While there are several reasons why mental health advocates want to ban sexual orientation change efforts, I want to focus on the recent push to legislate bans on the practice by licensed professionals.
Historically, therapists who treat gays with an aim to change them have viewed homosexuality as a developmental disorder. Some may also think same-sex sexual behavior is immoral, but principally the use of therapeutic techniques is driven by a belief that there is something psychologically wrong with someone who is attracted to the same sex. If the right techniques can be applied, eventually the GLB person will experience a shift in psychological perspective and find the opposite sex attractive. In short, homosexuality is an illness to be cured.
As most readers know, this view of same-sex orientation isn’t held by any medical or mental health professional organization today. Only a tiny group of practitioners hold to this view and they are among those who are fighting legislative efforts to ban sexual orientation change efforts. When legislators craft bills to stop treatment of same-sex orientation, they are hoping to stop efforts to cure something that isn’t a disorder.
To me, this is a sensible stance. No disorder, no need for treatment.
On the other hand, many religious traditions disagree with same-sex sexual behavior. They discourage such behavior as inconsistent with their moral teachings. Churches and religious groups have the right to teach this and advise their members in keeping with their principles. When people ask for their advice or opinion, churches can teach their views. In fact, anyone can teach and speak any view about homosexuality.
However, when a person joins a learned profession and gets a state license to practice that profession, there are certain restrictions that come along with that choice. Mental health professionals are not clergy. We have a role to enhance the mental health of our clients and curing non-existent diseases doesn’t seem to me to be a part of that mandate. If clergy need to speak against certain behaviors, that is their right and the state’s regulation of mental health professionals cannot stop them.
I do have sympathy for those clients who believe that their same-sex attractions result from some historical trauma. In fact, there is a very small subset of people for whom those factors might be relevant to an understanding of their overall personality, including their sexual interests. I also believe that those people can continue to receive therapy, under these laws, if the treatment is not framed as a direct effort to change orientation.
Ultimately, I believe this is an issue of regulation of mental health professionals and not one of religious liberty. Since there is no universe in which sexual orientation change efforts are effective, why would mental health professionals make space for them? The rare exceptions can be accommodated via other frameworks (e.g., identity exploration, trauma recovery). Religious views will continue to be shared and any challenge to them will not succeed. We can coexist.
For more information on helping non-affirming same-sex attracted people live in keeping with traditional sexual ethics without engaging in sexual orientation change efforts, see the following articles and websites:
To hear Focus on the Family’s public policy arm, Family Policy Alliance, talk about it, the opponents of forcing teens to go to sexual orientation change efforts (aka conversion therapy) don’t want kids to go to counseling. Listen to Stephanie Curry use the phrase “basic talk therapy” like it is her job (which in this case it is).
Transcript:
Hi, I’m Stephanie Curry and I’m a public policy manager with Family Policy Alliance. I’m here today to talk to you about a series of bills that we’re seeing across the country that would seek to ban basic talk therapy for our children. Family Policy Alliance cares about this issue because we care about our children and that they’re able to have access to basic talk therapy if they are struggling with unwanted same-sex attraction and gender identity issues. We believe that families and parents know what’s best for their children and they should have the ability to find licensed therapists that support their moral and religious principles.
Some bills we’re seeing that are cause for concern are for example a bill in Massachusetts that said it was child abuse for a family to take their child to a therapist to get therapy for their unwanted same-sex attractions or gender identity issues. We also have seen a bill in Massachusetts that equates this type of basic talk therapy to torture. Now we know that this isn’t true. Because we love our children, we want them to have access to compassionate and ethical basic talk therapy that is open to change. Thank you so much for joining us today.
The Basic Talk Therapy Bill
In fact, the only bill I could find in MA did not refer to therapy as child abuse or torture. The bill does not prohibit basic talk therapy. The 2017 bill — H1190 — specifically forbids interventions which serve sexual reorientation or gender identity change. However, the bill does allow a neutral exploration of sexual and gender identity issues.
Read the the bill below:
SECTION 1. Chapter 112 of the General Laws, as appearing in the 2014 Official addition, is hereby amended by adding following new section:-
Section 266. (a) Definitions.
