Op-Ed

To end conversion therapy, we must understand what it actually means: Dr. Travis Salway

May 26, 2020   |   Op-Ed

This op-ed by Dr. Travis Salway first appeared in the The Globe & Mail on May 26, 2020.

On Monday, Calgary City Council voted, nearly unanimously, to pass a municipal ban of advertising around conversion therapy, which the city defined as “practice, treatment, or service designed to change, repress, or discourage a person’s sexual orientation, gender identity, or gender expression, or to repress or reduce non-heterosexual attraction or sexual behaviour.” In doing so, Calgary joined cities such as Vancouver, Edmonton and Fort McMurray, along with provinces including Ontario and Nova Scotia, in passing legislation banning conversion therapies.

The discourse at the publicly-broadcast citizen debate before the council vote was polarizing, however, with hundreds of speakers passionately arguing on either side of the issue over two days. Those opposed to the ban argued that they do not want to see their fellow citizens subjected to torture – referencing electroshock and other physically severe forms of conversion therapy – but the proposed law unfairly criminalizes practitioners who are merely offering advice to people who are struggling with “unwanted” same-sex attraction or gender dysphoria.

Opponents of the ban claimed that these well-meaning conversations should not be conflated with “true forms” of conversion therapy. They defended this argument by noting that practitioners targeted by the ban do not try to “convert” anyone but, rather, aim to help people live cisgender, heterosexual lives that are compatible with religious doctrine.

This debate had a cardinal flaw: It didn’t centre on a single definition. As with many contentious social issues, language and meanings matter. By clarifying the intent of conversion therapy practices – their defining feature – we will be better prepared to evaluate legislative action at multiple levels of government, as efforts to end this practice continue.

Conversion therapy is a misnomer: Survivors of conversion therapy are not “converted”, and it is not therapeutic. All forms of conversion therapy – whether practiced in a licensed health care clinic, spiritual support group, pastor’s office or other setting – share a common premise, as described by Canadian legal scholar Florence Ashley: They begin with an assumption that some gender identities, gender expressions and sexual orientations are more desirable than others. More specifically, these practices seek to deny and suppress the identities of lesbian, gay, bisexual, transgender, queer and two-spirit (LGBTQ2) people.

The practices themselves rely upon a variety of methods, including coaching, counseling, therapy, prayer and conversation. Individuals who undergo it are often left with feelings of self-doubt, anxiety and hopelessness, losing years of their lives that would otherwise be spent achieving a positive sense of self.

From national surveys conducted last year, we know that tens of thousands of LGBTQ2 Canadians have experienced conversion therapy. With the support of conversion-therapy survivors, I and other public-health researchers have been interviewing these Canadians. They frequently describe exactly the kind of “talk therapy” that opponents of the ban seek to protect, where a provider attempts to compel an individual to manage and resist expressions of gender or sexuality that differ from mainstream expectations. And these forms of conversion therapy induce psychological distress just as other more obviously traumatic forms of conversion therapy do.

To effectively prevent conversion therapy, legislative bans must adjust their definitions to clearly state that the defining feature of conversion therapy is not an attempt to “convert” or “change” intrinsic feelings of gender identity or expression or sexual orientation. Rather, the defining feature is the goal of avoiding acceptance and acknowledgement of LGBTQ2 lives as compatible with being healthy and happy. This healthy sense of self is something that all Canadians deserve, regardless of sexual orientation, gender identity or gender expression. That sense of self is what is fundamentally at stake in the debates over conversion therapy.

We must also acknowledge that no ban can eradicate all forms of conversion therapy. We need bans at all levels of government – municipal, provincial and federal – and for these legislative bans to share language, so they are all effectively complementary. And bans must be coupled with broader educational efforts.

In Canada, we must promote the affirmation of LGBTQ2 people, particularly to parents and caregivers who may otherwise consider conversion therapy for their children when they are struggling. Continuing legislative debates offer an opportunity for us as Canadians to clarify our position that LGBTQ2 people should be celebrated. Canadians who share these views should make their majority view known – particularly as our politicians continue to consider opportunities to safeguard the well-being of LGBTQ2 citizens.

Calgary’s new bylaw is just one example of an upsurge of proposed and enacted Canadian legislation to prevent conversion therapy. Bill C-8, an amendment to the federal Criminal Code, was tabled by federal government on March 9. While our country has gradually affirmed LGBTQ2 lives through legal and social changes in recent decades – including the addition of sexual orientation in 1995 and gender identity and expression in 2017, as statuses protected by the Charter of Rights and Freedoms – the public debate in Calgary served as a stark reminder: Stigma, fear and hatred of LGBTQ2 people are alive and well. The only way to resist these social biases is by speaking the same language.

Dr. Travis Salway is a CGSHE research scientist, social epidemiologist and assistant professor in the Faculty of Health Sciences at Simon Fraser University. His research investigates population health inequities in the context of stigma.