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==Theories and techniques== As [[societal attitudes toward homosexuality]] have become more tolerant over time, the most harsh conversion therapy methods such as aversion have been reduced. Secular conversion therapy is offered less often due to reduced medical pathologization of homosexuality, and religious practitioners have become more dominant.<ref>{{cite journal |last1=Andrade |first1=G. |last2=Campo Redondo |first2=M. |title=Is conversion therapy ethical? A renewed discussion in the context of legal efforts to ban it |journal=Ethics, Medicine and Public Health |date=2022 |volume=20 |pages=100732 |doi=10.1016/j.jemep.2021.100732 }}</ref> ===Aversion therapy=== {{see also|Behavior modification}} [[Aversion therapy]] used on homosexuals included electric shock and nausea-inducing drugs during presentation of same-sex erotic images. Cessation of the aversive stimuli was typically accompanied by the presentation of opposite-sex erotic images, with the objective of strengthening heterosexual feelings.<ref>{{Harvnb|Haldeman|1991|p=152}}</ref> Another method used was the covert sensitization method, which involves instructing patients to imagine vomiting or receiving electric shocks, writing that only single case studies have been conducted, and that their results cannot be generalized. Haldeman writes that behavioral conditioning studies tend to decrease homosexual feelings, but do not increase heterosexual feelings, citing Rangaswami's "Difficulties in arousing and increasing heterosexual responsiveness in a homosexual: A case report", published in 1982, as typical in this respect.<ref>{{Harvnb|Haldeman|1991|pp=152β153}}</ref> Other methods of aversion therapy in addition to electric shock included ice baths, freezing, burning via metal coils, and hard labor. The intent was for the subject to associate homosexual feelings with pain and thus result in them being reduced. These methods have been concluded to be ineffective.<ref>{{Cite web |date=April 11, 2022 |title=Summary of Findings: A Review of Scientific Evidence of Conversion Therapy |url=https://www.health.state.mn.us/people/conversiontherapy.pdf |access-date=November 9, 2023 |website=Minnesota Department of Health}}</ref> Aversion therapy was developed in [[Czechoslovak Socialist Republic|Czechoslovakia]] between 1950 and 1962 and in the British Commonwealth from 1961 into the mid-1970s. In the context of the Cold War, Western psychologists ignored the poor results of their Czechoslovak counterparts, who had concluded that aversion therapy was not effective by 1961 and recommended [[decriminalization of homosexuality]] instead.<ref>{{cite journal |last1=Davison |first1=Kate |title=Cold War Pavlov: Homosexual aversion therapy in the 1960s |journal=History of the Human Sciences |date=2021 |volume=34 |issue=1 |pages=89β119 |doi=10.1177/0952695120911593|s2cid=218922981 }}</ref> Some men in the United Kingdom were offered the choice between prison and undergoing aversion therapy. It was also offered to a few British women, but was never the standard treatment for either homosexual men or women.<ref name=":2">{{cite journal |last1=Spandler |first1=Helen |last2=Carr |first2=Sarah |title=Lesbian and bisexual women's experiences of aversion therapy in England |journal=History of the Human Sciences |date=2022 |volume=35 |issue=3β4 |pages=218β236 |doi=10.1177/09526951211059422|pmid=36090521 |pmc=9449443 |s2cid=245753251 }}</ref> In the 1970s, behaviorist [[Hans Eysenck]] was one of the main advocates of counterconditioning with malaise-inducing drugs and [[electric shock]] for homosexuals. He wrote that this type of therapy was successful in nearly 50% of cases. However, his studies were disputed.