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CURBING DECEPTION A world survey on legal regulation of so-called “conversion therapies”
2020 ilga.org
COPYRIGHT
Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) This is a human-readable summary of (and not a substitute for) the license. Disclaimer. You are free to: § Share — copy and redistribute the material in any medium or format. § Adapt — remix, transform, and build upon the material. •
Suggested citation ILGA World: Lucas Ramon Mendos, Curbing Deception: A world survey on legal regulation of so-called “conversion therapies” (Geneva: ILGA World, 2020).
Names of countries and territories in this publication ILGA World is an organisation with ECOSOC-accredited consultative status at the United Nations and our publications therefore have to follow UN-recommended language on the names of countries and territories. Nothing in an ILGA World publication should be taken as a position made by the organisation on the status of any country or territory. If you have any doubts or queries with regard to this aspect of this publication, please contact ILGA at info@ilga.org.
Author
Lucas Ramón Mendos
Main Research Assistants
Enrique López de la Peña Lucía Belén Araque
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CURBING DECEPTION A world survey on legal regulation of so-called “conversion therapies”
2020 ilga.org
TABLE OF CONTENTS
TABLE OF CONTENTS
TABLE OF CONTENTS Co-Secretaries’ General Foreword
13
Author’s Preface and Acknowledgements
15
1. CHAPTER 1 - RELEVANT TERMS: MISNOMERS FOR A MYRIAD OF HARMFUL PRACTICES
17
1.
“Conversion therapy”
17
2.
“Reparative therapy”
18
3.
“Gay cure”
18
4.
“Ex-gay therapy”
19
5.
“Gender critical therapy”
19
6.
Sexual Orientation Change Efforts (SOCE)
19
7.
Sexual orientation, gender identity or gender expression change efforts (SOGIECE)
20
2. CHAPTER 2 - WHAT FORMS CAN SOGIECE TAKE?
21
1.
Pathologisation of sexual and gender diversity
22
2.
Early attempts: bicycle riding, lobotomy and castration
23
3.
Hormone intake
23
4.
Aversion therapy
24
4.1. Electroshock aversion therapy
25
4.2. Chemical aversion therapy
27
4.3. Other forms of aversive techniques
27
5.
Masturbatory reconditioning
27
6.
Hypnosis
28
7.
Internment in clinics or camps
29
8.
Psychotherapy and counselling
30
9.
Abusive or otherwise questionable methods used within psychotherapy or counselling
36
9.1. Nudity
36
9.2. Touch therapy
36
9.3. Bioenergetics
37
10. Religious counselling
38
11. Exorcism and spiritual/miracle cures
43
12. Specific forms of Gender Identity Change Efforts (GICE)
45
13. Gender Expression Change Efforts
47
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3. CHAPTER 3 - THE GLOBAL CONSENSUS AGAINST SOGIECE 1.
Survivor groups and civil society organisations
49
2.
Professional associations
49
3.
Religious institutions and organisations against SOGIECE
50
4.
Repudiation of SOGIECE by so-called “ex-gay” leaders
51
4. CHAPTER 4 - OVERVIEW OF SOGIECE PROPONENTS TODAY
53
1.
Religious leaders, organisations and institutions
53
2.
Health care practitioners
54
3.
State-Sponsored Conversion Therapies
55
4.
Court mandated “treatment”
57
5.
Political leaders
58
5. CHAPTER 5 - RIGHTS AT STAKE
59
1.
Freedom from torture
59
2.
Rights to health and psychological integrity
60
3.
Right to life
61
4.
Parental rights
62
5.
Freedom of speech/expression
63
6.
Freedom of conscience and religion
64
7.
Patient autonomy
65
7.1. SOGIECE provided by professionals
66
7.2. SOGIECE provided by non-professionals
66
7.3. Legal approaches to regulating consent to SOGIECE provided by non-professionals
67
7.3.1.
The law should not allow for adult consent
7.3.2.
The law should ‘keep an eye’ on adult consent
7.3.3.
The law should not impair adult consent
6. CHAPTER 6 - STRATEGIES TO RESTRICT SOGIECE 1.
6
49
Legal bans or restrictions on the provision of SOGIECE
71 71
1.1. Are legal restrictions necessary?
71
1.2. Criminal or non-criminal laws?
73
1.3. Who should be prevented from engaging in SOGIECE?
74
1.4. Who should be protected from SOGIECE?
75
1.5. How should SOGIECE be defined?
75
2.
Legal regulation of health care professions
76
3.
Anti-fraud or consumer rights legislation
76
4.
Anti-discrimination law
77
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5.
Child protection law
77
6.
Health insurance legislation and policies
77
7.
Advertising and referrals
78
8.
Public policy
78
9.
8.1. Enforcement agencies
78
8.2. Access to justice
79
8.3. Survivor support
79
8.4. Official Statements against SOGIECE
80
8.5. Withdrawing official support to SOGIECE
80
8.6. Awareness raising
81
8.7. Education
81
8.8. Dialogue with religious institutions
82
The role of NHRIs and other domestic human rights bodies
82
10. The role of the media
83
11. The role of Professional Associations
83
7. CHAPTER 7 - LAWS RESTRICTING SOGIECE 1.
Nationwide legal restrictions in force 1.1. Brazil (1999)
85 85
1.1.1.
Judicial challenges
86
1.1.2.
Legislative attempts to repeal or limit the restriction
87
1.2. Ecuador (2012 / 2014)
87
1.2.1.
Ministerial Agreement No. 767/12
87
1.2.2.
Aggravating circumstances in the Penal Code
88
1.3. Malta (2016)
2.
85
88
1.3.1.
Restrictions for non-professionals
89
1.3.2.
Restrictions for professionals
89
Sub-national restrictions (regions, states and provinces) 2.1. Canada 2.1.1.
90 90
Ontario (2015)
90 90
2.1.2.
Nova Scotia (2018)
2.1.3.
Prince Edward Island (2019)
91
2.1.4.
City of Vancouver (2018)
91
2.1.5.
City of Edmonton (2019)
91
2.2. Spain
92
2.2.1.
Community of Madrid (2016)
92
2.2.2.
Community of Andalusia (2017)
93
2.2.3.
Community of Valencia (2018)
94
2.2.4.
Community of Aragon (2018)
94
2.2.5.
Region of Murcia (2016)
95
2.3. United States of America
95
2.3.1.
California (2012)
96
2.3.2.
New Jersey (2013)
96
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3.
4.
2.3.3.
District of Columbia (2014 and 2019)
96
2.3.4.
Oregon (2015)
97
2.3.5.
Illinois (2015)
97
2.3.6.
Vermont (2016)
98
2.3.7.
Connecticut (2017)
98
2.3.8.
Nevada (2017)
98
2.3.9.
