| |
|
| |
| 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 |
| |
1 | Prohibiting mental health providers from engaging in sexual |
2 | orientation change efforts with minor patients. |
3 | The General Assembly of the Commonwealth of Pennsylvania |
4 | hereby enacts as follows: |
5 | Section 1. Short title. |
6 | This act shall be known and may be cited as the Prohibition |
7 | on Sexual Orientation Change Efforts in Mental Health Treatment |
8 | Act. |
9 | Section 2. Declaration of policy. |
10 | The General Assembly finds and declares as follows: |
11 | (1) Being lesbian, gay or bisexual is not a disease, |
12 | disorder, illness, deficiency or shortcoming. The major |
13 | professional associations of mental health practitioners and |
14 | researchers in the United States have recognized this fact |
15 | for nearly 40 years. |
16 | (2) The American Psychological Association convened a |
17 | Task Force on Appropriate Therapeutic Responses to Sexual |
18 | Orientation. The task force conducted a systematic review of |
|
1 | peer-reviewed journal literature on sexual orientation change |
2 | efforts and issued a report in 2009. The task force concluded |
3 | that sexual orientation change efforts can pose critical |
4 | health risks to lesbian, gay and bisexual people, including |
5 | confusion, depression, guilt, helplessness, hopelessness, |
6 | shame, social withdrawal, suicidality, substance abuse, |
7 | stress, disappointment, self-blame, decreased self-esteem and |
8 | authenticity to others, increased self-hatred, hostility and |
9 | blame toward parents, feelings of anger and betrayal, loss of |
10 | friends and potential romantic partners, problems in sexual |
11 | and emotional intimacy, sexual dysfunction, high-risk sexual |
12 | behaviors, a feeling of being dehumanized and untrue to self, |
13 | a loss of faith and a sense of having wasted time and |
14 | resources. |
15 | (3) The American Psychological Association issued a |
16 | resolution on Appropriate Affirmative Responses to Sexual |
17 | Orientation Distress and Change Efforts in 2009, which |
18 | states: |
19 | "[T]he [American Psychological Association] advises |
20 | parents, guardians, young people, and their families to |
21 | avoid sexual orientation change efforts that portray |
22 | homosexuality as a mental illness or developmental |
23 | disorder and to seek psychotherapy, social support, and |
24 | educational services that provide accurate information on |
25 | sexual orientation and sexuality, increase family and |
26 | school support and reduce rejection of sexual minority |
27 | youth." |
28 | (4) The American Psychiatric Association published a |
29 | position statement in March of 2000 in which it stated: |
30 | "Psychotherapeutic modalities to convert or 'repair' |
|
1 | homosexuality are based on developmental theories whose |
2 | scientific validity is questionable. Furthermore, |
3 | anecdotal reports of 'cures' are counterbalanced by |
4 | anecdotal claims of psychological harm. In the last four |
5 | decades, 'reparative' therapists have not produced any |
6 | rigorous scientific research to substantiate their claims |
7 | of cure. Until there is such research available, [the |
8 | American Psychiatric Association] recommends that ethical |
9 | practitioners refrain from attempts to change |
10 | individuals' sexual orientation, keeping in mind the |
11 | medical dictum to first, do no harm. The potential risks |
12 | of reparative therapy are great, including depression, |
13 | anxiety and self-destructive behavior, since therapist |
14 | alignment with societal prejudices against homosexuality |
15 | may reinforce self-hatred already experienced by the |
16 | patient. Many patients who have undergone reparative |
17 | therapy relate that they were inaccurately told that |
18 | homosexuals are lonely, unhappy individuals who never |
19 | achieve acceptance or satisfaction. The possibility that |
20 | the person might achieve happiness and satisfying |
21 | interpersonal relationships as a gay man or lesbian is |
22 | not presented, nor are alternative approaches to dealing |
23 | with the effects of societal stigmatization discussed. |
24 | Therefore, the American Psychiatric Association opposes |
25 | any psychiatric treatment such as reparative or |
26 | conversion therapy which is based upon the assumption |
27 | that homosexuality per se is a mental disorder or based |
28 | upon the a priori assumption that a patient should change |
29 | his/her sexual homosexual orientation." |
30 | (5) The American School Counselor Association's position |
