Photo "Signature" by Sebastien Wiertz. Some Rights Reserved.

SIGN THE CONVERSION THERAPY SURVIVORS' STATEMENT

If you support survivors of Conversion Therapy (including professional therapy, religious counseling, 'ex-gay' programs, self-help books, or other methods) and agree with the Survivors' Statement, please consider publicly adding your name to the statement: 

NAME *
NAME
Please enter your name. Your name will be displayed as supporting the statement.
Your social media or website URL you would like published with your name (e.g. http://facebook.com/first.last; @username, http://www.website.com, etc.).
Please provide your US state or country. This information will be displayed with your name.
What comment would like displayed with your name? Comments may be displayed if space is available.
AFFIRMATION *
SELF CERTIFICATION *
AUTHORIZATION *

Thank you for your support.