SPECIAL REPORT

Conversion Therapy Online: The Ecosystem

Online Search Algorithms Allow Access to Anti-LGBTQ+ Conversion Therapy Providers and Other Harmful Materials, Especially in Non-English Languages

Content Warning:

This report contains offensive and potentially triggering language, specifically in reference to anti-LGBTQ+ practices related to “conversion therapy,” which have in common the belief that a person’s sexual orientation or gender identity can and should be changed. These efforts are widely discredited by medical professionals in multiple countries and by international medical associations. These practices are inherently degrading and discriminatory and rooted in the belief that LGBTQ+ persons are somehow inferior, or sinful, and that they must at any cost modify their orientation or identity to remedy that supposed inferiority. The list of terms used in this research can be found in appendix. The authors chose to include offensive quotes in the report to illustrate the dangers of conversion therapy and to show how these groups and individuals violate social media and other technology companies’ terms of service and community standards.

Executive Summary

In early July 2020, the UN’s independent expert on protection against violence and discrimination based on sexual orientation and gender identity called for a global ban on efforts to “cure” LGBTQ+ people through efforts such as conversion therapy, arguing these practices inflict “severe pain and suffering” on those that experience them. Victor Madrigal-Borloz wrote, “These interventions exclusively target LGBT+ persons with the specific aim of interfering in their personal integrity and autonomy because their sexual orientation or gender identity do not fall under what is perceived by certain persons as a desirable norm…They are inherently degrading and discriminatory and rooted in the belief that LGBT+ persons are somehow inferior, and that they must at any cost modify their orientation or identity to remedy that supposed inferiority.” Nearly every reputable medical association has said the same, including the American Medical Association (AMA), the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the Pan American Health Association (part of the World Health Association), the World Psychiatric Association, the Psychological Association of Ireland, Australian Medical Association, Royal College of Psychiatrists, English National Health Service, and dozens of similar bodies across the globe. Many of these professional organizations, including the AMA, have endorsed banning the “therapy.” In sum, there is worldwide agreement among medical and psychological professionals that conversion therapy is dangerous and causes harm to LGBTQ+ individuals.

Overwhelming evidence shows that the practice is harmful and can lead to clinical depression and an increase in suicide attempts, in addition to other possible effects. These disastrous results have led to conversion therapy being banned for minors and sometimes adults in seven countries: Brazil, Canada, Ecuador, Germany, Malta, France, and Taiwan. Partial bans are also in place in 20 U.S. states, and parts of Mexico, Australia, and Spain. Conversion therapy is often offered by institutions that are religiously based, but many religious leaders reject the practice. In 2020, more than 400 faith leaders worldwide, including the late anti-apartheid campaigner Desmond Tutu, called for countries to overturn bans on same-sex relations and end LGBTQ+ conversion therapy. Pope Francis has shown concern about the practice, though the Catholic Church’s leadership varies in its response. Evangelical churches frequently push conversion therapy as do large American social conservative far-right organizations such as Alliance Defending Freedom, Focus on the Family, and the Family Research Council.

Rally in London on June 23, 2021 against conversion therapy.

Legislative bans or not, the online ecosystem remains filled with problematic material on conversion therapy. In the past year, the Global Project Against Hate and Extremism (GPAHE) has undertaken extensive research into the online world of conversion therapy. GPAHE researchers have conducted thorough examinations of online content about conversion therapy efforts that appear on various platforms and in multiple languages. The research was conducted in English and Spanish in the U.S., English in Ireland and Australia, German in Germany, Spanish in Colombia, and English and Swahili in Kenya. GPAHE has found that the internet is filled with disinformation on conversion therapy and supposed social media bans on conversion therapy material are essentially toothless. 

Shortly after the UN announcement, major social media platforms claimed to have banned material related to conversion therapy. In July 2020, Facebook and Instagram announced that they would ban all content that promotes conversion therapy. Facebook said it would expand its existing policies on hate speech worldwide to include posts that advertise or promote the practice in a move that applies to both platforms. “We don’t allow attacks against people based on sexual orientation or gender identity and are updating our policies to ban the promotion of conversion therapy services,” Tara Hopkins, Instagram’s public policy director for Europe, the Middle East and Africa, said in a statement. At about the same time, Twitter reported that conversion therapy falls under their “wishes of harm” rule and is therefore removed when reported, but is “working to make the training decks more clear so that team members have a wide variety of examples to refer to and our enforcement of this is consistent and scalable globally.”

In June 2021, Google Israel undertook an effort to combat the continued use of this dangerous treatment. Working with two Israeli LGBTQ+ organizations, Google Israel moved to filter search page results for information on conversion therapy. Instead of bringing up information about where and how individuals “can access the dangerous pseudoscientific treatment which aims to change the individual’s sexual orientation to heterosexual using psychological or physical methods, Google will instead show the user adverts for various LGBT organizations which will be able to help them instead.” In 2019, Google also removed a conversion therapy app from its app store (this only happened after Google was dropped from the Human Rights Campaign’s index that rates employers’ LGBTQ+ friendliness). It is unclear if Google Search writ large, which hosts more than 90 percent of online search traffic, now has a policy to filter all searches about conversion therapy worldwide and return more authoritative results. It is also unclear if Bing, the second most widely used search platform, has any policies at all related to conversion therapy searches.

It is however clear that, at least on Google, much conversion therapy information should be considered low-quality content by its algorithm. Google claims to give the lowest search ranking to web pages that are “Harmful to Specified Groups” and that promote or condone “Ill Treatment to a Specified Group.” It also gives a low rating to sites with “Harmfully Misleading Information” that provide “Harmful information that contradicts well-established expert consensus.” This is further described as, “Harmful claims that contradict well-established expert consensus…with expert consensus defined as a set of positions, facts, or findings that are widely agreed upon by authorities in the relevant field (e.g., widely-adopted medical guidelines, an investigative report put forth by a relevant watchdog group, etc.).” Conversion therapy arguably falls under these categories given the expert consensus of its harms. 

Search results on social media are often much worse in non-English languages. Major research on conversion therapy material on Facebook in Arabic by the Thompson Reuters Foundation found the material extensive and proliferating. They also documented a general unwillingness on the part of Facebook to remove the material even when it was flagged for the company. GPAHE’s research in Spanish, both in the U.S. context and in Colombia, and particularly in Swahili, find the results to be considerably less authoritative when compared to those in English. This lack of attention and resources to moderating non-English content is a pattern for other forms of supposedly banned content, such as hate speech, on social media platforms.

It’s time for the major internet and social media companies to wake up to their role in promoting harmful practices and disinformation. Conversion therapy is dangerous. If someone is searching for this material on any internet platform, they should only find authoritative results that document the therapy’s harms and offer real options for individuals and families who are looking for help. Anything else is spreading harmful disinformation. Akin to lies about vaccines, disinformation about conversion therapy is potentially deadly and should be taken just as seriously.

For years, civil rights organizations and policymakers have raised concerns both privately and publicly, begging the company to take action. It has not. Out of desperation to be heard, many organized boycotts, called for the board and company leadership to be replaced, and asked governments to step in. Still, Facebook’s strategy was to wait and do almost nothing.

Outside of the U.S., where vulnerable communities have fewer options for recourse, the picture is even bleaker. In a most horrifying case, Facebook was cited by the U.N. for playing a “determining” role in the genocide perpetrated against the Muslim Rohingya community in Myanmar. And in India, the Delhi State Assembly’s Peace and Harmony Committee just recently found that Facebook was complicit in the Delhi riots of February 2020, and should be investigated for every riot since 2014. Evidence shows that Facebook has at times seemingly collaborated with anti-Muslim regimes, such as the current ruling party in India, to protect hate speech by its leadership in contravention of its own anti-hate policies.

Facebook’s leadership has said repeatedly that the company’s policies against hate apply to everyone regardless of who they are or where they are, and yet the company continues to allow anti- Muslim material to stay on the platform, using a variety of excuses including “newsworthiness.” For example, Facebook has said that exceptions to its hate speech policy are sometimes made if content is “newsworthy, significant or important to the public interest.”

At the same time, the company contends that hate speech does not help its bottom line. If so, why has Facebook repeatedly chosen to leave up dangerous hate content, often generated by public figures with large audiences, such as President Donald Trump? Another case in point is India, where Facebook now has its largest user base and is investing in expansion and growth to dominate that very large market. The company is working closely with the current Indian government, in particular Prime Minister Narendra Modi, who was himself allegedly involved with stoking anti-Muslim violence when he was governor of the Indian state of Gujarat that led to the deaths of 1,000 Muslims. There appears to be a clear financial incentive to pander to Modi, who has one of the largest number of followers of any political leader on Facebook, and his political party. It is, of course, hate speech by such figures that is the most dangerous because of their reach and influence.

Facebook is seeding and cultivating anti-Muslim bigotry amongst its users, leading to real world violence against the 270 million Muslims living in the nine countries covered in this report. Facebook is indisputably the world’s engine for anti-Muslim violence. The time for discussion of this issue is over. Facebook must act now and end anti-Muslim hate on its platform, no matter who or what entity, is proliferating it.

Recommendations

The different online platforms, whether search engines, social media, or other technologies, each have unique problems when it comes to the presence of conversion therapy materials.  As a result, each sector needs to tackle the problem accordingly. These recommendations reflect the need to specifically address different aspects of the online ecosystem to ensure that users have access to authoritative material and information. 