New Mexico (2017)
98
2.3.10. Rhode Island (2017)
99
2.3.11. Delaware (2018)
99
2.3.12. Hawaii (2018)
99
2.3.13. Maryland (2018)
99
2.3.14. Washington (2018)
100
2.3.15. New Hampshire (2019)
100
2.3.16. New York (2019)
101
2.3.17. Massachusetts (2019)
101
2.3.18. Colorado (2019)
101
2.3.19. Maine (2019)
101
2.3.20. Puerto Rico (2019)
102
2.3.21. Utah (2020)
102
Non-explicit / indirect bans 3.1. Oceania
102
3.2. Latin America
103
Caselaw
103
4.1. United States 4.1.1.
Pickup et al. v. Brown et al. and Welch et al. v. Brown et al.
103
King et al. v. Christie et al.
104
4.1.3.
Ferguson et al. v. JONAH et al.
106 106
4.2.1.
Peng v. Xinyu Piaoxiang Psychotherapy Centre
106
4.2.2.
Yu X vs. No. 2 Zhumadian Hospital
107
4.3. Costa Rica 4.3.1.
107 Decision No. 2013-3090
Bills and initiatives under consideration 5.1. Australia
107 108 108
5.1.1.
Queensland
108
5.1.2.
Victoria
109
5.2. Canada
8
103
4.1.2.
4.2. China
5.
102
109
5.2.1.
Federal level
109
5.2.2.
British Columbia
109
5.3. Chile
109
5.4. France
110
5.5. Germany
110
5.6. Ireland
110
5.7. Mexico
110
5.7.1.
Federal level
110
5.7.2.
Mexico City
111
5.7.3.
State of Jalisco
111
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6.
5.8. New Zealand
111
5.9. Poland
111
5.10. Spain (national level)
111
5.11. Taiwan (China)
111
5.12. United Kingdom
111
5.13. United States (federal level)
111
Official Statements by Governmental Bodies or Officials 6.1. Argentina 6.1.1.
112 112
City of Buenos Aires (2011)
6.2. Australia
112 112
6.2.1.
Federal level (2018)
112
6.2.2.
Victoria (2018)
112
6.2.3.
West Australia (2018)
112
6.3. Austria (2018)
112
6.4. Canada
112
6.4.1.
Manitoba (2015)
112
6.5. Chile (2016)
112
6.6. Israel (2014)
113
6.7. Taiwan (China) (2018)
113
6.8. United Kingdom (2017)
113
6.9. Mexico
114
6.9.1.
Federal level (2017, 2018)
114
6.9.2.
Mexico City (2015)
114
6.10. Peru (2019)
114
6.11. United States of America (2015)
114
6.12. European Parliament (EU) (2018)
114
8. ANNEX 1: POSITION STATEMENTS: PROFESSIONAL ASSOCIATIONS AGAINST SO(GIE)CE
115
1.
International 1.1. World Psychiatric Association 1.2. International Society of Psychiatric-Mental Health Nurses 1.3. Pan American Health Organization 1.4. World Medical Association
2.
National/regional level 2.1. Australia 2.1.1.
Australian College of Nurse Practitioners
2.1.2.
Australian Medical Association
2.1.3.
Australian Psychological Society
2.1.4.
Queensland Psychoanalytic Psychotherapy Association
2.1.5.
Royal Australasian College of Physicians
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2.1.6.
Royal Australian and New Zealand College of Psychiatrists (regional)
2.2. Austria 2.2.1.
Austrian Public Health Association
2.2.2.
Austrian Society for Psychiatry, Psychotherapy and Psychosomatics
2.3. Brazil 2.3.1.
Federal Council of Psychology
2.4. Canada 2.4.1.
Canadian Psychological Association
2.4.2.
College of Psychologists of Quebec (regional)
2.4.3.
College of Alberta Psychologists (regional)
2.5. Chile 2.5.1.
Chilean College of Psychologists
2.6. Costa Rica 2.6.1.
Professional Association of Psychologists
2.7. Germany 2.7.1.
German Medical Association
2.8. Hong Kong (China) 2.8.1.
Hong Kong College of Psychiatrists
2.8.2.
Hong Kong Psychological Society
2.9. India 2.9.1.
Indian Psychiatric Society
2.10. Ireland 2.10.1. Psychological Society of Ireland 2.11. Israel 2.11.1. Israel Medical Association 2.11.2. Israel Psychiatric Association 2.11.3. Israeli Adolescent Medicine Society 2.11.4. Israel Pediatric Association 2.11.5. Israel Association of Family Physicians 2.11.6. Israel Child and Adolescent Psychiatric Association 2.12. Lebanon 2.12.1. Lebanese Psychiatric Society 2.13. New Zealand / Aotearoa 2.13.1. Aotearoa New Zealand Association of Social Workers 2.14. Norway 2.14.1. Norwegian Psychiatric Association 2.15. Paraguay 2.15.1. Paraguayan Society of Studies on Human Sexuality 2.16. Philippines 2.16.1. Psychological Association of the Philippines 2.17. Poland 2.17.1. Polish Sexology Society 2.18. South Africa 2.18.1. Psychological Society of South Africa 2.18.2. South African Society of Psychiatrists
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2.19. Spain 2.19.1. General Council of Psychology 2.20. Turkey 2.20.1. Turkish Psychological Association 2.21. United Kingdom 2.21.1.
British Association for Counselling and Psychotherapy
2.21.2.
British Psychoanalytical Council
2.21.3.
British Psychological Society
2.21.4.
National Counselling Society
2.21.5.
Royal College of Psychiatrists
2.21.6.
Association for Family Therapy
2.21.7.
Association of Christian Counsellors
2.21.8.
British Association of Behavioural and Cognitive Psychotherapies
2.21.9.
British Association of Drama Therapists
2.21.10. College of Sex and Relationship Therapists 2.21.11. Psychotherapy and Counselling Union 2.21.12. Royal College of General Practitioners 2.21.13. UK Council for Psychotherapy 2.21.14. National Association of School Psychologists 2.22. United States of America 2.22.1.
American Academy of Child Adolescent Psychiatry
2.22.2.
American Academy of Nursing
2.22.3.
American Academy of Pediatrics
2.22.4.
American Academy of Physician Assistants
2.22.5.
American Counseling Association
2.22.6.
American Federation of Teachers
2.22.7.
American Medical Women’s Association
2.22.8.
Child Welfare League of America
2.22.9.
