On April 11, a federal judge awarded two Florida counselors a combined $175,000 after ruling that local conversion therapy bans in Palm Beach County and the city of Boca Raton violated their First Amendment rights to free speech. The two therapists — Robert W. Otto and Julie H. Hamilton — received legal support from a conservative anti-LGBTQ group called the Liberty Counsel to appeal municipal and county-level conversion therapy bans after they went into effect in 2017.

The term “conversion therapy” refers to medicalized practices attempting to eliminate same-gender sexual desires or to change subjects’ gender identities from transgender to cisgender. Research has shown such practices have more often resulted in reduced self-esteem, self-harm or suicide than in lasting change to gender identities or sexual attraction. This is why conversion therapies are illegal in some parts of the world and have been denounced by several major professional mental health organizations as harmful, unethical and ineffective.

In America, 26 states and the District of Columbia at least partially ban using this damaging practice on minors. When Otto and Hamilton’s case was heard by the U.S. Court of Appeals for the 11th Circuit in 2020, the court decided that Otto and Hamilton suffered “content based regulations of speech,” according to Judge Britt Grant. This case also prompted the court to grant a preliminary injunction preventing the enforcement of city- and countywide conversion therapy bans in Florida, as well as Alabama and Georgia. This injunction remains in effect today.

This case demonstrates that, despite bans, denouncements and continuous documented evidence of these programs’ negative effects on patients and survivors over the past century, conversion therapies remain a part of the United States’ medical landscape. This is because conversion therapies, in all their variable historical forms, have never been about offering medical or mental care to recipients. Instead, they have been a tool to eradicate LGBTQ activism, culture and people.

Medical reports of conversion therapies in the United States date to the late 1800s. However, such articles faced criticism and created an uproar because of long-standing medical taboos around open discussion of sexual behavior. For example, when Chicago physician Denslow Lewis attempted to publish his findings on treating female “sexual abnormalities” in JAMA in 1899, his draft for the medical journal was rejected as “more or less filth,” unfit for public discussion.

But in the early 20th century, rising concerns about “criminal sexual psychopaths” who threatened the sexual and moral safety of vulnerable Americans created new opportunities for medical experts to publish books and articles on their conversion therapy efforts. Various doctors concluded that homosexuality and the desire to change one’s gender were biologically quantifiable, treatable medical conditions. In this view, queer people were undeserving of legal punishments because they suffered from a congenital, biological affliction outside of their control. This conviction allowed doctors — not legal experts — to claim greater authority over matters of “abnormal” sexuality and gender expression.