Commentary
Conversion therapy still exists in Puerto Rico
Bill would ban discredited practice on the island

The former governor of Puerto Rico, the Hon. Ricardo Rosselló, in 2019 signed Executive Order EO-2019-16 that “partially” banned conversion therapy for minors on the island after the House of Representatives decided not to vote on Senate Bill 1000, which would have made these therapies illegal. The executive order requires all medical institutions applying for a license from the Health Department to guarantee that they will not offer conversion therapy. However, this is not enough to address the problem since the order is limited to the executive’s powers. Also, any future governor can repeal it, so it cannot be relied on to guarantee the protection that minors deserve. Although the EO does represent a positive advance to prohibit conversion therapies, it is vitally important to enact it into law to address them and expressly prohibit them. This legislation should be extended to the religious sector and mental health professionals to protect minors.
Different senators recently introduced Senate Bill 184 to expand protections for minors’ physical and mental health and prohibit the practice of conversion therapy against LGBTIQ+ people. The bill defines conversion therapy as a “practice or treatment provided by an entity or professional who is licensed or certified to provide mental health services that seeks to change the sexual orientation or gender identity in an individual.” The definition includes any effort or treatment to change a person’s bodily behavior, expressions, or sexual orientation and eliminate or reduce romantic or sexual attractions or feelings towards individuals of the same gender. The bill identifies conversion therapy as a form of child abuse, including “institutional abuse,” as established in the Child Safety, Well-being and Protection Act of Puerto Rico. However, legislators keep debating the bill’s approval under the assumption these therapies do not happen on the island anymore.
Over the decades, conversion therapies used to “cure” homosexuality included hypnosis, lobotomies, inducing nausea, vomiting, paralysis, electric shock, chemical castration, among other things. In Puerto Rico, conversion therapies exist, and they are far from being what they once were in the ’60s, ’70s and ’80s. Conversion therapies that are practiced today in Puerto Rico, the United States and around the world occur with the consent and the enforcement of the religious sector and health professionals with faith-based beliefs. We focus on our minors’ physical abuse, forgetting the emotional and psychological abuse that continues to occur in each corner of Puerto Rico, in doctor’s offices and churches. To forget this fact on purpose and use it to defend the non-existence of reparative therapies in Puerto Rico by our majority legislators (members of the Popular Democratic Party) is irresponsible and ignorant. It threatens the best welfare of our minors and their responsibility as state entities to ensure it.
In 2018, Senate Bill 1000 favored eliminating conversion therapies on the island. It would have allowed the survivors of these therapies to relate their experiences and traumatic processes to psychological clinics and churches. Several victims of these therapies told their stories during public hearings. Some of their stories are the following:
Survivor Caleb Esteban said that he received therapy at a counseling center when he was between 14- and 15-years-old. He later learned that the counselor had no education to give mental health treatment, but she was there because she was a church leader. He said that the therapy consisted of performing exorcism-type prayers to get rid of the “demons.”
Another survivor, Sofia Padrón, said she “was taken at 16 by my mother to a psychologist because I was attracted to women. The psychologist said that he treated me as a pastor, not as a psychologist, that same-sex attraction was a temporary phase and that I was confused. He told me that I couldn’t be happy and that my attraction to women was not normal …”
Alvín A. Rivera was 14 – and 15-years-old in 2014 and 2015 when he was taken by his mother to the church because he felt attracted to men. There, the pastor, who was also a psychologist, performed exorcisms to combat his homosexuality and charged his mother for these services. After several occasions, the pastor told Alvin and his mother that he “was cured” that he “had managed to free him from his demon.”
Alejandro Santiago between 2008-2013 attended his church. There, the pastor recommended fasting and long hours of praying to cure him of homosexuality and “not behaving as a man should behave.” The fasts began at 5 a.m. and ended at midnight. Sometimes they summoned the congregation of the church for a prayer circle to cure Alejandro of his homosexuality. Sometimes Alejandro stood in front of hundreds of people to claim the homosexuality demon had been released from his body. Alejandro suffered from depression and anxiety for many years after this. Today, he is a human rights activist.
