Those identifying as LGBTQ+ experience an excess of mental health problems and suicide in our society, and their mental health needs are poorly catered for. In the recent past, aversion therapy was given to lesbian and transwomen and conversion therapy remains legal. The ‘gender wars’ have also opened up spaces within society and feminism that can be difficult to negotiate. For transwomen, timely access to adequate care remains a major problem causing considerable emotional distress while public anti-trans sentiment has increased. Repeated denial of the lived experience of trans people is causing psychological harm. The rise in gender dysphoria in assigned female at birth (AFAB; or natal female) girls and their treatment has caused major controvery. We must to acknowledge both the distress of trans people, who feel frustrated and angry at having to jump through the hoops of psychiatric assessment and being blamed for male violence from which they are also at risk, and the distress and fear of women who have been conditioned lifelong to fear, and/or have experienced violence, at losing their safe spaces. Seeking ways to ensure that everyone feels welcomed not only in services but also in society.

Conditioning affects a wide range of behaviors, far beyond just salivation. One is how we react to painful stimuli. Our bodies work to maintain internal states within safe limits (homeostasis), and conditioning allows us to anticipate painful stimuli, and to take action to counteract them. Conditioning also affects a wide range of emotions, including fear, hunger, sexual arousal, and cravings for alcohol and drugs. And conditioning can also be used to treat problems involving these emotions. In aversion therapy, exposure to alcohol is followed by inducd illness; by creating an aversion to alcohol, this therapy has had considerable success in treating alcoholism. Conditioning has also been used to treat phobias. Phobias often develop through conditioning, and conditioning principles can be used to overcome them. In exposure therapies such as systematic desensitization, the feared stimulus is presented and not followed by harmful consequences (in one variant, virtual reality therapy, the stimuli are presented through virtual reality headsets). The aim is to extinguish the fear, and this treatment too has had considerable success.