Kentucky ‘Conversion-Therapy’ Ban Could Be Used to Push Gender-Confused Kids Toward Medicalization

Kentucky governor Andy Beshear’s new executive order banning so-called conversion therapy could be used to criminalize the traditional watchful-waiting approach to gender dysphoria, pushing minors who are confused about their gender toward irreversible medical procedures.

Historically, the term “conversion therapy” referred to efforts to change a person’s sexual orientation through therapy, usually administered by religious or spiritual leaders or, in other cases, by licensed health-care professionals. But the term has been inflated in recent years to include any approach to gender dysphoria in which the mental-health professional does not immediately affirm the child’s stated gender identity.

The executive order authorizes Kentucky’s licensure board to take disciplinary action against medical professionals found to have practiced conversion therapy on children. It also prohibits state and federal funding of conversion therapy, which is now considered illegal in the state.

Previous efforts to enact the ban, most recently a 2023 bill, have failed in the Republican-controlled legislature, leading Beshear to implement the ban himself by executive order. He cited mental-health risks to justify the conversion-therapy ban.

“Let’s be clear: conversion therapy has no basis in medicine or science, and it has been shown to increase rates of suicide and depression,” Beshear said in a statement. “This is about doing what is right and protecting our children. Hate is not who we are as Kentuckians.”

Despite its well-intended goal of addressing these health risks, the order could prevent a therapist from telling a child to consider embracing their biological sex instead of immediately affirming that child’s chosen gender identity, according to a legal expert.

Matt Sharp, senior counsel of conservative law firm Alliance Defending Freedom, told National Review that a lawyer could potentially argue that the watchful waiting approach to gender dysphoria in children is not permitted under state law because the method fundamentally changes the client’s gender expression.

“Governor Beshear’s executive order creates a one-way street to push vulnerable children toward gender transition because it only prohibits counseling in one direction,” Sharp said. “For example, it allows counseling conversations that aim to steer young people toward a gender identity different than the client’s sex but prohibits a watchful waiting approach and conversations that aim to help that same person return to comfort with his or her sex.”

Therefore, any licensed counselor or therapist who recommends that a child abstain from medical treatments such as puberty blockers while undergoing talk therapy to determine if there are underlying mental-health issues driving their dysphoria could be in jeopardy of losing their license.

“The government has no business censoring private conversations between clients and counselors,” Sharp added, “nor should counselors be used as a tool to impose the government’s biased views on their clients.”

Notably, the Kentucky governor’s order states conversion therapy does not constitute “acceptance, support, or understanding to an individual . . . so long as such practice, treatment, or intervention does not seek to change an individual’s sexual orientation or gender identity.” Should the watchful waiting approach be interpreted as an effort to “change” the child’s stated gender identity, the mental-health professional pursuing that approach could be in violation of the order.

The order also exempts medical gender transitions from its definition of conversion therapy, allowing doctors who prescribe puberty blockers, cross-sex hormones, and even surgical interventions to continue operating freely.

Meanwhile, major medical associations claim to have discredited the practice of conversion therapy — as newly defined to include the watchful waiting approach to gender dysphoria — because it’s not based on medical or scientific evidence. For instance, the American Medical Association criticizes the pseudoscientific practice for treating homosexuality and gender nonconformity as mental disorders. The American Psychiatric Association similarly opposes conversion therapy in a position statement, opting for gender affirmation instead.

The American Academy of Pediatrics rejected the consensus that the watchful waiting approach could be an effective strategy, “despite research findings which strongly suggests that most of these cases would eventually desist if left untreated,” according to a 2021 scientific article published by the National Library of Medicine.

In 2020, Andrea Jones of the Heritage Foundation argued the watchful waiting approach is strongly backed by research showing 80 to 95 percent of children experiencing gender dysphoria will see their confusion or distress resolve over time. But if they buckle under social pressure to identify as the opposite gender, minors can be steered toward irreversible medical transition.

“Those placed on the path of social transition go on to undergo medical transition in almost all cases, suggesting that unquestioning affirmation by adults of a child’s professed transgender identity becomes a self-fulfilling prophecy,” Jones wrote, endorsing watchful waiting as an effective strategy. Bans on conversion therapy would prohibit this approach and “classify anything other than affirmation of transgender ideology as an unlawful attempt to ‘change gender identity,'” she noted.

While earlier efforts to change a person’s homosexuality via electroshock therapy or prescribing sexual depressants were often cruel, conversion-therapy bans mostly involve talk therapy today. A psychiatry professor says states’ politicized responses to psychotherapy suggest that affirmative care can be the only viable method when it comes to treating gender-confused children.

In a statement to National Review, Dr. Stephen Levine of Case Western Reserve University said the term “conversion therapy” is a “rhetorical device” that has made “any attempt to question the patient or family about the forces that have shaped the decision to identify as a trans person unethical and at times illegal in some jurisdictions.”

Kentucky is now the twenty-third state, in addition to Washington, D.C., to forbid the use of minor-focused conversion therapy, Beshear’s office said. Some of those states include California, Delaware, Massachusetts, New York, and Oregon. Moreover, over 100 municipalities have imposed similar bans.

In Wisconsin, the state Department of Safety and Public Standards implemented a new rule prohibiting licensed mental-health professionals from practicing conversion therapy after Democrats failed to pass a bill through the legislature banning the practice due to Republican opposition.

Lee Webster, a Wisconsin therapist who advocates a watchful waiting approach to gender dysphoria, spoke out against the rule, which he views as an unconstitutional limit on his free speech. In an interview with National Review last year, Webster explained that he could run afoul of the rule simply by explaining some of the consequences of medicalization to a gender-dysphoric patient.

“If you were to explore those things under this rule, there’s a possibility that somebody is going to come back to you and say what you’re doing is you’re forcing your ideas on them,” Webster said of the Wisconsin rule, adding that “there’s no other areas of counseling, or very few, where you’re told you have to affirm what somebody thinks.”

Federal courts are divided on the constitutionality of conversion-therapy bans, and opponents of the ban are hopeful that they will one day will be struck down by the Supreme Court on First Amendment grounds. The ADF has recently led free-speech challenges in Colorado and Washington state, but so far those legal efforts have been rejected.

Three Kentucky cities — Covington, Louisville, and Lexington — banned conversion therapy prior to the statewide order, according to local CBS affiliate WLKY. At the time of the announcement, Beshear was joined by representatives from the Kentucky Mental Health Coalition, Fairness Campaign, Kentucky Psychological Association, and National Association of Social Workers in Frankfort, Ky.