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Conversioin Therapy and Symbolic Interactionism 

By Kiana Pujols 


            Conversion therapy, also known as sexual reorientation therapy or reparative therapy, utilizes a range of spiritual and therapeutic intervention practices in an attempt to change an individual’s same-sex orientation to a heterosexual orientation or to promote celibacy for queer-identified individuals (Haldeman 2016). Conversion therapy derived mainly from the belief that homosexuality is a mental illness and the perception that homosexuality is a sin and, therefore, is not compatible with religious identities (Maccio 2010). In 1973, homosexuality was no longer considered a mental disorder and was removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM); however, conversion therapy persisted for individuals who “chose” to participate (Flentje, Heck and Cochran 2013).

           As researchers began to study conversion therapy in-depth, they found that conversion therapies are typically ineffective in changing one’s sexual orientation and can actually cause harm to the individual (Flentje, Heck and Cochran 2013; Weiss et. al. 2010; Drescher et. al. 2016). Due to the building research on the negative outcomes of conversion therapy, many organizations, such as the National Association of Social Work and the American Psychological Association, have developed policy statements that oppose conversion therapy (Maccio 2010). Opposition from these organizations in addition to the increased visibility of the LGBTQ+ community in society and in the media has led to a change in public discourse regarding conversion therapy for minors (Flentje, Heck and Cochran 2013; Haldeman 2016). Previously, parents could send minors to conversion therapy regardless of the wishes of the minor. California pioneered the movement toward banning conversion therapy for minors in 2012 with five states and six cities in the U.S. following their lead (National Center for Lesbian Rights 2019). According to Drescher et. al. (2016), other states in the U.S. are drafting their own legislations to ban conversion therapy for minors; therefore, more states are likely to continue this movement in the coming years.

         Despite the changes in public opinion and policy as well as the mounting evidence of the negative outcomes of the process, conversion therapy is still regularly practiced in the U.S. In fact, there is an organization called “Exodus Global Alliance” that has over 100 ex-gay affiliates in the U.S. and Canada (Maccio 2010). The majority of these affiliates that offer conversion therapy are religious organizations due to the dismissal of these practices by mental health and medical facilities (Haldeman 2016). The issue of conversion therapy is, therefore, still a prominent and relevant issue in the U.S. The purpose of this paper is to explore this issue using Mead’s theory of symbolic interactionism, which argues that meaning and an individual’s mind and sense of self are contingent upon interactions between people and their social environment (Lecture Notes 2015). Symbolic interactionism can be used to explain how individuals experience conversion therapy and the motivations to participate.


         Symbolic interactionism states that individuals create meanings and their sense of self based on a social process of interaction and experiences (Lecture Notes 2015). George Herbert Mead introduced the concepts and ideas that became the basis for the development of symbolic interactionism. Several of Mead’s concepts can be applied to the issue of conversion therapy. “Taking the attitude of the other” was a term Mead used to describe the internal conversation in which individuals shape their own actions based on how they imagine others will respond to them (Appelrouth and Edles 2016). The implicit assumption with “taking the attitude of the other” is that self-control is a form of social control since the individual acts based on the anticipated reaction of others (Appelrouth and Edles 2016). Individuals often take the attitude of the generalized other, which is the community or group that a person belongs to (Appelrouth and Edles 2016). Within each community and group, there is an organized and generalized attitude that individuals use as a reference to control their own lines of conduct (Lecture Notes 2015). Two phases of self respond to the generalized other: “me” and “I”. “Me” is the social self that expresses the attitude of the generalized other. “I”, however, is the response to that attitude through individual action (Lecture Notes 2015). Although they represent different aspects of the self, they work hand in hand. Social situations shape the “me” through interactions and the “I” responds to both the situation and the “me” through the individual’s course of action (Lecture Notes 2015). An important aspect of social situations that help develop the generalized other and, consequently, the “me”, is significant symbols. These are words and/or gestures with the same meaning for everyone involved in a situation (Appelrouth and Edles 2016). Mead’s ideas around symbolic interactionism are relevant to many social issues and will be applied to the issue of conversion therapy.


Motivations to Attend Conversion Therapy

            Individuals seek out conversion therapy for a variety of reasons; however, some reasons show up more often in empirical data than others. According to a study completed by Weiss et. al. (2010), the most common motivators for people to participate in conversion therapy were the desire to save a heterosexual marriage and religious experiences. Another study by Elaine Maccio (2010) further expanded on the importance of religion in seeking conversion therapy. She found that the majority of individuals who are in conversion therapy hold a Christian identity (Maccio 2010). Some queer individuals with a strong religious identity feel that it comes into conflict with their sexuality; therefore, they attempt to change their orientation in order to maintain their religious identity (Maccio 2010). Others simply attend conversion therapy to please members of their church (Maccio 2010). Evidence suggests that the association between religion and conversion therapy is so strong that as one’s level of religious fundamentalism increases, the likelihood of participating in conversion therapy increases (Maccio 2010). Maccio (2010) additionally found that real and expected negative reactions from family members encouraged individuals to seek conversion therapy. Internalized negative messages from society about the LGBTQ+ community reinforce the idea that queer individuals should change their orientation to heterosexual (Haldeman 2016). Although a less common motivator, unfamiliarity with the social world of the LGBTQ+ community discourages some from accepting their queer identity and they participate in conversion therapy to try to sever that identity (Haldeman 2016). Individuals go to conversion therapy for a multitude of reasons; however, the experiences in conversion therapy tend to be relatively similar.

