By Margie Nichols, Ph.D.
California just passed a law, SB 21172, making it illegal to practice ‘conversion therapy’ – the attempt to convert a homosexual to a heterosexual orientation – on minors. Few people understand the importance of this law, not only for gay teens, but also for all trans and gender nonconforming children, some of whom are as young as four when brought for treatment.
And last week State Assemblyman Tim Eustace, openly gay representative from Bergen County, said he would introduce a similar bill in New Jersey. If he does and it is passed, New Jersey will be the second state, after California, to ban this dangerous therapy. He’s framing the bill as protecting children from abuse, and he’s right.
Before I explain why, let me explain a little of the history of psychiatry’s relationship to sexual minorities. Since the late 1800’s, psychiatrists considered all forms of unusual sexual behavior and gender expression automatically ‘sick,’ in need of ‘treatment.’ The perception of gay people as mentally ill stood in the way of many other rights, so much so that after Stonewall in 1969 psychiatrists were one of the first groups targeted for political action. And in 1973 the activists succeeded: by a 51-49% vote, psychiatrists removed homosexuality from the Diagnostic and Statistical Manual – DSM- the ‘Bible’ of mental disorders. Although even the ‘liberal’ psychiatrists didn’t actually think being gay was normal, they did agree – barely- that it wasn’t a ‘mental illness,’ and therefore not in need of treatment. The impact of the DSM change was enormous. Almost immediately, the forced hospitalizations, drugging, and electroshock aversive therapies commonly used to ‘treat’ homosexuality were discontinued. The behaviorist John Bancroft even expressed his regrets publicly and admitted his treatments had failed.
And that, the gays thought, was that- diagnostic removal, treatment over. But attempts to cure same-sex sexual orientation never totally died, and they were revived with gusto by the Christian Right during the anti-sex backlash of the 80’s and 90’s. Still, reparative therapy may have become an oddity in the millennium but for psychiatrist Robert Spitzer, ironically an early supporter of the 1973 DSM removal. In 2003 his paper claiming that reparative therapy could change sexual orientation was published without peer review in the prestigious journal, Archives of Sexual Behavior. Spitzer’s study gave credibility to the Christian fundamentalist ‘ex-gay’ movement, and it grew exponentially.
For the last nine years the issue of the effectiveness, and the ethics, of conversion therapy has been hotly debated. In 2009 the American Psychological Association undertook a review of all research on so-called ‘ex-gay,’ ‘conversion,’ or ‘reparative therapy. They concluded that there was no evidence that such therapy is effective, and some research suggesting that it was harmful.
The evidence that conversion therapies harm is accumulating. There are higher than normal rates of depression and suicide among those who undergo it, for example. This makes sense: the ‘reparative therapy’ model contends that sexual orientation is not inborn. Clients are told that their orientation is the result of bad parenting , that is it not ‘natural’ to them, and that it is under their control. They are convinced that ‘giving in’ to urges is sinful – and willful. What better way to inculcate self-hatred and despair than to tell someone they can change when they can’t, and then tell them they’ll burn in Hell if they don’t change?
And now we have evidence, research that has come out in the last year,that damns this treatment from another angle (read more here). We know, for example, that the LGBTQ people with the highest rates of depression and other mental problems are the ones who are gender-nonconforming, especially gender-nonconforming young males. We know these kids are more likely to be abused and abandoned by parents and bullied outside the family, and that the bullying, harassment, and abuse from school and peers explains their mental unbalance. We know that the more they are expected to live up to gender stereotypes – ‘act like a boy’ or ‘act feminine’ – the more depressed they get. And we know that parents who support and validate their LGBTQ children, who affirm their uniqueness instead of urging them to change, can shield their children from the insults of the outside world.
In the past few years, the American Psychological Association, along with virtually all professional associations in mental health, have condemned conversion therapy as unethical.
In 2012 Gabriel Arana published an online memoir of his experienced with ‘ex-gay’ treatment – and in the process got Robert Spitzer to recant and apologize for his 2003 paper. He now believes sexual orientation can’t be changed. (Read about this here )
And Saturday California became the first state to make conversion therapy with minors illegal.
Why is this so important? Because children, as our research shows, are particularly at risk from any therapy that tells them that ‘who they are’ is wrong. Kids need to be visible, and to feel secure that they are loved for who they are. Being attracted to people of the same sex is not a voluntary behavior, and it cannot be voluntarily eliminated, and that is why attempts to cure young people of their orientation is cruel.
And there is another lesser known form of ‘conversion therapy’ going on with kids even younger than the ones treated for their expressed gayness, kids so young they often don’t know who they are attracted to. These children who, as young as toddlers, behave in ways society doesn’t consider appropriate for their assigned gender. Sometimes they express a wish or a belief that they are the ‘other’ gender. Sometimes they just violate our expectations of how little boys and little girls ‘should’ act- the girl who wants short hair and rebels against dresses, the boy who loves dolls and make-up. And they are being preventatively treated with therapy aimed at making them gender conforming. For many years, the standard protocol for these children was behavioral therapy aimed at pressuring the young person into gender conformity. The rationale was that this was the way to prevent the child from growing up to be gay or transgender. The man who developed this type of treatment is a psychologist named Kenneth Zucker – ‘throw away the Barbies’ Zucker he is sometimes called. And coincidentally, Zucker is the guy who published Spitzers 2003 study defending conversion therapy – without peer review.
More and more, this type of treatment of gender nonconforming children- preventative conversion therapy – is widely condemned as unethical by progressive mental health groups. But it is still practiced. Uninformed parents are convinced that the treatment can be successful and that it carries no risk. And But, like the treatment aimed at slightly older children who have ‘come out’ as gay, it inculcates deep shame, self-hatred, and despair in the kids who are subjected to it. Imagine being told that all your likes and dislikes, desires, even the way you physically move, is bad. And imagine being told that by your parents, your therapist, and every other adult around you that this is true, that you can control your behavior – and that you should hide a big part of your authentic self.
If that’s not abuse, I don’t know what is. The practitioners of gay conversion therapy are mainly Christian fundamentalists. The therapists who practice preventative conversion treatment are not – they are Zucker and his colleagues, the old guard dinosaurs of the field. But these guy still wield tremendous power, and the only thing that will make them desist is the threat of loss of professional status – and loss of income.
So I’m sad to say that I believe that the only thing that will eradicate conversion therapy of minors is legislation. We need the California legislation in New Jersey. We need it everywhere. We need it to protect our kids from abuse- and from a lifetime of struggle to heal their psychic wounds.