Many social media companies claim to ban conversion therapy materials, but, as this report shows, a plethora of disinformation is slipping through their inadequate filters, especially in non-English languages. Tech companies must fulfill their promises to adequately moderate and assure the safety of users in other languages. 

All online systems must keep up with the constant rebranding and use of new terms, in all languages, that the conversion therapy industry uses. For example, “reintegrative therapy” and “same-sex attraction” are terms that return blatantly unauthoritative results and lead people to harmful resources.

Search Companies

Between them, the search companies Bing and Google cover nearly 95 percent of all search traffic worldwide. Both companies must immediately put in place filters that will direct those who search for conversion therapy material to authoritative sources. This is happening to some extent with Google, and to a lesser extent with Bing, but it is clear these companies are not up to date on the various euphemisms and terms that are used for conversion therapy. Because Amazon’s Alexa uses Bing, and Bing produces less authoritative results in all situations, voice search is a major source of disinformation on conversion therapy. Both companies must avail themselves of experts to keep their systems current.  They also need to invest in foreign language expertise and cultural competency as their results are far less authoritative in languages other than English. In some cases, they even direct their users to sites that are filled with dangerous disinformation. Even in English, outside the U.S., results are generally less authoritative.

Additionally, almost all searches returned unauthoritative material for “reintegrative therapy” and “unwanted same-sex attraction.” Search companies should address this problem in their determinations of authoritative material. Bing should analyze its knowledge boxes and automated additional search options, such as “conversion therapy near me,” which lead to additional pro-conversion therapy providers and resources.

Many tech companies add rainbows to their logos during pride month. True support of the LGBTQ+ community would be to deplatform conversion therapy and other anti-LGBTQ+ material.

Amazon

Amazon’s voice assistant, Alexa, uses Bing as its search engine. As a result, any problems discovered on Bing also apply to Alexa. Amazon should also take care that nonprofit conversion therapy providers are not included in its matching gift program, Amazon Smile. To its credit, Amazon has banned some books by Joseph Nicolosi, Sr., who used a technique, “reparative therapy,” that he created to help men overcome same-sex desires.

A preliminary search on Amazon’s Silk browser, which is the default browser on Amazon products apart from Alexa, returns a mixed bag of results for terms like “conversion therapy” and “reparative therapy,” which are largely authoritative on other browsers. For terms like “same-sex attraction” and “ex-gay cure”, the results are wildly unauthoritative and potentially damaging for users. It seems clear that Amazon has not invested resources in this area, but more research should be done.

Social Media

The big four–Facebook, Instagram, Twitter, and YouTube–all say they ban ads for and promotion of conversion therapy. GPAHE’s research has found that these bans are largely inadequate, and that conversion therapy is thriving on these networks. But there are differences by platform. For example, although Facebook continues to host several conversion therapy providers even after their ban (see Conversion Therapy Online: The Players) its search mechanism generally provides authoritative material on the dangers of conversion therapy. That does not hold true for YouTube, where search terms return non-authoritative material, some conversion therapy videos are monetized, and many providers have their own channels. On YouTube, non-English languages are highly problematic. Twitter is more of a mixed bag. Its search mechanism turns up a jumble of authoritative material and conversion therapy providers and promoters, regardless of language. 

Because so many conversion therapy providers are still present on the platforms, it is unclear if these social media bans were ever thoroughly applied. Overall, social media companies need to improve their content moderation practices, enforce their bans, fix their search systems where applicable, and invest in content moderation in non-English languages and increase their cultural competency.  YouTube needs to stop running ads on conversion therapy providers’ videos. And if they insist on flagging material rather than taking it down, despite their own rules, they need to do it systematically and reliably, in all languages. Also, every single provider profiled in Conversion Therapy Online: The Players that had a YouTube channel should be labelled appropriately and have some videos, if not all, removed from the platform. All social media platforms need to engage experts to make sure they are handling conversion therapy material according to their community guidelines and terms of service.

PayPal

It is unclear if PayPal has an official position on conversion therapy. In GPAHE’s report, Conversion Therapy Online: The Players, conversion therapy providers who have PayPal accounts are documented. In some cases, these organizations are listed on PayPal’s Giving Fund, which helps users fund their favorite charities. PayPal should drop all conversion therapy providers from its system.

Wikipedia

Search results routinely link to Wikipedia as an authoritative source for information about conversion therapy. In English and other major languages, that tends to be generally fine as items are heavily edited and vetted by the Wikipedia community. But GPAHE’s research has found horrific material on the site in Swahili, which search companies simply link to without considering what is published there. That needs to be addressed, and Wikipedia should take a hard look at its material on conversion therapy and the LGBTQ+ community in all languages.


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    What is Conversion Therapy and Why is it Dangerous? 

    In 2020, the Independent Forensics Expert Group (IFEG), established by the International Rehabilitation Council for Torture Victims (IRCTL) in partnership with Copenhagen University’s Department of Forensic Medicine, issued a “Statement of the Independent Forensic Expert Group on Conversion Therapy.” The statement reads in part, “Conversion therapy is a set of practices that aim to change or alter an individual’s sexual orientation or gender identity. It is premised on a belief that an individual’s sexual orientation or gender identity can be changed and that doing so is a desirable outcome for the individual, family, or community. Other terms used to describe this practice include sexual orientation change effort (SOCE), reparative therapy, reintegrative therapy, reorientation therapy, ex-gay therapy, and gay cure.” The IFEG found evidence of conversion therapy in 60 countries. The goal of such techniques is “to change, suppress, or divert an individual’s sexual orientation, gender identity, or gender expression,” and IFEG determined that there is a “lack of medical and scientific validity of conversion therapy” and significant harms because of the practice.  Other research has documented harms from these practices, including a higher rate of attempted suicide. The highly negative effects of this practice led the UN’s Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity to call for a “global ban on conversion therapy.” 

    Conversion therapy has also been deemed fraudulent. The IFEG declared that offering “conversion therapy” is a form of deception, false advertising, and fraud. A New Jersey court case also determined that a particular conversion therapy provider had engaged in consumer fraud and the provider was ordered permanently closed.

    The IFEG’s statement describes different techniques used by conversion therapists: “In those countries where it is performed, a wide and variable range of practices are believed to create change in an individual’s sexual orientation or gender identity. Some examples of these include: talk therapy or psychotherapy (e.g., exploring life events to identify the cause); group therapy; medication (including anti-psychotics, anti-depressants, anti-anxiety, and psychoactive drugs, and hormone injections); Eye Movement Desensitization and Reprocessing (where an individual focuses on a traumatic memory while simultaneously experiencing bilateral stimulation); electroshock or electroconvulsive therapy (ECT) (where electrodes are attached to the head and electric current is passed between them to induce seizure); aversive treatments (including electric shock to the hands and/or genitals or nausea-inducing medication administered with presentation of homoerotic stimuli); exorcism or ritual cleansing (e.g., beating the individual with a broomstick while reading holy verses or burning the individual’s head, back, and palms); force-feeding or food deprivation; forced nudity; behavioral conditioning (e.g., being forced to dress or walk in a particular way); isolation (sometimes for long periods of time, which may include solitary confinement or being kept from interacting with the outside world); verbal abuse; humiliation; hypnosis; hospital confinement; beatings; and ‘corrective’ rape.”

    For the purposes of this report, GPAHE relied broadly on the terms identified by the IFEG as associated with conversion therapy. See appendix for the exact list of terms used in GPAHE’s research into the nature of conversion therapy online.

    Additionally, almost all searches returned unauthoritative material for “reintegrative therapy” and “unwanted same-sex attraction.” Search companies should address this problem in their determinations of authoritative material. Bing should analyze its knowledge boxes and automated additional search options, such as “conversion therapy near me,” which lead to additional pro-conversion therapy providers and resources.

    Introduction

    This is a story that shows how the internet should work. A 17-year-old immigrant named Huong (a pseudonym to protect his identity) living in Australia was almost forced into a horrific conversion therapy program by his family. Huong, whose story is included in the 2018 report Preventing Harm, Promoting Justice: Responding to LGBT conversion therapy in Australia, had moved to Australia at the age of 11 with two family members. He was assigned female at birth, but always felt “different” in terms of gender. As a young teen, he assumed a more masculine look, cutting his hair short and doing “everything to make people see me as not female.” This upset his family, who assumed Huong was a lesbian. When he told his mother, who remained in their home country, about this gender dysphoria during one of her visits to Australia, her response was: “… like basically trying to talk me into conversion therapy … mom was like, ‘if you love me and if you love yourself, then you should go [home] during mid-year break … your uncle-in-law has been praying for you a lot, every night for a year or so. He has cured someone like you before. So, you should go because he could help you.’” 

    Huong initially agreed to go home, but then began online research on conversion therapy in his home country and became “really scared.” Huong describes what he read, “I looked up online and there were a lot of really shit stories. So, for example, things like parents could force [their queer children] to stay in a mental health hospital or asylum, even when they have no mental health condition that they need to be in there. They were parents who locked their children in … until they agreed to not be queer anymore … or … beat them up … And then there was one case that really struck me, where the father of a person … [that] either told their family that she was a lesbian, or their family found out somehow … [the family] got them drunk … and then when they were unconscious … let a guy who liked this young person [in] to … basically to rape them.”

    Story Bridge in Kangaroo Point, Australia, lit up in celebration of a Parliamentary “yes” vote on marriage equality.

    Armed with this terrifying information, Huong courageously decided not to return home and be subjected to possible abuse. He was eventually able to find help to remain in Australia and enroll in university there. Because he found this information about conversion practices online, he was able to avoid terrifying techniques that might have been used to “correct” him. Authoritative resources from a search provider saved Huong from that.

