Since the time that Mike Pence was chosen as Donald Trump's running mate in July, he has faced complaints from groups critical of his record on gay and transgender rights, who said he has long been an opponent of the gains made by the LGBT community in recent years.
Pence has been particularly dogged by accusations that he is a supporter of "conversion therapy," the practice of trying to change someone's sexual orientation or gender identity. It has been discredited by the medical establishment and denounced by gay and transgender groups.
Pence spokesman Marc Lotter denied to the New York Times over the weekend that the vice president-elect supports the practice, saying a past campaign statement had been misinterpreted. LGBT groups remain skeptical, pointing to his record of opposition to gay rights as a member of Congress and as governor of Indiana and an approving reference to conversion therapy in the 2016 Republican Party platform.
What is conversion therapy?
The phrases "conversion therapy" and "reparative therapy" refer to discredited psychotherapy methods that aim to change a person's sexual orientation or gender identity. Spiritual efforts to accomplish the same goal are sometimes called "ex-gay ministry."
Conversion therapy has been condemned by a range of groups, including the American Medical Association and the American Psychological Association, which said it was based on the view that homosexuality is a disorder, an idea "that has been rejected by all the major mental health professions."
Conversion therapy practitioners "often frame the inability to change one's sexual orientation as a personal and moral failure," the APA said.
In the past, efforts to change someone's sexual orientation sometimes involved extreme measures like institutionalization, castration and electroshock therapy, according to the National Center for Lesbian Rights.
A statement on an archived version of the website for Pence's 2000 congressional campaign has been widely interpreted as signaling his support for conversion therapy. After listing his opposition to same-sex marriage and anti-discrimination laws that protect gay people, Pence's website takes up the issue of the Ryan White Care Act, which provides federal funding for HIV/AIDS patients and was reauthorized by Congress that year:
"Congress should support the reauthorization of the Ryan White Care Act only after completion of an audit to ensure that federal dollars were no longer being given to organizations that celebrate and encourage the types of behaviors that facilitate the spreading of the HIV virus. Resources should be directed toward those institutions which provide assistance to those seeking to change their sexual behavior."
Pence had not addressed speculation about his support for conversion therapy until last weekend, when Lotter told the Times it was "patently false" that Pence "supported or advocated" the practice.
Lotter said the vice president-elect had been calling for federal funds to "be directed to groups that promoted safe sexual practices" during his 2000 congressional campaign, and he said it was a "mischaracterization" to see the statement as a reference to conversion therapy. But he declined to explain which organizations Pence had wanted to lose their federal funding or what Pence meant when he referred to groups that "celebrate and encourage" activity that spreads HIV. Gay and transgender groups see that as a reference to their community.
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"That is very specific language — some might call it a dog whistle — that has been used for decades to very thinly cloak deeply homophobic beliefs," Carey said. "Particularly the phrase 'seeking to change their sexual behavior,' to me, is code for conversion therapy."
Conversion therapy was tacitly endorsed in the Republican Party platform for the first time this year in a line that supported the "right of parents to determine the proper medical treatment and therapy for their minor children."
Reince Priebus, the chairman of the Republican Party and the incoming White House chief of staff, told reporters that the language did not refer to conversion therapy, but gay and transgender groups did not believe him.
A coalition of former leaders of the ex-gay movement wrote an open letter in July denouncing the platform as "essentially affirming" conversion therapy. They said they could "attest to the emotional and spiritual damage caused to men, women, children and their families" by the practice.
The Republican position differs sharply from the Democrats'. President Barack Obama called for an end of conversion therapy for minors in 2015 after a 17-year-old transgender girl, Leelah Alcorn, killed herself after leaving a suicide note that talked about her time in conversion therapy.