Conversion therapy is a pseudoscientific and discredited practice that attempts to force LGBTQ+ individuals to change their sexual orientation or gender identity and instead identify as heterosexual or cisgender. Because it is now understood that sexual orientation is not a choice or something that can be changed, so-called conversion therapy—sometimes called reparative therapy, ex-gay therapy, or
Why Does Conversion Therapy Develop?
Understanding what causes conversion therapy is essential for prevention and treatment. Research consistently shows that conversion therapy arises from a complex interplay of biological, psychological, and social factors — rarely from a single cause.
Core Causes and Triggers
So-called conversion therapy is arguably among the more shameful parts of psychology’s past. In the U.S., homosexuality was considered a mental illness until 1973; before that, many psychologists, psychoanalysts, and psychiatrists around the world openly shamed or attempted to convert their queer clients. The form of "treatment" varied; some practitioners used hypnosis or aversion therapy tactics—for example, pairing homosexual stimuli with electric shocks—to “correct” a patient’s orientation; faith-based treatment was also common and may have included prayer or even, in extreme cases, attempt
Biological Factors
Biological contributors to conversion therapy include:
- Genetics: Family history increases risk; certain genes influence vulnerability
- Brain chemistry: Neurotransmitter imbalances (serotonin, dopamine, norepinephrine) play key roles
- Brain structure: Differences in the prefrontal cortex, amygdala, and hippocampus are documented
- Physical health: Chronic illness, hormonal changes, and sleep disruption can trigger or worsen conversion therapy
Psychological Factors
- Early experiences: Childhood adversity, attachment disruption, and trauma shape psychological vulnerability
- Cognitive patterns: Negative thinking styles, perfectionism, and rumination increase risk
- Coping skills: Limited emotional regulation skills make conversion therapy more likely under stress
- Personality: Certain traits (neuroticism, harm avoidance) are associated with higher risk
Social and Environmental Factors
Environmental factors — including chronic stress, relationship problems, financial difficulty, and major life events — can trigger conversion therapy in vulnerable individuals.
What Triggers an Episode?
Even in people with predisposing factors, conversion therapy often requires a triggering event:
- Major life transitions (job loss, relationship breakdown, bereavement)
- Prolonged stress without adequate recovery
- Substance use or withdrawal
- Physical illness or injury
- Social isolation or conflict
Protective Factors
Not everyone with risk factors develops conversion therapy. Protective factors include: strong social support, effective coping skills, physical health maintenance, access to care, and psychological resilience built through prior challenges.