The Ex-Gay Therapy Bill

So the Counsellors and Psychotherapists (Regulation) Bill has been published and it’s exactly what I expected.

Government BillA BILL TO

Provide that the Health Professionals Council be the regulatory body for counsellors and psychotherapists; and for connected purposes.

BE IT ENACTED

by the Queen’s most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows:—

1 Regulation of mental health practitioners

(1) Section 60 of the Health Act 1999 (Regulation of health care and associated professions) is amended as follows.

(2) After section 60(2)(ca) the following paragraph is inserted—

“(cb) the professions regulated by the Counsellors and Pyschotherapists (Regulation) Act 2013,”.

2 Code of ethics for registered counsellors, therapists and psychotherapists

(1) Counsellors, therapists and psychotherapists shall be registered by the Health and Care Professions Council, former ly known as the Health Professions Council, “the Council”.

(2) The Council shall prepare and publish a code of ethics (“the code”) for registered counsellors, therapists and psychotherapists.

(3) The code must include a prohibition on gay to straight conversion therapy.

(4) Agreement to abide by the code shall be a condition of admission to the register maintained by the Council under the Health and Social Work Professions Order 2001 (“the register”).

3 Complaints and disciplinary procedures

(1) Where a patient complains to the Council that a registered counsellor, therapist or psychotherapist has breached the code, the Council must investigate that complaint.

(2) A practitioner found by the Council to have breached the code shall be subject to disciplinary action by the Council, including temporary or permanent removal from the register. A breach of that section of the code relating to prohibition of gay to straight conversion therapy shall result in permanent removal from the register.

4 Short title and commencement

(1) This Act may be cited as the Counsellors and Psychotherapists (Regulation) Act 2013.

(2) This Act comes into force at the end of the period of 6 months beginning with the day on which it is passed.

Mike DavidsonSo, this leaves us with the obvious question – why should “gay to straight conversion therapy be banned”?

There was an interesting discussion this morning on 5Live with Mike Davidson of the Core Issues Trust and a representative of Stonewall. Listen to it by clicking play below.

Note the two studies mentioned in the report – Shidlo and Shroeder (2002) and Spitzer (2003). I wrote about these two studies last year and noted that if you reject one then you have to reject the other.

It’s worth stopping for a moment at this point and reflecting on same key points from the S&S methodology. Key factors in their approach were,

  • Specifically seeking out people who had experienced harm from SOCE. They ran adverts in gay magazines that asked for those who had experienced harm to get in touch
  • Participants were asked to think back to three separate points in time (before, during and after therapy) and report how they had felt
  • “Harm” was self-reported – standard psychological community measures of distress were not used, instead participants engaged in a telephone interview where they were asked to talk through their experience of SOCE.

Now, at this point you might be suddenly wanting to scroll up the page to have another look at Daniel Gonzalez’s list of criticisms of Spitzer’s study. To save you the time, I’ll just provide a table right here so you can compare the two methodologies.

Methodology Spitzer 2003 Shidlo and Schroeder 2002
Sample selection Advertised for those wanting to report success of SOCE Advertised for those wanting to report failure of SOCE
Recall of Events Asked participants to recall events from SOCE and to self-report current perspective on those events Asked participants to recall events from SOCE and to self-report current perspective on those events
Method of Interview Telephone Interview Telephone Interview
Measure of Success / Harm Self-reported understanding of outcome Self-reported understanding of outcome

OK….

It strikes me that advocates of S&S 2002 cannot be logically consistent if they (quite rightly) reject Spitzer 2003 on the basis of it’s methodology and then quote Shidlo and Schroeder 2002 on the subject of harm. If Spitzer’s methodology was flawed for only seeking participants who wanted to report success of SOCE, for asking them to recall events in the past which they might either falsely recall because of the passage of time OR because they wilfully wanted to misrepresent the truth of the outcome of therapy and for using only a telephone interview, then Shidlo and Schroeder’s methodology is equally so. One cannot reject one of the basis of methodology without rejecting the other.

That then is the context of this Bill. It is being propagated on the basis of ONE piece of research that is itself flawed in the most basic senses (selection bias, unqualified and unquantified outcomes). Do we really want to make legislation on the basis of this?