{{sfn|Rolls|2019|p={{page needed|date=June 2023}}}} Behavior therapists, including Eysenck, used [[Aversion therapy|aversive]] methods. This led to a protest against Eysenck by gay activist [[Peter Tatchell]] in a London Medical Group Symposium in 1972. Tatchell said that the therapy promoted by Eysenck was a form of [[torture]].{{sfn|Rolls|2019|p={{page needed|date=June 2023}}}} Tatchell denounced Eysenck's form of behavioral therapy as inducing [[clinical depression|depression]] and [[suicide]] among gay men who were subjected to it.<ref name=":2" /> ===Brain surgery=== In the 1940s and 1950s, U.S. neurologist [[Walter Jackson Freeman II|Walter Freeman]] popularized the [[Lobotomy#Transorbital lobotomy|ice-pick lobotomy]] as a treatment for homosexuality. He personally performed as many as 3,439<ref>{{cite news |last1=Day |first1=Elizabeth |title=He was bad, so they put an ice pick in his brain... |url=https://www.theguardian.com/science/2008/jan/13/neuroscience.medicalscience |work=The Observer |date=13 January 2008 |access-date=16 November 2017 |archive-date=20 October 2013 |archive-url=https://web.archive.org/web/20131020075415/http://www.theguardian.com/science/2008/jan/13/neuroscience.medicalscience |url-status=live }}</ref> lobotomy surgeries in 23 states, of which 2,500 used his ice-pick procedure,<ref>{{cite web|title=Top 10 Fascinating And Notable Lobotomies|url=http://listverse.com/2009/06/24/top-10-fascinating-and-notable-lobotomies/|date=24 June 2009|website=listverse.com|access-date=26 December 2013|archive-date=27 December 2013|archive-url=https://web.archive.org/web/20131227024430/http://listverse.com/2009/06/24/top-10-fascinating-and-notable-lobotomies/|url-status=live}}</ref> despite the fact that he had no formal surgical training.<ref name="rowland">{{cite journal|last=Rowland|first=Lewis|date=April 2005|title=Walter Freeman's Psychosurgery and Biological Psychiatry: A Cautionary Tale|journal=Neurology Today|volume=5|issue=4|pages=70β72|doi=10.1097/00132985-200504000-00020}}</ref> In West Germany, a type of brain surgery usually involving destruction of the [[ventromedial nucleus of the hypothalamus]] was done to some homosexual men during the 1960s and 1970s. The practice was criticized by sexologist [[Volkmar Sigusch]].<ref>{{cite journal |last1=Rieber |first1=Inge |last2=Sigusch |first2=Volkmar |date=1979 |title=Psychosurgery on sex offenders and sexual "deviants" in West Germany |url=https://link.springer.com/article/10.1007/BF01541419 |journal=Archives of Sexual Behavior |language=en |volume=8 |issue=6 |pages=526 |doi=10.1007/BF01541419 |issn=1573-2800 |pmid=391177 |s2cid=41463669 |access-date=20 June 2023 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070658/https://link.springer.com/article/10.1007/BF01541419 |url-status=live }}</ref> ===Castration and transplantation=== {{see also|Persecution of homosexuals in Nazi Germany}} [[File:Stolperstein von Friedrich Paul von Groszheim.jpg|thumb|[[Friedrich-Paul von Groszheim]] (1908β2006) was spared from a concentration camp after agreeing to castration under pressure in 1938.]] In early twentieth century Germany, experiments were carried out in which homosexual men were subjected to [[unilateral orchiectomy]] and testicles of heterosexual men were transplanted. These operations were a complete failure.{{sfn|Schmidt|1985|pp=133β134}} [[Surgical castration]] of homosexual men was widespread in Europe in the first half of the twentieth century.<ref>{{cite book |last1=Lehring |first1=Gary |title=Officially Gay: The Political Construction Of Sexuality |date=2010 |publisher=Temple University Press |isbn=978-1-4399-0399-5 |page=63 |language=en}}</ref> SS leader [[Heinrich Himmler]] ordered homosexual men to be [[persecution of homosexuals in Nazi Germany#Concentration camps|sent to concentration camps]] because he did not consider a time-limited prison sentence sufficient to eliminate homosexuality.