Frequently Asked Questions About ABA, the LGBTQ+ Community, and Affirming Practice

1. What is conversion therapy and why is it relevant to behavior analysis?

Conversion therapy refers to any practice intended to change a person's sexual orientation, gender identity, or gender expression. It is relevant to behavior analysis because behavioral researchers and practitioners were involved in developing and implementing conversion therapy procedures, particularly in the mid-twentieth century.

These procedures included aversive conditioning techniques such as pairing same-sex stimuli with electric shock or other aversive stimuli. The field's involvement in these harmful practices has created a legacy of distrust between the LGBTQ+ community and behavior analysis.

Understanding this history is essential for behavior analysts who want to practice ethically and work to repair the harm that has been done.

2. What does the BACB Ethics Code say about working with LGBTQ+ clients?

The BACB Ethics Code (2022) explicitly addresses LGBTQ+ issues through its nondiscrimination principle (Core Principle 1.06), which prohibits discrimination based on gender expression, gender identity, and sexual orientation. Additionally, the requirements for effective treatment (2.01), truthfulness (1.01), and minimizing risk (2.15) all prohibit conversion therapy because it is not evidence-based, is based on false premises, and causes documented harm.

While the Code does not use the term conversion therapy, its principles clearly preclude any practice that targets sexual orientation, gender identity, or gender expression for change. Behavior analysts are expected to provide services that affirm and respect the identities of all clients.

3. How can behavior analysts distinguish between affirming practice and conversion-like practices?

Affirming practice supports the client's self-identified gender and sexual orientation, uses the client's preferred name and pronouns, sets goals that reflect the client's welfare and preferences rather than societal norms about gender or sexuality, and creates environments that are safe and inclusive. Conversion-like practices, by contrast, target sexual orientation, gender identity, or gender expression for change, even when framed as addressing other concerns.

Key warning signs include goals that reduce gender-nonconforming behavior, discourage same-sex attraction, or use compliance with gender norms as a measure of treatment success. The critical question is: Would this goal exist if the client were not LGBTQ+?

If the answer is no, the goal may reflect conversion-like thinking.

4. What should a behavior analyst do if a family requests conversion therapy or similar goals?

The behavior analyst should decline to implement conversion therapy or any goal that targets sexual orientation, gender identity, or gender expression for change. The Ethics Code (2022) is clear that the client's welfare takes precedence over family preferences when those preferences conflict with the client's well-being.

The behavior analyst should explain, with compassion and without judgment, why conversion therapy is harmful and not supported by evidence. They should provide the family with accurate information about LGBTQ+ identities and offer to connect the family with resources that support understanding and acceptance.

If the family insists on conversion-oriented goals, the behavior analyst should not implement them.

5. Are there specific risks for LGBTQ+ youth receiving ABA services?

Yes. LGBTQ+ youth receiving ABA services may face several specific risks.

These include having gender-nonconforming behavior targeted for reduction without clinical justification, experiencing invalidation of their identity through misuse of names or pronouns, encountering practitioners who lack training in LGBTQ+-affirming approaches, and being subjected to environments where heteronormative or cisnormative assumptions are embedded in goals, materials, and interactions. Additionally, LGBTQ+ youth with developmental disabilities may have fewer opportunities to access LGBTQ+ community resources and support, increasing their reliance on the behavior analyst to provide an affirming environment.

Awareness of these risks enables practitioners to take proactive steps to mitigate them.

6. How should behavior analysts handle preferred names and pronouns in clinical practice?

Behavior analysts should ask all clients about their preferred name and pronouns and use them consistently in verbal interactions, written documentation, and communications with other team members. This applies regardless of whether the client's preferred name or pronouns differ from those on their legal documents.

Using a client's preferred name and pronouns is a basic expression of respect and dignity, consistent with the Ethics Code (2022). When team members or family members use incorrect names or pronouns, the behavior analyst should model correct usage and, when appropriate, provide gentle correction.

Intake forms should include fields for preferred name and pronouns.

7. What is the difference between gender-nonconforming behavior and a clinical concern?

Gender-nonconforming behavior, such as a child assigned male at birth preferring dresses, dolls, or other items culturally associated with femininity, is not inherently a clinical concern. It is an expression of the child's preferences and identity.

A clinical concern exists when the child experiences distress, when the behavior causes safety issues, or when the child's functioning is impaired. Importantly, distress caused by others' negative reactions to gender nonconformity is an environmental problem, not a problem with the child's behavior.

The appropriate response is to address the environment, not the child's gender expression. Behavior analysts must be careful not to pathologize gender diversity by framing normative identity exploration as a behavior problem.

8. How can behavior analysts advocate for LGBTQ+-affirming policies in their organizations?

Behavior analysts can advocate for affirming policies by proposing inclusive language in organizational forms and documents, requesting LGBTQ+-affirming training for all staff, advocating for nondiscrimination policies that explicitly protect LGBTQ+ clients and employees, ensuring that clinical spaces are welcoming through inclusive signage and materials, and establishing clear protocols for addressing anti-LGBTQ+ behavior by staff or clients. Behavior analysts in supervisory or leadership positions have particular influence and responsibility to create organizational cultures that affirm LGBTQ+ identities.

Citing the Ethics Code (2022) provides a professional framework for these advocacy efforts.

9. What resources exist for behavior analysts seeking LGBTQ+-affirming training?

Several resources are available for behavior analysts seeking LGBTQ+-affirming training. Professional organizations such as the Association for Behavior Analysis International have featured presentations on LGBTQ+ topics at their annual conferences.

Continuing education providers offer courses specifically on LGBTQ+-affirming behavior analytic practice. The broader mental health literature includes extensive resources on affirming therapy practices that can be adapted for behavior analytic contexts.

Behavior analysts can also seek consultation with LGBTQ+-affirming colleagues, participate in reading groups focused on relevant literature, and engage with LGBTQ+ community organizations to build their understanding and competence.

10. Why is it important for the field of behavior analysis to publicly acknowledge its role in conversion therapy?

Public acknowledgment serves several important functions. First, it demonstrates honesty and accountability, which are core ethical values.

Second, it communicates to LGBTQ+ individuals and communities that the field takes their experiences seriously and is committed to change. Third, it creates a foundation for trust-building, which is necessary for LGBTQ+ individuals to feel safe accessing behavior analytic services.

Fourth, it educates current and future practitioners about the field's history, helping them understand why LGBTQ+-affirming practice is not merely a preference but an ethical necessity. Without acknowledgment, the field risks appearing dismissive of the harm it has caused, which undermines efforts to move forward.