So-called conversion therapy is a subject that has appeared frequently in public discourse and international headlines in recent months. As several states and countries across the world consider bans, awareness about these practices – which are based on bogus science, never work, and cause lasting harm –  has grown. But little has been known about conversion therapy outside North America, parts of Europe and Australia, and few conclusions could be drawn about its prevalence, or the drivers behind it. This makes tackling it effectively tricky.

At the end of August, OutRight Action International issued a groundbreaking report, “Harmful practices: The global reach of so-called conversion therapy,” showing that so-called conversion therapy seeking to change, suppress, or divert one’s sexual orientation, gender identity or gender expression, takes places all over the world. And, crucially, identifying that globally the main perpetrators and advocates of “conversion therapy” are people acting in the name of religion, usually with significant pressure or even coercion from families.

In Asia, however, only 22% of respondents identified religion as a key driver of conversion therapy. Instead, protection of perceived family honor and cultural reasons were identified by 89% and 80% of respondents respectively. Correspondingly, the key perpetrators of “conversion therapy” in Asia are not religious leaders or organizations, but rather private medical (72%) and mental health providers (68%). By contrast, in Africa private medical professionals were identified by only 24% of respondents, and 21% in Latin America, where religious leaders and institutions were by far the top perpetrators.

This is interesting and worth exploring, as globally the key opponents to LGBTIQ (lesbian, gay, bisexual, transgender/transsexual, intersex and queer/questioning) equality tend to come from religious and ultra-conservative circles, while medically both sexual orientation and gender identity have been de-pathologized by, among others, the World Health Organization. Prevalence of so-called conversion therapy is directly related to societal beliefs about LGBTIQ people and the degree to which our lives are accepted and embraced within families, faiths, and societies at large, indicating that in parts of Asia LGBTIQ people are still seen as sick, diseased and in need of a medical “cure.”

Indeed the Chinese Classification of Mental Disorders still includes “sexual orientation disorder.” A number of countries, such as Malaysia, Sri Lanka, Singapore and others, continue to criminalize same-sex relations, while authorities in Indonesia have launched a campaign to “cleanse LGBTIQ people of their social sickness.” Legal provisions that paint LGBTIQ people as criminals, classifications of diseases that still include same-sex attraction or gender variance despite both having been removed from international classifications, all serve to perpetuate societal perceptions of LGBTIQ people as unacceptable and, in turn, in need of “conversion therapy.”

OutRight’s study shows that “conversion therapy” practices vary greatly in their levels of physical or psychological abuse. According to responses received by OutRight for this report, in Asia physically abusive methods such as aversion therapy and electroshock are widely used, causing both mental and physical scars in survivors. But “conversion therapy” is neither therapy nor does it result in conversion. Such practices are based on bogus science and have no place anywhere, let alone within the walls of licensed health professionals.

Only four jurisdictions worldwide have banned “conversion therapy” – Taiwan being one of them (the others are Malta, Brazil and Ecuador). Several others have partial bans, and a number are considering imposing some form of ban. Bans are extremely important and more states need to be passing them. They send a strong message that “conversion therapy” is not acceptable, and that LGBTIQ people are fine the way we are. But bans are not enough. As the supply and demand of so-called conversion therapy is so linked to societal perceptions, any efforts to eradicate it need to be accompanied by proactive efforts to ensure understanding and inclusion of LGBTIQ people. In short, societal perceptions must change, not LGBTIQ people.

In parts of Asia significant work needs to go into educating health professionals. We need once and for all to put an end to the long-debunked perceptions of LGBTIQ people as sick. Two landmark court cases in China already ruled that clinics should not offer “conversion therapy” as this is not legitimate treatment, and both received fines. This is a welcome step, but it is not strong enough. These practices are not grounded in science or medicine, therefore medical professionals offering “conversion therapy” should not only be fined, but have their licenses revoked.

Ultimately, until the classifications no longer mention sexual orientation or gender identity, until medical associations and boards openly and categorically condemn “conversion therapy,” and until societal perceptions of us change, bans and fines alone will not eradicate “conversion therapy.” It is a global issue, and is symptomatic of just how much of an uphill battle LGBTIQ people have yet to fight until we are accepted and included as we are. Families, faith communities and medical professionals need to stop trying to mold us into outdated perceptions of the norm. We need to work across civil society, states and multilateral organizations to ensure a global, and sustainable effort to embrace and include LGBTIQ people as fully fledged members of our societies.