{{sfn|Zinn|2020b|pp=11β12}} Although theoretically voluntary, some homosexuals were subject to severe pressure and coercion to agree to castration. There was no age limit; some boys as young as 16 were castrated. Those who agreed to castration after a [[Paragraph 175]] conviction were exempted from being transferred to a concentration camp after completing their legal sentence.{{sfn|Wachsmann|2015|p=147}} Some concentration camp prisoners were also subjected to castration.{{sfn|Weindling|2015|p=30}} An estimated 400 to 800 men were castrated.{{sfn|Schwartz|2021|p=383}} Endocrinologist [[Carl Vaernet]] attempted to change homosexual concentration camp prisoners' sexual orientations by implanting a pellet that released [[testosterone]]. Most of the victims, non-consenting prisoners at [[Buchenwald concentration camp|Buchenwald]], died shortly thereafter.{{sfn|Whisnant|2016|p=223}}{{sfn|Weindling|2015|pp=183β184}} An unknown number of men were castrated in [[West Germany]] and [[chemical castration]] was used in other Western countries, notably against [[Alan Turing]] in the United Kingdom.<ref>{{cite book |last1=Huneke |first1=Samuel Clowes |title=States of Liberation: Gay Men between Dictatorship and Democracy in Cold War Germany |date=2022 |publisher=University of Toronto Press |isbn=978-1-4875-4213-9 |pages=53β54 |language=en}}</ref> ===Ex-gay/ex-trans ministries=== {{Main|Ex-gay}} [[File:One by One booth.jpg|thumb|right|[[OneByOne]] booth at a [[Love Won Out]] conference]] Ex-gay ministries are religious groups that attempt to use religion to eliminate or change somebody's sexual orientation.<ref name="APA">{{citation |url=http://www.apa.org/pi/lgbt/resources/just-the-facts.pdf |title=Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel |access-date=14 May 2010 |year=1999 |publisher=Just the Facts Coalition |archive-date=22 April 2018 |archive-url=https://web.archive.org/web/20180422101943/http://www.apa.org/pi/lgbt/resources/just-the-facts.pdf |url-status=live }}</ref><ref name="DrescherandZucker">{{Harvnb|Drescher|Zucker|2006|pp=126, 175}}</ref><ref>{{Harvnb|Haldeman|1991|pp=149,156β159}}</ref><ref name="JonesandYarhouse">{{Harvnb|Jones|Yarhouse|2007|p=374}}</ref> The ex-gay umbrella organization [[Exodus International]] in the United States ceased activities in June 2013, and the three member board issued a statement which repudiated its aims and apologized for the harm their pursuit had caused to [[LGBT]] people.<ref>{{Cite web |last=Burnett |first=John |date=20 June 2013 |title=Group That Claimed To 'Cure' Gays Disbands, Leader Apologizes |url=https://www.npr.org/2013/06/20/193965227/group-that-claimed-to-cure-gays-disbands-leader-apologizes |website=NPR |access-date=27 January 2024 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070613/https://www.npr.org/2013/06/20/193965227/group-that-claimed-to-cure-gays-disbands-leader-apologizes |url-status=live }}</ref><ref name="Change">{{citation |url=http://exodusinternational.org/2013/06/i-am-sorry |first=Alan |last=Chambers |archive-url=https://web.archive.org/web/20130623013409/http://exodusinternational.org/2013/06/i-am-sorry |archive-date=23 June 2013 |title=I Am Sorry |access-date=22 June 2013 |publisher=Exodus International}}</ref> Ex-trans organizations often overlap and portray being trans as inherently sinful or against God's design, or pathologize gender variance as due to trauma, social contagion, or "[[gender ideology]]".