“Consensual Conversion Therapy”

Recently I gave a talk to a group of people about conversion therapy, based on my beliefs after having lived through six years of it, and then I read an excerpt from my book, The Inheritance of Shame, at the end of which a 60’s-something looking man in the audience, a psychiatrist, asked me a question about what he termed “consensual conversion therapy.” He said a colleague of his, another psychiatrist, had treated a male adult with “same-sex attractions,” who he said had asked for “conversion therapy” because he did not want to live as a gay man—he wanted “a conventional heterosexual life.” The psychiatrist in the audience said that his colleague and this patient “embarked on the conversion therapy by mutual consent, and by all accounts the therapy was a big success,” so he wanted to hear my thoughts—what did I think of the idea of “consensual conversion therapy”?

For a moment, after this psychiatrist’s question, I just stared at him, horrified, speechless. He was sitting near the back of the crowded room of about 40 adults, all of whom were looking at me, waiting for my response. 

Considering I’d just finished talking for about 60 minutes, and my views on the practice of conversion therapy were about as clear as I could have made possible, I almost didn’t know how to respond.

A moment later I started by saying, “As I said in my talk”—and then I repeated my position, which is that I believe so-called conversion therapies turn a person’s desire to belong into a desire to change one’s sexuality; the locus of attention, therefore, no longer remains on the hatred or intolerance, the ignorance, but on the person whose sexuality is now under direct attack. Killing, I repeated (since I’d said it moments earlier in my talk) turns out to be as easy as “therapy.” The fact that this man had “asked” for the “therapy,” as far as I was concerned, does not make it any less abusive, or unethical for the doctor to have agreed to it and done whatever he did to try and “change” this man’s sexuality; in fact, people engage, seemingly “voluntarily,” in abusive relationships all the time, but that doesn’t make them any less abusive.

I’m not sure this psychiatrist in the audience really heard me, or maybe he didn’t like my response, because he repeated his question. 

“This patient,” he said—“he wanted conversion therapy; the therapy was consensual; it was a success.”

I honestly didn’t know how better to state my position, but repeated another point from my talk—that I believed these “therapies” confused the “map” of someone’s sexual identity for their “territory” of desire—and anyone, if they wanted it bad enough, could change their life map; but that would never change their inner territory, their essence. “A map is not the territory it represents,” I said, repeating the famous lines that I’d said minutes earlier. What sort of “success” could come from any of that?

By the look on this doctor’s face in the audience I am convinced he did not really like, or appreciate, or “get,” what I was saying, but the question, as far as I was concerned, was answered, and so we moved on.

Conversion therapy induces cognitive dissonance, since the person undergoing treatment will undoubtedly end up in a state of mental and emotional incongruence—living according to the map of heterosexuality, while simultaneously experiencing same-sex attractions; and if there is one common trait with nearly anyone who has ever discussed their years in these treatments, whether or not they “asked for it,” it is that they leave treatment dissociated, depersonalized, and deeply depressed, if not outright suicidal. 

If someone asks for conversion therapy, the “helping professional” should absolutely decline—in the same way that they would hopefully decline if the patient asked if they could engage in a “consensual sexual relationship.” Then the “helping professional” should tell the person seeking “help” that instead of conversion therapy, perhaps they should address their feelings of internalized homophobia.

From Alberta’s Minister of Health

Yesterday I received a letter from Alberta’s Minister of Health, responding to an email I sent in support of the Lethbridge Public Interest Research Group’s “petition and a letter writing campaign directed to the government of Alberta, Canada, asking for conversion therapy for lesbian, gay, bisexual, transgender, queer, questioning, intersex, and asexual people to be made ineligible for Alberta Health Care funding.” Minister Sarah Hoffman, who is also Deputy Premier of Alberta, writes:

Thank you for your email regarding banning conversion therapy.

The Government of Alberta shares your opposition to the use of “conversion therapy.”

