What Is Conversion Therapy?

What is conversion therapy?

What Happens in Conversion Therapy

The word “therapy” is doing a lot of work in the name, and it is worth taking apart before anything else. It suggests a counselor and a couch. What the practice has meant, and still means, is narrower and stranger than that.

Through roughly the 1990s it was openly physical. A Minnesota Department of Health review of the scientific evidence records lobotomy and aversive conditioning by electric shock, ice baths, freezing, burning with metal coils, and hard labor. The theory behind aversion therapy was simple, and it is the reason for the electric shocks. Make a person associate attraction with pain, and the attraction stops. It did not stop, and aversion therapy is now abandoned by every mainstream body that once used it.

Those methods are largely historical, and saying so matters. Today most of it is talk. A practitioner treats a young person’s orientation as a symptom of something else, often a distant father, an overbearing mother, or past abuse, and works to trace it back to that supposed cause. Sessions may coach stereotyped masculinity or femininity, assign gender-conforming behavior as homework, and frame the goal as resolving “unwanted same-sex attraction” rather than changing a person. Ex-gay therapy and ex-gay ministry programs run on the same premise. In religious settings the practice can include prayer sessions, deliverance, and exorcism.

That last setting is where most of it now happens, and it is where the law does not reach.

Reading a state ban as “conversion therapy is illegal here” overstates what it does. The bans reach licensed professionals treating minors. A church program, an unlicensed coach, and any provider seeing a 19-year-old sit outside them. Courts have also had to weigh whether banning gender identity change efforts and SOCE is discriminatory toward the practitioners who want to offer it, which is the argument that reached the Supreme Court.

Why conversion therapy doesn’t work

Sexual orientation does not change because someone is pressured to change it. Decades of research find it is highly resistant to deliberate attempts at modification, and not a single rigorous study has shown reparative therapy can do it. The American Psychological Association reviewed the literature and found no reliable evidence that sexual orientation change efforts produce change.

The clearest proof is what happened to the studies claiming it works. Only two were ever published, and both collapsed.

The harm to LGBTQ youth

Mathew Shurka was 16 when a licensed therapist promised to make him straight and told him to stop speaking to his mother and sisters. The reasoning was that female influence had made him gay. He followed that instruction for three years, and spent five years in treatment, from 16 to 21, that changed nothing about who he was.

The cutting-off was not a side effect. Separating a teenager from the people who accept him is a technique, because the practice needs the young person to believe the therapist over everyone else in the room. What it costs is the thing a person that age needs most.

Shurka now runs Born Perfect, the campaign he co-founded with the National Center for Lesbian Rights, and describes the outcome in a way worth sitting with.

That sentence contains the whole injury. In a practice built on the premise that who you are is a problem to be solved, getting better means failing the treatment, and the people who do not fail spend years believing they are the defect. That is the part that follows someone into adulthood, and it is what the research measures across thousands of people like him.

In the largest study of its kind, the Trevor Project surveyed 22,462 LGBTQ youth and found that those subjected to conversion therapy were more than twice as likely to attempt suicide in the past year. It was the single strongest predictor of multiple attempts, even after accounting for family rejection and discrimination.

44 of 100 Subjected to conversion therapy

17 of 100 Not subjected to conversion therapy

Attempted suicide in the past year, after conversion therapy Did not attempt suicide

Source: The Trevor Project survey of 22,462 LGBTQ youth (43.6% vs 17.3%). Shown per 100 youth.

For transgender people the pattern holds and sharpens. A JAMA Psychiatry study of more than 27,000 transgender adults found that gender-identity change efforts doubled the odds of a lifetime suicide attempt. For those targeted before age 10, the odds were more than four times higher.

Suicide is not the only measured outcome. Modeling for the Minnesota review attributed about $83,000 in additional lifetime costs per person exposed, driven by suicidal ideation, anxiety, severe psychological distress, depression, and substance abuse. Across the population that came to roughly $9.23 billion in economic burden, which is what happens when a practice sold as psychotherapy produces the conditions real psychotherapy treats.

The clearest verdict came from the people who ran it. Exodus International was the largest ex-gay ministry in the world, operating for 37 years across dozens of countries. In June 2013 its president, Alan Chambers, shut it down and apologized to the people it had treated.

