An estimated 5% of LGBTQ+ youth are subjected to conversion therapy, the widely discredited practice of trying to change a person’s sexual orientation or gender identity, according to The Trevor Project’s 2024 U.S. National Survey on the Mental Health of LGBTQ+ Young People. Approximately 27% of these youths also attempted suicide over the past year.

While numerous scientific studies on conversion therapy repeatedly show that the pseudoscientific form of emotional abuse substantially increases the suicidality of those who undergo it, the numbers don’t explain why that is. But there is a substantial body of research that explains the link.

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To learn more, LGBTQ Nation spoke with Dr. Jonah DeChants, a senior research scientist at The Trevor Project who specializes in queer youth mental health, and Lorin Pritts, LMFT, a pansexual nonbinary licensed psychotherapist who has counseled survivors of conversion therapy. (Full disclosure: Pritts is also the author’s therapist.)

Why the young are especially susceptible to conversion therapy

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Adolescence is a very stressful time, DeChants says, because it’s a critical period when one starts to figure out their own identity and social roles and understand how those differ from family members, peers, and their expectations. During this period, adolescents are often susceptible to peer influence and dependent on adult approval.

This approval is important both because humans are naturally wired for social connections and because young people are so dependent on a connection to their parents to meet their survival needs, like housing, food, safety, financial support, emotional support, and other kinds of support, Pritts says. Because the need for survival is much stronger than one’s need for authenticity, Pritts added, a young person may be more receptive to messages from anti-LGBTQ+ caregivers or authority figures, even if they conflict with one’s internal sense of self.

Dr. DeChants calls conversion therapy “a very, very intense form” or “dose” of discrimination and invalidation because it often occurs in intimate therapeutic, home, or religious settings from adult “caregivers” or authorities who mix proclamations of love and healing with messages that one should feel bad about one’s “wrong” and “immoral” internal identity and must change it because it will harm one’s health, cause familial rejection, wreck future chances of happiness, and even damn one’s soul.

“Any kind of therapy that basically starts with the premise of ‘There is something wrong with you that needs to be fixed or repressed,’ can be really harmful,” Pritts says. The ultimate goal of conversion therapy, they added, is to get clients to internalize another person’s morality, whether from a family’s cultural mindset or a religious system.

To accomplish this, conversion therapists primarily use aversion therapy, which negatively associates any expressions of same-sex attraction or gender dysphoria with physical or psychological pain; repression, which encourages suppression of one’s unwanted thoughts and behaviors; or sublimation, which transfers one’s own natural inclinations onto acceptable substitutes (like refocusing homosexual attraction into gender-stereotyped behaviors aligned with how a man or woman “should” act).

The difference between a client’s internal experiences and a counselor’s preferred morality creates “cognitive dissonance,” mental discomfort from holding two or more contradictory beliefs simultaneously, Pritts says. For example, a client might experience cognitive dissonance if they feel that their gender identity is naturally inborn while also being told that it’s a mental illness and a sin.

A pre-teen who is just starting to explore their identity may be more affected by a conversion therapist’s anti-LGBTQ+ messaging than a 30-year-old who has been out for years, Pritts says, because a young person’s mind is more mentally pliable and less self-assured than an adult whose sense of self has been reinforced by supportive and loving relationships.

Living within a disapproving family and community can also make it harder for kids to maintain support systems, DeChants says, since strict rules and threats of cutting off support can destabilize a child’s ability to make friends, pursue social interests, navigate an independent future (by going to college, for example), and access LGBTQ+-affirming messages.

Though the internet and media are filled with positive depictions of LGBTQ+ people and refutations of conversion therapy’s harmful, unscientific, and ineffective methods, DeChants’ previous work with young people showed him that “families who don’t accept their child’s LGBTQ+ identity will go to extraordinary lengths to isolate the child” so that they’re forbidden or shamed from accessing such media or deliberately kept away from supportive family, friends or LGBTQ+ community members, he says.

