I Fought the Law… [To Be Determined]

If you hap­pened to read my series Tak­ing Sex­u­al­ity in for Repairs, or you have an inter­est in the issues of “con­ver­sion” from homo­sex­u­al­ity, Repar­a­tive Ther­a­pies – and the riff referred to as “sex­ual ori­en­ta­tion change efforts” (SOCE) – or you have an inter­est in the role of gov­ern­ment in the deter­mi­na­tion of the moral issues of our time, keep reading.

On Sep­tem­ber, 30, 2012, Gov­er­nor Jerry Brown signed into law a pro­hi­bi­tion of sex­ual ori­en­ta­tion change efforts for any patient under the age of eighteen:Gov. Brown tweeted that “This bill bans non-scientific ‘ther­a­pies’ that have dri­ven young peo­ple to depres­sion and sui­cide. These prac­tices have no basis in sci­ence or med­i­cine.” And this was echoed by a Sen­a­tor attend­ing the sign­ing, “[Today] young peo­ple are pro­tected from these unscrupu­lous ther­a­pists who are really engag­ing in ther­a­peu­tic decep­tion that is based on junk science.”

Exist­ing law pro­vides for licens­ing and reg­u­la­tion of var­i­ous pro­fes­sions in the heal­ing arts, includ­ing physi­cians and sur­geons, psy­chol­o­gists, mar­riage and fam­ily ther­a­pists, edu­ca­tional psy­chol­o­gists, clin­i­cal social work­ers, and licensed pro­fes­sional clin­i­cal counselors.

This bill would pro­hibit a men­tal health provider, as defined, from engag­ing in sex­ual ori­en­ta­tion change efforts, as defined, with a patient under 18 years of age. The bill would pro­vide that any sex­ual ori­en­ta­tion change efforts attempted on a patient under 18 years of age by a men­tal health provider shall be con­sid­ered unpro­fes­sional con­duct and shall sub­ject the provider to dis­ci­pline by the provider’s licens­ing entity.

Pre­dictably, the jus­ti­fi­ca­tions for this leg­is­la­tion come the “top of the heap”: the ven­er­a­ble APA’s (Psy­chi­a­try & Psy­chol­ogy), School Coun­selors, Amer­i­can Acad­emy of Pedi­atrics, NASW, Amer­i­can Psy­cho­an­a­lytic Asso­ci­a­tion, Amer­i­can Acad­emy of Child and Ado­les­cent Psy­chi­a­try, and the Pan Amer­i­can Health Orga­ni­za­tion of the WHO. Rea­son­ing:

  • Lacks med­ical justification.
  • 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.”
  • Psy­cho­an­a­lytic tech­nique does not encom­pass pur­pose­ful attempts to ‘con­vert,’ ‘repair,’ change or shift an individual’s sex­ual ori­en­ta­tion… and often result in sub­stan­tial psy­cho­log­i­cal pain by rein­forc­ing dam­ag­ing inter­nal­ized atti­tudes.”; “Sex­ual ori­en­ta­tion con­ver­sion ther­a­pies assume that homo­sex­ual ori­en­ta­tion is both patho­log­i­cal and freely chosen.”
  • [SOCE] is con­traindi­cated, since it can pro­voke guilt and anx­i­ety while hav­ing lit­tle or no poten­tial for achiev­ing changes in orientation.”
  • Sex­ual ori­en­ta­tion is not an ill­ness and does not require treatment.”
  • [SOCE] 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/her sex­ual homo­sex­ual orientation.”
  • In the last four decades, ‘repar­a­tive’ ther­a­pists have not pro­duced any rig­or­ous sci­en­tific research to sub­stan­ti­ate their claims of cure.”

Thus, the State of Cal­i­for­nia, dan­gling your pro­fes­sional liveli­hood in the form of your license over your head, WARNS you:

865.1.
Under no cir­cum­stances shall a men­tal health provider engage in sex­ual ori­en­ta­tion change efforts with a patient under 18 years of age.

865.2.
Any sex­ual ori­en­ta­tion change efforts attempted on a patient under 18 years of age by a men­tal health provider shall be con­sid­ered unpro­fes­sional con­duct and shall sub­ject a men­tal health provider to dis­ci­pline by the licens­ing entity for that men­tal health provider.

Com­men­tary

If there was ever an argu­ment to be made that gov­ern­ment shame­lessly aligns itself with special-interest with­out a sem­blance, even an aroma of objec­tive cause, this would be it. And the col­lec­tive out­rage should be breath­tak­ing. And it is not. Why? I have my thoughts, opin­ions I have read (e.g. vocal­ity of the lobby. elec­tion year, pan­der­ing, etc.), but I will leave the why momen­tar­ily and speak to the issue of jus­ti­fi­ca­tion.

Lit­er­ally, the State of Cal­i­for­nia is hold­ing inde­pen­dent sci­en­tific research hostage for the iden­ti­cal rea­sons it prof­fers to sup­port the pro­hi­bi­tion of repar­a­tive therapies/SOCE: it has no empir­i­cal evi­dence that it is not help­ful, nor do they have empir­i­cal evi­dence that it does in fact, cause harm – and if it causes harm, to what extent does it cause harm. It is epic hypocrisy. AND, the State of Cal­i­for­nia has estab­lished a per­fect Catch 22.

