BILL NUMBER: SB 1172	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 16, 2012
	AMENDED IN SENATE  APRIL 9, 2012

INTRODUCED BY   Senator Lieu

                        FEBRUARY 22, 2012

   An act to add Article 15 (commencing with Section 865) to Chapter
1 of Division 2 of the Business and Professions Code, relating to
healing arts.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1172, as amended, Lieu. Sexual orientation change efforts.
   Existing law provides for licensing and regulation of various
professions in the healing arts, including physicians and surgeons,
psychologists, psychiatric technicians, marriage and family
therapists, educational psychologists, clinical social workers, and
licensed professional clinical counselors.
   This bill would prohibit psychotherapists, as defined, from
performing sexual orientation change efforts, as defined, in the
absence of informed consent of the patient  , which is to be
provided on a form developed by the State Department of Mental Health
 .  The bill would require a specified statement to be
included on the informed consent form.  Informed consent would
not be effective for patients under 18 years of age.  The
bill would require the department to prepare and disseminate an
informational brochure on sexual orientation change efforts. The bill
would require a psychotherapist who performs sexual orientation
change efforts to report certain data to the department, which would
be required to summarize this information in an annual report.
 The bill would provide for a cause of action against
psychotherapists by patients  or   , 
former patients  , or certain other persons  in specified
cases.
   Vote: majority. Appropriation: no. Fiscal committee:  yes
 no  . State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    The Legislature finds and declares all
of the following:  
   (a) An individual's sexual orientation, whether homosexual,
bisexual, or heterosexual, is not a disease, disorder, illness,
deficiency, or shortcoming. The major professional associations of
mental health practitioners and researchers in the United States have
recognized this fact for nearly 40 years.  
   (b) Sexual orientation change efforts pose critical health risks
to lesbian, gay, and bisexual people, including confusion,
depression, guilt, helplessness, hopelessness, shame, social
withdrawal, suicidality, substance abuse, stress, disappointment,
self-blame, decreased self-esteem and authenticity to others,
increased self-hatred, hostility and blame toward parents, feelings
of anger and betrayal, loss of friends and potential romantic
partners, problems in sexual and emotional intimacy, sexual
dysfunction, high-risk sexual behaviors, a feeling of being
dehumanized and untrue to self, a loss of faith, and a sense of
having wasted time and resources. This is documented by the American
Psychological Association Task Force on Appropriate Therapeutic
Responses to Sexual Orientation in its 2009 Report of the Task Force
on Appropriate Therapeutic Responses to Sexual Orientation. 

   (c) Recognizing that there is no evidence that any type of
psychotherapy can change a person's sexual orientation and that
sexual orientation change efforts may cause serious and lasting
harms, the American Psychiatric Association, the American
Psychological Association, the American Counseling Association, the
National Association of Social Workers, and the American Academy of
Pediatrics uniformly oppose efforts to change the sexual orientation
of any individual.  
   (d) Minors who experience family rejection based on their sexual
orientation face especially serious health risks. In one study,
lesbian, gay, and bisexual young adults who reported higher levels of
family rejection during adolescence were 8.4 times more likely to
report having attempted suicide, 5.9 times more likely to report high
levels of depression, 3.4 times more likely to use illegal drugs,
and 3.4 times more likely to report having engaged in unprotected
sexual intercourse compared with peers from families that reported no
or low levels of family rejection. This is documented by Caitlyn
Ryan et al. in their article entitled Family Rejection as a Predictor
of Negative Health Outcomes in White and Latino Lesbian, Gay, and
Bisexual Young Adults (2009) 123 Pediatrics 346.  
   (e) California has a compelling interest in protecting the lives
and health of lesbian, gay, and bisexual people. 
   SECTION 1.   SEC. 2   . 
Article 15 (commencing with Section 865) is added to Chapter 1 of
Division 2 of the Business and Professions Code, to read:

