CONVERSION THERAPY AND ITS COMPATIBILITY WITH EUROPEAN HUMAN RIGHTS LAW

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Marcus Veinan

Masterarbeit zur Erlangung des Grades eines

“Master of Laws” (LL.M.) am Europa-Institut der Universität des Saarlandes

CONVERSION THERAPY AND ITS COMPATIBILITY WITH EUROPEAN HUMAN RIGHTS LAW

A legal assessment of conversion therapy in light of the domestic legislation of European states and European human rights law

Betreut von Dr. Elif Askin

Oslo, 17.02.2021 [email protected]

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Table of content

A. Introduction ... 1

I. Topic and research question ...1

II. Background and relevance ...2

III. Methodology ...3

B. The concept of conversion therapy ... 4

I. Origin ...4

II. Practices ...5

III. Subjects ...7

C. The legal regulation of conversion therapy in European states ... 8

I. The position of states that have not banned conversion therapy ...8

1. States not in favour of imposing a ban ... 9

2. States in favour of imposing a ban ... 11

II. The regulation of states that have banned conversion therapy ...12

1. Definitions and scope ... 13

2. Recipients ... 15

3. Providers ... 15

4. Referrals ... 16

5. Advertisement ... 16

6. Criminalisation ... 17

7. Monitoring and enforcement ... 18

III. Summary ...18

D. Is conversion therapy compatible with European human rights law? ... 18

I. The European human rights system ...18

1. The Council of Europe ... 19

2. The European Union ... 20

3. Harmonisation of European human rights law... 20

II. Does conversion therapy violate the individual rights of recipients? ...21

1. The right to life... 21

2. The prohibition of torture ... 24

3. The right to respect for private life ... 26

4. The right to health ... 29

5. The prohibition of discrimination ... 30

6. Consumer protection ... 33

III. Do individual rights grant providers a right to perform conversion therapy? ...33

1. Religious providers ... 34

2. Health practitioners and other providers ... 36

3. Parental rights... 39

IV. Can a domestic ban on conversion therapy be justified?...40

1. Justification under the limitations to Articles 9-10 of the ECHR in light of the individual interests of states and providers ... 40

V. Conclusion ...43

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E. Future considerations ... 44 I. Bibliography... I II. Table of cases ... VI III. Affidavit ... XIII

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List of abbreviations

CFREU Charter of Fundamental Rights of the European Union CJEU Court of Justice of the European Union

CoE Council of Europe

CRC Convention on the Rights of the Child

EC European Commission

ECHR European Convention on Human Rights ECoHR European Commission of Human Rights ECtHR European Court of Human Rights ECSR European Committee of Social Rights EP European Parliament

ESC European Social Charter

EU European Union

LGBTI Lesbian, gay, bisexual, transsexual, intersex NGO Non-Governmental Organisation

OHCHR Office of the United Nations High Commissioner for Human Rights TEU Treaty on European Union

TFEU Treaty on the Functioning of the European Union UCPD Unfair Commercial Practices Directive

UDHR Universal Declaration of Human Rights

UN United Nations

UNHRC United Nations Human Rights Council WHO World Health Organisation

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A. Introduction

I. Topic and research question

“[I]n Ukraine, he met with a 16-year-old gay young person who had been sent by his parents to a psychologist for treatment and to a priest to express repentance, forced to cut all contact with his brother and his friends, ousted from the family home, deprived of his livelihood and threatened with violence and death. The young man, exhausted but determined and resilient, had finally decided to make his family believe that he had changed – until such time as he could freely make his own life decisions.”¹

This testimony, which was put forward by a young Ukrainian recipient of conversion therapy, is an illustrative backdrop for this thesis and its importance. Having a gay son was never an option for the parents. The only way their son could live normally was to go through therapy to get rid of his homosexuality. When therapy did not help, the young man chose the only path he could see fit. Instead of living his life candidly, seeking relations with peers and exploring his sexuality, he decided to hide an imperative aspect of his personality and identity in order to avoid being ostracised by his family. The laws did not help him. In fact, they hardly existed. The young man was left entirely to himself. In a state of lawlessness.

The question to be examined in this thesis is whether conversion therapy is compatible with European human rights law. Although no single definition has been adopted,² the term

“conversion therapy”³ refers to a set of practices that aim to change or suppress the sexual orientation⁴ and gender identity, including gender expression,⁵ of lesbian, gay, bisexual, transsexual and intersex (LGBTI) people.⁶ The idiom “practices” denotes the methods or forms

1 United Nations Human Rights Council (UNHRC), 44^th session, Practices of so-called “conversion therapy”:

Report of the Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, 1 May 2020, A/HRC/44/53, para. 18.

2 ILGA World: Mendos, Curbing Deception: A world survey on legal regulation of so-called “conversion therapies”, www.ilga.org/Conversion-therapy-global-research-ILGA-World-curbing-deception-february-2020 (last accessed on 15.02.21), p. 17.

3 Ibid, p. 17 ff. This term is also known as “conversion practices”, “reparative therapy”, “gay cure”, “ex-gay therapy”, “gender critical therapy”, “Sexual Orientation Change Efforts” (“SOCE”) and “Sexual Orientation, Gender Identity or Gender Expression Change Efforts” (“SOGIECE”).

4 “Sexual orientation” refers to “each person’s capacity for profound emotional, affectional and sexual attraction to, and intimate and sexual relations with, individuals of a different gender or the same gender or more than one gender”, see International Commission of Jurists (ICJ), Yogyakarta Principles - Principles on the application of international human rights law in relation to sexual orientation and gender identity, 2007, Preamble. According to the Preamble, the Yogyakarta Principles serve as binding international legal standards and the document is meant as an interpretative aid to existing international human rights treaties, cf. Additional Recommendation (i).

5 “Gender identity” refers to “each person’s deeply felt internal and individual experience of gender, which may or may not correspond with the sex assigned at birth, including the personal sense of the body (which may involve, if freely chosen, modification of bodily appearance or function by medical, surgical or other means) and other expressions of gender, including dress, speech and mannerisms”, cf. ICJ, Yogyakarta Principles, 2007, Preamble.

6 UNHRC, 44^th session, Practices of so-called “conversion therapy”, para. 17.

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that are used to change or suppress the sexual orientation and gender identity of LGBTI people.⁷ While individuals responsible for performing conversion therapy are recognised as “providers”, proponents endorsing the practices are referred to as “promoters”.⁸ Finally, LGBTI people who are subjected to conversion therapy will be referred to as “recipients”.