Experiences in Conversion Therapy

            Studies find that the majority of conversion therapies are led by individuals with religious affiliations, including religious leaders (Flentje, Heck and Cochran 2013; Maccio 2010). Because of this trend, interventions to change one’s sexuality typically focus on re-training the mind and body to reject same-sex attractions and usually involves heavily religious approaches. Interventions include aversive conditioning (electric shock therapy), masturbatory reconditioning, castration, individual counseling, prayer, and Bible study (Flentje, Heck and Cochran 2013; Haldeman 2016). Some of these interventions, such as aversive conditioning and castration, are not as common today as they were in the past due to ethical issues. Studies, however, found that patients in conversion therapy today still experience practices that are considered unethical, such as aversive conditioning, breaches in confidentiality, and abandoning or blaming patients who do not change their orientation after therapy (Flentje, Heck and Cochran 2013; Drescher et. al. 2016). In the study by Flentje, Heck, and Cochran (2013), almost half of the participants in conversion therapy admitted to lying in their therapy interventions. Lying was possibly a way to avoid blame and shame because they were not experiencing any changes in their sexuality. Additionally, the vast majority of individuals who participate in conversion therapy experienced several negative outcomes. Outcomes include, but are not limited to, depression, anxiety, guilt, shame, anger, self-hatred, social withdrawal, low self-esteem, and sexual dysfunction (Weiss et. al. 2010; Maccio 2010; Haldeman 2016). Professional opinion about conversion therapy has changed drastically as a direct result of research on these outcomes.


            Applying Mead’s concepts can help explain the reasons that motivate individuals to participate in conversion therapy as well as the experiences within conversion therapy. The desire to preserve a heterosexual marriage comes from the meaning behind “marriage”. Marriage is a significant symbol that indicates commitment and for those with a strong religious identity, commitment is valued even more. In many religions, divorce is looked down upon and sometimes forbidden; therefore, the individual may choose to participate in conversion therapy to save a marriage due to the stigma against divorce within their religion and their personally held value for commitment. As previously noted, religion plays an important role in an individual’s choice to attend conversion therapy. The individuals that participate to please church members are essentially taking the role of the generalized other and acting accordingly. The church acts as the generalized other and typically holds a negative attitude toward the LGBTQ+ community; therefore, individuals can expect negative reactions if they come out and decide to change their orientation instead. Others participate to resolve the internal conflict between being religious and being queer. The “me” holds the attitude of their church that someone who is gay cannot be religious and religious people cannot be gay. As a reaction to that dissonance, the “I” comes into play when the individual seeks out conversion therapy.

            Decisions to attend conversion therapy come from taking the attitude of their family and society as well. Individuals who take the attitude of their family and expect negative reactions are more likely to seek conversion therapy. Although some have not told their family about their orientation, the anticipation of how they would react is enough to get people to attend conversion therapy. Society generates negative images of the LGBTQ+ community, which makes “LGBTQ+” a significant symbol with a negative connotation. Queer individuals internalize that image through the “me”. After taking the attitude of society, individuals may make a decision to attend conversion therapy because they do not want to be associated with the negative attitude towards the LGBTQ+ community. Additionally, a queer person’s lack of ability to take the attitude of the broader LGBTQ+ community keeps them from identifying strongly in the community and encourages conversion therapy to match their orientation with the group(s) they are actively involved with.

            Experiences within conversion therapy can also be explained with Mead’s theory. The unethical practices that take place in some conversion therapies reflect an inability of the leaders to take the attitude of the patients. These leaders cannot understand LGBTQ+ experiences and some may not truly care to try to understand. Because of this, they act based on what they believe is right instead of taking the attitude of LGBTQ+ individuals and acting based on that. Consequently, many people in conversion therapy lie about changes in their sexual orientation to appease the leaders of the therapy. They have taken the attitude of the organization providing the therapy and acted based on fear of a negative reaction. They know that if they do not show a change in their orientation, they will be shamed and blamed; therefore, the reaction of the “I” is to lie in order to save face. Although individuals can lie about their progress externally, they cannot lie internally. The negative outcomes associated with conversion therapy are in large part due to this. The “me” of the individuals expresses the attitude of society and the religious organizations that suggest heterosexuality is normal and desired over homosexuality. Through the “I”, they take actions to try to become heterosexual and match society’s expectations. When this does not work, however, that is when depression, anxiety, shame, and guilt settle in. In this instance, the individual is able to take the attitude of the other, but they are not successful in completing the actions to match that attitude.


            Symbolic interactionism helps to explain the issue of conversion therapy because many motivating factors and experiences in therapy are the direct result of daily interactions. Most of the authors cited in this paper hint at the impact of interactions in conversion therapy experiences; however, none of them explicitly mention or apply symbolic interactionism to their research. Drescher et. al. (2012) could utilize a symbolic interactionism analysis to explore the reasons behind research, clinical, and ethical issues in conversion therapy. Symbolic interactionism could be helpful for the study by Elaine Maccio (2010) because her findings on the influence of family and religion in conversion therapy concur with the impact of daily interactions on an individual’s self and decisions. Additionally, Weiss et. al. (2010) would benefit from a symbolic interactionism analysis on their study to explain how the differences in interactions and group memberships between ex-gays and ex-ex-gays contribute to their different experiences in conversion therapy.

            More research is needed in this area in order to better inform policies throughout the U.S. Future research should explore the experiences and outcomes of minors in conversion therapy. Because of the ethical issues surrounding minors in conversion therapy, researchers should use caution in developing methods for this kind of study. Another future direction for research should be to explore the reasons behind parental decisions to place minors in conversion therapy. By following these ideas for potential studies, researchers can develop a more knowledgeable understanding of conversion therapy and use that understanding in political discourse.


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