HealthyGamerGG - We Need To Talk About Gay Conversion Therapy

Episode Date: April 18, 2026

In this episode, Dr. K provides an evidence-based analysis of gay conversion therapy—scientifically known as sexual orientation change efforts (SOCE)—following a recent Supreme Court ruling regarding its regulation,. He moves past the religious and political debate to examine the medical data on whether these interventions are effective or, more importantly, harmful,. What to expect in this episode: The Supreme Court Ruling: A look at the legal argument regarding free speech that led to the overturning of a ban on conversion therapy in Colorado,. The Efficacy Gap: Why scientific evidence suggests these efforts do not work, with one study showing that 97% of participants found no benefit or reduction in homosexual feelings,. Methodological Flaws: An analysis of why existing studies that claim success are often weak, relying on small sample sizes and biased recruitment from "ex-gay" ministries,,. The Reality of Harm: A deep dive into the "really scary" data linking conversion therapy to increased depression, anxiety, and a 75% increase in suicidal planning,. Not a Pathology: Dr. K explains why medical organizations like the APA and AMA oppose these treatments: they are trying to "fix" something that isn't a biological illness or broken state,,. Biology in the Wild: A fascinating look at how same-sex behavior is the "default state" in over 500 species and is actually more common in primitive organisms,,. A Roadmap for Struggling Individuals: Advice for parents and individuals on how to seek regular therapy to explore feelings in a way that is free from pressure and value-based stances,,. Dr. K's NEW Guide to Love, Sex, & Relationships is coming May 2026! Pre-order now: https://bit.ly/4dO3x0VHG Coaching : https://bit.ly/46bIkdo Dr. K's Guide to Mental Health: https://bit.ly/44z3SztHG Memberships : https://bit.ly/3TNoMVf Products & Services : https://bit.ly/44kz7x0 HealthyGamer.GG: https://bit.ly/3ZOopgQ Learn more about your ad choices. Visit megaphone.fm/adchoices

Hey, chat, welcome to the Healthy Gamer Gigi podcast. I'm Dr. Alokinoja, but you can call me Dr. K. I'm a psychiatrist gamer and co-founder of Healthy Gamer. On this podcast, we explore mental health and life in the digital age, breaking down big ideas to help you better understand yourself and the world around you. So let's dive right in. The United States Supreme Court recently overturned a ban on gay conversion therapy. So this was a case where there was a therapist who was trying to do gay conversion.

conversion therapy, and the state of Colorado has banned gay conversion therapy. They've said you're not allowed to do it. And the therapist made the argument that you cannot regulate my right to free speech. So basically, you as the state cannot police what I say in my sessions with a patient. The Supreme Court found this to be a valid argument and basically overturned the ban. So today we're going to talk about gay conversion therapy, or in the scientific literature, as it's known, sexual orientation change. efforts. But we're going to talk about it in the way that we do with most things on the channel, which is from a place of evidence. So what does the science show about gay conversion therapy? And let me be clear about this. I know this is a hot button issue. I know people have strong

religious beliefs that homosexuality may be a sin. All that stuff is fine. We are not, I'm not a constitutional scholar. It's not my job to say the Supreme Court ruling is right or wrong. I'm also not a religious authority to say that a certain religious belief is right or wrong. What I am as a medical doctor. And so today what we're going to be talking about, if you're interested in sending your son or daughter to gay conversion therapy, if you are someone who is considering gay conversion therapy or sexual orientation change efforts, or if you're just someone in our audience at large, my job today is to equip y'all with the information so that you can make the most informed decision about what kind of therapeutic

treatment is right for you. Today we're going to be looking at a handful of reviews. studies on sexual orientation change efforts. And when we look at these studies, we're going to present what they find, but then we also need to talk about the limitations of the study. This is something that's really important I learned when I trained at Harvard Medical School, which is, you know, I was interested in evidence-based complementary alternative medicine. We would study things like acupuncture and meditation and stuff like that. And sometimes those trials don't have great findings or they do have great findings. And it's important to be critical of science, just like we should be critical of all of our thinking. So not only are we going to present the evidence,

we will also look at potential reasons for why the studies show what they show. Let's start with efficacy. Does gay conversion therapy work? Well, according to the evidence, not really. So one study on 1,600 people from the Church of Latter-day Saints basically found that 3.1% of people found some kind of benefit or reduction in homosexual thoughts, feelings, behaviors, etc. So for 97% of people in this particular study, it basically didn't work. There are some studies that show some degree of efficacy in this, but these are usually fraught with methodological problems. I would call them weak studies.

