Alana Chen was 24-years-old when she took her own life after years of trying to become straight in a process known as conversion therapy, or a set of pseudoscientific or religious practices with the goal of turning LGBTQ+ people cis and straight.
Chen had confided to her priest that she was attracted to other girls when she was 14-years-old. The priest started meeting with her regularly to turn her straight and told her not to tell her parents. After she turned 18, she started going to a Christian counseling center with the goal of turning straight, and attended a conference organized by the Archdiocese of Denver about “healing the sexually and relationally broken” in order to “overcome homosexuality.”
Eventually, when her family saw the scars on her arm – including where she had cut the word “DEFILED” into her arm – she was hospitalized.
“I think the church’s counsel is what led me to be hospitalized,” she said in a haunting interview that was conducted shortly before she died. She had just left conversion therapy and was starting to speak out against it. “I was feeling so much shame that I was comforted by the thought of hurting myself.”
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“I felt a lot of shame and anxiety…. I couldn’t sleep. I couldn’t stop thinking about it. Was I going to hell?”
Chen’s experiences are not out of the norm. Conversion therapy has been studied for decades, and it’s associated with elevated risks of anxiety, depression, substance abuse, low self-esteem, and suicidality. Major medical associations like the American Medical Association, American Psychiatric Association, and American Psychological Association have issued statements opposing the practice.
The Supreme Court just issued its decision in Chiles v. Salazar – a First Amendment challenge to Colorado’s conversion therapy ban – where a majority of the justices agreed that conversion therapy bans violate free speech rights. Chen’s mother, Joyce Calvo, was one of the parents of conversion therapy victims who filed an amicus brief in the case, asking the Court to allow Colorado to keep its conversion therapy ban in hopes of stopping future tragedies.
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That conversion therapy ban, Colorado’s Minor Conversion Therapy Law (MCTL), was signed into law the same year that Chen died, but it would not have been able to prosecute any of the people who practiced conversion therapy on her. It applied only to conversion therapy practiced on minors, and she only started attending conversion therapy in an organized program when she was 18-years-old. Moreover, the law only applied to licensed mental health professionals, and Chen, like most of conversion therapy’s victims, got conversion therapy from religious figures, including her priest, when she was in high school.
It’s not just Chen’s abusers who would have escaped prosecution under the MCTL. Colorado did not prosecute anyone for violating its conversion therapy ban in the seven years that it was in effect. That makes sense, as licensed therapists are trained not to impose their worldviews on clients, and people with academic training in psychology are unlikely to believe that LGBTQ+ identities can be changed if a queer person is made to feel bad about who they are.
What was at stake in the case wasn’t whether therapists would or would not be legally allowed to practice conversion therapy in the 27 states and hundreds of municipalities that banned it. Licensed therapists aren’t practicing it, while people who aren’t licensed therapists continued to practice it without interference from the law.
“The term ban is inaccurate. Show me one conversion therapist who has been put out of business because of these laws.”
Anti-conversion therapy activist Wayne Besen
As anti-conversion therapy activist Wayne Besen put it in an interview with LGBTQ Nation, no conversion therapy practice in the U.S. was ever “put out of business because of these laws.”
What the right cares about here are the messages these laws send just by being on the books. These messages include the idea that sexual orientation and gender identity can’t be intentionally changed, that LGBTQ+ people exist and will always exist, that it’s dangerous to even try to change one’s sexual orientation or gender identity, and that heterosexuality is not the default state for all people.
This case was not an attempt by a conversion therapy practitioner to protect her job. Nor was it a free speech crusade against government interference in political speech – nothing in the MCTL banned a therapist from advocating for conversion therapy in their spare time. This was an ideological battle about the ideas expressed by the government through conversion therapy bans.
The ultimate goal of the anti-LGBTQ+ movement is the nonexistence of queer and trans people
Just last week, Elon Musk shared a post on X complaining about how various oppressed groups are “destroying the West.” The post claimed that all these groups were learning to “hate” the dominant group.
That is, except for LGBTQ+ people. The post accused every other group of learning to “hate,” while its beef with LGBTQ+ people was simply that they exist.
