Ninth Circuit Court Upholds California’s Gay Therapy Ban for Minors
August 29th, 2013
The Ninth Circuit Court of Appeals has upheld California’s law banning licensed profesionals from providing Sexual Orientation Change Efforts (SOCE) to minors. The critical point during oral arguments before the court was whether the ban infringes on therapists’ free speech rights or regulates professional conduct. In the unanimous decision by Chief Judge Alex Kozinski and Circuit Judges Susan P. Graber and Margan Christien, the court settled on the latter.
In the opinion written by Judge Graber, the court began by describing what the law, known as SB 1771, does and does not do (PDF: 171KB/36 pages):
Importantly, SB 1172 does not do any of the following:
- Prevent mental health providers from communicating with the public about SOCE
- Prevent mental health providers from expressing their views to patients, whether children or adults, about SOCE, homosexuality, or any other topic
- Prevent mental health providers from recommending SOCE to patients, whether children or adults
- Prevent mental health providers from administering SOCE to any person who is 18 years of age or older
- Prevent mental health providers from referring minors to unlicensed counselors, such as religious leaders
- Prevent unlicensed providers, such as religious leaders, from administering SOCE to children or adults
- Prevent minors from seeking SOCE from mental health providers in other states
Instead, SB 1172 does just one thing: it requires licensed mental health providers in California who wish to engage in “practices . . . that seek to change a [minor’s] sexual orientation” either to wait until the minor turns 18 or be subject to professional discipline. Thus, SB 1172 regulates the provision of medical treatment, but leaves mental health providers free to discuss or recommend treatment and to express their views on any topic.
The court drew on several precedents, including a case involving unlicensed psychoanalysts, who had claimed that being sanctioned by the state for being unlicensed amounted to an infringement on their free speech rights because, after all, they were only talking in their counseling sessions. Prior courts held that “communication that occurs during psychoanalysis is entitled to constitutional protection, but it is not immune from regulation.” The court also drew on another case in which a doctor’s prescribing privileges were beign revoked because he recommended medical marijuana for his patient. That court drew a distinction between the doctor’s recommendation — a discussion that occured in the office — and the doctor’s prescribing it – which had not occurred — in its ruling in the doctor’s favor. Based on those two cases:
We distill the following relevant principles from NAAP and Conant: (1) doctor-patient communications about medical treatment receive substantial First Amendment protection, but the government has more leeway to regulate the conduct necessary to administering treatment itself; (2) psychotherapists are not entitled to special First Amendment protection merely because the mechanism used to deliver mental health treatment is the spoken word; and (3)
nevertheless, communication that occurs during psychotherapy does receive some constitutional protection, but it is not immune from regulation.
The only remaining question before this court, then, was “whether or how the First Amendment applies to the regulation of specific mental health treatments.” The court chose to approach that question by “view(ing) this issue along a continuum.” At one end is where a professional is speaking publicly as an advocate. At that end, First Amendment protections are at their greatest. But moving toward a middle ground are laws which require doctors to “disclose truthful, nonmisleading information to patients about certain risks of abortion.” In that setting, a previous court had found that “the physician’s First Amendment rights not to speak are implicated, but only as part of the practice of medicine, subject to reasonable licensing and regulation by the State.” (Emphasis in the original.) Also, doctors do not enjoy First Amendment protections for giving negligent medical advice to their patients:
Thus, the First Amendment tolerates a substantial amount of speech regulation within the professional-client relationship that it would not tolerate outside of it. And that toleration makes sense: When professionals, by means of their state-issued licenses, form relationships with clients, the purpose of those relationships is to advance the welfare of the clients, rather than to contribute to public debate.
The far end of the court’s continuum is in the regulation of professional conduct, were that conduct is the provision of a medical service, even if that service is in the form of speech.
Most, if not all, medical treatment requires speech, but that fact does not give rise to a First Amendment claim when the state bans a particular treatment. When a drug is banned, for example, a doctor who treats patients with that drug does not have a First Amendment right to speak the words necessary to provide or administer the banned drug. …
Senate Bill 1172 regulates conduct. It bans a form of medical treatment for minors; it does nothing to prevent licensed therapists from discussing the pros and cons of SOCE with their patients. Senate Bill 1172 merely prohibits licensed mental health providers from engaging in SOCE with minors.
Moving from First Amendment considerations, the court then ruled that California’s legislature had a rational basis for regulating SOCE for minors, that SB 1172 is not unconstitutionaly vague or overly broad, and that it does not infringe on parents’ fundamental rights to determine the care their children would recieve:
We are unaware of any case that specifically addresses whether a parent’s fundamental rights encompass the right to choose for a child a particular type of provider for a particular treatment that the state has deemed harmful, but courts that have considered whether patients have the right to choose specific treatments for themselves have concluded that they do not.
…[T]o recognize the right Plaintiffs assert would be to compel the California legislature, in shaping its regulation of mental health providers, to accept Plaintiffs’ personal views of what therapy is safe and effective for minors. The aforementioned cases lead us to conclude that the fundamental rights of parents do not include the right to choose a specific type of provider for a specific medical or mental health treatment that the state has reasonably deemed harmful.
Therefore, SB 1172 does not infringe on the fundamental rights of parents.
The Ninth’s ruling settled two conficting lower-court rulings. In one case brought by the PAcific Justice Institute on behalf of two NARTH-associated therapists and a student who claimed to have benefited from SOCE, the lower court granted a very limited preliminary injunction against the state of California from enforcing the law. In a second case brought by Liberty Counsel on behalf of NARTH member David Pickup and backed by NARTH, the lower court denied their petition for an injunction.
