Overview

‘Conversion Practices’ or ‘Conversion Therapy’ are umbrella terms that describe a range of treatments, practices, or sustained efforts that aim to change, suppress, or eliminate a person’s sexual orientation, gender identity, or gender expression. The aim of these practices is to change them from gay, lesbian or bisexual to heterosexual, and from trans or gender diverse to cisgender. 

Human rights groups and medical and mental health associations condemn the use of ‘conversion therapy’, declaring it harmful due to its long-term adverse effects. 

As such, the use of ‘therapy’ is inaccurate and misleading, as it suggests that LGBTQ people are sick and need to be cured, despite the lack of evidence to support the practice. This is the opposite to the goal of therapy to affirm, support, and provide healthy therapy or counselling for individuals seeking to explore their sexual orientation or gender identity, whatever the outcome may be. It is better referred to as ‘conversion practices’ or ‘sexual orientation, gender identity or gender expression change efforts’ (SOGIECE).

Conversion practices heavily rely on the pathologisation of sexual orientation, gender identity and gender expression (SOGIE). This means classifying the LGBTQ people’s SOGIE, as a mental illness in national and international manuals used by healthcare professionals for diagnosing mental disorders. 

Sexual orientation and gender identity are no longer classified as mental illnesses in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). 

The first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952 classified homosexuality as a mental illness. It was removed from the DSM in 1973 as ‘research has found no inherent association between any of these sexual orientations and psychopathology” and “heterosexual behavior and homosexual behavior are normal aspects of human sexuality”.” Many medical associations have declared that sexual orientation and same-sex attraction do not imply any impairment and do not need changing. 

The classification of gender identity in the ICD-11 relates to sexual health and ensures access to healthcare and insurance for trans and gender diverse people. According to the World Health Organization, ‘while evidence is now clear that it is not a mental disorder, and indeed classifying it in this can cause enormous stigma for people who are transgender, there remains significant health care needs that can best be met if the condition is coded under the ICD.’

Conversion practices have a myriad of harmful side effects and are strongly associated with negative mental health and social outcomes.

 Long-term psychological harm

Conversion practices can take a significant toll on a person’s emotional and physical health, leading to depression, anxiety, shame, guilt, lowered self-esteem, internalised homophobia, intrusive imagery, difficulties in intimacy, social isolation, suicidal ideation or attempts, post-traumatic stress disorder, and physical pain.

A Justice for Sisters et al survey on conversion practices found 45.5% of 123 respondents reported increased stress, anxiety, isolation, and other forms of strain on mental health as a result of SOGIE-change pressure. While, 32.5% experienced suicidal thoughts and attempts. 

The same survey found 21 of 43 LGBTIQ people (48.8%) who were forcibly subjected to conversion practices reported increased stress, anxiety, isolation, and other forms of strain on mental health. 14 experienced suicidal ideation and attempts. 

 Increased barriers in accessing health services

LGBTIQ+ people seeking health services have reported being  offered conversion practices when they disclose SOGIE-related information. 

The JFS survey found 7 of 156 LGBTIQ respondents in Malaysia (4.5%) were offered SOGIE-change practices when seeking mental health services, while 6 (3.8%) were offered similar practices when seeking health services at a hospital. At least 4 respondents noted that they had stopped seeking health care services due to lack of trust. 

Studies show that LGBTIQ people in Malaysia already face poor access to healthcare due to various factors. For example, a study by CERiA attributes low health-seeking behaviour and knowledge amongst the Muslim queer men respondents to pressure to get married or change their SOGIE, criminalization, among other factors. Meanwhile, the Ministry of Health Malaysia in its 2020 Global AIDS Monitoring report acknowledges that access to HIV prevention services for GBQ men and other men who have sex with men (MSM) ‘have been poor probably because they are the most hard-to-reach and difficult to identify due to stigma and discrimination.’  

 Impact on access to education 

The JFS survey found young people as a key vulnerable population to conversion practices. Out of 123 LGBTIQ respondents, at least 36.6% felt unmotivated and lost interest in school, work, family activities, social activities and others as a result of pressure to change their SOGIE. Meanwhile, 4.9% dropped out of school.