National Association of School Nurses
2.22.10. National Association of Secondary School Principals 2.22.11. National Education Association 2.22.12. School Social Work Association of America 2.22.13. American Association for Marriage and Family Therapy 2.22.14. American Association of Sexuality Educators, Counselors and Therapists 2.22.15. American College of Physicians 2.22.16. American Counseling Association 2.22.17. American Medical Association 2.22.18. American Osteopathic Association 2.22.19. American Psychiatric Association 2.22.20. American Psychoanalytic Association 2.22.21. American Psychological Association 2.22.22. American School Counselor Association 2.22.23. American School Health Association 2.22.24. National Association of Secondary School Principals 2.22.25. National Association of Social Workers
9. ANNEX 2: REPUDIATION OF SOGIECE BY FORMER PROMINENT PROPONENTS
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FOREWORD
FOREWORD
ILGA CO-SECRETARIES’ GENERAL FOREWORD By Luz Elena Aranda1 and Tuisina Ymania Brown.2
As more and more survivors find the courage and the strength to come forward to share their stories, we are becoming more and more determined to put an end to so-called “conversion therapies”. For centuries we have been told we need to be mended, that we need some kind of fix because we are “evil”, “sick” or somehow “abnormal”. Our gender expression is policed by our parents, siblings, friends, extended family members, community members, and strangers alike even well before we become aware of our own sexual orientation or our gender identity, and from an early age many of us come to learn and internalise that there is something about us that needs to be silenced, concealed or even “corrected”. As archival academic material shows how members of our communities were subjected to the most egregious “medical” procedures in the name of science, we continue to receive reports of equally damaging “therapies” being carried out in the name of religion, culture, and family honour in all corners of the world today. Both brutal and veiled attempts to force us into the hetero-cis binary are still being imposed onto us in the name of religion, culture, science and even compassion. In fact, research shows that religious leaders appear to be among the most outspoken proponents of “conversion therapies” and that
those who seek their services tend to do so motivated by their perceived inner conflict between their religious identity and their sexual or gender identity. Therefore, it is vital that we pay special attention and listen to the members of our communities whose lived experience of faith, religion or spirituality may pose a threat to their well-being and their mental health. Fighting against institutionalized prejudice entrenched in religious institutions should not entail animosity against those of us who are religious and were convinced that being who they are or loving whom they love makes them unworthy of god’s love. When parental decisions related to our upbringing are informed by fear and prejudice, a caring and loving relationship turns into a damaging nightmare with the potential of causing permanent irreparable harm. Children and adolescents are particularly vulnerable to this, either because they can be easily coerced into “conversion therapies” by fearful parents or because false and biased ideas about sexual and gender diversity are systematically instilled into them. Since 2017, State-Sponsored Homophobia has tracked the countries where laws are in force to restrict these harmful practices and, although only 3 UN Member States have nationwide bans thus far, this report shows how considerable progress is being made at various levels. In any case, legal
1
Luz Elena Aranda is a Mexican Bisexual artivist. She studied Dramatic Literature at UNAM and Ethnology at ENAH, in addition to a technical career in Production in Media and Communication at the Ansel Adams Photography School. She is the General Director of Las Reinas Chulas Cabaret and Human Rights AC and Director of the International Cabaret Festival. She has worked in different organizations, including ProDesarrollo, Finanzas and Microempresa (where she developed the theater component for the Methodology for the Incorporation of the Gender Approach in the Mexican Microfinance Institutions MEGIM), Faces and Voices FDS, AC (where she created the campaign against poverty I look, I know, I act), and Oxfam Mexico, where she was a consultant for the project Building an integrated approach to inequality: indigenous peoples, rural populations and women victims of violence in Mexico. She obtained the Leadership Scholarship from the MacArthur Foundation through the Mexican Society for Women's Rights AC (SEMILLAS) and the recognition "Women investing in women" by the same institution. She is part of generation 54 of the Global Women in Management program: Advancing Women's Economic Opportunities sponsored by CEDPA and EXXON MOBIL. Since 2014 she is a member of the ILGALAC Regional Council, ILGA World (Co-Secretary General).
2
Tuisina Ymania Brown is a survivor of 40 years of institutionalised discrimination and spousal gender-based violence, racial profiling, and trans violence and persecution. She lives her truth as a trans woman of colour from Polynesia, a human rights defender and a former corporate In-house Counsel. She practices in trademarks and intellectual property law and holds a Masters of Intellectual Property Law and a Master of Law. She has over 15 years of volunteer experience in international NGOs including: Astraea Lesbian Foundation for Justice (New York, International Advisory Board Member); Global Interfaith Network on Sex, Sexual Orientation, Gender Identity and Expression (Johannesburg, Former Co-Chair); International Trans Fund (New York, CoChair), ILGA World (Co-Secretary General). Born and raised in Samoa, she currently lives as a single parent to two sons in Brisbane Australia.
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FOREWORD
reform is only one of the many avenues that can be explored to tackle so-called “conversion therapies” within a multi-faceted strategy. In this report ILGA World presents a wide array of tools, legal or otherwise, that our member organisations could discuss and eventually incorporate into their strategies to fight “conversion therapies” within their communities.
To all of those who contributed to the production of this report, our deepest and sincere appreciation. To all the survivors, and to those we have lost because of these practices, our heartfelt thank you for bringing your stories to light, so our communities can continue the fight. We issue this report in honour of your courage.
Too many lives have been ruined and many others will be if these inhumane attempts and conversion therapies are not stopped. We launch this report in the hope that these pages will add to raising awareness on this issue and inform debates on how to strategise against these dangerous pseudoscientific attempts that harm our communities so deeply.
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AUTHOR’S PREFACE
AUTHOR’S PREFACE
AUTHOR’S PREFACE By Lucas Ramón Mendos.1
As Andrew Park explains, stigma and prejudice operate to constrain people’s lives through social and legal structures. These place demands on individuals in three different ways: the demand to convert, the demand to hide and pretend, and the demand to downplay. The most strident is the demand to “convert to heterosexuality and to express a gender identity which conforms to local norms”. Criminalisation and attempts at “conversion therapy” are examples of this demand.2 In recent times, legal regulation of so-called “conversion therapies” has become a subject of great interest and controversy. Many complex questions—legal and otherwise—arise when this topic is debated in legislatures, in the media, and even among activists and scholars. Granted, these questions will vary greatly in each community and no one way of tacking this issue will be the “correct” one. This publication does not intend to bring definitive answers for all these questions. Those answers lie within each of our communities and will be the result of debates and efforts informed by local perspectives, strategies, ideas and testimonies. However, as we engage in global conversations, it is essential that we become familiar with some of the main elements and arguments that could be of use when debating this issue.
For too long, too much suffering has been validated or justified in the name of medicine, culture and religion. Much of this suffering was unknown to many us, as the shame that still dominates our lives managed to silence stories of harm, desperation and deep emotional despair. In light of the progress that has already been achieved—and hoping that we may one day be free from the harm produced by the mere existence of “conversion therapies”—ILGA World has decided to produce a report that will hopefully contribute to
1
2
the ongoing discussions on how to legally restrict these harmful pseudo-scientific practices around the world.