NARTH has issued a statement saying that it plans to appeal the Ninth Circuit’s ruling:
At a time when adolescents who experience themselves as being the wrong biological sex are allowed to pursue sexual reassignment surgery, licensed therapists who are willing to assist youth with unwanted same-sex attraction and behaviors will be prohibited from even talking to minors in a manner that could be construed as promoting the pursuit of change.
Politicians and non-elected judges have seen fit to approve of such encroachments on personal and professional freedoms in spite of the fact that the American Psychological Association admits the exact causes of same-sex attractions are not known, virtually no research exists directly addressing the modification of same-sex behaviors and attractions with minors, and the prevalence of harm from such change efforts is unknown and has therefore not been established as being any greater than the rates of harm documented for psychotherapy in general. Furthermore, much research has documented that fluidity in sexual attractions and identity often occurs naturally and is particularly pronounced in adolescence and early adulthood, which suggests the viability of therapeutic change efforts for some youth.
These facts make it clear that science is not at the forefront of this effort to restrict freedoms. If that were the case, gaps in our knowledge of this area would be addressed through a bipartisan program of research, not by the heavy hand of government squelching professional practice in order to appease powerful interests of activists within professional associations and lobbying groups. NARTH sincerely hopes that these crucial facts will be considered by a more receptive judicial audience in the future.
Gov. Christie To Sign Conversion Therapy Ban (Updated)
August 19th, 2013
New Jersey Gov. Chris Christie (R) is expected to sign legislation today which would ban licensed therapists from providing sexual orientation conversion therapy to minors. The bill was passed by the New Jersey legislature last June, with veto-proof majorities in both houses. With today’s expected signing, New Jersey will become the second state, after California, to impose such a ban:
“Government should tread carefully into this area,” he said in the signing note, which was obtained by The Associated Press, “and I do so here reluctantly.”
“However, I also believe that on the issues of medical treatment for children we must look to experts in the field to determine the relative risks and rewards,” Christie said, citing a litany of potential ill effects of trying to change sexual orientation, including depression and suicide. “I believe that exposing children to these health risks without clear evidence of benefits that outweigh these serious risks is not appropriate.”
Troy Stevenson, of Garden State Equality, praised the governor’s move, and hope that it would be a first step toward Christie’s reversing his position on marriage equality. He vetoed a marriage equality bill in 2012.
Update: it’s signed, and Gov. Christie’s office has released the full statement:
Assembly Bill No. 3371, which I have signed today, prohibits individuals who are licensed to provide professional counseling under Title 45 of the New Jersey statutes from attempting to change a minor’s sexual orientation.
At the outset of this debate, I expressed my concerns about government limiting parental choice on the care and treatment of their own children. I still have those concerns. Government should tread carefully into this area and I do so here reluctantly. I have scrutinized this piece of legislation with that concern in mind.
However, I also believe that on issues of medical treatment for children we must look to experts in the field to determine the relative risks and rewards. The American Psychological Association has found that efforts to change sexual orientation can pose critical health risks including, but not limited to, depression, substance abuse, social withdrawal, decreased self- esteem and suicidal thoughts.
I believe that exposing children to these health risks without clear evidence of benefits that outweigh these serious risks is not appropriate. Based upon this analysis, I sign this bill into law.
NJ Senate Sends Conversion Therapy Ban To Gov’s Desk
June 27th, 2013
In a 28-9 vote, the New Jersey Senate approved A3371, a bill which would prohibit the state’s licensed mental health professionals from providing Sexual Orientation Change Efforts (SOCE) to minors. The Senate vote comes swiftly after the Assembly approved the measure on Monday.
The measure now goes to Gov. Chris Christie (R) for his signature. Christie has stated his opposition to conversion therapy in the past, but he hasn’t indicated whether he will sign this bill.
New Jersey Assembly Approves Conversion Therapy Ban
June 25th, 2013
Supporters of the bill, including the American Psychological and American Psychiatric associations, have called the practice damaging and demoralizing, while opponents have accused state lawmakers of interfering with the counselor-patient relationship and intruding on parents’ rights.
…The bill’s Assembly sponsor, Tim Eustace (D-Bergen) called the practice, “an insidious form of child abuse. The Assembly approved the bill, (A3371) by a 56-14 vote with seven abstentions.
The bill will now to to the Senate. Gov. Chris Christie (R) has not said whether he will sign the measure, although he has spoken out againztr conversion therapy generally.
South Africa Teen’s Death Shows It’s Time to Ban Ex-gay Therapy Everywhere
June 13th, 2013
The following guest commentary was submitted by Glen Retief, author of the Lambda Literary Award-winning The Jack Bank: A Memoir of a South African Childhood. He teaches creative nonfiction at Susquehanna University. His husband, Peterson Toscano, is co-founder of the ex-gay survivor forum, Beyond Ex-Gay.
The New Jersey and New York legislatures consider bills banning ex-gay therapy for minors. Federal courts review California’s law protecting youth against homophobic pseudo-medicine. And now a new exgay survivor survey details the harm sustained by LGBT people who entered so-called “reparative therapy.”
Thankfully, in North America so-called “reparative therapy” and the damage it causes seem increasingly to be making the news. But in the midst of this conversation, spare a thought for one freckled, skinny Afrikaner boy who can’t share his story this month with lawmakers and pundits—a story that in many ways sheds a lot of light on our current political and judicial debates.
A South African court is currently in the middle of a murder hearing involving a white-supremacist paramilitary leader named Alex de Koker and the April 2011 death of a 15-year-old boy, Raymond Buys. Buys had been signed up for a “game ranger training camp” at a farm called Echo Wild, about an hour’s drive from Johannesburg. In reality the camp was an expensive exgay program run by De Koker and designed to turn “moffies”—the Afrikaans word for “faggots”—into macho Afrikaners.
