Liu Xiaoyun had no idea what was about to happen to him.
The helmet he was wearing was wired to a machine; when the machine was turned on, a weird feeling of numbness washed across his scalp. The doctor turned a dial and that feeling was replaced by pain, as if he was being pinched all over, or stabbed by needles.
After a few minutes, his body began trembling. It was not until afterward he realized he had been shocked.
Liu, a pseudonym, is one of more than a dozen Chinese LGBT people who spoke to Human Rights Watch (HRW) for a new report into so-called “conversion therapy” – procedures intended to alter their sexuality that are often abusive and based on shoddy science.
According to HRW, the pseudoscientific practice is widespread in China, carried out in public hospitals and government approved clinics even though homosexuality is neither a crime nor regarded as a mental illness in the country.
China’s National Health and Family Planning Commission, which oversees hospitals, did not respond to a request for comment. Letters sent to the NHFPC and the Chinese Society of Psychiatry by HRW also did not receive a response.
Conversion therapies have been around for decades, including in the US, where homosexuality was only declassified as a mental disorder in 1973, according to the American Psychological Association.
The APA describes the idea gay people alter their sexuality as “rejected by all the major mental health professions,” and it warns conversion therapies have “serious potential to harm young people because they present the view that the sexual orientation of lesbian, gay and bisexual youth is a mental illness or disorder.”
Multiple US states have banned the practice, as have parts of Australia and Canada.
The practice has also been challenged in China. In 2014, a Beijing court ruled in favor of a gay man who sued a conversion clinic, and other lawsuits against the practice have also seen success since.
Homosexuality was decriminalized in China in 1997, and in 2001, the Chinese Society of Psychiatry removed homosexuality from its list of mental disorders.
But despite slowly growing acceptance for gay and trans people in China, many clinics still offer conversion treatments, according to HRW, taking advantage of ongoing anti-LGBT stigma, particularly among older Chinese.
For its latest report, HRW spoke to men and women from across China, but the practices they described were largely uniform – forced medication, hypnotherapy, and electroshock treatment.
In the latter practice, patients were strapped to chairs or beds and wired up to machines, they were then shown gay porn or told to think of personal sexual experiences while they were shocked, with the idea being they would associate the pain and discomfort with homosexual arousal.
Those interviewed by HRW described being pressured by their parents and families, with some even saying they were forced into conversion therapy and held against their will.
“My dad kneeled down in front of me, crying, begging me to go,” one man told HRW. “My dad said he did not know how to continue living in this world and facing other family members if people found out I was gay.”
Traditional parental pressure to continue the family line and produce grandchildren has been exacerbated by China’s one-child policy, which was only relaxed (and not completely) last year, meaning LGBT people are often their parents only hope of having grandchildren.
Because same-sex marriage is not legal in China, and same-sex couples cannot adopt children, this can lead them to enter into sham marriages in order to have children, or be pressured – or forced – into conversion therapy.
Once they were in therapy, interviewees said they were often prevented from leaving and subjected to treatments – such as electroshock – without knowing in advance what would happen to them.
No legal protections
Unsurprisingly, the therapies, which lack any scientific evidence to back them up, did not work.
“Individuals were released, either because the family could no longer afford the expenses, or because the doctors at the psychiatric hospitals gave up for complete lack of ‘intended effect’ of conversion therapy,” the report said.
That’s not to say that the people subjected to these practices were unaffected, however.
Interviewees described to HRW side effects such as depression, as well as psychological trauma from the abuse they received from staff and the constant framing of homosexuality as unhealthy and abnormal.
According to HRW, the majority of interviewees were treated at public hospitals or government-licensed clinics.
However, the report said despite the declassification of homosexuality as a mental disorder, and the successful legal cases against conversion therapy, at present guidelines for treatment do not ban or limit the practice.
“Against the backdrop in which there are no laws or regulations to protect individuals from discrimination due to sexual orientation, in which there are no proscribed professional guidelines on relevant psychiatric practice, in which families are willing to pay large sums to ‘cure’ an individual from homosexuality, an abusive practice has persisted,” the report said.
The group recommended the NHFPC “issue regulations or guidelines that clearly prohibit public hospitals and private clinics from conducting conversion therapy” and strengthen the monitoring of hospitals to stamp out the practice.