We agree that the psychiatry community should do more to help end harmful practices of so-called conversion therapy for LGBTQ+ people.
Preliminary research suggests conversion practices are a problem with global reach. Further research is needed to clarify its scope. Updating professional consensus on appropriate treatment for LGBTQ+ people is especially important now when medical care for these populations is miscast as scientific pseudocontroversy for political reasons.
International human rights law and bioethics provide several strategies for ending harmful conversion therapy within a health justice framework.
Examples include criminalisation of such practices by legislatures; strengthening of professional guidelines for licensing, ethics, and other regulatory bodies; and application of anti-discrimination, anti-torture, or consumer-protection law to conversion practice. Of these strategies, we believe that strengthening professional guidelines has many advantages and is an important tool.
Many leading mental health organisations around the world have position statements about the harms of conversion therapy dating back 10 years or more (eg, the Memorandum of Understanding on Conversion Therapy among UK bodies, and the Pan American Health Organization’s and the World Psychiatric Association’s statements). These position statements help to define the appropriate scope of mental health practice for LGBTQ+ people. Doing so helps to guide professional ethics regulators, licensing bodies, and other professionally qualified overseers to appropriately limit conversion therapies and prevent the abuses associated with them. Periodically updating professional guidelines on appropriate care is a useful alternative to increasingly widespread legislative bans. Such bans risk normalising excessive legislative and judicial regulation of medical practice. In the USA, this overreach has paved the way for recent outlawing of medical practice to treat gender dysphoria based upon long-established evidence-based treatment guidelines,
and has mischaracterised it as child abuse. Strengthening guidelines would also avoid excessive criminalisation or concern about potential encroachments on other human rights.
For these reasons, it would be helpful for professional psychiatric organisations to update their position statements on conversion therapy to reflect recent research findings on what constitutes appropriate and inappropriate care for historically under-represented groups across sex, gender identities, and expression, and racial, ethnic, and cultural groups (eg, the ILGA World and American Psychological Association’s resolutions). A great deal of research has also been done in the past decade on the relationship of stigma to mental and physical health disparities among LGBTQ+ people, which underscores the potential harm of conversion practices and would be important to include in updated guidelines.
Source: Lancet
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