INTRODUCED BY   Senator Lieu
   (Coauthor: Assembly Member Ma)

                        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.


   SB 1172, Lieu. Sexual orientation change efforts.
   Existing law provides for licensing and regulation of various
professions in the healing arts, including physicians and surgeons,
psychologists, marriage and family therapists, educational
psychologists, clinical social workers, and licensed professional
clinical counselors.
   This bill would prohibit a mental health provider, as defined,
from engaging in sexual orientation change efforts, as defined, with
a patient under 18 years of age. The bill would provide that any
sexual orientation change efforts attempted on a patient under 18
years of age by a mental health provider shall be considered
unprofessional conduct and shall subject the provider to discipline
by the provider's licensing entity.
   The bill would also declare the intent of the Legislature in this


  SECTION 1.  The Legislature finds and declares all of the
   (a) Being lesbian, gay, or bisexual 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) The American Psychological Association convened a Task Force
on Appropriate Therapeutic Responses to Sexual Orientation. The task
force conducted a systematic review of peer-reviewed journal
literature on sexual orientation change efforts, and issued a report
in 2009. The task force concluded that sexual orientation change
efforts can 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.
   (c) The American Psychological Association issued a resolution on
Appropriate Affirmative Responses to Sexual Orientation Distress and
Change Efforts in 2009, which states: "T]he American Psychological
Association] advises parents, guardians, young people, and their
families to avoid sexual orientation change efforts that portray
homosexuality as a mental illness or developmental disorder and to
seek psychotherapy, social support, and educational services that
provide accurate information on sexual orientation and sexuality,
increase family and school support, and reduce rejection of sexual
minority youth."
   (d) The American Psychiatric Association published a position
statement in March of 2000 in which it stated:
   "Psychotherapeutic modalities to convert or 'repair' homosexuality
are based on developmental theories whose scientific validity is
questionable. Furthermore, anecdotal reports of 'cures' are
counterbalanced by anecdotal claims of psychological harm. In the
last four decades, 'reparative' therapists have not produced any
rigorous scientific research to substantiate their claims of cure.
Until there is such research available, the American Psychiatric
Association] recommends that ethical practitioners refrain from
attempts to change individuals' sexual orientation, keeping in mind
the medical dictum to first, do no harm.
   The potential risks of reparative therapy are great, including
depression, anxiety and self-destructive behavior, since therapist
alignment with societal prejudices against homosexuality may
reinforce self-hatred already experienced by the patient. Many
patients who have undergone reparative therapy relate that they were
inaccurately told that homosexuals are lonely, unhappy individuals
who never achieve acceptance or satisfaction. The possibility that
the person might achieve happiness and satisfying interpersonal
relationships as a gay man or lesbian is not presented, nor are
alternative approaches to dealing with the effects of societal
stigmatization discussed.
   Therefore, the American Psychiatric Association opposes any
psychiatric treatment such as reparative or conversion therapy which
is based upon the assumption that homosexuality per se is a mental
disorder or based upon the a priori assumption that a patient should
change his/her sexual homosexual orientation."
   (e) The American School Counselor Association's position statement
on professional school counselors and lesbian, gay, bisexual,
transgendered, and questioning (LGBTQ) youth states: "It is not the
role of the professional school counselor to attempt to change a
student's sexual orientation/gender identity but instead to provide
support to LGBTQ students to promote student achievement and personal
well-being. Recognizing that sexual orientation is not an illness
and does not require treatment, professional school counselors may
provide individual student planning or responsive services to LGBTQ
students to promote self-acceptance, deal with social acceptance,
understand issues related to coming out, including issues that
families may face when a student goes through this process and
identify appropriate community resources."
   (f) The American Academy of Pediatrics in 1993 published an
article in its journal, Pediatrics, stating: "Therapy directed at
specifically changing sexual orientation is contraindicated, since it
can provoke guilt and anxiety while having little or no potential
for achieving changes in orientation."
   (g) The American Medical Association Council on Scientific Affairs
prepared a report in 1994 in which it stated: "Aversion therapy (a
behavioral or medical intervention which pairs unwanted behavior, in
this case, homosexual behavior, with unpleasant sensations or
aversive consequences) is no longer recommended for gay men and
lesbians. Through psychotherapy, gay men and lesbians can become
comfortable with their sexual orientation and understand the societal
response to it."
   (h) The National Association of Social Workers prepared a 1997
policy statement in which it stated: "Social stigmatization of
lesbian, gay and bisexual people is widespread and is a primary
motivating factor in leading some people to seek sexual orientation
changes. Sexual orientation conversion therapies assume that
homosexual orientation is both pathological and freely chosen. No
data demonstrates that reparative or conversion therapies are
effective, and, in fact, they may be harmful."
   (i) The American Counseling Association Governing Council issued a
position statement in April of 1999, and in it the council states:
"We oppose 'the promotion of "reparative therapy" as a "cure" for
individuals who are homosexual.'"
   (j) The American Psychoanalytic Association issued a position
statement in June 2012 on attempts to change sexual orientation,
gender, identity, or gender expression, and in it the association
states: "As with any societal prejudice, bias against individuals
based on actual or perceived sexual orientation, gender identity or
gender expression negatively affects mental health, contributing to
an enduring sense of stigma and pervasive self-criticism through the
internalization of such prejudice.
   Psychoanalytic technique does not encompass purposeful attempts to
'convert,' 'repair,' change or shift an individual's sexual
orientation, gender identity or gender expression. Such directed
efforts are against fundamental principles of psychoanalytic
treatment and often result in substantial psychological pain by
reinforcing damaging internalized attitudes."
   (k) The American Academy of Child and Adolescent Psychiatry in
2012 published an article in its journal, Journal of the American
Academy of Child and Adolescent Psychiatry, stating: "Clinicians
should be aware that there is no evidence that sexual orientation can
be altered through therapy, and that attempts to do so may be
harmful. There is no empirical evidence adult homosexuality can be
prevented if gender nonconforming children are influenced to be more
gender conforming. Indeed, there is no medically valid basis for
attempting to prevent homosexuality, which is not an illness. On the
contrary, such efforts may encourage family rejection and undermine
self-esteem, connectedness and caring, important protective factors
against suicidal ideation and attempts. Given that there is no
evidence that efforts to alter sexual orientation are effective,
beneficial or necessary, and the possibility that they carry the risk
of significant harm, such interventions are contraindicated."
   (l) The Pan American Health Organization, a regional office of the
World Health Organization, issued a statement in May of 2012 and in
it the organization states: "These supposed conversion therapies
constitute a violation of the ethical principles of health care and
violate human rights that are protected by international and regional
agreements." The organization also noted that reparative therapies
"lack medical justification and represent a serious threat to the
health and well-being of affected people."
   (m) 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 Caitlin
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.
   (n) California has a compelling interest in protecting the
physical and psychological well-being of minors, including lesbian,
gay, bisexual, and transgender youth, and in protecting its minors
against exposure to serious harms caused by sexual orientation change
   (o) Nothing in this act is intended to prevent a minor who is 12
years of age or older from consenting to any mental health treatment
or counseling services, consistent with Section 124260 of the Health
and Safety Code, other than sexual orientation change efforts as
defined in this act.
  SEC. 2.  Article 15 (commencing with Section 865) is added to
Chapter 1 of Division 2 of the Business and Professions Code, to

