Substance Abuse and Mental Health Services Administration Calls for End of "Ex-Gay" Therapy (SAMHSA)

As long time readers know, I am a vocal opponent to "ex-gay" therapy or "conversion therapy" and believe that the practice needs to be banned nationwide, especially for minors.  While I never underwent formal "ex-gay" therapy myself, for many, many years I tried to "pray away the Gay" and try to change my attractions.  I never changed, but I was filled with self-hate and self-loathing and believed that it was my fault that I did not "change."  The result? Years of inner unhappiness and constant thoughts of suicide.  Nowadays, all legitimate medical and mental health associations condemn "ex-gay" therapy and hold that it does not work and has the potential for great harm.  The take away? Those who push or engage in administering "ex-gay" therapy are delusional, charlatans or both.  Now, the  Abuse and Mental Health Services Administration has upped the stakes and called for a nationwide ban of "ex-gay" therapy.  Here are highlights from the Administration's press release:

The Substance Abuse and Mental Health Services Administration (SAMHSA) is releasing “Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth,” a comprehensive report that provides an in-depth review of research and clinical expertise related to conversion therapy.  This important new resource makes it clear that conversion therapy is not an appropriate therapeutic approach based on the evidence, and explores alternative ways to discuss sexual orientation, gender identity, and gender expression with young people.

This report includes the first publication of consensus statements developed by an expert panel held by the American Psychological Association in July 2015.  The expert panel included researchers and practitioners in child and adolescent mental health with a strong background in gender development, gender identity, and sexual orientation in children and adolescents.  Experts with a background in family therapy, ethics, and the psychology of religion also participated.

Through a collaborative process, this panel found that variations in sexual orientation and gender identity are normal, and that conversion therapies or other efforts to change sexual orientation or gender identity are not effective, are harmful, and are not appropriate therapeutic practices.  The report provides an overview of existing efforts to eliminate the practice of conversion therapy.

The information and resources contained within the report include a review of the research in this area, detailed information on supportive therapeutic approaches, areas of opportunity for future research, existing strategies to end the practice of conversion therapy, and targeted guidance for various audiences.

These materials help providers, families, and care-givers support their LGBTQ and gender non-conforming children and adolescents.  They also illuminate practices that may contribute to the health disparities facing LGBTQ youth, which should be avoided.

The full report can be found here.  Here are a few important findings:

[C]onversion therapy—efforts to change an individual’s sexual orientation, gender identity, or gender expression —is a practice that is not supported by credible evidence and has been disavowed by behavioral health experts and associations. Conversion therapy perpetuates outdated views of gender roles and identities as well as the negative stereotype that being a sexual or gender minority or identifying as LGBTQ is an abnormal aspect of human development. Most importantly, it may put young people at risk of serious harm.

Eliminating the practice of conversion therapy with sexual and gender minority minors is an important step, but it will not alleviate the myriad of stressors they experience as a result of interpersonal, institutional, and societal bias and discrimination against sexual and gender minorities.

Interventions aimed at a fixed outcome, such as gender conformity or heterosexual orientation, including those aimed at changing gender identity, gender expression, and sexual orientation are coercive, can be harmful, and should not be part of behavioral health treatments. 

The ban needs to be nationwide and there need to be NO exceptions for quack religious based "ministries."  I would go even farther and advocate that submitting one's child to "ex-gay" therapy should be grounds for the termination of parental rights.  There should be no exceptions and no undeserved deference to "deeply held religious belief."   

Coming Out: When Parents Are the Enemy

I have several younger friends who has not come out to their parents.  Why?  Because of fear about how their parents - most of whom are described as "deeply religious" - will react.  Meanwhile, as more and more LGBT individuals come out and refuse to live in the closet, especially in their private lives, these individuals face an increasingly daunting prospect of finding enduring relationships because fewer and fewer of us are willing to be someone's "dirty secret."   The suicide death of Leelah Alcorn has focused a spot light on the deadly results of parents becoming the enemy of their child, usually as they cling to ignorance embracing religion or their own concerns over how people will perceive them for having an gay child.  To me, it's the height of parental selfishness.  An op-ed in The Advocate looks at the problem faced by those whose parents are their enemies and the failure of the justice system to protect LGBT youth.  Here are highlights:

A couple of weeks ago, Leelah Alcorn, a 17-year-old transgender girl, walked in front of a tractor-trailer on an Ohio interstate in the middle of the night. She left behind a prescheduled-to-post suicide note on her Tumblr page (which has since been deleted, presumably by her family) that explained in explicit detail the abuse she had experienced at the hands of her parents. 

I don't think I will ever forget how it felt to be surrounded by adults who told 17-year-old me that I was "wrong" and that the most important thing was that I be "normal." These adults were the usual suspects — my mother, the adult friends I spent six months living with after I ran away from home — but most disturbingly, I was told I was wrong by the adults put in place by the system to protect me. My "victim's advocate" assigned to me by the court after my mother pled guilty to felony assault, explicitly blamed me for the violence in childhood home.

Even today, nearly 15 years later, queer youth are being told the same damaging messages about themselves that I heard, and those words are killing them.

For LGBTQ people, our parents are often the enemy. This is particularly true for LGBTQ youth, who are generally legally dependent upon their abusers for food, shelter, and other basic needs. Domestic violence survivors and advocates have done incredible work educating about how damaging and dangerous it is to encourage survivors to maintain relationships with or stay living with their abusers, it's past time for us to share the same messages about LGBTQ youth and abusive parents.  It has been refreshing amid the sadness of the last week, to hear queer activists and advocates publicly acknowledge that parents are the problem and not the answer, and that transgender youth should be removed from homes where they are unsafe due to unaccepting and abusive parents. But where will they go?

It is impossible for us to truly understand Leelah's suicide, the dangers of reparative therapy on the lives of LGBTQ youth, unless we understand the intersectionality of child/adolescent abuse, reparative therapy, dysfunctional foster care systems where LGBTQ youth aren't safe, and the epidemic of LGBTQ youth homelessness. It is one thing for us to demand that transgender youth be removed from unaccepting and abusive homes, it's another to provide the services they need not only to survive, but to thrive.

[W]e must remember that 40 percent of all homeless youth across the country identify as LGBTQ. LGBTQ youth homelessness is not just a problem in large urban environments. Although LGBTQ youth run away and are pushed out of homes in every region in this country, many cities and communities (like the county I'm from) don't have any youth shelter beds, let alone any that are culturally appropriate for LGBTQ youth. 

It is not enough to ban conversion therapy and to pay lip service by saying that transgender youth shouldn't live in homes where they are abused. We must open our hearts, our homes, and our wallets. We must work in partnership with youth to create LGBTQ youth centered programs that will care for them, and we ourselves must care about them too — while they are still alive.

We must make Leelah's final haunting words were a heartbreaking call to action.

There is much work to be done, including making adherents of conservative, anti-gay religious belief utterly unacceptable in society.