<ref>{{cite journal |last1=Robinson |first1=Christine M. |last2=Spivey |first2=Sue E. |title=Ungodly Genders: Deconstructing Ex-Gay Movement Discourses of 'Transgenderism' in the US |journal=Social Sciences |date=17 June 2019 |volume=8 |issue=6 |pages=191 |doi=10.3390/socsci8060191 |doi-access=free }}</ref><ref>{{cite journal |last1=Jones |first1=Tiffany |last2=Jones |first2=Timothy W. |last3=Power |first3=Jennifer |last4=Pallotta-Chiarolli |first4=Maria |last5=Despott |first5=Nathan |title=Mis-education of Australian Youth: exposure to LGBTQA+ conversion ideology and practises |journal=Sex Education |date=3 September 2022 |volume=22 |issue=5 |pages=595β610 |doi=10.1080/14681811.2021.1978964 |s2cid=241018465 |doi-access=free |hdl=10536/DRO/DU:30156953 |hdl-access=free }}</ref> === Hypnosis === Hypnosis was used in conversion therapy since the 19th century by [[Richard von Krafft-Ebing]] and [[Albert von Schrenck-Notzing]]. In 1967, Canadian psychiatrist Peter Roper published a case study of treating 15 homosexual (some of which would probably be considered bisexual by modern standards) people with hypnosis. Allegedly, 8 showed "marked improvement" (they reportedly lost sexual attraction towards the same sex altogether), 4 mild improvements (decrease of "homosexual tendencies"), and 3 no improvement after hypnotic treatment; he concluded that "hypnosis may well produce more satisfactory results than those obtainable by other means", depending on the [[hypnotic susceptibility]] of the subjects.<ref>{{cite journal |last1=Roper |first1=P. |title=The effects of hypnotherapy on homosexuality |journal=Canadian Medical Association Journal |date=11 February 1967 |volume=96 |issue=6 |pages=319β327 |pmid=6017544 |pmc=1935956 }}</ref>{{better source needed|date=February 2023}} ===Psychoanalysis=== {{Main|Psychoanalysis}} Haldeman writes that psychoanalytic treatment of homosexuality is exemplified by the work of Irving Bieber ''et al.'' 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 rate from long-term therapy, but only 18% of the patients in whom Bieber considered the treatment successful had been exclusively homosexual to begin with, while 50% had been bisexual. In Haldeman's view, this makes even Bieber's unimpressive claims of success misleading.<ref>{{Harvnb|Haldeman|1991|pp=150β151}}</ref> 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 its 19 subjects were exclusively heterosexual in behavior four and a half years after treatment, but 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 capacity for heterosexual sex as change of sexual orientation.<ref>{{Harvnb|Haldeman|1991|pp=151, 256}}</ref> ===Reparative therapy=== The term "reparative therapy" has been used as a synonym for conversion therapy generally, but according to [[Jack Drescher]] it properly refers to a specific kind of therapy{{clarify|date=July 2022}} associated with the psychologists [[Elizabeth Moberly]] and [[Joseph Nicolosi]].<ref name="Drescher1998">{{Harvnb|Drescher|2000|p=152}}</ref> 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.<ref>{{cite web |last=Nicolosi |first=Joseph |title=The Traumatic Foundation of Male Homosexuality| url=https://crisismagazine.com/opinion/traumatic-foundation-male-homosexuality}}</ref> The term ''reparative'' refers to Nicolosi's postulate that same-sex attraction is a person's unconscious attempt to "self-repair" feelings of inferiority.<ref name="Hicks_1999">{{cite journal |last1=Hicks |first1=Karolyn A. |title='Reparative' Therapy: Whether Parental Attempts to Change a Child's Sexual Orientation Can Legally Constitute Child Abuse |journal=American University Law Review |volume=49 |issue=2 |date=December 1999 |pages=505β547 |url=https://digitalcommons.wcl.american.edu/aulr/vol49/iss2/4/ |access-date=10 June 2023 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070611/https://digitalcommons.wcl.american.edu/aulr/vol49/iss2/4/ |url-status=live }}</ref><ref name="Bright">{{Harvnb|Bright|2004|pp=471β481}}</ref> After California banned conversion practices, Nicolosi argued that "reparative therapy" didn't attempt to directly change sexual orientation but instead encourage exploration into its underlying causes, which he believed was often childhood trauma.