After two months in this program, Buys arrived at a local hospital malnourished, burned, dehydrated, and with wounds all over his body. He soon died. Allegedly, two other Afrikaans teenagers had been tortured to death at Echo Wild over the previous six years, although at the time police attributed these deaths to “natural causes.”
Alex de Koker, the self-styled camp “general” with ties to the neo-fascist Afrikaner Resistance Movement, now stands accused of beating, strangulation, humiliation, torture with boiling water, and dragging kids along the back of a pickup truck, all in the service of making them more masculine.
Two months ago, Buy’s story initially sparked some coverage in the international media. Since then, however, this exgay trial has fallen off the radar screen, although the Afrikaans press has continued to cover the trial’s sometimes bizarre twists and turns, which included a recent courthouse marriage for the accused murderer and a neo-Nazi rally in the spectator bench to support the defendant.
However, Buys’s story instantly struck a chord with me as a gay white South African—now a naturalized American—who grew up in the Kruger National Park under apartheid. As a child, I was taught to admire the local game rangers’ macho self-reliance: they could shoot a poacher, fix a windmill, and survive in the bush. So it didn’t surprise me that in South Africa, an exgay program would be disguised as a game ranger training camp.
Then, at age 12, I was sent away to a whites-only boarding school, where a militaristic 17-year-old prefect-disciplinarian took it upon himself to try to “cure” me of my girlishness. He used some of the same methods as De Koker—beatings, mock hangings, and electroshock.
The school didn’t officially tolerate this, any more than South African law officially tolerated De Koker’s beating adolescent boys to death. But in both cases, regulatory ambiguity facilitated the violations. It was legal for De Koker to “toughen up” sissies, while at my school instilling militaristic manliness was part of the curriculum. My parents had to threaten a lawsuit before the prefect was transferred.
Buys’s story, and mine, may strike American readers as outlandish. Yet the US situation may not be as different to the South African one as Americans might wish. In many ways, Buys’s story is just that of thousands of Americans, writ large and taken to its logical conclusion.
Currently, in the USA, perhaps a hundred or so exgay treatment programs admit women and men who wish to change both their sexuality and/or gender presentation. Many of them also provide “refuges” where parents can send their queer teenagers.
As recently as 2007, the Love in Action residential clinic in Memphis, TN—the “flagship” program of the exgay movement—taught forcibly-admitted minors that their gender and sexual instincts were evil and immoral. They were subjected to methods of psychological abuse ranging from the forbidding of hugs and friendly eye contact to humiliating public confessions of sexual fantasies and behavior.
Such cruelties may not be the same as burn marks or ruptured vital organs. Yet they can inflict fatal wounds on mental health, resulting in sharply heightened rates of substance abuse, suicide, and self-harm. They may also result in the reduction of a group or individual’s social vitality—one of scholars’ definitions of genocide. Mainstream medical bodies sharply critical of sexual orientation conversion therapy today include the American Medical Association, the American Psychiatric Association, and the American Psychological Association.
In addition, Box Turtle Bulletin has previously exposed how exgay programs, under pressure at home, have exported their toxic ideologies to my home continent, resulting in murderous laws, like Uganda’s Anti-Homosexuality Bill.
Arguably, adult citizens have a constitutional right to harm themselves. However, youth need to be protected against abuse, and dangerous hate groups need to be curtailed as far as free speech laws permit. Buys’s story should remind LGBT and other Americans what is at stake. Like DDT or raw asbestos, exgay ideology may, unchecked, claim our very lives.
NJ Assembly Committee Moves Conversion Therapy Ban
June 13th, 2013
The New Jersey Assembly’s Women and Children’s Committee voted to approve A3371, which would prohibit licensed therapists in the sate of New Jersey from providing therapies intended to change sexual orientation to minors. The 4-1 vote (with one abstention) occurred after two and a half hours of testimony by opponents and supporters, including Parsippany High School student Jacob Rudolph, who told the panel “I am not broken, I am not confused. I do not need to be fixed.”
“Our government has an obligation to protect children in our society – individuals who are unable to make their own legal decisions. Our government therefore has an obligation to prohibit the fraudulent and cruel practice of conversion therapy from being imposed on minors,” Rudolph said.
Jean Mercer, a developmental psychologist and retired Stockton College professor, said the only research that supports conversion therapy is “fraught with inaccuracies and omissions.”
“If conversions therapies had been shown to be necessary, safe and effective, discomfort associated with them might be acceptable, as we accept a certain amount of discomfort with medical treatments. Because they have not, we must consider whether in fact these treatments are abusive,” Mercer said.
Christopher Doyle a counselor at the California-based International Healing Foundation and a former homosexual, said the stories about this form of therapy forced on minors are distorted and untrue. He said he has been providing this therapy for four years, assisting as many as 150 clients with “unwanted same sex attractions who come to me wanting to change.”
The International Healing Foundation is run by ex-gay gadfly Richard Cohen, who was permanently expelled from the American Counseling Association in 2002 for multiple ethical violations. He has been criticized for his unorthodox holding technique for “curing” gay people.
The bill now goes to the floor of the Assembly and the Senate.
NARTH Counselor Admits Failure in Changing Sexual Orientation, Blames Patient, Sues California for the Right to Try Again
January 25th, 2013
The American Medical Association’s publication American Medical News has a very good article about efforts in California and New Jersey to regulate Sexual Orientation Change Efforts (SOCE). The article opens with a vignette about a patient who has undergone SOCE, failed to change his sexual orientation (predictably), and now has to come to terms with that failure:
After attending a religious-based therapy six times a week and experiencing no change in his sexuality, the patient was left feeling ashamed, depressed and suicidal, Dr. Drescher said.
