The Science and Harms of Gay Conversion Therapy: An Evidence-Based Analysis

The episode critically examines gay conversion therapy, or Sexual Orientation Change Efforts (SOCE), in light of a recent U.S. Supreme Court decision overturning a ban on the practice in Colorado. The host, a medical doctor, emphasizes an evidence-based approach, explicitly stating that his role is not to debate constitutional law or religious beliefs, but to provide scientific information to help individuals and families make informed decisions about therapeutic treatments. He highlights the medical community's stance against SOCE, rooted in data and patient outcomes, rather than political activism alone.

The analysis begins by scrutinizing the efficacy of SOCE, concluding that scientific evidence overwhelmingly shows it is ineffective. Studies cited, including one involving 1600 individuals from the Church of Latter-day Saints, indicate a minimal success rate (e.g., 3.1% reporting benefit). The host points out severe methodological flaws in studies claiming positive outcomes, such as small sample sizes, reliance on retrospective surveys, problematic recruitment from "ex-gay ministry communities," and a complete absence of rigorous randomized controlled trials. Crucially, these studies often fail to measure negative outcomes, a fundamental requirement in clinical trials for any new intervention.

The podcast then details the significant harms associated with gay conversion therapy. It is linked to increases in depression, anxiety, lowered self-esteem, difficulties in familial and non-romantic relationships, issues with sexuality, and an increased sense of "homonegativity." Most alarmingly, SOCE is strongly associated with increased suicidality, including a 75% rise in suicidal planning, which psychiatrists consider a strong risk factor for completed suicide. These severe negative consequences are why major medical organizations like the American Psychiatric Association and American Medical Association unequivocally oppose the practice.

The episode explores *why* SOCE is ineffective and harmful. Reasons include the wide variation in its practice and techniques, ranging from licensed professionals to pastors, and incorporating diverse methods from Bible study to CBT, making consistent outcomes impossible to measure. More fundamentally, the host argues that being gay is not a pathology; therefore, there is "nothing to fix," rendering any "treatment" inherently futile. This perspective is supported by historical figures like Freud, who did not view homosexuality as an illness, and by biological evidence suggesting that same-sex behavior is a common, even default, state in the animal kingdom, observed in over 500 species and more prevalent in primitive organisms lacking sexual dimorphism. The episode concludes by advocating for general therapy for those struggling, emphasizing a non-value-based approach to help individuals find their own conclusions.

What I am is a medical doctor. And so today, what we're going to be talking about, if you're interested in sending your son or daughter to gay conversion therapy, if you are someone who is considering gay conversion therapy or sexual orientation change efforts, or if you're just someone in our audience at large, my job today is to equip y'all with the information so that you can make the most informed decision about what kind of therapeutic treatment is right for you.

Does gay conversion therapy work? Well, according to the evidence, not really.

No one has done like anything like a randomized controlled trial on gay conversion therapy like so we haven't taken 200 people right and set the control group as therapy as usual set the uh intervention group as gay conversion therapy and measured outcomes.

The first thing that we tend to study is, is it harmful for people to begin with? And when we look at a lot of these studies, the studies that do examine harm, what we find is really scary.

Gay conversion therapy is associated with an increase in suicidality. What's more troubling to me as a psychiatrist is an a 75% increase in suicidal planning.

My stance as a psychiatrist is that this is a terrible intervention to use with anyone. The studies that say that it's good are fraught with methodological flaws.

There is plenty of evidence that is ineffective and even harmful. So based on that, I don't think it's a good idea to do. And this is why organizations like the American Psychiatric Association and the American Medical Association have come out against these sorts of things.

The other main reason why we may not find good evidence that gay conversion therapy is effective is because being gay isn't a pathology. So generally speaking, when we do a medical treatment, someone is ill in some way. We are fixing something that's broken.

Interestingly enough, Freud didn't think that homosexuality was an illness. So he sort of thought that, you know, they are basically normal variants of the population.

It's that same sexual behavior is actually the default state. It's not that homosexuality is aarent. That it is actually very, very common in the animal kingdom.