<ref name="ashley_202209" /> ===Marriage therapy=== {{See also|Relationship counseling}} 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 has caused problems in their relationship may lead some people to turn to a marriage therapist for help to change their sexual orientation.<ref name="Rosik-2003">{{cite journal |last=Rosik |first=Christopher H |title=Motivational, ethical, and epistemological foundations in the treatment of unwanted homoerotic attraction |journal=Journal of Marital and Family Therapy |volume=29 |issue=1 |pages=13β28 |date=January 2003 |pmid=12616795 |doi=10.1111/j.1752-0606.2003.tb00379.x |oclc=5154888155 }}</ref> Sexual orientation disorder was removed from the most recent ICD, [[ICD-11]], after the Working Group on Sexual Disorders and Sexual Health determined that its inclusion was unjustified.<ref>{{Cite journal |last1=Reed |first1=Geoffrey M. |last2=Drescher |first2=Jack |last3=Krueger |first3=Richard B. |last4=Atalla |first4=Elham |last5=Cochran |first5=Susan D. |last6=First |first6=Michael B. |last7=Cohen-Kettenis |first7=Peggy T. |last8=Arango-de Montis |first8=IvΓ‘n |last9=Parish |first9=Sharon J. |last10=Cottler |first10=Sara |last11=Briken |first11=Peer |date=2016 |title=Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations |journal=World Psychiatry |volume=15 |issue=3 |pages=205β221 |doi=10.1002/wps.20354 |pmc=5032510 |pmid=27717275 }}</ref> === Gender exploratory therapy === Gender exploratory therapy (GET) is a form of conversion therapy<ref name="WPATH-NHS">{{Cite web |date=November 25, 2022 |title=WPATH, ASIAPATH, EPATH, PATHA, and USPATH Response to NHS England in the United Kingdom (UK) |url=https://www.wpath.org/media/cms/Documents/Public%20Policies/2022/25.11.22%20AUSPATH%20Statement%20reworked%20for%20WPATH%20Final%20ASIAPATH.EPATH.PATHA.USPATH.pdf?_t=1669428978 |website=[[WPATH]] |access-date=2 January 2024 |archive-date=30 November 2022 |archive-url=https://web.archive.org/web/20221130183416/https://www.wpath.org/media/cms/Documents/Public%20Policies/2022/25.11.22%20AUSPATH%20Statement%20reworked%20for%20WPATH%20Final%20ASIAPATH.EPATH.PATHA.USPATH.pdf?_t=1669428978 |url-status=dead }}</ref><ref name="Bharat">{{Cite journal |last1=Bharat |first1=Bharat |last2=Dopp |first2=Alex |last3=Last |first3=Briana |last4=Howell |first4=Gary |last5=Nadeem |first5=Erum |last6=Johnson |first6=Clara |last7=Stirman |first7=Shannon Wiltsey |title=OSF |url=https://osf.io/gz5mk/ |journal=The Behavior Therapist |publisher=Association for Behavioral and Cognitive Therapies |publication-date=October 2023 |volume=46 |issue=7 |doi=10.31234/osf.io/gz5mk |access-date=1 January 2024 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070611/https://osf.io/gz5mk/ |url-status=live }}</ref><ref name="Lawson">{{Cite journal |last1=Lawson |first1=Zazie |last2=Davies |first2=Skye |last3=Harmon |first3=Shae |last4=Williams |first4=Matthew |last5=Billawa |first5=Shradha |last6=Holmes |first6=Ryan |last7=Huckridge |first7=Jaymie |last8=Kelly |first8=Phillip |last9=MacIntyre-Harrison |first9=Jess |last10=Neill |first10=Stewart |last11=Song-Chase |first11=Angela |last12=Ward |first12=Hannah |last13=Yates |first13=Michael |date=October 2023 |title=A human rights based approach to transgender and gender expansive health |url=https://explore.bps.org.uk/lookup/doi/10.53841/bpscpf.2023.1.369.91 |journal=Clinical Psychology Forum |language=en |volume=1 |issue=369 |pages=91β106 |doi=10.53841/bpscpf.2023.1.369.91 |issn=1747-5732 |s2cid=265086908 |access-date=1 January 2024 