    If only Huong’s experience was the typical one. More typical is Omar’s, whose story was told in a 2021 series about conversion therapy by the Thompson Reuters Foundation.

    Growing up in a small town outside of Cairo, Omar, whose last name is omitted because his family is unaware he is gay, began to feel sexually attracted to other men. Terrified to tell those around him, something common for those who may be gay and live in conservative societies, he turned to Facebook for information. Searching in his native Arabic, Omar didn’t find authoritative information: rather he was led to conversion therapy by what he found on Facebook.

    “Facebook led me to conversion therapy, and I’m not alone,” said Omar, now 24. As a teenager, he came upon the Facebook page of Awsam Wasfy, who has nearly 150,000 followers and says his therapy sessions can “treat” homosexuality. Omar read Wasfy, connected with his followers, and began sessions with another therapist he found through Facebook. “I didn’t start out looking for treatment, I wanted to understand, is it normal?” Omar told the Thomson Reuters Foundation. But after feeling threatened by the way the therapist interrogated him, Omar stopped the sessions – describing it as a narrow escape. “I am lucky the so-called doctor wasn’t violent towards me. He definitely had the potential to be,” said Omar, now an activist who has moderated several Arabic Facebook groups created by LGBTQ+ activists.

    Wasfy, who has over 150,000 followers on a page where he advertises his abilities to “cure” homosexuality, remained active on Facebook after the Thomson Reuters Foundation report. So, too, Heba Kotb, who has over two million followers and says she has successfully “treated” over 3,000 gay people from all over the Arab world, including by performing anal exams as part of a “sexual assessment.” Facebook told Reuters that neither page had any “active” violations.

    GPAHE’s extensive research into online conversion therapy indicates that Omar’s story is likely more typical than that of Huong. The problems are multi-fold and touch on every aspect of accessing information online. What follows is a deep dive into how conversion therapy presents online in different countries and languages. 

    Among thousands of Facebook users who were members of multiple extremist Facebook groups, Squire found that 61 percent of “multi-issue” users who were in anti-immigrant groups had also joined anti-Muslim groups; the same was true for 44 percent of anti-government groups, 37 percent of white nationalist groups, and 35 percent of neo-Confederate groups. “Anti-Muslim groups are way worse, in every way, than what I would have guessed coming in,” Squire said at the time, “Some of the anti-Muslim groups are central players in the hate network as a whole. And the anti-Muslim groups show more membership crossover with other ideologies than I expected.”

    Civil rights organizations have repeatedly warned Facebook that anti-Muslim posts, ads, private groups, and other content are rampant on a global scale. As early as 2015, Muslim Advocates informed Facebook that its event pages were being used to organize activities by anti-Muslim militias and hate groups, including armed anti-Muslim protests in the U.S. The Southern Poverty Law Center also reached out to Facebook privately starting in 2014 to warn the company about hate groups on its platform, including dozens of anti-Muslim hate groups.

    Methodology

    GPAHE employed researchers to conduct online investigations in six countries: Australia, Colombia, Ireland, Germany, Kenya, and the United States. In the U.S., research was conducted in both English and Spanish. Each researcher was given a list of terms to use in their searches of Google, Bing, Facebook, Instagram, Twitter, and YouTube. They conducted these searches on laptops, mobile devices, and on Alexa and Siri. Researchers collected screen shots of search outcomes and documented any autogenerated items such as Google’s knowledge panels or the suggested search terms that surfaced. Conversion therapy providers found on social media were documented on every platform and any monetization, for example a PayPal account, was also documented. Search functions on social media were used to determine if the systems linked conversion therapy providers together and suggested accounts were captured to see if they favored additional conversion therapy outfits. It should be noted that because of the way the technology, search, and social media companies retain data about all users and use that data to influence what we see as users, it’s possible that an individual may not be able to replicate the described GPAHE report results exactly, but they will be very close.

    The terms used in these searches are found in appendix. 

    The online ecosystem of conversion therapy providers discovered through this process, as well as their social media or monetization of accounts can be found in Conversion Therapy Online: The Players. That report is intended to profile current conversion therapy promoters and provide authoritative resources on their activities. Thanks to excellent reports by openDemocracy, OutRight International, The Trevor Project, Human Rights Campaign, GLAAD, and many others, a corpus of research on the conversion therapy universe does exist, especially on organizations in the U.S. and Europe. GPAHE’s report is expected to serve as an authoritative resource along with existing material for the tech platforms to use as a screening mechanism and as an additional resource for those who search for these organizations or conversion therapy in general. 


    RELATED REPORT

    Conversion Therapy Online: The Players

    Anti-LGBTQ+ Conversion Therapy Proponents Who Wrongly Believe that Sexual Orientation and Gender Identity Can and Should be Changed Have Found a Home Online.

    Conversion therapy never goes away, no matter the scandals, reports of its harms, official condemnations, or legislative bans. The movement, under new names and with new justifications and “therapies,” continually rebrands and resurfaces to carry on its demonization of LGBTQ+ people in a coordinated and international way.

    Country Studies: Conversion Therapy Online

    Australia

    Searches on Google in Australia generally follow the same patterns as those in other English-speaking countries. 

    “Ex-gay therapy,” “conversion therapy,” and “gay cure” return highly authoritative results and display ads by reputable organizations, such as the Arcus Foundation and Child USA. “Reparative therapy” returns largely authoritative results, but it does surface a link to josephnicolosi.com, that links to Joseph Nicolosi, Jr.’s reintegrative therapy website through a popup. “Reintegrative therapy” returns about a dozen links to Joseph Nicolosi, Jr.’s material or sites that host material about his therapy. Only the last two links on the page reference authoritative sources or news reports about conversion therapy. The “related searches” at the bottom of the page point to other conversion therapy providers including the National Association for Research and Therapy of Homosexuality (NARTH), now renamed as Alliance for Therapeutic Choice and Scientific Integrity, and David Pickup. The problems spill onto page two, where images from Nicolosi Jr.’s website are prominently displayed, as are links to other conversion therapy providers.  

    Google search for “unwanted same-sex attraction” returned unauthoritative results, even directing users to providers.

    “Unwanted same-sex attraction” is more of an assortment, with legitimate reports interspersed among links to conversion therapists and anti-LGBTQ+ organizations such as Focus on the Family. There is also an ad at the bottom of the page that links to a piece by the National Catholic Register that defends conversion therapy.

    On Bing, searching for “ex-gay therapy,” “gay cure,” and “conversion therapy” returns authoritative results. As is the case in other countries, Bing returns suggested searches including “conversion therapy near me” and “conversion therapy in” various local areas. “Reparative therapy” is predominantly authoritative, though there is a link to josephnicolosi.com and to a YouTube video of him talking about his work. Related searches include “national association of reparative therapy” which leads to NARTH, now called Alliance for Therapeutic Choice and Scientific Integrity, and more unauthoritative information. This is how someone looking for real information ends up down a rabbit hole of disinformation.

    Results for “reintegrative therapy” are another matter. Bing returns direct links to Joseph Nicolosi, Jr.’s website, YouTube videos of Nicolosi, Sr., the Reintegrative Therapy Association’s Facebook page and a YouTube channel devoted to the therapy, and a report on his lawsuit against two Canadian researchers. “Unwanted same-sex attraction” returns links to conversion therapy providers and an automated question “are there therapists that treat unwanted same-sex attraction” that is answered with a glowing review of NARTH’s work on the Ottawa, Canada-based Campaign Life Coalition’s website. Another automated question links to material found on the anti-LGBTQ+ Focus on the Family’s website.

    YouTube searches for “reintegrative therapy” return several videos by practitioners, including the first five videos on the page. “Unwanted same-sex attraction” returns videos from conversion therapy providers and supporters, including the Colorado Springs, Colorado-based Family Policy Alliance and anti-LGBTQ+ Gilbert, Arizona-based and SPLC-designated hate group Family Watch International, both of which have YouTube channels.  “Reparative therapy” returns authoritative videos and a disclaimer by The Trevor Project. “Ex-gay therapy” and “conversion therapy” return authoritative sources, with the latter also displaying a disclaimer with information from The Trevor Project. 

    Experience on Facebook and Twitter mirrors that of other English-speaking countries. The algorithms of the social media companies can lead users down a conversion therapy rabbit hole once they land on a provider. It is usually not possible to use those search mechanisms to find the providers without having their exact names typed into search. Since conversion therapists are linked together on these sites, once a user has found one, they are then led to the others. In general, Facebook’s search mechanism is largely authoritative and Twitter’s less so, but YouTube’s search mechanism returns pro-conversion therapy material quite frequently.

    Conversion Therapy Online in Ireland

    The search results on Google in Ireland pertaining to “ex-gay therapy” and “gay cure therapy” are predominantly authoritative. They return medical journals, reports documenting the harm of conversion therapy, and authoritative newspaper articles about providers. Phrases such as “is my gay child my fault” and “I don’t want to be gay” led mostly to authoritative sources as well, although links to quora.com, a discussion site, sometimes led to anti-LGBTQ+ material. Only occasionally did these searches lead to actual providers in Ireland and the UK, including the Core Issues Trust and the True Freedom Trust (see Conversion Therapy Online: The Players).

    A Google search for “unwanted same-sex attraction” returned “related searches” that led directly to a conversion therapy provider and additional searches for “conversion therapy.”

