The inherent harm of conversion therapy

Tom Doyle

Dr Doyle is postdoctoral fellow at the Indiana University Center for Bioethics in Indianapolis, Indiana. He is a philosophically trained phenomenologist interested in illness experiences as well as issues of justice and harm within healthcare.

“Conversion therapy” most commonly refers to a set of practices whose aim is to change or “convert” non-heterosexual individuals into heterosexual individuals (although it can also include the set of practices whose aim is to convert non-gender conforming and/or queer individuals into gender-conforming, non-queer individuals). At present, many nations and jurisdictions are in the process of deciding whether or not to ban the practice in light of the numerous accounts of the harmful effects of Conversion Therapy. Recently, two films—Netflix’s Pray Away and Chronicle Cinema’s Conversion—have highlighted these harms by gathering the powerful testimony of survivors of Conversion Therapy.

While some legislators are hesitant to ban Conversion Therapy, the consensus in the scholarly literature is that it is both ineffective and harmful.¹ No rigorous, empirical studies have determined Conversion Therapy to be an effective intervention (i.e., it does not work) and a 2022 review of empirical studies revealed that it often resulted in psychological distress, depression, substance use disorder, and even attempted suicide amongst LGBTQ individuals who were subjected to it.²

When considering the harms associated with Conversion Therapy, we have not only to consider harmful effects (e.g., psychological distress, depression, substance use disorder, suicide) but also inherent harms. To color this distinction a bit more, a harmful effect refers to an injury suffered due to Conversion Therapy, whereas an inherent harm refers to the harm inherent in the practice of Conversion Therapy itself. For instance, riding a bicycle too fast might have the harmful effect of colliding with something and injuring oneself but we would not say that speeding along on a bicycle is inherently harmful. On the other hand, torture would be inherently harmful because regardless of how one performs the torture, harm will be done to an individual. I believe that much empirical work has been done to show that Conversion Therapy has harmful effects but there has been relatively minimal theoretical work done to show how it is inherently harmful. So, in response to this, I hope to briefly show how Conversion Therapy is inherently harmful.

To do this, I’ll first identify the immediate harm that is done to persons who are subjected to Conversion Therapy. General conceptions of human rights often center around the notion that persons ought to be allowed both negative and positive freedoms. That is, they ought to be afforded freedom from certain things and freedom to certain things. In more specific terms, conceptions of human rights indicate that persons ought to be free from suffering as well as free to pursue their own well-being. It should be noted that these freedoms require some context-dependent interpretation. In other words, not all persons share the same notion of what counts as “well-being” or “happiness”. As a result, positive freedom generally requires a respect for how each individual person pursues their life-affirming activities.

And so, each person pursues an interpretation of themselves in order to determine what is meant by a sense of happiness or sense of well-being for themselves. Insofar as we wish to promote a human being’s innate right to happiness or well-being, then, we must protect their right to interpret themselves as they are so that they can pursue, ponder, and plot out a set of actions or goals that will provide meaning and happiness within the context of their life.

This right to an interpretation of oneself, is what we might call a “hermeneutical right”. Our existence, in general, contains numerous hermeneutical rights—to give a mundane example, I have the hermeneutical right to interpret myself as left-handed. To encroach upon someone’s hermeneutical right amounts to what Miranda Fricker refers to as “hermeneutical injustice” since it would be a wrong done to them as a person capable of interpreting their experience and thereby diminish their ability to pursue, ponder, and plot out their own life.³ Following with the mundane example, to have someone tell me that I’m not left-handed and to no longer lead my life as a left-handed person would be harmful to me because I would no longer be able to interpret myself as I truly and authentically am.

I think we can now see how Conversion Therapy is inherently harmful. Its aim is to bring into question whether a person has interpreted themselves correctly. Conversion Therapy’s goal is to essentially state: “you’re wrong about interpreting yourself as a non-heterosexual person”. Such questioning essentially amounts to gaslighting one’s self-interpreted identity and this gaslighting is inherently harmful because it directly infringes upon one’s hermeneutical right. So, regardless of if Conversion Therapy could ever be defined as “successful”—if it could actually “convert” people—it nevertheless would still be harmful because it is grounded in an inherently harmful practice. Given this, one might hope that more governments take the necessary steps in protecting their citizens from Conversion Therapy.

References

1.           Jowett, Adam, Brady, Geraldine, Goodman, Simon, Pillinger, Claire, Bradley, Louise. Conversion therapy: an evidence assessment and qualitative study. GOV.UK. Published June 2021. Accessed January 31, 2023. https://www.gov.uk/government/publications/conversion-therapy-an-eviden…

2.           Forsythe A, Pick C, Tremblay G, Malaviya S, Green A, Sandman K. Humanistic and Economic Burden of Conversion Therapy Among LGBTQ Youths in the United States. JAMA Pediatr. 2022;176(5):493. doi:10.1001/jamapediatrics.2022.0042

3.           Fricker M. Epistemic Injustice: Power and the Ethics of Knowing. Oxford University Press; 2007.