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070719/https://explore.bps.org.uk/content/bpscpf/1/369/91 |url-status=live }}</ref><ref name="Amery">{{Cite journal |last=Amery |first=Fran |date=2023-12-11 |title=Protecting Children in 'Gender Critical' Rhetoric and Strategy: Regulating Childhood for Cisgender Outcomes |url=https://www.digest.ugent.be/article/id/85309/ |journal=DiGeSt - Journal of Diversity and Gender Studies |volume=10 |issue=2 |doi=10.21825/digest.85309 |issn=2593-0281 |doi-access=free |access-date=1 January 2024 |archive-date=24 September 2024 |archive-url=https://web.archive.org/web/20240924070616/https://www.digest.ugent.be/article/id/85309/ |url-status=live }}</ref><ref name="Caraballo">{{Cite journal |last=Caraballo |first=Alejandra |date=December 2022 |title=The Anti-Transgender Medical Expert Industry |url=https://www.cambridge.org/core/journals/journal-of-law-medicine-and-ethics/article/antitransgender-medical-expert-industry/25EFFECB8F71CA9A37F9F089E13BC41E |journal=Journal of Law, Medicine & Ethics |language=en |volume=50 |issue=4 |pages=687β692 |doi=10.1017/jme.2023.9 |issn=1073-1105 |pmid=36883410 |access-date=1 January 2024 |archive-date=1 March 2024 |archive-url=https://web.archive.org/web/20240301135428/https://www.cambridge.org/core/journals/journal-of-law-medicine-and-ethics/article/antitransgender-medical-expert-industry/25EFFECB8F71CA9A37F9F089E13BC41E |url-status=live }}</ref> 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.<ref name="WPATH-NHS" /><ref name="Lawson" /><ref name="Amery" /><ref name="ashley_202209">{{Cite journal |last=Ashley |first=Florence |date=6 September 2022 |title=Interrogating Gender-Exploratory Therapy |journal=Perspectives on Psychological Science |volume=18 |issue=2 |pages=472β481 |doi=10.1177/17456916221102325 |pmc=10018052 |pmid=36068009 |s2cid=252108965}}</ref><ref name="MacKinnon">{{Cite journal |last1=MacKinnon |first1=Kinnon R. |last2=Gould |first2=Wren Ariel |last3=Enxuga |first3=Gabriel |last4=Kia |first4=Hannah |last5=Abramovich |first5=Alex |last6=Lam |first6=June S. H. |last7=Ross |first7=Lori E. |date=2023-11-29 |title=Exploring the gender care experiences and perspectives of individuals who discontinued their transition or detransitioned in Canada |journal=PLOS ONE |language=en |volume=18 |issue=11 |pages=e0293868 |bibcode=2023PLoSO..1893868M |doi=10.1371/journal.pone.0293868 |issn=1932-6203 |pmc=10686467 |pmid=38019738 |doi-access=free}}</ref> Practitioners of GET propose their patient's dysphoria is caused by factors such as homophobia, social contagion, sexual trauma, and autism.<ref name="Lawson" /><ref name="Caraballo" /> Some practitioners of GET avoid using their patients' chosen names and pronouns while questioning their identification.<ref name="MacKinnon" /> Commenting on gender exploratory therapy in 2022, bioethicist [[Florence Ashley]] argued that its framing as an undirected exploration of underlying psychological issues bore similarities to gay conversion practices such as "[[Conversion therapy#Reparative therapy|reparative]]" therapy.<ref name="ashley_202209" /> 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.<ref name="Pauly">{{Cite news |last=Pauly |first=Madison |last2=Carnell |first2=Henry |date=July 2024 |title=First they tried to "cure" gayness. Now they're fixated on "healing" trans people. |url=https://www.motherjones.com/politics/2024/05/conversion-therapy-lgbtq-anti-trans-gay-gender-affirming-care/ |access-date=2024-06-05 |work=Mother Jones |language=en-US}}</ref> There are no known empirical studies examining psychosocial or medical outcomes following GET.