It reminded me of a similar post from right-wing blogger Michelle Malkin that I stumbled across decades ago (thankfully, it has been lost to the sands of time), where she complained that newspaper comics were becoming too “politically correct.” She whined that comics were full of people of color talking about racism, women with jobs outside the home, and teenagers being gay.
While I disagreed with her on all those points – those are all good things! – it stood out to me that her problem with the first two groups was what they were doing, while her issue with gay people was just the fact that they were existing.
It’s something that, once you notice it, you can’t un-notice it. It underpins everything the anti-LGBTQ+ movement does. For example, in the early 2020s, right-wing activists tried to exert greater control over school curricula. To this end, they passed laws that banned teaching accurate histories of Black people in the U.S., claiming that teaching about the history of racism makes white people feel bad. They also passed “Don’t Say Gay or Trans” laws banning any mention of LGBTQ+ people in front of students, especially in younger grade levels, claiming that parents have a right to prevent their children from knowing that queer and trans people exist, a right they don’t claim about any other group of people. The idea that anyone would have the right to keep knowledge of an entire class of people – say, left-handed people or women – away from their kids is absurd when applied to any group of people other than LGBTQ+ people, but for LGBTQ+ people, it’s just a matter of “parental rights.”
The same logic can be found in right-wing activism on any LGBTQ+ issue, from gender-affirming care bans to marriage rights to ending protections against discrimination. The argument’s basic form, when stripped of any language that hides the actual point, is that if society affords some protection or right to LGBTQ+ people, then that will just encourage more people to become gay or trans. In short, anti-LGBTQ+ forces don’t want to make LGBTQ+ people do or not do anything; they want LGBTQ+ people to stop existing.
That is what conversion therapy is built on. The premise is that LGBTQ+ people should not exist, something that its victims are told they have to agree with in order to start treatment to erase a part of themselves, and that premise is built into every step of the conversion therapy process. Conversion therapy victims have to want to turn straight/cisgender in order to enter into it, they have to say that they aren’t gay or trans as part of the treatment protocol, they will then claim that they are at least celibate or “saved” – if not actually straight or cis – when they’ve been through it, and then anti-LGBTQ+ activists can hold htem up as proof that other LGBTQ+ people who haven’t been through conversion therapy don’t have to be queer or trans and are effectively choosing to remain queer or trans.
And while conversion therapy is a practice that happens in a room with a therapist (or a member of the clergy or a lay religious leader or a quack in a basement…), it’s part of a spectrum of behaviors intended to eliminate LGBTQ+ identities from public life, either by converting LGBTQ+ people to cis-het people or at least getting LGBTQ+ people to stop publicly identifying as such.
Conversion therapy, then, is an integral part of a larger cultural phenomenon
A brief history of conversion therapy
Conversion therapy is as old as the scientific examination of homosexuality. The word “homosexuality” was first used in the mid-19th century. As historian Michel Foucault described in his History of Sexuality, prior to this time, a man who engaged in same-sex activity would have been seen as a person who committed the sin of sodomy. But with the involvement of the medical and scientific community, he became a new “species,” a homosexual, a kind of person defined by his same-sex activities. (Early gay rights activist Harry Hay would note that this distinction lingered into the mid-20th century. In his biography, he discussed how difficult it was to organize gay men when many in the 1950s didn’t view their sexuality as part of their identity.)
The person who popularized the term “homosexuality” was German psychiatrist Richard von Krafft-Ebing in his 1886 sexology book Psychopathia Sexualis. The book brought the word into the medical mainstream and described it as a degenerative illness, suggesting that homosexuality could be cured through hypnosis. The idea of being gay was used as a means of describing conversion therapy, something that couldn’t exist if homosexuality were simply a behavior that anyone could engage in, unrelated to their psyche or personality or fundamental “sexual instinct.”
Homosexuality had to become something one can be so that the idea of eliminating it – of making it not exist – could be comprehensible.
(To be fair to Krafft-Ebing, by the end of his life, he believed “homosexuality was the equivalent of heterosexuality and therefore not a psychoneuropathic degenerative illness” and could not be changed.)
