Why Conversion Therapies are Harmful

These attempts to "reverse homosexuality" can cause serious harm to individuals.

As in other scientific disciplines, the development of psychology has not been free of homophobic biases and practices. Proof of this has been the long and, until recently, annulled presence of homosexuality as a clinical category in psychopathology; as well as the creation of its corresponding "conversion therapies", "reparative correction therapies" or "sexual reorientation".

Although in many contexts the latter is not only discredited is not only discredited but also legally criminalized.In other places, the medieval and violent idea that homosexuality is an illness or a disorder that can therefore be reversed, continues to hold sway.

With the intention of to analyze why conversion therapies are harmful, we willIn this article, we will begin by reviewing what these therapies are and where they come from, to finally see what some of their effects are.

Psychopathology and the logic of correction.

The idea of "curing", or rather of "correcting", is a logic that runs through the entire production of psychopathology, sometimes explicitly and sometimes implicitly. Such an idea easily becomes a fantasy that fills the gaps of the most conservative Western ideology, and by the same token, psychopathology has easily offered itself as a powerful strategy of control; in this way, psychopathology has become a powerful strategy of control. as a potent strategy of control; in this case, of homosexuality..

As Foucault would say in the 70's (quoted in Montoya, 2006), from its beginnings, psychiatry was proposed as an option that was not useful to "cure" in essence, because what it did was to intervene in cases of fixed abnormality without a precise organic basis.

What could it do then? Correct such abnormality, or try to control it. Beyond reducing psychic discomfort, psychiatry acquires a function of social protection; that is to say, to procure order in the face of the danger represented by what is morally placed as "abnormal". In this context, sexuality, or rather non-heterosexuality, was not left out of the gaze of psychiatry, was not left out of the gaze of pathology.. Initially, it is controlled from the bodily, and later from the psychic.

An inseparable relationship thus arises between morality, which is read in statistical terms of normality, and medicine, which later becomes psychopathology. As a result, heterosexuality has been understood in many contexts as normal and synonymous with health. And homosexuality as abnormal and synonymous with disease, or at best, as a disorder.

Sexuality always in the spotlight

Being a fundamental part of the human condition, sexuality has remained very present in the deepest philosophical, scientific and political debates. debates. At times, these debates have taken the form of moral prescriptions about sexual behavior, which in turn have impacted desires, pleasures, practices, identities and overall views of sexuality.

In fact, until not so long ago, the doubts generated by the Biological foundations of sexuality, under which the latter is reduced to the reproductive capacity of men and women.. Not without having been absent in other times and societies, it was not until the middle of the last century when sexual dissidence took to the streets to claim the free exercise of sexuality as a human right.

With the so-called "Sexual Revolution", a lot of lives, identities and pleasures that neither morality nor pathology had managed to capture gained visibility, especially in the European and American context.

With this came the struggle for equal rights and for the eradication of forms of discrimination based on sexual orientation. eradicate forms of discrimination on the basis of sexual orientation and sexual orientation.. Not only that, but finally, in 1973, the APA removed homosexuality from its compendium of mental disorders. The WHO did the same until 1990, and in the first year of our century, the APA also publicly rejected the implementation of conversion therapies.

On the other hand, but also in the United States, there is a strong conservative current that fights in the opposite direction, that of denying sexual diversity, and advocates granting rights only if sexuality is lived in a heteronormative way. Faced with the problem of how to make it heteronormative, conservative psychology and psychiatry offer the solution: a series of corrective therapies can "reverse," or some even "cure," homosexuality.

Questioning the immutability of sexual orientation

On the other hand, although in a minority, another part of science has generated knowledge that has allowed us to firmly question the idea of homosexuality as a pathology.

Montoya (2006) tells us about some research that analyzes, for example, gonadal, cerebral and psychological development and diversity. The latter question the essentialist and immutable view of heterosexualityIt also makes it clear that no genes or anatomical or behavioral factors have been found that can give a complete account of sexual orientation.

Thus, sexual orientation is not something predetermined and immutable but a "process of continuous interaction between the biological and psychic structure of the person and the environment where he expresses his sexuality" (ibidem: 202).

Emergence and conversion therapies

We have seen from a Foucauldian perspective that, in its beginnings, psychiatry is presented as a technology of correction, in which sexuality plays a leading role. When the latter was thought to have been overcome, the 21st century came to condense all the above in the emergence of techniques offered as a corrective option for homosexuality.

Reparative therapy emerged for the first time in 1991, one year after the WHO removed homosexuality from the compendium of diseases.. The term is attributed to the American clinical psychologist Joseph Nicolosi, who proposed it as a therapeutic model for changing from homosexuality to heterosexuality. Basically, the idea of "therapeutic" assumes in a generalized way that homosexuality is, in reality, latent heterosexuality, and that it is a condition that generates unhappiness or important psychic discomfort; therefore, it must be corrected.

The therapist thus positions himself from a homophobic paternalism that suppresses the autonomy of the person. And part of the options available to him range from aversive conditioning with from aversive conditioning with electroconvulsive therapy to practicing celibacy by reinforcing guilt..

From this point on, corrective therapies are not presented as options based on an integral, comprehensive and respectful vision of diversity, which allows to explore the discomfort beyond the subject himself (for example, as a consequence of the difficulties to express sexuality socially), but as an attempt to correct the person because he lives in a non-normative sexuality.

Harm and ethical questions

Says the APA (2000) that "Psychotherapeutic modalities aimed at changing or repairing homosexuality are based on developmental theories whose scientific validity is questionable" and also recommends ethical clinicians to refrain from attempts to change the orientation of individuals and to consider possible harms.

The latter can be psychological effects that include increasing internalized homophobia (with consequent disruption of sexual freedom and rights), but also (with the consequent interruption of sexual freedom and rights), but also clinical manifestations of depression, anxiety and self-destructive behaviors.

In his bioethical analysis on the subject, Montoya (2006) tells us that the main ethical questions that can be raised about the harms of conversion therapies are broadly the following:

• There is not a sufficient body of scientifically validated knowledge to support the efficacy of reparative therapies. the efficacy of reparative therapies.
• Therefore, it can hardly be argued that there are professionals who are really qualified to apply them; individual ideological criteria are easily imposed.
• In the informed consent, the possibilities of success are emphasized, i.e., the false reparative consequences and minimizes the damages..
• They start from the premise that homosexual behavior and identity are morally unacceptable and therefore a pathology.
• They disregard respect for the autonomy and dignity of the person.
• They involve dissuasion techniques by reinforcing in the person the idea that his or her sexuality is pathological, inferior or reprehensible.
• They are not harmlessThey increase homophobia and increase the risk of suicide.
• They ignore the achievements made in human, sexual and reproductive rights.
• They hide human diversity.
• They misrepresent the power of the physician.

Bibliographic references:

• Montoya, G. (2006). Bioethical approach to reparative therapies. Treatment for the change of homosexual orientation. Acta Bioethica, 12(2): 199-210.
• APA (2000). Position Statement on Therapies Focused on Attempts to Change Sexual Orientation (Reparative or Conversion Therapies). APA Official Actions. Retrieved July 25, 2018. Disponible en position statement on therapies focused APA.