So for example, they have small sample sizes. They are surveys in retrospective. So no one has done anything like a randomized controlled trial on gay conversion therapy. So we haven't taken 200 people, right, and set the control group as therapy as usual, set the intervention group as gay conversion therapy and measured outcomes. So I wasn't able to find a single randomized control trial on something like this that has an appropriate control. So most of the studies will be retrospective. They'll be surveys, and their recruitment is pretty problematic. So they'll recruit from places like, you know, specifically ex-gay ministry communities and then assess sexual orientation change efforts.

That's a methodological problem when you're studying something. So it's sort of like if I take everyone who joined a Buddhist meditation circle and then ask them, is meditation helpful for you? What do you think the answer would be? A better way to study meditation, which is how we've studied meditation, generally speaking, as a scientific community, is we take a lot of people who are meditation naive, haven't done meditation. We teach a meditation and then we measure outcomes.

Another huge problem with these studies is that they don't even measure negative outcomes. So, for example, if I'm putting a new drug on the market, the early phases of clinical trials aren't even about the efficacy of the medication, how well it works. The first thing that we tend to study is, is it harmful for people to begin with? And when we look at a lot of these studies, the studies that do examine harm, what we find is really scary, that gay conversion therapy or sexual orientation change efforts are associated with a lot of negative outcomes. increases in depression, increases in anxiety, lowering of self-esteem, difficulty with familial relationships, other non-romantic relationships, difficulties with issues like sexuality, an increased sense of something called home negativity, which is viewing homosexual people in a bad way. And one of the most troubling things of all, gay conversion therapy is associated with an

increase in suicidality. What's more troubling to me as a psychiatrist is a 75% increase in suicidal planning. So this is something that I just want to explain a little bit. So it is somewhat normal for people to sometimes want to go to sleep and never wake up. What we really get worried about as psychiatrists is when people start making plans. The making of a plan is a strong risk factor for actually completed suicide. And several studies are showing that there are strong negative effects from gay conversion therapy or sexual orientation change efforts.

So this is sort of a situation where, irrespective of your religious beliefs, it's not for me to say that it is a sin or isn't a sin. We'll get to a little bit about homosexuality in general in a second. But my stance as a psychiatrist is that this is a terrible intervention to use with anyone. The studies that say that it's good are fraught with methodological flaws. I don't really trust their clinical outcomes. I could not find a single solid prospective study to support. good outcomes with gay conversion therapy. There is plenty of evidence that is ineffective and even harmful. So based on that, I don't think it's a good idea to do. And this is why organizations like

the American Psychiatric Association and the American Medical Association have come out against these sorts of things. This is why we as a field don't recommend this stuff. And I want to be super clear about this. So there's absolutely an element of advocacy, right? So the APA and the AMA do advocacy work. I've gone to Congress in the White House and lobbied for like two billion dollars of funding to train addiction professionals because we have an addiction crisis in the United States. So we're involved in some degree of political activism, but I want to be super clear about where our activism as a field comes from. It comes from data. It comes from patients. It comes from people who are going through this stuff. And as medical professionals, we advocate for basically stuff

that works and advocate against stuff that is harmful. And the evidence for gay conversion therapy suggests that it is both of those things, not helpful and harmful. Now, the question is why? So this is where an argument could be made that something about the way that we are studying gay conversion therapy, because remember, we've never done a good clinical, randomized controlled trial, right? So there's a possibility it could work.

Now what we have to do is be a little bit critical of these findings and try to understand why. Why is it, if so many people believe in it, why is it that it's so damn ineffective and harmful? So let's start with a couple of basics. The first is variation in the way that gay conversion therapy is practiced. It is practiced by some licensed professionals, like licensed mental health professionals. It's practiced by some pastors or lay people. So there's a variety of practice.

So anytime you don't have a standard of practice, you are going to get different kinds of outcomes. The second thing is, if you actually look at like, so, you know, one study actually cited when people would reach out to someone who does gay conversion therapy, and they asked them, like, okay, what do you all do? And the answer that they got is that we helped them develop a clearer relationship with Christ. Other studies will say will incorporate techniques from cognitive behavioral therapy, emotional regulation. Some people will include things like Bible study or retreats.

And so there's a lot of variety to what constitutes gay conversion therapy, which could explain part of the reason that we can't see in effect. There are some studies that show some benefits of sexual orientation change efforts. So people will describe benefits from social support. So they sort of join an ex-gay community. And once they join that community, they find camaraderie, they find friendship. Some of these interventions are associated with mentor relationships, things like weekend men's retreats where there's a lot of same-sex, non-romantic platonic bonding.

So there are some benefits that have been noted related to gay conversion therapy. Interestingly enough, what we don't see is benefits like reductions in depression, reductions in anxiety, improvements in self-esteem, or reductions in suicidality. So from a medical treatment standpoint, I think there's not a whole lot of evidence for it. The other main reason why we may not find good evidence that gay conversion therapy is effective is because being gay isn't a pathology. So generally speaking, when we do a medical treatment, someone is ill in some way. We are fixing something that's broken.