    A Google search for “reparative therapy” returned authoritative results and only one link to a provider, Joseph Nicolosi, Sr. But a search for “reintegrative therapy” leads largely to providers of the practice, a problem found in other countries and languages as well. The same is true with a search for “unwanted same-sex attraction.”

    As is the case in many other locations, Bing’s results are less authoritative. For “conversion therapy,” the results are highly authoritative not just in terms of links but also autogenerated boxes. “Reparative therapy” leads to links to Joseph Nicolosi, Sr.’s material. Nothing authoritative comes up for “I don’t want to be gay.” For “ex-gay therapy,” the results are mostly authoritative, but an autogenerated question, “Are there any reparative therapy programs for gays?” answers with a pro-conversion therapy sentence from an article in Christianity Today. Searching for “unwanted same-sex attraction” leads to conversion therapy providers, and autogenerated questions use Christianity Today and the anti-LGBTQ+ Focus on the Family as sources. Searching for “reintegrative therapy” leads directly to several sites or social media accounts of Joseph Nicolosi, Jr. The automated questions simply repeat Nicolosi’s own words. The related search results all lead to conversion therapy sites or therapists.

    The Irish experience in terms of social media parallels that of the American experience in English. The algorithms of the social media companies can lead users down a conversion therapy rabbit hole once they land on a provider, as conversion therapists are linked together on these sites. Facebook’s search mechanism is largely authoritative and Twitter’s less so, but YouTube’s search mechanism returns pro-conversion therapy material quite frequently.

    Germany: Authoritative Material Predominates

    There are two things unique about the German online ecosystem when it comes to conversion therapy. First, Germany banned the practice for minors in 2020. The passage of the law did not evince massive protest in the country, and nearly every political party, except the anti-immigrant Alternative for Germany, voted in support of the law or abstained because they believed the law should be stronger. The political class was united in that the LGBTQ+ community needs no fixing. “Homosexuality is not an illness,” said the openly gay Health Minister Jens Spahn at the time. “Therefore, the term therapy is already misleading.” Under the new law, advertising or offering conversion therapy is banned for children up to the age of 18. Violators can be fined up to €30,000 or sentenced to up to one year in prison. 

    A German Google search for “conversion therapy” led to authoritative results.

    The ban appears to have been extremely effective in terms of the online presence of conversion therapy, as GPAHE’s research found no practitioners in Germany and only links to one provider in Switzerland. 

    Secondly, Germany has one of the most developed laws against hate speech online, the NetzDG. Passed in 2017, the law requires major tech companies to remove toxic content quickly. The law led to an increase in content moderators in Germany due to the massive fines for failure to comply. It is an open question how well the law has worked, but it appears tech companies have responded, if not completely effectively. 

    Unlike what GPAHE found in most other countries and languages, Google searches in German for various conversion therapy terms came up almost entirely with authoritative results. Wikipedia entries dominate page one, as well as government reports decrying conversion therapy. Even the Knowledge Graph for “ex-gay bewegung” was accurate about the methods. The same was true of searches for “reparativ therapie,” which nearly always pointed to material for “Konversion therapie,” where the results were almost entirely authoritative. There is one exception, “reintegrative therapie,” where links to reintegrativethereapy.com dominate the first four results, although authoritative sources do surface after that. The results on mobile search tracked these same patterns.

    As has been the case throughout GPAHE’s research, Bing’s results are less authoritative. They led to YouTube videos created by “ex-gays,” and disinformation on “reparative therapie,” but also authoritative materials about the practice. Searches for “reintegrative therapy” on Bing favored Joseph Nicolosi, Jr., and his website, and led to a Russian site, pro-LGBT.ru, that pushes viciously anti-LGBTQ+ ideas and include Nicolosi Sr.’s and material from a conference by the International Federation for Therapeutic and Counseling Choice (IFTCC) in London. 

    YouTube searches connected with ex-gay videos, including Ramin Parsa, Carlos Catari (whose videos are subtitled in Polish), and “reintegrative therapy” on YouTube turned up a number of videos. 

    No German conversion therapy organizations surfaced, though a Swiss outfit run by a German who fled after the ban did show in the results. Called Wuestenstrum, the group employs techniques derived from Desert Stream Living Waters and is featured in YouTube videos on the Voices of the Silenced channel. 

    Conversion Therapy Online in Kenya

    Kenya has two official languages, English and Swahili. But when it comes to conversion therapy online, it’s as though the two languages are from two different universes. In the English universe, internet users receive relatively authoritative material, though not as much as English speakers in other regions. In the Swahili universe, the LGBTQ+ population is disparaged and mocked, blatant anti-LGBTQ+ propaganda flourishes, and conversion therapy is treated as legitimate. 

    Disastrous Search Results in Swahili

    GPAHE’s research conducted from Kenya on conversion therapy in Swahili, which is spoken in several East African countries and is the first language of about 16 million people, although spoken by about 80 million people, are particularly troubling. Whereas Google search results in English in multiple countries have problems, the searches appear to be moderated with authoritative material, but the results in Swahili are shameful. In searches for phrases connected to conversion therapy, about half of the results on the first page are problematic and many of the results that surface are disparaging to the LGBTQ+ community. 

    The Russian, viciously anti-LGBTQ+ and pro-conversion therapy site, pro-LGBT.ru, came up repeatedly in Bing searches.

    A Google search for “gay cure therapy” finds four authoritative sources, three of which are at the bottom of the first search page. While the first link is to an authoritative source by Human Rights Watch, other results include a highly troubling Wikipedia page, and YouTube videos, “homosexual medicine,” and “the gay medicine,” both of which were monetized with ads. Another video depicted a grotesque stereotype of an LGBTQ+ person. The second page of results was worse, with links to a Russian website, pro-lgbt.ru filled with disinformation and supportive of conversion therapy. 

    Bing’s results for “gay cure therapy” were dismal. The first page returned results linked to pro-lgbt.ru, disparaging YouTube videos, and a semi-supportive page that directs members of the LGBTQ+ community to medical resources for STDs but speaks of the community in a disparaging tone. One link does point out that conversion therapy is a fraud. 

    A search on Google for “reintegrative therapy,” sends searchers more than once to pro-LGBT.ru, and to other sites pushing conversion therapy. A Google search for “treatment of unwanted same-sex attraction” mimics that of “reintegrative therapy.” 

    Searching on Google for “is homosexuality a sin,” the results are mostly problematic on the first page. There are links to pages that declare yes, it is a sin, that homosexuality is a “life of debauchery,” a speech by Rev. Innocente Kamote called “How to Overcome the Sin of Homosexuality!” and a link to bibleinfo.com, which sends readers to an ex-gay site. 

    Bing has similar problems. Its first page of results links to “God again promises power over sin, as well as homosexuality, for all who will believe in Jesus Christ,” What does the Holy Bible say about homosexuality? Is homosexuality a sin?” and a piece on maxshimbaministries.com titled, “God did not create humans to live a life of debauchery. The Bible tells us that a person becomes homosexual because of sin.” Not one piece supportive of LGBTQ+ rights appears on the first page.

    Many of the searches led to a particularly disturbing website filled with disinformation, the Russian site pro-lgbt.ru, a massive anti-LGBTQ+ website filled with disparaging material on the community and translated into dozens of languages, notably many that are relatively rare. The site describes itself as existing “to disseminate facts that are deliberately kept silent by the leaders of the LGBT movement, which leads to the involvement of unsuspecting citizens in a destructive lifestyle fraught with the most serious consequences for their health and well-being.” 

    An anti-LGBTQ+ YouTube video in Swahili was monetized with a VRBO ad.

    The site features articles such as “secrets of gay propaganda,” “The LGBT sect recruits your children,” and “Demographic Consequence of non-traditional sexual behavior.” Promoting conversion therapy, it says, “The assertions that conversion therapy is not only ineffective, but in all cases causes great harm to the body are false. The corresponding argumentation can be found in our articles. Moreover, a number of our works have presented the effective use of conversion therapy.”

    Interestingly, the website also seems to block the translation of some of its most inflammatory material into English. For example, an article in Swahili titled, “Can I Change my Sexual Orientation?” that asserts “There is strong clinical evidence that unwanted homosexual attraction can be effectively eliminated,” will not translate into English. More research is needed to learn how much false “information” the site may be disseminating in the many languages it hosts.

    Another interesting aspect of search in Swahili is that, as is common in English, one of the first results is often a Wikipedia entry. But in Swahili, the entry that is linked as a top search result is filled with disinformation. On the Wikipedia page, “Ushoga,” translated as “Homosexuality,” the amount of disinformation and disparagement of the LBGTQ+ community is shocking. Filled with information including, “But sometimes it is that the person has been affected by an incident that occurred especially in childhood or has allowed himself to try to do it until he is so used to it that he is unable to recover” and “Advocates of homosexuality, however, want the youths to be given anti-retroviral drugs so that they can later undergo surgery for genital mutilation.” The page suggests that human beings should not follow their “tendencies” such as having sex with a child or eating too much, and they must first consider the “moral good.” After stating that in Africa, coming out can be dangerous and subject individuals to violence, it warns that one’s family will likely reject you, which is an encouragement to seek conversion therapy. It describes “homosexuals” as having “unhealthy desires” that “destroy the very foundation of social life.” After noting that some religious traditions no longer accept discrimination against the LGBTQ+ population, the entry asks, “Yet the question of morality remains: is it lawful to follow any pattern that we feel or have practiced by repeating evil deeds? If we allow people to do whatever they want, what will society be like?”