<ref name="MacKinnon" /><ref name="Leising">{{Cite journal |last=Leising |first=Julie |date=September 2022 |title=Gender-affirming care for youthβseparating evidence from controversy |url=https://bcmj.org/sites/default/files/BCMJ_Vol64_No7-premise-corrected%20%28ID%202375120%29.pdf |journal=Bc Medic al Journal |volume=64 |issue=7}}</ref> 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 trans youth,<ref name="Lawson" /><ref name="MacKinnon" /> while the [[gender-affirming care|gender-affirming model of care]] already promotes gender identity exploration without favoring any particular identity, and individualized care.<ref name="MacKinnon" /> GET proponents deny this.<ref name="Santoro">{{Cite news |last=Santoro |first=Helen |date=2023-05-02 |title=How Therapists Are Trying to Convince Children That They're Not Actually Trans |url=https://slate.com/technology/2023/05/gender-exploratory-therapy-trans-kids-what-is-it.html |access-date=2024-01-01 |work=Slate |language=en-US |issn=1091-2339 |archive-date=21 January 2024 |archive-url=https://web.archive.org/web/20240121062936/https://slate.com/technology/2023/05/gender-exploratory-therapy-trans-kids-what-is-it.html |url-status=live }}</ref> In 2017, [[Richard Green (sexologist)|Richard Green]] published a legal strategy which called for circumventing bans on conversion therapy by labelling the practice "gender identity exploration or development".<ref name="Eckert">{{Cite news |last=Eckert |first=A. J. |date=2022-10-22 |title=Cutting through the Lies and Misinterpretations about the Updated Standards of Care for the Health of Transgender and Gender Diverse People |url=https://sciencebasedmedicine.org/cutting-through-the-lies-and-misinterpretations-about-the-updated-standards-of-care-for-the-health-of-transgender-and-gender-diverse-people/ |access-date=2024-12-22 |language=en-US |publisher=Science-Based Medicine}}</ref><ref name="Green-2017">{{Cite journal |last=Green |first=Richard |year=2017 |title=Banning Therapy to Change Sexual Orientation or Gender Identity in Patients Under 18 |url=https://pubmed.ncbi.nlm.nih.gov/28270456 |journal=The Journal of the American Academy of Psychiatry and the Law |volume=45 |issue=1 |pages=7β11 |issn=1943-3662 |pmid=28270456}}</ref> Multiple groups now exist worldwide to promote GET and have been successful in influencing legal discussions and clinical guidance in some regions.<ref name="Amery" /> 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|social transition]] is "risky".<ref name="Santoro" /> 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.<ref name="Santoro" /> In late 2023, GETA changed their name to "Therapy First".<ref name="Pauly" /> 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.<ref name="splc-defining-pseudoscience">{{Cite web |title=Group dynamics and division of labor within the anti-LGBTQ+ pseudoscience network |url=https://www.splcenter.org/captain/defining-pseudoscience-network |access-date=2024-01-01 |website=Southern Poverty Law Center |language=en}}</ref> GETA co-founder Lisa Marchiano stated U.S. President Joe Biden's executive order safeguarding trans youth from conversion therapy would have a "chilling effect" on GET practices.<ref name="Santoro" /><ref name="Reed">{{Cite news |last=Reed |first=Erin |date=2023-01-13 |title=Unpacking 'gender exploratory therapy,' a new form of conversion therapy |url=https://xtramagazine.com/health/gender-exploratory-therapy-243833 |access-date=2024-01-01 |work=Xtra Magazine |language=en-CA}}</ref> 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.<ref name="Reed" /> The [[American College of Pediatricians]], a small group aligned with the Christian Right,<ref group="Note">not to be confused with the [[American Academy of Pediatrics]]</ref> has cited numerous studies from SEGM to claim GET is necessary to restore transgender people's "biological integrity".<ref name="splc-defining-pseudoscience" />
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