Roadmap Chapter 1 of the report deals with the complexities around terminology and explores the underlying assumptions of many of the terms we commonly use when talking about efforts to change a person’s sexual orientation, gender identity or gender expression. In Chapter 2, the report walks our readers through a vast field of practices and techniques that have been used in the past—and continue to be used today—for the purpose of “rendering” lesbians, gays and bisexuals heterosexual, to prevent trans youth from transitioning or make trans people detransition, or to force our gender expressions or roles to fit and align with the social binary stereotypes of masculinity and femininity. Our readers will be able to explore and become aware of how science, culture, religion, prejudice and sheer ignorance have come together to form a disturbing mosaic of damaging, hurtful and even bizarre attempts to erase us from our families and communities. For too long many of these attempts took place (and still occur) under the legitimising cloak of science and, in many places, they still enjoy that impunity. Note: Survivors of these practices may find parts of this chapter upsetting. Chapter 3 provides a quick glance at the global consensus against SOGIECE and the main driving forces behind the progress made thus far in the battle against these pseudo-scientific practices.
Annexes 1 and 2 expand this chapter with a list of professional associations that have repudiated
Lucas Ramón Mendos (he/him) is ILGA World’s Senior Research Officer. He is a lawyer, lecturer and researcher, specialized in international human rights law and sexual and gender diversity issues. He earned his LL.B. degree with a focus on international law from the University of Buenos Aires (UBA) and his LL.M. degree on sexuality and the law from the University of California in Los Angeles (UCLA). He has worked as an attorney with the LGBTI Rapporteurship of Inter-American Commission on Human Rights (OAS) and the Williams Institute International Program. He has served as a defence attorney for asylum seekers with the Office of the Defender General (Argentina) and as an adviser on SOGIESC issues to the Human Rights Secretariat of the Province of Buenos Aires. He has also consulted for LGBTI organisations, including ILGA and RFSL. He is the author of the 2019 State-Sponsored Homophobia report. Andrew Park, A Development Agenda for Sexual and Gender Minorities (Los Angeles, Williams Institute, 2016), 60.
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AUTHOR’S PREFACE
SOGIECE a list of former prominent leaders that have come out to reject their effectiveness and to warn about the harms produced by many of the techniques they created, or they were involved in. Chapter 4 maps the array of SOGIECE proponents as we may find them today. This chapter is just an exploratory exercise and could be further developed to include many more proponents. Chapter 5 is an attempt to map many of the rights that have been discussed when restrictions to these deceptive practices became laws, regulations or position statements, or upon being challenged in local courts. The relevance of many of the arguments discussed in this chapter will greatly depend on elements that lie beyond the scope of this report, such as local legislation and caselaw, constitutional clauses, and even the level of influence of religious laws and regulations in each country. Chapter 6 explores the elements of a multifaceted strategy to restrict SOGIECE including legal bans but going beyond legal reform. Complementary initiatives, legal or otherwise, are explored. Additionally, the role of other relevant stakeholders is also discussed.
Acknowledgements The author would like to heartfully thank Lucía Belén Araque for her unconditional support and assistance during the production of this report. Special thanks go to Enrique Lopez de la Peña for his work and commitment. Insights and support offered by Julia Ehrt were of immense value. The author is appreciative of the support provided by a person who wishes to remain anonymous. Input and assistance provided by Gabriel Gallil, Zhan Chiam, Kseniya Kirichenko, Daniele Paletta, Ymania Tuisina Brown, Bess Hepworth, Rubén López (Acrópili, Spain), Noé Garrigues Mafé (Orienta Valencia), Inna Iryskina, and Denis Znioka were of great use to produce this report. The author would also like to thank André du Plessis, Andrea Ayala, Oscar Noel Fitzpatrick, Kellyn Botha, Paula Kilk and J. Andrew Baker for their insights and comments. Daniele Paletta continued to offer his patience, passion and commitment in assisting the team in the dissemination of this report. The author is particularly grateful for his permanent support.
Chapter 7 analyses the legal restrictions that are currently in force around the world, both at the national and the sub-national level. Our readers will be able to become familiar with how these laws operate, how they protect victims and how they regulate, among other things, the professional conduct of mental health professionals. Additionally, this chapter maps ongoing discussions, initiatives and bills currently under discussion in at least 10 countries at the national level, reviews relevant caselaw from the United States of America, China and Costa Rica and lists a wide array of statements and interventions by governmental bodies and officials against SOGIECE.
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CHAPTER 1 - RELEVANT TERMS
RELEVANT TERMS
CHAPTER 1
RELEVANT TERMS MISNOMERS FOR A MYRIAD OF HARMFUL PRACTICES
There is no one single term consistently and universally adopted to denote attempts to modify a person’s sexual orientation, gender identity or gender expression. Numerous terms of art and colloquial expressions have been used in the past to refer to such attempts and, even today, these terms vary greatly across time and location. One of the few aspects that all of the practices that fall under this category share in common is the fact that they entail efforts with an a priori goal of achieving gender expressions that align with stereotypical binary gender norms, a cisgender identity, and/or heterosexual desire, behaviour or identity.1 In other words, these efforts are not intended to change any given SO/GIE from one to another, as if all alternatives existed on an equal footing. On the contrary, these attempts are certainly not neutral about SOGIE. Rather they work on a logic that conceives anything that deviates from heterosexual or cisgender identities as problematic and undesirable.
1. “Conversion therapy” “Conversion therapy” has nowadays become the common umbrella expression to refer to any sustained effort to modify a person’s sexual orientation, gender identity or gender expression. As most of these efforts were originally conceived in the mid-twentieth century as a response to what was largely considered to be a “pathology”, they were framed and administered in the mental health field as “therapies”. Under such paradigm, heterosexuality and the alignment of the sex assigned at birth with the gender identity was
1
2
3 4 5
understood as “the biologic norm” and sexual diversity was characterized as a deviation, a perversion or a mental illness which could be cured, shifted or “converted” with specific “treatment”.2 However, the are several reasons why the use of this expression can be problematic on various levels: First, common definitions of the word “therapy” refer to any treatment “of a physical problem or an illness”,3 “of someone with a particular illness”,4 or a “treatment that helps someone feel better, grow stronger, etc., especially after an illness”.5 Therefore, using this term to refer to efforts that aim to change a person’s sexual orientation, gender identity or expression implies the idea that these characteristics constitute illnesses or that there is something to “heal” or “cure” in those who are not cisgender, gender conforming or heterosexuals. As it will be developed below, this runs contrary to the medical and social consensus on the matter, especially after these categories were officially depathologised. Secondly, the use of the term “therapy” conveys the idea that these practices are grounded on sound medical or scientific research but, as it will be developed below, an extensive list of reputable medical and mental health professional associations have repudiated these practices precisely because they lack scientific support.
