Since at least a decade ago, a rare consensus has prevailed on a provocative issue for L.G.B.T.Q. people. Professional counseling aimed at changing the sexual orientations of gay teenagers, sometimes known as conversion therapy, was viewed as harmful and widely rejected.
The American Medical Association dropped support for programs offering gay patients “the possibility of sex preference reversal” in 1994. In 2009, the American Psychological Association concluded that “sexual orientation change efforts” could be harmful, inducing “depression, suicidal ideation, self-blame, guilt and loss of hope” in some people. A few years later, Exodus International, the largest Christian ministry promising to “cure” homosexuality through prayer and psychotherapy, closed after its leader apologized to gay men and lesbians and said he no longer believed people could rid themselves of those desires.
State legislatures took notice. Between 2012 and 2024, roughly half of states placed restrictions on therapy for minors that “attempts or purports to change an individual’s sexual orientation or gender identity,” in the words of Colorado’s statute. Eight of the therapy bans were signed by Republican governors, and dozens of cities and counties adopted similar limitations.
But as debates over gay rights have given way to a national focus on transgender identities, questions about what sorts of therapy should be off-limits for L.G.B.T.Q. youth are being revisited. Some groups are pushing for talk therapy that steers children and adolescents who identify as transgender to live in accordance with the sex they were assigned at birth. This push, which is playing out in legislatures and courts, and fueling discussion among mental health professionals and parents, has led to a new round of sparring over whether such therapy would inflict the sort of harm on minors that led experts to reject conversion therapy for gay and lesbian teenagers.
Kelsy Burke, a sociologist at the University of Nebraska, Lincoln, who has tracked public opinion polling on how Americans view L.G.B.T.Q. rights, said the shift in the consensus around such talk therapy reflected a growing discord over the nature of transgender identity.
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