Question Period Note: HEALTH IMPACTS OF CONVERSION THERAPY

• Conversion therapy is a series of practices, discredited by scientific communities, that attempts to change an individual’s sexual orientation to heterosexual or gender identity to cisgender. Sexual orientation and gender identity are inherent characteristics of individuals that cannot be changed through external efforts, and LGBTQ2 identities are normal and should be affirmed as such. The Government of Canada has introduced legislation to ban conversion therapy across Canada, in line with actions already taken by five provinces/territories and 19 municipalities.

KEY MESSAGES:
• Conversion therapy can lead to problems with mental health, self-esteem, and overall quality of life, including suicidal ideation, self-harm, problematic substance use, depression, anxiety, and social isolation. 30% of men who experienced conversion therapy have attempted suicide.
• Youth, Indigenous people, and racialized people are especially likely to be harmed by conversion therapy.
• On December 1st, unanimous consent was reached in the House of Commons to amend the Criminal Code to ban the practice of conversion therapy.
IF PRESSED ON THE MENTAL HEALTH IMPACTS OF CONVERSION THERAPY
• Conversion therapy does not cause changes to sexual orientation or gender identity.
• Conversion therapy causes harm. Survivors experience suicidal ideation, self-harm, problematic substance use, poor self-esteem and self-hatred, social isolation, difficulties with relationships, and sexual dysfunction.
• Legal equality and human rights protections significantly reduce the disproportionately high rates of mental health disorders that LGBTQ2 communities experience. Banning conversion therapy is an opportunity to protect Canadians and improve their health.

Conversion Therapy

The Department of Justice is leading the file on banning conversion therapy. Health Canada has supported the Department of Justice by reviewing definitions, providing journal articles and conducting an environmental scan on conversion therapy.

The Government of Canada has committed to amend the Criminal Code to “ban the practice of conversion therapy and take other steps required with the provinces and territories to end conversion therapy in Canada.”

Conversion therapy is a practice that aims to change an individual's sexual orientation to heterosexual or gender identity to cisgender, which means identifying with the sex assigned to them at birth. Conversion therapy consists of efforts such as counseling, religious practices, behavioral modification, cognitive reframing, and other means to attempt to change an individual’s sexual orientation. Conversion therapy can result in negative outcomes such as distress, anxiety, depression, negative self-image, a feeling of personal failure, difficulty sustaining relationships, and sexual dysfunction.

There are differences across provincial legislation: Ontario, Québec, Yukon, Nova Scotia, and PEI have legislation restricting or banning conversion therapy. British Columbia has introduced similar legislation, and the government of Manitoba has issued a policy statement prohibiting conversion therapy from being practiced within the provincial healthcare system. Many Canadian municipalities also restrict or ban the practice. 55% of Canadians feel that it is definitely or probably impossible to change someone’s sexual orientation, and 58% of Canadians support a ban on conversion therapy.

Ineffectiveness of conversion therapy

Conversion therapy is ineffective in changing sexual orientation or gender identity. The World Psychological Association’s position is that there is “no sound scientific evidence that innate sexual orientation can be changed.” Similarly, the Canadian Psychological Association asserts that “Scientific research does not support the efficacy of conversion or reparative therapy”.

Prevalence in Canada

Between 4% and 11% of sexual and gender minority men have experienced conversion therapy, and one in five has experienced efforts to change their sexual orientation or gender identity. Transgender people, Indigenous and racialized men, and men whose annual income was less than $30 000 are more likely than cisgender, White, and higher-income-earning men to be exposed to conversion therapy. Prevalence is highest in the youngest age groups, making youth especially vulnerable to harm.

Health impacts of conversion therapy

Exposure to stigma and discrimination leads to disproportionately high rates of psychiatric disorders in members of LGBTQ2 communities. These rates begin to decrease in settings where their identities are affirmed and they have access to equal rights. In contrast, conversion therapy is associated with substantial harm to survivors, including suicidal ideation and self-harm, anxiety, depression, poor self-esteem, self-hatred, problematic substance use, social isolation and loneliness, and sexual dysfunction. Suicide attempts are common in conversion therapy survivors: 30% of sexual minority men who have survived conversion therapy have attempted suicide. Almost 50% of conversion therapy survivors were exposed to these practices in a licensed healthcare provider’s office, which could lead to significant barriers to accessing healthcare services in future.

Indigeneity and conversion therapy

Two-Spirit and other Indigenous people in residential schools were the target of increased physical and sexual violence as part of attempts to change their gender identities and/or sexual identities to better fit European norms. The intersection of Indigeneity with gender identity and sexual orientation should be considered in discussions of harms, and the ongoing legacy of residential schools and colonization provides an important context for understanding the damage conversion therapy may do to Indigenous people now.

Youth and concerns about desistance

Some concerns have been raised in the academic literature about “desistance,” in which people who pursued gender transition later return to their gender assigned at birth. These concerns are often raised in discussions of conversion therapy, citing concern that youth who have a genuine desire to desist from transition will be unable to find support due to the criminalization of conversion therapy. There is no good scientific consensus that desistence should be recognized as a psychological phenomenon. Concerns have been raised about the methods, theory, and ethical frameworks used in research supporting desistance claims, as well as how the data should be interpreted. Many people who have decided to reverse a gender transition report that they did so not due to a change in gender identity, but due to lack of support or experiences of discrimination, and later go on to transition again when their life circumstances permit

KEY FACTS
• 30% of men who experienced conversion therapy have attempted suicide.