I am writing in support of Guidance Document 115-10: Guidance on conversion therapy. “Homosexuality,” or same-sex attraction and partnership, has not been listed as a diagnosable psychiatric condition since 1973. Still, social stigma and mainstream narratives about how humans ought to be in consensual relationship (romantic, sexual) with other humans continues to contribute to pathologizing of non-heterosexual identities, and LGBTQ+ youth are vulnerable to these narratives and judgements. LGBTQ+ youth are three times as likely as their non-LGBTQ+ peers to report suicidality and are six times more likely to experience depression than the general population (Marshal et al., 2011; NAMI, 2019). This already vulnerable population should not be subject to ineffective and harmful treatments like conversion therapy. Research on conversion therapy from peer-reviewed literature released by the American Psychiatric Association, the American Psychological Association, and the American Academy of Child and Adolescent Psychiatry has shown no evidence that conversion therapy is effective in changing sexual identity, and other peer-reviewed journals have published evidence that this treatment is harmful (Drescher, 2016).
Certainly, mental health professionals may encounter clients who are interested in changing their sexual identity, and yet mental health professionals would do well to wonder about the why of this request. LGBTQ+ youth often experience “minority stress,” which, according to NAMI (2019) are disparities in this community, made from a combination of “social stigma, discrimination, prejudice, denial of civil and human rights, abuse, harassment, victimization, social exclusion and family rejection.” This minority stress may be a primary factor in a young person’s desire to change their sexual identity, since humans are wired to be in connection with others, and the components of minority stress, as listed above, produce considerably disconnected experiences.
Before engaging in treatment, it is important for mental health professionals to understand the context in which a client is experiencing distress, and certainly if that distress is societally-inflicted and not due to the fault of the client of interest (which is how I, as an emerging mental health counselor, conceptualize difficulty related to sexual identity in clients I see), it would be important to instead treat the distress in a way that is affirmative, empowering, and healing. As the American Counseling Association (2013) states in “Ethical issues related to conversion or reparative therapy,” counselors are ethically bound to share information about potential treatments and must have expertise and training in the treatment methods they utilize. Since there is no ACA-approved training or certification for conversion therapy, a counselor engaging in conversion therapy is not acting within the ethical code for the profession, and counselors who are being asked to provide referrals for a therapist who offers conversion therapy are bound by the ethical code of the profession to share this information with the client prior to a referral, as well. I encourage anyone within the field of professional counseling, mental health, and the helping professions to read the ACA statement on conversion therapy to clarify how the counseling profession views conversion therapy, located here: https://www.counseling.org/news/updates/by-year/2013/2013/01/16/ethical-issues-related-to-conversion-or-reparative-therapy