Why are therapy ban attempts so harmful?

SUMMARY:

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• The components of sexual orientation (e.g., attractions and behaviors) are not immutable for many non-heterosexual people.

  • Sexual orientation fluidity is common for men and especially women.

• People are not simply born gay. Strict biological or genetic determination of sexual orientation is a myth.

• An extreme lack of ideological and sociopolitical diversity within major mental health organizations has created bias in their policy resolutions and inhibited scholarship that runs counter to preferred world views and advocacy interests.

• There is no definitive scientific evidence that professional change efforts are inherently harmful.

• These bills will likely have unintended consequences.   

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Here are the Facts -

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Sexual orientation is not fixed or immutable for many non-heterosexual people. 

• “Reported sexual identity, attraction, and behavior have been shown to change substantially across adolescence and young adulthood” (Ott et al., 2013, p. 466)

• “People with changing sexual attractions may be reassured to know that these are common rather than atypical” (Dickson, Paul, & Herbison, 2013, p. 762).

• “All attraction categories other than opposite-sex were associated with a lower likelihood of stability over time” (Savin-Williams & Ream, 2007, p. 389).

• “In the LGB population, the dominant pattern was change” (Hu, Xu, & Tornello, 2016, p. 654).

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People are not simply born gay. Large scale twin studies show that if one twin sibling has a non-heterosexual orientation the other sibling shares the orientation only about 11% of the time (Bailey, Dunne, & Martin, 2000; Bearman & Brueckner, 2002; Langstrom, Rahman, Carlstrom, & Lichtenstein, 2010).  Identical twins should always be identical for same-sex attraction if genetics or conditions in the womb overwhelmingly caused non-heterosexual orientations. These studies suggest the largest influence on the development of same-sex attractions are environmental factors that effect one twin sibling but not the other, such as unique events or idiosyncratic personal responses. 

 

Major mental health associations are extremely lacking in ideological and sociopolitical diversity. A few of many relevant examples of a “statistically impossible lack of diversity” (Duarte et al., 2015; Tierney, 2011) will have to suffice here:

• Although many qualified conservative psychologists were nominated to serve on the American Psychological Association’s (2009) task force cited in these bills, all of them were rejected (Yarhouse, 2009). The APA operated with a litmus test in determining task force membership—the only viewpoints allowed on the science relative to change of sexual attractions and behaviors were those the APA deemed acceptable.

• In 2011, the leadership of the APA voted 157-0 to support same-sex marriage, hardly a reflection of a country evenly divided on the issue (Jayson, 2011).  

• The National Association of Social Workers formally endorsed 339 federal candidates in the last two elections—every one of which was a Democrat (Pace, 2014).

• Conservative and moderate mental health professionals have largely disaffiliated from the mental health associations.  The American Medical Association now represents only 20% of physicians in the country (Pipes, 2011, Robiner, Fossum, & Hong, 2015). The APA represents only 43% of psychologists in America (Robiner et al., 2015).  Support for left-of-center social agendas appears to be a significant factor in the exodus of non-progressives from these organizations.    

 

There is no definitive scientific evidence that professional therapeutic change efforts are harmful.

• “[T]here are no scientifically rigorous studies of recent SOCE [sexual orientation change efforts] that would enable us to make a definitive statement about whether recent SOCE is safe or harmful and for whom” (APA task force report on SOCE, 2009, p. 83, cf. p. 67, 120).

• Studies used to support claims of harm have severe methodological limitations which render them unfit to generalize to the entire population of clients who may pursue change. These studies often oversampled people who felt harmed, were religiously disaffected, or who identified as formerly ex-gay. In addition, many of the care providers in such studies were religious counselors, not licensed therapists (Bradshaw, Dehlin, Crowell, & Bradshaw, 2015; Dehlin, Galliher, Bradshaw, Hyde, & Crowell, 2015; Flentje, Heck, & Cochran, 2013; Shidlo and Schroeder, 2002).

• Utilizing this research to evaluate therapies that allow for change makes no more sense than interviewing a sample of former marital therapy patients who had subsequently divorced to determine the effectiveness and harm of marital therapy in general.

 

These bills will likely have unintended consequences.

• They set a bad precedent of letting professional practice issues be arbitrated as consumer fraud issues.  Such matters should remain within the jurisdiction of the Board of Psychology and the Board of Behavioral Sciences.  The existence of this legislation creates the impression of significant negligence or incompetency on the part of the BOP and BBS.

• These bills are an invitation to take legal action against therapists and will have a chilling effect even on clinicians who provide only support and affirmation of sexual minorities. 

• For example, the sexual orientations and identities of transgender persons frequently change in the process of transitioning (Auer et al., 2014; Katz-Wise et al., 2017). Disgruntled transgender clients could conceivably sue their therapists under this bill by claiming their therapeutic process led to an unwanted change in sexual orientation.

• The risk of clients experiencing commonly occurring naturalistic change in sexual attractions (Katz-Wise, 2015; Katz-Wise & Hyde, 2015) and later using this as grounds for legal action could make therapists in general wary of working with non-heterosexual individuals.