“I felt sad[ness] and also anger, because sometimes a therapist would say things that were very hurtful to the patient,” said Dr. Drescher, an author and medical expert on gay conversion therapy. He also is president of the Group for the Advancement of Psychiatry, a think tank that analyzes issues in the field of psychiatry. “It’s distressing when you see professionals, regardless if they are well-meaning or otherwise, deliver intentional or inadvertent harm to a patient.”
For an example of just what kind of harmful statements, the article points to Psychiatrist Anthony Duk, who is a plaintiff in one of the lawsuits challenging California’s ban on SOCE for minors:
“With this bill, what’s really at stake is the definition of masculinity as well as the entire basis of civilization,” he said. “When men don’t act like men, you have a breakdown of traditional family roles and weakening of the entire human race.”
Dr. Duk said he sees about three patients a year who he said need help fighting same-sex attractions. His treatment of such patients has not resulted in the desired outcomes, he said.
“I was not successful with the ones I had because they did not stay long enough,” he said. “The major factor is whether the patient really wants to heal. The ones who want to get better, those are the ones” able to change.
What you will notice is 1) Duk has been unsuccessful in trying to change the sexual orientation of his patients 2) he blames them for their failures, and 3) he wants the State of California to allow him to continue to inflict this same harm onto others — I guess in the vain hope that some day he might get it right?
Gov. Brown Appeals Injunction Against California Conversion Therapy Law
January 3rd, 2013
California Gov. Jerry Brown announced that he would appeal a court injunction barring the enforcement of California’s new law which places restrictions on Sexual Orientation Change Efforts (SOCE) provided by licensed therapists:
The notice of appeal was filed on behalf of Brown and the Medical Board of California by state Atty. Gen. Kamala Harris with the U.S. 9th Circuit Court of Appeals, which decided Dec. 21 to block the law that took effect Jan. 1 pending a decision on its constitutionality.
Second Judge Denies Request for Injunction Against California’s Ex-Gay Therapy Bill
December 4th, 2012
In a second, separate case filed in Federal District Court seeking to block California’s ban on Sexual Orientation Change Efforts (SOCE) for minors from taking effect, Judge Kimberly K. Mueller denied (via Scribd) Liberty Counsel’s request to issue a preliminary injunction against the state of California. In Judge Mueller’s 44-page ruling denying the request, she reviewed the state legislature’s methodology for modifying the proposed law in consultation with the state’s licensing mental health organizations which are ultimately responsible for enforcing the ban. She concluded that “the court finds plaintiffs are not likely to prevail on the merits so as to prevail at this stage of the litigation.”
This case is David Pickup v Edmund G Brown, which is NARTH and Liberty Counsel’s challenge to California’s S.B. 1172, which prohibits California’s licensed professionals from providing SOCE for minors. Therapists who violate the ban will be subject to discipline by the professional organization responsible for their licensing. The bill does not prohibit therapists from providing SOCE to adults, nor does it affect unlicensed counsellors, pastors, and other ex-gay therapy providers such as religious-based ex-gay ministries.
David Pickup, who say s he is ex-gay and is now a therapist with NARTH, has emerged as NARTH’s chief spokesman against the new law. Pickup was particularly critical of Exodus International when the evangelical ex-gay organization distanced itself earlier this year from Reparative Therapy, a particular form of SOCE which is rooted in a specific set of unproven theories of sexual orientation. (A particularly cringe-worthy video featuring Pickup explaining his approach to “increasing manhood” can be seen here.)
Earlier today, a different Federal District Judge issued a preliminary injunction (via Scribd) which prevents the state of California from enforcing S.B. 1172 against three plaintiffs who are also seeking to overturn the ban. That injunction however is limited to those three plaintiffs only. Judge William Shubb found that the plaintiffs “are likely to succeed on the merits of their 42 U.S.C. § 1983 claims based on violations of their rights to freedom of speech under the First Amendment.”
Judge Issues Temporary Injunction Against California’s Gay Therapy Law
December 4th, 2012
U.S. District Court Judge William Shubb has issued a very limited temporary injunction which bars the state of California from enforcing its ban on Sexual Orientation Change Efforts (SOCE) for minors when the law goes into effect on January 1. Judge Shubb limited the injunciton’s effectivity to the three ex-gay therapists who have sued to overturn the measure. According to the Associated Press:
U.S. District Court Judge William Shubb made a decision just hours after a hearing on the issue, ruling that the First Amendment rights of psychiatrists, psychologists and other mental health professionals who engage in “reparative” or “conversion” therapy outweigh concern that the practice poses a danger to young people.
“Even if SB 1172 is characterized as primarily aimed at regulating conduct, it also extends to forms of (conversion therapy) that utilize speech and, at a minimum, regulates conduct that has an incidental effect on speech,” Shubb wrote.
The judge also disputed the California Legislature’s finding that trying to change young people’s sexual orientation puts them at risk for suicide or depression, saying it was based on “questionable and scientifically incomplete studies.”
The injunctions applies only to the three plaintiffs: psychiatrist Anthony Duk, marriage and family therapist Donald Welch, and student Aaron Blitzer who is studying to become an SOCE provider and who claims that he is now heterosexual after having undergone ex-gay therapy. Duk was a speaker at NARTH’s 2011 convention in Phoenix. Blitzer claims that he is now heterosexual after having undergone ex-gay therapy. The three plaintiffs are being represented by the Pacific Justice Institute.
In granting the injunctions, Judge Shubb indicated that the plaintiffs stand a good chance of getting the law struck down on constitutional grounds.
