Editor—Smith et al reveal some of the personal views and experiences of medical and psychology professionals in the United Kingdom who tried to make homosexual men and women heterosexual in the 20th century.¹

These experiences must, however, rank as comparatively mild compared with the appalling events in the South Africa Defence Force (SADF) during the apartheid years, known as the aversion project.² Over 18 years 900 men and women were coerced into having sex change surgery after the crude attempts at behaviour therapy failed.

This atrocity, which must rank as one of the worst abuses in psychiatry since the second world war, went on with the full connivance of the military authorities, which regarded homosexuality as an intolerable defect that had to be weeded out of the conscript ranks. Victims were often handed in for treatment after they had confessed to the regimental chaplain.

Victims were discharged from the force with no support, in some cases with the surgical conversion incomplete. The psychiatrists who ran this system have not been brought to justice.

The South African medical establishment has many sins to account for during the apartheid years. The failure to act, even retrospectively, about these psychiatric abuses is inexcusable.