Discussion
Our community-based qualitative study demonstrates that BIPOC, immigrant, newcomer, and refugee 2SLGBTQIA+ individuals who have experienced conversion ‘therapy’ have unique experiences and needs, which require dedicated resources and support. While there was some knowledge of Bill C-4, participants shared that stronger efforts are needed to increase knowledge of the Bill, of conversion ‘therapy’ and SOGIECE. Participants’ experiences confirmed that conversion ‘therapy’ in Canada and abroad take place in a variety of settings, especially within familial, religious, faith, and healthcare environments. The intersections of race, migration experience, gender, sexuality, religion/faith mean that BIPOC, immigrant, newcomer, and refugee 2SLGBTQIA+ individuals face distinct challenges including systemic barriers, yet they are often relying on themselves for support. The strength of the participants and their courage in sharing their experiences must be noted.
Past studies demonstrated how conversion ‘therapy’ persisted in Canada, and they most commonly occur within religious or faith-based settings or within healthcare environments [7-8]. The study results were similar to the past findings but demonstrated the importance of employing a broader definition of conversion ‘therapy’ related practices such as SOGIECE, which occur in diverse settings, including family settings, and in overt and more insidious forms, with many harmful impacts on 2SLGBTQIA+ people. Additionally, it may be helpful to rethink the term, ‘conversion therapy’ because the term ‘therapy’ is often associated with a clinical setting, which can make it difficult for 2SLGBTQIA+ people who experience more subtle forms of conversion practices to recognize their experience as conversion ‘therapy.’
As previously stated, BIPOC, immigrant, newcomer, and refugee 2SLGBTQIA+ people have been marginalized in past studies on conversion ‘therapy,’ even though these individuals experience disproportionate rates of conversion ‘therapy’ [7; 13]. This study sought to address the gap by centring the voices of BIPOC, immigrant, newcomer, and refugee 2SLGBTQIA+ survivors. Our results illuminated that these people who face intersecting oppressions may experience additional vulnerabilities to conversion ‘therapy’ and face more barriers to support due to systemic inequities. BIPOC, immigrant, and refugee 2SLGBTQIA+ people may face anti-2SLGBTQIA+ stigma from mainstream society and their ethnoracial communities, but also racism and xenophobia from mainstream society and 2SLGBTQIA+ communities. Addressing conversion ‘therapy’ requires addressing anti-2SLGBTQIA+ stigma, racism, and xenophobia. The findings also highlight the importance of support interventions that are intersectional, that is they take into account not just experiences of anti-2SLGBTQIA+ stigma, but also racism and xenophobia.
Consistent with past study results [7; 9; 10-12], this study demonstrated the devastating consequences of conversion ‘therapy’ for 2SLGBTQIA+ people’s mental and physical health, sense of self, interpersonal relationships, and life opportunities. Additionally, losing important connections with their ethnoracial and religious communities can be even more devastating for BIPOC, immigrant, newcomer, and refugee people who may need to rely on these communities to navigate racism and xenophobia in Canada. The impacts of the trauma of conversion ‘therapy’ are wide-ranging, and the study affirms the need for trauma-informed approaches to working with survivors.
As this study also demonstrated, some 2SLGBTQIA+ survivors have to leave their country of origin to seek a safer place to live. However, many 2SLGBTQIA+ immigrants, newcomers, and refugees face significant challenges in Canada such as obtaining their immigration status, navigating complex social and healthcare systems, racism, and xenophobia. Immigration systems need to be more knowledgeable and supportive of the harms that 2SLGBTQIA+ conversion ‘therapy’ survivors have experienced and employ a trauma-informed approach in their practices. Since not all survivors will disclose their experiences of conversion ‘therapy’ or even their 2SLGBTQIA+ identities to immigration officials, settlement agencies or international student support services, these institutions must have adequate knowledge and training to utilize a trauma-informed approach.
An important contribution made by the study is the connection between housing and conversion ‘therapy.’ When BIPOC, immigrant, newcomer, and refugee 2SLGBTQIA+ individuals are living in a family home where conversion ‘therapy’ and/or SOGIECE are occurring, and when there are no opportunities to leave for safe or secure housing, this can exacerbate the impacts on survivors. For immigrants, newcomers, and refugees, and especially for international students, this can be especially damaging. Investments in 2SLGBTQIA+ housing support services are desperately needed, with eligibility criteria to be inclusive of 2SLGBTQIA+ communities who experience additional systemic barriers, such as immigrants, refugees, international students, temporary foreign workers, and those without immigration status.
