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Ban Conversion Therapy
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On December 28, 2014 the tragic suicide of Cincinnati teenager, Leelah Alcorn became international news. Leelah identified as transgender but was not accepted by her parents who forced her into conversion therapy which aimed to change her gender identity and sexual orientation. Hours after her death her suicide note was posted online which included her contempt for the "therapy" and the following: "The only way I will rest in peace is if one day transgender people aren't treated the way I was, they're treated like humans, with valid feelings and human rights. My death needs to mean something."

 

Since Leelah's death NASW Ohio Chapter has been pursuing legislation and rule changes on a state level to ban the discredited and dangerous practice of "conversion therapy", sometimes referred to as
"reparative therapy", or "ex-gay therapy" like what Leelah was forced to undergo. The neutral term is "sexual orientation change efforts" (often abbreviated SOCE), which eliminates the notion that harmful reparative or conversion practices are a form of therapy. In April 2015, President Obama made a statement against conversion therapy and gave his support for statewide bans of the practice. Senate Bill 74 has been introduced in the Ohio General Assembly by Senator Charleta Tavares to ban any healthcare professional from performing a sexual orientation or gender identity change effort with minors. NASW strongly supports the immediate passage of this bill. Ohio would join California, Oregon, New Jersey, Vermont, and Washington D.C. if it were to pass the legislation. In the meantime, the Ohio Chapter has been pursuing action with the Ohio Counselor, Social Worker, and Marriage & Family Therapist Board to warn licensees under the Board’s jurisdiction that performing a change effort with minor clients is unethical. Unfortunately, neither legislation nor rule change would have stopped Leelah’s treatment as it was provided by a counselor through a religious institution. Both changes would only apply to healthcare professionals and to minors.

 

Complaints

Partnering with Equality Ohio, NASW Ohio has been presenting to client groups and professionals about the need to submit complaints on the practice of conversion therapy. Encourage your clients and colleagues to ask others if they have been the victim of conversion therapy attempts, and encourage them to submit a complaint if they have. It is important to remember though that submitting a complaint may be a traumatizing experience because it requires the victim to recall memories that can be deeply upsetting. 

 

Preparing to make a complaint regarding conversion “therapy”

Reflect: Consider the identified patient's emotional readiness. Confrontation can be very taxing even under the best circumstances. Regardless of who is filing, a complaint investigation may be stressful as it is likely to involve highly sensitive and personal issues. While the patient's confidentiality is prioritized, formal complaints do result in a public record, which could impact the patient's life, particularly if they are not "out" in all areas of life.

Reach out: Use an ally. Friends and family of choice are crucial for support during times of stress and conflict. Consider also seeking the services of an affirming counselor to discuss potential trauma reactions and boost coping skills. You may also reach out to a formal organization working on the conversion therapy ban for guidance and support throughout the process.

Prepare: Gather all of the relevant documents available. Patients have the right to request records from a previous healthcare provider and have the records sent to them or anyone else. The record request may need to be in writing which will be dictated by the policies and procedures of the healthcare provider in question. Please see the back of this page for steps to take if your records request is denied or delayed. Consider asking for the following documents:

  • Assessment and diagnosis
  • Treatment plan
  • Case or progress notes
  • Discharge paperwork

You may also seek advertising or business cards of the provider, particularly if "conversion therapy" is mentioned. Think creatively too. Journals or communication with family and friends from the time in "therapy" may help support the complaint.

Frame: In writing a complaint, emphasize what can be supported in documentation. While a strong, impactful narrative is important, the licensing board is not going to be able to take action without documentation to support the compliant. Equality Ohio and NASW Ohio are happy to provide further guidance in this area.

Should your records request be denied or delayed...
In general, records requests should be fulfilled within 30 days. Records should be accessible for at least five years after the termination of services. The only reason that a record request would be denied is regarding a specific restriction related to the client or patient's treatment needs in the treatment plan. If your request for records is denied or delayed, you can file a Health Information Privacy Complaint with the United States Office for Civil Rights online within six months. Go to https://ocrportal.hhs.gov and answer the screening questions, followed by the complaint form. As with licensure complaints, anonymous complaints cannot be investigated.

HIPAA Prohibits Retaliation
Under HIPAA an entity cannot retaliate against you for filing a complaint. You should notify the Office for Civil Rights immediately in the event of any retaliatory action.

