Out of California over the weekend come reports about measures to ban a particular type of therapy targeting young people. On Saturday, the Californian governor signed legislation to forbid mental health professionals from attempting “sexual orientation change efforts” (SOCE”) on Children and teenagers.
The “treatment” in question is controversial. It relates to attempts to alter sexual orientation, in other words making gay children straight. It comes in various forms, from the religiously-motivated (“pray the gay away”) all the way through to behavioural techniques and cognitive therapy.
Of the range of “treatments”, the California State governor said this on Saturday:“This bill bans non-scientific 'therapies' that have driven young people to depression and suicide. These practices have no basis in science or medicine and they will now be relegated to the dustbin of quackery. "California will become the first State in the USA to introduce such a blanket ban. The bill will provide that any sexual orientation change efforts attempted on a patient under 18 by a mental health provider shall be considered unprofessional conduct and shall render him or her liable to discipline by his or her regulatory body.
Do we need similar legislation in England? I believe we do. Who makes decisions about the treatment of young people in the UK depends on a concept called Parental Responsibility (PR). PR is the bundle of rights a person has just by virtue of being a parent – namely the right to make decisions about a child’s upbringing. A parent who has PR is entitled to participate in all important decisions affecting a child’s upbringing.
PR includes the responsibility of parents to make decisions for children about medical and mental health treatment. This is properly viewed as a parental obligation, rather than a parental right. For so long as a child lacks understanding, those with PR are required to make decisions for him or her about a range of issues, to include medical ones. The rights surrounding the treatment belong to the child, but he or she is too young to exercise them properly.
The parental obligation exists for the benefit of the child rather than his or her parents. It exists only for as long as needed for the protection of the child. With understanding begins the gradual transfer of this obligation from the holders of PR back to the young person. Eventually, the young person is able to make those decisions. At sixteen, there is a presumption in England that the transfer will be complete. At eighteen, when the young person becomes a legal adult, it is complete. In 1992, the World Health Organization ended its categorisation ofHomosexuality as a mental illness. The UK Government followed suit in 1994. No credible mental health professional organisation supports SOCE and most have adopted policy statements cautioning the profession about using them. These include the American Psychiatric Association, the Royal College of Psychiatrists, the UK Council for Psychotherapy and the Australian Psychological Society.
Yet there remain individuals in the UK sufficiently fixated with sexual orientation that they are keen to “help” others revert to the straight and true path of heterosexuality. In April 2012, London buses carried a Christian advertising campaign asserting the power of therapy to make homosexuals heterosexual, and in May 2012, counsellor; Lesley Pilkington had her accredited status withdrawn by the British Association for Counselling & Psychotherapy. This was after Pilkington, who believes that homosexuality is sinful, suggested that a gay patient undergo a controversial counselling technique known as “reparative therapy” involving counselling and prayer. The fact that there exists a need for charities like the Albert Kennedy Trust (AKT) highlights the particular vulnerability of young people coming to terms with their sexual orientation. AKT supports teenagers and young adults who are made homeless or who are living in a hostile environment due to their sexuality. It helps young people who have experiencedDomestic Violence or have been ejected from home for coming out as LGBT.
As professionals, we universally condemn other abuses of the physical and mental integrity of children and young people. Forced marriage, for example, is recognised as a human rights abuse and efforts are underway to criminalise it. Female genital mutilation on parental religious and / or cultural grounds is already a crime. The government has launched an action plan to tackle child abuse linked to witchcraft or religion in England. In its own way, the use of SOCE on Children or young people is as exploitative and potentially damaging as any of these. This remains so whether the “treatment” is sought by parents exercising PR, or by young people made to feel sufficiently uncomfortable in their own skins on account of sexuality that they will do anything to feel they belong. “Quackery” is a perfect label to apply to SOCE generally. A law banning its use on children and young people should not be required. But, given we have to accept it is (in light of the home-grown examples given of SOCE in practice), copying the Californian approach is a no-brainer.
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