In the recent Netflix documentary “Pray Away,” former leaders of Exodus International, once America’s leading conversion therapy organization, express shame over perpetuating efforts to change people’s sexual orientation and gender identity.
The interdenominational Christian organization shuttered in 2013, with then-president Alan Chambers apologizing in a statement “for years of undue suffering and judgment at the hands of the organization and the church as a whole.”
One year earlier, in 2012, California became the first state to ban conversion therapy on minors. Nineteen more have followed suit, most recently Virginia, in 2020. Five additional states have partial bans on the practice, which has been associated with “severe psychological distress.”
LGBTQ adolescents subjected to efforts to change their sexual orientation or gender identity are more than twice as likely to attempt suicide, according to The Trevor Project, an LGBTQ youth suicide prevention and crisis intervention nonprofit.
But despite the growing body of research about its dangerous effects and the condemnations it has received from nearly every major medical association — including the American Psychological Association, the American Academy of Pediatrics and the American Medical Association — conversion therapy is still being practiced across the United States, both legally and subversively.
A 2018 report from the Williams Institute at the UCLA School of Law found that nearly 80,000 LGBTQ adolescents in the U.S. between the ages of 13 and 17 would be subjected to conversion therapy before they turned 18. A separate report published by The Trevor Project last year found that 13 percent of LGBTQ respondents ages 24 and younger reported undergoing conversion therapy — also known as ex-gay therapy, reparative and, more recently, reintegrative therapy — with 83 percent of those having been subjected to the practice as minors.
Opponents of conversion therapy say state bans are not enough, and some of them are employing different tactics to root out the practice. These strategies include having governors issue executive orders to chip away at the practice in states without bans, as Minnesota Gov. Tim Walz, Wisconsin Gov. Tony Evers and Michigan Gov. Gretchen Whitmer have this summer.
Outside of the political process, though, former patients are also approaching state licensing boards, going on the record and filing complaints against individual practitioners.
'Serious and lasting harm'
Curtis Galloway, 27, is the founder of the Conversion Therapy Dropout Network, which helps survivors with one-on-one meetings, group counseling and writing exercises.
Galloway is a survivor himself. He lives in Los Angeles, but he grew up in rural southern Illinois and, after coming out to his parents at age 16, they took him to Joseph A. Williams, a licensed clinical social worker in Mayfield, Kentucky, about an hour away.
According to Galloway, Williams told him “that being gay is not my identity.”
“He said he was going to be able to help me with my ‘sexual confusion,’ as he put it. And to help me realize that it was a choice to be gay,” Galloway said. “He’d say, ‘The media says being gay is OK, but that’s not the truth.’ Just different gaslighting techniques, you know. Like threats of isolation — telling me that I may need to be taken out of school if I didn’t get better.”
Kentucky doesn’t have a conversion therapy ban, and the statute of limitations on a fraud suit has likely run out for Galloway. So, in June, he filed a complaint against Williams with the Kentucky Board of Social Work, alleging Williams caused “serious and lasting harm.”
Galloway would like to see Williams’ license revoked, or at least have him face disciplinary action.“I’d be very curious to learn if he did this to anyone else,” he said, “but I don’t know if we’ll ever know.”
Galloway said his time with Williams just involved talk therapy, though some conversion therapy efforts involve more extreme or invasive methods.
“It was very much based in counseling — but counseling pseudoscience,” Galloway said. “He’d used a lot of the stereotyped, outdated theories, like, ‘Your mother was overbearing and your father was absent.’ And these correlations — you know, like, ‘Rapists and child molesters and alcoholics, have a choice, too. It’s up to you whether you act on your sinful lifestyle or not.’”
Hearing that at 16 “was pretty shocking,” Galloway said. But it wasn’t the worst part — that came afterward, at home.
“He preyed on my parents, too — on their fears,” he said. “They grew up during the AIDS crisis, and, of course, being in rural Illinois it was all very negative. He really played on their fears, saying ‘Your son’s going to be unhappy, he’s going to be abused. He’s going to do drugs.’ He fed their fears to the point where they were in this frenzied state. He really pushed them to push me, and abuse me — verbally, emotionally mentally.”
