Conversion Practices in Eating Disorder Treatment: A Lived Experience Narrative

BACKGROUND AND AIM: Conversion practices (sometimes referred to as 'conversion therapy') refer to interventions that aim to change a person's sexual orientation or gender identity. While these are often associated with faith-based settings, they can also occur in secular healthcare contexts. The practices are associated with significant psychological harm. This paper aims to provide a lived experience account of gender identity conversion practices perpetrated in the context of inpatient eating disorder (ED) treatment. METHODS: This paper provides the first author's narrative of his inpatient ED treatment as a young trans man and maps this experience to the key features aligned with accepted definitions of conversion practices and their enduring impact. FINDINGS: This paper describes an inpatient ED treatment experience characterised by (1) pathologisation of the first author's gender diversity; (2) the use of coercion and institutional power to enforce cisnormative developmental outcomes; (3) the persistent withholding, delaying, and problematising of gender-affirming medical care; and (4) the enduring psychological harm and extended disengagement from further treatment-seeking that results from these practices. DISCUSSION: This narrative highlights the urgent need to safeguard against conversion practices within inpatient mental health settings and ensure ED treatment is provided from a gender-affirming framework.