Let me say it again. There is only one piece of research that even approaches the acceptable standards for having good research in this area (a proper longitudinal approach, quantified and qualified definitions of “harm”) and that is the Jones and Yarhouse ExGay Study. They found (in the most statistically significant part of their outcomes) that the SOCE therapies they observed did not cause any harm in participants, even those who dropped out of the programme and later adopted a “gay lifestyle”.

This Bill in front of Parliament presents us with a very interesting moment. Are we going to introduce legislation based on proper researched concerns of evidenced harm from such therapies (none exists) or are we just going to let a dogmatic approach over-rule common sense?

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  • Charlie Angel

    Although I personally have no truck with the whole idea of conversion therapy, it doesn’t stop me feeling much disquiet at this sort of intervention of the state into such personal matters. This is surely one of those times when the Law must tread carefully lest it ‘open windows into men’s souls’?

    When I think of the issue of conversion therapy, I always compare it to the various creams and treatments that can be used to lighten skin which I believe are rather popular with some people of various ethnic communities.

    I don’t agree with their desire to have whiter skin. I regard them as to be frank, quite foolish and believe their efforts to be a waste of time and money. I think they would be much better off not trying to emulate the ‘other’ and rest peacefully in their own beauty. I also recognise that what they are often sold is simple snake oil and probably won’t do the job anyway…

    But…and of course this is the big but….I would defend to the death….ok, maybe not to the death… I’m not going to the pyre for skin products….but I will defend vehemently their right to do what they want with their own bodies and money. If that’s what they want to do, however misguided I personally may find the practise then I want to live in a free country which allows them to do that.

    As long as I have the right to point the finger and say “How silly is that?” then equally they must have the right to do it. And then equally turn around to me and say “Actually it’s not silly! I much prefer being white!” etc.

    Of course the only proviso is if those products are clearly a danger to the health of the person concerned. And there are plenty of skin bleaching treatments – to continue with my analogy – which have proved to be dangerous and the state hopefully steps in to prohibit them.

    Which of course is what people will try to argue in the case of conversion therapy. But just like those skin creams, nobody suggests a ban-all approach. It’s simply not practical. Nor is it acceptable to do so in a liberal society.

    Likewise, such therapies have to be seen in a much more nuanced way than this blunderbuss of an Act is offering.

    • Charlie Angel

      Immediately after posting, I then see that Andrew Lilico makes – much more eloquently I must say! – the point that I was trying to get across. Although in his case, he’s referring to eye colour rather than skin but it’s a similar thrust I guess.

      Anyway, rather than my cod attempt, I refer you to his much better phrased post!

    • Guglielmo Marinaro

      I think that there are two different questions here, and they are being conflated and confused.

      The first is, if someone doesn’t like their sexual orientation for whatever reason, have they got the right to go to an “ex-gay ministry” or to a “conversion therapist” in an attempt to change it? Yes, they most definitely have, just as they have the right to consult an astrologer or a tarot reader for advice about their future, to go to a chiromantist to have their hand read, to call in a tasseographer to read their tea-leaves, to seek treatment from a Christian Science practitioner or a spirit healer, or to fly out to Brazil or the Philippines for psychic surgery. It is perfectly proper that we should warn them against being taken for a ride, but PROVIDED THAT THEY ARE ADULTS, they must be free to do these foolish things at their own risk.

      The second is, should ACCREDITED HEALTH PROFESSIONALS be allowed to practise conversion therapy – which is what this bill is about? No, of course they should not, for the same reason that they are not allowed to practise the other forms of quackery that I have mentioned above. You speak of “the various creams and treatments that can be used to lighten skin” and you defend people’s right to use them if they insist, no matter how misguided they are. I entirely agree, but I think you would find that any doctor who prescribed them would soon find himself/herself in trouble, and rightly so. But I recognize that a case can be made for saying that regulation in these matters should be left to professional bodies – although I am inclined to feel that it ought to be illegal to inflict such hocus-pocus on minors.

      No doubt someone will challenge me to provide proof that conversion therapy never works. I can’t, but the burden of proof is not on me. It has not been proved that Christian Science healing or spirit healing NEVER works either, and I don’t see how it ever could be. It is enough that the evidence for the efficacy of these things is very poor.

