Transgender 'Conversion Therapy' Common, Potentially Harmful

More than one in 10 transgender people say they've been pressured by a professional counselor to accept their birth sex.

So finds the largest survey to date on the issue.

Nearly 14% of transgender people say that some sort of professional -- a psychologist, counselor or religious advisor -- urged them to identify only with their sex assigned at birth, the survey revealed.

That amounts to more than 180,000 people across the United States who've been potentially subjected to a form of conversion therapy, said lead researcher Dr. Jack Turban. He is a child and adolescent psychiatrist at Harvard Medical School, in Boston.

Major medical organizations, including the American Medical Association, oppose such conversion efforts, deeming them ineffective and unethical, Turban said.

"State legislators have argued that these attempts to change gender identity don't happen in their state, and they've used that as an argument against passing legislation that would make it illegal to try to change a person's gender identity," Turban said.

The percentage of transgender people who experienced conversion efforts ranged from a low of 9% in South Carolina to a high of 25% in Wyoming, the researchers found.

The survey "shows just how pervasive conversion therapy still is," said Amy Green, director of research for The Trevor Project, the world's largest suicide prevention and crisis intervention organization for LGBTQ (lesbian, gay, bisexual, transgender, and queer or questioning) young people.

"Conversion therapy is dangerous, and The Trevor Project is proud to work with local coalitions and national organizations to end the discredited practice in all 50 states," Green continued. "We know that with support, transgender and non-binary youth are resilient in the face of such harmful practices."

Transgender conversion therapy was most commonly reported from a cluster of western states that include Montana, Idaho, Wyoming, Utah and South Dakota, the survey showed. These efforts also were common in Nevada, Oklahoma, West Virginia and Alaska.

The 2015 U.S. Transgender Survey involved more than 27,700 transgender people, with representation from all 50 states, the researchers said. As part of the survey, participants were asked if a professional had ever tried to make them stop being transgender.

Data have shown that conversion therapy can increase a person's risk of suicide and psychological distress, Turban and Green said.

"In our latest survey, youth who reported having undergone conversion therapy attempted suicide at more than twice the rate as those who did not," Green said. "In addition, more than half of transgender and non-binary youth surveyed seriously considered attempting suicide."

Turban said, "We hope that these findings will provide inspiration for state legislators to outlaw gender identity change efforts. We also hope that parents and individuals will be less likely to seek out such modalities as we build public understanding that being transgender isn't a disease that needs to be cured."

The survey was published recently in the American Journal of Public Health.

These results are not surprising because there is not across-the-board agreement on how to deal with gender dysphoria in children, said Clinton Anderson, director of the American Psychological Association's Sexual Orientation and Gender Diversity Office.

There's widespread agreement that adults who declare themselves transsexual be assisted in making the transition to whatever extent they want, be it simple appearance or hormone therapy or surgery, Anderson said.

Adolescents who are transsexual also tend to be automatically accepted and assisted. "Increasingly, as they get older, it becomes clearer there is no likelihood that person will ever be able to accept their gender, except as a transgender person," Anderson said.

But there's ongoing debate over how to approach gender dysphoria in younger children, he added.

"Some people are hesitant about affirming completely a transition for that child, when you're not sure if that transition is going to be what they will want when they are 15 or 25," Anderson said.

On the other hand, such hesitancy is seen by some as being unsupportive or even opposed to a child's exploration of their gender.

"Some people perceive that being anything less than affirming as being conversion therapy and, therefore, as being unethical and being bad," Anderson said. "Sometimes that does get perceived by some people as being undermining to a child's sense of themselves or of controlling their own destiny or autonomy."

The term "conversion therapy" originally was coined to talk about efforts to change people's sexual orientation, Anderson explained. But the term has been broadened in recent years to also refer to efforts to change a person's gender identity.

"They're two distinct parts of a person's sexuality," Anderson said of sexual orientation and gender identity. "They're not the same."

Turban recommends that parents of a child questioning their gender identity "keep an open, supportive stance toward your child. Remind them that you love them no matter what. Let them explore their gender identity, and don't try to force them one way or another."

He added that "research continues to show that shame and rejection drive most of the mental health problems in this population."

But there's ongoing debate over how to approach gender dysphoria in younger children, he added.

"Some people are hesitant about affirming completely a transition for that child, when you're not sure if that transition is going to be what they will want when they are 15 or 25," Anderson said.

On the other hand, such hesitancy is seen by some as being unsupportive or even opposed to a child's exploration of their gender.

"Some people perceive that being anything less than affirming as being conversion therapy and, therefore, as being unethical and being bad," Anderson said. "Sometimes that does get perceived by some people as being undermining to a child's sense of themselves or of controlling their own destiny or autonomy."

The term "conversion therapy" originally was coined to talk about efforts to change people's sexual orientation, Anderson explained. But the term has been broadened in recent years to also refer to efforts to change a person's gender identity.

"They're two distinct parts of a person's sexuality," Anderson said of sexual orientation and gender identity. "They're not the same."

Turban recommends that parents of a child questioning their gender identity "keep an open, supportive stance toward your child. Remind them that you love them no matter what. Let them explore their gender identity, and don't try to force them one way or another."

He added that "research continues to show that shame and rejection drive most of the mental health problems in this population."

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