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Peer Reviewed: Studying SOGICE with Willow Sipling
Conversion therapy by any other name... is still torture.
BJ Ferguson
June 21, 2025 • Estimated Reading Time: 9 minutes
MEET TODAY’S GUESTWillow SiplingWillow Sipling is an organizational sociologist working in public health and policy who has both experienced and studied SOGICE within high control environments like fundamentalist religious communities. This week, she shares with Well Beings News about the qualities of SOGICE and fundamentalist thought, and explores how conversion therapy is hiding in plain sight. |
Hey there!
You’re reading Well Beings News — a queer trans health and wellness newsletter for practitioners, providers, and professionals who care about improving LGBTQ+ lives. This is Peer Reviewed, a monthly interview with scientists, researchers, and academics, sharing their insights and knowledge from their published or soon-to-be published work.
Ready? Let’s dive in!
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THE INTERVIEW
Studying SOGICE with Willow Sipling
Conversion therapy by any other name… is still torture.
This week the Supreme Court ruled in United States v Skrmetti, the challenge to the Tennessee ban on gender-affirming medical care for minors. While many news outlets have covered the decision, few have zoomed in on what the courts suggest medical professionals should be offering to young people suffering from gender dysphoria, instead of puberty blockers and hormone therapy—that is, SOGICE: sexual orientation and gender identity change efforts, colloquially known as conversion therapy.
In particular, anti-trans lawmakers tout what they call “Gender Exploratory Therapy” as a “less invasive” alternative to gender-affirming care. In addition to the recent Supreme Court ruling, this recommendation was highlighted in the unsigned Health and Human Services report. It’s not waterboarding or electroshock, but according to the United Nations and numerous studies, even talk therapy with the aim of changing one’s sexuality or gender identity counts as torture. But when conversion therapy looks more like your average counselling session than videos from Gitmo, how do we identify it? This is what Willow Sipling wants to understand.
“What I’m trying to study,” Sipling tells me about her work, “is how do we identify SOGICE when it isn’t as clear as ‘we’re waterboarding that guy for being gay.’ When it’s not that obvious, how do we actually put our finger on it, identify it as being a problem, and build public policy.”
A scene of torture from the 2018 movie, Boy Erased
Many people have an idea in their head of what conversion therapy looks like, akin to the camp scenes in movies like Boy Erased, The Miseducation of Cameron Post, or But I’m a Cheerleader. You might think about, as Sipling describes, “a youth pastor saying, ‘Hey, being gay? Isn't God's best for you.’” But increasingly, SOGICE looks like a credentialed therapist, in their office, seeing paying patients, offering “care” or “reparative therapy” rooted not in scientific evidence of efficacy, but in fundamentalist thought and practice.
This practice, rooted in the US in Christian Fundamentalism, is distinct from actual therapeutic care. “If there is a singular difference between evidence-based clinical care and the SOGIC practiced by clinicians which they consider to be clinical,” says Sipling, “it is a directive approach. Most [therapeutic] models today are non-directive approaches. Clinicians will work with their clients based on those clients stated goals, and as long as those stated goals are not harmful to themselves or others, even if the clinician disagrees with them, that’s what a clinician helps that person achieve.”
SOGICE is different. It places the goals of the therapist above the goals of the patient, and explicitly ignores the proven harms caused by attempts to circumvent or change one’s sexuality or gender identity. We see this in how clinicians who practice SOGICE are attempting to reclaim the ability to engage in it legally. “I live in Michagan,” Sipling begins. “There is a Catholic therapist named Emily McJones who has actually challenged the Governor of Michigan… in a legal complaint, alleging that not being able to practice conversion therapy on minors is stepping on her first amendment rights.” The idea that a therapist’s right to “free speech” in clinical sessions should supersede their duty to do no harm is at the heart of the “fundamentalist pastoral care” which Sipling studies and from which she aims to help survivors recover.
And recovery is a long road. For providers of clinical, evidence-based care who find themselves working with survivors of SOGICE, there can be great challenges even after the patient has accepted themselves and decided to seek an affirming practitioner. “Fundamentalism gets in your bones.” This is the takeaway Sipling emphasizes near the end of our call. The characteristics of fundamentalism—belief in infallibility, perspicuity, directivity—can outlive faith in the church itself.
Fundamentalism gets in your bones.
SURVIVING FUNDAMENTALISM
In clinical settings, these remnants of fundamentalist thought can shape everything from how a patient asks for help to how they respond to ambiguity, intimacy, or care. We break down what that looks like in practice—and what providers need to know to avoid retraumatizing the very people they’re trying to support.
1. Infallibility: A deep-seated need for certainty. A belief that there must be a correct answer—one truth, one right way to live, one acceptable identity narrative.
How it might show up:
Intense fear of “doing queerness wrong” or making the “wrong” choice about medical transition, pronouns, labels, or relationships.
A craving for external validation or permission, even while claiming autonomy.
Panic or self-criticism in the face of cognitive dissonance or ambiguity.
Seeking the therapist’s opinion as a substitute authority: “Just tell me what to do.”
2. Perspicuity: The expectation that identity, healing, or self-understanding should be instantly clear and fully knowable—like reading a single, self-evident text.
How it might show up:
Frustration with the nonlinear nature of healing or self-acceptance: “Why don’t I feel better yet?”
A tendency to collapse complex emotions into binaries (e.g., right/wrong, gay/straight, man/woman, good/bad queer).
Discomfort with layered or fluid identities.
Resistance to exploratory or open-ended therapeutic methods—expecting clarity instead of process.
3. Directivity: A residual belief that growth or healing must be achieved by following prescribed steps handed down from someone in authority.
How it might show up:
Expecting the therapist to be didactic or moralistic—“Tell me how to be good now that I’m not in church.”
Internalizing therapeutic frameworks as new dogma rather than useful tools.
Avoidance of self-directed reflection or agency: “I don’t know what I want; just give me the plan.”
Alternating between idealizing and rejecting authority figures, including clinicians.
Overall Clinical Presentation:
This client may be outwardly affirming of their gender or sexuality but inwardly still operating within a control-based system of thought. They might be high-functioning but rigid, intelligent but uncomfortable with nuance, and emotionally stuck in shame spirals if they perceive themselves as failing to meet an internalized standard—even if they no longer believe in sin.
They may struggle with:
Self-trust ("What if I’m just deluding myself?")
Ambivalence ("What if this version of me isn’t actually the real me?")
Therapeutic alliance ("I want your help—but I need to you tell me what to do.")
What They Need from Clinicians:
Permission to not know (and to still be okay).
Decentering authority: Relational, not hierarchical, therapeutic posture.
Normalizing uncertainty: Especially around gender, healing, desire, and faith loss.
Somatic or parts-based work to bypass rigid intellectualization.
Validation of how deeply epistemology shapes trauma.
In other words, even when a patient is not looking for a new doctrine or religion, part of them may still believe they need one. And until that part is gently re-patterned, full self-acceptance may remain out of reach. “What this comes down to is how somebody thinks of knowledge, how one comes to know things and then do things,” Sipling says. There can be comfort found in a world that is prescriptive, where there is only one right way to do things, where everyone has their role and knows the rules. Getting out of that comfort zone requires a great deal of courage, support, and willingness to change on a fundamental level.
REFERENCE MATERIAL
Where to Find More of Willow’s Work
▶ To Listen: Willow on the Getting Reflective podcast
▶ To Study: Check out her research portfolio
▶ To Read: read Willow’s “Spotlight on Society” Substack
▶ Bonus: follow Willow’s public Instagram account
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