With reference to this thesis, “European human rights law” is used as an umbrella term for the human rights systems of the European organisations Council of Europe (CoE) and European Union (EU). While these systems are composed of independent frameworks, the organisations have created certain principles to harmonise the human rights system in Europe.⁹ The thesis thus concerns the human rights instruments of both European organisations. Yet, due to the fact that the CoE has adopted more instruments and developed richer case law than the EU, the primary focus will be on the instruments of the CoE.

The expression “compatibility” refers to the question of whether conversion therapy corresponds to or conflicts with European human rights law, and thus serves as a connector between the two preceding terms. Due to the nature of the European human rights system and the lack of relevant sources in the context of conversion therapy,¹⁰ this question will not be answered definitely. Rather, the focal point will be on the individual rights of recipients and providers under European human rights law. By applying the principles and rationales that have been established by the European courts, the thesis will attempt to illustrate how the European courts would approach cases of conversion therapy if an actual complaint was to be submitted before them.

II. Background and relevance

The background for deciding on this topic is primarily due to what I perceive as a lack of legal regulation of conversion therapy in Europe. Today, while these practices have been recorded in numerous European states, the minority of them have introduced bans.¹¹ Other states are either evaluating whether conversion therapy should be banned or, more commonly, do not have specific plans to ban the practices.¹² Moreover, numerous research reports have concluded that the practices are harmful and cause damage to recipients.¹³ Thus, the combination of inadequate legal protection and the harmful effects recipients face creates a legitimate need to shed light on conversion therapy from a legal standpoint.

7 ILGA World, Curbing Deception, p. 21.

8 UNHRC, 44^th session, Practices of so-called “conversion therapy”, p. 6.

9 See part D.I.3.

10 See part D.I. and D.II.

11 See part C.II.

12 See part C.I.

13 See part B.III.

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III. Methodology

This thesis is legally placed under the area of European human rights law. The focal point will be on rights and obligations stemming from European human rights treaties and case law of the European courts. By reason of their interpretation techniques,¹⁴ the European courts also draw attention to the domestic legislation of Member States. Consequently, the thesis will focus on European human rights law in combination with certain national legislation.

The starting point in this thesis is to describe the concept of conversion therapy. In part B, I will explain how these practices came to life, the various forms that conversion therapy can take, the subjects involved and the outcome for recipients. The aim is to provide a clearer picture of how conversion therapy degenerates.

Part C deals with the legal regulation of conversion therapy in European states. At the outset, I will give an overview of the states that have not yet banned conversion therapy and their positions on the matter. This part is important to show some of the ambiguities that prevail in European states. The main focus will be on the legal regulation of states that have enacted some form of ban. The laws currently existing have both similarities and dissimilarities and, in order to best illustrate these differences, I have chosen a comparative analysis of these laws.

The aim is to describe the current legal regulation of conversion therapy in European states.

The research question in this thesis will be sought answered in part D. Initially, I will briefly provide an overview of the European human rights system, including the European organisations CoE and EU, the European courts and their instruments to protect and harmonise human rights in Europe. Subsequently, I will assess conversion therapy in light of the individual rights of recipients and providers under European human rights law. On one hand, I will examine if conversion therapy violates the individual rights of recipients and, on the other, whether individual rights grant providers a right to perform conversion therapy. This approach allows a description of the current legal situation in Europe, even though the majority of states have not yet banned conversion therapy. The last section alters the focus to the situation where a state has prohibited conversion therapy by law. The question to be examined is whether such a ban can be justified under European human rights law. To answer this, the limitations to specific individual rights will be scrutinised, which, among other, require a balancing of the interests of providers and states. Consequently, part D aims to describe the current legal status of conversion therapy under European human rights law. To delineate the thesis, the different forms of state responsibility will not be examined.

Finally, in part E, I will make a normative description of the current legal regulation of

14 See part D.I.1.

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conversion therapy in Europe. In other words, I will describe how I think conversion therapy should be regulated in the future as opposed to how the practices actually are regulated today.

The aim is to emphasise the imminent need to ban conversion therapy in Europe.

B. The concept of conversion therapy

I. Origin

Conversion therapy arose in the late 1800s as a result of the pathologisation of LGBTI people.¹⁵ Scientists began to scrutinise and classify as illnesses several “socially unaccepted behaviours”

that were considered “sins under moral or religious beliefs”, such as homosexuality and transvestism.¹⁶ Thus, while heterosexuals and cisgenders were perceived as the “biological norm”, sexual and gender diversity was considered “a deviation, a perversion or a mental illness that could be cured, shifted or “converted” with specific “treatment”.”¹⁷ These theories were primarily based on Freudian concepts that ascribed homosexuality to, inter alia, unconscious childhood conflicts, developmental arrest, sexual abuse and dysfunctional parenting.¹⁸

The classification of sexual deviancies as mental disorders in the 1940s until the early 1970s, caused practitioners within psychology and psychiatry to function as “providers of conversion therapy”.¹⁹ With the depathologisation of homosexuality starting from the early 1970s, causing health practitioners to be unable to perform conversion therapy, religious groups took part in offering these practices.²⁰ The depathologisation of homosexuality by the World Health Organisation (WHO) in 1990,²¹ combined with the increased recognition of sexual and gender diversity as “part of the normal range of human development”,²² led to augmented knowledge and understanding of the harm conversion therapy could cause.

Throughout the 2000s, providers began a “shape-shift”, by decreasing the focus on

“conversion” from gay to straight and toning down the language used to help people attain

“freedom from homosexuality”.²³ Instead, some providers have reoriented their practices into

15 ILGA World, Curbing Deception, p. 22. The term “pathologisation” can be defined as “the psycho-medical, legal and cultural practice of identifying a feature, an individual or a population as intrinsically disordered”, see Kara, Gender is not an illness. How pathologizing trans people violates international human rights law, https://gate.ngo/gender-is-not-an-illness (last accessed on 15.02.21), p. 4.

17 Ibid.

18 Ibid; OutRight Action International: Bishop, Harmful Treatment: The Global Reach of So-Called Conversion Therapy, https://outrightinternational.org/reports/global-reach-so-called-conversion-therapy (last accessed on 15.02.21), p. 8.