Galloway said Williams had his parents monitor his every move, question him constantly and patrol for outside influences “that might infiltrate their home with the homosexual lifestyle.”
He only saw Williams for five or six months, but his ideologies “ran rampant in our house” for several years, Galloway said. “But my parents don’t think that way anymore — they’re very supportive now and very open.”
The Kentucky Board of Social Work would not comment about the case or whether it supported members practicing conversion therapy. Its executive director, Marc Kelly, directed NBC News to the board’s website to “find the statutes and regulations that the Board of Social Work follows.”
Williams did not respond to a request for comment either. He’s still practicing in Mayfield, offering “Christ-centered counseling” for a variety of ills, according to his website, including “sexual issues” and “sexual behavior problems of children and teens.”
A violation of 'professional and ethical rules'
Going through licensing boards is a new approach for Born Perfect and the National Center for Lesbian Rights. They’ve only done it once before — nine months ago, in Texas, on behalf of Jessica Ritter, a 28-year-old who underwent conversion therapy as a teen.
“I grew up in a very conservative Christian family, so when I ‘came out,’ my parents decided this was the course of action,” Ritter said. “But, also, I was so unhappy, and I knew if I didn’t go along I’d never get away from Dallas.”
Between 2010 and 2013, from the ages of 17 to 20, Ritter was sent to Mary Damkroger, a licensed psychologist in Plano, Texas.
“Right now there are licensed practitioners who continue to perform conversion therapy and continue to bill without telling the insurers.”
Amy Whelan, national center for lesbian rights
For the first year, while Ritter was still in high school, the sessions were once or twice a week. When she graduated and moved to Memphis, Tennessee, to attend Rhodes College, there would be “follow-up visits” on school breaks.
In her complaint, Ritter said Damkroger told her that her lesbian identity was “pathological and could be changed through counseling services.”
According to Ritter, Damkroger compared homosexuality to alcoholism and said her same-sex attractions must have come from “some kind of trauma,” likely past sexual abuse or her poor relationship with her mother.
She repeatedly encouraged Ritter to lose weight and walk and act more feminine — assigning her “homework,” like learning how to apply makeup and walk in heels, Ritter said. Damkroger also encouraged her to date boys “even if she had no romantic interest in them whatsoever," Ritter added.
Damkroger would reportedly often quoted Scripture during her sessions, according to the complaint, and told Ritter the Bible treated homosexuality as a “sin.”
Mary Damkroger did not respond to several requests for comment, but according to the Texas Behavioral Health Executive Council, she is still a licensed psychologist in good standing. Her website lists her as a member of the American Association of Christian Counselors and states that she spent over 20 years practicing with the Minirth-Meier New Life Clinics, “the first to integrate psychology/psychiatry into Christianity,” before going into private practice in 2008.
According to her site, Damkroger utilizes “an eclectic form of therapies,” but there is no mention of efforts to change a person’s sexual orientation or gender identity.
Conversion therapy isn’t banned in Texas, but Ritter’s complaint maintains her former therapist’s conduct “violates various professional and ethical rules … and should be subject to discipline by the Texas State Board of Examiners of Psychologists and/or the Texas Behavioral Health Executive Council (TBHEC).”
Damkroger violated state regulations, according to the filing, by holding private sessions with Ritter’s siblings without Ritter’s knowledge and by billing Ritter’s parents and their insurance carrier for “treatment that...was improper, unreasonable, or medically or clinically unnecessary.”
“Right now there are licensed practitioners who continue to perform conversion therapy and continue to bill without telling the insurers,” said Amy Whelan, a senior staff attorney for the National Center for Lesbian Rights. Kentucky’s Joseph A. Williams, for example, has a long list of insurance companies he accepts on his website, she noted.
They bill for talk therapy or cognitive behavioral therapy, “never for conversion therapy outright,” Rebecca Blankenship, co-director of Ban Conversion Therapy Kentucky, said. “It’s a rose by any other name.”
