PRINTER'S NO. 9
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
26
Session of
2021
INTRODUCED BY A. WILLIAMS, STREET, COLLETT, FONTANA, KEARNEY,
SANTARSIERO, MUTH AND CAPPELLETTI, JANUARY 20, 2021
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE,
JANUARY 20, 2021
AN ACT
Prohibiting mental health professionals from engaging in sexual
orientation change efforts with an individual under 18 years
of age.
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 Protection of
Minors from Sexual Orientation Change Counseling Act.
Section 2. Legislative findings.
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
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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, thoughts of suicide, 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
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 2000, which stated:
(i) "Psychotherapeutic modalities to convert or
'repair' homosexuality are based on developmental
theories whose scientific validity is questionable.
Furthermore, anecdotal reports of 'cures' are
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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."
(ii) "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."
(iii) "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
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that "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 that "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 that "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 that "social
stigmatization of lesbian, gay and bisexual people is
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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 "opposing
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:
(i) "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."
(ii) "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
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Psychiatry, stating that "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 of 2012 and in it the organization states that "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
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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, David Huebner, Rafael
Diaz and Jorge Sanchez 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) Pennsylvania 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 professional." An individual who is licensed,
certified or otherwise authorized to administer or provide
professional mental health care or counseling under the act of
March 23, 1972 (P.L.136, No.52), known as the Professional
Psychologists Practice Act, the act of July 9, 1976 (P.L.817,
No.143), known as the Mental Health Procedures Act, the act of
December 20, 1985 (P.L.457, No.112), known as the Medical
Practice Act of 1985, or the act of July 9, 1987 (P.L.220,
No.39), known as the Social Workers, Marriage and Family
Therapists and Professional Counselors Act.
"Sexual orientation change efforts." Any practices by mental
health professionals that seek to change an individual's sexual
orientation, including, efforts to change behaviors, gender
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identity or gender expressions, or to reduce or eliminate sexual
or romantic attractions or feelings toward an individual of the
same gender. The term does not include counseling for an
individual seeking to transition from one gender to another,
counseling that provides acceptance, support and understanding
of an individual or facilitates an individual's coping, social
support and identity exploration and development, including
sexual orientation-neutral interventions to prevent or address
unlawful conduct or unsafe sexual practices, or counseling that
does not seek to change sexual orientation.
Section 4. Sexual orientation change efforts prohibited.
(a) General rule.--A mental health professional may not
engage in sexual orientation change efforts with an individual
under 18 years of age.
(b) Consent of minors.--Nothing in this act shall be
construed to prevent a minor from voluntarily consenting to
mental health care as provided in 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."
Section 5. Effective date.
This act shall take effect immediately.
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