Thirdly, the wide array of practices that were (and still are) employed with the aim of modifying a person’s SOGIE is so vast and diverse that the term “therapy” does not
Substance Abuse and Mental Health Services Administration (SAMHSA) – (U.S. Department of Health and Human Services), Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth (Rockville: SAMHSA, 2015), Appendix A. See, generally: Eli Coleman, “Changing Approaches to the Treatment of Homosexuality: A Review”, American Behavioral Scientist 25, No 4 (1982); Jack Drescher, “I’m Your Handyman: A History of Reparative Therapies” in Sexual Conversion Therapy: Ethical, Clinical and Research Perspectives (New York: Haworth Medical Press, 2001); Tom Waidzunas, The Straight Line: How the Fringe Science of ExGay Therapy Reoriented Sexuality (Minneapolis: University of Minnesota Press, 2015), 35-66. “Therapy”, Oxford Learner's Dictionaries (online edition). “Therapy”, Collins Online Dictionary (online edition). “Therapy” Cambridge Dictionary (online edition).
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accurately reflect the nature of many of the practices involved. This is especially the case when brutal or heinous methods are used. In this sense, the use of the word “therapy” in cases where the “patient”/victim is humiliated, debased, intimidated, abused, or even raped, is clearly inadequate. Last, but not least, the term “conversion” implies the idea that people can actually be changed or “converted”, whereas the efficacy of any of these attempts has been seriously put to question. The expression “conversion practices”6 and other subtle variations like “sexual orientation change therapy”7 or “sexual reorientation therapy”8 are subject to the same caveats. Therefore, in order to explicitly denounce the expression “conversion therapy” as a misnomer and hence question the problematic aspects mentioned above, when using this expression, it is recommended that both words be written between inverted commas or otherwise preceded by the expression “so-called”.
2. “Reparative therapy” Oftentimes used interchangeably with “conversion therapy”, the term “reparative therapy” presents specific nuances that are worth noting. In the late 80s and 90s, when consensus for depathologising sexual and gender diversity was growing, a group of American mental health practitioners adopted the term “reparative therapy” to frame their practices to change a person’s sexual orientation. Led by Joseph Nicolosi, this particular approach is “based loosely on psychoanalytic ideas”9 and includes “a fusion of spiritual and psychoanalytic thought”,
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drawing on literature from the field of pastoral counselling.10 Even though the term “reparative therapy” has been trademarked by Nicolosi in the United States of America,11 it has become widely used to refer to “conversion” practices more generally. The term “reparative” is highly problematic as it conveys the idea that there is something “broken” or “wrong” about a person’s sexual orientation, gender identity or gender expression, “with practitioners acting as if trying to repair or fix them”.12 Therefore, “reparative therapy” should always be written between inverted commas or otherwise preceded by the expression “so-called”.
3. “Gay cure” “Gay cure” is a colloquial term that has become widely used in several countries to informally refer to attempts to change a person’s SO/GIE. It is a short, powerful, catchy expression that has been favoured by the media in journalistic headlines and campaigns.13 For instance, in 2015, All Out launched an online tool called “Gay Cure Watch” that allowed users to easily report where attempts to change SO/GIE were taking place.14 The term “cure” reflects the pathologizing views that support “conversion therapies” and, even though it frames the issue as though it only affected gay men, it is frequently used to refer to “conversion therapies” broadly and regardless of whether the take place in a medical setting or not. As with other problematic terms frequently used to name efforts to change a person’s SO/GIE, it should always be used between inverted commas.
This is the term adopted by the Maltese ban on SO/GIECE, The Affirmation of Sexual Orientation, Gender Identity and Gender Expression Act. Act No. LV of 2016 (2016). See, for example: Marshall Forstein, “The pseudoscience of sexual orientation change therapy” BMJ 328 (2004), e287; Ozanne Foundation, 2018 National Faith & Sexuality Survey (2019), 5, 17, 18. See, for example: Annesa Flentje, Nicholas C. Heck and Bryan N. Cochran, “Sexual Reorientation Therapy Interventions: Perspectives of Ex-Ex-Gay Individuals” Journal of Gay & Lesbian Mental Health 17, No. 3. American Psychological Association (APA), Report of the American Psychological Association Task Force: Appropriate Therapeutic Responses To Sexual Orientation (2009), 22. Jack Drescher, “I’m Your Handyman: A History of Reparative Therapies” in Sexual Conversion Therapy: Ethical, Clinical and Research Perspectives (New York: Haworth Medical Press, 2001), 34. Justia Trademakrs, ”Reparative Therapy” - Trademark Details. Status: 700 – Registered (2018).
Registered as: “Mental health therapy services, namely, voluntary psychotherapy for individuals seeking to explore underlying psychodynamic factors which may have led to the development of unwanted same-sex attractions, in which treatment interventions are directed toward resolution of underlying gender-related traumas reported by the client using evidence-based treatment interventions”. Florence Ashley Torture Isn’t Therapy: Banning Conversion Practices Targeting Transgender People (2020) (under review). See, for example: Owen Jones "Giving the ‘gay cure’ quack a TV platform is an abuse of free speech", Irish Times, 7 September 2017; "The damage done by ‘gay cure’ therapy", The Guardian, 5 June 2019; "Spanish Church defends bishop in 'gay cure' controversy", France 24, 5 April 2019; "Juez brasileño avala las polémicas terapias de "cura gay"", Deutsche Welle, 16 December 2017; "Amazon deixa de vender livros sobre terapia de cura gay", Carta Capital, 15 September 2019. Joseph McCormick, “New online tool launched to eradicate gay ‘cure’ therapies”, Pink News, 23 November 2015.