20 Ibid, p. 38.

21 Ibid, p. 22.

22 Streed et al., TNEJM 381/2019, p. 500, 501.

23 OutRight Action International, Harmful Treatment, p. 11.

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getting recipients to “suppress” their sexual identities, by “living celibate lives, reclaiming their cisgender identities, and regaining social acceptance”.²⁴

II. Practices

The absence of research reports exclusively focusing on conversion therapy in Europe is not synonymous with the fact that the practices do not occur on the continent. A global report from 2020 indicate that conversion therapy is performed in several European states, including Malta, Spain, Russia, The United Kingdom (UK), Ireland, Portugal, France, Germany and Moldova.²⁵

Various forms of conversion therapy have been documented in Europe. During the Nazi period, several hundreds of gay men were castrated and exposed to hormonal treatment by German doctors in order to find a “cure” for homosexuality.²⁶ In the UK, particularly from the 1940s-1960s, mental health practitioners often used “aversion therapy”, including electroshock and chemotherapy, with the aim of “modifying” the behaviour of recipients.²⁷ Another method is known as “masturbatory reconditioning”.²⁸ In the late 1990s, a young man from Spain stated that his therapist told him to think of women while masturbating, and to pull a rubber band on his wrist every time he thought about men in order to reorient his homosexual thoughts to pain.²⁹ In Russia, reports indicate that various health practitioners have offered and still offers hypnosis to eradicate same-sex attraction.³⁰ Moreover, young people are frequently forced to intern in clinics or camps, which leave them isolated and exposed to abuse.³¹ For example, in 2012, sixteen year old Ivan Kharchenko from Russia was forcibly interned by his father in a clinic in Moscow, in which he was offered psychotropic drugs to “cure” him of homosexuality.³² Psychotherapy and counselling are seemingly the preferred forms of conversion therapy used by mental health practitioners.³³ In 2019, Spanish “coach” Elena Lorenzo was fined by local authorities for performing conversion therapy but soon after introduced a course called “Road to heterosexuality” (Camino a la heterosexualidad).³⁴ As stated on her website, the course is “a process of personal growth aimed at people with homosexual feelings”, that should not be

24 Ibid.

25 ILGA World, Curbing Deception, Chapter 2 “What forms can SOGIECE take?”.

26 Tamagne, p. 387 and 427.

27 ILGA World, Curbing Deception, p. 24 ff.

28 Ibid, p. 27 ff.

29 Inzunza, Oraciones para dejar de ser gay, elpais.com/diario/2010/06/20/sociedad/1276984802_850215.html (last accessed on 15.02.21).

31 Ibid, p. 29 ff.

32 The Moscow Times, Gay Teen Forcibly Taken to Drug Rehab Clinic Released,

themoscowtimes.com/2012/04/25/gay-teen-forcibly-taken-to-drug-rehab-clinic-released-a14357 (last accessed on 15.02.21).

34 Ibid, p. 35 and 93.

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“confused with aversion or conversion therapies”.³⁵ This case is a good illustration of the

“shape-shift” providers have made in the recent years. Closely related is religious counselling offered by faith or religious-based organisations – a practice documented in, inter alia, Portugal, Ireland, the UK, Spain and France.³⁶ In 2010, Irish journalist Cormac O’Brien went undercover to attend conversion therapy provided by a Christian group called “Courage”.³⁷ The materials provided by this group included statements like “[i]ts not gay, it’s not bad, it’s SSAD”, with the acronym referring to “Same Sex Attraction Disorder”, in addition to other false and biased information about sexual and gender diversity.³⁸ Moreover, a priest in the group asserted that homosexuals were “people who would never find happiness, no matter how much they tried”.³⁹ In Russia, 13-year-old Maria was forced by her family to attend conversion therapy in a church, in which she had holy water poured over her and was beaten with rods.⁴⁰ In 2019, a Norwegian newspaper introduced the documentary “Homoterapi” (gay therapy), with the aim of revealing how conversion therapy is performed in Norway.⁴¹ One of the victims, Arne Christian Nielsen, attempted to change his homosexual orientation for 13 years, from the ages of 13 to 26, with the “help” of the local Christian congregation “Kristent Fellesskap”. He was, among other, sent to several gay camps in Norway and the UK, such as “Healing Week” with 60 participants in London in 2012.⁴² Another victim, Brian Furnes, who grew up in a Muslim family under a different name, told that his family and community subjected him to negative social control, beatings and later expulsion, causing him to change his name and disaffiliate his religion.⁴³ Shockingly, a former provider named Ulf Lidman told that he stopped counting after 56 persons had committed suicide.⁴⁴ Moreover, reports indicate that rituals and spiritual cures, including exorcism to cast out “evil spirits”, have been applied in, inter alia, Germany, the UK, Moldova, Italy, France and Russia.⁴⁵ In Italy, Catholic priests have allegedly been requested by parents to perform exorcism on children.⁴⁶ In the Norwegian documentary “Homoterapi” from 2019, a

35 Lorenzo, Camino a la heterosexualidad: Un curso de Elena Lorenzo, www.caminoalaheterosexualidad.org (last accessed on 15.02.21), “¿Qué es el Coaching de Identidad?”.

37 O’ Brien, Gay Conversion Therapy: Is It Brand New To Ireland?, https://gcn.ie/gay-conversion-therapy-brand- new-ireland/ (last accessed on 15.02.21).

38 Ibid.

39 Ibid.

40 Golubeva, Hypnosis and holy water: Russian 'cures' for gay people, https://www.bbc.com/news/world-europe- 39777612 (last accessed on 15.02.21).

41 VG, Homoterapi, https://www.vg.no/spesial/2019/homoterapi/ (last accessed on 15.02.21), episode 2 “Gay- campen” (The gay camp).

42 Ibid.

43 Ibid, episode 8 “Utstøtelsen” (The expulsion).

44 Ibid, episode 1 “Himmel og helvete (Heaven and hell).

46 Radaelli, Vita da esorcista, https://d.repubblica.it/dmemory/2004/03/27/attualita/attualita/093vit39493.html (last accessed on 15.02.21).

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woman told that members of a Pentecostal church sought to change her sexual orientation through exorcism, by “asking the demons to depart”.⁴⁷ The number of examples indicate that conversion therapy takes a range of forms. Yet, these methods are, ostensibly, not exhaustive.