So if we're like giving you a kidney transplant because your kidneys don't work, there is a baseline pathology that is negatively affecting you. And by fixing that pathology, we will improve things. But if this isn't a pathology to begin with, then there's nothing to fix and therefore treatments won't work. Interestingly enough, Freud didn't think that homosexuality was an illness. So he sort of thought that, you know, they're basically normal variants of the population. they shouldn't be treated any differently.

And if anything, he said that gay people are potentially highly intelligent and cultured, which is kind of weird. There are psychoanalytic perspectives that do believe that homosexuality is a pathology of some kind. So there's an analyst named Rado in the 1940s who basically said that homosexuality arises out of a phobia of heterosexual attraction. So if I'm a dude and I'm attracted to women, but I'm also scared of women, then maybe that can manifest as homosexuality towards men. I think a lot of those theories are not really taken very seriously now. They've been basically disproven. And this sort of gets to the general idea of homosexuality in human species in living organisms to begin with.

Because for a long time, people have been sort of wondering, right? So even from a Darwinian or evolutionary perspective, how is it that homosexuality exists within a population to begin with? So if we sort of think about being gay, let's say we take the case of men or women, It doesn't matter. If you're engaging with sexual activity with someone that you can't result in a pregnancy and bringing a child into the world, how do those traits get passed on? Right? So how can we select for homosexual behavior if those people never reproduce? And there are some theories about this. So one example is sort of like the gay uncle hypothesis, which is this idea that, okay, if I have like five siblings and one of them is homosexual and they don't have their own children to take care of, does. having one extra adult to take care of, let's say, 10 kids improve the survival of those 10 kids. So this is something called kin selection. There's a lot of like theories around this. But I actually think the strongest evidence for why people are gay goes way deeper than that.

It's actually basic biology. And this is kind of going to blow your mind, but bear with me for a second. It's that same sexual behavior is actually the default state. It's not that homosexuality is aberrant. that it is actually very, very common in the animal kingdom. Now, it sounds weird, but hear me out. So first of all, homosexual behavior has been observed in more than 1,500 species. And the really interesting thing is the more primitive the organism is, the more likely that organism is to engage in same-sex behavior. So if you look at very primitive organisms like sea urchins and starfish that don't have something called sexual dimorphism,

where you can't tell the difference between boys and girl, male and female starfish very easily, they engage in a lot of same-sex behavior because they can't tell the difference. They can't tell if it's a male-sarfish or a female starfish, so let me just mate with it anyway. And this is what's really interesting. If you think about sexual dimorphism, i.e. males and females being very different, that happened later in the evolutionary tree. So the earlier you go, the more same-sex behavior you find. And so there's also all kinds of, like, really fascinating examples of this.

you know, the common toad will mate with other male toads, and this is what's really fascinating, male toads will actually have a specific call to signal to other male toads when they are being mounted that I'm not a female. So like literally, toads will say no homo when they're engaging in sexual activity. There's, you know, some evidence that some animals will give each other brojobs. So animals will lick the erect penises of other animals. And I'm not trying to be like click bait here or anything like that. My point is that. it appears that homosexuality is well present in the animal kingdom, and the more primitive organisms you get to, the more common it is.

So there's actually a strong argument to be made that homosexuality is actually a leftover from earlier same sexual behavior. Or you can go with the gay uncle hypothesis, we're not really sure. Key thing here is that if we're trying to understand why gay conversion therapy doesn't work, it's simply because there's nothing for it to work on. There's no pathology there to begin with. So I know that this video touches a really hot topic. I know that a lot of people feel very strongly about homosexuality, gay conversion therapy, et cetera.

If you're a parent who is really pushing your child or you're concerned that your child may be homosexual, I strongly encourage you to consider this evidence. If you're someone who is struggling with thoughts of homosexuality and you think it's bad or a sin or whatever, once again, I'm not a religious authority, right? It's not my place to say what is a sin or what isn't a sin? But please be informed about the potential consequences of engaging in this treatment. And the last thing that I'd like to advocate for is treatment in general. If you're someone who's struggling, you don't have to go to a gay conversion therapist first or ever.

You could just go to a regular therapist and share your thoughts, your struggles, your feelings, right? I've had people in my office who are very religious, have homosexual feelings, and I don't take a value-based stance when I work with them. I don't take the stance that homosexuality is right or is wrong. My job as a therapist is to help this other person come to their own conclusions, free of pressure, free of their emotions, and really try to find the answer that's right for them. Thanks for joining us today. We're here to help you understand your mind and live a better life.

If you enjoyed the conversation, be sure to subscribe. Until next time, take care of yourselves and each other.