Gay Conversion Therapy Is Not Free Speech

Last fall the state of California adopted a ground-breaking bill, S.B. 1172. It was the first in the nation to ban licensed therapists from performing gay conversion therapy on minors under the age of 18. Known by various names -- ex-gay therapy, reparative therapy, sexual orientation change efforts (SOCE) -- conversion therapy's goal is to turn a gay person straight.

The bill's opponents have filed two separate appeals on the grounds that the law violates the First Amendment right to free speech. On April 17 the Ninth District Court of Appeals will hear oral arguments in Pickup v. Brown and Welch v. Brown.

Practitioners of conversion therapy employ a variety of methods. Some use aversion techniques, including inducing nausea or vomiting or providing electric shocks when the individual becomes aroused as a result of same-sex erotic images. Others use talk therapy to search for childhood wounds that supposedly led to the patient's homosexual cravings. These therapists may also attempt to address and "correct" gender-nonconforming characteristics. But whatever the techniques, conversion therapy is based on the belief that homosexuality is a pathological and abnormal condition.

As a state-licensed California psychotherapist, like my colleagues, I am not allowed to subject patients to practices based on discredited views, such as the belief that homosexuality is a mental illness or a pathology. That belief is outdated by four decades; it's been 40 years since homosexuality was removed from the Diagnostic and Statistical Manual of Mental Disorders in 1973.

S.B. 1172 only governs licensed California therapists. It does not apply to ordained clergy or pastoral or religious counselors who are not licensed mental health professionals. They are still free to attempt to "pray away the gay."

State licensing boards and the courts already enforce speech-based restrictions on mental health professionals: Therapists are barred from false, deceptive or harmful statements. The government absolutely has the power to protect children from treatments by state-licensed mental health professionals that are ineffective, harmful and abusive. In the case of conversion therapy, national mental health organizations of psychologists, psychiatrists, social workers and marriage and family therapists, as well as the American Academy of Pediatrics, have all concluded that efforts to change sexual orientation are both ineffective and harmful. Such treatments can result in anxiety, hopelessness, self-hatred, isolation, increased substance abuse, grief, guilt and suicide.

Say I had a severely depressed, possibly suicidal client, and I said, "I suggest that tonight you go to a bar. Cheer yourself up by drinking all night. Don't hold back. Then, when you get home, go up on the roof of your apartment house, step close to the edge, and stare at the beautiful stars." This is not professional freedom of speech but malpractice.

As therapists, our job is to offer relief from suffering and to help people develop into their full adult selves. But conversion therapy offers the opposite, reinforcing damaging internalized attitudes. It is blatant homophobia, based on the idea that being LGBT is sinful or sick, diseased and disturbed. The therapy that comes from this stance is profoundly damaging and traumatic because it presses patients to suppress their true selves.

Last year the Human Rights Campaign surveyed more that 10,000 LGBT youth and found that the largest problem they faced was non-acceptance from their families. Under family pressure, adolescents who submit to conversion therapy have the message reinforced that they are defective. That message is made even more potent delivered by a therapist in a power position as a mental health expert. Just at the time when adolescents are exploring their sexual identity, conversion therapy often leads to profound confusion, a sense of despair and feeling ashamed and broken.

There is a terrible price that LGBT youth pay when subjected to parental rejection, often demonstrated by parents sending children to conversion therapy. Research has found that youths whose parents reject their identity are over eight times more likely to attempt suicide, more than five times more likely to be highly depressed, over three times more likely to use illegal drugs and over three times more likely to have engaged in unprotected sexual intercourse than LGBT teens whose parents accept them.

In my therapy practice, when lesbian, gay and bisexual clients heal enough from trauma, rejection, bullying or internalized homophobia to accept who they are, they often express a sense of being more fully alive. They use words like these to describe themselves: whole, real, wise, at-ease, true and authentic. Now that is beautiful free speech.