⚧ Increased mis/disinformation related to LGBT people 

Conversion practices are built on the harmful assumption that LGBT people are inferior, deviant, and immoral due to their non-conformity to the cisnormative and heteronormative standards. 

Many forms of mis/disinformation are linked to conversion practices. In Malaysia, some of the common misconceptions are that people ‘become’ LGBT due to 

• history of sexual violence, 
• Access to the internet and social media 
• Parenting styles, overprotective parents, lack of supervision and love by parents 
• Pornography, 
• Bullying and name-calling, 
• Boarding schools where young people pick up ‘gay behaviour’

Consequently, LGBTIQ people are subjected to mistreatment, discrimination and attempts to cure them. At times, these so-called cures can employ harmful, degrading and violent methods, placing the lives of LGBTIQ people at risk. 

Some of these myths have been debunked. Read more here.

❌ Reinforcement of gender binary ideology

Conversion practices reinforce the notion that there can only be gender-conforming, heterosexual, cisgender men and women. The reinforcement of a gender binary or cis-hetero patriarchal ideology impacts not only LGBTIQ+ and gender diverse people, but also cisgender, heterosexual people, as everyone is forced into binary and gendered boxes, restricting our freedom of expression and right to self-determination. 

💬 Increased restrictions on freedom of expression

In Malaysia, activists advocating for LGBTIQ+ rights have faced restrictions in expressing concerns or criticism over state-sponsored conversion practices. Concerns raised over the compliance of these programmes with human rights standards have been met with backlash by state and non-state actors, including ex-LGBT groups linked to the state. This not only has a detrimental impact on their ability to carry out human rights advocacy work, but also creates an overall environment or climate of censorship. 

Conversion practices undeniably violate many human rights. 

The ‘Born Free and Equal’ handbook by the Office of the United Nations High Commissioner for Human Rights (OHCHR) outlines five key state obligations in relation to LGBTIQ persons. In line with international human rights law, the state has an obligation to prevent torture against LGBTIQ persons, which includes the elimination of so-called conversion practices. 

It recommends States take ‘necessary legislative, administrative and other measures to guarantee respect for the autonomy and physical and personal integrity of LGBT persons and prohibit the practice of “conversion therapy” and other forced, involuntary or otherwise coercive or abusive treatments performed on them’ and ‘ensure that health professionals and public officials receive training in respecting the human rights of LGBTI persons.’

Malaysia has only ratified three of the nine international human rights treaties by the United Nations — Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), Convention on the Rights of the Child (CRC), and Convention on the Rights of Persons with Disabilities (CRPD). 

When a country ratifies a human rights treaty, it is obligated to harmonise the content of the treaty into domestic laws, policies and practices. It is also responsible for submitting periodic reviews of their progress in meeting the standards set by the treaty, which will be assessed by a committee. The committee can then provide recommendations to help the countries meet these standards and goals. 

In Malaysia’s 2018 CEDAW review, the CEDAW committee recommended that the country to ‘Expedite measures to discontinue all policies and activities aimed at “correcting” or “rehabilitating” lesbian, bisexual and transgender women and intersex persons.’ 

The Committee on Economic, Social and Cultural Rights found that regulations requiring LGBTI persons to be treated as mental or psychiatric patients or to be ‘cured’” by undergoing so-called ‘treatment’ are clear violations of their right to sexual and reproductive health.

23. Non-discrimination, in the context of the right to sexual and reproductive health, also encompasses the right of all persons, including lesbian, gay, bisexual, transgender and intersex persons, to be fully respected for their sexual orientation, gender identity and intersex status. Criminalisation of sex between consenting adults of the same gender or the expression of one’s gender identity is a clear violation of human rights. Likewise, regulations requiring that lesbian, gay, bisexual transgender and intersex persons be treated as mental or psychiatric patients, or requiring that they be ‘cured’ by so-called ‘treatment’, are a clear violation of their right to sexual and reproductive health. State parties also have an obligation to combat homophobia and transphobia, which lead to discrimination, including violation of the right to sexual and reproductive health.

While Malaysia is not a party to the International Covenant on Economic, Social and Cultural Rights, the following human rights standards broadly apply to all countries in protecting and promoting the rights of all people, including LGBTIQ and gender diverse people. These are additional reasons to advocate for Malaysia to ratify human rights treaties.