In regard to funding such a practice, we do not support this and we will not. Alberta Health covers insured medical services as outlined in the Schedule of Medical Benefits (SOMB). Benefits for these services are provided through the Alberta Health Care Insurance Plan (AHCIP).  The SOMB does not list conversion therapy as an insured service that is billable and covered by the AHCIP.

The Government of Alberta is committed to ensuring health care services in Alberta are delivered safely and effectively by competent health care practitioners. Through the Health Professions Act (HPA), we delegate to professional colleges the authority to govern their members in a manner that serves and protects the public interest. The HPA provides the legal framework for colleges to establish, maintain, and enforce a code of ethics and standards of practice for their members.

Early in this term of government, Alberta Health staff met with several regulatory colleges, whose members perform psychosocial interventions, to determine their perspectives and positions on conversion therapy. They were assured that these colleges are not aware of any of their regulated members performing conversion therapy, and have accountability mechanisms in place to discipline members if they were to learn otherwise.

If you are aware of this practice happening, please do not hesitate to contact my office or the relevant regulatory body of the HPA.

Thank you again for writing and for your advocacy on this important topic.

Sincerely...

In essence, the Minister is saying that they believe conversion therapy is not happening in Alberta because no licensed therapists admit to practicing it, and the province does not fund it.

Okay.

This kind of language reminds me of when my former psychiatrist, who treated me for six years in an effort to "change" my sexual orientation, and I appeared before British Columbia’s College of Physicians and Surgeons’ ethics committee. At one point near the start of the two-hour hearing, the chair of the committee asked my psychiatrist if he had ever treated my homosexuality in an effort to change me to heterosexuality. To which he said: “How could I treat a patient for something that hasn’t been included in the DSM since 1973?”

Everyone's language becomes a game of chess. Human chess.

The “problem” with Minister Hoffman’s diplomatic response, and I suppose even the well-intentioned Research Group’s original petition and letter writing campaign, is they do not go far enough, they do not address the underlying problem, which is that any therapist practicing “conversion therapy” today would never actually bill an insurer for anything even remotely called “conversion therapy.” As a survivor of one of these “treatments,” I can say without hesitation that my own former psychiatrist billed British Columbia’s Medial Services Commission for six years of depression—which I was. I was depressed when I sought his help after coming out as gay and being rejected by my family at the age of 23. By the time I met him I’d been depressed for most of my life, because I’d also been sexually abused as a child and had never fully confronted the trauma of that abuse, let alone mourned the loss of my childhood. The doctor’s “treatment” for my depression, however, was to tell me that the sexual abuse had “caused” me to turn out gay, that my homosexuality was “an error in need of correction,” and then to prescribe near fatal doses of various psychiatric medications and inject me with ketamine hydrochloride for the next several years, all the while reframing my history of trauma as I underwent his treatment plan of intense primal scream therapy in an effort to revert to my (his words) “innate heterosexuality.” Words like “conversion therapy” were never mentioned, and certainly they were never considered as part of his billing cycle. Believing that therapists won’t practice conversion therapy—that they won’t treat their gay or trans patients in an effort to “change” them—because it’s been deemed ineligible for funding seems to imply that there is a thing or product actually called “conversion therapy” that can be removed from the marketplace, like a prescription drug or a tainted food, and therefore withdrawn from public consumption. It's a lie.

I honestly don’t know anymore when politicians write letters like this if they are being purposefully obtuse, or if they really just don’t get it. Do they honestly think that medically licensed doctors (especially, not to mention other kinds of “therapists”) would even try and bill a government-funded insurer for something called “conversion therapy,” which isn’t even included in any chart of approved medical “services”—and that as long as they don’t bill for something that isn’t included in these charts it isn’t happening?

Laws must be created banning the practice of conversion therapy, because only laws will help—not guarantee, but at least help—dissuade a therapist from telling their patient that “we can fix your sexuality” (or some version of that line). No law is foolproof—people commit acts of inhumanity, rape and battery, all the time, no matter the law. But what options do we have? Not funding conversion therapy is a no-brainer; but conversion therapy is abuse—any survivor will tell you it is torture—and must be made illegal.