Conversion therapy is psychological treatment or spiritual counseling designed to change a person's sexual orientation from homosexual or bisexual to heterosexual. Such treatments are controversial, and are a form of pseudoscience. Medical, scientific, and government organizations in the United States and Britain have expressed concern over conversion therapy and consider it potentially harmful. The American Psychiatric Association opposes psychiatric treatment "based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that a patient should change his/her sexual homosexual orientation" and describes attempts to change sexual orientation by practitioners as unethical. It also states that debates over the integration of gay and lesbian people have obscured science "by calling into question the motives and even the character of individuals on both sides of the issue" and that the advancement of conversion therapy may cause social harm by disseminating unscientific views about sexual orientation.United States Surgeon General David Satcher in 2001 issued a report stating that "there is no valid scientific evidence that sexual orientation can be changed". The highest-profile advocates of conversion therapy today tend to be fundamentalist Christian groups and other organizations which use a religious justification for the therapy rather than speaking of homosexuality as "a disease". The main organization advocating secular forms of conversion therapy is the National Association for Research & Therapy of Homosexuality (NARTH), which often partners with religious groups.
Techniques used in conversion therapy prior to 1981 in the United States and Western Europe included ice-pick lobotomies; chemical castration with hormonal treatment;aversive treatments, such as "the application of electric shock to the hands and/or genitals"; "nausea-inducing drugs ... administered simultaneously with the presentation of homoerotic stimuli"; and masturbatory reconditioning. More recent clinical techniques used in the United States have been limited to counseling, visualization, social skills training, psychoanalytic therapy, and spiritual interventions such as "prayer and group support and pressure", though there are some reports of aversive treatments through unlicensed practice as late as the 1990s. The term reparative therapy has been used as a synonym for conversion therapy in general, but it has been argued that strictly speaking it refers to a specific kind of therapy associated with Elizabeth Moberly and Joseph Nicolosi.