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Conversion therapy 4/6 https://en.wikipedia.org/wiki/Conversion_therapy reference science, encyclopedia 2026-05-05T07:04:51.595146+00:00 kb-cron

Haldeman writes that psychoanalytic treatment of homosexuality is exemplified by the work of Irving Bieber and colleagues in Homosexuality: A Psychoanalytic Study of Male Homosexuals. They advocated long-term therapy aimed at resolving the unconscious childhood conflicts that they considered responsible for homosexuality. Haldeman notes that Bieber's methodology has been criticized because it relied upon a clinical sample, the description of the outcomes was based upon subjective therapist impression, and follow-up data were poorly presented. Bieber reported a 27% success frequency from long-term therapy, but only 18% of those deemed successful were exclusively homosexual initially, while 50% had been bisexual. In Haldeman's view, this makes even Bieber's unimpressive claims of success misleading. Haldeman discusses other psychoanalytic studies of attempts to change homosexuality. Curran and Parr's "Homosexuality: An analysis of 100 male cases", published in 1957, reported no significant increase in heterosexual behavior. Mayerson and Lief's "Psychotherapy of homosexuals: A follow-up study of nineteen cases", published in 1965, reported that half of the 19 subjects included were exclusively heterosexual in behavior four and a half years after treatment; its outcomes were based on patient self-report and had no external validation. In Haldeman's view, those participants in the study who reported change were bisexual at the outset, and its authors wrongly interpreted the capacity for heterosexual sex as a change of sexual orientation.

=== Reparative therapy === The term "reparative therapy" has been used as a synonym for conversion therapy generally, but according to Jack Drescher, it more correctly refers to a specific kind of therapy associated with the psychologists Elizabeth Moberly and Joseph Nicolosi.
For example, he wrote:

The pursuit of fulfillment through same-sex eroticism is spurred by the fearful anticipation that their masculine self-assertion will inevitably fail and result in humiliation. The term reparative refers to Nicolosi's postulate that same-sex attraction is a person's unconscious attempt to "self-repair" feelings of inferiority. After California banned conversion practices, Nicolosi argued that "reparative therapy" did not attempt to change sexual orientation directly but instead encouraged exploration into its underlying causes, which he believed was often childhood trauma. A phone study by Robert Spitzer reported that "about 66 percent of the men respondents and 44 percent of the women were able to function as heterosexuals after the therapy," while conceding that "his subjects did not constitute a study population representative of the gay and lesbian population in the U.S."

=== Marriage therapy ===

Previous editions of the World Health Organization's ICD included sexual relationship disorder, in which a person's sexual orientation or gender identity makes it difficult to form or maintain a relationship with a sexual partner. The belief that their sexual orientation causes problems in their relationship may lead some to turn to a marriage therapist for help to change their sexual orientation. Sexual relationship disorder was removed from ICD-11 after the Working Group on Sexual Disorders and Sexual Health determined that its inclusion was unjustified.

=== Gender exploratory therapy ===

Gender exploratory therapy (GET) is a form of conversion therapy characterized by requiring mandatory extended talk therapy attempting to find pathological roots for gender dysphoria while simultaneously delaying social and medical transition and viewing it as a last resort. Practitioners propose that their patients' dysphoria is caused by factors such as homophobia, social contagion, sexual trauma, and autism. Some practitioners avoid using their patients' chosen names and pronouns while questioning their identification. Commenting on GET in 2022, bioethicist Florence Ashley argued that its framing as an undirected exploration of underlying psychological issues bore similarities to conversion practices, such as "reparative" therapy. States that have banned gender-affirming care for minors in the United States have called expert witnesses to argue that exploratory therapy should be the alternative treatment. As of 2023, there are no known empirical studies examining psychosocial or medical outcomes following gender exploratory therapy. Concerns have been raised that by not providing an estimated length of time for the therapy, the delays in medical interventions may compound mental suffering in transgender youth, while the gender-affirming care model already promotes gender identity exploration—without favoring any particular identity—and individualized care. GET proponents deny this. In 2017, Richard Green published a legal strategy that called for circumventing bans on conversion therapy by labelling the practice "gender identity exploration or development". Multiple groups now exist worldwide to promote gender exploratory therapy and have been successful in influencing legal discussions and clinical guidance in some regions. The Gender Exploratory Therapy Association (GETA) asserts that "psychological approaches should be the first-line treatment for all cases of gender dysphoria", that medical interventions for transgender youth are "experimental and should be avoided if possible", and that social transitioning is "risky". All of GETA's leaders are members of Genspect, a "gender-critical" group that promotes GET and argues that gender-affirming care should not be available to those under 25. In late 2023, GETA changed its name to "Therapy First". GETA also shares a large overlap with the Society for Evidence-Based Gender Medicine (SEGM), which promotes GET as first-line treatment for those under 25. GETA co-founder Lisa Marchiano stated US President Joe Biden's executive order safeguarding trans youth from conversion therapy would have a "chilling effect" on GET practices. GETA also opposed Biden's Title IX changes protecting trans students from discrimination, stating allowing trans youth in restrooms would harm the mental health of their peers. The American College of Pediatricians, a small group aligned with the Christian Right, has cited numerous studies from SEGM to support the claim that 'gender exploratory therapy' is necessary to restore transgender people's "biological integrity".