Past studies showed that it was not uncommon for 2SLGBTQIA+ people who fled their home country to acquire HIV in Canada and face access barriers to HIV care due to isolation, lack of access to information and resources, and systemic forms of oppression like racism and xenophobia [20;21;23]. Even though our interview questions were not developed around the topic of HIV/AIDS, some participants shared their experiences related to HIV/AIDS and pointed out the continuing need to improve HIV community education and care for 2SLGBTQIA+ immigrants, refugees, and newcomers.
The findings reiterate general gaps in support for 2SLGBTQIA+ survivors, which were identified in past literature [7; 9; 11; 13], and highlight unique additional barriers BIPOC, immigrant, newcomer, and refugee 2SLGBTQIA+ people face. Governments need to invest in low-barrier mental health services that are free, culturally appropriate, trauma-informed, and designed specifically to support survivors of conversion ‘therapy.’ These services need to be offered online and in-person, include opportunities to be accessed anonymously, be designed, and developed in consultation with survivors, and be available in places beyond large urban centres. In addition to mental health services, increased community-based supports for BIPOC, immigrant, newcomer, and refugee 2SLGBTQIA+ individuals (for example through 2SLGBTQIA+ or ethnoracial community-based organizations) are needed, including those that are culture and language specific, peer-based, and attend to a diversity of individuals, including those who are neurodivergent, those who cannot be “out,” those living in rural communities, etc.. One example shared by participants was the creation of a safe anonymous online chat, text, or phone service specifically developed to support survivors of conversion ‘therapy.’
We recognize that existing peer groups for conversion ‘therapy’ survivors, such as C.T. Survivors Connect (https://www.ctsurvivorsconnect.ca/) and Conversion Therapy Dropout Network (https://www.conversiontherapydropout.org/) have been offering support directly. Many participants identified peer support as a potential culturally sensitive model for BIPOC, immigrant, newcomer, and refugee survivors of conversion ‘therapy’ and highlighted existing examples of these initiatives. To better support them, these peer support models need to be enhanced and expanded.
In considering the implementation of Bill C-4, the study findings indicate that while some participants wanted to hold the perpetrators of conversion ‘therapy’ accountable, that is not the interest of many participants. For this study’s participants, as with many other survivors, conversion ‘therapy’ is often practiced by those close to 2SLGBTQIA+ individuals such as family members. Participants also noted that Canadian criminal justice systems and policing have harmed and continue to harm 2SLGBTQIA+, BIPOC, immigrant, newcomer, and refugee communities. Thus, seeking justice through these systems may not be helpful or effective for these communities unless systemic oppression is adequately addressed. As an alternative to a punitive approach, employing educational or restorative approaches could be more effective, given the nature of who may be responsible for perpetuating conversion ‘therapy.’ For example, broad campaigns aimed at building knowledge and acceptance of 2SLGBTQIA+ identities and understanding the harmful effects of conversion ‘therapy’ could be helpful. Involving ethnoracial and immigrant, newcomer, and refugee serving community organizations may be one way to promote culturally sensitive campaigns and outreach. Relatedly, there is a need to continue to address the gaps in knowledge or understanding of Bill C-4 through public education.
The importance of addressing conversion ‘therapy’ is particularly important, given the resurgence of anti-2SLGBTQIA+ movements (and which have also expanded to anti-2SLGBTQIA+ legislation or policies), which all have detrimental consequences for 2SLGBTQIA+ people [25; 26]. The need for policymakers, community leaders, and community-based organizations to prioritize supporting 2SLGBTQIA+ communities is a pressing one, growing more important by the day. Support for 2SLGBTQIA+ communities includes preventing and addressing conversion ‘therapy’ and SOGIECE, ensuring safe spaces for 2SLGBTQIA+ individuals including within schools, improvement of services to reduce barriers, access to education about sexuality and gender, recourse for in-person and online hate, and much more.
Although this study was able to shed light on BIPOC, immigrant, newcomer, and refugee 2SLGBTQIA+ survivors who are often neglected in this area of work, the study has limitations. First, participants had to be able to speak English, French, or Spanish to participate in the study, which excluded 2SLGBTQIA+ individuals who could not communicate in at least one of these languages. Secondly, most participants were those who had already come far in their healing journey; some participants explicitly mentioned they would not have been able to share their story many years ago.
As one of the participants said, many 2SLGBTQIA+ people do not even have the opportunity to share their experience with conversion ‘therapy.’ This study also had only sixteen participants, and one of them subsequently withdrew. Due to these limitations, the generalizability of our study is limited. However, the study does provide valuable insight into the experiences of BIPOC, immigrant, newcomer, and refugee 2SLGBTQIA+ survivors of conversion ‘therapy,’ which provides a step toward improving support for these survivors.
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