Banning Conversion Therapy: Good Intention But...
There's no data supporting conversion therapy--or the majority of what we do.
Posted Oct 06, 2012
California just became the first state to ban conversion “therapy” for minors. That’s “therapy” which attempts to “cure” people of homosexuality, same-gender desire, or gender non-conformity, “converting” them to heterosexuality and “normal” gender behavior.
My regular readers know that I have been a licensed psychotherapist for 32 years—about 35,000 sessions with men, women, teens, and couples of all kinds. And I mean ALL kinds.
I am totally AGAINST reparative or conversion “therapy.” Under all circumstances, period. It doesn’t work, and it’s bad for people.
But I am pretty queasy about this new California law banning conversion “therapy” for minors, or the suggestion that adults have to be notified about the lack of evidence supporting conversion “therapy” before they do it.
Every single day, the best therapists—including me—use conventional, accepted therapeutic modalities that have no evidence supporting their efficacy. And every excellent therapist has occasionally done a terrific, thoughtful job with a patient, only to watch in dismay as one or another intervention has had terrible, unexpected results.
Then there are the less-than-excellent therapists who do therapy with modalities and interventions that are perfectly legal—and theoretically bankrupt or morally corrupt.
In virtually none of these situations does the State intervene and say “that kind of therapy is illegal with minors, or can only be done if you tell patients there’s no efficacy data behind it.” Why privilege the obviously egregious modality of conversion “therapy”? Why provide protection for one part of the patient population, but not the rest? Why challenge the problematic work of a small sliver of professionals, but not the rest?
And finally, do we really want the State intervening in these admittedly troubling and even damaging situations? In most of the country, we’re already fighting a losing battle to keep State legislators out of the patient-doctor conversation when it comes to abortion.
Therapists deal with pretty serious situations in addition to issues regarding sexual orientation. To pick just a few, we deal with teens who are suicidal, adults recovering from rape, and parents grieving their dead children. California has no special guidelines for our interventions in these cases, other than the standard Code of Ethics.
Again, see my first sentence: I’m totally against reparative or conversion “therapy.” I just question California’s dramatic, single-minded intrusion into a therapy profession which lacks efficacy data for virtually anything we do.
You want to protect children? Start by requiring every therapist to learn about healthy childhood sexuality—totally missing in most training programs. Then require that every single social service, police, or legal interview with a kid discussing possible molestation be videotaped, and make the tapes available to all parties in any litigation.
You want to protect people with non-conforming sexuality? Require all therapists to learn about alternative sexualities. And challenge the use of training materials claiming that people like S/M because they’ve been abused, or claiming that people’s domination-oriented sexual fantasies change and become “healthier” when their past sexual trauma is resolved.
Many other therapy practices far more common than conversion “therapy” lack any efficacy data whatsoever, including:
* Molestation: Describing patients’ early experiences as sexual molestation, contrary to the patients’ own interpretations, is common. Patients and their families continue to be destroyed by therapists applying extraordinarily broad definitions of “molest” to common, non-hurtful family situations.
* “Sex addiction”: Features discomfort with healthy masturbation, antagonism to most kinds of sexual expression outside of traditional heterosexual monogamy, and a screening tool that judges nearly every American a sex addict. The program typically pays little attention to differential diagnosis, unwittingly accepting those struggling with bipolar disorder, obsessive-compulsive disorder, borderline personality disorder, and sociopathic personality disorder.
* Infidelity & affairs: Many approaches rigidly valorize monogamy; encourage punishment for the betrayer; and support the betrayed partner’s desire for the betrayer’s email passwords, cell phone records, and detailed descriptions of exactly what the betrayer did hour-by-hour—destroying the dignity of both partners and preventing the rebuilding of trust.
The California law’s meta-message—”there’s nothing wrong with your kid having whatever sexual orientation s/he has”—is valuable. But State interference with one kind of (rather uncommon) irresponsible therapy—without touching other, more common forms of undocumented therapy—is a rather heavy-handed way of reshaping social norms.
The American Psychological Association, among others, has deemed conversion “therapy” quackery. That’s good news for everyone. By singling out and challenging this modality, California’s legislature is implying that most conventional therapy is both documented effective and safe. Unfortunately, that’s just not true.