This essentially shrinks a young person’s world and can even make them distrustful of messaging that affirms their queer identities, he added.

The isolating effects of cognitive dissonance

Conversion therapy almost immediately causes young people to stop trusting themselves and their own internal sense of what feels right, Pritts says. This creates inner ambivalence and compels clients to begin “gaslighting themselves,” as they increasingly convince themselves that whatever feels good or natural (like physical closeness with members of the same sex) is actually wrong and immoral.

Even if a conversion therapy survivor goes on to marry a spouse of the opposite sex, have children, and receive praise for this and other associated social roles, they may still end up feeling isolated, inauthentic, and disconnected to both themselves and those around them; experiencing the long-term cognitive dissonance of living in a life that doesn’t really feel like their own.

“What winds up happening when we’re in that very dissonant state, is we wind up having a well-curated mask…. Even if you’re getting that affirmation, even if you’re surrounded by people who quote-unquote ‘love you,’ they don’t really know who you are,” Pritts says. “There’s a sense oftentimes that … if ‘those people’ knew who you really were, they wouldn’t love you … So [survivors’] sense of worth is often really, really low and … very dependent on them being a very specific thing.”

Survivors of conversion therapy often report lower levels of life satisfaction, Pritts says, both because they retain a feeling that there’s something fundamentally flawed about themselves and because they’re not forming genuine connections with others based on their actual selves. Survivors can often feel that the social isolation they feel is their fault, which can begin a distressing cycle of shame that can lead to even greater isolation and, in turn, even more shame.

Studies have shown that the extreme stress of prolonged cognitive dissonance has detrimental long-term consequences on mental health, shrinking the brain’s gray matter (that is, the neuron cells on the brain’s surface) and impairing one’s cognitive abilities, including attention and communication.

Conversion therapy inflicts lasting psychological damage

Even if a person leaves conversion therapy and the adults who subjected them to it, they may continue to carry an internal sense of shame and wrongness, especially living in a world that inflicts violence upon LGBTQ+ people, DeChants says.

Because of its abusive methods, conversion therapy survivors often also experience symptoms of complex post-traumatic stress disorder (CPTSD), Pritts says. While PTSD is often caused by a single, acute event (like an assault), CPTSD results from prolonged, repeated, and often interpersonal trauma (like continual abuse).

CPTSD can make its sufferers experience high anxiety, low self-esteem, hypervigilance, disassociation from one’s own body, emotional dysregulation, toxic self-shame, a lack of joy, increased hopelessness and despair, difficulty sustaining emotionally intimate relationships, as well as an increase in self-destructive behaviors (like addictions and suicidality). These symptoms worsen, Pritts says, depending on the harshness and frequency of a conversion therapist’s methods.

Over time, the continued depression and anxiety caused by cognitive dissonance — combined with low self-worth, isolating feelings of inauthenticity, drug abuse, and hopelessness — can drive someone to attempt suicide.

“The impact of being told by your loved ones and or a trusted professional that you need to change and that you should feel ashamed about who you are doesn’t magically turn off when you’re 18 or when you move to the big city,” DeChants says, adding that rising costs and a worsening economy put moving and college out of reach for many young people.

CPTSD symptoms can be significantly worsened by religious aspects of conversion therapy, which teach that one is constantly monitored by a vengeful, disapproving, and omnipotent authority figure and that one’s natural inclinations or common flaws are immoral sins that reduce a person’s inherent worth.

This religious trauma can also take time to resolve, Pritts says. As a therapist who has counseled cult survivors, Pritts says, “The first step is getting out of the cult, and the second step is getting the cult out of you.”

After Pritts themselves left the Jehovah’s Witness cult that they were raised in, they found it was easy to let go of some beliefs, like that every non-cult aspect of their life was a sin, but found it much more difficult to let go of other ingrained views, like an internalized sense of perfectionism or the sense of duty to evangelize people about right and wrong.

