Opinions of Professional Organizations Do Not Establish Science

Vulnerable youth and their parents should be able to seek the help they need without interference from the government. The Alliance for Therapeutic Integrity (previously called NARTH) conducted a review of 125 years of research and clinical experience—one of the most extensive reviews ever undertaken. This research shows unequivocally that many people with unwanted same-sex attraction can, and do, change their sexual orientation, and, of those who do not change, most still greatly benefit from therapy that helps them cope with their unwanted same-sex attractions. Unethical and abusive practices are already prohibited by law.

Further, a 2009 American Psychological Association Task Force report concludes that there is no proof of harm from “Sexual Orientation Change Efforts (SOCE).”   Although another part of the APA report states that SOCE therapy could be harmful, it also indicates the evidence is inconclusive on the matter. Yet, this same 2009 APA report is one of the primary “studies” that therapy ban activists use in legislatures to claim that therapy has been proven to cause actual harm. Notwithstanding the lack of evidence of harm, activists cherry-pick the parts of the report that support their bias. Moreover, it should also be noted that every APA doctor selected to be on that APA task force was gay except for one who was a LGBT-affirmative therapist. There is no need to limit the choices of youth and their parents based on hypothetical concerns.

Thousands of therapists and doctors have left the larger “mainstream” professional organizations that have abandoned the principle of self-determination to form their own organizations that more accurately communicate what the research shows in these areas. These organizations include the American College of Pediatricians and the Alliance for Therapeutic Integrity, which have issued strong statements opposing bans like the one Virginia is considering.

Claims of Harm from Non-Abusive Therapy Are Groundless

Advocates of limiting the choices of vulnerable youth and their parents argue that allowing choice in how to respond to same-sex attractions or concerns about sexual identity causes suicide. Suicide is a tragedy that all must work to prevent. Unsupported and simplistic claims about what leads to suicide do not make the situation better. Research does not, and probably cannot sort out causation.

In fact, there has been almost no research on this point and what has been conducted involves self-selected participants, no control groups and other methodological limitations. The most recent survey claims a heightened risk for those who seek help to live consistent with their biological sex but is based on reports of individuals who seek help after suicidality, totally undercutting any claim that the therapy was the cause.

Some states have made it illegal for vulnerable youth and their parents to seek the help they determine would be best when experiencing same-sex attractions or sexual-identity challenges. There is no evidence that these states have seen drops in their teen suicide rates as a result. This is not surprising because suicide is affected by many factors. The tragedy of youth suicide should not be a political tool to gain an advantage in public debates.

Although much is made of the states that have passed laws to preclude vulnerable youth and their parents from seeking the help they choose when their choice is inconsistent with currently popular notions in some circles, little attention has been paid to the fact that 24 states have rejected laws that would have done the same thing: Arizona, Colorado, Florida, Georgia, Iowa, Idaho, Indiana, Kentucky, Massachusetts, Maine, Michigan, Minnesota, Missouri, North Carolina, Nebraska, Ohio, Oklahoma, Pennsylvania, Texas, Utah, Virginia, Wisconsin, West Virginia, and Wyoming.

Research Counsels Caution with Supporting Gender Transition

Research shows that as many as 88% of girls and up to 98% of boys who experience gender dysphoria—significant discomfort with living consistently with their biological sex will eventually decide to live consistent with that sex. This proposal would, strangely, prohibit vulnerable youth and their parents form seeking help to ensure they make this choice successfully, while only allowing treatment aimed at increasing their discomfort and embracing the notion that they should seek radical treatment to change appearance that may be difficult to reverse and may have lifetime medical and psychological ramifications.

There is strong evidence that vulnerable youth who decide to pursue so-called “sex change” treatment are at heightened risk for poor mental health outcomes. A study of “324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden” and looked at conditions for those who had been “reassigned.” The study found “overall mortality for sex-reassigned persons was higher during follow-up than for controls of the same birth sex, particularly death from suicide. Sex-reassigned persons also had an increased risk for suicide attempts.” Cecilia Dhejne, et al., Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden, 6 PLOS ONE e16885 (2011).

Claims of increased risk experienced by vulnerable youth who seek help to live consistent with their biological sex do not typically mention that as many as 70 percent of patients with gender dysphoria have an additional psychiatric condition (comorbidity), which makes them much more susceptible to suicidal ideation, regardless of what kind of therapy they receive. Studies also show that that the very high suicide rate (as high as 19 times greater than the general population), is not significantly reduced by cross-sex surgery and hormone treatment and does not relieve many of the problems experienced by individuals with gender confusion. This proposal endorses one type of treatment—encouraging identification with the opposite-sex—despite evidence suggesting this is unlikely to address underlying concerns or to decrease risks to physical and mental health.

This Proposal Raises Serious Legal Concerns

Courts recognize that laws can have a chilling effect on free speech. Imagine a vulnerable youth who may be the victim of sexual abuse or bullying and whose concerned parents seek help from a therapist. Under this proposed law, a therapist who would otherwise be willing to help this youth to heal and live consistent with her deeply-held beliefs would surely be more hesitant to do so for fear of running afoul of this vague prohibition. 

While some courts have upheld laws that limit the therapeutic choices of vulnerable youth and their parents, there is reason to believe that such bans might not be constitutional. At least one trial court in Florida has noted the free speech implications of such a law. The Supreme Court has recently rejected the idea that licensed professionals have more limited rights of speech than other citizens, undercutting the rational for some of the cases upholding bans on choice in therapy. See Nat'l Inst. of Family & Life Advocates v. Becerra, 138 S. Ct. 2361, 2371–72 (2018) (abrogating Pickup v. Brown, 740 F.3d 1208 (2014) and King v. Governor of the State of New Jersey, 767 F.3d 216 (2014). Adopting this proposal would open Virginia to free speech litigation.