    Conversion Therapy in English in Kenya

    In English, Kenya’s internet users experience a similar environment to those in other English- speaking countries. In fact, there is so much similarity across countries in English searches that GPAHE’s research confirms other work revealing that tech companies put most of their resources for protecting users from harm into English, leaving speakers of other languages to experience a much less authoritative and more dangerous online experience. They also, at least when it comes to conversion therapy, appear to prioritize American sources over those of other countries that predominantly speak English.

    A Google search for “ex-gay therapy” turns up several articles on the first page from legitimate sources including America’s National Public Radio, an authoritative Wikipedia entry on the “ex-gay movement” along with a knowledge panel based off the entry, and material from mainstream American newspapers and NGOs. There are also a series of links to the recent documentary, “Pray Away,” that explored the horrors of conversion therapy. It isn’t until page three that users are directed to specific conversion therapy organizations. Similar results are found on Bing, but the first link to come up is a pro-conversion therapy site, ex-gay.com. Interestingly, although the other results are also authoritative, they come from completely different sources than Google, including Huffington Post, The Advocate, and The American Prospect. Bing has a knowledge panel that sources from Wikipedia, and on page two, it features at the top of the page an article from The Cut, along with a photograph, called “What it’s like to experience gay conversion therapy.”

    As has been found in other contexts, searches on YouTube lead to very concerning results. The top result is about right-wing firebrand Milo Yiannopoulos, who recently claimed to be cured of homosexuality and now has made it his mission to rehabilitate conversion therapy as a practice. Only one of the next five search results was authoritative, with the others supporting the notion that one can become ex-gay. 

    Conversion Therapy Online in Colombia

    GPAHE conducted online research into how conversion therapy surfaces online in Spanish in the U.S. and Colombia. The U.S. has about 43 million native Spanish speakers, and Colombia has a population of 45 million, most of whom are native Spanish speakers. Worldwide, Spanish is the native language of about 450 million people and is the second most widely spoken language in the world behind Mandarin. Online activity in Spanish is critical to an enormous number of people. 

    A search for “terapia de reintigración” on Bing leads the user to a site that pushes viciously anti-LGBTQ+ ideas.

    Considerable research has already shown that disinformation and hate in Spanish is a serious problem, particularly on social media. So too are the results, depending on the platform used, for conversion therapy.

    Google search was surprisingly authoritative in Colombia. The results for “ex-gay therapy,” “therapy to cure homosexuality,” “is it a sin to be gay,” “reintegrative therapy,” and “reparative therapy” returned authoritative results. There were also several links to statements by Catholic Church officials including Pope Francis that is it not a sin to be gay, links to official statements by psychological associations in Latin America decrying the practice, links to the film “Pray Away,” and legitimate articles from international newspapers on the harms of conversion therapy. Interestingly, the term “reintegrative,” which in Spanish translates as “reintegracion,” pulled up articles in the Colombian context about the reintegration of guerilla groups after demobilization, which may have obscured any search for conversion therapy using that term. A search using the English term “reintegrative” and Spanish for therapy (terapia), returned an article in the Chilean religious publication, PortaLuz, defending Nicolosi Jr.’s therapeutic practices as separate from past conversion therapy practices and citing as evidence a study published by another conversion therapy provider, the Alliance for Therapeutic Choice and Scientific Integrity. The rest of the results were unrelated. A search for “reintegrative therapy” in English, which Google autosuggested be used, gave the Reintegrative Therapy Association’s website as the first result. Second was the PortaLuz article. The other results were unrelated but there were pictures from Nicolosi Jr.’s website depicted at the bottom of the search, which linked to his materials.

    The experience on Bing was far more concerning. For “ex-gay therapy,” most results were authoritative, but the search pulled up and featured YouTube videos supporting the therapy and a link to the National Association for Research and Therapy of Homosexuality (NARTH), now renamed as the Alliance for Therapeutic Choice and Scientific Integrity. A search for “reintegrative terapia” brought up an autogenerated box that sampled material from the viciously anti-LGBTQ+ Russian website, pro-lgbt.ru. The second page of results led searchers directly to reintegrativetherapy.com. A search for “reintegrative therapy” in English, brought up an autogenerated box that included material directly from the Reintegrative Therapy Association’s website as well as two more links to its website. Other searches for “reparative therapy,” “is it a sin to be gay,” and “therapy to cure gays,” were largely authoritative.

    On both Bing and Google, related searches drove users to additional conversion therapy sources that returned nonauthoritative results.

     

    Videos by anti-LGBTQ+ groups surfaced on YouTube in Spanish searches in Colombia.

    YouTube’s search mechanism provides authoritative material on conversion therapy when searching for “ex-gay therapy” or “gay cures,” in Spanish, but other terms lead to worrisome results. “Reparative therapy” led to videos by Joseph Nicolosi Sr. as well as videos of conferences on the topic, though they are mixed in with more authoritative material. A search for “unwanted same-sex attraction” is particularly problematic. The first video is by the anti-LGBTQ+ group Family Watch International, and the next is a video of a woman who claims she found freedom from “a Homosexual lifestyle” (which was monetized with ads from VRBO and Lexus when viewed by GPAHE researchers). Another video tells the story of Kevin Williams, an “ex-gay” activist. “Reintegrative therapy” had no results related to conversion therapy. 

    There are prominent Colombians who are anti-LGBTQ+ and who promote conversion therapy on their social media channels. Angela Hernandez, a former Colombian local elected official, has more than 30,000 followers on Twitter and has promoted “ex-gay” individuals. Andres Corson, leader of the church El Lugar de Su Presencia, calls homosexuality sinful if acted upon and believes gay people can be cured. He has a YouTube channel with nearly two million followers, a Facebook page with 640,000 followers, and more than 300,000 on Instagram.

    The United States English-Speaking Experience

    Google search returned largely authoritative results for several terms, including “ex-gay therapy,” where only authoritative results returned, though ads for “gay conversion therapist near you” did appear. Similar authoritative results returned for “conversion therapy,” though there was one ad by the National Catholic Register for “Reparative theory is under attack.” “Gay cure” returned only authoritative results. “Reparative therapy” only returned one problematic result, a link to josephnicolosi.com. 

    “Reintegrative therapy” was a different story. In the search box, Google suggested a companion search to Tim Long, who is a provider. The first five results led directly to providers, including reintegrativetherapy.com and images for the website were prominently displayed. Related searches also drove traffic to Reintegrative Therapy founder, Joseph Nicolosi, Jr., both his reintegrative website and his Breakthrough Clinic. “Unwanted same-sex attraction” led to providers and supporters, including Family Watch International, the Nebraska Family Alliance and Desert Stream Living Waters (see NAME report). 

    On Bing, “ex-gay therapy” led mostly to authoritative material, but a Family Policy Alliance YouTube video was prominently featured. For “conversion therapy,” only one troubling source surfaced from Christian Life Magazine. “Gay cure” was similarly authoritative. “Reparative therapy” was largely authoritative for the first five results, including knowledge boxes autogenerated by Bing, but there were also links to josephnicolosi.com, and links to Nicolosi Sr.’s videos and providers, including David Pickup. For “reintegrative therapy,” nearly half the page was taken up by links to reintegrativetherapy.com. There were also links to its Facebook page and other providers, including David Pickup. “Unwanted same-sex attraction” was similarly nonauthoritative. It returned links to conversion therapy providers and the anti-LGBTQ+ Focus on the Family, which also served as a reference page for automated questions including “do you have to act on same-sex attraction?” and another, “Are there any therapists that treat same-sex attraction,” which directed users to conversion therapy proponent the National Association for Research and Therapy of Homosexuality, or NARTH, now called the Alliance for Therapeutic Choice and Scientific Integrity. (see Conversion Therapy Online: The Players).

    In the U.S. in English, a Bing search for “reintegrative therapy” returned more than a half-page of results from the Reintegrative Therapy Association’s website.

    For YouTube in the U.S., searches for “ex-gay therapy,” “conversion therapy,” and “gay cure” are authoritative. “Reparative therapy” is also authoritative except for one link to a video by the Alliance for Therapeutic Choice and Scientific Integrity, which also has a YouTube channel. The results for “reparative therapy” are predominantly authoritative and have a label from The Trevor Project. The results for “reintegrative therapy” are mostly links to providers, including the top result sending users directly to the Reintegrative Therapy YouTube channel as well as its videos, IFTCC, and New Hampshire Cornerstone, which also has a channel.

    The United States Spanish-Speaking Experience

    Google searches for conversion therapy terms in Spanish from the United States are in some cases even more disturbing than they were in Colombia. The search results for “conversion therapy” are highly authoritative and link to several expert reports as well as advertisements by groups like the Arcus Foundation and Human Rights Campaign. Searches for “ex-gay therapy” and “gay cure” return medical results and legitimate news articles as well as authoritative Wikipedia entries. “Reintegrative therapy” also returns authoritative results as well as results related to therapies that have nothing to do with conversion, but rather relate to different therapies, sometimes court-ordered having to do with the “reintegration of families.”

    The situation is different with “reparative therapy.” In this case, the first two links are to catholic.net and provide ill-informed defenses that assert changing sexuality is possible and cite disinformation regarding health issues in gay men. There is also a link to Parents and Friends of Ex-Gays (P-FOX), and to a site hosting an excerpt of a book by Joseph Nicolosi Sr. There are three more links to Nicolosi material on the first page, and a link to the conversion therapy group, Exodus Latino America. A search for “Unwanted same-sex attraction” returns links to the National Association for Research and Therapy of Homosexuality (NARTH), now the Alliance for Therapeutic Choice and Scientific Integrity, the anti-LGBTQ+ Spanish group CitizenGO, Voice of the Voiceless, and a link to the Church of Latter-Day Saints that advocates celibacy. Page two links to additional conversion therapy providers Joel 2:25 and Exodus Latino America. A search for “I don’t want to be gay,” led to more Nicolosi material, but also legitimate results from the American Psychological Association and PFLAG. 

