THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY JOSEPHS, McGEEHAN, FRANKEL AND CALTAGIRONE, OCTOBER 17, 2012

REFERRED TO COMMITTEE ON HUMAN SERVICES, OCTOBER 17, 2012  

AN ACT

Prohibiting mental health providers from engaging in sexual

orientation change efforts with minor patients.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Prohibition

on Sexual Orientation Change Efforts in Mental Health Treatment

Act.

Section 2.  Declaration of policy.

The General Assembly finds and declares as follows:

(1)  Being lesbian, gay or bisexual is not a disease,

disorder, illness, deficiency or shortcoming. The major

professional associations of mental health practitioners and

researchers in the United States have recognized this fact

for nearly 40 years.

(2)  The American Psychological Association convened a

Task Force on Appropriate Therapeutic Responses to Sexual

Orientation. The task force conducted a systematic review of

peer-reviewed journal literature on sexual orientation change

efforts and issued a report in 2009. The task force concluded

that sexual orientation change efforts can pose critical

health risks to lesbian, gay and bisexual people, including

confusion, 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.

(3)  The American Psychological Association issued a

resolution on Appropriate Affirmative Responses to Sexual

Orientation Distress and Change Efforts in 2009, which

states:

"[T]he [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."

(4)  The American Psychiatric Association published a

position statement in March of 2000 in which it stated:

"Psychotherapeutic modalities to convert or 'repair'

homosexuality are based on developmental theories whose

scientific validity is questionable. Furthermore,

anecdotal reports of 'cures' are counterbalanced by

anecdotal claims of psychological harm. In the last four

decades, 'reparative' therapists have not produced any

rigorous scientific research to substantiate their claims

of cure. Until there is such research available, [the

American Psychiatric Association] recommends that ethical

practitioners refrain from attempts to change

individuals' sexual orientation, keeping in mind the

medical dictum to first, do no harm. The potential risks

of reparative therapy are great, including depression,

anxiety and self-destructive behavior, since therapist

alignment with societal prejudices against homosexuality

may reinforce self-hatred already experienced by the

patient. Many patients who have undergone reparative

therapy relate that they were inaccurately told that

homosexuals are lonely, unhappy individuals who never

achieve acceptance or satisfaction. The possibility that

the person might achieve happiness and satisfying

interpersonal relationships as a gay man or lesbian is

not presented, nor are alternative approaches to dealing

with the effects of societal stigmatization discussed.

Therefore, 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."

(5)  The American School Counselor Association's position

statement on professional school counselors and lesbian, gay,

bisexual, transgendered and questioning (LGBTQ) youth states:

"It is not the role of the professional school counselor

to attempt to change a student's sexual

orientation/gender identity but instead to provide

support to LGBTQ students to promote student achievement

and personal well-being. Recognizing that sexual

orientation is not an illness and does not require

treatment, professional school counselors may provide

individual student planning or responsive services to

LGBTQ students to promote self-acceptance, deal with

social acceptance, understand issues related to coming

out, including issues that families may face when a

student goes through this process and identify

appropriate community resources."

(6)  The American Academy of Pediatrics in 1993 published

an article in its journal, Pediatrics, stating:

"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."

(7)  The American Medical Association Council on

Scientific Affairs prepared a report in 1994 in which it

stated:

"Aversion therapy (a behavioral or medical intervention

which pairs unwanted behavior, in this case, homosexual

behavior, with unpleasant sensations or aversive

consequences) is no longer recommended for gay men and

lesbians. Through psychotherapy, gay men and lesbians can

become comfortable with their sexual orientation and

understand the societal response to it."

(8)  The National Association of Social Workers prepared

a 1997 policy statement in which it stated:

"Social stigmatization of lesbian, gay and bisexual

people is widespread and is a primary motivating factor

in leading some people to seek sexual orientation

changes. Sexual orientation conversion therapies assume

that homosexual orientation is both pathological and

freely chosen. No data demonstrates that reparative or

conversion therapies are effective, and, in fact, they

may be harmful."

(9)  The American Counseling Association Governing

Council issued a position statement in April 1999, and, in

it, the council states:

"We oppose 'the promotion of "reparative therapy" as a

"cure" for individuals who are homosexual.'"