Conversion therapy practices diversified in the 20th century, with mental health professionals trying hormone therapy, electroshock treatments, aversion therapy, and even lobotomies. Over time, the attempts to cure homosexuality became more painful and exotic, likely because none of the less invasive options were working.
But the last few decades of the twentieth century saw conversion therapy get moved to the margins. In 1973, the American Psychiatric Association (APA) delisted homosexuality as a disorder as a growing scientific consensus determined that homosexuality was more common than previously thought and that gay people could live happy and productive lives. The decision was based on the research of people like Alfred Kinsey and Evelyn Hooker, as well as a generational change in the leadership of the APA and gay activism. Fourteen years later, the same organization got rid of its diagnosis for “ego-dystonic homosexuality,” a label for patients who were distressed about being queer that was used to justify conversion therapy. In 1998, the APA issued a statement opposing conversion therapy. Other major medical associations did as well at around this time. By the late 2000s, researchers who had once said that sexual orientation could possibly be changed took back their previous support for the practice.
In the 1990s, several psychologists who still believed in conversion therapy launched the National Association for Research & Therapy of Homosexuality (NARTH), an organization intended to promote conversion therapy based on secular practices and arguments, while conversion therapy practices moved into the religious sphere. Exodus International, a Christian conversion therapy organization founded in the 1970s, found its heyday in the 90s as mainstream psychology turned against conversion therapy.
Conversion therapy moved out of the mainstream and into the margins
“We were asked to sit across from this empty chair and imagine our fathers in the chair, because of the stereotypes that gay men always hate their fathers or have a bad relationship with them. We had to sit across from this empty chair and yell at this father and say, ‘Oh, I hate you. You’ve done all this to me.’ I remember thinking, ‘Why am I being asked to hate my father?’”
Conversion therapy survivor Garrard Conley
Briefs filed in Chiles that describe survivors’ experiences over the past several decades have a few common threads: Counselors generally tell survivors that their sexuality or gender identity resulted from something bad that happened to them in the past that caused them to deviate from the default of heterosexuality and cisgender identity.
One of the theories commonly espoused is the pseudo-psychoanalytic argument that people become queer due to early childhood experiences, like an overbearing mother and an absent father for male homosexuality, that cause a person to identify with the parent of the wrong gender (homosexuality, here, is a form of gender inversion just like trans identity).
Garrard Conley, who wrote the book that inspired the 2018 movie Boy Erased, said that his conversion therapy program blamed his sexuality on “deficient parenting” and that he “needed to recognize that he hated his father in order to be healed,” according to one amicus brief filed in Chiles.
“We were asked to sit across from this empty chair and imagine our fathers in the chair, because of the stereotypes that gay men always hate their fathers or have a bad relationship with them,” he told Men’s Health. “We had to sit across from this empty chair and yell at this father and say, ‘Oh, I hate you. You’ve done all this to me.’ I remember thinking, ‘Why am I being asked to hate my father?’”
Conversion therapy programs with a more modern framework might blame some kind of trauma. Participants are told that they are queer because of a traumatic childhood experience, often sexual abuse. If they don’t remember any such abuse, they are told to think harder because they buried the memory. One gay man interviewed in a study was told to hit a box with a baseball bat to “get the anger that they repressed at the time out, and then the idea was that same sex attraction would shift because of this anger that had been repressed and stored.”
Last, these programs often involve more explicitly religious practices, such as prayer and exorcism. Of course, these were not mentioned in the plaintiffs’ arguments in Chiles because the point was to get a mainstream – that is, secular – endorsement of conversion therapy as a scientifically plausible practice.
Throughout each of these methods, the act of saying that one is not gay is key. Conversion therapy programs discuss “same-sex attraction” instead of using identity-based language. Even while a person may experience such attraction and even engage in same-sex activity, they are told that they should “name it and claim it,” that is, claim their heterosexuality and say that they are heterosexual, and be the person they want to be, a sort of affirmation that lets them will heterosexuality into reality through faith.