Chambers also apologized for promoting sexual orientation change efforts and the reparative theories behind them. An organization does not close after 37 years and apologize to its own clients because the practice was working.

698,000 Have Been Through Conversion Therapy

Conversion therapy is still happening at scale. The Williams Institute at UCLA estimates that 698,000 LGBTQ adults have undergone it, and that 16,000 more teens will be put through it by a licensed professional before they turn 18, where it remains legal.

A 2023 systematic review found that 13% of LGBTQ people in the U.S. have experienced conversion practices at some point. For transgender and nonbinary people the rate runs about three times higher than for cisgender people. It happens in churches, camps, and prayer groups, but also in regulated counselors’ offices.

Which States Have Bans

Whether a teenager is protected depends entirely on where they live. 23 states and the District of Columbia ban conversion therapy for minors, covering 49% of LGBTQ youth. The other 51% have no statutory shield at all.

Full ban for minors (23 states + DC)

No full ban (27 states)

Source: Movement Advancement Project, June 17, 2026.

Conversion Therapy Bans for Minors

State	Status	Detail
California	Full ban for minors	First state to ban it for minors, 2012.
Colorado	Full ban for minors	Ban remanded for strict-scrutiny review after Chiles v. Salazar (2026).
Connecticut	Full ban for minors	Conversion therapy is prohibited for minors.
Delaware	Full ban for minors	Conversion therapy is prohibited for minors.
District of Columbia	Full ban for minors	Conversion therapy is prohibited for minors.
Hawaii	Full ban for minors	Conversion therapy is prohibited for minors.
Illinois	Full ban for minors	Conversion therapy is prohibited for minors.
Maine	Full ban for minors	Conversion therapy is prohibited for minors.
Maryland	Full ban for minors	Conversion therapy is prohibited for minors.
Massachusetts	Full ban for minors	Conversion therapy is prohibited for minors.
Michigan	Full ban for minors	Ban facing federal court challenge.
Minnesota	Full ban for minors	Conversion therapy is prohibited for minors.
Nevada	Full ban for minors	Conversion therapy is prohibited for minors.
New Hampshire	Full ban for minors	Conversion therapy is prohibited for minors.
New Jersey	Full ban for minors	Conversion therapy is prohibited for minors.
New Mexico	Full ban for minors	Conversion therapy is prohibited for minors.
New York	Full ban for minors	Conversion therapy is prohibited for minors.
Oregon	Full ban for minors	Conversion therapy is prohibited for minors.
Pennsylvania	Full ban for minors	Conversion therapy is prohibited for minors.
Rhode Island	Full ban for minors	Conversion therapy is prohibited for minors.
Utah	Full ban for minors	Conversion therapy is prohibited for minors.
Vermont	Full ban for minors	Conversion therapy is prohibited for minors.
Washington	Full ban for minors	Conversion therapy is prohibited for minors.
Wisconsin	Full ban for minors	Conversion therapy is prohibited for minors.
Alabama	No full statutory ban	11th Circuit blocked enforcement of local bans on free-speech grounds.
Alaska	No full statutory ban	No state law protects minors from conversion therapy.
Arizona	No full statutory ban	Executive order bars state funding, but no statutory ban.
Arkansas	No full statutory ban	No state law protects minors from conversion therapy.
Florida	No full statutory ban	11th Circuit blocked enforcement of local bans on free-speech grounds.
Georgia	No full statutory ban	11th Circuit blocked enforcement of local bans on free-speech grounds.
Idaho	No full statutory ban	No state law protects minors from conversion therapy.
Indiana	No full statutory ban	State law deters local-level bans.
Iowa	No full statutory ban	No state law protects minors from conversion therapy.
Kansas	No full statutory ban	No state law protects minors from conversion therapy.
Kentucky	No full statutory ban	No state law protects minors from conversion therapy.
Louisiana	No full statutory ban	No state law protects minors from conversion therapy.
Mississippi	No full statutory ban	No state law protects minors from conversion therapy.
Missouri	No full statutory ban	No state law protects minors from conversion therapy.
Montana	No full statutory ban	No state law protects minors from conversion therapy.
Nebraska	No full statutory ban	No state law protects minors from conversion therapy.
North Carolina	No full statutory ban	No state law protects minors from conversion therapy.
North Dakota	No full statutory ban	No state law protects minors from conversion therapy.
Ohio	No full statutory ban	No state law protects minors from conversion therapy.
Oklahoma	No full statutory ban	No state law protects minors from conversion therapy.
South Carolina	No full statutory ban	State law deters local-level bans.
South Dakota	No full statutory ban	No state law protects minors from conversion therapy.
Tennessee	No full statutory ban	State law deters local-level bans.
Texas	No full statutory ban	No state law protects minors from conversion therapy.
Virginia	No full statutory ban	2020 ban left unenforceable under a 2025 settlement.
West Virginia	No full statutory ban	No state law protects minors from conversion therapy.
Wyoming	No full statutory ban	No state law protects minors from conversion therapy.

