The American Psychiatric Association has recognized since 1973 that homosexuality is not a disorder, yet a handful of therapists continue trying to “treat” gay and lesbian patients. Where reason and science failed to stop them, a law recently passed in California might.
The law will prohibit any “mental health provider” from offering anyone under the age of 18 any treatment that aims to “eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same sex.” Violations would be considered unprofessional conduct and could potentially result in the revocation of medical licenses.
The alleged therapies the law will restrict rely on bunk science and, in many cases, are themselves the root of genuine psychological issues. Therapists offering so-called “reparative” or “conversion” therapies for sexual orientation use the mantle of the mental health profession to gain credibility, while failing to follow the professional guidelines that have generated that credibility. In the process, they cause further harm to young people who are often already the victims of prejudice in their own homes.
One of the few studies that alleged that sexual orientation could be changed through therapeutic intervention was retracted earlier this year, leaving those who continue to practice the therapies with no legitimate scientific backing. The researcher behind that study, Robert L. Spitzer - who, interestingly, also played a pivotal role in the movement to end the classification of homosexuality as a mental disorder - issued an apology in May, explaining that the study had suffered from serious methodological flaws. In the letter, he referred to his earlier results as “unproven claims” and personally apologized to those who had “wasted time and energy” on the therapies.
Meanwhile, the American Psychiatric Association has found that, in addition to being ineffective, the therapies can increase the risk of depression and suicide. The Pan American Health Organization, which serves as the World Health Organization’s regional office for the Americas, has also issued a strong condemnation of the therapies, citing an association between the alleged treatments and “feelings of guilt and shame, depression, anxiety, and even suicide.”
Minors, because of their inability to provide informed consent, are particularly in need of protection from these unsafe therapies. The California law will provide them with that protection. I see no reason why California and other states should not eventually extend this same protection to adults. Adults may be better prepared to make their own decisions about potential risks, but they cannot assess those risks when practitioners make false claims about the efficacy and safety of supposed treatments. This is why medical practices and practitioners are regulated in the first place.
Opponents of the ban, including the National Association for Research and Therapy on Homosexuality (NARTH), a professional organization of therapists who practice what they call “sexual orientation change efforts,” argue that the ban will interfere with the rights of young people and their parents to seek the “treatments” they desire. NARTH and another group, the Pacific Justice Institute, have said they will file suits to attempt to stop the law from taking effect.
State Sen. Ted Lieu, who sponsored the law, has been vocal in addressing these objections. Lieu agrees with his opponents that the law limits parents’ freedom of choice - but he argues that doing so is a good thing. “The attack on parental rights is exactly the whole point of the bill because we don't want to let parents harm their children,” he said.
There is a genuine freedom of expression issue here. Under the First Amendment, individuals and religious organizations have the legal right to state that homosexuality is wrong. They may arguably have the right to state that it is curable, though I wonder whether this crosses a line and becomes fraud - which is not constitutionally protected - if there is no credible evidence to support that claim and much evidence to the contrary. Regardless, those who cloak themselves in religion or morality, rather than medicine, retain their rights to speak and to worship, and no law should try to stop them.
The California law meets these constitutional requirements. It does not try to limit what individuals or churches can say. It places limits only on state-licensed therapists, preventing them from using their status to falsely represent something as a legitimate medical or psychological practice when it is not.
Also, while we all have the right to freedom of expression, we do not have the right to mentally, physically, or emotionally abuse our children. Abuse is exactly what many attempts at “sexual orientation change” amount to.
California’s new law does not fully address such abuse. Much of the damage that is done to gay and lesbian youth goes on outside medical offices: in homes, in classrooms and at religious retreats. Besides laws that regulate harmful medical practices, we also need measures that allow young people, upon reaching adulthood, to sue in civil courts for monetary damages based on the mental and emotional harm inflicted upon them by non-medical professionals who attempt to change their sexual orientation. The state might also consider whether such attempts constitute the unlicensed practice of medicine or psychotherapy.
It will likely be a long time before these harmful practices are eradicated, and an even longer time before those who have been subjected to them see justice. Already, however, a few states, including New Jersey, are considering following in California’s footsteps.
We have known for decades that homosexuality is not a disorder and that it does not require treatment. Now, finally, we are beginning to recognize the dangers of a different disorder, the social disorder of anti-gay prejudice. Legislation like California’s is a long-overdue therapy for intolerance.