A few weeks ago, in “Silence = Death,” I addressed Robert Spitzer’s retraction of his famous 2003 “ex-gay” study. Since then, Spitzer has issued a more formal retraction that was published in the New York Times, and he was interviewed by Neal Conan on NPR’s “Talk of the Nation” a few days ago. And while all of this has been going on, the California legislature has been debating SB 1172, a bill introduced back in February by Senator Ted Lieu (D-28th District). Essentially, three stipulations are made in this bill:
- It mandates that, prior to initiating any form of sexual orientation change efforts (SOCE), informed consent must be obtained from the patient. “Informed consent” means that the patient must be able to demonstrate an understanding of the risks and benefits before agreeing to any therapeutic intervention.
- It clarifies the fact that minors are unable to provide informed consent for SOCE. Because of this, the use of SOCE with minors is prohibited, regardless of the desire of the minor’s parents for such therapy.
If these provisions are violated in any way, affected patients have the right to sue for damages.
The rationale for SB 1172 rests heavily on the 2009 Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation, a 138-page review of research on SOCE. Shortly after this report was published, the American Psychological Association passed a resolution opposing any type of conversion therapy for homosexuality. The American Psychiatric Association, the American Academy of Pediatrics, the American Medical Association’s Council on Scientific Affairs, the National Association of Social Workers, and the American Counseling Association have also issued statements opposing efforts to change the sexual orientation of any individual.
However, not all professional organizations are unilaterally supporting this bill. The American Association for Marriage and Family Therapy, the California Association for Licensed Professional Clinical Counselors, the California Association of Marriage and Family Therapists, the California Psychiatric Association, and the California Psychological Association have all taken an “oppose unless amended” position, and are supportive of the intent of the bill. In some cases, the requested amendments involve taking a stronger stance against SOCE – the concerns of The American Association for Marriage and Family Therapy, for example, involve the ethical conflict posed by offering a harmful and ineffective form of treatment to an individual under any circumstances, even if the patient is requesting it and is aware of the potential risks. Other organizations have called for a clearer definition of “sexual orientation change efforts” so that the law isn’t inappropriately applied to sex offender treatment. In my opinion, these are important clarifications to make, and I’m grateful that these organizations are carefully considering the legal and ethical implications of this bill.
One of the more challenging concerns, however, involves a minor’s right to consent. Per SB 543, enacted in 2009, a minor who is 12 years of age or older may consent to mental health treatment or counseling services if, in the opinion of the attending professional person, the minor is mature enough to participate intelligently in the mental health treatment or counseling services. SB 1172 would create an exception to SB 543, and that is an issue that, from the perspective of these professional organizations, is a very important consideration.
Is it just me, or does this “parental consent” issue sound at all like the abortion argument to you? In fact, some of the most powerful arguments supporting SOCE sound eerily similar to the pro-choice “right to choose” rationale. Christopher Rosik, president of the National Association for Research and Therapy of Homosexuality (which, by the way, is the largest supporter of reparative therapy in the United States) issued the following argument against a potential ban against SOCE:
“[T]he majority of parents who bring their children to therapists for SOCE are conservatively religious. SB 1172 sponsors assume that with SOCE prohibited among licensed mental-health professionals, these parents would then bring their children to clinicians who would only provide care aimed at encouraging their children to embrace GLB identity and behavior. I think the more likely scenario is that these parents, many of whom are already suspicious of the mental health professions, will simply pursue SOCE for their children with unlicensed, unregulated, and unaccountable religious counselors that do not fall under the jurisdiction of this bill” (emphasis mine).
In effect, Rosik is saying that parents have the right to seek safe SOCE for their children, and that they will resort to “back-alley” SOCE if safe SOCE by a trained professional is unavailable. In fact, NARTH’s mission statement is firmly anchored in the “right to choose” argument:
“We respect the right of all individuals to choose their own destiny (emphasis mine). NARTH is a professional, scientific organization that offers hope to those who struggle with unwanted homosexuality. As an organization, we disseminate educational information, conduct and collect scientific research, promote effective therapeutic treatment, and provide referrals to those who seek our assistance.
“NARTH upholds the rights of individuals with unwanted homosexual attraction to receive effective psychological care and the right of professionals to offer that care. We welcome the participation of all individuals who will join us in the pursuit of these goals.”
How sad it is that we need to consider passing a law in order to uphold the Hippocratic Oath (“First, do no harm”). and Principle A of the APA Ethical Principles of Psychologists and Code of Conduct (“beneficence and nonmaleficence”). And how sad it is that organizations like NARTH still cling to the idea, even in the face of substantial contradictory evidence, that homosexuality is a mental disorder that can be successfully treated. Barry Goldwater may have said, “You can’t legislate morality,” but sometimes passing a law is the only way to enforce moral behaviors.