The stories mentioned above are just a few of the many others happening in Puerto Rico every day. However, legislators persist in the narrative that conversion therapies do not exist in Puerto Rico. The new position of the legislators confirms again that the stigma and prejudices towards homosexuality continue. Unfortunately, this only creates more bigotry and more significant harm to the most vulnerable.
About 28 percent of LGBTQ youth who have undergone the above conversion therapies have attempted suicide, compared to 12 percent of LGBTQ youth who had not undergone conversion therapy, according to the Williams Institute. Suicide rates among LGBTQ youth who have undergone conversion therapies, such as the ones mentioned above, are extremely high, and these practices in Puerto Rico are a clear example of how the state fails to fulfill its duty to ensure the best welfare of our minors.
The Puerto Rico Supreme Court has upheld the state’s duty to protect minors on countless occasions. The constitutional right to religious freedom or parents’ power over their children is not absolute, and it yields to the state’s responsibility to ensure that our minors do not suffer from emotional abuse, such as those currently caused by reparative therapies on the island. It is the responsibility of the state to ensure that these minors are protected, or we will continue to be responsible for the increase in numbers of depression and suicide in Puerto Rico. On three different occasions, the U.S. Supreme Court upheld 3rd U.S. Circuit Court of Appeals’ decisions that allowed New Jersey’s anti-conversion therapy law to remain in effect. The U.S. Supreme Court also refused to hear challenges to California’s anti-conversion therapy law in May 2017 and in June 2014 it left in place decisions from the 9th U.S. Circuit Court of Appeals that affirmed the law’s constitutionality.
There is extensive scientific evidence on the harm that conversion therapies do to minors, including those that not physically invasive. Conversion therapies constitute mistreatment of our children, and this must be established through legislation in Puerto Rico. Health professionals and members of the religious sector charge for these exorcism services, therapies, and spiritual sessions. Parents and minors themselves believe that they will have “a normal” life upon completion of these therapies. These practices promote depression, anxiety, and invalidation in our youth. They are not practices of love or an affirmation of the love of God, and they result in increased suicide rates and low self-esteem in our society. Our minors’ lives and their emotional state are again in Puerto Rico’s legislators’ hands. Hopefully, this time they will listen and vote to prohibit these tortures on the island.
Commentary
Protecting the trans community is not optional for elected allies and candidates
One of oldest political tactics is blaming vulnerable group for societal woes
Being an ally to the trans community is not a conditional position for me, nor should it be for any candidate. My allyship doesn’t hinge on polling, focus groups, or whether courage feels politically convenient. At a time when trans people, especially trans youth of color, are under coordinated attack, elected officials and candidates must do more than offer quiet support. We must take a public and solid stand.
History shows us how these moments begin. One of the oldest political tactics is to single out the most vulnerable and blame them for society’s anxieties — not because they are responsible, but because they are easier to blame than those with power and protection. In Nazi Germany, Jewish people were primarily targeted, but they were not the only demographic who suffered elimination. LGBTQ people, disabled people, Romani communities, political dissidents, and others were also rounded up, imprisoned, and killed. Among the earliest acts of fascistic repression was the destruction of Berlin’s Institute for Sexual Science, a pioneering center for gender-affirming care and LGBTQ research. These books and medical records were among the first to be confiscated and burned. It is not a coincidence that these same communities are now the first to suffer under this regime, they are our canaries in the coal mine signaling what’s to come.
Congress, emboldened by the rhetoric of the Donald Trump campaign, recently passed HR 3492 to criminalize healthcare workers who provide gender-affirming healthcare with fines and imprisonment. This bill, sponsored by celebrity politicians like Marjorie Taylor Greene, puts politics and headlines over people and health outcomes. Healthcare that a number of cis-gendered people also benefit from byway of hair regeneration and surgery, male and female breast augmentation, hormone replacement therapy etc. Even when these bills targeting this care do not pass, they do real damage. They create fear among patients, legal uncertainty for providers, and instability for clinics that serve the most marginalized people in our communities.
