Conversion therapy is a term that covers a range of practices with a single shared premise: that a gay, lesbian, or bisexual orientation is a pathology that can be corrected through intervention. The interventions vary widely — from religious prayer and pastoral counselling, to psychoanalytic approaches, to behavioural techniques, to residential programmes. What they share is the premise, and the harm that premise inevitably produces.
The clinical consensus is unambiguous. Conversion therapy does not work. Sexual orientation is not modifiable through psychological or religious intervention. What conversion therapy does produce, reliably, is harm: elevated rates of depression, anxiety, suicidality, and a particular kind of damage to the relationship between a person and their own psychological experience. The evidence for this is now extensive enough that every major professional body governing psychological therapists in the UK and internationally prohibits its members from practising it.
That should be the end of the conversation. It is not, for two reasons: conversion therapy continues to be practised, particularly in religious contexts; and gay men who have been through it rarely receive effective clinical support for what was done to them.
What Conversion Therapy Actually Is
The term is often associated with its most dramatic forms: electric shock aversion therapy, residential programmes, the overtly coercive approaches that characterised earlier decades of practice. These still exist but are not the dominant form.
Most conversion therapy that gay men encounter today is less visible. It takes the form of:
- Religious pastoral counselling — typically framed as support with “unwanted same-sex attraction,” operating on the premise that orientation can change through prayer, spiritual disciplines, and accountability structures.
- Reparative or reorientation therapy — psychotherapeutic approaches, often drawing on outdated psychoanalytic theories about homosexuality as developmental arrest, that aim to redirect attraction toward heterosexuality.
- Support groups framed as spaces for “sexual brokenness” — community structures in which gay men are encouraged to suppress or manage their orientation, typically in religious contexts.
- Individual therapists operating outside professional registration — practitioners who offer “healing” of sexual orientation outside the structures of professional accountability that would prohibit it.
Many gay men who have been through conversion therapy did not call it that at the time. They went looking for help with distress about their orientation, or were directed there by family or religious communities, or encountered it as part of broader pastoral care. The framing was usually one of support, healing, and God’s love rather than coercion. The damage was no less real for that.
What It Does
Conversion therapy fails to change orientation. That is established. What it does produce is a specific cluster of psychological effects that are worth naming precisely, because they shape what clinical work with survivors actually involves:
Alienation from internal experience. When a person’s attractions, emotions, and psychological states are consistently framed as symptoms of pathology and targets for change, they learn to distrust their own inner life. The result is not a changed orientation but a damaged relationship to one’s own mind — a person who has learned to treat their experience as a problem rather than information.
Consolidated shame. Conversion therapy works by treating the orientation as a defect. Men who go through it typically arrive with existing shame about their sexuality. The therapy confirms and deepens that shame rather than relieving it.
Elevated risk of depression and suicidality. The research on this is consistent. Multiple large-scale studies show that people who undergo conversion therapy have significantly elevated rates of depression, anxiety, and suicidal ideation compared to LGBTQ people who did not. The elevated risk persists even years after the therapy ended.
“I spent four years in weekly sessions trying to become someone I wasn’t. I didn’t become straight. I just stopped trusting myself.” — a client, in session
That sentence captures the primary damage with precision. Not a changed orientation. A broken relationship with one’s own experience.
Why It Persists
If the evidence is this clear, why does conversion therapy continue? Several reasons, none of them satisfying:
First, significant portions of it operate in religious contexts that are not regulated by professional bodies. The prohibitions of BACP, BPS, UKCP, and HCPC apply to registered professionals. A religious leader who is not a registered therapist faces no professional consequences for practising conversion approaches.
Second, it is sought. Gay men who are in significant distress about their sexuality, who have been raised in religious communities, or who are facing intense family pressure sometimes actively seek it out. Demand that comes from genuine pain is harder to regulate than supply imposed on unwilling recipients.
Third, it is rarely framed as what it is. “Support for unwanted same-sex attraction” does not obviously announce itself as conversion therapy, even to the person receiving it.
“The orientation didn’t change. What changed was how you relate to your own experience. That can be worked with.”
See how we work together →What Survivors Actually Need
Clinical work with gay men who have been through conversion therapy has specific requirements. The presenting difficulties are often not what they appear to be.
Men who have experienced conversion therapy often arrive at clinical settings with depression, anxiety, or relationship difficulties. These are real and deserve direct attention. But underneath them, typically, is the specific damage described above: a learned distrust of their own internal experience, a consolidated shame about their orientation that the conversion therapy confirmed rather than resolved, and often a very complicated relationship to religion, family, and the communities that directed them there.
Effective clinical work with this presentation involves working to restore the person’s relationship to their own psychological experience — helping them develop trust in their own perceptions, emotions, and attractions. This is slow work. It requires a clinical relationship that is explicitly affirmative without being prescriptive about what identity the person arrives at. The work is about access to one’s own experience, not about reaching a predetermined identity outcome.
For related reading, see Gay Shame: What It Is and How It Operates and Internalised Homophobia and Gay Identity.
For more clinical writing on gay male psychology, explore Unfiltered Clarity on Substack →