In 2013, Exodus International closed down, a year after its president renounced conversion therapy and apologized for the “pain and hurt” conversion therapy survivors had gone through. That same year, New Jersey and California became the first two states to pass conversion therapy bans, further pushing the practice out of the mainstream. Twenty-five other states would follow suit over the next decade.
But those bans, at least in the U.S., all contained two major exemptions. First, conversion therapy practiced by anyone who was not a licensed mental health professional is not affected by the laws. That included members of the clergy, religiously affiliated organizations, as well as independent and sometimes secular charlatans. This exemption was seen as necessary to avoid courts invalidating these laws on Free Exercise grounds.
Second, the laws only applied to children, under the (now disproved) idea that it would be easier to argue that the state should protect children, who could easily be coerced by their parents. That left many young adults who were still very dependent on their parents unprotected.
While it was certainly understandable that these laws included large exemptions, they also rendered them toothless. During the years that conversion therapy was banned in those states, it was exceedingly rare for a conversion therapist to face legal consequences for their actions. Even several famous cases of states shutting down conversion therapy practices didn’t involve these bans. For example, a lawsuit was used to shut down the Jewish conversion therapy organization JONAH in the 2010s, but the case was brought under consumer protection laws. Floyd Godfrey in Arizona, who founded a counseling center to treat “unwanted same-sex attraction,” only lost his license because several of his employees accused him of sexual harassment.
Some states never prosecuted anyone for providing conversion therapy, like Colorado, despite its ban lasting for over six years old.
Conversion therapists are not threatened by conversion therapy bans
No one should know that these laws weren’t used to prosecute better than Kaley Chiles, the Christian therapist who brought the lawsuit that the Supreme Court used to shut down Colorado’s MCTL, its conversion therapy ban. She was not prosecuted under Colorado’s MCTL and was told repeatedly for years that she would not be prosecuted under the MCTL if she continued to practice therapy, as she said she wanted to.
Chiles is a licensed professional counselor. She describes herself as “a practicing Christian” who believes that “people flourish when they live consistently with God’s design.” She was represented by the anti-LGBTQ+ hate group Alliance Defending Freedom (ADF), a right-wing legal group that has its hands in numerous lawsuits across the country that attempt to rewrite the law to conform to conservative Christian values.
The involvement of the ADF should have dispelled any doubt that this lawsuit was more about political messaging than about an individual’s material concerns. ADF was founded by several prominent conservative Christian activists in the 1990s, including Alan Sears, who wrote that gay people are “trapped” and want to create a nation of “broken families and broken lives.” He saw ADF as a means of getting “faith-based lawyers” involved in the process of making law through the courts.
In her case, Chiles claimed that she wasn’t able to have the conversations with clients that she felt were necessary because of the MCTL, which was why she filed a pre-enforcement challenge. This was in spite of the fact that she was very careful to assert that what she wanted to do wasn’t really conversion therapy.
“Plaintiff does not seek to ‘cure’ clients of same-sex attractions or to ‘change’ clients’ sexual orientation; she seeks only to assist clients with their stated desires and objectives in counseling,” one of her filings said, “which sometime includes clients seeking to reduce or eliminate unwanted sexual attractions, change sexual behaviors, or grow in the experience of harmony with one’s physical body.” She stressed that she “does not begin counseling with any predetermined goal” like turning clients straight and cis.
Colorado’s MCTL said that it only applied to therapy that “attempts or purports to change an individual’s sexual orientation or gender identity” and had an exemption for “identity exploration and development.” The state even wrote in its court filings that Chiles “has faced no disciplinary action and has carefully avoided stating that she seeks to practice conversion therapy on her minor clients, instead describing practices the MCTL would not prohibit.”
Chiles responded, saying she felt there was a “credible threat” to her because her words might be construed as a violation of the law, perhaps by an overzealous prosecutor. But her claim was hard to believe. Even Supreme Court Justice Sonia Sotomayor – who ultimately sided with the Court’s majority in ruling against the MCTL – pointed out during oral arguments last year that it was hard to see the “credible threat” of prosecution when the state never prosecuted anyone under the law, “and we have the entity charged with administering the law saying we’re not going to apply it to your kind of… therapy.”