|
1 | statement on professional school counselors and lesbian, gay, |
2 | bisexual, transgendered and questioning (LGBTQ) youth states: |
3 | "It is not the role of the professional school counselor |
4 | to attempt to change a student's sexual |
5 | orientation/gender identity but instead to provide |
6 | support to LGBTQ students to promote student achievement |
7 | and personal well-being. Recognizing that sexual |
8 | orientation is not an illness and does not require |
9 | treatment, professional school counselors may provide |
10 | individual student planning or responsive services to |
11 | LGBTQ students to promote self-acceptance, deal with |
12 | social acceptance, understand issues related to coming |
13 | out, including issues that families may face when a |
14 | student goes through this process and identify |
15 | appropriate community resources." |
16 | (6) The American Academy of Pediatrics in 1993 published |
17 | an article in its journal, Pediatrics, stating: |
18 | "Therapy directed at specifically changing sexual |
19 | orientation is contraindicated, since it can provoke |
20 | guilt and anxiety while having little or no potential for |
21 | achieving changes in orientation." |
22 | (7) The American Medical Association Council on |
23 | Scientific Affairs prepared a report in 1994 in which it |
24 | stated: |
25 | "Aversion therapy (a behavioral or medical intervention |
26 | which pairs unwanted behavior, in this case, homosexual |
27 | behavior, with unpleasant sensations or aversive |
28 | consequences) is no longer recommended for gay men and |
29 | lesbians. Through psychotherapy, gay men and lesbians can |
30 | become comfortable with their sexual orientation and |
|
1 | understand the societal response to it." |
2 | (8) The National Association of Social Workers prepared |
3 | a 1997 policy statement in which it stated: |
4 | "Social stigmatization of lesbian, gay and bisexual |
5 | people is widespread and is a primary motivating factor |
6 | in leading some people to seek sexual orientation |
7 | changes. Sexual orientation conversion therapies assume |
8 | that homosexual orientation is both pathological and |
9 | freely chosen. No data demonstrates that reparative or |
10 | conversion therapies are effective, and, in fact, they |
11 | may be harmful." |
12 | (9) The American Counseling Association Governing |
13 | Council issued a position statement in April 1999, and, in |
14 | it, the council states: |
15 | "We oppose 'the promotion of "reparative therapy" as a |
16 | "cure" for individuals who are homosexual.'" |
17 | (10) The American Psychoanalytic Association issued a |
18 | position statement in June 2012 on attempts to change sexual |
19 | orientation, gender, identity or gender expression, and, in |
20 | it, the association states: |
21 | "As with any societal prejudice, bias against individuals |
22 | based on actual or perceived sexual orientation, gender |
23 | identity or gender expression negatively affects mental |
24 | health, contributing to an enduring sense of stigma and |
25 | pervasive self-criticism through the internalization of |
26 | such prejudice. Psychoanalytic technique does not |
27 | encompass purposeful attempts to 'convert,' 'repair,' |
28 | change or shift an individual's sexual orientation, |
29 | gender identity or gender expression. Such directed |
30 | efforts are against fundamental principles of |
|
1 | psychoanalytic treatment and often result in substantial |
2 | psychological pain by reinforcing damaging internalized |
3 | attitudes." |
4 | (11) The American Academy of Child and Adolescent |
5 | Psychiatry in 2012 published an article in its journal, |
6 | Journal of the American Academy of Child and Adolescent |
7 | Psychiatry, stating: |
8 | "Clinicians should be aware that there is no evidence |
9 | that sexual orientation can be altered through therapy, |
10 | and that attempts to do so may be harmful. There is no |
11 | empirical evidence adult homosexuality can be prevented |
12 | if gender nonconforming children are influenced to be |
13 | more gender conforming. Indeed, there is no medically |
14 | valid basis for attempting to prevent homosexuality, |
15 | which is not an illness. On the contrary, such efforts |
16 | may encourage family rejection and undermine self-esteem, |
17 | connectedness and caring, important protective factors |
18 | against suicidal ideation and attempts. Given that there |
19 | is no evidence that efforts to alter sexual orientation |
20 | are effective, beneficial or necessary, and the |