Last October, Gov. Jerry Brown signed S.B. 1172, making California the first in the nation to prohibit licensed professionals in the state from providing SOCE for minors. Therapists who violate the ban will be subject to discipline by the professional organization responsible for their licensing. The bill does not prohibit therapists from providing SOCE to adults, nor does it affect unlicensed counsellors, pastors, and other ex-gay therapy providers such as religious-based ex-gay ministries.
NARTH co-founder Joseph Nicolosi recently admitted that about half of all NARTH clients are teens. NARTH and Liberty Counsel have also joined forces to fight the ban in a separate case in Federal Court.
Update: Judge Shubb’s ruling is available here (via Scribd).
NARTH: Half of Clients are Teens
October 16th, 2012
Positive Alternatives to Homosexuality (PATH), a coalition of organizations which promote ex-gay therapy, has launched a new web site called “Voices of Change” (warning: A noisy video autoplays when the site is loaded). The web site appears to have been launched in response to California’s ban on licensed therapists providing Sexual Orientation Change Efforts (SOCE) to minors under the age of eighteen. Legislators in New Jersey and Pennsylvania are now planning to introduce similar legislation in their states.
In one video posted on Voices of Change, Joseph Nicolosi, co-founder and former president of the National Association for Research and Therapy of Homosexuality (NARTH) discloses that half of all clients are teenagers and represent a growing customer base:
Nicolosi: We are getting more an more teenagers coming to our clinic. Years ago when I did this work, the average age of our clients were late 20′s and early 30′s…Today, I would say that 50-percent of the clients at our clinic, and we have 135 ongoing cases a week. We have seven therapists that only deal with homosexuality. Fifty percent are teenagers.
NARTH, Liberty Counsel to Challenge California’s Ex-Gay Ban for Minors in Court
October 1st, 2012
The National Association for Research and Therapy of Homosexuality (NARTH) has just sent an email blast by president Christopher Rosik, announcing that they fight California’s new ban on licensed therapists providing Sexual Orientation Change Efforts (SOCE) to minors:
NARTH is saddened but not surprised by this unprecedented legislative intrusion and will lend its full support to the legal efforts to overturn it. California citizens and especially parents should know the indifference that supporters of this bill have toward their freedom of choice, as reflected in Senator Lieu’s recent acknowledgement that, “The attack on parental rights is exactly the whole point of the bill…” The Senator went on to equate the harms to minors of smoking and alcohol abuse, which have been documented over decades of research, with the reported harms of sexual orientation change efforts, the prevalence of which the American Psychological Association admits we have no way of knowing.
Anecdotal stories of harm are no basis from which to ban an entire form of psychological care. If they were, the psychological professions would be completely out of business. We fully anticipate that activist groups like Equality California will be back next year to see what further erosions of parental rights and professional judgment politicians and mental health associations will authorize in California and other states. Counselors adhering to traditional values cannot be blamed for wondering what other practices disliked by these activists are going to be targeted as “unprofessional conduct” in the future, particularly in states that have legalized same-sex marriage.
The non-sequiter about same-sex marriage is puzzling. California currently prohibits same-sex marraige. NARTH will join forces with Mat Staver of Liberty Counsel in challenging the California law in court.
“We are filing on behalf of mental health professionals who find themselves in a catch-22,” Staver said. Therapists have an ethical obligation to help clients deal with conflict. If a client is experiencing conflict between religious beliefs and same-sex attractions and wants to prioritize those beliefs over such attractions, the counselor is ethically obligated to directly help or refer for help. Under this law, the counselor will be forced to disregard the client’s religious beliefs or change them. “This bill and the ethical codes of all of the licensing boards in California are on an inevitable collision course,” Staver said. “The licenses of countless mental health professionals hang in the balance.”
Therapists also have an ethical obligation to provide effective treatment. There is, to date, no evidence (PDF: 816KB/138 pages) that SOCE is or has been effective in changing sexual orientation, making it, essentially, the Laetrile of the social sciences.
California’s Gov. Brown Signs Ex-Gay Therapy Restrictions Into Law
October 1st, 2012
California Gov. Jerry Brown on Saturday signed S.B. 1172, making the Golden State the first in the nation to prohibit licensed professionals in the state from providing Sexual Orientation Change Efforts (SOCE) for minors. Therapists who violate the ban will be subject to discipline by the professional organization responsible for their licensing. In response to objections by various mental health licensing organizations, the earlier civil penalties were removed from the bill. The bill does not prohibit therapists from providing SOCE to adults, nor does it affect unlicensed counsellors, pastors, and other ex-gay therapy providers such as religious-based ex-gay ministries.
California’s Ex-Gay Therapy Restrictions Go To Gov. Brown
August 31st, 2012
As expected, the California Senate quickly approved the stripped down version of the proposed restrictions on ex-gay therapy for minors by licensed therapists that passed the House on Monday. The bill is now headed to Gov. Jerry Brown’s desk. Brown has not indicated whether he will sign the bill or not.
The bill, known as S.B 1172, prohibits California’s licensed professionals from offering Sexual Orientation Change Efforts (SOCE) to minors under the age of eighteen. Unlike earlier versions of the bill, the state of California will not enforce the ban. That task will fall to the professional organization responsible for licensing the mental health professional. And also unlike earlier versions of the bill, no penalties or sanctions are specified; they are left up to the licensing organization to determine. Unlicensed organizations and individuals — religious-based ex-gay ministries, pastors, unlicensed counselors and life coaches, etc. — are not subject to the ban on providing SOCE for minors.
California Passes Ex-Gay Therapy Restrictions
August 28th, 2012
The California Assembly today, in a 51-21 vote, approved a significantly scaled-back measure to ban licensed therapists in the state of California from providing Sexual Orientation Change Efforts (SOCE) to minors under the age of eighteen. The bill must now go back to the Senate to be reconciled with a much broader version of the bill which passed that chamber last May. The scope of the bill was significantly reduced in order to win the approval of several state mental health professional organizations.