For the purposes of this section, “licensed professional” means any licensed medical, mental health, or human service professional licensed under Chapter 112, including any psychologist, psychiatrist, social worker, psychiatric nurse, allied mental health and human services professional, licensed marriage and family therapist, licensed rehabilitation counselor, licensed mental health counselor, licensed educational psychologist, or any of their respective interns or trainees, or any other person designated or licensed as a mental health or human service professional under Massachusetts law or regulation.
The term “sexual orientation” shall mean having an orientation for or being identified as having an orientation for heterosexuality, bisexuality, or homosexuality.
The term “Gender identity” shall mean a person’s gender-related identity, appearance or behavior, whether or not that gender-related identity, appearance or behavior is different from that traditionally associated with the person’s physiology or assigned sex at birth. Gender-related identity may be shown by providing evidence including, but not limited to, medical history, care or treatment of the gender-related identity, consistent and uniform assertion of the gender-related identity or any other evidence that the gender-related identity is sincerely held as part of a person’s core identity; provided, however, that gender-related identity shall not be asserted for any improper purpose.
“Sexual orientation and gender identity change efforts” means any practice by a licensed professional that attempts or purports to impose change of an individual’s sexual orientation or gender identity, including but not limited to efforts to change behaviors or gender expressions, or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same sex. The term “sexual orientation and gender identity change efforts” does not include practices:
(A)(1) to provide acceptance, support, and understanding of an individual’s sexual orientation, gender identity, or gender expression; (2) facilitate an individual’s coping, social support, and identity exploration and development; or (3) that are sexual orientation-neutral or gender identity-neutral including interventions to prevent or address unlawful conduct or unsafe sexual practices; and
(B) Do not attempt or purport to impose change of an individual’s sexual orientation or gender identity.
(b) Under no circumstances shall a licensed professional advertise for or engage in sexual orientation and gender identity change efforts with a patient less than 18 years of age. Any licensed professional violating this prohibition shall be such subject to discipline by the appropriate licensing board, which may include suspension or revocation of license.
(c) Whoever violates this section shall be considered to have violated section 2 of chapter 93A. Any such claim brought under this section shall be subject to sections 5A and 7 of chapter 260.
SECTION 2. (a) Subsection (a) of Section 51A of chapter 119 of the General Laws, as appearing in the 2010 Official addition, is hereby amended by inserting after the words “chapter 233” the following words:-
or (vi) being subjected to sexual orientation and gender identity change efforts as defined by section 169 of chapter 112
(b) Section 51A of chapter 119 is further amended in subsection (i) after the word “family.” by adding the following words:-
Any report including licensed professionals engaging in sexual orientation and gender identity change efforts as defined under section 169 of chapter 112 shall be filed within 30 days to the appropriate licensing board for review and possible suspension or revocation of license.
Therapists Should Be Neutral
Religious right pundits have been distorting these bills since they first came along. The MA bill clearly allows “basic talk therapy” which “provide[s] acceptance, support, and understanding of an individual’s sexual orientation, gender identity, or gender expression” and “facilitate[s] an individual’s coping, social support, and identity exploration and development” or “that [is] sexual orientation-neutral or gender identity-neutral including interventions to prevent or address unlawful conduct or unsafe sexual practices.”
Therapist should facilitate coping, social support and identity exploration and do so in a neutral manner. Therapists should not try to push sexual reorientation.
As a result of supportive therapy, some teens will determine that they are straight or cisgender and others will come out as a sexual minority. Such therapy is legal under this bill. Religious therapists should be perfectly fine with this arrangement. Therapy should not be a platform for spreading religious beliefs or making clients into Christian disciples.
What the state of MA is trying to prevent is for a therapist to use the cover of a state license to pursue sexual orientation or gender identity change. Therapists may do many things to support families who are traditional in their beliefs, but under a law like this, they may not actively use techniques or prescribe methods which have the intent to change orientation. Given that those techniques rarely, if ever, work, this would be beneficial for teens on balance.
Over the past few weeks, I have written about the Nashville Statement. In doing so, I realized that many readers here haven’t followed this blog since the beginning (2005) and aren’t aware of my work in the area of sexual identity. In fact, I would say a significant number of readers came along in 2014 when I wrote about Mars Hill Church.
