposite sex
• Sexual intercourse with a sex worker of the opposite sex
• Marrying someone of the opposite sex
• Fantasizing about people of the opposite sex
• Humiliation (verbal insults or hazing)
• Group therapy (public shaming and peer pressure)
• Solitary confinement
• Involuntary commitment
• Chastity/celibacy
• Electroshock therapy
• Nausea-inducing drugs
• Prayer and Bible study (aka. “Pray the gay away”)
• Hypnosis
• Radiation treatment
• Forced hormone therapy (aka. chemical castration)
• Frontal lobe lobotomy
• Beauty therapy: Forcing queer people to dress/act like cis-hets
• Exorcism
• Castration
• Bodily harm
• “Corrective” rape
• Placing the testicles of dead straight men into the bodies of gay men (yes, really)

There have also been numerous reports of male conversion therapists encouraging their male patients to cuddle, sleep, or have sex with them, which is deeply unethical, immoral, and also completely contradictory to conversion therapy’s aims.

Is LGBTQ+ identity a mental illness?

No, LGBTQ+ identity is not a mental illness. All major American medical and mental health organizations recognize that sexual orientation and gender identity are normal variations of human experience.

Homosexuality was removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1973, and the World Health Organization removed “gender identity disorder” from its list of mental disorders in the International Classification of Diseases (ICD) in 2019.

While being LGBTQ+ is not a disease, some queer people experience depression, anxiety, or other mental health struggles that are often linked to external factors — such as stigma, discrimination, and lack of social acceptance — rather than being inherent to their identity. Psychologists often encourage such patients to identify and alleviate such stressors, develop healthy self-acceptance, and form support networks through social integration.

Some trans people experience gender dysphoria (clinically significant distress or discomfort when a person’s gender identity doesn’t align with their assigned sex). Gender dysphoria can be alleviated by social transitioning (changing how a person expresses their gender to align with their identity rather than their sex assigned at birth by using a new name, different pronouns, altering clothing or hair, and coming out to others) or by gender-affirming medical care (puberty blockers to delay bodily changes, hormone replacement therapy to align physical characteristics with gender identity, or surgeries to augment one’s body in line with their gender identity).

How many people practice conversion therapy?

Over 1,300 therapists nationwide are still offering conversion therapy, according to the Trevor Project.

Many of these individuals avoid identifying themselves online with terms like “reparative therapy,” “ex-gay,” and “unwanted same-sex attraction.” Instead, they discreetly advertise their services using terms like “sexual attraction fluidity exploration,” “rapid-onset gender dysphoria,” “sexual addiction,” “sexual wholeness,” “sexual integrity,” and claim to help clients “align their related behaviors with their faith.”

How many people undergo conversion therapy?

Nearly 700,000 LGBTQ+ adults in the U.S. have received conversion therapy, half of them as adolescents, according to an October 2025 report from The Williams Institute.

A March 2022 peer-reviewed study from The Trevor Project showed that 13% of LGBTQ+ youth nationwide had reported being subjected to conversion therapy. Of those, 83% were subjected to it before reaching the age of 18.

A 2015 survey of more than 27,000 trans adults found that nearly 1 in 7 said that a professional — like a therapist, doctor, or religious adviser — had tried to change their gender identity; about half of respondents said they were minors at the time.

Does conversion therapy work?

No. Numerous studies have shown that conversion therapy doesn’t work and that those who have been subjected to it often experience higher rates of depression and suicidality.

Why have some states banned conversion therapy?

Currently, 27 U.S. states – along with D.C., Puerto Rico, and over 100 local governments – have banned so-called conversion therapy for minors. These laws say that any medical professional offering conversion therapy can face disciplinary measures from the state medical licensing board, lose their license to practice, and face other potential civil or criminal consequences.

Some state legislative bans posit that the practice violates state licensing standards because the methods are ineffective and harm patients. Other states have said that practitioners who purport to change an individual’s LGBTQ+ identity are, in essence, using false advertising to market their services, something which can violate other state regulatory business statutes.

What groups have offered conversion therapy?

Numerous groups (listed below) have offered and promoted conversion therapy. Many of these groups have since disbanded, and some of their various leaders have either apologized for their harmful work or later came out as LGBTQ+ themselves

• Exodus International
• Love in Action (aka. Restoration Path)
• Courage International
• Homosexuals Anonymous
• Parents and Friends of Ex-Gays and Gays
• Joel 2:25 International
• Jews Offering New Alternatives for Healing (JONAH)
• National Association for Research and Therapy of Homosexuality (NARTH) — which later changed its name to the Alliance for Therapeutic Choice and Scientific Integrity (ATCSI)

Who supports conversion therapy?

Anti-LGBTQ+ groups like The Liberty Counsel and the Family Research Council say conversion therapy can be “beneficial and effective” for changing one’s LGBTQ+ identity.

The Christian anti-LGBTQ+ legal advocacy group Alliance Defending Freedom (ADF) — defined as a hate group by the Southern Poverty Law Center — is trying to get the U.S. Supreme Court to overturn state bans on conversion therapy for minors by claiming that the bans violate practitioners’ rights to free speech and free exercise of religion. 

Who is against conversion therapy?

Major medical organizations like the American Academy of Child and Adolescent Psychiatry, American Association for Marriage and Family Therapy, American Medical Association (AMA), American Psychiatric Association,  American Psychological Association (APA), and the American School Health Association all oppose conversion therapy as a debunked form of pseudoscience that harms those subjected to it.

The LGBTQ+ advocacy group Truth Wins Out, the youth suicide prevention organization The Trevor Project, and most other major LGBTQ+ organizations have publicly opposed conversion therapy as well.

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