“Conversion therapy” refers to attempts to change a person’s sexual orientation, gender identity, or related behaviors. Sometimes called “reparative” or “reorientation” therapy, these practices stem from the scientifically discredited belief that being LGBTQ+ is a mental illness that should be cured.
APA uses the terms “sexual orientation change efforts” (SOCE) and “gender identity change efforts” (GICE). These practices are not evidence-based therapy.
Decades of psychological research reveal these efforts are largely ineffective and pose serious risks of harm:
Psychologists play a crucial and distinct role in the care of youth experiencing gender identity concerns. This role is grounded in comprehensive assessment, mental health support, and upholding the highest standards of ethics and scientific inquiry.
Psychologists provide evidence-based therapeutic approaches that serve essential functions, including:
Research consistently demonstrates that “conversion therapy” is associated with an extensive list of long-lasting social and emotional consequences (PDF, 322KB)opens in new window, including depression, anxiety, suicidality, substance misuse, a range of posttraumatic responses, loss of connection to community, damaged familial relationships, self-blame, guilt, and shame.
A 2020 study published in the Journal of Homosexualityopens in new window found that youth whose parents attempted to change their sexual orientation at home and through therapists or religious leaders reported three times greater likelihood of high levels of depression, suicide attempts, lower educational attainment, lower income levels, and reduced life satisfaction in young adulthood. Similarly, adults who had been exposed to GICE at any point in their life reported increased distress and two-fold higher odds of lifetime suicidal attempts, according to a 2020 study published in JAMA Psychiatryopens in new window.
In addition, a 2022 review published in JAMA Pediatricsopens in new window estimated that the total annual cost of SOCE and GICE in the U.S. could reach an annual economic burden of $9.23 billion, when the associated harms, substance misuse, and suicide attempt costs were also considered.
In 2021, APA’s Council of Representatives passed two resolutions addressing sexual orientation (PDF, 322KB)opens in new window and gender identity (PDF, 106KB)opens in new window change efforts, both opposing such change efforts given evidence of harm and lack of evidence of efficacy.
In March 2025, the Supreme Court of the United States announced it would hear a case on the topic of “conversion therapy.” In Chiles v. Salazar, the Supreme Court heard arguments on what therapists may say to their patients—specifically, whether counseling is “conduct” or “speech,” and whether counseling is entitled to protection under the First Amendment and the Free Exercise Clause.
Kaley Chiles, a Colorado-licensed professional counselor, challenged a state law that bars licensed mental health providers from performing “conversion therapy” on minors—counseling minors to change their “sexual orientation or gender identity, even if clients have requested wanting to change their behaviors or gender expressions,” as stated in her petition. Colorado law prohibits mental health care providers from engaging in “conversion therapy” with patients younger than age 18, based on “overwhelming evidence that efforts to change a child’s sexual orientation or gender identity are unsafe and ineffective.”
In August 2025, APA filed an amicus brief in support of the law, which was joined by the American Psychiatric Association and 12 other mental health and medical professional organizations. The brief explained the scientific, professional nature of therapy, justified the state’s regulation of professional conduct, and described the scientific evidence of the harms that conversion efforts cause. APA presented extensive evidence showing that SOGICE (sexual orientation and gender identity change efforts) do not meet the criteria of a legitimate therapeutic treatment, are potentially harmful, discredited practices, and are not supported by credible scientific evidence. The brief reaffirms APA’s 2009 report findings that SOGICE are ineffective at changing sexual orientation and can pose a risk of harm to individuals who undergo them, with updated 2021 resolutions confirming that SOGICE lack sufficient bases in scientific principles.
On March 31, 2026, the U.S. Supreme Court directed the Tenth Circuit to reconsider the case under a stricter constitutional standard. The decision leaves open the question of whether states can still enact laws that protect patients from harmful therapeutic practices delivered through talk therapy. Read APA’s full statement on the ruling.
APA is conducting a careful analysis of the opinion’s scope and will work with state psychological associations, licensing boards, and policymakers to assess its impact and identify appropriate responses to protect patients within the constitutional parameters the Court has established.
A new ruling deepens the circuit split in a high-stakes SCOTUS case
APA, 2026
Is talk therapy speech or conduct?
APA, 2025
Is counseling entitled to protection under the First Amendment?
LaFortune, K, A., Monitor on Psychology, October 2025
The Case Against Conversion “Therapy”
Haldeman, D. C., APA, 2022