Those protections are newer than they look, and the ground under them is already shifting.

The Supreme Court weakened the bans

On March 31, 2026, the Supreme Court ruled 8-1 in Chiles v. Salazar that Colorado’s ban, applied to a licensed counselor’s talk therapy, is a viewpoint-based restriction on speech. That means it must survive strict scrutiny, the hardest standard in constitutional law, a test most laws fail.

Justice Gorsuch wrote the majority. Justice Jackson dissented alone, warning that the decision “could be ushering in an era of unprofessional and unsafe medical care.” The Court did not strike Colorado’s ban outright. It sent the case back to the lower court to apply the new standard, and put every other state with a similar ban on notice.

The fight did not start in 2026. It runs from the day psychiatry stopped calling gay people sick to the day the Court reopened the question.

1. 1973 Homosexuality removed from the DSM The American Psychiatric Association stops classifying being gay as a mental illness.
2. 1998 Ex-gay ad campaign A national campaign promotes "change" and fuels the conversion therapy industry.
3. 2012 First state ban California becomes the first state to ban conversion therapy for minors.
4. 2012 The signature study is retracted Spitzer repudiates his own 2001 study and apologizes.
5. 2013 Exodus International closes The largest ex-gay ministry shuts down and apologizes for the harm it caused.
6. 2025 The last pro-change study falls The 2021 Sullins analysis is retracted for methodological flaws.
7. 2026 Chiles v. Salazar The Supreme Court rules 8-1 that bans on licensed talk therapy face strict scrutiny.

From a diagnosis to a Supreme Court reversal, 1973-2026: 1973 — Homosexuality removed from the DSM (The American Psychiatric Association stops classifying being gay as a mental illness.). 1998 — Ex-gay ad campaign (A national campaign promotes "change" and fuels the conversion therapy industry.). 2012 — First state ban (California becomes the first state to ban conversion therapy for minors.). 2012 — The signature study is retracted (Spitzer repudiates his own 2001 study and apologizes.). 2013 — Exodus International closes (The largest ex-gay ministry shuts down and apologizes for the harm it caused.). 2025 — The last pro-change study falls (The 2021 Sullins analysis is retracted for methodological flaws.). 2026 — Chiles v. Salazar (The Supreme Court rules 8-1 that bans on licensed talk therapy face strict scrutiny.).

1973: The American Psychiatric Association removed homosexuality from the Diagnostic and Statistical Manual. A membership referendum confirmed it in 1974. Being gay was no longer a disorder to be cured.

2012: California passed the first state ban on conversion therapy for minors. The same year, Robert Spitzer retracted the 2001 study that the entire “change is possible” movement had leaned on.

2025: The last study claiming conversion therapy worked, a 2021 analysis, was retracted. The scientific case for the practice was now empty on both ends.

2026: In Chiles v. Salazar, the Supreme Court ruled 8-1 that Colorado’s ban on licensed talk therapy is a speech restriction subject to strict scrutiny. Garrard Conley, who survived a Love in Action program and wrote the memoir Boy Erased, called the ruling a green light for the same practice that nearly destroyed him.

Gender-Exploratory Therapy Renames an Old Practice

Conversion therapy did not disappear as the bans spread. It changed its name and its target, moving from gay people to transgender and nonbinary youth.

Gender-exploratory therapy is the newest version. It is a counseling approach for transgender and nonbinary young people that treats their gender identity as something to question rather than affirm, with the goal of delaying or preventing transition.

