How Survivor Trauma Appears In Mental Health Care: Working With Survivors of Conversion “Therapy” Practices and Change Efforts

This second of a four-part series for practitioners and service providers includes contributions from those with lived experience (survivors) and from interviews with mental health practitioners conducted for CBRC’s learning course, Mental Health, Conversion “Therapy” Practices in Canada.

Question: What are the different ways that trauma appears in mental health care, when working with people who have lived experience of conversion practices and change efforts

Case Scenario One: A service user or client who is a trans man had an unsupportive family. He presented with a lot of pervasive anger. His life was one of seclusion and shame. He felt that nobody understood him. Clinically, it was important to see beyond the anger to understand what was happening in the therapeutic space and how it was reflecting external dynamics. How did his expression of hostility inform the ways he saw the world and how he had been let down by people? In what ways did he experience the clinician as a symbolic gatekeeper or yet another person who would tell him what to do? Eventually, he came to understand that his anger was at his family who were not allowing him to be who he wanted to be, and the ways in which he experienced the world as a reflection of their rejection and anger.

Case Scenario Two: At an anonymous counselling program’s drop-in space, a visitor who was an older gay man asked a mental health clinician if he was Muslim. Upon confirmation that the clinician was indeed Muslim, the man replied, “You can’t be Muslim and also be gay.” The clinician's response was to ask how the man’s sense of incompatibility affected him. The man shared that he believed that he “did the right thing,” got married, and pushed part of himself away. When asked if he had seen other people who were queer and Muslim, he got angry and said, “Stop saying that! You can’t be both of those things!” The clinician then reflected upon who they represent to this person. What makes him angry? One possible clinical response might be: “When you tell me it’s not possible to be queer and Muslim, and I tell you that’s what I am, what feelings does that bring up for you?" So much of this man’s life was structured around the belief that these two identities were incompatible. What grief must be explored when reflecting upon the impact of this belief and sense of obligation?

Jorge’s Story: Jorge grew up in a fundamentalist evangelical Christian religion in Ecuador. He came out as gay to his parents when he was 12 and right away his parents sent him to conversion therapy. Shortly afterwards, Jorge attempted suicide. He didn’t connect his experience to “conversion therapy” at the time, because he thought that was what God wanted for him. 

One of the worst things that I still experience and battle with is suicidal ideation... that started almost as soon as I started conversion “therapy.” I have had three suicide attempts in my life and even after all this time, I struggle with chronic depression and PTSD. I thought coming out was the end of the suffering, but the trauma showed up in friendships and romantic relationships. The other effect that it had on me was a lot of shame. Conversion “therapy” portrays homosexual sex as the most vile thing in the universe, so I experience sexual struggles as well.

Many survivors talk about long-term impacts on their mental health, functioning, and ability to thrive. This can include flashbacks or intrusions; persistent grief and loss; a mistrust of others, persistent social anxiety; fear of rejection or abandonment, problems in relationships; problems with sex; mistrust of their thoughts or feelings; low self-esteem or self-worth; body dysmorphia, or body image concerns; anger, suppression of emotions, shame, depression, or anxiety; eating disorders, sleep disorders, phobias, substance use, homelessness, and suicidality. These symptoms, and more, can all be related to complex trauma (PTSD), developmental trauma, or religious trauma.

Survivors of traumas that happen in relationship with self or others often walk away with long-term core beliefs such as “I’m not good enough,” “People will disappoint me,” “If people meet the real me, they wouldn’t like me,” or “Happiness is not a possibility for people like me.”   

It can be useful to help people work backwards to identify where their core beliefs came from. Naming the source of shame-based beliefs can help clients identify if they have experienced attempts to convert or subvert their identity in ways that have harmed them. A lot of the work that is done in therapy is to help people unlearn the core belief that they are the problem, that there’s something wrong with them. This is part of memory reconsolidation and the healing work that is needed to recover from the foundational attacks on self and identity that are inherent to conversion practices.


Rahim Thawer, MSW, RSW, is a psychotherapist, clinical supervisor, facilitator and public speaker, sessional lecturer, writer, and community organizer. Nearly half of Rahim’s clinical practice has evolved into clinical supervision and consultation work.

Sly Sarkisova, MSW, is a queer and nonbinary trans-identified psychotherapist working in the field of mental health, addictions, and trauma therapy. He provides consultation, clinical supervision, and training around trauma informed, holistic, anti-oppressive practices in mental health.

Naj Siritsky, MSSW, BCC, RSW, D.Min., (he/they), is a Professional Practice and Advocacy Consultant at the Nova Scotia College of Social Workers. He is a social worker with doctoral training in spiritual counseling, a survivor of conversion practices, and the first transgender nonbinary Reform rabbi in Canada.

Jorge Andrade is a conversion practice survivor and a refugee from Ecuador. He is currently the Community Engagement and Belonging Coordinator at Rainbow Refugee in Vancouver, British Columbia.


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Community-Based Research Centre (CBRC) promotes the health of people of diverse sexualities and genders through research and intervention development.
How survivor trauma appears in mental health care
How Survivor Trauma Appears In Mental Health Care: Working With Survivors of Conversion “Therapy” Practices and Change Efforts
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