Here in D.C., organizations like Planned Parenthood and Whitman-Walker Health are lifelines for many communities. They provide gender-affirming care alongside primary care, mental health services, HIV treatment, and preventative medicine. When healthcare is politicized or criminalized, people don’t wait for court rulings — they delay care, ration medication, or disappear from the system entirely.
As a pharmacist, I know exactly what that means. These are life-saving medications. Continuity of care matters. Criminalizing and politicizing healthcare does not protect children or families — it puts lives at risk.
Instead of centering these realities, political discourse has been deliberately diverted toward a manufactured panic about trans women in sports. Let me be clear: trans women deserve to be protected and allowed to compete just like anyone else. Athletics have always included people with different bodies, strengths, and abilities. Girls and women will always encounter competitors who are stronger or faster — that is not a gender or sports crisis, it is the nature of competition.
Sports are meant to teach fairness, mutual respect, and the shared spirit of competition — not suspicion or exclusion. We should not police young people’s bodies, and we should reject attempts to single out trans youth as a political distraction. Families and doctors should be the authority on sex and gender identity.
This narrative has been cynically amplified by the right, but too often Democrats have allowed it to take hold rather than forcefully rejecting it. It is imperative to pay attention to what is happening — and to push back against every attempt to dehumanize anyone for political gain.
Trans people have always been part of our communities and our democracy. Protecting the most vulnerable is not radical — it is the foundation of a just society. My work is grounded in that commitment, and I will not waver from it. I’m proud to have hired trans political team Down Ballot to lead my campaign for DC Council At Large. We need more ally leaders of all stages to stand up for the LGBTQ+ community. We must let elected detractors know that when they come for them, then they come for all of us. We cannot allow Fox News and social media trolls to create a narrative that scares us away from protecting marginalized populations. We must stand up and do what’s right.
Anything less is not leadership.
Rep. Oye Owolewa is running for an at-large seat on the D.C. Council.
Commentary
America is going in the wrong direction for intersex children
Lawmakers are criminalizing care for trans youth, while permitting irreversible harm to intersex babies
I live with the consequences of what America is willing to condone in the name of “protecting children.”
When I was young, doctors and adults made irreversible decisions about my body without my informed consent. They weren’t responding to an emergency. They were responding to discomfort with innate physical differences and the social and medical pressure to make a child’s body conform to a rigid female-male binary. That’s the part people like to skip over when they talk about “child welfare”: the harm didn’t begin with my identity. It started with adults deciding my healthy body needed fixing.
That’s why the hypocrisy unfolding right now from statehouses to Capitol Hill feels so familiar, and so dangerous.
While harmful medical practices on intersex children, the nearly 2 percent born with differences in one or more of their physical sex characteristics, have been ongoing in the U.S. for decades, until recently, there was no law specifically condoning it.
This month, House Republicans passed one of the most extreme anti-trans bills in modern American history, advancing legislation that would criminalize gender-affirming medical care for transgender youth and threaten doctors with severe penalties for providing evidence-based treatment. The bill is framed as a measure to “protect children,” but in reality, it weaponizes the criminal legal system against families and providers who are trying to support young people in surviving adolescence.
At the same time, the administration has proposed hospital and insurance policies designed to choke off access to affirming care for trans youth nationwide by making providers fear loss of federal funding, regulatory retaliation, or prosecution. This is a familiar strategy: don’t just ban care outright; instead, make it so risky that hospitals stop providing it altogether. The result is the same everywhere. Young people lose access to care that major medical associations agree can be lifesaving.
All of this is happening under the banner of preventing “irreversible harm.”
But if America were genuinely concerned about irreversible harm to minors, the first thing lawmakers would address is the medically unnecessary, nonconsensual surgeries still performed on intersex infants and young children, procedures that permanently alter healthy tissue, often without urgent medical need, and long before a child can meaningfully participate in the decision. Human rights organizations have documented for years how these interventions are justified not by medical necessity, but by social pressure to make bodies appear more typically “female” or “male.”