III. Subjects

Proponents of conversion therapy, often responsible for coercing LGBTI people to go through the practices, are known as “promoters”. In a global survey from 2020, former recipients of conversion therapy stated that parents forced them in 22 per cent of cases, while religious leaders were responsible in 11,9 per cent, other community members in 11 per cent and mental health practitioners in 9,7 per cent.⁴⁸ Additionally, 5 per cent of recipients were forced by school authorities, 4 per cent by state authorities as well as 3,6 per cent by their employers.⁴⁹

The subjects responsible for performing conversion therapy, known as “providers”, are mainly practitioners with health and faith or religious-based backgrounds. According to the global survey from 2020, medical and mental health practitioners were the main perpetrators in 45,8 per cent of the cases, while 18,9 per cent were religious authorities, traditional healers and groups.⁵⁰ Conversely, a different report claim that faith or religious-based organisations are the most active proponents of conversion therapy.⁵¹ This constellation may vary between states.

For example, providers operating in eastern-European states have mainly been recognised as health practitioners,⁵² while more than half of providers in the UK seems to be part of faith- based organisations⁵³. Moreover, recipients have identified conversion camps and rehabilitation centres as the perpetrators in 8,5 per cent, parents in 6,9 per cent, state authorities in 4,4 per cent, as well as school authorities in 4,4 per cent of the cases.⁵⁴

The religious and moral beliefs of promoters and providers seem to be the main reasons why individuals are subjected to conversion therapy.⁵⁵ In other words, the pathologisation of LGBTI people is the major driving force to endorse the practices. Parents often force their children to go through conversion therapy “to have them conform to expectations, either theirs

47 VG, Homoterapi, episode 5 “Demonene” (The demons).

48 LGBT Foundation: Adamson et al., The Global State of Conversion Therapy - A Preliminary Report and Current Evidence Brief, https://osf.io/preprints/socarxiv/9ew78 (last accessed on 15.02.21), p. 12.

49 Ibid.

50 Ibid, p. 11.

53 Gov.uk, National LGBT Survey: Summary report, www.gov.uk/government/publications/national-lgbt-survey- summary-report (last accessed on 15.02.21), p. 14. Such organisations are not only Christian but also Jewish and Muslim, see OutRight Action International, Harmful Treatment, p. 10.

54 LGBT Foundation, The Global State of Conversion Therapy, p. 12.

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or their communities, regarding sexual orientation and gender identity”.⁵⁶ Among these reasons are “gender non-conformity in children” and “lack to adherence to stereotypical gender roles”.⁵⁷ Finally, some providers appear to offer conversion therapy for financial gains.⁵⁸

LGBTI individuals exposed to conversion therapy, referred to as “recipients”, are often children and adolescents. In a survey from 2019, more than 80 per cent of the respondents were under the age of 24 and, of those, approximately half of them were under 18 years.⁵⁹ According to a report, children and adolescents are particularly vulnerable to the practices, either because they can be “easily coerced” by their parents or because “false and biased ideas” are forced onto them.⁶⁰ Moreover, children do not normally have the capacity to consent to medical or mental health decisions, making them “especially prone to undue influence or coercion”.⁶¹ Conversion therapy causes immense harm to recipients. In a global survey from 2020, more than 97 per cent of the respondents stated that they had suffered damage in the form of suicide thoughts and attempts, permanent physical harm, depression, anxiety, shame, guilt, self-hatred, loss of faith as well as loss of relationships with family and friends.⁶² Several of the respondents also testified to having irreparable damage, such as repeated, disturbing and unwanted memories and dreams about conversion therapy, feelings of being back in therapy, strong physical reactions in addition to strong negative beliefs about oneself.⁶³ These results indicate that the practices are highly damaging to LGBTI people. As stated by Victor Madrigal-Borloz,⁶⁴ conversion therapy “provoke profound psychological and physical damage in lesbian, gay, bisexuals, trans or gender-diverse persons of all ages, in all regions of the world”.⁶⁵

C. The legal regulation of conversion therapy in European states

I. The position of states that have not banned conversion therapy

At present, the majority of European states have not yet banned conversion therapy. Among the reasons is that conversion therapy, although the practices have existed for over a decade, is a relatively new concept in the legal sphere in Europe. With reference to this part, a distinction is made between states in favour and states not in favour of imposing a ban. The aim is to show

62 LGBT Foundation, The Global State of Conversion Therapy, p. 12.

63 Ibid, p. 13-14.

64 UN Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, see UNHRC, 44^th session, Practices of so-called “conversion therapy”, para. 1.

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some of the ambiguities about conversion therapy in European states.

1. States not in favour of imposing a ban

Seemingly, a number of European states are not in favour of banning conversion therapy. The reasons appear to be two-folded. A first group of states are of the opinion that the practices are covered by existing legislation. A second group of states have not taken a formal stance against conversion therapy and/or lack mechanisms to combat them. These groups will be outlined in the following.

The first group of states consider that existing legislation is capable of safeguarding the rights of LGBTI people without introducing an explicit ban. Denmark reports that LGBTI civil society organisations have not yet presented conversion therapy as a problem but that several provisions in the Danish Criminal Code are applicable to the practices.⁶⁶ Sweden states that its state institutions do not perform conversion therapy and that forcing someone to go through the practices could be punishable as, inter alia, unlawful coercion.⁶⁷ Similarly, Lithuania holds that conversion therapy is not performed in state health care institutions and that national legislation restrict the practices.⁶⁸ Italy seems to surmise that domestic instruments, including the Italian Constitution, LGBTI frameworks and cooperation with LGBTI civil society organisations, are sufficient to protect LGBTI people.⁶⁹ Bosnia-Herzegovina holds that, even though conversion therapy is not explicitly regulated by law, it is a criminal offence to treat a person without his or her consent, referred to as “arbitrary medical treatment”.⁷⁰ Although certain measures have been introduced to “eliminate” discrimination against LGBTI people, the State admits that one case of “involuntarily medical treatment” in relation to gender identity took place in 2018.⁷¹ Yet, Bosnia-Herzegovina states that the authorities “shall consider issuing a position” when more comprehensive information is available.⁷² Ukraine utters that LGBTI people are exposed to high levels of prejudice and discrimination but that no incidents related to conversion therapy are identified.⁷³ According to the State, international obligations and national frameworks are sufficient to combat discrimination of LGBTI people.⁷⁴ Nonetheless, a regional NGO reveals that conversion therapy is performed on Ukrainian citizens but that providers cannot be held

66 Office of the United Nations High Commissioner for Human Rights (OHCHR), Report on conversion therapy, www.ohchr.org/EN/Issues/SexualOrientationGender/Pages/ReportOnConversiontherapy.aspx (last accessed on 15.02.21), Submission by Denmark, p. 1-2.