The fun­da­men­tal tenet of treat­ment – any form of treat­ment – is do no harm. Never, ever, under any cir­cum­stance. We will stop a clin­i­cal trial into which mil­lions of dol­lars and untold hours of work have been invested COLD the moment we dis­cover that the poten­tial harm out­weighs any poten­tial ben­e­fit. Even “vol­un­tar­ily,” we will not expose human sub­jects to harm. Sec­ondly, anec­do­tal infor­ma­tion indi­cate one thing: the need for research. Anec­dote is never, ever the basis for deter­mi­nates of sci­ence. Those who would sug­gest so are char­la­tans and rodents. At the same time, we are con­tin­u­ally eval­u­at­ing effi­cacy: at its most fun­da­men­tal, is more help­ful than doing noth­ing, and if so, is it more help­ful than what is already avail­able, and so on. We will not expose patients to need­less, point­less treat­ment. And how do we deter­mine effi­cacy and estab­lish benefit-harm ratios? Research; prop­erly designed, prop­erly admin­is­tered, prop­erly eval­u­ated research.

The Catch 22 here is that in order to answer the ques­tions we are inter­est in answer­ing, 1) is repar­a­tive therapies/SOCE more help­ful than offer­ing noth­ing; OR 2) is repar­a­tive therapies/SOCE more help­ful than the life of chastity, sin­gle­mind­ed­ness, and obe­di­ence to which we are all called in the full­ness of the Ortho­dox Church and guided by an expe­ri­enced spir­i­tual father; OR 3) per­haps a com­bi­na­tion, we would be eth­i­cally bound to empir­i­cal clin­i­cal tri­als that ensure the safety of human sub­jects. But the State of Cal­i­for­nia pro­hibits clin­i­cal trial by statute, with­out requir­ing evi­dence prov­ing the ratio­nale for the statute to be true. In effect, we will never know with­out vio­lat­ing the law and jeop­ar­diz­ing pro­fes­sional licens­ing – and thereby the liveli­hood – of clin­i­cal inves­ti­ga­tors. Unless, of course, you are a charlatan.

In the best of Amer­i­can tra­di­tion, Jerry Brown’s sig­na­ture was not dry on the leg­is­la­tion before the first pre-prepared law­suit was filed in court. But it is the sec­ond suit that was filed in fed­eral court on Octo­ber 5, 2012 that is of spe­cial inter­est, in that among the plain­tiffs is the Chief Char­la­tan and for­mer pres­i­dent of the National Asso­ci­a­tion for Research & Ther­apy of Homo­sex­u­al­ity (NARTH) [Again, I refer you to the series linked above],

James Nicolosi, Ph.D.

James Nicolosi, Ph.D.

Dr. Nicolosi and his cast of pseudo-scientists have no qualms, no hes­i­ta­tions what­so­ever of defy­ing the estab­lished ethic of estab­lish­ing a benefit-to-harm ratio before ini­ti­at­ing a ver­i­ta­ble indus­try. Sec­ondly, any­one who works by the acute mea­sure­ment of “out­comes” – that can get away it – will tend to “spin” the best of their “out­comes” data. Nicolosi et al. will not only “spin,” they will fab­ri­cate and out­right lie. In fact they devel­oped their own “pro­fes­sional” sci­en­tific jour­nal to prof­fer their fab­ri­ca­tions. As noted above, while in the pre­vi­ous four decades they have gen­er­ated not a sin­gle inde­pen­dent, inde­pen­dently ref­er­eed, inde­pen­dently data-scrutinized study worth the time it takes to read, they con­tinue to make “suc­cess­ful con­ver­sion” claims unseen, unclaimed, and unsup­ported by any­one, any­where, ever.

So, I con­clude by not­ing this: CA SB 1172 pro­hibit­ing any efforts of repar­a­tive therapy/SOCE for per­sons eigh­teen years of age or under,

  • is an aston­ish­ingly mis­guided and sci­en­tif­i­cally unsup­port­able action that pre­vents the legit­i­mate fur­ther­ance of per­sonal choice among med­ical consumers,
  • need­lessly and care­lessly hin­ders the legit­i­mate fur­ther­ance of alter­na­tive and inno­v­a­tive treat­ment modalities,
  • sets a prece­dent for the unsup­port­able con­tentions of spe­cial inter­est in the fur­ther­ance of research science,
  • sets a prece­dent of dis­rupt­ing licens­ing & fund­ing – and thereby the liveli­hood – of legit­i­mate researchers engaged in research that oth­er­wise meets inter­na­tional eth­i­cal stan­dards for research with human subjects,

AND

  • sanc­tions and pre­vents unscrupu­lous rodents from prac­tic­ing treat­ment modal­i­ties unproven to be help­ful and demon­strat­edly proven not to harm patients, in defi­ance of inter­na­tional stan­dards of the eth­i­cal treat­ment of human subjects.

Life, some­times, is a series of trade­offs. I for one, am ter­ri­bly dis­mayed that it appears that yet another moral issue of our time has made its first steps to being decided in a court­room; not by clin­i­cians, by clergy, by ethi­cist, by “con­sumers,” by “vic­tims,” or those who park their cars. By “impar­tial tri­ers of fact,” fact as I have pre­sented it, or fact as the other guy presents it. I was sit­ting on the front steps dis­cussing this with my neigh­bor – an attor­ney, whose father was the first attor­ney for Apple Com­puter – and she said, “This is as it should be! This is our democ­racy. The leg­isla­tive process will be cor­rec­tive as is nec­es­sary.” “And the court will over­turn it.” “And we’ll keep doing it until we get it right! It’s beau­ti­ful.” “I can’t think that dif­fer­ent.” I hope to live so long.


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