Supportive relationships are the key to recovering from CPTSD

Psychologists have long wondered why different people may respond in vastly different ways to trauma, including those inflicted by conversion therapy, Pritts says. While some conversion therapy survivors may internalize its harmful messages and struggle with deep angst, others may seem to more easily disregard them and go on happily fulfilling their queer identity.

It’s unclear whether people develop greater internal and mental resilience against negative messaging and cognitive dissonance due to inherited genetic traits hard-coded in familial DNA or because they learned it from their own parents and caregivers.

Pritts says that one’s resilience to conversion therapy could depend on “protective factors,” that is, individual, family, and community strengths that enhance resilience, helping people navigate stressors and reducing the risk of mental health challenges. These factors can include a strong, secure attachment style instilled during one’s formative infant years, strong social connections with supportive adults and peers, effective coping skills, stable environments away from home, and personal emotional regulation.

One can heal from CPTSD in many ways, including working with a trauma-informed and queer competent therapist, revisiting formative experiences to understand how they changed one’s thoughts and behaviors, replacing self-defeating thoughts and behaviors with more empowering ones, and reconnecting the mind-body association by physically expressing repressed emotions (like grief, anger, anxiety, and joy) through activities like exercise, stage performance, or bodywork.

However, Pritts believes that strong relationships can be the most effective form of healing. Sometimes, early in therapy with newer clients, they encourage them to make friends with people who affirm and care about an aspect of themselves they’re struggling with, so the client has a supportive community.

“People who have undergone horrific things, once they get to a safe place, a lot of healing can happen really quickly,” Pritts told LGBTQ Nation. “A lot of this happens outside of therapy… If you’re having an hour a week of protective time, even if that therapist is amazing, but all the rest of your time is invalidating or lacks affirmation, it’s going to be much more difficult to make change.”

“It’s about building those [strong, affirming] connections first that take precedence over hard therapeutic work, because people need protective factors to start doing that hard therapeutic work,” Pritts adds.

DeChants agrees, saying, “Our research also shows that … having an adult who does accept you and supports you is one of our key factors associated with better mental health and lower suicide risk.”

Conversion therapy hurts, no matter what the government says

It’s especially important to understand the harms of conversion therapy now, both DeChants and Pritts agree, since the federal government is pushing so-called “gender exploratory therapy” as a form of conversion therapy on transgender youth. A recent Supreme Court ruling may also one day overturn state prohibitions on licensed mental health professionals offering conversion therapy

This, combined with the government’s and right-wing Christian conservatives’ hostility against trans people, is destroying trans people’s sense of safety and discouraging them from fully expressing their gender identities, Pritts says.

“Right now, we’re seeing it with the trans community: A lot more people are, quote-unquote ‘going stealth’ and de-transitioning because, for them, the visceral threat to their survival is more critical than whatever self-actualization might come from being [trans] itself,” Pritts commented.

However, DeChants feels hopeful that right-wing attempts to normalize conversion therapy into the mainstream will be unsuccessful.

“The science shows that gender-affirming care can have very positive effects on folks’ mental health, and that conversion therapy can have disastrous effects on their mental health. There is no true scientific debate about either of those statements, really,” DeChants says.

“Now we have political leaders and bureaucratic political appointees who want us to reject that science and want us to accept their version of what they believe to be true, and that is very challenging, for me as a scientist,” he says, “[because] they don’t have good studies, they don’t have evidence in the same way, and so they have to impose this through political and bureaucratic means.”

“This is the rejecting of decades of scientific inquiry and evidence in favor of unsupported beliefs, some of which seem to have political origins and some of which seem to have religious origins, but are not backed up by a process of inquiry, data collection, and analysis.”

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. The Trans Lifeline (1-877-565-8860) is staffed by trans people and will not contact law enforcement. The Trevor Project provides a safe, judgement-free place to talk for youth via chat, text (678-678), or phone (1-866-488-7386). Help is available at all three resources in English and Spanish.

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