67 Ibid, submission by Sweden, p. 1.

68 Ibid, submission by Lithuania, p. 1.

69 Ibid, submission by Italy, p. 1-8.

70 Ibid, submission by Bosnia-Herzegovina, p. 1.

71 Ibid, p. 2-3.

72 Ibid, p. 3.

73 Ibid, submission by the Ukrainian Parliament Commissioner for Human Rights, p.1.

74 Ibid.

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responsible due to lack of domestic legal regulations.⁷⁵

The second group, which is mainly composed of central and eastern European states, has not taken a position on whether a ban on conversion therapy should be introduced and/or have not adopted appropriate mechanisms to combat the practices. Various LGBTI civil society organisations report that conversion therapy is being performed in these states today. In North- Macedonia, young LGBTI persons are reportedly referred to psychologists, psychiatrists and psychotherapists by their parents, while being exposed to discrimination by mental health professionals when seeking help.⁷⁶ Although a discrimination law was adopted in 2019, which lists sexual orientation and gender identity as grounds of discrimination, the State does not have adequate mechanisms to combat discrimination.⁷⁷ Additionally and, quite disturbingly, North- Macedonian school curriculum still pathologises homosexuality.⁷⁸ In Slovenia, a local NGO informs that there is a systematic lack of information and mechanisms to deal with conversion therapy and that, so far, three cases of conversion therapy have been detected.⁷⁹ The situation seems to be more severe in eastern-European states. In Russia, conversion therapy is allegedly very widespread and offered by several providers, since the Russian society is highly oriented towards preserving traditional gender norms, that is, treasuring heterosexual cisgender people while ignoring the existence of LGBTI people.⁸⁰ Accordingly, the State does nothing to prevent conversion therapy from happening.⁸¹ While a federal law imposes strict requirements on health practitioners to treat people in psychiatric care, Russia has not adopted specific laws to prevent any further dissemination of the practices.⁸² The Georgian Government informs that conversion therapy does not occur in the State and that human rights and domestic laws protect individuals from being exposed to the practices.⁸³ Yet, a regional Non-Governmental Organisation (NGO) has documented three distinct cases involving the intent of various Georgian sexologists and endocrinologists to “treat” gay persons.⁸⁴ In fact, one of the cases was reported to a state agency for medical activity, which uttered that it was “beyond their competence to assess the doctor’s comments on the issue of homosexuality”.⁸⁵ According to a regional NGO, eastern-European states suffer from prejudice as well as lack of legal regulation and enforcement mechanisms.⁸⁶

75 Ibid, submission by the Eastern European Coalition for LGBT+ Equality, p. 2.

76 Ibid, submission by Subversive Front, p. 1.

77 Ibid.

78 Ibid.

79 Ibid, submission by Association Legebitra, p. 1-2.

80 Ibid, p. 6.

81 Ibid, submission by Coming out and Nuntiare et Recreare, p. 2 ff.

82 Ibid, p. 7 ff.

83 Ibid, submission by Georgia, p. 1.

84 Ibid, submission by the Eastern European Coalition for LGBT+ Equality, p. 1-2.

85 Ibid.

86 Ibid, p. 2-3.

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2. States in favour of imposing a ban

The many debates about conversion therapy that have surfaced in the recent years have led more and more European states to consider banning the practices. A national ban not only helps to improve the rights of LGBTI people but can also have an impact on how the European courts deal with conversion therapy in the future. Consequently, this section aims to give an overview of the European states that are in favour of banning conversion therapy. A distinction is made between states that have introduced bills and states that are in the process of evaluating a ban.

The first group of states that are in favour of banning conversion therapy, composed of Ireland and Poland, has introduced legislative bills. In Ireland, a bill to ban conversion therapy was introduced to the Irish Senate in 2018.⁸⁷ The Bill is comprehensive and prohibits both professionals and non-professionals from performing conversion therapy, subject to limitations in cases related to, inter alia, an individual undergoing a gender transition and certain practices that do not aim to change the sexual orientation or gender identity of LGBTI people.⁸⁸ Under this Bill, providers are subject to criminalisation in the form of fines of up to 10,000 euros or imprisonment for up to one year.⁸⁹ The Bill gained comprehensive support by the Senate in the second reading in 2018 and has since advanced to the third stage in the Senate.⁹⁰ In Poland, a draft bill was submitted to the Polish Parliament in 2019.⁹¹ The draft bill proposes a ban on

“using, offering the use of, promoting and advertising” conversion therapy as well as any form of “conversion pseudotherapy”.⁹² However, no progress seems to have been made after the introduction of the draft bill, and the continuous discrimination of LGBTI people in Poland creates doubts as to whether conversion therapy will be banned in the near future.⁹³

The second group is comprised of states that are evaluating a ban on conversion therapy.

In 2017, the UK ran a national survey of the experiences of LGBTI people, which implied that five per cent had been offered and two per cent had gone through conversion therapy.⁹⁴ In 2018, the State introduced a national LGBT action plan which, among other, commits it to “[b]ringing

87 Houses of the Oireachtas, Prohibition of Conversion Therapies Bill 2018 (Bill 39 of 2018), www.oireachtas.ie/en/bills/bill/2018/39/?tab=bill-text (last accessed on 15.02.21).

88 Ibid, Sections 1 and 2.

89 Ibid, Section 3.

90 House of the Oireachtas, Prohibition of Conversion Therapies Bill 2018, https://oireachtas.ie/en/bills/bill/2018/39/?tab=bill-text (last accessed on 15.02.21).

91 Kampania Przeciw Homofobii, Poland with the new act banning the use of conversion pseudotherapies on the LGBT people, https://kph.org.pl/poland-with-the-new-act-banning-the-use-of-conversion-pseudotherapies-on- the-lgbt-people/ (last accessed on 15.02.21).

92 Ibid.

93 See, for instance, BBC, Poland LGBT: Diplomats from 50 countries call for end to discrimination, https://www.bbc.com/news/world-europe-54317902; Strzelecki/Bartyzel, Where Your Sexuality Can Make You Enemy of the State, https://www.bloomberg.com/news/features/2020-11-22/lgbtq-news-homosexuality-makes- you-enemy-of-state-in-poland (last accessed on 15.02.21).