When the bill was first introduced into the Senate, there were additional provisions which would have required that adults undergoing SOCE to sign a state-mandated informed consent form, and it would have left therapists open to fines of $$5,000 or “actual damages, or statutory damages” if the client later determined that he or she had been harmed by the therapy or if the therapist had contravened California’s restrictions on SOCE. Due to objections form several mental health organizations, the state-mandated informed consent form was dropped, and the fines were eliminated in favor of a new clause which subjects the licensed therapist “to discipline by the licensing entity for that mental health provider.” The bill affects licensed therapists only. It does not affect religious-based ex-gay ministries or unlicensed pastors, counselors or self-described “life coaches.”
Due to the opposition to the original bill by mental health professional organizations, it is expected that the House version of the bill will go back to the Senate for approval rather than having a compromise bill being worked out between the two chambers. After Senate approval, it will then go on to Gov. Jerry Brown’s desk for his signature. He has not yet indicated his position on the bill.
NARTH and Liberty Counsel Pledge To Fight California Ex-Gay Therapy Ban In Court
July 5th, 2012
With the California Assembly poised to consider S.B. 1172, which would bar licensed therapists in California from offering therapies identified as Sexual Orientation Change Efforts (SOCE) to minors, the National Association of Research and Therapy of Homosexuality (NARTH) and Liberty Counsel pledged in an email blast to NARTH supporters to seek to have the law blocked in court if it becomes law:
NARTH to officially work with Liberty Council to pursue an injunction and all other necessary court action against SB 1172
While we are doing everything possible to defeat SB 1172 in the California Assembly NARTH is also working with Liberty Council to stop this destructive legislation if it is passed and signed into law by the Governor. As we have said from the beginning, NARTH will continue to oppose these efforts to limit client rights by taking whatever action is legally open to us as an organization.
The proposed legislation has been scaled back since it was first introduced in the Senate in April. The provisions requiring that adult clients seeking SOCE sign a mandated informed consent statement has been dropped, along with provisions allowing SOCE clients to sue their therapists if they feel they were harmed by such therapies. The Senate approved S.B. 1172 on a 23-13 vote in May. Because the proposed law would only apply to licensed therapists, religious ex-gay ministries are exempt. In a statement on SOCE issued in June, Exodus International declined to oppose the bill.
Exodus Issues Non-Committal Response To California Ex-Gay Bill
June 5th, 2012
In response to questions from the media about California’s proposed SB 1172, which would regulate the practice of sexual orientation change efforts (SOCE) among licensed professionals and bar providing such therapies to minors, Exodus International has issued the following position statement:
Exodus International supports an individual’s right to self-determine as they address their personal struggles related to faith, sexuality and sexual expression. As an organization, we do not subscribe to therapies that make changing sexual orientation a main focus or goal. Our ministry’s objective is to equip the Church to become the primary place where people of faith seek support, refuge and discipleship as they make the decision to live according to Christian principles.
We believe in a “gospel-centric” view, meaning that all people, regardless of individual life struggles, can experience freedom over the power of sin through a daily relationship with Jesus Christ, a commitment to scripture, and by being a part of a vibrant, transparent and relational community of believers found in the local church. Exodus is partnered with more than 260 churches and support-based ministries who serve individuals and families experiencing a conflict between their faith and sexuality. [Emphasis in the original.]
The closest Exodus comes to opposing the bill is in mimicking the National Association for Research and Therapy of Homosexuality’s formulation that Exodus “supports an individual’s right to self-determine” — a coded phrase which places the onus on determining the appropriateness of SOCE on the patient rather than the licensed therapists who should know better. Those who haven’t been closely following NARTH may not see that connection. But even for those of us who do, it appears that Exodus is happy to break that connection in the second sentence, where they distance themselves from “therapies that make changing sexual orientation a main focus or goal.” So if Exodus intends to oppose S.B. 1172, this statement is a strange way to go about it.
[Update: Exodus president Alan Chambers has clarified that the language about "an individual’s right to self-determine" was taken from the APA, not NARTH. For more information on what that means, read this update.]
Exodus appears to have taken the position of not taking a position on S.B. 1172. This, I think, again breaks new ground for a couple of reasons. First, Exodus provides a fairly extensive list online of professional counselors who, if I’m not mistaken, probably do provide therapies in which changing sexual orientation as “a main focus or goal.” I recognize two names immediately: Phillip Sutton, who on this outdated page is listed as NARTH’s “President-elect” (NARTH’s actual president following the tenure of Julie Hamilton is Christopher Rosik), is one that I’m sure hasn’t abandoned the idea of change for change’s sake. Another counselor, Robert Brennan of San Francisco presented a workshop for parents of gay kids at the Exodus Freedom Conference in 2007. Maybe his views have changed since then, but when I attended that workshop, he was very reassuring to those parents about the likelihood for change in sexual orientation.
It seems that this is still a contradiction that Exodus has not fully worked out, but Exodus may not see it that way because it’s not a big contradiction to begin with. Exodus’s listing of licensed therapists is only twenty-four names long, less than ten percent of their “260 churches and support-based ministries. And they’ve already removed books on reparative therapy (a particular form of a broad array of ex-gay therapies), which is NARTH’s mainstay. Those facts, combined with this statement, suggests that Exodus don’t appear to be much interested in preserving their counselors’ career paths in the ex-gay movement. Increasingly, they are looking more and more like a vestigial organ, like an appendix or the tailbone that’s still a part of the body but which no longer serves a purpose. This statement also appears to portend a wider rift between NARTH and Exodus.
