Ending conversion therapies for sexual orientation and gender identity: a narrative review of health professions’ position statements and analysis of regulatory options

Purpose Many international health organizations have issued position statements repudiating Conversion Therapies (CTs) practiced on sexual and gender minority (SGM) people. Although some U.S. legislatures have passed laws prohibiting CT, it remains common practice in the U.S. and globally. Legislative bans have been challenged on constitutional grounds, and followed by counter-legislation prohibiting other evidence-based healthcare practices and policies that support SGM people. Therefore, legislative bans may have disadvantages including political opposition, constitutional vulnerability, and normalization of reactionary anti-SGM legislation. To explore other strategies against CT, we examine health organizations’ existing position statements and analyze how they could support alternative regulatory options.Methods Narrative review of position statements addressing sexual orientation and/or gender identity change efforts published up to October 14, 2023.Results At least 60 healthcare organizations have repudiated CT over the last 25 years. Research over the past 25 years documents the harms of CT. This includes evidence of significant long-term adverse mental health outcomes associated with CT practiced on minors, and evidence of harm in a variety of SGM sub-populations beyond gay cisgender males. However, few, if any, position statements have been updated to include the evidence of harm/potential harm.Conclusions Updating professional position statements on CT could support a variety of regulatory strategies for ending it. Alternatives to legislation exist within both healthcare and governmental spheres. Healthcare regulation grounded in scientific evidence and bioethical principles could have advantages over legislative bans. These include immunity from wavering governmental support for SGM populations’ health and rights, and avoiding inadvertent normalization of reactionary legislation that inappropriately limits healthcare for SGM populations and others.