      Article 15.  Sexual Orientation Change Efforts


   865.  For the purposes of this article, the following terms shall
have the following meanings:
   (a)  "Department" means the State Department of Mental
Health. 
   (b)    "Informed consent" means
consent that is  voluntarily  provided in writing by a
patient to a psychotherapist with whom the patient has a therapeutic
relationship. The informed consent must explicitly manifest the
patient's  voluntary informed consent  
agreement  to sexual orientation change efforts  and include
a statement  as set forth in Section 865.1.  Consent that
is provided as a result of therapeutic deception or duress or
coercion is not informed consent.  
   (c) 
    (b)  "Psychotherapist" means a physician and surgeon
specializing in the practice of psychiatry, a psychologist, a
psychological assistant, a psychiatric technician, a marriage and
family therapist, a registered marriage and family therapist, intern,
or trainee, an educational psychologist, a licensed clinical social
worker, an associate clinical social worker, a licensed professional
clinical counselor, or a registered clinical counselor, intern, or
trainee. 
   (d) 
    (c)  "Psychotherapy" means the professional assessment,
evaluation, treatment, or counseling of a mental or emotional
illness, symptom, or condition by a psychotherapist. 
   (e) 
    (d)  "Sexual orientation change efforts" means
psychotherapy aimed at altering the sexual or romantic desires,
attractions, or conduct of a person toward people of the same sex so
that the desire, attraction, or conduct is eliminated or reduced or
might instead be directed toward people of a different sex. It does
not include psychotherapy aimed at altering sexual desires,
attractions, or conduct toward minors or relatives or regarding
sexual activity with another person without that person's consent.

   (f) 
    (e)  "Therapeutic deception" means a representation by a
psychotherapist that sexual orientation change efforts are endorsed
by leading  psychological   medical and mental
health  associations or that they can or will reduce or
eliminate a person's sexual or romantic desires, attractions, or
conduct toward another person of the same sex. 
   (g) 
    (f)  "Therapeutic relationship" means the relationship
that exists during the time the patient receives psychotherapy.

   (h) 
    (g)  "Leading  psychological  
medical and mental health  associations" means the American
Psychiatric Association, the American Psychological Association, the
American Counseling Association, the National Association of Social
Workers, and the American  Academy of  Pediatrics 
Association  .
   865.1.  (a)  Sexual   No psychotherapist
shall engage in sexual  orientation change efforts 
shall not be engaged in absent   without first obtaining
the patient's  informed consent to therapy  by the
patient  as prescribed in subdivision (b).
   (b) To obtain informed consent, a treating psychotherapist shall
provide a patient with  a form to be signed by the patient that
provides informed consent. The form shall include  the following
 information prior to engaging in sexual orientation change
efforts, on a form prescribed by the department  
statement  : 
   (1) The reason or reasons for recommending the use of sexual
orientation change efforts, including, but not limited to, the nature
and seriousness of the patient's mental illness, disorder, or
condition leading to the recommendation.  
   (2) The nature of the procedures to be used in the sexual
orientation change efforts and the anticipated frequency and duration
of the sexual orientation change efforts.  
   (3) The probable degree and duration, either temporary or
permanent, of improvement to the patient's mental illness, disorder,
or condition expected as a result of sexual orientation change
efforts. 
   (4) The nature, degree, duration, and the probability of the risks
and side effects that may be attributable to sexual orientation
change efforts.  
   (5) The views of leading psychological associations on sexual
orientation change efforts.  
   (6) A list of all reasonable alternative treatments and why the
psychotherapist is recommending sexual orientation change efforts
over these alternative treatments.  
   (c) At the time a psychotherapist provides the patient with the
informed consent form, as prescribed in subdivision (b), the patient
shall also receive a copy of the informational brochure disseminated
by the department as described in subdivision (c) of Section 865.2.



   "Having a lesbian, gay, or bisexual sexual orientation is not a
mental disorder. There is no scientific evidence that any types of
therapies are effective in changing a person's sexual orientation.
Sexual orientation change efforts can be harmful. The risks include,
but are not limited to, depression, anxiety, and self-destructive
behavior.  
   Medical and mental health associations that oppose the use of
sexual orientation change efforts include the American Medical
Association, the American Psychological Association, the American
Psychiatric Association, the National Association of Social Workers,
the American Counseling Association, the American Academy of
Pediatrics, and the American Association for Marriage and Family
Therapy." 