It is marketed as neutral. Its supporters say they are not trying to change anyone, only to “explore” where a young person’s gender feelings come from before any social or medical transition. In practice, the exploration starts from the assumption that a trans identity is a symptom to explain away, often blamed on trauma, autism, or social contagion, and the goal is to delay or prevent transition.

Clinical ethicist Florence Ashley, writing in Perspectives on Psychological Science, found the resemblance hard to miss: “When you begin from the premise that trans identities are suspect and often rooted in pathology, your therapeutic approach soon becomes indistinguishable from conversion practices.”

The major medical bodies have already drawn the line on the trans version. The American Psychological Association passed a 2021 resolution opposing gender identity change efforts, and the World Professional Association for Transgender Health states plainly in its standards of care that being transgender “is not undesirable and should not be approached as if it were.”

What conversion therapy is not

Conversion therapy is not the same as ordinary mental health care, and the difference matters when the two get deliberately confused.

It is not affirming therapy. Affirming therapy supports a person in understanding and accepting their identity. Conversion therapy starts from the position that the identity must change. One reduces suicide risk; the other doubles it.

It is not always overt abuse. Most of it now happens in talk-therapy offices and prayer groups, not residential camps. The licensed-counselor version is exactly what the Supreme Court just treated as protected speech.

It is not a thing of the past. 16,000 LGBTQ teens are projected to be put through it by a licensed professional before turning 18, in the states that still allow it.

Banning it does not silence therapists. A counselor can discuss anything with a client. State bans restrict a specific licensed treatment that aims to change orientation or identity, the same way licensing law bars other discredited treatments.

Frequently asked questions

Does conversion therapy work? No. Sexual orientation and gender identity are highly resistant to deliberate change, and no credible study has shown conversion therapy changes either. The only two studies that ever claimed success were both retracted.

What happens in conversion therapy? There is no single method. It ranges from talk therapy that treats a person’s identity as a defect to fix, to behavioral and aversion techniques, to intensive religious programs and live-in camps. Most of it today is talk therapy in a counselor’s office or a faith setting, which is the version the Supreme Court just shielded as speech.

Does conversion therapy target transgender people? Yes. It has always tried to change gender identity as well as sexual orientation, and as bans spread it has increasingly focused on transgender and nonbinary youth, often under the rebrand “gender-exploratory therapy.” The goal is the same: to stop a person from being who they are.

Is conversion therapy legal in the United States? It depends on the state. 23 states and DC ban it for minors. The rest allow it. After Chiles v. Salazar in 2026, even the existing bans face new legal challenges.

What did the Supreme Court decide in Chiles v. Salazar? On March 31, 2026, the Court ruled 8-1 that Colorado’s ban on conversion talk therapy by a licensed counselor is a viewpoint-based speech restriction subject to strict scrutiny. It did not strike the ban outright but sent it back to the lower court and put similar bans nationwide at risk.

What is “gender-exploratory therapy”? It is a rebranded approach aimed at transgender youth that treats a trans identity as a symptom to be explored away. Researchers and medical bodies have found it functionally indistinguishable from conversion therapy.

Is conversion therapy the same as counseling for someone questioning their identity? No. Supportive counseling helps a person explore and accept who they are without a predetermined outcome. Conversion therapy has a fixed goal: changing the person’s orientation or identity.

What you can do

1. Tell Congress to pass federal protection from conversion therapy. After Chiles v. Salazar, state bans are vulnerable and a national standard is the durable fix. Ask your members of Congress to support a federal ban on conversion therapy for minors and to fund survivor services. Use the letter below.

2. Defend or pass a ban in your state. If your state is one of the 27 without a full ban, ask your state legislators to pass one. If your state has a ban, ask your attorney general to commit to defending it under the new strict-scrutiny standard. The Movement Advancement Project tracks where every state stands.

3. Support the organizations litigating and tracking this. The National Center for Lesbian Rights runs the Born Perfect campaign to end conversion therapy. The Trevor Project produces the research that bans are built on.

4. Know the crisis resources and share them. For LGBTQ youth in crisis, the Trevor Project is reachable at 1-866-488-7386 or by texting START to 678-678. Trans Lifeline is 877-565-8860. If someone is in immediate danger, call 911. For any mental health crisis, call or text 988.

5. Write your representative in support of protecting LGBTQ youth from conversion therapy. Use the letter below.