In 2018, in a narrative systemic review titled "Conversion therapies and access to transition-related healthcare in transgender people", Zuckers work was provided as a case study in conversion therapy including open-ended play psychotherapy, parent counselling, and parent-guided interventions to prevent "transsexualism". The study was criticized by the reviewers for relying on flawed estimates of desistance as well as actively trying to reduce cross-gender identification.In 2015, the American Psychological Association and the Substance Abuse and Mental Health Services Administration collaborated on a report stating "conversion therapy—efforts to change an individuals sexual orientation, gender identity, or gender expression—is a practice that is not supported by credible evidence and has been disavowed by behavioral health experts and associations. Conversion therapy perpetuates outdated views of gender roles and identities as well as the negative stereotype that being a sexual or gender minority or identifying as LGBTQ is an abnormal aspect of human development. Most importantly, it may put young people at risk of serious harm." Already by 2017, the majority of major medical associations had defined attempts to change an individuals gender identity or gender expression as conversion therapy.In 2021, the World Professional Association for Transgender Health concluded that treatment aimed at trying to change a persons gender identity and expression to become more congruent with sex assigned at birth "is no longer considered ethical." Edgardo Menvielle, a child-adolescent psychiatrist at the Childrens National Medical Center in Washington advised that "Therapists who advocate changing gender variant behaviours should be avoided."
: 291  Ketorolac is used to treat idiopathic pericarditis, where it reduces inflammation.For systemic use, ketorolac can be administered orally, under the tongue, by intramuscular injection, intravenously, and by nasal spray. Usually, it is initially administered by intramuscular injection or intravenously, with oral therapy used as a continuation after the initial IM or IV dose.Ketorolac is also used as an eye drop. It can be given during eye surgery to help with pain, and is effective in treating ocular itching. The eye drops are associated with decreased development of macular edema after cataract surgery. Ketorolac eye drops have also been used to manage pain from corneal abrasions.During treatment with ketorolac, clinicians monitor for the manifestation of adverse effects. Lab tests, such as liver function tests, bleeding time, BUN, serum creatinine and electrolyte levels are often used and help to identify potential complications. Contraindications
Ketorolac is contraindicated in those with hypersensitivity, allergies to the medication, cross-sensitivity to other NSAIDs, prior to surgery, history of peptic ulcer disease, gastrointestinal bleeding, alcohol intolerance, renal impairment, cerebrovascular bleeding, nasal polyps, angioedema, and asthma. Recommendations exist for cautious use of ketorolac in those who have experienced cardiovascular disease, myocardial infarction, stroke, heart failure, coagulation disorders, renal impairment, and hepatic impairment. Adverse effects
A common (>10%) side effect is drowsiness. Infrequent (<1%) side effects include paresthesia, prolonged bleeding time, injection site pain, purpura, sweating, abnormal thinking, increased production of tears, edema, pallor, dry mouth, abnormal taste, urinary frequency, increased liver enzymes, itching and others. Platelet function can be decreased by use of ketorolac.