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4. “Ex-gay therapy” The term “ex-gay therapy” can also be found as an equivalent of “conversion therapies”, especially in informal or journalistic sources. The prefix “ex-” again implies the possibility that sexual orientation can be changed completely (and even consider it as a “status” one used to have in the past). In light of the growing evidence against the actual possibilities of change, many SOGIECE proponents are starting to be more specific and explicit about the aspects of sexual orientation (desire/attraction, behaviour, identity) that they claim can actually be changed. In some cases, they go as far as admitting that same-sex desire/attraction will rarely change, as opposed to same-sex behaviour, which, according to some of them, could be targeted more easily. However, the aspect that can be changed—at least based on the simple decision—is the identity element. Many people who identify as “ex-gay” may have ceased to identify as gay, lesbian or bisexual but may still experience same-sex attraction and may even still engage in same-sex behaviour. Therefore, the term “ex-gay” is problematic in and of itself as it creates a category that validates the idea that sexual orientation is actually modifiable or something that can be “overcome”. In response to this term, those who have denounced SOCE after having suffered its effects may call themselves “exex-gays”.15
5. “Gender critical therapy” Activists and survivors have pointed out that the term “gender critical therapy” is a term used to refer to a form of “conversion therapy” practiced on trans youth: both notions “rely on the same ideas and want the same end results”.16 As it will be developed below, “conversion” practices targeting trans youth include sustained efforts to deter them from transitioning.17 In February 2020, an Irish psychotherapist—who had previously written a chapter for the book “Inventing Transgender Children”, which portrays trans people as an “ideology” and “dangerous”—announced she would
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be creating a list of therapists for parents with transgender children. She said she hated the phrase “gender critical” but she “was making a list!” [sic] anyway.18 As explained by a survivor, “often such ‘therapy’ is performed by putting us in extreme pain, to create an association between who we are and pain to act as a deterrent”.19 Research found that trans people who were exposed to “conversion therapy” before the age of 10 were four times more likely to try to die by suicide over the course of their lifetime than trans people who weren’t subjected to attempts to change their gender identity.20
6. Sexual Orientation Change Efforts
(SOCE)
Since 2009, the American Psychological Association (APA) has adopted the term “Sexual Orientation Change Efforts” (SOCE) to describe all means to change sexual orientation, including behavioural techniques, psychoanalytic techniques, medical approaches, religious and spiritual approaches.21 As stated by the APA, this includes “efforts by mental health professionals, lay individuals, including religious professionals, religious leaders, social groups, and other lay networks such as self-help groups”.22 This term has gained acceptance in the academic field term as it appears to be the most appropriate way to refer to practices aimed at modifying or altering a person’s sexual orientation: it clearly reflects their aims and avoids the misrepresentations explained above. When addressing the issue with technical precision this term should be the preferred way to refer to these practices. SOCE are not designed to change any given sexual orientation from one to another, as if all alternatives existed on an equal footing. On the contrary, SOCE attempt only to “convert” gay, lesbians or bisexuals into heterosexuals. This should be noted as a clear starting point evincing how SOCE are not neutral about sexual orientation,
Annesa Flentje, Nicholas C. Heck and Bryan N. Cochran, “Sexual Reorientation Therapy Interventions: Perspectives of Ex-Ex-Gay Individuals” Journal of Gay & Lesbian Mental Health 17 No. 3 (2013). “Gender critical mental health professionals are trans conversion therapists by another name” The Idependent, 16 February 2020. See also: QuillsQuackings “The wrong side of history”-A response to Graham Linehan” Medium, 12 February 2020. See Section 2.13 in Chapter 2 below. Oisin Kenny, “Graham Linehan calls for list of Irish 'gender critical' therapists for trans children” GCN, 5 February 2020. “Gender critical mental health professionals are trans conversion therapists by another name” The Independent, 16 February 2020. See Section 2.13 in Chapter 2 below. American Psychological Association, Resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts (2009), fn. 1. American Psychological Association, Resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts (2009), fn. 1.
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but rather work on a logic that conceives anything that deviates from heterosexual or cisgender identities as problematic and undesirable.
7. Sexual orientation, gender identity or
gender expression change efforts (SOGIECE)
In this report, the acronym “SOGIECE” will be used to refer to efforts to change a person’s sexual orientation, gender identity or gender expression. This choice should not be understood as the ultimate and definitive way of conceptualising these practices. As discussions on the matter progress in different parts of the world, other terms may be found to more accurately reflect these practices in the future. For instance, it has been recently suggested that the term “change” may not properly reflect how attempts to modify a person’s gender identity actually operate.23 Reference to other terms may also be used, especially if used by sources. As with other terms that have evolved in the past, it is reasonable to expect that the same will occur with the terminology we use today in this specific field of activism.
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See below, Section 2.13 in Chapter 2.
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WHAT FORMS CAN SOGIE CE TAKE?
CHAPTER 2
WHAT FORMS CAN SOGIECE TAKE? Efforts to change a person’s sexual orientation, gender identity or gender expression can adopt a myriad of forms, methods or practices. Hence, capturing the whole universe of techniques implemented to this end in the entire world in an exhaustive way is an almost impossible task. The object of this section is to offer an overview of the methods that have been documented in the past and those that continue to be used at present. However, certain caveats and variables need to be stated and put in context. Historically, medical standards have evolved in a way that certain forms of experimentation and medical practices that were regularly carried out in the name of mental health care, especially in Europe and North America, would under current standards be tantamount to torture and heinous practices. Many SOGIECE proponents, especially in the Global North, are frequently quick to repudiate and to take distance from any of the practices that were used during the times in which “homosexuality” and “transvestism” were treated as mental illnesses. They often argue that those who oppose SOGIECE try to intentionally conflate those “archaic/barbaric” techniques with their “psychotherapeutic” approach, so as to create confusion and push for restrictive legislation in the political arena.
However, despite the fact that a number of the practices that will be described below abhor current medical standards and have been deprecated and explicitly rejected by numerous professional associations,1 there is a large grey area between the methods that have been effectively abandoned and those that continue to be used to this day. In fact, in recent years numerous reports showing that many of these heinous practices are still being administered in several countries in different regions of the world have become known thanks to the tireless efforts and advocacy work carried out by survivors and activists. The global scope of this report poses an additional challenge in this regard. Academic literature on the
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issue—mostly produced in the English-speaking Global North—cannot be used to draw conclusions on how the situation is understood in the entire world today. When reading about the type of practices that “patients”/victims were subjected to in the mid-50s and 60s, it may be easy to assume that such brutal attempts definitely belong in the past. For instance, the idea of patients being electroshocked in public hospitals to eliminate their same-sex attractions is likely to appear unrealistic to many people. However, the recent court cases brought before the Chinese judiciary show that such “treatment” is still taking place, to cite just one single example. Moreover, although many of these practices were widely documented by professionals in the past, it has become increasingly difficult to access information on the extent to which these “therapies” are being carried out these days. Therefore, a wide array of different sources needs to be consulted in order to get a clearer image of the current situation worldwide.
This includes judicial decisions, transcripts of judicial proceedings, accounts by victims who were able to survive SOGIECE and share their stories in public hearings or to the media, journalistic investigations that have gone undercover to penetrate the often opaque field in which practitioners operate, and reports by human rights organisations working on the ground, among many others. Another particular aspect of the overview that is presented in this section has to do with the large scope of providers of these efforts to change a person’s SO/GIE. The list of methods described below includes attempts carried out by medical doctors, mental health practitioners, counsellors, nurses, religious or spiritual leaders, coaches and non-professionals in general. The methods, procedures, standards and the paradigm under which they operate will vary greatly in each case. Additionally, much of the focus and discussions around “conversion therapies” (as stated above, frequently referred to as “gay cure” or “ex-gay therapy”) has frequently revolved around attempts to “make gay people straight”. However, the issue
For a list of associations that have adopted position statements against SOGIECE, see Annex 1 of this report.