      Article 15.  Sexual Orientation Change Efforts

   865.  For the purposes of this article, the following terms shall
have the following meanings:
   (a) "Mental health provider" means a physician and surgeon
specializing in the practice of psychiatry, a psychologist, a
psychological assistant, intern, or trainee, a licensed marriage and
family therapist, a registered marriage and family therapist, intern,
or trainee, a licensed educational psychologist, a credentialed
school psychologist, a licensed clinical social worker, an associate
clinical social worker, a licensed professional clinical counselor, a
registered clinical counselor, intern, or trainee, or any other
person designated as a mental health professional under California
law or regulation.
   (b) (1) "Sexual orientation change efforts" means any practices by
mental health providers that seek to change an individual's sexual
orientation. This includes efforts to change behaviors or gender
expressions, or to eliminate or reduce sexual or romantic attractions
or feelings toward individuals of the same sex.
    (2) "Sexual orientation change efforts" does not include
psychotherapies that: (A) provide acceptance, support, and
understanding of clients or the facilitation of clients' coping,
social support, and identity exploration and development, including
sexual orientation-neutral interventions to prevent or address
unlawful conduct or unsafe sexual practices; and (B) do not seek to
change sexual orientation.
   865.1.  Under no circumstances shall a mental health provider
engage in sexual orientation change efforts with a patient under 18
years of age.
   865.2.  Any sexual orientation change efforts attempted on a
patient under 18 years of age by a mental health provider shall be
considered unprofessional conduct and shall subject a mental health
provider to discipline by the licensing entity for that mental health