 

Presentations on Complaints

If you would like for NASW Ohio to present to your agency or client groups about the complaint process as it relates to conversion therapy e-mail dsmith.naswoh@socialworkers.org.

 

Testimony to Columbus City Council in support of a ban on conversion therapy

February 21, 2017


Council President Klein, members of city council, and residents of Columbus, thank you for the opportunity to speak this afternoon in support of a ban on the dangerous practice of conversion therapy. My name is Danielle Smith and I represent the profession of social work through my position as executive director of the Ohio Chapter of the National Association of Social Workers.
On December 28, 2014, a teenager from Cincinnati, Leelah Alcorn, ended her life when she stepped in front of a truck headed north on 71. Leelah, who identified as transgender, had been forced into conversion therapy against her will by her parents who believed that her identity could be changed and that she could learn to live life as the gender she was assigned at birth. The pain caused by this treatment was clear in her suicide note as she wrote that the conversion therapy caused her emotional distress, and exacerbated the isolation between her and her family. News of her tragic suicide travelled around the world causing an immediate outcry to end the practice of conversion therapy. President Obama and many others urged state legislatures to ban conversion therapy in their states to protect LGBTQ youth from this harmful practice.


I, personally, felt responsible for taking action to ban conversion therapy after Leelah’s death. She was a fellow Ohioan who had been left vulnerable to discrimination and exploitation based on her gender identity. I deeply wish that Leelah would not have made the decision to end her life, but now we must do everything within our power to protect other youth. In her memory and honor, now is the time to ban conversion therapy.


I’m grateful to Columbus City Council for stepping up and finding solutions within your power to ban the practice of conversion therapy. It sends a powerful message to LBGTQ youth in this city that their lives and well-being matter. For many of us that are heterosexual and cisgender, our privilege has afforded us the luxury of being unfamiliar with the oppression they face. I certainly know that my own privilege blinded me to the reality that conversion therapy was indeed happening in Columbus and elsewhere in Ohio, even by licensed professionals within social work, counseling, and psychology. I was appalled to discover the reality that there are dozens of licensed practitioners across the state performing conversion therapy as it is so clearly in violation of the values, ethics, and principles of our professions. As licensed professionals, we are required to do no harm and work within the rules and laws that govern our practice. Any licensed professional that is performing conversion therapy knows they are in violation of their license and professional code of ethics. The entire purpose of a license is to protect the public from harmful practice and certainly conversion therapy falls within that definition.


Conversion therapy is harmful because it is based on the notion that being gay or trans is wrong and disordered. We now know that this belief is not based on any research or reason. Unfortunately, our professions have a dark history of perpetuating the fallacy that being LGBTQ is a mental illness, and we bear a terrific amount of responsibility for resolving the oppression that we contributed to. This is why all of our professional associations have led the call for protection from this practice, condemning conversion therapy since the early 1990s. Since that time, we have educated, trained, and re-trained professionals on the harms of conversion therapy and the need for the opposite, affirmative therapy.
As professionals we condemn conversion therapy because it is a deliberate violation of our professional ethics and principles of practice as it is discriminatory, exploitative, and dangerous. First and foremost, there is no medically valid basis for attempting to prevent homosexuality or gender identity variances, because they are not illnesses. Furthermore, there is no evidence that sexual orientation can be altered through therapy and research has found that attempts to do so may be harmful. There is no empirical evidence that adult homosexuality can be prevented if gender non-conforming children are influenced to be more gender conforming. On the contrary, such efforts may encourage family rejection and undermine self-esteem, connectedness and caring, which are important protective factors against suicidal ideation and attempts. Young people who experience high levels of family rejection face serious health risks, including being 8.4 times more likely to report having attempted suicide, and 5.9 times more likely to report high levels of depression. Research shows that lesbian, gay, and bisexual youth are 4 times more likely, and questioning youth are 3 times more likely to attempt suicide as their straight peers. Nearly half of young transgender people have seriously thought about taking their lives and one quarter report they have made a suicide attempt.