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of SOGIECE affects lesbian and bisexual women, trans people and gender diverse children and adults alike, albeit in different ways. As with other aspects of cis-heteronormative oppression, research on the impact on these populations is not abundant and discussions are still ongoing. As explained by Jack Drescher: Many cultures routinely conflate homosexuality with transgender identities because they rely upon several beliefs that use conventional heterosexuality and cisgender identities as a frame of reference. Once regarded as synonymous, it is only relatively recently that sexual orientation [...] and gender identity [...] have been regarded as separate categories.2 Additionally, gender expression also tends to be conflated with a person’s sexual orientation or misrepresented as a definite predictor of how a child will identify or behave as an adult, especially among SOGIECE proponents. Indeed, under this logic, a large number of so-called “conversion therapies” target gender non-conformity in an attempt “to prevent homosexuality”. As it will be analysed below, gender non-conformity in children and lack to adherence to stereotypical gender roles are among the reasons why many parents force their children to undergo SOGIECE. These preliminary observations offer an idea of how vast and complex this issue can be.
The broad category of SOGIECE encompasses so many different practices, techniques and conducts — including acts which are of an evident criminal nature—that it is impossible to think of one single way by which this phenomenon can be tackled.
1. Pathologisation of sexual and gender
diversity
Even though an in-depth analysis on the issue of pathologisation is beyond the scope of this report, it should be noted that the paradigm under which any form of sexual or gender diversity is considered a “pathology”, a “deviant” or “abnormal behaviour”, or even a “perversion”, provides the basis for the
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search for “cures” or “treatment” to “reverse” people into “normalcy”. Pathologisation can be defined as “the psychomedical, legal and cultural practice of identifying a feature, an individual or a population as intrinsically disordered”.3 With the advent of secular societies, and especially since the late 19th century, scholars explain that science took the role of casting a critical eye on a range of “socially unacceptable behaviours”. Hence, many conducts that had been considered “sins” under moral or religious beliefs would eventually come to be classified as illnesses, including “homosexuality” and later on “transvestism”, among many others.4 Under this paradigm, largely driven by the Global North, sexual and gender diversity would be framed as manifestations of a set of mental illnesses that could be “cured” if “underlying causes” were properly treated. Outright speculation and questionable research informed most professional fields and led to a profusion of academic literature elaborating on the ultimate causes of “sexual deviancy”, which mainly revolved around the idea of “unconscious childhood conflicts”, developmental “arrest”, sexual abuse, dysfunctional parenting, among many others.
As it will be outlined below, much of this literature led to experimentation with human beings and to the administration of “therapies” that have caused irreparable harm and unmeasurable suffering, ruining or putting an end to the life of millions of people. The process of depathologisation progressively gained momentum in the Global North in the mid and late twentieth century, especially after homosexuality was depathologised in 1973 in the United States of America and then internationally, by the World Health Organisation (WHO), in 1990. For diverse and gender expressions and under the auspices of the WHO, the process started much later and is still ongoing and far from conclusive.5 However, the global picture of depathologisation is far more complex. Even though the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association may be considered a reputable source in many countries, the process advanced in the United States cannot be taken as a global standard. Additionally, despite
Jack Drescher, “Queer Diagnoses: Parallels and Contrasts in the History of Homosexuality, Gender Variance, and the Diagnostic and Statistical Manual Article” Archives of Sexual Behavior 39 (2010), 440. Sheherezade Kara, Gender is not an illness. How pathologizing trans people violates international human rights law (GATE, 2017), 4. For an overview of the history of pathologisation of sexual and gender diversity, see: Jack Drescher, “Queer Diagnoses: Parallels and Contrasts in the History of Homosexuality, Gender Variance, and the Diagnostic and Statistical Manual Article” Archives of Sexual Behavior 39 (2010). See, generally: Sheherezade Kara, Gender is not an illness. How pathologizing trans people violates international human rights law (GATE, 2017).
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the steps taken by the WHO at the international levels, many countries kept (and still keep) pathologising many forms of sexual and gender diversity under their own national compendiums of illnesses. To cite only a few examples, in China, “homosexuality” was removed from the Chinese Classification of Mental Disorders (CCMD-3) in 2000,6 and in Lebanon, the Lebanese Psychiatric Society followed suit only in 2013.7 Further, there is only a handful states on the globe that depathologised gender diversity—among them Argentina or Malta—and, even with such measures, pathologising practice has not yet eradicated in those countries. Even more, in the case of sexual orientation, when homosexuality was removed from the DSM and the International Classification of Diseases (ICD), a residual pathology was introduced to frame the situation of people who suffered stress or were otherwise “troubled” by their sexual orientation. In the case of the DSM, this pathology was named “Sexual Orientation Disturbance (SOD)”8 and in the case of the ICD it was called “Ego-dystonic Homosexuality”.9 These pathologies were removed only in 1987 (from the DSM-III-R)10 and in 2018 (for the ICD-11).11 Many efforts aimed at changing a person’s sexual orientation were (and still are) “justified” under these clinical classifications.
Indeed, the Chinese CCMD-3 still lists “egodystonic sexual orientation” as a mental disorder.12
2. Early attempts: bicycle riding,
lobotomy and castration
Early attempts to “cure” homosexuality can be traced back to the late 19th century. In 1892, an
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American doctor formally reported that he had found nothing “more serviceable” to a young man suffering from “sexual abnormality” than bicycle riding. Therefore, he prescribed “severe and fatiguing bicycle riding” and found that the “patient”/victim’s sexual appetite was thereby eliminated.13 Even though there are no extensive records on the widespread use of lobotomy (also referred to as “leucotomy”) to “treat” gays or lesbians to modify their sexual orientation, in the United States, trans or gender diverse people appear to have been the primary target of this practice. Documented cases show that lobotomies were performed on “homosexuals” when other factors were the primary target such as “marked cross-gendered behaviour”.14 During the Nazi regime, both before and during World War II, attempts to find a “cure” to homosexuality led to experimentation with gay men, especially through hormonal treatment (see below). However, a pre-war report by Friedemann Pfäfflin analysed 600 cases of castration of homosexual men, including 120 “volunteers”, and emphasized its “beneficial and therapeutic effects”.15
3. Hormone intake Early endocrinological research during the 1930s led doctors to hypothesize that lesbian women had lower levels of oestrogens and higher levels of testosterone than “normal” women (and the reverse for gay men). Even without any serious support for the idea that hormones affected sexual
Sing Lee, “From Diversity to Unity: The Classification of Mental Disorders in 21st Century China” Psychiatric Clinics of North America 24, No. 3 (2001), 421. Arab Foundation for Freedoms and Equality: Nour Nasr and Tarek Zeidan, As long as they stay away” Exploring Lebanese Attitudes Towards Sexualities and Gender Identities (2015), 16. Jack Drescher, “Out of DSM: Depathologizing Homosexuality”. Behavioural Sciences 5, No. 4 (2015): “SOD regarded homosexuality as an illness if an individual with same-sex attractions found them distressing and wanted to change. The new diagnosis legitimized the practice of sexual conversion therapies (and presumably justified insurance reimbursement for those interventions as well), even if homosexuality per se was no longer considered an illness”. Susan D Cochran et al., “Proposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11)” Bulletin of the World Health Organisation (WHO) 92, No. 9 (2014). Jack Drescher, “Out of DSM: Depathologizing Homosexuality”. Behavioural Sciences 5, No. 4 (2015).
