All leading professional medical and mental health associations reject “conversion therapy” as a legitimate medical treatment. In addition to the clinical risks associated with the practice, the means through which providers or counselors administer change efforts violate many important ethical principles, the foremost of which: “First, do no harm.” A health care provider’s nonjudgmental recognition of and respect for patients’ sexual orientations, sexual behaviors and gender identity are essential elements in rendering optimal patient care in health, as well as in illness. This recognition is especially important to address the specific health care needs of people who are or may be LGBTQ as these patients often experience disparities in access to care. Yet administering change efforts is an inherently discriminatory practice often administered coercively and fraught with ethical problems, such as: • Uninformed consent: change efforts are often prescribed without full descriptions of risks and disclosure of lack of efficacy or evidence • 

Breaches of confidentiality: content of treatment, sexual orientation and gender identity may be shared with family, school or religious leaders without proper consent • 

Patient discrimination: change efforts reinforce bias, discrimination and stigma against LGBTQ individuals • Indiscriminate and improper treatment: change efforts are recommended regardless of evidence

• Patient blaming: the failure of treatment may be blamed on the patient19 It is clinically and ethically inappropriate for health care providers to direct mental or behavioral health interventions, including SOCE and GICE, with a prescriptive goal aimed at achieving a fixed developmental outcome of a child’s or adolescent’s sexual orientation, gender identity or gender expression.20