Why bans on conversion therapy are misguided

Last month, Nevada became the eighth state to ban conversion therapy, defined as any practice or treatment that seeks to change a minor’s sexual orientation or gender identity. Similar legislation has been passed in New Jersey, while New York Gov. Andrew M. Cuomo has barred insurance companies from covering such approaches.

Though it’s been hailed as a progressive victory, the ban is misguided. By incorrectly conflating sexual orientation with gender identity, the ban will accomplish more harm than good for the children it purports to protect.

The most recent scientific research shows that sexual orientation is immutable and there is no evidence to suggest it can be changed through conversion therapy or otherwise. Gender identity, however, is different — it is flexible in young children, particularly those who identify as the opposite sex, according to the research.

Across 11 studies conducted on this topic, 60 percent to 90 percent of transgender youth will desist, or outgrow their gender dysphoria, by puberty, growing up to be gay adults. Statistically speaking, a little boy who identifies as a girl is more likely to grow up to be a gay man than a trans woman. I myself was a desister, who grew up to be straight.

Transgender activists often dismiss the statistic, saying desisters were milder in their symptoms or were merely gender non-conforming. Yet, in one 2012 study of 139 gender dysphoric boys, even those with severe gender dysphoria outgrew it.

On average, most gay boys and girls come out around the ages of 15 and 18, respectively. In contrast, gender dysphoric children undergoing early transitioning typically begin puberty inhibitors around age 12, and research has shown that even a non-medical social transition, such as changing one’s name and clothing, leads to higher rates of gender dysphoria persisting.

From a neuroscientific perspective, research supports differences in brain structure associated with homosexuality. For example, in gay men the part of the brain involved in regulating sexual behavior tends to be more similar in size to straight women than straight men.

When it comes to MRI studies of people with gender dysphoria, the neuroanatomy of male-to-female and female-to-male transgender people tends to be shifted in the direction of the gender they identify with — more specifically, the brain anatomy of male-to-female individuals is similar to women, and for female-to-male individuals it is similar to men.

Although the studies are often touted as evidence that being transgender is biological, they are confounded in a serious way: In a study of male-to-female individuals, both they and the comparison group of women they resembled were attracted to men; similarly, female-to-male individuals and the group of men they resembled were attracted to women. It’s unclear whether the brain differences seen were reflective of being transgender or being gay, since the transgender participants in the studies were attracted to people who shared their birth sex.

By passing a law that confuses sexual orientation and gender identity, states are inadvertently permitting a new form of conversion therapy — because a gay boy, now living as a girl, will appear to be straight — while going down a path of sterilization and irreversible surgery.

It is crucial that support be available to transgender youth, including access to transitioning for those whose dysphoria persists upon reaching puberty. But this calls for a scientifically based middle ground instead of politically charged, sweeping changes to policy. In our attempt to correct for mistakes of the past, we must be cautious to not create new ones.

Debra W. Soh writes about sexuality and is a sexual neuroscientist at York University in Toronto.