Parents Play Key Role in “Conversion Therapy” Efforts — and Harm — for LGBT Youth

A new study has shown the key, damaging, role parents play in “conversion therapy” efforts to change their LGBT children’s sexual orientation, and how this exacerbates health and adjustment problems for their children even into young adulthood.

The study’s lead author, Dr. Caitlin Ryan, director of the Family Acceptance Project at San Francisco State University, has long looked at how family acceptance (or lack thereof) impacts LGBT youth. Her most recent research is the first effort to examine sexual orientation change efforts across several domains, asking about conversion experiences not only with healthcare practitioners and religious leaders, but also with parents and caregivers.

No matter where these change efforts occur, and regardless of who conducts them, “parents serve as gatekeepers to both engage in and take their LGBT children for external conversion interventions,” Ryan and her co-authors say in a press statement. Whether at home or away, these interventions “contribute to multiple health and adjustment problems in young adulthood,” including “higher levels of depression and suicidal behavior, as well as lower levels of self-esteem, social support and life satisfaction, and lower levels of education and income in young adulthood, compared with LGBT young people who did not experience conversion efforts.”

To many of us in the LGBTQ community, it may seem obvious that conversion efforts are harmful. The fact is, though, that they are still used far too frequently. Ryan and her team tell us, “More than half (53%) of LGBT non-Latino white and Latino young adults, ages 21-25, reported experiencing sexual orientation change efforts during adolescence. Of these, 21% reported specific experiences by parents and caregivers to change their sexual orientation at home; and 32% reported sexual orientation change efforts by both parents and by therapists and religious leaders.”

Not only that, but while LGBT youth experience harm from any sexual orientation change efforts, “those who experience both parental and external conversion efforts by therapists or religious leaders had the highest levels of risk.” The researchers found that:

• Rates of attempted suicide by LGBT young people whose parents tried to change their sexual orientation were more than double (48%) the rate of LGBT young adults who reported no conversion experiences (22%). Suicide attempts nearly tripled for LGBT young people who reported both home-based efforts to change their sexual orientation by parents and intervention efforts by therapists and religious leaders (63%).
• High levels of depression more than doubled (33%) for LGBT young people whose parents tried to change their sexual orientation compared with those who reported no conversion experiences (16%) and more than tripled (52%) for LGBT young people who reported both home-based efforts to change their sexual orientation by parents and external sexual orientation change efforts by therapists and religious leaders.
• Sexual orientation change experiences during adolescence by both parents/caregivers and externally by therapists and religious leaders were associated with lower young adult socioeconomic status: less educational attainment and lower weekly income.
• LGBT adolescents from highly religious families and those from families with lower socioeconomic status were most likely to experience both home-based and external conversion efforts, while those who were gender nonconforming and who were from immigrant families were more likely to experience external conversion efforts initiated by parents and caregivers.

Having peer-reviewed, academic research that healthcare practitioners and others can use to better understand the entire harmful landscape of conversion efforts is an important step to addressing them. Study co-author Stephen T. Russell, Ph.D., Regents Professor, University of Texas at Austin explains, “We now have even more dramatic evidence of the lasting personal and social cost of subjecting young people to so-called ‘change’ or ‘conversion’ therapies. Prior studies with adults have shown how harmful these practices are. Our study shows the role central role that parents play. It is clear that there are public health costs of ‘change’ efforts for LGBT adolescents over the long-term. The kind of change we really need is family education and intervention.”

Ryan’s Family Acceptance Project has been a leader in such education efforts. The project broke new ground nearly a decade ago in showing how LGBT youth can often best be helped by serving them in the context of their families, involving the parents and showing them how their acceptance can have a significant positive impact on their children’s lives—and conversely, how their rejection can harm them. And the project is putting its findings into action. “That’s why we developed a family support model to help diverse families learn to support their LGBT children that we’re integrating in behavioral health, out-of-home care, primary care and pastoral care in communities across the country,” explains Ryan.

Additionally, the project’s multi-lingual, multicultural series of family education booklets, “Supportive Families, Healthy Children,” was named the first “Best Practice” resources for suicide prevention for LGBT youth and young adults by the national Best Practices Registry for Suicide Prevention in 2012.

Despite Ryan (and others’) findings on the critical role that families play in LGBT youths’ well-being, most efforts to stop sexual orientation conversion have focused on adopting state laws to stop healthcare practitioners from engaging in them, in line with the position of mainstream professional associations such as the American Academy of Pediatrics, which have deemed them unethical and harmful. Although legislative efforts remain important, Ryan and her team assert that they are not in themselves enough, saying, “This study underscores the urgent need for culturally appropriate education and guidance for families and religious leaders to provide accurate information on sexual orientation, gender identity and expression, on the harmful effects of family rejecting behaviors which include sexual orientation conversion efforts, and on the need for supporting LGBT young people to reduce risk and increase well-being.”

The study is “Parent-Initiated Sexual Orientation Change Efforts With LGBT Adolescents: Implications for Young Adult Mental Health and Adjustment,” Journal of Homosexuality, Caitlin Ryan, Ph.D., Russell B. Toomey , Ph.D., Rafael M. Diaz , Ph.D., and Stephen T. Russell , Ph.D. Published online November 7, 2018.

(Full disclosure: In 2013, I did some paid consulting work for the Family Acceptance Project.)