(10)  The American Psychoanalytic Association issued a

position statement in June 2012 on attempts to change sexual

orientation, gender, identity or gender expression, and, in

it, the association states:

"As with any societal prejudice, bias against individuals

based on actual or perceived sexual orientation, gender

identity or gender expression negatively affects mental

health, contributing to an enduring sense of stigma and

pervasive self-criticism through the internalization of

such prejudice. Psychoanalytic technique does not

encompass purposeful attempts to 'convert,' 'repair,'

change or shift an individual's sexual orientation,

gender identity or gender expression. Such directed

efforts are against fundamental principles of

psychoanalytic treatment and often result in substantial

psychological pain by reinforcing damaging internalized

attitudes."

(11)  The American Academy of Child and Adolescent

Psychiatry in 2012 published an article in its journal,

Journal of the American Academy of Child and Adolescent

Psychiatry, stating:

"Clinicians should be aware that there is no evidence

that sexual orientation can be altered through therapy,

and that attempts to do so may be harmful. There is no

empirical evidence adult homosexuality can be prevented

if gender nonconforming children are influenced to be

more gender conforming. Indeed, there is no medically

valid basis for attempting to prevent homosexuality,

which is not an illness. On the contrary, such efforts

may encourage family rejection and undermine self-esteem,

connectedness and caring, important protective factors

against suicidal ideation and attempts. Given that there

is no evidence that efforts to alter sexual orientation

are effective, beneficial or necessary, and the

possibility that they carry the risk of significant harm,

such interventions are contraindicated."

(12)  The Pan American Health Organization, a regional

office of the World Health Organization, issued a statement

in May 2012, and, in it, the organization states:

"These supposed conversion therapies constitute a

violation of the ethical principles of health care and

violate human rights that are protected by international

and regional agreements."

The organization also noted that reparative therapies "lack

medical justification and represent a serious threat to the

health and well-being of affected people."

(13)  Minors who experience family rejection based on

their sexual orientation face especially serious health

risks. In one study, lesbian, gay and bisexual young adults

who reported higher levels of family rejection during

adolescence were 8.4 times more likely to report having

attempted suicide, 5.9 times more likely to report high

levels of depression, 3.4 times more likely to use illegal

drugs and 3.4 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.

This is documented by Caitlin Ryan et al. in their article

entitled "Family Rejection as a Predictor of Negative Health

Outcomes in White and Latino Lesbian, Gay, and Bisexual Young

Adults" (2009) 123 Pediatrics 346.

(14)  The Commonwealth has a compelling interest in

protecting the physical and psychological well-being of

minors, including lesbian, gay, bisexual and transgender

youth, and in protecting its minors against exposure to

serious harms caused by sexual orientation change efforts.

Section 3.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Mental health provider."  A physician and surgeon

specializing in the practice of psychiatry, a psychologist, a

psychological assistant, intern or trainee, a licensed marriage

and family therapist, a registered marriage and family

therapist, intern or trainee, a licensed educational

psychologist, a credentialed school psychologist, a licensed

clinical social worker, an associate clinical social worker, a

licensed professional clinical counselor, a registered clinical

counselor, intern or trainee or any other person designated as a

mental health professional under Pennsylvania law or regulation.

"Sexual orientation change efforts."  Any practices by mental

health providers that seek to change an individual's sexual

orientation. The term includes efforts to change behaviors or

gender expressions or to eliminate or reduce sexual or romantic

attractions or feelings toward individuals of the same sex. The

term does not include psychotherapies that:

(1)  provide acceptance, support and understanding of

clients or the facilitation of clients' coping, social

support and identity exploration and development, including

sexual orientation-neutral interventions to prevent or

address unlawful conduct or unsafe sexual practices; and

(2)  do not seek to change sexual orientation.

Section 4.  Sexual orientation change efforts.

(a)  General rule.--Under no circumstances shall a mental

health provider engage in sexual orientation change efforts with

a patient under 18 years of age.

(b)  Disciplinary action.--Any sexual orientation change

efforts attempted on a patient under 18 years of age by a mental

health provider shall be considered unprofessional conduct and

shall subject a mental health provider to discipline by the

licensing entity for that mental health provider.

Section 5.  Construction.

Nothing in this act is intended to prevent a minor from

consenting to any mental health treatment or counseling

services, consistent with the act of February 13, 1970 (P.L.19,

No.10), entitled "An act enabling certain minors to consent to

medical, dental and health services, declaring consent

unnecessary under certain circumstances," other than sexual

orientation change efforts.

Section 6.  Effective date.

This act shall take effect in 60 days.