    On Bing, a search for “conversion therapy,” “ex-gay,” and “gay cure” therapy turned up predominantly authoritative results. Just as in Colombia, a search for “reintegrative therapy” brought up an autogenerated top of the page box that sampled material from the viciously anti-LGBTQ+ Russian website, pro-lgbt.ru, and the second link was to the site as well. The other results were unrelated. The second page had a link to reintegrativetherapy.com. A search for “reparative therapy” did bring up an authoritative autogenerated box at the top of the page, but then there were links to disinformation on catholic.net, YouTube videos on the practices, and links to anti-LGBTQ+ sites such as P-FOX. The first page results for “overcoming same-sex attraction” were riddled with pro-conversion therapy sites, including NorthstarLDS, a story on the founder of the conversion therapy organization Courage, and Mormon Church pages. Page two results were even less authoritative. 

    A YouTube search for “conversion therapy” surfaced videos produced by anti-LGBTQ+ groups.

    YouTube results for Spanish in the U.S. are quite different than in Colombia. Results for “ex-gay therapy,” “conversion therapy,” “reintegrative therapy,” and “gay cure therapy” are all authoritative. A search for “reparative therapy” returns a handful of links to Joseph Nicolosi, Sr., videos, though they are farther down on the page. The results for “same-sex attraction” are the least authoritative, with several links to videos pushing conversion therapy. “Unwanted same-sex attraction” comes up with multiple providers and almost no authoritative material. Videos from pro-conversion therapy outfits including Family Watch International, Core Issues Trust, and International Federation for Therapeutic and Counseling Choice, among others, are displayed.

    Social Media Rabbit Holes 

    Because conversion therapy providers network tightly with one another, social media algorithms tend to send people down rabbit holes of additional providers and information, without much effort to surface authoritative materials. Meaning that their search functions have been better moderated than their suggested additional content algorithms.

    On Twitter’s recommendation algorithm, the Core Issues Trust suggests another conversion therapy outfit, True Freedom Trust.

    On Twitter, once one lands upon a conversion therapy organization, the recommendation systems lead to additional providers. For example, starting with the Core Issues Trust’s account on Twitter, a user is then given the suggestion to follow the True Freedom Trust, another provider. They are also exposed to hashtags like #ex-gay or #freedommarch, an event put on by another related organization, or sent to YouTube videos by the group. If one clicks on True Freedom Trust, the same process continues with additional suggestions to follow other providers, more related hashtags and so on. The accounts also link to the groups’ websites or other social media accounts, leading to more material off platform. 

    It is notable that on Twitter, using the search box to find material on conversion therapy leads to a measure of authoritative material for certain search terms. A search for “conversion therapy,” returns accounts for “Therapists against conversion therapy & transphobia,” and “BanconversiontherapyNI.” Tweets pulled up by such searches were somewhat authoritative, including news reports, medical statements, and other useful resources. But other providers also came up in the search. As was the case in Google and Bing searches, the terms “reintegrative therapy” and “unwanted same-sex attraction” returned less authoritative results than “conversion therapy” or “ex-gay therapy.”

    On Facebook, the situation is somewhat better than Twitter. Searches for “conversion therapy” and similar terms largely return authoritative material. Also, the automated “see all groups for ‘conversion therapy’” returns authoritative results. That said, there are dozens of conversion therapy providers on the platform. Their pages distribute their conversion therapy materials and propaganda and drive individuals off the Twitter platform to other social media and websites. Some problems arise with “reparative therapy,” which leads to the Reintegrative Therapy page, as does a search for “reintegrative therapy.” Interestingly, on the Reintegrative Therapy page, Facebook’s algorithm suggests as related pages LGBTQ+-affirming ministries. But the page for “SSA Hope,” suggests Reintegrative Therapy’s page, so there is an aspect of a rabbit hole on Facebook, but it does not seem to be as problematic as Twitter’s.

    Problems with YouTube have been documented throughout this report. Several conversion therapy providers have channels on the site with thousands of subscribers and videos with hundreds of thousands of views. YouTube’s search function also leads to nonauthoritative material in many instances, and GPAHE research has found conversion therapy videos that are monetized. Additionally, although YouTube does label some conversion therapy videos with a disclaimer about the practice, the labels are applied sporadically and do not cover many materials. But on YouTube, suggested videos (videos that run on the right side of a video that is playing) do not uniformly link to other conversion therapy videos, which somewhat lessens the chances of one going down a rabbit hole.  

    Search Results for Conversion Therapy Providers 

    Besides generalized searches on Google and Bing for phrases and concepts related to conversion therapy, the other way in which searchers may come upon this material is by looking up a particular provider. It is the responsibility of Alphabet and Microsoft to provide authoritative material in those situations, and yet it is not happening in any systematic fashion. 

    In the United States, a Google search for the Alliance for Therapeutic Choice and Scientific Integrity, a long-time conversion therapy provider, returned a half-page of results from the group’s website and knowledge box that gave a map to their location, links to their website, and driving directions and described the group as “Non-profit organization in Murray, Utah.” There were two other supportive links but also authoritative sources from GLAAD, PFLAG, and the Southern Poverty Law Center.

    On Bing, a search for the group also gave a half-page of results directly linking to the Alliance. Of the rest, only a Wikipedia entry was authoritative and the others either linked to more Alliance material or other conversion therapy providers. Bing’s knowledge box was more authoritative than Google’s, describing the group’s work as “conversion therapy.” Related suggested searches included “conversion therapy camps near me” and “conversion therapy sign up.”

    A Google search for Desert Stream Living Waters, a long-time conversion therapy provider, returned seven links to the group itself at the top and then its Facebook page. Two videos from the group on YouTube also surfaced, as well as a link to its app on the Apple App Store. The only authoritative link was to a Wikipedia page on the group’s founder. 

    On Bing, the first result was an autogenerated box to a site that rates the group’s activities. It does not mention their work on conversion therapy but rather describes them as “an outpatient program for adults who are 18 and over seeking help for a number of issues including substance abuse or addiction.” There is another box, on the right side of the search results, that features an image from the group’s website and says, “Andrew Comiskey founded Desert Stream/Living Waters Ministries in 1980, when he and his wife, Annette, responded to their pastor’s call to start a healing/support group.” The information box, oddly enough, says it is derived from Google. It also links to a flattering profile of the group on another conversion therapy site, couragerc.org and its videos on YouTube. There are no authoritative results.

    A Google search for Restored Hope Network, another long-time conversion therapy provider, returned seven links on the first page to the group’s site, its Instagram account, and a GuideStar profile. The page also included a knowledge box with prominent pictures of its principals and website, a link to its website, and related links to other conversion therapy proponents and providers. The description of Restored Hope Network was authoritative, having been pulled from Wikipedia. The only authoritative source was the group’s Wikipedia entry.

    On Bing, Restored Hope Network’s first six results were from its website. That was followed by four autogenerated click options, labeled as “other content from restoredhopenetwork.org,” that lead searchers to its mission page, its donation page, a page of “resources” on “transgenderism,” and an article by the group’s leader on why conversion therapy is not harmful. On the right side of the results is an autogenerated box that describes the group as an “organization” and then provides a description from Wikipedia, “Restored Hope Network is an ex-gay network of interdenominational Christian ministries and individuals. The network holds an annual conference in a different location in the United States each year that offers counseling and conversion therapy and has speakers that offer advice for families with LGBT relatives and outreach to churches.” The box links to the group’s website and other conversion therapy providers. The only authoritative site in the search results is Wikipedia, and there is one Facebook page devoted to shutting down one of the group’s conferences in 2019. In an autogenerated ad half-way down the page labeled “People Also Ask,” there are questions such as “Why do we need Restored Hope Network?” which then leads to the group’s website. There are also links to the group’s videos on YouTube.

    These examples reveal the problems with these searches. The same issues arose in research on other providers and in other languages. 

    Reintegrative Therapy – The Next Generation of “Curing” LGBTQ+ People 

    The anti-LGBTQ+ movement continues to rebrand ineffective and harmful “therapies,” now supposedly as scientific and evidence-based

    There is much discussion and argument over the definitions and different approaches to conversion therapy, reparative therapy, and reintegrative therapy, collectively SOGIECE (sexual orientation and gender identity and expression change efforts), but the one thing they all have in common is a desired outcome of a reduction and/or elimination of same-sex attraction and homosexual acts. In other words, they all see being LGBTQ+ as an unwanted and unnatural condition that needs to be addressed. 

    What is important to understand about these terms is the calculated and strategic rebranding efforts employed by the anti-LGBTQ+ movement to distance itself from the general term “conversion therapy.” The term’s meaning is well-accepted to be a practice which attempts to change a person’s sexual orientation or gender identity to heterosexual or cisgender. There is an additional negative connotation because of the sometimes brutal and physical tactics that have been used to achieve this change by some practitioners, but not all. Additionally, conversion therapy has been associated with involuntary participation from the client. In describing conversion therapy as an “egregious violation of rights” and calling for a global ban, UN Independent Expert Victor Madrigal-Borioz said, “Practices of conversion therapy are rooted in the belief that persons of diverse sexual orientation and gender identity are somehow inferior, either morally, spiritually, or physically because of their orientation or identity, and that they must modify that orientation or identity to remedy that inferiority.” 

