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AN ACT concerning the protection of minors from attempts to change sexual orientation, gender
identity, or gender expression.
BE IT ENACTED by the [LEGISLATIVE BODY] of the State of [STATE]:
Section 1. This act shall be known as the "Youth Mental Health Integrity Act".
Section 2. The Legislature finds and declares that:
a. Being lesbian, gay, or bisexual is not a disease, disorder, illness, deficiency, or shortcoming.
The major professional associations of mental health practitioners and researchers in the United
States have recognized this fact for nearly 40 years;
b. The American Psychological Association convened a Task Force on Appropriate Therapeutic
Responses to Sexual Orientation. The task force conducted a systematic review of peer-reviewed
journal literature on sexual orientation change efforts, and issued a report in 2009. The task force
concluded that sexual orientation change efforts can pose critical health risks to lesbian, gay, and
bisexual people, including confusion, depression, guilt, helplessness, hopelessness, shame, social
withdrawal, suicidality, substance abuse, stress, disappointment, self -blame, decreased self-
esteem and authenticity to others, increased self -hatred, hostility and blame toward parents,
feelings of anger and betrayal, loss of friends and potential romantic partners, problems in sexual
and emotional intimacy, sexual dysfunction, high-risk sexual behaviors, a feeling of being
dehumanized and untrue to self, a loss of faith, and a sense of having wasted time and resources;
c. The American Psychological Association issued a resolution on Appropriate Affirmative
Responses to Sexual Orientation Distress and Change Efforts in 2009, which states: "[T]he
[American Psychological Association] advises parents, guardians, young people, and their
families to avoid sexual orientation change efforts that portray homosexuality as a mental illness
or developmental disorder and to seek psychotherapy, social support, and educational services
that provide accurate information on sexual orientation and sexuality, increase family and school
support, and reduce rejection of sexual minority youth";
d. (1) The American Psychiatric Association published a position statement in March of 2000 in
which it stated: "Psychotherapeutic modalities to convert or `repair' homosexuality are based on
developmental theories whose scientific validity is questionable. Furthermore, anecdotal reports
of `cures' are counterbalanced by anecdotal claims of psychological harm. In the last four
decades, `reparative' therapists have not produced any rigorous scientific research to substantiate
their claims of cure. Until there is such research available, [the American Psychiatric
Association] recommends that ethical practitioners refrain from attempts to change individuals'
sexual orientation, keeping in mind the medical dictum to first, do no harm;
(2) The potential risks of reparative therapy are great, including depression, anxiety and self-
destructive behavior, since therapist alignment with societal prejudices against homosexuality
may reinforce self -hatred already experienced by the patient. Many patients who have undergone
reparative therapy relate that they were inaccurately told that homosexuals are lonely, unhappy
individuals who never achieve acceptance or satisfaction. The possibility that the person might
achieve happiness and satisfying interpersonal relationships as a gay man or lesbian is not
presented, nor are alternative approaches to dealing with the effects of societal stigmatization
discussed; and
(3) Therefore, the American Psychiatric Association opposes any psychiatric treatment such as
reparative or conversion therapy which is based upon the assumption that homosexuality per se
is a mental disorder or based upon the a priori assumption that a patient should change his or her
sexual homosexual orientation";
e. The American Academy of Pediatrics in 1993 published an article in its journal, Pediatrics,
stating: "Therapy directed at specifically changing sexual orientation is contraindicated, since it
can provoke guilt and anxiety while having little or no potential for achieving changes in
orientation";
f. The American Medical Association Council on Scientific Affairs prepared a report in 1994 in
which it stated: "Aversion therapy (a behavioral or medical intervention which pairs unwanted
behavior, in this case, homosexual behavior, with unpleasant sensations or aversive
consequences) is no longer recommended for gay men and lesbians. Through psychotherapy, gay
men and lesbians can become comfortable with their sexual orientation and understand the
societal response to it";
g. The National Association of Social Workers prepared a 1997 policy statement in which it
stated: "Social stigmatization of lesbian, gay, and bisexual people is widespread and is a primary
motivating factor in leading some people to seek sexual orientation changes. Sexual orientation
conversion therapies assume that homosexual orientation is both pathological and freely chosen.