94 Gov.uk, National LGBT Survey: Summary report, p. 14.

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forward proposals to end the practice of conversion therapy in the UK”.⁹⁵ In 2019, the Austrian National Council unanimously passed a motion for a resolution on banning conversion therapy for minors.⁹⁶ In 2019, France established a parliamentary fact-finding commission to evaluate how conversion therapy is conducted nationally and to propose adequate measures to combat it and support victims.⁹⁷ The fact-finding commission made a report with several observations and recommendations, including the introduction of a provision in the penal code that prohibits the practices.⁹⁸ Slovakia informs that several psychologists have held lectures on conversion therapy in 2019-2020.⁹⁹ In 2019, during a debate on conversion therapy held by the Committee for Rights of LGBTI, the Slovakian Ministry of Healthcare informed that this topic should be addressed by the Health Care Surveillance Authority and other professional associations.¹⁰⁰ In 2019, the Norwegian Government agreed to initiate an evaluation of conversion therapy in light of international and domestic law, after two proposals to ban the practices were submitted to the Parliament.¹⁰¹ The Netherlands holds that conversion therapy is not allowed under the Dutch healthcare system and that clients can lodge a complaint to a number of its state institutions.¹⁰² For example, in 2014 Dutch authorities ended funding to an organisation accused of performing the practices.¹⁰³ In 2019, the Dutch Parliament accepted a statement to ban conversion therapy by law and, presently, the Government is conducting research on the practices.¹⁰⁴ Finally, Luxembourg informs that several of its instruments restrict conversion therapy but that the topic could be addressed in its LGBTI action plan in the future.¹⁰⁵

II. The regulation of states that have banned conversion therapy

The ambiguities surrounding conversion therapy have left their mark on the legal regulation in

95 Gov.uk, LGBT Action Plan 2018: Improving the lives of Lesbian, Gay, Bisexual and Transgender people, https://www.gov.uk/government/publications/lgbt-action-plan-2018-improving-the-lives-of-lesbian-gay-

bisexual-and-transgender-people (last accessed on 15.02.21), p. 2.

96 Republic Österreich Parlament, Nationalrat einstimmig für gesetzliches Verbot von Konversionstherapien an Minderjährigen, https://www.parlament.gv.at/PAKT/PR/JAHR_2019/PK0759/#XXVI_A_00558 (last accessed on 15.02.21).

97 OHCHR, Report on conversion therapy, submission by France, p. 2.

98 Vanceunebrock/Lachaud, Mission d’information flash de la commission des lois sur les pratiques pretendant modifier l’orientation sexuelle ou l’identité de genre d’une personne, https://www2.assemblee- nationale.fr/15/commissions-permanentes/commission-des-lois/missions-flash/pratiques-pretendant-modifier-l- orientation-sexuelle-ou-l-identite-de-genre-d-une-personne (last accessed on 15.02.21), p. 4.

99 OHCHR, Report on conversion therapy, submission by Slovakia, p. 1.

100 Ibid.

101 Stortinget, Innst. 87 S (2019–2020): Innstilling til Stortinget fra familie- og kulturkomiteen, https://www.stortinget.no/no/Saker-og-publikasjoner/Publikasjoner/Innstillinger/Stortinget/2019-2020/inns- 201920-087s/?all=true (last accessed on 15.02.21), p. 23.

102 OHCHR, Report on conversion therapy, submission by The Netherlands, p. 1.

103 Ibid.

104 Ibid.

105 Ibid, submission by Luxembourg, p. 1-3.

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Europe. Currently, only four European states have introduced some form of ban, namely Malta, Spain, Germany and Albania.¹⁰⁶ Yet, while these states were able to reach a consensus on a ban, the legal regulation differs between them. This part thus intends to uncover the parities and disparities of the various bans through a comparative analysis of the national legal frameworks.

The aim is to describe the present legal regulation of conversion therapy in European states.

1. Definitions and scope

In 2016, Malta became the first European state to place a nationwide ban on conversion therapy by adopting the Affirmation of Sexual Orientation, Gender Identity and Gender Expression Act (ACT No. LV of 2016). The title of the Act emphasises that sexual orientation, gender identity and gender expression do not constitute “a disorder, disease, illness, deficiency, disability and, or shortcoming” and refers to “conversion practices” as “a deceptive and harmful act”. Section 2 of the Act defines “conversion practices” as “any treatment, practice or sustained effort that aims to change, repress and, or eliminate a person’s sexual orientation, gender identity and, or gender expression”. According to the Maltese Government, this wide definition was chosen to encompass a range of different practices, making the “intention of such practices” the common denominator.¹⁰⁷ Such practices include, inter alia, counselling, psychotherapeutic services and religious practices such as prayer meetings.¹⁰⁸ Yet, Sections 2(a)-(c) limit the types of practices that fall in under the definition. Section 2(a) states that conversion practices do not include “any services and, or interventions related to the exploration and, or free development of a person and, or affirmation of one’s identity with regard to one or more of the characteristics being affirmed by this Act, through counselling, psychotherapeutic services and, or similar services”.

This limitation seems to denote that counselling can be offered to LGBTI people who seek general guidance and support. Yet, a prerequisite must be that the provider does not seek to change the sexual orientation or gender identity of the person. Similarly, the term does not include “any healthcare service related to the free development and, or affirmation of one’s gender identity and, or gender expression of a person”, cf. Section 2(b). Finally, Section 2(c) states that conversion practices do not apply for “any healthcare service related to the treatment of a mental disorder”. This exception is not applicable to sexual orientation, gender identity and

106 In 2020, Albania became the fourth European state to ban conversion therapy in Europe, although not in the traditional form of adopting a law. In May, the “Order of Psychologists” of Albania imposed a ban on psychologists to perform conversion therapy, see Thoreson, Albanian Psychologists Prohibit Anti-LGBT “Conversion Therapy”, www.hrw.org/news/2020/05/20/albanian-psychologists-prohibit-anti-lgbt-conversion-therapy (last accessed on 15.02.21). Given the fact that all Albanian psychologists are obliged to be members of the organisation, this decision constitutes a de facto ban on the practices (ibid). However, since neither the Order of Psychologists nor Albanian authorities have disclosed a detailed scope of the ban, the ban will be omitted from this section.

107 OHCHR, Report on conversion therapy, submission by Malta, p. 1.

108 Ibid.

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gender expression, since neither of these constitute a disorder. The limitations in Sections 2(a)- (c) are narrow, which means that most practices fall in under the definition in Section 2.

