Why Reparative Therapy is Viewed Negatively but Sex Change Surgery is Not

Reparative Therapy

Reparative therapy, also known as sexual orientation conversion therapy, is a controversial practice aimed at changing an individual's sexual orientation from homosexual to heterosexual. This approach is founded on the belief that homosexuality is a disorder, a view that has been categorically rejected by major mental health professions. Reparative and conversion therapies are largely discredited and dismissed within most mental health circles, except in instances where clients possess strong religious convictions opposing homosexuality. The consensus among mental health organizations and professions asserts that both heterosexuality and homosexuality are normal expressions of human sexuality, a stance supported by the DSM-5, which does not classify homosexuality as a disease (p. 380). Indeed, Jones-Smith (2020) states that “for the most part, conversion therapy is rejected in most circles, except when clients have strong religious sanctions against homosexuality” (p. 380). This suggests that unless specifically requested by a client on moral grounds, reparative therapy is not something professionally widely adopted in the field.

The critical view of reparative therapy within the mental health community stems from concern over its potential harm and questionable effectiveness (Jones-Smith, 2020). Leading mental health organizations, including the American Psychiatric Association, the APA, and the American Academy of Pediatrics, have all denounced conversion and reparative treatments based on what they see as risks. The National Association of Social Workers, along with the American School Counselor Association, has issued policy statements against sexual orientation conversion therapies, highlighting the lack of evidence supporting their effectiveness and the potential for harm. These policies emphasize the importance of understanding and accepting sexual orientation, discouraging treatments aimed at changing this innate aspect of identity. Oddly, while sexual orientation conversion therapy is seen as shocking, literal sexual surgery and hormone blockers to literally change one’s sex is seen as normative more and more, today—which suggests an inconsistency in how this topic is approached.

Nonetheless, the alleged harm associated with reparative therapy is believed by professionals to include psychological distress, identity confusion, and an increased risk of depression and anxiety (Jones-Smith, 2020). Clients who undergo such therapies are believed to often face significant internal conflict, as they are encouraged to deny what professionals see as a core part of their identity. This internal struggle can lead to long-term mental health issues, including suicidal ideation, especially among adolescents grappling with their sexual orientation, although why this should be is unclear since internal struggle with identity is a core stage of Erikson’s stages of adolescence (identity vs. role confusion). However, professionals in the field highlight the stigmatization and pathologization of homosexuality, which are inherent to the rationale behind reparative therapy, and say that this is what contributes to the overall distress and psychological harm experienced by individuals subjected to these practices (Jones-Smith, 2020).

In conclusion, reparative therapy represents to most professionals in this field a harmful and scientifically discredited approach to dealing with sexual orientation. Its continued use, despite widespread condemnation and evidence of its ineffectiveness and potential for harm, underscores the importance of promoting acceptance and understanding of all sexual orientations within the therapeutic context. Mental health professionals are urged to provide support that affirms individuals' identities, fostering well-being and acceptance rather than attempting to change an integral aspect of who they are. The discourse around reparative therapy within the mental health community reflects a broader movement towards inclusivity, respect for diversity, and the rejection of outdated and harmful practices.