But the second significance of this statement, as I see it, is this: as I noted before, California’s S.B. 1172, applies only to licensed therapists, not religious ministries. And so when asked to comment on S.B. 1172, Exodus sidesteps the question altogether and shifts the focus toward churches and ministries, not licensed therapists and counselors — and not even its own licensed therapists and counselors. It wasn’t that long ago when Exodus relished jumping into a large number of public policy issues. But now, when asked to weigh in on public policy which relates to their own home turf, Exodus demurs. In reading between the lines ,they are effectively say that they don’t care one way or another about s.B. 1172 because it doesn’t affect them. They posit that people don’t exercise their “right of self-determination” on matters of religious beliefs and practices in in the offices of licensed therapists and counselors, but in churches and associated ministries. Which, I think, is as it should be. If someone wants to live according to their religious principles, then it is at church (or the synagogue or mosque) where those discussions should take place, not at a doctor’s office. After all, I don’t think very many psychologists provide intensive therapies to help flagging Orthodox Jewish patients keep a kosher home.
California Senate Passes Ex-Gay Therapy Bill
May 30th, 2012
The California state Senate today passed SB 1172, a bill which will prohibit licensed professionals from providing sexual orientation change therapy for patients under the age of eighteen. The bill would also mandates an informed consent statement to be signed by adults seeking ex-gay therapy. Because the bill applies only to licensed therapists, religious ex-gay ministries and programs are not affected by the legislation.
The bill passed in a 23-13 vote, and is now on its way to the House.
Researcher Predicts Rising Unemployment Among Ex-Gay Therapists
May 25th, 2012
Dr Brian Mustanksi is the director of the IMPACT LGBT Health and Development Program. He has also published several research papers on sexual development and mental health issues of LGBT populations. Today, Dr. Mustanski published a blog post at Psychology Today which gives a run-down on recent events — Dr. Robert Spitzer’s apology, the Pan American Health Organization resolution, the California proposal to regulate ex-gay therapy among licensed therapists — and concludes that ”job prospects are not looking good” if you’re an ex-gay therapist. While times may be getting tough for licensed ex-gay therapists, Dr. Mustanski says that California’s so-called “ban” will not eliminate the ex-gay programs altogether:
While I mentioned in a previous blog that a bill was introduced in the California legislature to outlaw so called “conversion therapy,” I suspect in the U.S. that public policies will have a hard time eliminating the practice in places where it is entrenched. That’s because anyone in the U.S. can call themself a “psychotherapist,” “therapist,” or “counselor” because these are not legally regulated terms (however, calling yourself a psychologist or psychiatrist would be illegal if you don’t have the proper credentials and license). Unfortunately, consumers don’t always know the credentials of their therapist, and I suspect most of the “conversion therapy” practitioners are not licensed psychologists, psychiatrists, or other licensed mental health professionals. If you don’t have a license, you can’t have it taken away.
This goes along with what I noted earlier concerning the limitations of the proposed legislation. A significant chunk of ex-gay counseling is provided by religious ministries rather than professional licensed therapists.
Why I oppose the ‘Don’t Say Ex-Gay’ bill
April 26th, 2012
As has been discussed on other threads, the California State Legislature is proposing a bill that will prohibit licensed mental health professionals from offering therapy to minors with the goal of diminishing same-sex attraction or encouraging opposite-sex attraction. Many in our community, including other Box Turtle Bulletin authors, see this as at least a partially positive action. I see it a horrific.
There are many reasons, some philosophical – some pragmatic, why I oppose this bill. Here are a few:
It isn’t needed
No mental health organization has called for this action. But that is not because of ignorance about the issue or a lack of willingness to address it.
In August 2009 the American Psychological Association Task Force Task Force on Appropriate Therapeutic Response to Sexual Orientation issued it’s report. The conclusion was
The American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation conducted a systematic review of the peer-reviewed journal literature on sexual orientation change efforts (SOCE) and concluded that efforts to change sexual orientation are unlikely to be successful and involve some risk of harm, contrary to the claims of SOCE practitioners and advocates. Even though the research and clinical literature demonstrate that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality, regardless of sexual orientation identity, the task force concluded that the population that undergoes SOCE tends to have strongly conservative religious views that lead them to seek to change their sexual orientation. Thus, the appropriate application of affirmative therapeutic interventions for those who seek SOCE involves therapist acceptance, support, and understanding of clients and the facilitation of clients’ active coping, social support, and identity exploration and development, without imposing a specific sexual orientation identity outcome.
However, the findings seem to stop short of banning change therapy. And this is an important distinction.
The Task Force also found
The conflict between psychology and traditional faiths may have its roots in different philosophical viewpoints. Some religions give priority to telic congruence (i.e., living consistently within one’s valuative goals) (W. Hathaway, personal communication, June 30, 2008; cf. Richards & Bergin, 2005). Some authors propose that for adherents of these religions, religious perspectives and values should be integrated into the goals of psychotherapy (Richards & Bergin, 2005; Throckmorton & Yarhouse, 2006). Affirmative and multicultural models of LGB psychology give priority to organismic congruence (i.e., living with a sense of wholeness in one’s experiential self (W. Hathaway, personal communication, June 30, 2008; cf. Gonsiorek, 2004; Malyon, 1982). This perspective gives priority to the unfolding of developmental processes, including self-awareness and personal identity.
