Doctors used to prescribe long strenuous bike rides and testicular transplants to cure gay men of their "sexual abnormality." More than a century later, fear and controversy continue to characterize the mysterious world of conversion therapy.
From injections to electric shocks, from prayer to rape, there are many methods promoted by doctors, counselors and moralists to suppress the sexual desire or gender identity of members of the LGBT population.
Reuters conducted a series of interviews with practitioners and patients, and they provide insight into practices that dozens of medical associations claim are ineffective and harmful.
In Egypt, a young man, on the advice of a friend, sought the help of a famous TV doctor. Years later, he is still traumatized by the anal exam.
In post-Soviet Georgia, teenage lesbians were injected with hormones as a "medicine" at the initiative of her mother.
A Mexican pastor used prayers to convince a transgender woman to cut off her hair in an effort to erase her identity.
These are all examples of modern conversion therapy, which persists despite global efforts to ban it.
"Wherever there is homophobia and transphobia, some form of conversion therapy will be available," he told Reuters Randy Thomas, former vice president of Exodus International, a US-based organization of "ex-gay" Christian groups.
This organization was dissolved in 2013 by its then president Alan Chambers, who apologized for promoting "sexual orientation change efforts" and for the "pain and harm" it caused.
That, however, was not the end of conversion therapy.
The secret
Its biggest proponents are often religious or conservative groups, writes the British agency. Many work in secret, but those that are open claim that the therapy works, that it is safe, and that adults should feel free to undergo it.
"It is necessary that they want it, that they have decided to do it and that they are aware that it will be difficult," she said. Heba Kotb, an Egyptian doctor specializing in sexual medicine who "treats" gay men.
"The main line of therapy is changing the "program" of a person who is attracted to people of the same sex. We're removing that and replacing it with heterosexual attraction.”
Bans on certain forms of conversion therapy have been proposed in at least 13 states, according to a Thomson Reuters Foundation survey.
Brazil, Ecuador, Malta, Albania and Germany have partially or completely banned these practices. Argentina, Fiji, Uruguay, Samoa and Switzerland, as well as Taiwan, have indirect bans.
However, because discrimination against LGBT people is widespread, conversion therapy persists in every region of the world.
Its full extent is difficult to grasp, but global studies indicate its existence in every region of the world.
Consent?
Taha Metveli began to have certain feelings towards a friend who suggested that he go to a doctor who could cure him.
"I left only because I loved him," Metveli, who is now 28 and lives in Paris, where he moved from Egypt three years ago, told Reuters.
During the second session, Kotbova performed an anal examination on Metveli without first explaining why it was necessary.
"She took something without first talking to me and asking for my consent," said Merveli, who is now an LGBT activist.
Kotbova declined to speak to Reuters about Metvali's allegations, citing patient-doctor confidentiality, but said she only performs anal exams with patients' consent.
"My percentage of healing is 100 percent," she said. "I have had at least 3000 cases of homosexuals, all over the Arab world".
Metveli says it took him years to deal with the trauma, and numerous studies point to a link between conversion therapy and suicide attempts.
Professional mental health associations in 22 states have condemned conversion therapy as ineffective and harmful, Reuters points out.
History
Conversion therapy was first used in the second half of the 19th century, he says Timothy Murphy from the University of Illinois.
In 1982, an American doctor prescribed "strenuous and exhausting cycling" to a man diagnosed with a "sexual abnormality," according to Murphy in a 1992 research paper.
In "The Origins of Organ Transplantation" Thomas Shlik, medical historian at McGill University in Canada, details how German and Austrian surgeons attempted testicular transplants at the time.
Nazi doctors experimented with castration as a "cure" for gay men, writes a French historian Florence Tamanj.
Electroshock therapy was used on transsexual women and gay and bisexual men in the 1960s in Britain and by the South African apartheid army.
Doctors have allegedly used electroshock therapy on members of the LGBT population in the past in China, Iran and India.
Corrective rape
Lesbian and bisexual women have also been raped by men who want to force them into heterosexuality, researchers claim.
So-called "corrective rape persists... in all regions of the world," said the United Nations' independent expert on sexual orientation and gender equality in a 2020 report.
"The cause is ignorance, homophobia and our churches," said Nomandla, a South African activist whose name has been changed for her safety.
Lesbians have reported cases of "corrective rape" and beatings at drug addiction clinics in Ecuador, despite a 2012 ban.
Talk therapy is also widely used as a tool, although many therapists deny that their work constitutes conversion therapy.
"What people like me offer is psychological therapy, which is identical to the method of therapy used for people who need help due to addiction or to confirm their sexual identity, only the goal is different," he said. Phelim McIntyre, a British psychotherapist.
However, many prohibitions on conversion therapy specifically apply to mental health professionals so that they do not participate in efforts to change sexual orientation or gender identity.
The first ban on psychotherapy of this kind was issued in 1999 in Brazil. In 2012, California became the first US state to ban medical and mental health professionals from conducting conversion therapy on minors.
Today, bans are in place in 20 US states, although there are loopholes.
The bans await approval in seven parliaments, including those of New Zealand, Canada and Spain. Dutch and Austrian MPs voted for the introduction of the law.
In Finland, a petition calling for a ban has been signed by over 50.000 people and must now be considered in parliament.
President of the USA Joe Biden promised during the election campaign that he would outlaw this type of therapy, conversion, and similar promises were made in Britain and Norway, all of which have yet to be fulfilled.
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