    Inventing a new name for conversion therapy, for example Reparative Therapy, Reintegrative Therapy, or sexual attraction fluidity exploration in therapy (SAFE-T), doesn’t change the core of what it is. Declaring that a form of therapy is not conversion therapy because it’s not coercive or physically harmful does not negate the inherent definition, which is about trying to change one’s sexual orientation or identity. The methods for achieving that may vary from prayer, to psychological consultation, to physical abuse, but it is all based on the anti-LGBTQ+ idea that sexual orientation or gender identity can and should be changed. These therapies are ineffective and harmful, and even “talk” therapy can cause severe and permanent psychological damage. Several major professional organizations including the American Psychological Association, the National Association of Social Workers, and the American Academy of Pediatrics have made statements against reparative therapy because of concerns for the harm caused to patients. The American Psychiatric Association has said, “The potential risks of reparative therapy are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient.” Adding, “Therefore, the American Psychiatric Association opposes any psychiatric treatment, such as reparative or conversion therapy, which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her sexual homosexual orientation.”

    Instead of allowing conversion therapy to be continually rebranded, it should be banned – in all forms, everywhere. 

    The Rebranding of Conversion Therapy

    “Reparative Therapy” was created and trademarked in the early 1980s by Joseph Nicolosi, Sr., frequently called the father of conversion therapy and a founding member of the National Association for Research and Therapy of Homosexuality (NARTH), now Alliance for Therapeutic Choice and Scientific Integrity, which attempts to apply a “science” to the idea that being LGBTQ+ is optional and problematic, a theory that has been discredited by multiple professional and medical associations. In 2006, the American Psychological Association (APA) stated: “There is simply no sufficiently scientifically sound evidence that sexual orientation can be changed.” The APA added, “Our further concern is that the positions espoused by NARTH and [the anti-LGBTQ+] Focus on the Family create an environment in which prejudice and discrimination can flourish.” 

    On the home page of Nicolosi’s website, which is still active after his 2017 death, the quote “If gay doesn’t define you, you don’t have to be gay” is front and center. According to the website, Nicolosi believed that underlying traumas cause people to be LGBTQ+, and when those traumas are treated by Reparative Therapy, the treatment “will often result in reducing unwanted same-sex attractions.“ Nicolosi believed that our bodies were not made for homosexuality and that homosexuality is pervasive throughout the personality, preventing gay men from forming non-erotic relationships with men. 

    Reparative Therapy “views most same-sex attractions as reparations for childhood trauma. Such trauma may be explicit, such as sexual or emotional abuse, or implicit in the form of negative parental messages regarding one’s self and gender.” In an attempt to confer credibility upon his work, his website writings state that Reparative Therapy is not “conversion therapy” because it is in no way coercive and is based on science. The therapy is intended for those who wish for their same-sex attractions to go away, not those who accept their sexuality. 

    However, when people are told by their families, their church, and their community that being LGBTQ+ is unacceptable, even revolting, that in itself is a form of coercion that can lead LGBTQ+ people to be uncomfortable with who they are and to seek out “solutions.” And by definition, it is coercion for children to experience this “therapy,” as they have no ability to consent when their parents sign them up. 

    Whatever Nicolosi’s beliefs about the source of homosexuality, it is clear that he believed that it is among the most undesirable of conditions and should be remedied. To wit, Nicolosi wrote, “Homosexuality… is rooted in a same-sex attachment problem that leaves the boy alienated from his masculine nature.” His books, including A Parent’s Guide To Preventing Homosexuality – New, Revised 2017 Edition, Including a New Chapter on the Health Consequences of Homosexuality (which was removed from the Amazon bookstore in 2019) and his Reparative Therapy training DVD for mental health professionals are still available for purchase on his website. In 2010, Patrick Strudwick attended conversion therapy events incognito and wrote about his experience for The Guardian. During a conference in London for therapists and clergy “wanting to learn how to ‘cure’ their clients,” Strudwick was present for a session by Joseph Nicolosi, Sr., who was “treating” a young man in front of the audience. Strudwick said of the event, “I felt like I was watching a blood sport.”

    The Rebranding of Reparative Therapy into the Next Generation

    Around the same time that Joseph Nicolosi, Sr., died, his son, Joseph Nicolosi, Jr., founded the 501(c)3 nonprofit, Reintegrative Therapy Association (RTA), and launched his own trademarked “therapy,” Reintegrative Therapy (not to be confused with reintegration therapy). As with his father, Nicolosi, Jr., has taken great pains to say that Reintegrative Therapy is not conversion therapy, even providing a chart comparing the two “treatments.” And similar to his father’s therapy, he says that the primary differences from conversion therapy are that Reintegrative Therapy is not coercive and is bound by professional ethics and protocols determined by RTA. Like Reparative Therapy, he argues that changes in sexuality come as a byproduct of the trauma treatment and are not the primary goal. 

    Nicolosi, Jr. is adamant that Reintegrative Therapy not be compared to previous therapies, even going so far as to distance himself from his father’s trademarked Reparative Therapy. On his website, he provides an explainer on the differences, saying that Reintegrative Therapy is broader and can benefit straight women with trauma and behavioral addictions, like binge eating, as much as it can help men with same-sex attractions. Though he has distanced himself from his father’s work, oddly, when landing on Nicolosi Sr.’s webpage, a pop-up with facts about how sexuality can be changed appears, redirecting the visitor to the Reintegrative Therapy Association website.

    A closer look at the Reintegrative Therapy Association, Reintegrative Therapy, and Nicolosi Jr.’s own words, shows continual rebranding, even over its short existence, intended to downplay RTA’s work to change sexual orientation and identity. The Reintegrative Therapy Association received its IRS nonprofit status in 2018 with a stated mission of “To provide community advancement in the fields of education, therapeutic practice and science of reintegrative therapy to assist those who are conflicted with their sexuality.” A January 2018 version of the Reintegrative Therapy Association website stated, “our mission is to educate the public about this important new form of therapy, and to assist individuals as they successfully navigate through the sexual-fluidity journey,” a clear claim that there is value in trying to change one’s orientation. (Note the co-opting of the term sexual fluidity to describe an effort to change orientation or identity, rather than a natural function of people’s evolving sexuality.) An August 2018 version of the website says, “Reintegrative Therapy™ is a specific combination of established, evidence-based treatment interventions. The Reintegrative Therapy Association is a 501(C)3 non-profit organization which promotes the highest standards of excellence in Reintegrative Therapy™. Our mission is to educate the public and train professional therapists about this therapeutic approach.” It also says that “Reintegrative Therapy helps the client to ‘reintegrate’ the split-off parts of himself that were created due to childhood trauma.” Elsewhere on the site, it says RTA’s mission is to educate the public and train professional therapists about this important form of therapy, which is a specific combination of established, evidence-based treatment interventions.

    In 2021, the website now reads, “The Reintegrative Therapy Association is a 501(c)(3) nonprofit organization that promotes standards of excellence and integrity in Reintegrative Therapy. The association’s mission is to educate the public and train professional therapists about this specialized combination of established, evidence-based treatment interventions.” Sexual fluidity is no longer mentioned in this context. 

    It seems that Nicolosi, Jr. has gradually changed the language on his website and papers in hope of steering how Reintegrative Therapy is perceived. Why the intense desire to disassociate his work from conversion therapy? It appears that Nicolosi, Jr. is worried that Reintegrative Therapy as a business venture will be eradicated, according to a lawsuit he recently filed.

    As local, state, national, and international governing bodies take steps to outlaw conversion therapy, particularly for minors, many conversion therapists have launched complex campaigns to stop these efforts. It is evident that Nicolosi Jr. fears that his Reintegrative Therapy will be perceived as SOGIECE and included in the bans, effectively shutting down his practice and possibly those of therapists who are certified by RTA. Nicolosi testified in 2018 against California’s AB2943 which would classify SOGIECE efforts as fraudulent and later gave an interview, saying, “They’re actually outlawing treatment goals, the goal to decrease one’s unwanted same-sex attractions in the privacy of one’s own therapy.” The legislation and new laws make no distinction between the names of the therapies, instead focusing on the desired outcome of the therapy. This is how Nicolosi’s concerns are described in a lawsuit he filed in July 2021 against Canadian researchers. “In sum, the Disputed Article and Disputed Allegation falsely characterize Reintegrative Therapy® as SOGIECE, thereby creating a substantial peril that proposed legislation will ban Reintegrative Therapy® based on the false premise that Reintegrative Therapy® is a form of SOGIECE. Plaintiffs have expended substantial resources in developing the Reintegrative Therapy® trademark, building a Reintegrative Therapy practice, and in promoting it to other mental health practitioners for licensure. There is a cognizable risk that Plaintiffs’ Reintegrative Therapy® practice may be criminalized in the near future because Defendants’ false and defamatory Disputed Allegation characterizes Reintegrative Therapy® as ‘SOGIECE.’ This cognizable risk represents serious harm to Plaintiffs’ business and the Reintegrative Therapy® trademark.”

