THE CONVERSION therapists met last November at the south end of the Las Vegas Strip. Behind the closed doors and drawn blinds of a Hampton Inn conference room, a middle-aged woman wearing white stockings and a Virgin Mary blue dress issued a call to arms to the 20-some people in attendance. “In our current culture, in which children are being indoctrinated with transgender belief from the moment they’re out of the womb, if we are confronted with a gender-confused child, you must help,” declared Michelle Cretella, a board member of the Alliance for Therapeutic Choice and Scientific Integrity. “We must do something.”
Cretella was delivering a keynote speech at the first in-person conference in four years of the Alliance, which describes itself as a “professional and scientific organization” with “Judeo-Christian values.” Its purpose: to defend and promote the practice of conversion therapy by licensed counselors.
Not that they’d call what they do “conversion therapy.” That term lacks a precise definition, but it is used colloquially to describe attempts to shift a person’s sexual orientation or gender identity. In the 1960s, some psychologists tried to make gay men straight by pairing aversive stimuli, like electric shocks or chemically induced nausea, with images of gay porn—techniques that ran the risk of causing serious psychological damage even as they failed to change participants’ sexual orientation, researchers eventually concluded. Today, “conversion therapy” more often takes the form of verbal counseling. Participants are typically conservative Christians who engage voluntarily—motivated by internalized stigma, family pressure, and the belief that their feelings are incompatible with their faith. Others are children, brought into therapy by their parents.
The American Psychological Association has said that conversion therapy lacks “sufficient bases in scientific principles” and that people who have undergone it are “significantly more likely to experience suicidality and depression.” Similarly, the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the Department of Health and Human Services, published a report concluding that “none of the existing research supports the premise that mental or behavioral health interventions can alter gender identity or sexual orientation. Interventions aimed at a fixed outcome, such as gender conformity or heterosexual orientation…are coercive, can be harmful, and should not be part of behavioral health treatment.”
Accordingly, the Alliance and the ideas it promotes have been relegated to the scientific and political fringes. In the 2010s, as acceptance of gay rights grew rapidly, 18 states and dozens of local governments passed laws forbidding mental health professionals from attempting conversion therapy on minors.
Yet by 2020, a new front had opened in the war against LGBTQ people. Republican state legislatures started passing laws targeting transgender and nonbinary children at school—restricting their access to bathrooms, barring them from participating in sports, and stopping educators from teaching about sexual orientation or gender identity. The most intense attacks have banned doctors from providing the treatments for gender dysphoria backed by all major US medical associations. Nearly 114,000 trans youth live in states where access to puberty blockers and hormone therapy has been wiped out.
Last year, I received leaked emails illustrating how these laws are crafted and pushed by a network of anti-trans activists and powerful Christian right organizations. The Alliance is deeply enmeshed in this constellation of actors. Though small, with an annual budget of under $200,000, it provides both unsubstantiated arguments suggesting LGBTQ identities are changeable and a network of licensed counselors to lend their credibility to these efforts. Among the collaborators were David Pickup, the Alliance’s president-elect; Laura Haynes, an