On Saturday, Yahoo News published a profile of my work by Senior Political Correspondent Jon Ward. In the well written piece, Jon focused on my prior support for sexual orientation change efforts. However, he also connected the dots from that work to my opposition to Uganda’s Anti-Homosexuality Bill and later opposition to Christian nationalism and megachurch exploitation. I appreciate Jon’s careful attention to the nuances in the story.
If you are interested in more information about how I went from being a supporter of reorientation therapy to being a vocal opponent and how that journey connects to current interests, I encourage you to go read Jon’s profile.
Robert Spitzer at his home in 2004, screencap from I Do Exist.
According to the New York Times, psychiatrist and author of the third edition of the American Psychiatric Association’s diagnostic manual Robert Spitzer died on Christmas Day. Spitzer is credited with changing the way mental health professionals view diagnosis of mental disorders. By basing the assessment of mental disorder on personal distress and diminished functioning, Spitzer promoted a more rigorous approach to diagnosis.
More famously, Spitzer’s modifications also paved the way for reconsidering homosexuality as a mental disorder. After meeting gay psychiatrists who did not experience distress over homosexuality, Spitzer, in the early 1970s, led the effort to remove homosexuality from psychiatry’s list of mental disorders.
I first talked to Bob Spitzer when he invited me to take part in a debate over sexual orientation change efforts at the American Psychiatric Association meeting in 2000. The debate was canceled when, near the beginning of the conference, the two psychiatrists arguing against sexual orientation change backed out. Bob later told me that the psychiatrists who declined to participate wanted out because they heard that I was a member of the National Association for the Research and Therapy of Homosexuality (NARTH). While I had been a NARTH member for one year in 1997, I had allowed my membership to lapse by 2000. An irony is that I later became one of NARTH’s biggest critics. Bob knew I tracked NARTH’s actions and about once a year asked about any news on their activities.
Although I was unable to attend, the following year Bob invited me to speak as a part of a symposium where he presented results of his research on ex-gays. Eventually, that study was published in 2003 in the Archives of Sexual Behavior and was one of the most controversial studies in modern psychiatry. At the time, due to his conversations with people who described themselves as ex-gay, Spitzer believed that some gays had been able to modify their sexuality toward the straight side of the continuum. Later, in 2012, Spitzer retracted that interpretation of his research, denounced his earlier beliefs, and apologized to gays.
In 2004, I met Bob Spitzer in person and spent a few hours at his home near New York City while filming for the videoI Do Exist, a video with the testimonies of five people who told me they changed from gay to straight. Because one of the main participants retracted his statements and two others had significant changes, I later retracted the video in January 2007. My views were also altered by the emergence of new data on sexual orientation and the failure of change therapy supporters to produce evidence in their favor.
After he published his study, Bob’s collaboration with social conservatives was something he later regretted. On one occasion in November 2008, I sent him a link to Focus on the Family’s website where they had misrepresented his study. He wrote back and said, “That is awful. Whoever wrote it must have known it to be incorrect. Can you do something about it?” Focus later modified the statements slightly but still did not fully represent Bob’s views.
In 2007, Spitzer told me in a phone call that he endorsed the sexual identity therapy framework that I developed with Mark Yarhouse. The endorsement was later published on the SIT framework site:
I have reviewed the sexual identity framework written by Warren Throckmorton and Mark Yarhouse. This framework provides a very necessary outline to help therapists address the important concerns of clients who are in conflict over their homosexual attractions. The work of Drs. Throckmorton and Yarhouse transcend polarized debates about whether gays can change their sexual orientation. Rather, this framework helps therapists work with clients to craft solutions tailored to their individual situations and personal beliefs and values. I support this framework and hope it is widely implemented. Robert L. Spitzer, M.D., Professor of Psychiatry, Columbia University, New York State Psychiatric Institute, New York City, NY. Co-editor of the Diagnostic and Statistical Manual of Mental and Emotional Disorders, 3rd Edition and 3rd Edition (Revised).
On a personal level, I liked Bob immediately. He was friendly and very approachable. While he seemed to like the controversy, in my hearing he communicated no malice toward any side of the gay change debate. He seemed to be a genuine truth seeker and wanted to follow the evidence no matter what. I will miss him.
Bob Spitzer, R.I.P.
legislate bans on the practice by licensed professionals.
