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Stop Psychological Abuse: The Facts About “Reparative Therapy”

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What Are These Practices Also Known As?

These practices are  sometimes referred to as:

  • Sexual Orientation Change Efforts (SOCE)
  • Psychological abuse
  • “Reparative therapy”
  • “Conversion therapy”
  • “Ex-gay therapy”

What Are Examples of SOCE? 

In the past, some mental health professionals resorted to extreme measures such as castration and electroshock to try to stop people from being lesbian, gay, bisexual, or transgender (LGBT). Today, the techniques most commonly used include a variety of behavioral, cognitive, psychoanalytic, and other practices that try to change or reduce same-sex attraction or alter a person’s gender expression. While these contemporary versions of SOCE are less shocking and extreme than some of those used in the past, they are equally devoid of scientific validity and pose serious dangers to patients—especially to minors, who are often forced to undergo them by their parents or legal guardians, and who are at especially high risk of being harmed.

According to a 2009 report of the American Psychological Association, the techniques therapists have used to try to change sexual orientation and gender expression include inducing nausea, vomiting, or paralysis while showing the patient homoerotic images; providing electric shocks; having the individual snap an elastic band around the wrist when aroused by same-sex erotic images or thoughts; using shame to create aversion to same-sex attractions; orgasmic reconditioning; and satiation therapy. Other techniques include trying to make patients’ behavior more stereotypically feminine or masculine, teaching heterosexual dating skills, using hypnosis to try to redirect desires and arousal, and other techniques—all based on the scientifically discredited premise that being LGBT is a defect or disorder.

The current practice guidelines for the National Association for Research & Therapy of Homosexuality (NARTH), which is a group of therapists who endorse these practices in the United States, encourage its members to consider techniques that include hypnosis, behavior and cognitive therapies, sex therapies, and psychotropic medication, among others.

What Do Mainstream Mental Health Professionals Say About These Practices?

 All of the nation’s leading medical and mental health professional associations have rejected these practices as unnecessary, ineffective, and dangerous. These groups have said that the practices do not work and have warned patients that they may be harmful.  For example, the American Psychological Association “advises parents, guardians, young people, and their families to avoid sexual orientation change efforts that portray homosexuality as a mental illness or developmental disorder and to seek psychotherapy, social support, and educational services that provide accurate information on sexual orientation and sexuality, increase family and school support, and reduce rejection of sexual minority youth.”

The American Psychiatric Association “opposes any psychiatric treatment such as reparative or conversion therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that a patient should change his/her sexual homosexual orientation.”

The American Academy of Pediatrics has stated: “Therapy directed at specifically changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation.”

The Pan American Health Organization, a regional office of the World Health Organization, has stated that these practices “lack medical justification and represent a serious threat to the health and well-being of affected people.”

For more statements about these practices, see Just the Facts about Sexual Orientation and Youth, a joint publication of several major medical and mental health organizations, available at http://www.apa.org/pi/lgbt/resources/just-the-facts.pdf.

 Can Any Type of Therapy Change a Person’s Sexual Orientation or Gender Identity?

No. In 2009, the American Psychological Association conducted a comprehensive review of the published literature on these practices and concluded that they are not supported by any reliable evidence. In fact, the APA found that the opposite was true: “The results of scientifically valid research indicate that it is unlikely that individuals will be able to reduce same-sex sexual attractions or increase other-sex attractions through SOCE.”

Similarly, in 2000, the American Psychiatric Association published a statement concluding that: “In the last four decades, ‘reparative’ therapists have not produced any rigorous scientific research to substantiate their claims of cure.”

What Are the Harms Caused by Sexual Orientation Change Efforts?

These practices can be extremely dangerous and, in some cases, have led to death. The 2009 APA report concluded that the reported risks of the practices include: depression, guilt, helplessness, hopelessness, shame, social withdrawal, suicidality, substance abuse, stress, disappointment, self-blame, decreased self-esteem and authenticity to others, increased self-hatred, hostility and blame toward parents, feelings of anger and betrayal, loss of friends and potential romantic partners, problems in sexual and emotional intimacy, sexual dysfunction, high-risk sexual behaviors, a feeling of being dehumanized and untrue to self, a loss of faith, and a sense of having wasted time and resources.

The risks are even greater for youth.  Minors who experience family rejection based on their sexual orientation or gender expression face especially serious health risks. Research shows that lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were more than eight times more likely to report having attempted suicide, more than five times more likely to report high levels of depression, more than three times more likely to use illegal drugs, and more than three times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection.