Ritter’s complaint asks the council to “impose appropriate sanctions” on Damkroger, including possibly revoking her license, and preventing her from subjecting other patients to conversion therapy.
On April 16, the Texas Behavioral Health Executive Council denied Ritter’s request and said the case was closed because the complaint was filed more than five years after she stopped seeing Damkroger, and was therefore not “considered timely.”
Ritter’s lawyers filed a motion for a rehearing — arguing that the seriousness of Damkroger’s conduct and the fact that she could still be using the “damaging and unethical practice” on others were overriding factors. They also wrote that the council “does not mandate any deadline by which patients must file complaints against clinicians.”
Whelan told NBC News that the Texas Behavioral Health Executive Council has still not responded to the motion to reconsider.
“When our local counsel called the office about it, TBHEC’s general counsel eventually said during a phone call that he did not think the reconsideration request applies to Jessica’s case,” Whelan said in an email, “and that TBHEC had no plan to respond to it in writing.”
Darrel D. Spinks, executive director of the Texas State Board of Examiners of Psychologists, said “the agency cannot comment on a complaint regardless of whether the complaint is pending or closed.”
In some cases, licensing bodies are hesitant to take responsibility for policing or disciplining members, according to Matthew Shurka, the co-founder of Born Perfect, a global movement to end conversion therapy.
“Being on a licensing board is, unfortunately, still a potentially political position,” he said. “These boards often are exceedingly cautious in general and do not always do a good job of enforcing ethical and legal requirements.”
And even when they do want to enforce guidelines, their hands can be tied by lawmakers: In March, Wisconsin Republicans introduced a bill to block the state Department of Safety and Professional Standards from prohibiting licensed practitioners from performing conversion therapy. Both the state House and state Senate kept the bill in committee, sidestepping a likely veto from Gov. Tony Evers, a Democrat, while effectively preventing the regulation from taking effect at least for the rest of the Legislature’s two-year session.
Shurka said at least 12 bills were introduced this year that would prohibit banning conversion therapy. None were signed into law, but a measure in Arizona made it out of committee.
'We wanted it on record'
Ritter said she wasn’t surprised “in the least” that the Texas Behavioral Health Executive Council threw out her complaint.
“Knowing Texas — and knowing who we’re filing with — we were not surprised,” Ritter said. “But we wanted it on record.”
“If bad things happen and you don’t try to do anything about it, you’re agreeing to the status quo ... And other people might suffer."
Jessica ritter, born perfect
Last October, the council changed its code of conduct in order to allow social workers to refuse to serve clients based on their sexual orientation, gender identity or disability. After a firestorm of criticism from activists, social workers and even lawmakers, the board reversed its decision two weeks later.
An ambassador for Born Perfect, Ritter encourages anyone who feels they were traumatized by conversion therapy to file a complaint, “even if it’s anonymously.”
“If bad things happen and you don’t try to do anything about it, you’re agreeing to the status quo,” she said. “And other people might suffer. If a therapist had a big file of complaints against them, even in Texas, that’s going to draw attention — someone is going to have to at least look into it.”
She also said it helps raise awareness of an outdated and dangerous practice.
“A lot of people don’t know what conversion therapy is or — and this is even LGBTQ people — they think it’s something in the past,” Ritter said. “Even if it’s not a legal victory, it’s imperative people know what’s going on.”
'Putting lipstick on a pig'
Texas State Rep. Celia Israel, a Democrat from Austin, has sponsored a conversion therapy bill every session since she joined the legislature in 2015. In the last session, the bill was debated in a public hearing for the first time, the Texas Tribune reported.
In Kentucky, a bipartisan bill has been pre-filed in both the House and Senate for consideration when the new regular session starts in January.
Galloway supports these measures — but doesn’t believe such laws have much real power.
“I testified for the ban that passed in Illinois, and even then I knew it wasn’t sufficient because it only covers licensed therapists,” he said. “It doesn’t cover pastors or faith leaders, who are the majority of who people go to for this. And it doesn’t cover adults, who can still be very vulnerable and preyed on. So [these laws] miss the vast majority of victims.”
