In 2013 California and New Jersey passed laws that ban licensed mental health providers from offering sexual orientation change efforts (SOCE) to minors. Massachusetts, Pennsylvania, Ohio, New York, Minnesota and Maryland are considering similar legislation. Recently, however, this legislation died in the Virginia House, and a stay was imposed in California pending review by the Supreme Court of the United States.
To be clear, the present debate concerns banning voluntary (not coerced) SOCE by professionals for minors who are distressed by their unwanted homosexual feelings. Support for this ban is based upon four claims. First, that sexual orientation is a fixed, inborn trait. Secondly, that homosexual attractions experienced during adolescence are enduring. Thirdly, that homosexual behavior carries no increased health risks as compared to heterosexual behavior, and finally, that scientific research proves SOCE is universally harmful. None of these claims, however, is based in science.
Homosexuality is not innate
Identical twins share exactly the same genetic makeup and are exposed to the same pre-natal hormones. If homosexuality were genetic like race or determined by pre-natal hormones alone, then identical twins would have the same sexual orientation 100% of the time. Instead, at most, identical twins are both homosexual only 20% of the time.1 Dr. Francis Collins, former director of the Human Genome Project, summed it up best when he wrote sexual orientation “is not hardwired by DNA, and whatever genes are involved represent predispositions, not predetermination.”2
The American Psychiatric Association acknowledges that “[s]ome people believe that sexual orientation is innate and fixed; however, sexual orientation develops across a person’s lifetime.”3 The psychodynamic and social learning theories of homosexuality have never been disproven. There is good evidence that parental and social influences, including childhood trauma, can contribute to SSA for some.4,5, These adolescents have the right to therapy for their trauma, they do not deserve the added trauma of being legislated into a false sexual identity.
During adolescence homosexual attractions are more fluid than fixed
Adolescence is well recognized for its sexual fluidity and instability of homosexual attractions. In 2007, Savin-Williams and Ream conducted a large longitudinal study that documented changes in attraction so great between the ages of 16 and 17 that they questioned whether the concept of sexual orientation had any meaning for adolescents with homosexual attractions. Seventy-five percent of adolescents who had some initial homosexual attraction between the ages of 17-21 changed to experience heterosexual attraction only.6 This is in stark contrast to the stability they found among adolescents experiencing heterosexual attractions. Among these adolescents, fully 98% retained their heterosexual-only attractions into adulthood.7 Another study demonstrating significant change away from homosexual attractions in adolescence involved 13,840 youth. Of those initially “unsure” of their sexual orientation, 66% became exclusively heterosexual.8
No studies have examined the success rates of SOCE among adolescents. Logically, however, if such high rates of change in homosexual attraction occur adventitiously, many adolescents who desire therapeutic assistance should succeed.
Reason to Seek SOCE: Homo/Bi-sexual Behavior Carries Grave Health Risks
There are many reasons for adolescents, especially males, who are distressed by unwanted homosexual attractions to seek therapy. According to the CDC, from 2006-2009, young men who have sex with men aged 13-24 years had the greatest percentage increase in diagnosed HIV infections of all age groups.9 Among all adolescent males aged 13-24 years, approximately 91% of all diagnosed HIV infections were from male-to-male sexual contact.10 This is because receptive anal intercourse is 20 times more risky than receptive vaginal intercourse.11
Moreover, compared with heterosexual youth, non-heterosexual youth are at increased risk (by a median of 76% if bisexual; 63.8% if homosexual) for contracting other sexually transmitted infections, using tobacco, alcohol and other drugs, and engaging in behaviors that contribute to violence, depression and suicide.12
There is no scientific proof of harm from therapeutically assisted SOCE
No therapy is free from harm. Regarding all forms of psychotherapy for any given condition a surprisingly high 14-24% of children deteriorate during psychotherapy.13 There is not one study demonstrating that SOCE causes harm greater than or even equal to this baseline level.14 The research cited as “proving” universal harm from SOCE is a 2002 study by Shidlo and Schroeder even though the authors themselves never made such a claim. Instead, they stated: “[This study does] not provide information on the incidence and prevalence of failure, success, harm, help or ethical violations in conversion therapy [i.e., SOCE].”15 However, there are a number of surveys of individuals who have experienced positive outcomes from SOCE.16,17,18,19
Anti-SOCE claims have no basis in science. Therefore, the American College of Pediatricians and the National Association for Research and Therapy of Homosexuality insist that adolescents retain their right to choose SOCE with full informed consent under the care of experts in the field.
1 Collins, F. The Language of God: A Scientist Presents Evidence for Belief. New York. Free Press. 2007 (p.260).
2 Ibid. p.263.
3 American Psychiatric Association fact sheet available from: http://www.psychiatry.org/mental-health/people/lgbt-sexual-orientation [accessed February 13, 2014].
5 Alanko, K., Santitila, P., Sato, B., Jem, P., Johansson, A., et al. (2011). Testing causal models of the relationship betwen childhood gender atypical behavior and parent-child relationship. British Journal of Developmental Psychology, 29, 214-233. doi: 10.1348/2044-835X.002004
6 Savin-Williams, RC and Ream, GL (2007), Prevalence and Stability of Sexual Orientation Components During Adolescence and Young Adulthood, Archives of Sexual Behavior, 36, 385-394.
8 Ott, MQ, Corliss, HL, et. al. (2011), Stability and Change in Self-Reported Sexual Orientation Identity in Young People: Application of Mobility Metrics, Archives of Sexual Behavior, June; 40(30): 519-532. Published online 2010 December 2. doi: 10.1007/s10508-010-9691-3
9 http://www.cdc.gov/healthyyouth/sexualbehaviors/pdf/hiv_factsheet_ymsm.pdf [accessed February 12, 2014].
11 Grossman, M. (2009) You’re Teaching My Child What? Regnery Publishing, Inc. Washington, DC , p. 87
12 Kann, L., Olsen, E., et.al. “Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9-12 — Youth Risk Behavior Surveillance, Selected Sites, United States, 2001-2009.” MMWR/June 6, 2011/Vol. 60
13 Lambert (2011). Psychotherapy research and its achievements. In J.C. Norcross, G.R. VandenBos, & D.K. Freedheim (eds.), History of psychotherapy: Continuity and change (2nd ed., pp. 299-332).
14 Rosik, C. “The (Complete) Lack of a Scientific Basis for Banning Sexual-Orientation Change Efforts with Minors” available from: http://www.narth.com/#!narth-analysis-of-soce-ban/c1q8f [accessed February 13, 2014].
15 Shidlo, A., & Schroeder, M. (2002). Changing sexual orientation: A consumers’ report. Professional Psychology: Research and Practice, 33(3), 249-259.
16 Santero, P., Whitehead N., Ballasteros, (2014) Change Effects in U.S. Men with Unwanted Same-Sex Attraction after Therapy. Psychological Reports (in process; personal communication w/ Dr. Whitehead February 3, 2014).
17 Karten, EY and Wade, JC (2010). Sexual Orientation Change Efforts in Men: A Client Perspective. Journal of Men’s Studies. 18, 84-102.
18 Spitzer, R.L. (2003). Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation. Oct;32(5):403-17; discussion 419-72.