Friday, July 1, 2016

AASECT Position Statements on Sex and Gender Diversity and Reparative Therapy


On June 9, 2016 at its board meeting in San Juan, Puerto Rico, AASECT unanimously adopted two position statements authored by other organizations.  The first was initiated primarily by the National Coalition for Sexual Freedom, stimulated by AASECT’s Position on Sexual Expression, including Orientation and Identity adopted in November of 2015, and available here:  AASECT Position on Sexual Expression

NCSF required a statement that explicitly named activities that were subjected to discriminatory court cases and devised this language as congruent with parts of the Position on Sexual Expression:

“Sexual Freedom Resolution

Working within the position of social justice and human rights, we support the right of freedom of sexual expression among consenting adults.  We affirm that sexual expression is integral to the human experience, that this right is central to overall health and well-being, and that this right must be honored.  We support the right to be free from discrimination, oppression, exploitation and violence due to one’s sexual expression.

The best contemporary scientific evidence finds that consenting adults that practice BDSM, fetishism, cross dressing and non-monogamy can be presumed healthy as a group.  We believe that any sexuality education of therapies that treat sexualities must avoid stigmatizing or pathologizing these sexual expressions among fully informed consenting adults.
 
As professionals in the field of sexuality and sexual health, we actively seek to destigmatize consensual sexual expression and consensual practices among consenting adults, as well as to help create and maintain safe space for those who have been traditionally marginalized.

Signed:

National Coalition for Sexual Freedom
AASECT (American Association for Sexuality Educators, Counselors and Therpists)
CARAS (Community-Academic Consortium for Research on Alternative Sexualities)
Center for Positive Sexuality
Institute fir Sexuality Education and Enlightenment
Projects Advancing Sexual Diversity
Science of BDSM Research Team
TASHRA (The Alternative Sexualities Health Research Alliance)”

The National Coalition for Sexual Freedom (NCSFreedom.org) continues to solicit organizational signers for this document.  Arrangements can be made either through contacting them through their website, or by leaving a comment here on Elephant.


The second position statement originated from the American Psychiatric Associations United States Joint Statement work group.with ties to working communities in the American Medical Association, The American Psychological Association, the American Academy of Family Physicians, the National Association of Social Workers, and other national organizations.  It has already been adopted by the several organizations listed in the ‘Action Paper’ below:



“Joint Statement on Conversion Therapy in the U.S.
This statement is a framework for values and action to address issues raised by conversion therapy (also known as reorientation therapy, sexual orientation change efforts, ex-gay therapy, or reparative therapy). This statement expresses a shared commitment of two core principles of ethical mental health services: 1) facilitate individual self-determination and 2) do no harm.

The ethical principle of self-determination requires that each individual is seen as a whole person supported in their right to explore, define, articulate, and live out their own identity. For this reason, it is essential for clinicians to acknowledge the broad spectrum of sexual orientations and gender identities/expressions. In order to do so, it is necessary to have an equal understanding of and respect for sexual and gender minorities as well as the religious, spiritual, and other ideological values of individuals, families, and communities.

To ensure all healthcare providers do no harm, it is essential to recognize that a person is not mentally ill or developmentally delayed because they experience same-sex attractions or a nontraditional gender identity or expression. The focus of treatment must not be to convert an individual’s sexual orientation or gender identity/expression. The signatories share a commitment to protecting the public from the harms of conversion therapy.

There is no intention in this statement to deny those with conflicted feelings around sexuality or gender identity from seeking qualified and appropriate help. Nothing in this statement is intended to preclude ethical research relative to gender identity or sexual orientation.

Background

Historically, research findings and clinical expertise have found that variations in sexual orientation and gender identity are within the normal range of human development, and that conversion therapy or other efforts to make sexual orientation or gender identity/expression conform to specific standards and expectations are not effective, are not appropriate therapeutic practices, are not ethical, and are harmful.1, 2, 3  Many professional associations already have position statements relative to Lesbian, Gay, Bisexual, Transgender, Questioning, of Gender NonConforming (LGBTQ/GNC) health and/or the ineffectiveness of efforts to change sexual orientation and/or the potential harms of conversion therapy for sexual orientation.4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15

Goals and Objectives

Given the harm associated with conversion therapy efforts, other affirmative behavioral, psychological, and emotional health interventions are recommended for individual or family distress associated with sexual orientation and gender identity/expression. We commit ourselves to ensure that:
     The public is informed about the research on conversion therapy and the risks thereof;
     Healthcare professionals are made aware of the ethical issues relating to conversion therapy;
     New and existing healthcare providers are appropriately trained to competently deal with requests for conversion therapy and to provide appropriate support to clients in distress over their sexual orientation and/or gender identity/expression;
     Healthcare professionals from various disciplines work together to promote the public interest in addressing conversion therapy.

Roles and Responsibilities

This statement does not define a list of actions which every organization will carry out. It sets out a framework for how organizations will respond to the issue in areas where they have responsibilities.
     Each organization will review its codes of ethical conduct for members and consider the need for the creation of specific amendments to those codes;
     Professional associations will ensure their members have access to the latest information regarding the ineffectiveness and harms of conversion therapy;
     Professional associations will endeavor to make continuing professional development events available to further providers' understanding and cultural competence in working with lesbian, gay, bisexual, transgender, questioning and gender nonconforming (LGBTQ/GNC) clients;
     Organizations will work together to create a shared information resource on the ineffectiveness and harms of conversion therapy to help and support both members of the public and professionals, including sets of Frequently Asked Questions (FAQs);
     Those with a responsibility for clinical and academic training will work to ensure that such programs provide mental and behavioral health providers with a sufficient degree of cultural competence to work effectively with LGBTQ/GNC clients;
     Clinicians who are not sufficiently trained around issues of sexual orientation and/or gender identity/expression will make every effort to seek appropriate training or consultation or to connect patients with clinicians or agencies who are trained to provide appropriate clinical care;
     Auditing and accrediting organizations will review their current guidelines and policies for individual practitioners and training organizations to assess the need for more specific standards to demonstrate awareness of and compliance with policies regarding conversion therapy.