In one highly publicized case from the early 1970s, psychologist George Rekers treated a five-year-old boy named Kirk Murphy, who had exhibited stereotypically feminine behavior such as a preference for girls’ toys. Rekers instructed Murphy’s parents to reward him for exhibiting “masculine” behavior and to punish him (by ignoring or even spanking him) when he displayed “feminine” behavior. Rekers claimed this treatment would prevent the boy from becoming gay. Later, Rekers published an article citing his treatment of Murphy as a success story, which Rekers and other proponents of these practices continue to use to deceive other parents and entrap other clients struggling with the stigma and discrimination faced by LGBT people. In fact, however, Murphy was gay in adulthood, and struggled with the severe psychological distress caused by Rekers’s “treatments” throughout his life. Murphy attempted to take his own life when he was about 17, and died by suicide at the age of 38.

Do Any States Protect Youth From These Dangerous Practices?

In 2012, California became the first state to protect LGBT youth from dangerous and scientifically discredited efforts by state-licensed therapists to change their sexual orientation or gender expression. This law (Senate Bill 1172) prohibits therapists who are licensed by the State of California from trying to change the sexual orientation or gender expression of people under 18. In 2013, New Jersey enacted a second law (Assembly Bill 3371), and similar legislation has been introduced in a number of other states. Here are answers to some of the most often asked questions about how the new law protects lesbian, gay, bisexual, and transgender youth and their families from these dangerous practices.

What Do the California and New Jersey Laws Do?

 These laws prohibit therapists who are licensed in California and New Jersey from engaging in scientifically discredited and dangerous practices that try to change a young person’s sexual orientation or gender expression/identity.

The laws describe these practices as “sexual orientation change efforts” (SOCE), which is also the term used by the American Psychological Association and other groups that have warned patients about these dangerous practices. The laws provide that state-licensed mental health providers may not engage in sexual orientation change efforts with a patient under 18 years of age.

The laws define sexual orientation change efforts to include any practices by mental health providers that seek to change an individual’s sexual orientation or gender expression/identity. This includes efforts to change behaviors or gender expression, or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same sex.

The laws also state that SOCE does not include therapies that provide acceptance, support, and understanding of clients or the facilitation of clients’ coping, social support, and identity exploration and development, including sexual orientation-neutral efforts to prevent or address unlawful conduct or unsafe sexual practices.

 Why Are These Laws Needed?

These laws are needed to ensure that therapists who are licensed by the state are providing competent care and are not damaging patients.  Before 1973, many mental health organizations inaccurately considered being gay to be a mental illness. In 1973, the American Psychiatric Association removed “homosexuality” from its official list of mental disorders. For decades, the American Psychiatric Association has recognized that being lesbian, gay, or bisexual is not a mental illness and that trying to change a person’s sexual orientation or gender expression is ineffective and dangerous.  Despite this consensus, some therapists continue to engage in these discredited and unsafe practices.

These laws are especially needed to protect minors, who are almost always forced to undergo these dangerous practices by parents or legal guardians who do not understand that they are putting their children at risk of serious harm.  The harms caused to minors by undergoing these practices are especially serious.

The state has a strong interest in ensuring that licensed health care providers follow professional standards of competence and do not engage in practices that have no scientific basis and put patients at risk of serious harms.

 Have These Laws Been Challenged in Court?  

After California Governor Jerry Brown signed California’s bill into law, two anti-LGBT groups filed lawsuits claiming that it violates their constitutional rights to freedom of speech and religion and is unconstitutionally vague. These claims have no merit. Many laws regulate the conduct of licensed therapists when dealing with patients, and these laws are just as valid as other regulations that require licensed professionals to provide safe, competent care and protect patients from harm and abuse. A panel of the United States Court of Appeals unanimously ruled that the California law is valid.  The same anti-LGBT groups filed challenges to the law in New Jersey as well, where a federal district court upheld it as well.

What Can I Do if I Find Out that a California or New Jersey Licensed Mental Health Care Provider Is Engaging in These Practices?

Different licensing boards regulate different types of mental health professionals. If you discover that a California or New Jersey mental health provider is engaging in these practices with a minor, please contact NCLR.

How Can I Help Enact a Similar Law in my State?

NCLR is providing support and assistance to advocates who are seeking to enact such laws across the country. If you would like to help enacting a similar law in your state, please contact NCLR Staff Attorney Samantha Ames at NCLR at SAmes@NCLRights.org and NCLR Senior Policy & Legislative Strategist Geoff Kors at GKors@NCLRights.org 

 LGBT Youth

LGBT youth looking for help should contact The Trevor Project at www.TheTrevorProject.org.

 

 

 

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