A/HRC/44/53 intolerance that may include sexual and other violence, as well as socioeconomic deprivation. Exclusion from the family home as a result of refusal to undertake practices of “conversion therapy” triggers a cycle, with lesbian, gay, bisexual, trans and gender-diverse young people being disproportionately represented in foster care, begging and sex work and more likely to be turned away from shelters. 40. Some participants at the expert meeting highlighted that practices of “conversion therapy” became a “moving target”, making it difficult to identify, monitor and punish perpetrators of such abuse. When facing restrictions or bans on practices specifically denominated “conversion therapy”, proponents have rebranded and reshaped their communications strategies. 41. With due attention to those specificities, the Independent Expert considers it useful to describe three main approaches that seem to guide practices of “conversion therapy”: psychotherapeutic, medical and faith-based. It should be noted, however, that academic literature disproportionately represents lived experiences from the global North, including Australia, and China and, despite the inclusion of non-scientific sources, information on religious practices remains scarce compared with those that are health-based. 1. Psychotherapy 42. The use of psychotherapy as a practice of “conversion therapy” appears to be based on the belief that sexual or gender diversity is a product of an abnormal upbringing or experience. Providers claim to rectify deviations and support the development of desire for members of the opposite sex, which is considered the desirable norm, by having subjects work through past experiences, like absent paternal or officious maternal figures.64 That category comprised the majority of evidence in the Independent Expert’s literature review, with numerous variations of psychotherapy classified under, inter alia, psychodynamic, behavioural, cognitive and interpersonal therapies. 43. Aversion is another frequent practice, through which a person is subjected to a negative, painful or otherwise distressing sensation while being exposed to a certain stimulus, under the premise that the stimulus will become associated with the negative sensation. Aversion methodologies have seen a sharp decline in use, especially after the late 1970s, but recent reports indicate that electric shocks have been used in aversive treatments in Australia,65 China,66 Ecuador, India,67 Indonesia, Iran (Islamic Republic of),68 Lebanon, Malaysia, Panama, the Russian Federation, Sri Lanka, Uganda, the United States, Viet Nam and Zimbabwe69. Other aversion practices include injecting nausea-inducing or paralysisinducing drugs while exposing the subject to erotic material on a large screen, reportedly still being used in Iran (Islamic Republic of) and the United States.70 44. Other practices include subjects being encouraged to masturbate while fantasising about persons of a different gender (Iran (Islamic Republic of), 71 Peru,72 Spain73 and United 64 65 66 67 68 69 70 71 72 73 10 Ibid. See https://static1.squarespace.com/static/580025f66b8f5b2dabbe4291/ t/5bd78764eef1a1ba57990efe/1540851637658/LGBT+conversion+therapy+in+Australia+v2.pdf. See www.hrw.org/report/2017/11/15/have-you-considered-your-parents-happiness/conversiontherapy-against-lgbt-people. See www.dailymail.co.uk/indiahome/indianews/article-3098146/Exposed-Delhi-doctors-claim-curehomosexuality-hormone-therapy-seizure-inducing-drugs-electric-shocks.html. See ilga.org/Conversion-therapy-global-research-ILGA-World. For the Islamic Republic of Iran, see www.ilgaasia.org/news/2018/7/13/repost-from-6rang-reparative-therapies-on-gays-and-lesbiansthrough-cruel-inhumane-and-humiliating-treatments-has-increased-in-iran. See irct.org/media-and-resources/latest-news/article/1027. See irct.org/media-and-resources/latest-news/article/1027; see also www.ilgaasia.org/news/2018/7/13/repost-from-6rang-reparative-therapies-on-gays-and-lesbiansthrough-cruel-inhumane-and-humiliating-treatments-has-increased-in-iran. See www.ilgaasia.org/news/2018/7/13/repost-from-6rang-reparative-therapies-on-gays-and-lesbiansthrough-cruel-inhumane-and-humiliating-treatments-has-increased-in-iran. See https://larepublica.pe/politica/2019/08/12/las-terapias-de-la-tortura/ (in Spanish). See https://elpais.com/diario/2010/06/20/sociedad/1276984802_850215.html (in Spanish).

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