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.”
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:
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.
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,
- 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.