Laws have value even when they’re not enforced
“Conversion therapy programs have been extremely harmful, and the powerful testimony as to their danger has helped forge a broader consensus against efforts to change individuals’ sexual orientation.”
Legal scholar Marie-Amélie George
But the law is about more than just who gets prosecuted or sued. The law can also be a way for the state to send a message, something the legal scholar Cass Sunstein called the “expressive function of the law.” An action has a relationship with – that is, it either conforms to or violates – social norms, and that relationship can affect a person’s self-perception or even their reputation, Sunstein argues. Laws can set those social norms.
In his 1996 paper “On the Expressive Function of Law,” Sunstein points out that this is especially true when it comes to cases where “the relevant law is a signal or statement unaccompanied by much in the way of enforcement activity.” He discusses social norms that oppose equality and how the law can be a useful means of changing those norms because “if discriminators are ashamed of themselves, there is likely to be less discrimination.”
In 2018, queer legal scholar Marie-Amélie George applied this concept to the fight to implement conversion therapy bans. George noted the narrow scope of these laws as they were being passed in the 2010s, that they applied only to licensed mental health professionals, even though “most conversion therapy is practiced by religious counselors and lay ministers.” But both LGBTQ+ advocates and anti-LGBTQ+ advocates had a vested interest in the idea that these laws would have a significant effect on people’s lives, so no one had an incentive to point out just how limited they were.
LGBTQ+ advocates, she argued, wanted these laws passed because they would “create a broad social norm against conversion therapy” and “help ratify the idea that sexual orientation is either a characteristic that no one should be forced to change, or is immutable and thus cannot be altered…. Additionally, the laws indicate that the state needs to take an active role in protecting LGBT youth, a radical reformulation of typical child protection arguments, which have focused on defending minors from the dangers of LGBT adults.”
George agreed with Sunstein that the law can affect social norms, which are enforced through the fear of reputational harm that comes with violating them, and also explained that the legislative record accompanying the passage of these laws helped establish those norms by disseminating factual information about the harms of conversion therapy.
“Conversion therapy programs have been extremely harmful, and the powerful testimony as to their danger has helped forge a broader consensus against efforts to change individuals’ sexual orientation,” George wrote.
Now, nearly a decade later, it’s the anti-LGBTQ+ forces who fought a legal battle to win on abstract principles.
Chiles’ and ADF’s filings dismissed the scientific consensus that conversion therapy is harmful, rejecting all studies that don’t narrowly focus on “talk therapy… with a willing minor seeking change on issues of gender identity or sexual orientation,” even though minors generally don’t seek conversion therapy but are sent to it by their parents or religious leaders.
Chiles and the ADF made noble-sounding arguments about free speech and allowing people the freedom to choose their own goals in therapy, even though these laws only affected children who are unlikely to understand the long-term consequences of conversion therapy. They presented Christians as a maligned, oppressed minority trying to carve out a bit of freedom to live their lives as they choose in a culture that they see as hostile to them, despite how Christians actually hold a lot of sway in U.S. politics.
What message would a Supreme Court ruling against conversion therapy bans express?
“This is why the law is protective. It dissuades future teens from pursuing discredited practices, especially in contexts where mentors and counselors are not properly trained.”
Joyce Calvo
George argued that conversion therapy bans were implemented in order to promote certain ideas that LGBTQ+ advocates believed, largely because of how ineffective those laws are. Now that they have been proven to be ineffective at combating conversion therapy, why would ADF spend time and money fighting to overturn them? What message do they hope to send by getting the Supreme Court to declare these laws unconstitutional?
First, they want to promote the idea that heterosexuality and cis identity are normal and the default for humans, and that being LGBTQ+ is an aberration that can be changed. That’s why conversion therapy programs typically attempt to assign blame for homosexuality and trans identity – to establish being straight and cis as innate human characteristics that get corrupted and transformed into queer sexuality and gender.
