In 1974, the American Psychological Association voiced strong opposition to discrimination, prejudice and violence based on sexual orientation. Until that time, those with homosexual tendencies were often treated with “aversion” therapy that included electric shock, systemic desensitization and other techniques.
In 2007, the APA established a Task Force on Appropriate Therapeutic Responses to Sexual Orientation, which was charged with conducting research on Sexual Orientation Change Efforts. In response, some states have passed legislation that bans conversion/reparative therapy.
Rachel Gaillard Smook, Psy.D., owner of Birchtree Psychology in Northborough, Massachusetts, reported that 18 states have legislation pending to ban the practice of conversion therapy and applauded these initiatives as “we expand our cultural conversation about sexuality.” She said, “We have to stop treating people like they are sick when they are not.”
The repercussions from this therapy are wide ranging, according to Smook. “I’ve seen people stop having sexual feelings, which are a part of being human. [The therapy] harms the sense of self and can cause anxiety and depression. I know there have been suicide attempts, which dovetails with family rejection,” she said. “In adolescence, if conversion therapy is attempted, it’s been said to have a negative health impact on adulthood.”
According to Smook, during the last five years, the conversation around cultural awareness has broadened to a degree. “Heterosexuality is not the lens through which you should view and compare people. Calling it an alternate lifestyle makes it a fringe behavior when it’s just a way to be,” she said.
While professional organizations are taking a stance against conversion therapy, Smook said that individual psychologists should also express opposition.
“We have an obligation as a profession to be vocal about the therapy and refuse to participate. We should have some understanding of a treatment when we use it. We are lacking that with conversion. Psychologists who are doing this are not working within the profession’s guidelines. It conflicts with sections of the ethics code. We are bound to operate within science and consider the rights and dignity of all people.”
Rather than making attempts to change a person’s gender identity, psychologists should provide hope and help make connections to the LGBT community. “Creating a safe space is critical,” Smook said. “We need to help patients develop skill sets and strategies.”
Education is key to combating “bias that leads us to think that one group is less worthwhile and not equal by the majority’s standards,” she added.
Massachusetts Rep. Kay Khan (D-Newton) filed a bill in January 2015 that would ban mental health practitioners in the Commonwealth from “fraudulent practices that purport to change a minor’s same-sex attraction or gender identity.”
She said, “I have always been a very strong supporter of the LGBTQ community during my 20 years in the legislature and before, and look forward to seeing this through and signed into law.” She noted that legislation banning conversion therapy has passed in California, Oregon, New Jersey and Washington, D.C.
According to Khan, 35 co-sponsors and a coalition of 16 advocacy groups focused on the LGBT community have pledged support.
“This legislation is about protecting young people 18 and under, which is my mission as both a mental health professional, and as the house chair of the Committee on Children Families and Persons with Disabilities,” Khan said.
“Licensed, mental health professionals are trained to listen and to help young people and their families understand that these feelings are not due to a mental disorder, but rather one’s biological makeup. Unfortunately, there are instances where this is not happening and enough circumstances that made it necessary to bring this to the legislature.”
Khan explained that conversion therapy is more prevalent in Massachusetts than originally thought.
According to a Human Rights Campaign report, LGBT teens who cited higher levels of family rejection, including admission to conversion therapy, were 8.4 times more like to report having attempted suicide; 5.9 times more likely to have high levels of depression; 3.4 times more likely to use illegal drugs; and 3.4 times more likely to engage in unprotected sex when compared to peers with no or minimal levels of family rejection.
Khan has made passage of this bill one of her priorities for 2016. “Unfortunately, there is no guarantee. There are approximately 6,000 bills filed every year,” she said. “Advocacy needs to happen with any legislation.”
The Rhode Island legislature introduced the Prevention of Conversion Therapy for Children Act in February 2015, but put the bill on hold in November.
Heather Wilder, Psy.D., co-owner, Wilder Therapy in Warwick, R.I., indicated that poor publicity surrounding the bill may have impacted public support. “It is my firm belief that this bill is vitally important to the health and wellbeing of LGBT youth and I plan to contribute to lobbying efforts to ensure that the bill is reconsidered,” she said.
Wilder noted that current research and ethical guidelines strongly discourage, but do not explicitly prohibit mental health providers from providing conversion therapy, in spite of evidence that such therapy can cause harm. “In addition, religious counselors who are often the providers of reparative therapy are not bound by the ethical guidelines that govern the activities of other mental health providers. Therefore, legislation may be the only certain way to protect children from this type of harm.”
While reparative therapy may negatively impact self-esteem and mood in children, it also “damages family relationships, [and] unnecessarily lengthens the time that it will take for the family to accept the child for who they are,” said Wilder.
Allowing reparative therapy to continue unchecked and unchallenged legally “lends credibility to a treatment that, by its very nature, rejects and abuses a group of people for their identity,” said Wilder. “On a societal level, this perpetuates the myth that sexual orientation is a changeable and deviant behavior which fuels animosity, hate crimes and bullying instead of promoting understanding and acceptance.”
Bonnie Strickland, Ph.D., professor emerita in the Psychology and Brain Sciences Department at the University of Massachusetts Amherst, and member of APA Division 44, the Society for the Psychological Study of Lesbian, Gay, Bisexual and Transgender Issues, reported that the group recently held a business meeting. “We talked about recent judgments that were very important. Banning conversion therapy was one of the major accomplishments,” she said.