It is a sobering thought to think that perhaps a majority of the victims of conversion therapy are no longer living because the practice drove them to suicide. The high rates of suicide causality make conversion therapy a particularly challenging practice to quantify as its victims cannot speak up and its practitioners are cunning enough to know that admitting to performing conversion therapy would cause consequences. The survivors of conversion therapy whom you will hear from in this hearing are courageous in coming forward to tell their stories. I know that it took them many years to be able to talk about it. We have to assume that there are hundreds of other survivors in our city who endured similar situations as children and adults.
Conversion therapy is harmful because it co-opts principles of psychotherapy and behavior modification through the lens of homophobia and transphobia to actively force its target to change their gender identify or sexual orientation. Calling conversion therapy “therapy” is really a misnomer as it is more akin to brainwashing. The definition of conversion therapy is an active attempt to literally change someone’s sexual orientation or gender identity to a heterosexual or cisgender identity. To be clear, conversion therapy is not what I call “negative therapy” when a practitioner who has biases is non-affirming and unsupportive to clients who are LGBTQ. Conversion therapy goes a step further and employs behavior modification techniques to attempt a change in identity. These techniques can range from suggesting behavior change strategies based on stereotypes like avoiding events where the attendees identify predominately as LGBTQ to negative conditioning techniques such as electroshock therapy. Many conversion therapists use religious teachings to promote the concept that being LGBTQ is sinful but this is not always the case.


Banning conversion therapy by licensed professionals with minors in Columbus would draw a line to reinforce to professionals in our city that the practice is wrong, unethical, and illegal. It would send a message to Columbus families to avoid sending their children to conversion therapy. We know that many children who end up in conversion therapy have families who love them and are earnestly doing their best to find support but are unaware that conversion therapy is so dangerous. We must spread the word that no one should be subjected to conversion therapy. We must do all that we can to protect our children like we should have done for Leelah.
 


Sign the petition to ban conversion "therapy"


Resources

Professional mental health organizations that have publicly supported anti-conversion therapy regulations include:

  • American Association for Marriage and Family Therapy
  • American Counseling Association
  • American Psychoanalytic Association
  • National Association of School Psychologists
  • State chapters of the American Psychological Association
  • State chapters of Mental Health America
  • National Association of Social Workers (and state chapters)

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 non-conforming 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.[1] Young people who experience high levels of family rejection face serious health risks, including being 8.4 times 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. [2]

 

Research shows that lesbian, gay, and bisexual (LGB) youth are 4 times more likely, and questioning youth are 3 times more likely to attempt suicide as their straight peers. [3] Nearly half of young transgender people have seriously thought and taking their lives and one quarter report having made a suicide attempt.[4] This is reflected in the recent suicide of Ohio trans-youth, Leelah Alcorn in December 2014. Nationally, there has averaged one trans-youth suicide every week of 2015.

Having outspoken advocates for these laws within the mental health profession as well as LGBT supportive organizations underscores not only the scientific consensus of the dangers of conversion therapy but the need to end prejudiced and discriminatory practices against our vulnerable youth. We need legislation to educate parents and youth and to protect young people before they are harmed from abuse at the hands of unethical and ill-informed mental health professionals.

 

[1] American Academy of Child and Adolescent Psychiatry, Practice Parameter on Gay, Lesbian, or Bisexual Sexual Orientation, Gender Nonconformity, and Gender Discordance in Children and Adolescents, 51 J. Am. Acad. Child & Adolescent Psychiatry 957 (2012), available at http://www.guideline.gov/content.aspx?id=38417#Section420

[2] Caitlin Ryan et al., "Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults," 123 PEDIATRICS 346 (2009).

[3] 2011 CDC, "Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9-12"

[4] Arnold H. Grossman & Anthony R. D’Augelli, Transgender Youth and Life-Threatening Behaviors, 37(5) SUICIDE LIFE THREAT BEHAV.527 (2007)


Reparative Therapy Q&A With Dr. Michael Ian Rothenberg, LCSW

 


Paragraph taken from NASW’s legal brief filed in Obergefell v. Hines: “Although some groups and individuals have offered clinical interventions that purport to change sexual orientation from homosexual to heterosexual—sometimes called “conversion” therapies—these interventions have not been shown to be effective or safe. A review of the scientific literature by an APA task force concluded that sexual orientation change efforts are unlikely to succeed and can be harmful.” Report - http://www.apa.org/pi/lgbt/resources/therapeutic-response.pdf

 


Read a guidance document on how to prevent harm from Jim Struve, LCSW, Utah


 

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