Spain has not banned conversion therapy domestically. In 2017, an attempt was made to introduce a state regulation for the protection of the LGBTI community, however, this law never materialised.¹⁰⁹ Notwithstanding, five regions and autonomous communities in Spain have introduced regional laws to protect LGBTI people, that is, Madrid, Murcia, Andalucía, Aragón and Valencia. In 2016, the Community of Madrid adopted a regional law to protect LGBTI persons from phobia and discrimination on grounds of sexual orientation and gender identity (Ley No. 3/2016). Section 3(o) of the Act defines conversion therapy, referred to as

“sexual orientation and gender identity conversion or aversion therapy”, as “all medical, psychiatric, psychological, religious or any other interventions that seek to change the sexual orientation or gender identity of a person”. Like the Maltese law, this definition is broad and not limited to specific practices. Equally broad definitions can be found in the laws in the Communities of Andalucía, Aragón and Valencia.¹¹⁰ Conversely, the law in the Community of Murcia applies only to gender identity and not sexual orientation, and its scope is thus narrower than the other regional laws.¹¹¹

In June 2020, Germany adopted a federal law to protect LGBTI persons from conversion therapy (Gesetz zum Schutz vor Konversionsbehandlungen of 12 June 2020). Section 1(1) of the Act defines “conversion treatment” as “all treatments carried out on humans that are aimed at changing or suppressing sexual orientation or self-perceived gender identity”. In order for the treatment to fall in under the definition, attention must be given to the “overall context”, such as the physical and psychological influences on a person.¹¹² However, the law does not include all forms of treatment. Section 1(2) states that the Act does not apply to “treatment of medically recognised disorders of sexual preference”. The draft law specifies that neither sexual orientation nor gender identity constitute a disorder but includes examples like fetishism, exhibitionism and paedophilia.¹¹³ Additionally, Article 1(3) states that “conversion treatment”

does not apply to “surgical medical interventions or hormone treatments that are aimed at expressing a person's self-perceived gender identity or to meet a person's desire for a more male or female physical appearance.” This exception applies, for instance, in cases where transgender

109 OHCHR, Report on conversion therapy, submission by G37 Despacho Internacional, p. 2.

110 Andalucía: Ley No. 8/2017, Sections 3(o), 6(1) and 6(2); Aragón: Ley No. 18/2018, Section 4(o); Valencia:

Ley No. 23/2018, Section 7.

111 Ley No. 8/2016, Sections 8(3) and 14(3).

112 Deutscher Bundestag, Gesetzentwurf der Bundesregierung: Entwurf eines Gesetzes zum Schutz vor Konversionsbehandlungen, Drucksache 19/17278, 19 February 2020, p. 15.

113 Ibid, p. 9 and 15.

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minors want a breast reduction and hormone blockers.¹¹⁴

2. Recipients

The national and regional laws in Europe qualify recipients differently. In Spain, the regional laws apply for conversion therapy rooted in sexual orientation, gender identity and gender expression, except for the regional law in Murcia that applies only to gender identity and gender expression. Additionally, the laws do not qualify recipients based on minors and adults. Nor do they allow LGBTI people to consent to conversion therapy, making the bans “absolute”.¹¹⁵

In contrast, the national laws in Malta and Germany qualify recipients based on age.

The Maltese Act prohibits any provider from performing conversion therapy on a “vulnerable person”, including children “under the age of sixteen years”.¹¹⁶ Adults may also qualify as vulnerable persons provided that they have a “mental disorder”, or a national court determines that they are “particularly at risk” based on several factors.¹¹⁷ Yet, while adults may consent to go through conversion therapy if the practices do not fall in under certain exceptions, minors under the age of sixteen are not allowed to consent. Under the Maltese Act, the main distinction between adults and minors is thus the competences to give consent. A similar qualification is found in the German law. According to Section 3(1), providers are banned from performing conversion therapy on minors under the age of eighteen.¹¹⁸ Yet, Section 3(2) specifies that conversion therapy can be performed on adults, unless the consent is based on a “lack of will”.

Accordingly, while the regional laws in Spain do not allow adults and minors to consent to the practices, the Maltese and German laws permit adults to give their consent provided that certain exceptions do not apply.

3. Providers

The laws in Spain and Germany do not differentiate between providers, which must mean that all types of providers are included, irrespective of profession, public or private sector and so forth. For example, the German draft law states that the Act is aimed at everyone, including members of medical professions, religious practitioners, parents, other carers and guardians.¹¹⁹

In contrast, the Maltese law distinguishes professional and non-professional providers.

114 Ibid, p. 16.

115 Madrid: Ley No. 3/2016, Sections 7(3)(d) and 94(4)(c); Andalucía: Ley No. 8/2017, Section 62(e); Aragón:

Ley No. 18/2018, Section 49(4)(c); Valencia: Ley No. 23/2018, Sections 7 and 60(4)(d)-(e).

116 Affirmation of Sexual Orientation, Gender Identity and Gender Expression Act, Section 3(a)(i), cf. Section 2 paragraph 8(a).

117 Ibid, Section 2 paragraph 8(a)-(b).

118 According to the draft law, minors are “in the phase of identifying themselves” and should thus be particularly protected from the negative effects of conversion therapy, see Gesetzentwurf der Bundesregierung, p. 2 and 17.

119 Gesetzentwurf der Bundesregierung, p. 16.

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Section 3(a) of the Act states that it is unlawful for “any person”, meaning non-professionals, to (i) perform conversion therapy on a vulnerable person; or (ii) perform involuntary and, or forced conversion therapy; or (iii) advertise conversion therapy. By contrast, Section 3(b) states that it is unlawful for a “professional” to (i) offer and, or perform conversion practices on any person irrespective of whether compensation is received in exchange; or (ii) make a referral to any other person to perform conversion practices on any person. Subsection 6 of Section 2 defines a professional as “a person who is in possession of an official qualification and, or a warrant to practise as a counsellor, educator, family therapist, medical practitioner […]” and so on. Several types of providers are thus included in the wording. By comparing Sections 3(a) and (b), the distinction between professional and non-professional providers seems to be relevant for at least two reasons. First, professionals carry a greater responsibility and are thus banned from performing conversion therapy on anyone. Secondly, the criminal liability for professional and non-professional providers is dissimilar, cf. Section 4.