   865.2.  (a)  (1)   Under no
circumstances shall a patient under 18 years of age undergo sexual
orientation change efforts, regardless of the willingness of a
patient's parent, guardian, conservator, or other person to authorize
such efforts. 
   (2) 
    (b)  The right to refuse sexual orientation change
efforts is not waived by giving informed consent and that consent may
be withdrawn at any time prior to, during, or between sessions of
sexual orientation change efforts. 
   (3) 
    (c) Any act of duress or coercion by any person or
facility shall invalidate the patient's consent to sexual orientation
change efforts. 
   (b) (1) A psychotherapist who performs sexual orientation change
efforts shall file a report with the department setting forth the
data required by paragraph (2). An institution in which sexual
orientation change efforts are performed shall be the reporting
entity for all sexual orientation change efforts treatments performed
at that institution.  
   (2) The following detailed information for each reporting period
shall be made on forms prescribed by the department within 30 days
after January 1 and July 1 of each year:  
   (A) The total number of patients who received sexual orientation
change efforts.  
   (B) Information regarding each patient who received or continued
to receive sexual orientation change efforts, including all of the
following:  
   (i) Diagnosis. 
   (ii) Duration of sexual orientation change efforts and frequency
of therapeutic visits.  
   (iii) Age, sex, and ethnicity of the patient.  
   (iv) Whether the patient was capable of giving his or her written
informed consent.  
   (v) Whether any complications resulted from sexual orientation
change efforts, such as insomnia, anxiety, depression, loss of
appetite, loss of employment, suicidality, or death. 

   (vi) Whether any preexisting conditions related to the patient's
mental or emotional health were exacerbated or otherwise affected by
the sexual orientation change efforts.  
   (vii) The method of payment for the sexual orientation change
efforts and, if applicable, the name of the insurance company making
those payments.  
   (viii) Any other information required by the department by
regulation, except as provided in paragraph (3).  
   (3) The name of the patient receiving sexual orientation change
efforts shall remain confidential information. No state agency,
employee, or agent shall require release of the identity of any
person subjected to sexual orientation change efforts. The forms
prescribed by paragraph (2) shall not require any information that
would disclose, directly or indirectly, the identity of the patient.
 
   (4) The department shall prepare and publish an annual written
report summarizing the information received under this section. The
report shall not contain any information that identifies or tends to
identify any facility, psychotherapist, or patient. The report shall
be made available to members of the public electronically and in
writing upon request.  
   (c) (1) The department shall prepare and disseminate an
informational brochure for sexual orientation change efforts to
psychotherapists for distribution to patients contemplating being
subjected to sexual orientation change efforts. This brochure shall
be developed by the department in consultation with members of the
Medical Board of California, Board of Psychology, and the Board of
Behavioral Sciences. The brochure shall be provided to each
individual contacting the Medical Board of California and affiliated
health boards, the Board of Psychology, or the Board of Behavioral
Sciences regarding a complaint involving sexual orientation change
efforts.  
   (2) The brochure shall include, but is not limited to, the
following:  
   (A) A legal and an informal definition of sexual orientation
change efforts.  
   (B) A brief description of the scientific findings regarding the
ineffectiveness of sexual orientation change efforts as reported by
the American Psychiatric Association.  
   (C) A brief summary of the stated positions of the leading
psychological associations with respect to sexual orientation change
efforts.  
   (D) A right to legal redress to be set forth as follows: 


   "If you have been subjected to efforts to change your sexual
orientation without providing written informed consent, you may want
to consult an attorney about bringing legal action against your
psychotherapist." 

   (E) A description of services available for support of patients
with issues relating to their sexual orientation or gender identity.
 
   865.3.  (a) A cause of action may be brought against a
psychotherapist by a patient or former patient, either during the
duration of the sexual orientation change efforts or within two years
following termination of the therapeutic relationship, for injury
for harm caused by sexual orientation change efforts, if the sexual
orientation change efforts occurred to a patient who was under 18
years of age at any point during the use of sexual orientation change
efforts, or, if the patient is 18 years of age or older, by means of
therapeutic deception or without obtaining written informed consent.
The patient or former patient may recover damages and attorney's
fees. 
    865.3.    (a) (1) A cause of action may be brought
against a psychotherapist by a patient, former patient, or deceased
former patient's parent, child, or sibling if the sexual orientation
change efforts were conducted without first obtaining informed
consent or by means of therapeutic deception, or if the sexual
orientation change efforts were conducted on a patient who was under
18 years of age at any point during the use of the sexual orientation
change efforts.  
   (2) The patient, former patient, or deceased former patient's
parent, child, or sibling may recover actual damages, or statutory
damages in the amount of five thousand dollars ($5,000), whichever is
greater, in addition to costs and reasonable attorney's fees. 

   (3) The time for commencement of the action shall be within eight
years of the date the patient or former patient attains the age of
majority or within five years of the date the patient, former
patient, or deceased former patient's parent, child, or sibling
discovers or reasonably should have discovered that the patient was
subjected to sexual orientation change efforts in violation of this
article. 
   (b) Nothing in this article precludes  a patient's right
  or limits the right of a patient, former patient, or
deceased former patient's parent, child, or sibling  to bring a
civil action against a psychotherapist arising from other legal
claims.