      As for possible harm, there is one very serious harm which results directly from the futility of “sexual orientation change” programs, and which needs no elaborate Spitzer or Shidlo-Schroeder type study to document it. Unlike creams which one might spend a couple of minutes two or three times a day applying and discard after a few weeks or months when their uselessness has become obvious, these programs take over people’s lives in a big way. People can and often do spend years effectually putting their lives on hold while they wait in desperation for their sexual attractions to change, which seldom or never happens. All that wasted time is, as often as not, stolen out of what is probably for most people the sunniest and most carefree period of their lives, and it won’t come again: it has gone for ever. That, even if no other direct harm is done, is more than sufficient condemnation.

      • James Byron

        As sexual orientation isn’t a disorder I agree that conversion therapy isn’t appropriate in a clinical setting. Desire for change is rooted in theology. The problem isn’t homosexuality, but the belief that expressing that orientation is sinful.

        Theologians ought to be doing a lot more to challenge the idea of revealed authority, so fewer believers desired change because same-gender sex is condemned in the Bible. Psychology can help by examining the emotional and social foundations of beliefs.

        For me the context is key. So long as a medical professional isn’t offering “reparative therapy” in their professional capacity, and makes clear that distinction, it’s in effect a private arrangement between two individuals, and not something I believe the state, or their regulative body, should stop.

        I hope the day comes when it’s no longer sought.

  • http://u-church.blogspot.com/ David Shepherd

    For a moment, let’s look at the comparative Department of Health stance on alternative medicine. In respect of homeopathy, it describes the settled evidence is as follows:

    ‘There have been several reviews of the scientific evidence on the
    effectiveness of homeopathy. The House of Commons Science and Technology
    Committee said there is no evidence that homeopathy is effective as a treatment
    for any health condition’.

    ‘There is no evidence for the idea that substances that can induce certain
    symptoms can also help to treat them. There is no evidence for the idea that
    diluting and shaking substances in water can turn those substances into
    medicines’.

    ‘The ideas that underpin homeopathy are not accepted by mainstream science,
    and are not consistent with long-accepted principles on the way that the
    physical world works. The Committee’s 2010 report on homeopathy said the ‘like
    cures like’ principle is ‘theoretically weak’, and that this is the ‘settled
    view of medical science’.

    ‘It is of note, for example, that many homeopathic remedies are diluted to
    such an extent that there is unlikely to be a single molecule of the original
    substance remaining in the final remedy. In cases such as these, homeopathic
    remedies consist of nothing but water’.

    There is no outright ban on homeopathy and it is not legally regulated. No-one can stop a homeopath taking anywhere between £20 to £80 off you for an initial consultation. The decision to fund this kind of ‘therapy’ is still left to the local NHS trust:

    The Department of Health does not maintain a position on any particular
    complementary or alternative therapy, including homeopathy. It is the
    responsibility of local NHS organisations to make decisions on the commissioning
    and funding of any healthcare treatments for NHS patients, such as homeopathy,
    taking account of issues to do with safety, clinical efficacy and
    cost-effectiveness and the availability of suitably qualified practitioners.

    Even if you suggest that the consistent rule is that one causes harm, rather than lack of benefit, or that, in contrast with mental health practitioners, homeopaths are not regulated, there is still no reliable evidence that conversion therapy is harmful.

    The inescapable conclusion is that this bill is another part of the political fiat to engineer the sexual norms of society.

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  • Sigfridii

    “are we just going to let a dogmatic approach over-rule common sense?”
    Yes. This is Mr Cameron’s rule of thumb. Because it will keep Mr Clegg quiet for 48 hours.

  • Wolf Paul

    James Byron says, “Desire for change is rooted in theology.” I don’t think that is true for all who desire change, not even for all religious people, as theology is not concerned with orientation but with actions.

    I am also afraid that this bill will be used to harrass any therapist who does not affirm homosexuality or advises anything other than living it out, whether or not s/he engages in actual conversion therapy. And as in the infamous B&B case I think we will see activists seeking out and setting up such therapists.

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