Beyond ending potentially harmful practices, it is important to also build greater social acceptance of people of all gender identities, gender expressions, and sexual orientations, including lesbian, gay, bisexual, transgender, questioning, and gender nonconforming people of all ages; to adopt appropriate and supportive therapies; and to provide current, targeted and accurate resources and information for all patients and their families. Building better supportive environments and working to eliminate negative social attitudes will reduce health disparities and improve the health and well-being of all LGBTQ/GNC people.

Review

The undersigned organizations will review the statement 12 months after publication.

Mutual Understanding

This memorandum is signed in recognition of a shared professional responsibility to improve the support and help available to those at risk from conversion therapy.

Notes
  1. http://www.psychotherapy.org.uk/UKCP_Documents/policy/MoU-conversiontherapy.pdf
  2. http://store.samhsa.gov/product/Ending-Conversion-Therapy-Supporting-and-Affirming-LGBTQ-Youth/All-New-Products/SMA15-4928
  3. http://www.paho.org/hq/index.php?option=com_content&view=article&id=6803%3A2012-therapies-change-sexual-orientation-lack-medical-justification-threaten-health&catid=740%3Anews-press-releases&Itemid=1926&lang=en
  4. http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee/ama-policy-regarding-sexual-orientation.page?
  5. http://www.apa.org/about/policy/sexual-orientation.aspx
  6. http://www.socialworkers.org/diversity/new/documents/hria_pro_18315_soce_june_2015.pdf
  7. http://www.psychiatry.org/file%20library/about-apa/organization-documents-policies/policies/position-2013-homosexuality.pdf
  8. http://www.guideline.gov/content.aspx?id=38417#Section420
  9. http://www.aamft.org/iMIS15/AAMFT/Content/about_aamft/position_on_couples.aspx
  10. http://annals.org/article.aspx?articleid=2292051
  11. http://www.counseling.org/news/updates/2013/01/16/ethical-issues-related-to-conversion-or-reparative-therapy
  12. http://www.apsa.org/content/2012-position-statement-attempts-change-sexual-orientation-gender-identity-or-gender
  13. http://www.schoolcounselor.org/asca/media/asca/PositionStatements/PS_LGBTQ.pdf
  1. http://www.wpanet.org/detail.php?section_id=7&content_id=1807

ACTION PAPER

TITLE:   US Joint Statement on Conversion Therapy

Whereas:  In December of 1998, the Board of Trustees issued a position statement that 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,

Whereas:  In December 2013 the Board of Trustees issued a position statement that the American Psychiatric Association believes that the causes of sexual orientation (whether homosexual or heterosexual) are not known at this time and likely are multifactorial including biological and behavioral roots which may vary between different individuals and may even vary over time.  The American Psychiatric Association does not believe that same-sex orientation should or needs to be changed, and efforts to do so represent a significant risk of harm by subjecting individuals to forms of treatment which have not been scientifically validated and by undermining self-esteem when sexual orientation fails to change.  No credible evidence exists that any mental health intervention can reliably and safely change sexual orientation; nor, from a mental health perspective does sexual orientation need to be changed,

Whereas:   The World Psychiatric Association has taken the position that gender identity is not seen as pathological and “the provision of any intervention proposed to’ treat’ something that is not a disorder is wholly unethical,“

Whereas:  The American Academy of Nursing, the American Counseling Association, the American Medical Student Association, the American Psychoanalytic Association, AGLP The Association of LGBTQ Psychiatrists, the Association of Lesbian, Gay, Bisexual, Transgender Issues in Counseling, the Clinical Social Work Association, GMLA: the Health Professionals Advancing LGBT Equality, and the World Professional Association for Transgender Health have signed on to the US Joint Statement on Conversion Therapy; and the Woodhull Freedom Foundation and PFLAG International have endorsed the US Joint Statement on Conversion Therapy.

Be it Resolved:  That the American Psychiatric Association sign on as a signatory to the US Joint Statement on conversion Therapy which cautions mental Health Professionals that conversion or change therapies for Lesbian, Gay Bisexual and Transgendered patients are unethical and emboday a risk of harm to those patients.

AASECT would thus be added to the list of organizations under the fourth 'Whereas' in the 'Action Paper'.

The Joint Statement was started independently by the American Psychiatric Association work group, but AASECT's decision to become a signatory grows naturally both from the AASECT Vision of Sexual Health, and from the aforementioned Position on Sexual Expression adopted last November.  The ripples of that decision, and AASECT's earlier decisions to undertake systematic advocacy with the formation of its Public Relations, Media, and Advocacy Committee in 2004 and its adoption of the AASECT Vision of Sexual Health in 2006, continue to wash up on shores then undreamed of.  Elephant in the Hot Tub: Kink in Context is yet another unanticipated consequence of those decisions.




Even those of modest height can see farther when standing on the shoulders of giants, Sir Isaac!