American Psychological Association says, “Don’t tell patients they can change their sexual orientation.”

APA says, "Don't try and change sexual orientation."

Posted Sep 01, 2009

The American Psychological Association's (APA) governing Council of Representatives recently adopted a resolution stating that mental health professionals should avoid telling clients that they can change their sexual orientation through therapy or other treatments. The resolution also advises that parents, young people and their families avoid sexual orientation treatments that falsely portray homosexuality as a mental illness or developmental disorder. If a family or individual is struggling with acceptance, the resolution advises seeking services "that provide accurate information on sexual orientation and sexuality, increase family and school support, and reduce rejection of sexual minority youth."

APA appointed the six-member Task Force on Appropriate Therapeutic Responses to Sexual Orientation in 2007. The task force examined the peer-reviewed journal articles in English from 1960 to 2007, which included 83 studies. The group also reviewed the recent literature on the psychology of sexual orientation. Some of the major conclusions of this literature review were:

1) Sexual stigma is a major source of stress for LGBT people. This stress, also known as minority stress, is a factor in mental health disparities found in some sexual minorities (i.e. LGBT people). We have found evidence in our studies of LGBT youth in Chicago that support this idea. LGBT stigma and victimization were significant predictors of psychological distress and depression symptoms. Family and peer support reduced psychological distress, but did not eliminate the negative effects of victimization.

2) Same-sex sexual attractions, behavior, and orientations are normal and positive variants of human sexuality. They concluded this based on the fact that homosexuality is not a mental or developmental disorder.

3) "Gay, lesbian, and bisexual individuals form stable, committed relationships and families that are equivalent to heterosexual relationships and families in essential respects." See my blog on the Iowa Supreme Court decision for more about this.

4) The major conclusions of the report focused on if therapy can change a person's sexual orientation, if it is harmful, and if it has any benefits. The authors said, "These studies show that enduring change to an individual's sexual orientation is uncommon. The participants in this body of research continued to experience same-sex attractions following SOCE [sexual orientation change efforts] and did not report significant change to other sex attractions that could be empirically validated, though some showed lessened physiological arousal to all sexual stimuli. Compelling evidence of decreased same-sex sexual behavior and of engagement in sexual behavior with the other sex was rare." They also found some evidence that attempts to change a person's sexual orientation cause harm (i.e. iatrogenic effects) such as loss of sexual feeling, depression, suicidality, and anxiety. However, research in this area was limited; as the authors said, "There are no methodologically sound studies of recent SOCE that would enable the task force to make a definitive statement about whether or not recent SOCE is safe or harmful and for whom." The press release announcing the resolution included an interview with Dr. Judith Glassgold, chair of the task force, who said, "Without such information, psychologists cannot predict the impact of these treatments and need to be very cautious, given that some qualitative research suggests the potential for harm. Practitioners can assist clients through therapies that do not attempt to change sexual orientation, but rather involve acceptance, support and identity exploration and development without imposing a specific identity outcome."

What should we take away from this resolution? The resolution states that efforts to change a person's sexual orientation are unlikely to be successful and involve some risk of harm. If a licensed mental health profession ignores this resolution and tells a client or family that they can use therapy to change someone's sexual orientation they risk a malpractice lawsuit. While the standards for malpractice vary by jurisdiction, it is generally defined as deviation from the accepted standards of practice and causing injury to the patient. Gay youth who are in good mental health and may be in some way forced by family to undergo a "treatment" to change their sexual orientation may have particularly strong grounds for a malpractice lawsuit if the "treatment" leads to psychological distress or injury.

I hope that this resolution, and the threat of future malpractice, leads clinicians to abandon claims that they can alter a person's sexual orientation through therapy. I also hope it leads families and individuals to realize such practices are not in the best interest of the LGBT individual. It will be interesting to follow any resulting malpractice cases over the next few years.

Here are links to the press release and full resolution.

Image from Truth Wins Out.

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