President Obama called for an end to conversion therapy for LGBT youths on Wednesday. Though he did not  call for a federal law banning the practice, he did make a statement through his adviser Valerie Jarrett that conversion therapy is " neither medically nor ethically appropriate and can cause substantial harm."

We talked to Dr. Michael Friedman, Ph.D., about how conversion therapy is administered and what President Obama's statement means for LGBT youths. 

Can you tell me more about conversion therapy?

Everything about gay conversion therapy is based on a false premise. It starts off with the false premise that there’s something wrong with being gay, bi or trans and that’s probably the most powerful message of this treatment. There was a time where being gay was considered a mental disorder and this was decades ago, but that premise that there’s something wrong with LGBT is false. There’s no evidence that there’s anything wrong with being LGBT – there’s no psychological or medical problem.

Secondly, there’s no evidence that sexuality is a choice or something that can be changed. And the third false is most profound: There’s absolutely no evidence that this works. There’s none that’s been presented in front of respected research institutions – it would be rejected by most ethics boards.

There are false premises and a false promise. Everything about this approach is based on a lie. What is true, though, is that this approach – both the philosophy and practice – is something that is very much akin to other forms of discrimination and bullying that LGBT people face. They’re showing that there’s something wrong with being LGBT and that it’s a choice. These are all different aspects of discrimination. It’s basically bullying masquerading as medical practice.

There are parents and medical organizations and other organizations that support this kind of treatment that are all basically doing to children what everyday schoolyard bullies do to make them feel bad about being LGBT and in some cases, subjecting them to horrible things.

So we’ve talked about the premise – what is the practice?

It can vary. Historically there was a premise that there’s a problem – it’s one of the common psychoanalytic theories – that a gay person had an overbearing mother and distant father. If that were the case, everybody would be gay. So there were theories that hadn’t been proven.

They’d use psychoanalytic therapy to uncover the conflict that is somehow leading you to be LGBT; it could be that kind of therapy. There’s aversion therapy, where you try to pair same-sex images with something that’s physically not pleasurable or disgusting. There’s the “pray your gay away” approach with ongoing counseling. There’s a range of different practices that might be used; some may not seem harmful except when you go to the underlying premise that there’s something wrong with being gay and let’s do something to change that. That ongoing exposure is very harmful. People use that as a rationale for saying it’s wrong to be gay or gay people should be denied rights. It does more harm than good and there’s no evidence that it works.

Usually when I think of conversion therapy, I think of these horrible, abusive boot camps I’ve seen on TV. Is all conversion therapy like that?

I think it can range. There are horrible situations like boot camps, but there are practices that seem more benign but are still harmful because of the message that something is wrong with you if you’re LGBT.  

What are some of the harmful effects?

One thing that’s important to recognize is that most of this is anecdotal. No one will fund this kind of study. When we’re talking about the harmful effects, a lot of it is on people who have been through it or face other forms of discrimination. You can consider it a form of bullying – so there’s depression, suicidal thoughts, anxiety, low self-esteem – all things you’d expect if you’re told something innate about you that’s wrong and there’s an underlying psychological problem that you have and you spend tons and tons of time trying to change it. You can understand why most people who have gone through ex-gay experiences of them report that it was psychologically damaging.

Every major organization that studies this issue has said this is a practice that has no evidence that it works and it causes harm. People are understanding what the president was saying, that we as a society recognize that it’s one thing if an adult makes a choice and it’s another if a kid does. Adults have more of a chance of making a choice without being coerced, but the risk for a child is overwhelming. It’s very important that people realize that it’s about banning conversion therapy for kids, though personally, as an adult, I think it’s a potentially harmful practice.

Kids are not in a position to make this decision freely, which makes it particularly dangerous. For adults, it’s harmful, but in theory, an adult has more control over whether or not they can stop. Kids may not be in a position to stop.

Are there any laws that crack down on conversion therapy?

Only in a few states. As a field it’s very important that we go out there and talk about this because we created this monster – helped create. We’re the ones who said in the 50s that LGBT were different forms of mental illnesses and came up with the non-falsifiable theory as to how people become LGBT. Now people in the field say it’s not ethical, but it’s important for our field to speak out and say we made this mess; we’re the ones who have to clean it up.

Were you surprised to hear President Obama condemn conversion therapy and make it an issue?

I wasn’t expecting it, but I think the president has taken opportunities to speak out on important social issues before.

What do you think the impact will be?

I’m hoping it will be on multiple levels. There are millions of LGBT kids and adults out there who have been told there’s something wrong with them. I hope this at the very least is a powerful statement from the President of the United States saying there’s nothing wrong with you; you don’t need to change; you’re good the way you are.

That in and of itself is an incredibly powerful and important message. That’s huge – that’s not been said before by a sitting president. I think he’s also bringing to light that every major organization condemns this practice and the more people hear that, the more they’re like, “Oh, it’s not just the President giving his belief; let’s look into it; there’s no evidence of this. It’s not a mental health disorder.”

I think that’s a powerful message to LGBT people and non-LGBT people that this is a charade and the light is being shined on it. And maybe a certan number of practitioners were doing something they thought was harmful but now see the data doesn’t support it and that it can be harmful and they may not practice it anymore. And people will rally in more states and make it illegal with kids. There are multiple ways in which by saying this sort of thing, the President is really shining the spotlight on trying to reduce discrimination against LGBT people in the country and the world and I applaud it.