Even in Los Angeles, Galloway said, there are conversion therapists.
Because they’ve become aware of public sentiment being turned against them, they avoid certain phrases,” he said of L.A. conversion therapists. “They’re like, ‘Oh, it’s not conversion therapy, it’s ‘reintegrative therapy,’ but it’s just putting lipstick on a pig. It’s still preying on very vulnerable people who are obviously in a very precarious state.”
For example, the website of Joseph Nicolosi Jr. — whose father was the leading figure in conversion therapy before his death in 2017, with books like “A Parent’s Guide to Preventing Homosexuality” — states that his practice, Reintegrative Therapy Association, “is a 501(c)(3) with an unwavering commitment to those who struggle with unwanted homosexuality.”
Nicolosi Jr.’s assistant, Sara Trevino, said her boss was “not interested” in an interview, adding, “He only does interviews with serious, objective journalists.”
'The first bite'
Responsibility for prohibiting conversion therapy has become something of a hot potato, according to Blankenship, whose partner is a conversion therapy survivor.
“Nobody wants to stick their neck out and nobody wants to get sued,” she said. “The licensing board says they can’t prohibit it on their own, that they don’t have the authority. But then the state says they do have that right. So we hope whatever the decision is in Mr. Galloway’s case, it gives clarity to the situation.”
Blankenship and others in Ban Conversion Therapy Kentucky are also hopeful about the proposed legislative ban in the state.
“We believe it’s possible,” she said. “Our bill has more Republican co-sponsors than any other LGBTQ bill in Kentucky history.”
Some supporters are doing it tacitly, she added. “But conversion therapy is widely viewed as morally indefensible in both parties. Nobody supports kids killing themselves.”
The bill’s sponsor in the state Senate, Alice Forgy Kerr, is a Republican — and a Sunday school teacher. But conversion therapy is “religion gone bad,” she told local TV station WHAS 11.
Kerr’s youngest son, 31, is gay and came out to her while he was in college.
“It can’t be fixed and it shouldn’t be fixed,” she told the station, adding “We’ve got to understand that, wherever we come down on the issue of homosexuality, this bill is about banning conversion torture.”
Kentucky State Rep. Kim Banta, a Republican who is co-sponsoring the House version of the ban, said there are nearly 70 identified licensed therapists in Kentucky trying to change the sexuality or gender identity of minors, including nine in Northern Kentucky, where her district is.
“I was a high school principal — I see what happens when you don’t embrace differences and encourage young people to be their true selves,” Banta said.
She knows people feel frustrated because so many practitioners of conversion therapy are unlicensed and outside the purview of the law. “But the bill educates parents that this stuff isn’t sanctioned, that it’s not something you should do to your child,” she said.
Banta calls passing it “the first bite.”
”Maybe the next bite is making the person have to disclose that it’s not approved by medical authorities.”
Kentucky State Rep. Lisa Willner, a Democrat from Louisville, is another co-sponsor of the House version. She also happens to be a licensed psychologist and former executive director of the Kentucky Psychological Association.
Her years in practice and many friends in the LGBTQ community made it “crystal clear” that attempts to change someone’s identity are wrong, she said. “Every major mental health agency in the state of Kentucky has come out against it.”
In order to be enforced, conversion therapy bans rely on complaints being filed. They generally result in professional consequences, depending on the state and the particular licensing board, Willner said.
They could be a period of supervision, a suspended license, losing your license altogether “or just a slap on the wrist,” she said.
But, Willner added, advocates who blame licensing boards for not stopping conversion therapy are “missing the point.”
“These licensing boards are a function of government, an extension of the executive,” she said. “They’re regulatory — they ensure their members stay within the boundaries of the law, they don’t write the law. They write regulations, not statutes. If I’ve had my license revoked for something and there’s no statute against it, I’m going to sue. The regulations have no teeth if there’s no legislation to back it up.”