Primum non nocere, “first do no harm,” is a maxim well known to physicians and might be one that should be taken to heart by state decision makers. It is with this dictum in mind that NYSPA urges the NYS Senate to finally pass during its 2016 session the bill defining the practice of “Sexual Orientation Change Effort” (SOCE) with clients/ patients under the age of 18 as professional misconduct. This year such a bill (A. 4958) sponsored by Assemblywoman Deborah Glick passed the Assembly for the second time. A bipartisan Senate companion bill sponsored by Senator Brad Hoylman unfortunately has not advanced out of committee.
The proposed bill is meant to protect youth during their formative, developmental years from being exposed to “conversion” or “reparative” therapies the goal of which is to alter their sexual orientation. While research in the domain of gender identity and sexual orientation development is acknowledged to be both difficult to conduct and limited in its scope, there is virtually no sound scientific evidence of the efficacy of such efforts. There is considerable evidence that members of “sexual minorities”, especially during their adolescent years, experience unique stressors and developmental challenges which place them at heightened risk for developing clinical symptoms of depression, anxiety disorders, substance use disorders and even suicidality. Indeed, since “homosexuality” is recognized as normal variant of human sexual expression, there is, a priori, no reason to submit any person to therapy meant to change it.
Rather, it is considered clinically appropriate and ethical for therapists to assist their patient’s effort to define and express their core, individual preferences. The Assembly bill specifically allows for counseling and psychotherapies which support “coping, social support and identity exploration and development.” In other words, thinking as clinicians do about benefits and risks, there is no acceptable upside to SOCE but considerable potential for adverse outcomes. As such, it is appropriate to define SOCE as professional misconduct while favoring supportive, constructive therapies as defined in the bill.
To date, a number of states including Illinois, California, Oregon, and New Jersey along with Washington, D.C. have passed comparable legislation and legislation has been introduced and is currently wending its way through many other state legislatures. Interestingly, a jury in New Jersey recently found JONAH, (Jews Offering New Alternatives for Healing), a program claiming to change young men from gay to straight to be fraudulent and unconscionable. Lee Beckstead, a psychologist with expertise on SOCE and a member of the American Psychological Association’s task force which addressed that topic testified: “It’s outdated …it’s confusing, it’s misleading. It’s even reckless. And it’s harmful. It’s worse than snake oil.”
Furthermore, at this point in time, SOCE has been reviewed by and found to be both clinically and ethically unacceptable by the American Psychiatric Association, the American Psychological Association, the American Academy of Child and Adolescent Psychiatry, as well as several British specialty groups including the Royal College of Psychiatrists, the British Psychological Society, and the Pan American Health Organization and World Health Organization among others.
These professional societies have adopted their positions after reviewing the scientific literature in relation to the public benefits and harms resulting from SOCE. While some may view such findings as biased by a particular cultural agenda, it would be better to view the positions adopted as motivated by the respective societies shared mission of avoiding doing harm to those whom they serve. Lacking a rationale and scientific basis there can be no compelling reason for the state to allow such potentially harmful practices.
Based on the argument presented above, the NYSPA urges the NYS Senate to work with the Assembly to introduce and pass “same as” bills defining SOCE to be professional misconduct while affirming appropriate therapies during the 2016 session with the goal of protecting at risk youth. We believe that it is the moral obligation of health care practitioners as well as of our legislative representatives to protect our state’s vulnerable adolescents from fraudulent, harmful practices and a bill such as this year’s A.4958 can help that goal to be realized in NYS.
In addition to his current position as Chairman on Legislation, Dr. Perlman is a Past President of the NYS Psychiatric Association.