On March 10, the Supreme Court stated that it will review the constitutionality of a state ban on conversion therapy for minors. The case was filed by the right-wing Alliance Defending Freedom, on behalf of a Christian therapist in Colorado, and the Supreme Court’s willingness to hear it is a harbinger of what’s to come.
Conversion therapy, also known as reparative therapy, is an unscientific practice that purports to change a person’s sexual orientation or gender identity. It is not a legitimate medical therapy, and about half the states have banned it in some capacity.
We’re not just talking about a practice that’s controversial or unpopular. We’re talking about a practice that Colorado and other states have had very solid legal and medical reason to outlaw. Historically it’s been used to justify a slew of pseudoscientific treatments that border on torture, including from ice baths to electroshock therapy to chemical castration. It’s repeatedly been shown to increase risk of suicide. Those who don’t have a problem with the idea of subjecting LGBTQ+ youth to trauma should at least question why they’re supporting something that increases substance use, is bad for the economy and, at the of the day, doesn’t actually work. It’s quackery, not science.
When we pathologize something, when we say it’s an illness that needs to be cured, what’s the next step? Prevention.
Some conversion therapy is based in the idea that the patient is fundamentally heterosexual and cisgender but has been corrupted, and needs therapy to restore them to their true nature. Or that LGBTQ+ people are sick, and conversion therapy is the treatment.
When we pathologize something, when we say it’s an illness that needs to be cured, what’s the next step? Prevention. Coerced treatment. Involuntary hospitalization. Mass incarceration and the introduction of whatever laws can be passed to strip people of their civil rights and put them in the custody of the state. We see a similar trajectory playing out for people who use drugs.
The specific medicalization of transgender identity, while fraught, has had some benefits—or been a necessary evil, depending on how you look at it—because while gender identity is not a health condition, gender dysphoria can often be alleviated with access to the right health care. But the crux of this is that gender-affirming care is voluntary, and despite conservative rhetoric is not something teenagers are being pressured into against their best interests. Which is often the case for those who go through conversion therapy. The practice typically focuses on LGBTQ+ youth, particularly those from conservative religious families in low-income communities.
There’s plenty of scientific literature validating gender dysphoria as a medical condition for which there are evidence-based treatments that are effective, if that’s what the patient wants to pursue. Yet for those of us who do so, at every stage in the process medical providers question our judgment and ability to consent. If those tactics are permissible to use against patients pursuing, of their own volition, a legitimate medical treatment, why are they not applied to conversion therapy?
Striking down conversion therapy bans sets the stage for compulsory treatment.
Striking down conversion therapy bans sets the stage for compulsory treatment. And declaring LGBTQ+ identity to be a mental illness that warrants institutionalization makes it easier and easier to criminalize. Texas, for example, recently introduced a bill to criminalize “gender identity fraud.” It’s safe to assume that over the course of President Donald Trump’s second term, we’ll see a succession of legal precedents that facilitate the policing of LGBTQ+ identity and enforce heteronormative standards with the threat of incarceration.
My fear is not just that the Supreme Court will rule against the Colorado ban, but that the justices will tailor their ruling very broadly and open the doors even wider as we usher in a very wonderful era for anyone wanting to set public policy based on religious ideology.
First Amendment protections are often cited in support of cases like this one—that therapists should be able to practice conversion therapy as a matter of religious freedom. Yet the people who are avid supporters of the First Amendment in that context are often the same people who want to take away freedom of expression from anyone who does not share the opinion that gender is a binary.
Correction, March 13: A previous version of this article incorrectly stated that Louisiana had also introduced a “gender identity fraud” bill.
Image via Supreme Court of the United States
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