Here is the uncomfortable truth: all of the state laws now banning gender-affirming care for transgender youth explicitly include exceptions that allow nonconsensual and harmful intersex surgeries to continue.
A recent JAMA Health Forum analysis found that 28 states have enacted bans on gender-affirming care for minors that carve out intersex exceptions, preserving doctors’ ability to perform irreversible “normalizing” procedures on intersex children even while prohibiting affirming care for trans adolescents.
This contradiction is not accidental. It reveals the real priority behind these laws.
If the goal were truly to protect children from irreversible medical interventions, intersex kids would be protected first. Instead, these policies target one group of children, transgender youth, while continuing to permit permanent interventions on another group whose bodies challenge the same rigid sex and gender binary that lawmakers are trying to enforce.
Intersex people are routinely erased from American policy debates, except when our bodies are invoked to justify harmful laws, warning that intersex children are being used as legal loopholes rather than protected as human beings. This “protect the children” rhetoric is routinely deployed to justify state control over bodies, while preserving medical practices that stripped intersex children like me of autonomy, good health, and choice. Those harms are not theoretical. They are lifelong.
What makes this moment even more jarring is that the federal government had finally begun to recognize intersex people and attempt to address the harms suffered.
In 2024, at the very end of his term, the Biden administration released the first-ever intersex health equity report — a landmark admission that intersex people have been harmed by the U.S. health care system. Issued by the Department of Health and Human Services, the report documents medically unnecessary interventions, lack of informed consent, and systemic erasure and recommends delaying irreversible procedures until individuals can meaningfully participate in decisions about their own bodies.
This should have been a turning point. Instead, America is moving in the opposite direction.
On day one, President Trump issued an executive order defining “sex” in a way attempting to delegitimize the existence of transgender Americans that also erased the existence of many intersex people.
When medicine is used to erase difference, it is called protection, while care that supports self-understanding is treated as a threat. This is not about medicine. It is about control.
You cannot claim to oppose irreversible harm to children while legally permitting surgeries that intersex adults and human rights experts have condemned for decades. You cannot claim to respect bodily autonomy while denying it selectively, based on whose bodies make lawmakers uncomfortable.
Protecting children means protecting all children, transgender, intersex, and cisgender alike. It means delaying irreversible interventions when they are not medically necessary. It means trusting and supporting young people and families over politicians chasing culture-war victories.
America can continue down the path of criminalizing care for some children while sanctioning harm to others, or it can finally listen to the people who have lived the consequences.
Intersex children deserve laws that protect their bodies, not politics that hurt and erase them.
Kimberly Zieselman is a human rights advocate and the author of “XOXY: A Memoir”. The author is a co-author of the JAMA Health Forum article cited, which examined state laws restricting gender-affirming care.
Today, on World AIDS Day, we honor the resilience, courage, and dignity of people living with HIV everywhere especially refugees, asylum seekers, and queer displaced communities across East Africa and the world.
For many, living with HIV is not just a health journey it is a journey of navigating stigma, borders, laws, discrimination, and survival.
Yet even in the face of displacement, uncertainty, and exclusion, queer people living with HIV continue to rise, thrive, advocate, and build community against all odds.
To every displaced person living with HIV:
• Your strength inspires us.
• Your story matters.
• You are worthy of safety, compassion, and the full right to health.
• You deserve a world where borders do not determine access to treatment, where identity does not determine dignity, and where your existence is celebrated not criminalized.
Let today be a reminder that:
• HIV is not a crime.
• Queer identity is not a crime.
• Seeking safety is not a crime.
• Stigma has no place in our communities.
• Access to treatment, care, and protection is a human right.
As we reflect, we must recommit ourselves to building systems that protect not punish displaced queer people living with HIV. We must amplify their voices, invest in inclusive healthcare, and fight the inequalities that fuel vulnerability.
Hope is stronger when we build it together.
Let’s continue to uplift, empower, and walk alongside those whose journeys are too often unheard.
Today we remember.
Today we stand together.
Today we renew hope.
Abraham Junior lives in the Gorom Refugee Settlement in South Sudan.