4. Referrals

Section 3(b)(ii) of the Maltese Act explicitly states that it is unlawful for a professional to “make a referral to any other person to perform conversion practices on any person”. This prohibition appears to be excessive but is presumably a consequence of the distinction between professional and non-professional providers. While the law opens up for non-professionals to perform conversion therapy on LGBTI people in some cases, such as through consent, the same should not necessarily apply for professionals, since this permission allows them to refer a case of conversion therapy to, inter alia, a non-licensed practician. The rationale thus seems to be that LGBTI people should be particularly protected from professionals offering conversion therapy.

5. Advertisement

All of the laws in Europe ban providers from advertising conversion therapy. According to Section 3(a)(iii) of the Maltese Act, it is unlawful for “any person”, meaning both professionals and non-professionals, to “advertise” conversion therapy. The wording does not specify any particular form of advertising, which must mean that several forms are encompassed in the provision. Conversely, the regional laws in Spain provide for a prohibition of advertisement in the penal provisions. Section 70(4)(c) of the law in the Community of Madrid classifies the

“promotion” of conversion therapy as “very serious offences” and states that consent from the recipient is “irrelevant”, meaning that consent does not release the perpetrator from criminal

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liability.¹²⁰ Section 3 of the German Act maintains that it is forbidden to “advertise or offer or mediate” conversion therapy. This provision aims to protect “potential victims” and “third parties” from “effects of stigmatisation and discrimination”.¹²¹

6. Criminalisation

Providers of conversion therapy are subjected to criminal liability under all laws in Europe. The Maltese law differentiates the criminal liability of non-professional and professional providers.

According to the first subparagraph of Section 4(1), non-professionals are subjected to a fine of up to 5,000 euros or imprisonment for up to 5 months. Additionally, the liability increases between one to two times if conversion therapy is performed on a “vulnerable person”, cf. the second subparagraph of Section 4(1). Professional providers can, on the other hand, be fined up to 10,000 euros or be imprisoned for up to 12 months, cf. Section 4(2).

The regional laws in Spain vary slightly in terms of penalisation. None of the laws open up for providers to be incarcerated, but they can be fined and lose certain rights. Section 72(3) of the Act in the Community of Madrid stipulates that providers are subjected to fines of up to 45,000 euros and lose their rights to either receive public aid, have ownership of centres or services, or to enter into agreements with the public administration.¹²²

Section 5(1) of the German Act states that anyone acting contrary to the prohibition of conversion therapy stipulated in Section 2, shall be punished with a fine or imprisonment for up to one year.¹²³ The provision does not make a distinction between minors and adults in terms of criminalisation. Yet, the draft law stresses that conversion therapy performed on minors is

“such a serious misconduct that the use of criminal law as the sharpest sword of the state is justified”.¹²⁴ Section 5(2) provides an exception to the first paragraph in cases where providers are “persons who act as guardians or guardians” provided that they do not “grossly violate”

their duty of care or upbringing. This wording points to a high threshold and indicates that not all actions or omissions will lead to criminal liability. Finally, Section 6(1) stipulates that an

“administrative offense” is committed by providers that advertise or offer conversion therapy

120 Equivalent principles apply for the regional laws in the Communities of Andalucía: Ley 8/2017, Section 62(e);

Aragón: Ley No. 18/2018, Section 49(4)(c); Valencia: Ley No. 23/2018, Section 60(4)(e).

121 Gesetzentwurf der Bundesregierung, p. 18. The aim of protecting “third parties” is both to avoid the impression that conversion therapy is a recognised form of therapy but also to prevent discrimination of LGBTI people that have not yet gone through it.

122 Similar principles apply for the regional laws in the Communities of Andalucía: Ley 8/2017, Section 65(3);

Aragón: Ley No. 18/2018, Section 51(3); Valencia: Ley No. 23/2018, Section 62(3).

123 Not all violations lead to criminal liability. The draft law specifies that “insignificant violations of bodily integrity or sexual and sexual self-determination” fall outside the penal provision and that, in order for the threshold to be exceeded, the treatment must be “objectively suitable for a person to be significantly harmed in their physical or mental development”, see Gesetzentwurf der Bundesregierung, p. 19.

124 Ibid.

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contrary to Section 3. Providers found guilty can be fined up to 30,000 euros, cf. Section 6(2).

7. Monitoring and enforcement

In 2018, Malta established the “Sexual Orientation, Gender Identity, Gender Expression and Sex Characteristics Unit”, which is responsible for, inter alia, monitoring the situation of conversion therapy nationally and participating in discussions with NGO’s in the “LGBTIQ Consultative Council”.¹²⁵ In Spain, the regions and communities themselves are responsible for the monitoring and enforcement of the regional laws.¹²⁶ The Community of Madrid has so far provided the most extensive enforcement. As of 2019, the Community had decided on 18 cases primarily resulting in fines for minor offenses ranging between 200 and 1,800 euros.¹²⁷ The German Act does not indicate which body is competent to monitor and enforce the rules on conversion therapy. The draft law, however, stipulates that the competent body is the “Federal Ministry of Health”.¹²⁸ Since the law was adopted recently, no enforcement has yet taken place.

III. Summary

This part demonstrates that the legal regulation of conversion therapy differs between European states. While only a few states have enacted bans, several of them have agreed to either adopt a ban or to assess whether a ban should be introduced. The domestic and regional laws adopted by Malta, Germany and Spain have both resemblances and differences. Although the regulation differs between them, the laws have broad definitions and scope as well as they cover a wide range of practices, subjects and penalisation. However, since the legal regulation varies between the European states, there is presently no consensus on conversion therapy among them.

D. Is conversion therapy compatible with European human rights law?

I. The European human rights system

The European human rights system can, as will be explained below, be said to consist of the two independent organisations Council of Europe and European Union. These organisations have not only created instruments to safeguard individuals from state interferences, including the adoption of human rights treaties and the establishment of courts to enforce human rights law but have also developed certain mechanisms to harmonise the human rights protection in

125 OHCHR, Report on conversion therapy, submission by Malta, p. 1-2.

126 Madrid: Ley No. 3/2016, Sections 2(1) and 5; Andalúcia, Ley 8/2017 Sections 2(1) and 5; Aragón, Ley No.

18/2018, Sections 2(2), 5 and 6; Valencia, Ley No. 23/2018, Section 3(2).

127 El País, 20.000 euros de multa a una mujer por ofrecer terapias contra la homosexualidad en Internet, https://elpais.com/ccaa/2019/09/17/madrid/1568728826_727993.html (last accessed on 15.02.21). One of these cases includes “coach” Elena Lorenzo that received a fine of 20,001 euros.

128 Gesetzentwurf der Bundesregierung, p. 3 and 5.