Chiles serves as a way of getting that point of view back into the mainstream again, and they do so more with more subtlety when it comes to sexuality than gender identity. Chiles and ADF focused on the idea that it is legitimate for some people to believe that they can change their sexual orientation or at least repress it, claiming that “many have experienced life-changing benefits from the counseling Chiles wants to provide” (citing testimony from the Christian ex-gay ministry Changed) and that “no study” has ever disproved the efficacy of “voluntary counseling by licensed professionals with minors.” In typical conservative Christian fashion, when they found themselves in the minority, they argued that they should be allowed to hold their anti-scientific beliefs and act on them, that they may not be universal truths, but are true for them. In reality, they provided no real reason to believe that conversion therapy can work for them but not work for others, and if they win this argument in the public sphere, they will likely claim that the reason they can change their sexuality and secular gay people can’t is because of their faith and dedication to the program, effectively blaming other gay people for not trying hard enough.
When it comes to gender identity, Chiles and ADF spent more time arguing that it can be changed, using debunked studies that often don’t even discuss transgender people. Perhaps they thought that it would be easier to convince contemporary judges that trans kids can be turned into cis adults through conversion therapy, but understood that changing gay people to straight is a harder sell at the moment.
Ultimately, though, the goal is not to convince scientists – all major medical organizations oppose conversion therapy, and that’s unlikely to change any time soon – but to get an authority like the Supreme Court to agree that turning cis-het is possible and to portray scientists as influenced by their own liberal biases. And they may get that; Justice Samuel Alito at oral arguments asked Colorado’s solicitor general: “Have there been times when medical consensus has been… taken over by ideology?” The implication is that, sure, almost all people with a relevant scientific background disagree with me, but what if they’re the ones who are the victims of ideology and not me?
Second, anti-LGBTQ+ activists want to overturn conversion therapy bans to justify pushing LGBTQ+ people back into the closet. While it would be nice to think that people are advanced enough to recognize that it doesn’t matter if people choose to be queer or trans for them to be deserving of equal rights, in reality, people are more likely to be sympathetic to the equal rights cause if they think sexual orientation and gender identity are immutable (that is, unchangeable), or close to it.
This broadens the effects of conversion therapy. Anti-LGBTQ+ activists know that they can’t force every LGBTQ+ person into conversion therapy. There are just too many of them. But they believe that they can make society so hostile to LGBTQ+ people (through things like same-sex marriage bans or job discrimination) that they will all go back into the closet. But the public is unlikely to support more hostility towards a minority that can’t change who they are, so anti-LGBTQ+ activists need the public to believe that conversion therapy is a real option for queer people, that queer people could change if they tried hard enough, and that queer people could escape the discrimination and hostility if they really wanted to.
And that hostility would at least force LGBTQ+ people to be less visible. The original problem, for anti-LGBTQ+ activists, is being forced to perceive the existence of LGBTQ+ people. If they can get LGBTQ+ people to stop being visible, that’s effectively the same as getting LGBTQ+ people to stop existing.
Ultimately, both of these messages are aimed at the non-existence of LGBTQ+ people. It was only a couple of decades ago that the government refused to take action to stop the AIDS crisis, with many on the right calling HIV God’s punishment for homosexuality. It was a time when conservatives would openly talk about rounding up gay men and dropping a bomb on them. While that kind of rhetoric is less socially acceptable nowadays when directed at cis queer people, conservatives still talk openly about “eliminating transgenderism.”
If conversion therapy doesn’t work, that means that some portion of the population will always be queer. Even if LGBTQ+ people were eliminated with violence, more would be born. And that is unacceptable to people whose understanding of other people requires a clean and clear distinction between men and women based on gender roles.
And that’s because, even though these laws are about a battle over ideas, they are still important. Ideas motivate all aspects of human behavior.
“Symbolism matters, and when people see there’s a ban, it does lower the stature of the practice,” Besen said.
That’s why Calvo, Alana Chen’s mother, got involved in the fight against conversion therapy and tried to protect Colorado’s MCTS.
“Many church leaders know that Alana’s experience was not consistent with official church teaching, but remain confused when psychologically damaging approaches appear under the guise of orthodoxy,” she said in her amicus brief. “This is why the law is protective. It dissuades future teens from pursuing discredited practices, especially in contexts where mentors and counselors are not properly trained.”
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