This difference in worldviews can impact psychotherapy. For instance, individuals who have strong religious beliefs can experience tensions and conflicts between their ideal self and beliefs and their sexual and affectional needs and desires (Beckstead & Morrow, 2004; D. F. Morrow, 2003). The different worldviews would approach psychotherapy for these individuals from dissimilar perspectives: The telic strategy would prioritize values (Rosik, 2003; Yarhouse & Burkett, 2002), whereas the organismic approach would give priority to the development of self-awareness and identity (Beckstead & Israel, 2007; Gonsiorek, 2004; Haldeman, 2004). It is important to note that the organismic worldview can be congruent with and respectful of religion (Beckstead & Israel, 2007; Glassgold, 2008; Gonsiorek, 2004; Haldeman, 2004; Mark, 2008), and the telic worldview can be aware of sexual stigma and respectful of sexual orientation (Throckmorton & Yarhouse, 2006; Tan, 2008; Yarhouse, 2008). Understanding this philosophical difference may improve the dialogue between these two perspectives represented in the literature, as it refocuses the debate not on one group’s perceived rejection of homosexuals or the other group’s perceived minimization of religious viewpoints but on philosophical differences that extend beyond this particular subject matter. However, some of the differences between these philosophical assumptions may be difficult to bridge.
In a nutshell, that says that different people with different worldviews benefit from different types of therapy. Not exactly a shocking revelation.
The APA is taking a measured and cautious approach designed to address the needs of patients. They are looking to efficacy, but not only to results. They are also considering the side effects – positive and negative – of such therapy. And they are seeking ways to improve communication between differing people so as to maximize mental health consequences.
Which, of course, is of no concern to the California State Legislature. Their agenda is political, not therapeutic.
This removes all therapy for some individuals
Our community tends to focus on the potential harm of change therapy. And there is potential harm. But we are reluctant to admit that some people benefit from this therapy.
No, they don’t change their orientation. But we have heard many people share with us that through their therapy with a change therapist they were able to deal with other issues: finding their own worth, identifying their values, determining what matters, and overcoming messages of condemnation and rejection.
Change therapy has much to be criticized about. But change therapists do attempt to dispel some of the erroneous messages that their patients have heard, including “God hates you” and “you are an abomination” and “you choose to be this way”.
Some may argue that the bad outweighs the good. And in some instances that may be true. But the truth that many forget is that this is the only option for some gay Christian youth. They are not going to have access to an affirmative counselor. They are not going to want access to an affirmative counselor.
And any suggestion on our part that they seek an affirmative therapist is flippant, at best.
This is an extension of a micromanagement ‘government knows best’ approach
Were this coming from a psychiatrist turned state senator, I might see it as a matter of advancing and protecting the interests of the profession. But Senator Ted Lieu is not known for his desire to administer solutions to problems. Rather, it might be best to describe Senator Lieu as a man who is quite convinced that he knows what is best for you and is more than ready to force you to do it. He shares more than a little instinct with Dr. James Dobson – just from the opposite side.
Lieu lists his 2011 Legislative Accomplishments. They consist of a bill to establish committees to decide what job Californians should have, a bill “requiring all pets to be microchipped with the owner’s contact information”, a bill “prohibiting children under the age of 18 from using ultra violet tanning beds”, a bill designed to require out of state employers whose work force is predominantly out of state to provide domestic partner benefits to any employee within the state, a bill which eliminates the right of employers to collect costs or expenses resulting from an illegal strike, a bill which sought to “impose time and place restriction for funeral protests”, and a bill which “prohibits the practice of selling puppies and kittens in parking lots and sidewalks”.
Whether one thinks that these are all good things or all bad things, it’s pretty clear that Lieu has a consistent approach to individual rights: restrict them.
The motivations behind it are less than honorable
In the State of California, there are no more bills that can be passed to put gay people on an equal standing. They have passed them all. The only remaining hurdle is marriage and that is out of the hands of the legislature.
But certain elected officials, and certain gay advocacy groups desperately need for there to be conflict. They regularly send “call your assemblyman, send us money” emails so as to make sure that some unnecessary bill isn’t Defeated by the Right Wing which Wants to Take Away Your Freedom, before it passes overwhelmingly along a party line vote.
This is political cynicism. It is barely even masquerading as anything else. And we are fools if we let ourselves be so easily manipulated.
I was ambivalent about Harvey Milk Day. There’s no need for such a day. There’s no purpose for such a day. But it didn’t harm anyone and wasn’t an expensive waste so I really didn’t much care.
I was troubled about legislation which would require teaching about the contributions to early California history by gay, lesbian, bisexual and transgender people (which would involve some pretty creative revisionist storytelling) while banning anything whatsoever that might “negatively reflect” on gay, lesbian, bisexual and transgender people. This was a purely undisguised propaganda bill related in spirit to St. Petersburg’s bill to ban “homosexual propaganda”. Both are attempts to push a point of view while silencing any differing views. You may recall that I didn’t rejoice over that piece of Big Brother heavy-handedness.
This is the next logical step.
Having banned divergent views in the classroom, the legislature now is entering the private sphere to dictate what can and cannot be said.
Before we get all giddy that our views are winning and their views are banned, let’s ask ourselves what it is that we believe.
I hear so very much about “the h8ters”. But is it hate that we oppose, or just the target? If it is hate, then why do those who complain about them the most do so in terms or bald unvarnished hatred?
I hear that it is awful that Tennessee legislators want to ban support for gay kids in school. Is it the refusal to support that is bad, or is it only the target? Because if it is the refusal to support, why are we not upset about conservative kids who will not no longer be allowed to seek therapy that they find supportive?
Before we go down the “I’m right, so what I do is right” road, let’s recall that history and politics are a pendulum. It is swinging in our direction at the moment. But let our behavior and our responses be such that when it reverses, the structures and principles we set in place will ensure that we are not harmed.
Because the laws we pass today to punish, inhibit, and deny rights to those whom we feel are wrong or bad or inferior will give birth to the laws that will be used against us in the future.