21 | possibility that they carry the risk of significant harm, |
22 | such interventions are contraindicated." |
23 | (12) The Pan American Health Organization, a regional |
24 | office of the World Health Organization, issued a statement |
25 | in May 2012, and, in it, the organization states: |
26 | "These supposed conversion therapies constitute a |
27 | violation of the ethical principles of health care and |
28 | violate human rights that are protected by international |
29 | and regional agreements." |
30 | The organization also noted that reparative therapies "lack |
|
1 | medical justification and represent a serious threat to the |
2 | health and well-being of affected people." |
3 | (13) Minors who experience family rejection based on |
4 | their sexual orientation face especially serious health |
5 | risks. In one study, lesbian, gay and bisexual young adults |
6 | who reported higher levels of family rejection during |
7 | adolescence were 8.4 times more likely to report having |
8 | attempted suicide, 5.9 times more likely to report high |
9 | levels of depression, 3.4 times more likely to use illegal |
10 | drugs and 3.4 times more likely to report having engaged in |
11 | unprotected sexual intercourse compared with peers from |
12 | families that reported no or low levels of family rejection. |
13 | This is documented by Caitlin Ryan et al. in their article |
14 | entitled "Family Rejection as a Predictor of Negative Health |
15 | Outcomes in White and Latino Lesbian, Gay, and Bisexual Young |
16 | Adults" (2009) 123 Pediatrics 346. |
17 | (14) The Commonwealth has a compelling interest in |
18 | protecting the physical and psychological well-being of |
19 | minors, including lesbian, gay, bisexual and transgender |
20 | youth, and in protecting its minors against exposure to |
21 | serious harms caused by sexual orientation change efforts. |
22 | Section 3. Definitions. |
23 | The following words and phrases when used in this act shall |
24 | have the meanings given to them in this section unless the |
25 | context clearly indicates otherwise: |
26 | "Mental health provider." A physician and surgeon |
27 | specializing in the practice of psychiatry, a psychologist, a |
28 | psychological assistant, intern or trainee, a licensed marriage |
29 | and family therapist, a registered marriage and family |
30 | therapist, intern or trainee, a licensed educational |
|
1 | psychologist, a credentialed school psychologist, a licensed |
2 | clinical social worker, an associate clinical social worker, a |
3 | licensed professional clinical counselor, a registered clinical |
4 | counselor, intern or trainee or any other person designated as a |
5 | mental health professional under Pennsylvania law or regulation. |
6 | "Sexual orientation change efforts." Any practices by mental |
7 | health providers that seek to change an individual's sexual |
8 | orientation. The term includes efforts to change behaviors or |
9 | gender expressions or to eliminate or reduce sexual or romantic |
10 | attractions or feelings toward individuals of the same sex. The |
11 | term does not include psychotherapies that: |
12 | (1) provide acceptance, support and understanding of |
13 | clients or the facilitation of clients' coping, social |
14 | support and identity exploration and development, including |
15 | sexual orientation-neutral interventions to prevent or |
16 | address unlawful conduct or unsafe sexual practices; and |
17 | (2) do not seek to change sexual orientation. |
18 | Section 4. Sexual orientation change efforts. |
19 | (a) General rule.--Under no circumstances shall a mental |
20 | health provider engage in sexual orientation change efforts with |
21 | a patient under 18 years of age. |
22 | (b) Disciplinary action.--Any sexual orientation change |
23 | efforts attempted on a patient under 18 years of age by a mental |
24 | health provider shall be considered unprofessional conduct and |
25 | shall subject a mental health provider to discipline by the |
26 | licensing entity for that mental health provider. |
27 | Section 5. Construction. |
28 | Nothing in this act is intended to prevent a minor from |
29 | consenting to any mental health treatment or counseling |
30 | services, consistent with the act of February 13, 1970 (P.L.19, |
|
1 | No.10), entitled "An act enabling certain minors to consent to |
2 | medical, dental and health services, declaring consent |
3 | unnecessary under certain circumstances," other than sexual |
4 | orientation change efforts. |
5 | Section 6. Effective date. |
6 | This act shall take effect in 60 days. |
|