    It’s clear that Reintegrative Therapy is in the SOGIECE lexicon already and viewed as a rebranding of reparative therapy and conversion therapy by experts. For example, in 2020, the Independent Forensics Expert Group (IFEG), which was established by the International Rehabilitation Council for Torture Victims (IRCTL) in partnership with Copenhagens University’s Department of Forensic Medicine, issued a “Statement of the Independent Forensic Expert Group on Conversion Therapy.” The statement includes reintegrative therapy as a form of sexual orientation change efforts, reading in part, “Conversion therapy is a set of practices that aim to change or alter an individual’s sexual orientation or gender identity. It is premised on a belief that an individual’s sexual orientation or gender identity can be changed and that doing so is a desirable outcome for the individual, family, or community. Other terms used to describe this practice include sexual orientation change effort (SOCE), reparative therapy, reintegrative therapy, reorientation therapy, ex-gay therapy, and gay cure.” 

    Some of Nicolosi Jr.’s own colleagues in this space see reintegrative therapy as the next generation of reparative therapy. One of the licensed Reintegrative Therapists, Tim Long, who runs Kainos Christian Clinic in California, gave a much-anticipated training to representatives from 22 countries on Reintegrative Therapy at the International Federation for Therapeutic and Counselling Choice (IFTCC) conference in Budapest, Hungary in November 2019. The presentation was entitled “The Practical Work of Re-integrative (i.e. Reparative) Therapy for men struggling with SSA.”

    Looking to the Reintegrative Therapy Association website, we again note the strenuous efforts to say that Reintegrative Therapy is not about changing orientation but about treating trauma. However, there is a chart depicting how the brain can be rewired to achieve a change in male sexuality under the heading of The Science. And the homepage features a quote saying, “Everyone has the freedom to choose their own path,” above a photo of a happy, handsome young man. Below that is an October 2021 press release declaring, “Landmark Study Shows Trauma Treatment Significantly Alters Sexual Attractions: Surprising results challenge our assumptions about how fluid sexual attractions are.”  The study had 75 participants with same-sex attractions who wanted to explore their “sexual attraction fluidity” and were treated by Reintegrative Therapy certified therapists. The study was published in the Journal of Human Sexuality, the official publication of the Alliance for Therapeutic Choice and Scientific Integrity, (formerly NARTH, founded by Nicolosi Sr.) Conducted by colleagues of Nicolosi, Sr., the study attempts to take the rebranding of conversion therapy to the next level by creating a new acronym, SAFE-T, sexual attraction fluidity exploration in therapy. “Most therapists will not offer clients sexual attraction fluidity exploration because they’ve been told there is not enough research into its safety or efficacy. Now we know, thanks to this new research, that such an approach is both safe and effective,” Nicolosi, Jr. said of the study. 

    One of Nicolosi, Jr.’s most ardent claims is that only licensed and trained therapists are allowed to use his trademarked therapy. Two videos on the YouTube channel, Reintegrative Therapy, show a therapist putting Reintegrative Therapy into action. In the videos the men describe in detail their homosexual fantasies, are taken through their traumatic experiences, and then realize their homosexual desires are lessened. 

    The first video is captioned “During a live educational demonstration in Mexico City, Reintegrative Therapist® José Alberto Garza demonstrates with a volunteer member of the audience how, with the Reintegrative Protocol, the client’s most powerful sexual fantasy changes, as a byproduct of trauma work. At no time does the client try to change his sexuality. The therapist never tries to change it. It changes on its own, spontaneously, without effort. This video is for educational purposes.” In the video, a man describes the power he feels when touching another man’s penis, and after exploring the trauma of a dog bite as a child, (the video shows the whole process in nine minutes), he is no longer sexually interested in men.

    The second video includes a voice over from Nicolosi, Jr. and graphics explaining the therapy process as the man works through his therapy session. It’s captioned, “Self-compassion changed my sexuality. Watch Reintegrative Therapy. John considers this session a powerful step in treating his childhood trauma. Published evidence reveals the Reintegrative Protocol™ often triggers spontaneous changes in sexual feelings as a byproduct of trauma processing and has been shown to be both safe and effective.” Additional commentary from Nicolosi, Jr. follows. The video was retitled to “This Changed My Sexuality” a few days after being posted.       

    These videos are appalling and cringe-inducing to witness. Anyone could easily question the description, the method, and the outcome. The videos stretch credulity to the point of being unrecognizable – as does the idea that Reintegrative Therapy is not used to change a person’s sexual orientation or identity. 

    Conversion therapy, under any name, is dangerous. As long as providers of conversion therapy continue to rebrand their conversion therapy efforts, LGBTQ+ people will continue to be harmed. GPAHE believes that all forms of conversion therapy should be banned as we work toward a world where LGBTQ+ people are accepted for everything they are. 

    “Reintegrative Therapy” and “Same-Sex Attraction” Get a Pass

    Again and again in GPAHE’s research, the term “reintegrative therapy” did not trigger search results connected to authoritative sources. Created by Joseph Nicolosi, Jr., around 2016, reintegrative therapy is a rebranding of previous forms of conversion therapy, though Nicolosi rejects any connection between the two. In Kenya, an English Google search for this therapy returned only two results that explained that this is a renamed form of conversion therapy. The rest of the results took searchers directly to the provider and others pointed in that direction. The second page of search returns a host of reintegrative therapy providers and a link to a lawsuit the Reintegrative Therapy Association is bringing against the authors of a medical journal article about the practice.

    For the same search in Kenya on Bing, every single result on the first page either directed individuals directly to reintegrative therapy providers or to material that was completely irrelevant. In its associated knowledge box, Bing provided links to videos created by reintegrative therapy providers. The second page was just as bad. 

    In Ireland, where much of the search results are authoritative, that is not true for “reintegrative therapy.” That search leads to several links on the first page to this therapy’s providers and to other conversion therapy organizations such as Desert Stream Living Waters. In Colombia, results for the terms were somewhat obscured because “reintegracion” is a term used for decommissioning of guerillas in the years after that country’s conflicts. Even so, on Bing, a search for “reintegrative therapy” brought up an autogenerated box that sampled material from a viciously anti-LGBTQ+ Russian website, pro-lgbt.ru. The same result returned for Spanish searches from the U.S., though in Germany, searches on both Google and Bing generally returned authoritative results. Searches for “reintegrative therapy” on Bing favored Joseph Nicolosi, Jr. and his organization and led to the same viciously anti-LGBTQ+ Russian site. The site pushes anti-LGBTQ+ ideas and features material from both Nicolosi Sr. and Jr. in multiple languages, and an IFTCC conference in London. In the U.S. and Australia, “reintegrative therapy” returns far too many direct links to its providers. In the U.S. on Bing “reintegrative therapy” led to a search result where nearly half the page was taken up by links to reintegrativetherapy.com. There were also links to its Facebook page and other providers, including David Pickup. 

    The same problems are found on social media platforms. The first ten results of an English search in Kenya on YouTube returned only pro-reintegrative therapy videos, including a Joseph Nicolosi, Jr. interview and live counseling session. A Facebook search led to Nicolosi’s organizational page on the site. And a search on Twitter led to a rabbit hole of pro-reintegrative therapy posts and providers. 

    The other term that consistently leads to non-authoritative results is “unwanted same-sex attraction (SSA),” which is increasingly used by conversion therapy providers as a euphemism for their work. As the country summaries show, unwanted SSA rarely returns authoritative results from search providers. Like “reintegrative therapy,” Google and Bing should address how the terms work in their algorithms.

    For more on these issues in other languages, see the country sections of this report.

    Appendix: Search Terms and Phrases Employed in Research

    Terms in English
    Ex-gay therapy
    Gay cure
    Reintegrative therapy
    Reparative therapy
    Unwanted same-sex attraction
    Same-sex attraction
    Sexual Attraction Fluidity Exploration in therapy
    Overcoming same-sex attraction
    Conversion therapy near me
    Sexual orientation change efforts (SOCE)
    Conversion therapy
    SAFE-T
    “I don’t want to be gay”
    “Is it a sin to be homosexual/gay”
    “Is my gay child my fault”
    “Seeking to change my sexual orientation”
    “How do I turn straight”
    “Why am I gay”

    Terms in Spanish (United States and Colombia)
    Terapia ex-gay (ex-gay therapy)
    Terapia para curar gay (gay cure therapy)
    Es un pecado ser gay (“is it a sin to be gay?”)
    Es un pecado ser homosexual (“is it a sin to be homosexual”)
    Terapia de reintegración (reintegrative therapy)
    Terapia reparativa (reparative therapy)
    Atracción al mismo sexo no deseada (unwanted same-sex attraction)
    Atracción al mismo sexo (same-sex attraction)
    Superar la atracción al mismo sexo (overcoming same-sex attraction)
    Fluidez de atracción sexual (sexually fluid attraction)
    Orientación sexual (sexual orientation)
    Terapia de conversión (conversion therapy)
    No quiero ser gay (“I don’t want to be gay”)
    Por que soy gay (“why am I gay?”)
    Reintegrative therapy

    Terms in German
    Ex-gay therapie (ex-gay therapy)
    Konversions therapie (conversion therapy)
    Ex-gay bewegung (ex-gay movement)
    Heilung-gegen-homosexualitat (homosexual cure)
    Reparativ therapie or reparativtherapie (reparative therapy)
    Reintegrative therapie (reintegrative therapy)

    Terms in Swahili
    Je ushoga ni dhambi (Is homosexuality a sin?)
    Tiba ya uongofu (Conversion Therapy)
    Tiba ya kuacha ushoga (Ex-gay Therapy)
    Kubadilisha mwelekeo wa kijinsia (Sexual Orientation Change Efforts)
    Matibabu ya mashoga (Gay cure therapy)
    Tiba inayorudisha nyuma ushoga (reintegrative therapy)
    Mvuto wa ushoga usiohitajika (Unwanted same-sex attraction)

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