No data demonstrates that reparative or conversion therapies are effective, and, in fact, they may
be harmful";
h. The American Counseling Association Governing Council issued a position statement in April
of 1999, and in it the council states: "We oppose `the promotion of "reparative therapy" as a
"cure" for individuals who are homosexual'";
i. (1) The American Psychoanalytic Association issued a position statement in June 2012 on
attempts to change sexual orientation, gender, identity, or gender expression, and in it the
association states: "As with any societal prejudice, bias against individuals based on actual or
perceived sexual orientation, gender identity or gender expression negatively affects mental
health, contributing to an enduring sense of stigma and pervasive self-criticism through the
internalization of such prejudice; and
(2) Psychoanalytic technique does not encompass purposeful attempts to `convert,' `repair,'
change or shift an individual's sexual orientation, gender identity or gender expression. Such
directed efforts are against fundamental principles of psychoanalytic treatment and often result in
substantial psychological pain by reinforcing damaging internalized attitudes";
j. The American Academy of Child and Adolescent Psychiatry in 2012 published an article in its
journal, Journal of the American Academy of Child and Adolescent Psychiatry, stating:
"Clinicians should be aware that there is no evidence that sexual orientation can be altered
through therapy, and that attempts to do so may be harmful. There is no empirical evidence adult
homosexuality can be prevented if gender nonconforming children are influenced to be more
gender conforming. Indeed, there is no medically valid basis for attempting to prevent
homosexuality, which is not an illness. On the contrary, such efforts may encourage family
rejection and undermine self-esteem, connectedness and caring, important protective factors
against suicidal ideation and attempts. Given that there is no evidence that efforts to alter sexual
orientation are effective, beneficial or necessary, and the possibility that they carry the risk of
significant harm, such interventions are contraindicated";
k. The Pan American Health Organization, a regional office of the World Health Organization,
issued a statement in May of 2012 and in it the organization states: "These supposed conversion
therapies constitute a violation of the ethical principles of health care and violate human rights
that are protected by international and regional agreements." The organization also noted that
reparative therapies "lack medical justification and represent a serious threat to the health and
well-being of affected people";
1. Minors who experience family rejection based on their sexual orientation face especially
serious health risks. In one study, lesbian, gay, and bisexual young adults who reported higher
levels of family rejection during adolescence were 8.4 times more likely to report having
attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely
to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual
intercourse compared with peers from families that reported no or low levels of family rejection.
This is documented by Caitlin Ryan et al. in their article entitled Family Rejection as a Predictor
of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults
(2009) 123 Pediatrics 346; and
m. [STATE] has a compelling interest in protecting the physical and psychological well-being of
minors, including lesbian, gay, bisexual, and transgender youth, and in protecting its minors
against exposure to serious harms caused by sexual orientation change efforts.
Section 3. As used in this section, "sexual orientation change efforts" means the practice of
seeking to change a person's sexual orientation, including, but not limited to, efforts to change
behaviors, gender identity, or gender expressions, or to reduce or eliminate sexual or romantic
attractions or feelings toward a person of the same gender; except that sexual orientation change
efforts shall not include counseling that:
a. provides assistance to a person seeking to transition from one gender to another, or:
b. provides acceptance, support, and understanding of a person or facilitates a person's coping,
social support, and identity exploration and development, including sexual -orientation -neutral
interventions to prevent or address unlawful conduct or unsafe sexual practices, as long as such
counseling does not seek to change sexual orientation, gender identity, or gender expression.
Section 4. a. A person who is licensed to provide professional counseling under [CITE TO
RELEVANT STATE LAW], including, but not limited to, a psychiatrist, licensed practicing
psychologist, certified social worker, licensed clinical social worker, licensed social worker,
licensed marriage and family therapist, certified psychoanalyst, or a person who performs
counseling as part of the person's professional training for any of these professions, shall not
engage in sexual orientation change efforts with a person under 18 years of age.
b. Any sexual orientation change efforts attempted on a patient under 18 years of age by a
licensed professional as defined in section 4(a) shall be considered unprofessional conduct and
shall subject them to discipline by the relevant licensing entity.
Section 5. This act shall take effect immediately.