Susan D Cochran et al., “Proposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11)” Bulletin of the World Health Organisation (WHO) 92, No. 9 (2014). China LBT Rights Initiative, Discrimination Faced By Lesbian, Bisexual and Transgender Women in China (2014), 2 (The report also adds that China’s mental health educational and information materials still commonly describe homosexuality as a perversion, despite the 2001 revision to the CCMD). Timothy F. Murphy, “Redirecting sexual orientation: Techniques and justifications” The Journal of Sex Research 29 No. 4 (1992), 502 (citing Graeme. M. Hammond, “The bicycle treatment in the treatment of nervous diseases” Journal of Nervous and Mental Disease VIII, Vol. XIX (1986 reprint) (1892) 34-46). Vernon A. Rosario, Homosexuality and Science: A Guide to the Debates (Denver and London: ABC CLIO, 2002), 97. Florence Tamagne, A History of Homosexuality in Europe: Berlin, London, Paris 1919-1939, Volume II (2004), 387.
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orientation, hormonal therapy was extensively prescribed for “sexual perverts”.16
gets cured” and an upfront payment of Rs 1.1 lakh.22
Experimentation with hormonal treatment was also used by doctors in the German Third Reich. Experiments on prisoners to find a “cure” for homosexuality were mainly conducted in Buchenwald concentration camp, led by Danish physician Carl Peter Jensen (alias Carl Vaernet). Gay prisoners were implanted a metal capsule which contained a hormonal preparation that was supposed to act as an “artificial male sexual gland” that would “normalize” sexual orientation.17 These experiments were not explicitly mentioned during the Nuremberg trials, and Vaernet escaped to South America, where he was eventually hired by the Argentine Ministry of Health.18 It is believed that his experimentation with gay men was known to the Allies, who allowed him to escape, and that he continued experimenting with hormonal treatment to “cure” homosexuality until his death in Buenos Aires in 1965.19
As a mere example of how prevalent misinformation about sexual orientation can still be, a survey conducted in Lebanon in 2015 found that around 79% of respondents thought homosexuality was a “hormonal sickness” and agreed that homosexuals “should be taken in for psychological or hormonal treatment”.23
In South Africa, an extensive report published in 1999 called “The Aversion Project”, revealed that during apartheid years medical personnel working with South African Defence Force subjected white gay and lesbian personnel to brutal forms of “treatment” to “cure” their homosexuality, including systematic hormonal treatment.20 The head of the program, Colonel Aubrey Levin, former chief psychiatrist at the Voortrekkerhoogte military hospital, fled to Canada when the apartheid system crumbled.21 As recently as 2015, a journalistic investigation in India led by Mail Today revealed that hormonal treatment was still being prescribed in Delhi. Sexologist Vinod Raina, who claimed to have “cured over 1,000 homosexuals” in the past 15 years, was reported offering a hormone replacement therapy package, promising a “100 per cent cure”. According to the local media outlet, the “treatment” required a six to nine-month contract “until the boy
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4. Aversion therapy Aversion therapy is a type of treatment that aims at modifying behaviour by subjecting a person to a negative, painful or otherwise uncomfortable sensation while being exposed to a certain stimulus, under the premise that the stimulus will become associated with the negative sensation. The use of aversion therapy to “cure” homosexuality has been profusely documented, especially since the mid1930s in the United States and in Britain.24 Not only did these procedures expose “patients”/victims to traumatic and life-threatening techniques but they also proved to be highly unsuccessful. Many victims have reported suffering severe mental health problems as a consequence of these “therapies”, including anxiety, depression, and post-traumatic stress disorder, requiring further treatment from supportive mental health professionals. Most of the academic literature documenting extreme forms aversion therapies taking place in mental health facilities or hospitals in the United States and the United Kingdom was mainly produced between the 1940s and 1960s, when “homosexuality” and “transvestism” were officially considered mental illnesses. Even though these “therapies” have seen a sharp decline in use in the
Vernon A. Rosario, Homosexuality and Science: A Guide to the Debates (Denver and London: ABC CLIO, 2002), 95. Florence Tamagne, A History of Homosexuality in Europe: Berlin, London, Paris 1919-1939, Volume II: Appendix IV, Dr. Carl Vaernet’s Experiments at Buchenwald (2004), 427. Gunter Grau, Günter Grau and Claudia Schoppmann, Hidden Holocaust?: Gay and Lesbian Persecution in Germany, 1933-45 (Taylor & Francis, 1995), 291. “The Nazi doctor who experimented on gay people – and Britain helped to escape justice”, The Guardian, 5 May 2015; Dolores Curia, “El siniestro Doctor No", Pagina/12, 13 June 2014. Mikki van Zyl et al., The Aversion Project: Human rights abuses of gays and lesbians in the South African Defence Force by health workers during the apartheid era (Cape Town: Simply Said and Done, 1999), 85; Robert M Kaplan, “Treatment of homosexuality during apartheid: More investigation is needed into the shameful way homosexuality was treated” BMJ 329, No. 7480 (2004): 1415-16. Ana Simo, “South Africa: Apartheid Military Forced Gay Troops Into Sex-Change Operations”, The Gully, 25 August 2000. Sangeeth Sebastian and Kumar Vikram, “Mail Today Exclusive: Delhi doctors use electric shock to treat homosexuality” India Today, 27 May 2015.
Arab Foundation for Freedoms and Equality: Nour Nasr and Tarek Zeidan, As long as they stay away” Exploring Lebanese Attitudes Towards Sexualities and Gender Identities (2015), 16. M. P. Feldman and M. J. MacCulloch, Homosexual Behavior: Therapy and Assessment (Oxford, Pergamon Press, 1971), 26.