When the Evangelical Alliance of the United Kingdom wrote Prime Minister Boris Johnson about the country’s push to ban conversion therapy, its first request was that lawmakers define the term.

Conversion therapy has become a vague catchall that can refer to abusive and even violent efforts to change someone’s sexual orientation but also can be construed to mean any religious act that doesn’t affirm LGBT identities. In addition to proposals in the UK and Canada, bans have been enacted in Malta, Germany, Spain, Ecuador, Brazil, Taiwan, Australia, and 20 US states—some carefully defining conversion therapy, some not.

The term often evokes the most extreme attempts to eliminate unwanted same-sex attraction: shock therapy, exorcisms, forced heterosexual marriages, and even rape. More commonly, conversion therapy ministries have promised that people could overcome their desires through prayer, discipleship, and counseling.

In the past decade, however, even that kind of conversion therapy has mostly disappeared. Exodus International, evangelicalism’s flagship ex-gay ministry, shut down in 2013 after former leader Alan Chambers said it had caused pain and harm to too many people and that more than 99 percent of those who’d sought help there hadn’t actually experienced an orientation change. No major organization has emerged to take its place, and conversion therapy has fallen out of practice.

Psychologist Mark Yarhouse, director of Wheaton College’s Sexual and Gender Identity Institute, said that while some smaller organizations persist in prayer ministries aimed at changing people’s sexual orientation, he’s not aware of any major groups, mainstream evangelical ministries, or professional Christian counselors who practice any version of conversion therapy.

And yet, as the practice itself has all but disappeared, public campaigns to ban it are growing around the world. Some Christians worry that new regulations with poor definitions will take aim at what the UK Evangelical Alliance calls “everyday aspects” of church life.

A new law in Victoria, Australia, for example, will ban “religious practices, including but not limited to a prayer-based practice” aimed at “changing or suppressing the sexual orientation.” The government also says conversion therapy is illegal “with or without the person’s consent.” It is not yet clear how the law, which goes into effect in February 2022, will be applied, but it could criminalize praying for people who ask for prayer.

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Australian pastor and writer Stephen McAlpine says the law is intended to challenge Christian teachings on sexuality.

“They’re looking for churches to self-censor,” he said. “It’s not like there’s churches doing lots of conversion therapy. It’s prayer groups where someone comes to you and says, ‘I’ve got unwanted same-sex desires. Could you pray for me?’ ”

McAlpine worries that Victoria’s new law will prompt pastors to say no. “Churches are going to actually pastor people less,” he said.

While ministries including Exodus International and Focus on the Family used to preach that homosexual desire should be eliminated, most evangelical churches, pastors, and mental health professionals today emphasize chastity amid desires that might last a lifetime. “Conversion” is no longer the goal—faithfulness is.

“There’s a greater proportion [of Christians] today that see it as more of an enduring reality,” Yarhouse said. “The person may experience same-sex sexuality, but now it’s, ‘How do I live with it?’ ”

Even the Nashville Statement, a 14-point manifesto by the complementarian Council of Biblical Manhood and Womanhood, maintains that homosexual desire may never change. “We affirm that people who experience sexual attraction for the same sex may live a rich and fruitful life pleasing to God through faith in Jesus Christ, as they, like all Christians, walk in purity of life,” it reads.

Licensed counselor Jen Simmons says she has counseled clients and walked alongside friends who are same-sex attracted but have chosen celibacy or to marry someone of the opposite sex. She doesn’t try to change their orientation, but helps them develop skills to cope with unwanted same-sex attraction.

Simmons says therapy that promises to change a person’s sexual orientation is unethical, harmful, and simply impossible.

“Just like if someone has a genetic and biological propensity to anxiety, and they came in saying, ‘I want you to make my anxiety go away,’ ” she said. “I could never promise that.”

Still, Simmons is concerned about conversion therapy bans, since some of them, such as Australia’s, could target her work and prohibit “even just introducing a biblical ethic or talking about the biblical view of marriage,” she said.

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Jayne Ozanne, founder of the Ozanne Foundation and the Global Interfaith Commission on LGBTQ+ Lives, which advocates for a national conversion therapy ban in the UK, said such a law is necessary to curb self-harm and suicide among those who identify as LGBT. A 2019 government survey found that only 2 percent of LGBT people in the UK had undergone conversion therapy, but she believes it still happens widely.

Ozanne, a lesbian evangelical, says she was repeatedly told while growing up in church that God would change her orientation if she prayed hard enough. When it didn’t happen, she not only felt shamed, but it shook her faith.

She pushes back on concerns that conversion therapy bans would muzzle therapists, but she has confirmed some evangelicals’ fears: She believes the bans need to focus on what’s going on inside churches. She says that prayer ministry teams “aren’t as regulated as we’d like to think they are” and untrained professionals, like pastors or lay ministers, shouldn’t be talking to people about things like sexual orientation. Ozanne hopes the conversion therapy ban in Victoria, Australia, will be used as a model in the rest of the world.

In the US, where there are lots of protections for speech, federal courts have struck down bans in two Florida cities on First Amendment grounds. The bans that have withstood challenges have been more narrowly focused: In Virginia and other jurisdictions, the therapy is banned only for minors.

Most bans in the US also explicitly exempt churches and pastors, though they can still threaten Christian professionals, according to Matt Sharp, an attorney with Alliance Defending Freedom.

At the same time, licenced counselors are rarely trying to change orientation. Simmons said that when issues of sexuality come up, she is more likely to appeal to the science of trauma and attachment than she is to cite Scripture.

“We can rely on what’s true,” she said. “We can rely on a lot that’s being discovered in science...all truth is God’s truth.”

Maria Baer is a contributing writer for CT and is based in Columbus, Ohio.

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