China decriminalized homosexuality in 1997, and removed it from the list of official mental disorders four years later. But stories of families forcing their relatives to undergo conversion therapy remain common, in large part because Chinese society places a high value in filial piety, with getting married and having a child as a major component. In July, a Chinese court ordered a public hospital to compensate a gay man forced to endure such treatment—the first victory of its kind in China.

For a new report, Human Rights Watch interviewed 17 Chinese LGBT people (all under pseudonyms) who ended up in conversation therapy because of family and social pressure. The report, published today (Nov. 15), found that most of them underwent the process in state-owned public hospitals, while others did so in private psychiatric or psychological clinics. All of the cases took place between 2009 and 2017.

The report found that abuses routinely occur in conversion therapy—including arbitrary confinement, forced medication and injection, the use of electroshocks, and coercion and threats. “If Chinese authorities are serious about ending discrimination and abuse against LGBT people, it’s time to put an end to this practice in medical facilities,” said Graeme Reid, LGBT rights director at Human Rights Watch, in a press release.

Here are some of the first-hand accounts of abuses included in the report.

Under pressure

All interviewees told Human Rights Watch that they were forcefully taken to conversion therapy, typically within days of coming out to their parents. Xu Zhen, 21, a lesbian who received such treatment at a private clinic three years ago, said:

My mom started… screaming about unfortunate things happening to our family, how she could ever survive it… My dad kneeled down in front of me, crying, begging me to go [to the conversion therapy]. My dad said he did not know how to continue living in this world and facing other family members if people found out I was lesbian. He was begging me to go so that he could live… I mean, at that point, what else could I do? I didn’t really have any other options…

Zhang Zhikun, a transgender woman, went to conversation therapy at a state-owned hospital in Shenzhen in 2012, just as her parents wished.

After I told my parents that I am gay, they pressured me a lot and tried to persuade me to receive treatment. My parents kept pushing me to the point that I had to break up with my boyfriend. My parents also tried multiple times to set me up with girls and wanted me to get married… I saw that type of advertising [of conversion therapy] before. There wasn’t really much I could do to change my parents’ mind. I knew it was not going to work if I kept resisting their pressure. I thought I would give it a try… in some way, just to let my parents know I cannot be changed in that sense.

Verbal harassment

“Sick,” “pervert,” “diseased,” “abnormal,” “dirty,” and “slutty”—these are the terms doctors and psychiatrists have used to describe the interviewees, most of whom said they were subjected to verbal harassment and insulting language in conversion therapy. A gay man from northern Hebei province who received conventional therapy three years ago said:

I sat down, and the doctor gave me a form and asked me to fill it out… The doctor started saying to me: ‘You are sick. You know that yourself, right? I am not lying to you. If you feel like having sex with another man you are sick. But don’t worry about it too much now, I can help you with that. This is why your parents brought you here.’

Zhang remembered a similar conversation with her doctor:

This is pretty much what that doctor told me: ‘This [homosexuality] is promiscuous and licentious. If you don’t change that about yourself, you will get sick and you will die from AIDS. You will never have a happy family… Have you ever considered your parents’ happiness?’

Forced medicine

Eleven interviewees told Human Rights Watch that they were required or in some cases forced to take pills, and subjected to injections as part of their therapy. They said that doctors didn’t explain the purpose or potential risks involved when giving them the medication. A 29-year-old gay man still doesn’t know what pills he took at a public hospital in southern Fujian province three years ago:

The doctor and the nurse refused to tell me what the pills were. They just told me they were supposed to be good for me and help with the progress of the ‘treatment’… After I took them, I usually feel hyper-energized for a while, like a few hours. Then after a few hours, I started to feel very exhausted and depressed.

Zhang’s therapy included a technique reminiscent of the dystopian 1971 movie A Clockwork Orange.

They asked me to watch and concentrate on the gay porn playing on the screen. And a nurse injected some liquid into me with a syringe… The liquid has no color and it was usually injected in my arm… Soon my body started to feel like it’s burning. My stomach was very uncomfortable, I felt very disgusted and constantly wanted to vomit in the whole process, but I didn’t really vomit. I was having a headache too… Every few minutes, the doctor and the nurse asked me to calm down and keep focusing on what is being shown on the screen.

Electroshock

Five interviewees endured electroshock as part of their treatment. One of them remembered going through nine electroshock sessions in his two-month treatment. He said:

I was asked to sit down on a chair, with my hands both tied on the chair arms with leather strips. Then the nurse and the doctor attached pads to both of my wrists and my stomach and my temples. These pads are connected to a machine through cables… The nurse also set up a screen in front of me, where they later started playing gay porn on the screen. The doctor asked me to watch what was playing on screen and asked me to focus on what was content of the video… A few minutes later, they switched on the electric current. My wrists and arms felt numb, my head too. But the most painful part was my stomach… They repeated the electroshock for about six or seven times during the entire session.

A 26-year-old transgender woman described her fear and frustration when she was unaware that she would be subjected to electroshock: