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Today thousands of Utah children and teens who may be questioning or confused about their sexual attractions or gender identity are at risk of losing their right to explore their concerns fully and completely in a confidential counseling session with a licensed professional therapist.

 In our last legislative session, with the stated goal of protecting LGBT youth from therapeutic harm, Utah House Bill 399 sought a ban on what political activists labeled “conversion therapy” that was defined as:

“…any practice or treatment that seeks to change the sexual orientation or gender identity of a patient or client, including mental health therapy that seeks to change, eliminate, or reduce behaviors, expressions, attractions, or feelings related to a patient or client’s sexual orientation or gender identity.”

This may sound innocuous at first glance but the bill created a “safe harbor” only for therapy that affirms same-sex attractions and gender confusion, and that seeks to help those struggling with these feelings accept and be more comfortable with them. Any other therapy that did not take an “affirming” approach would put a therapist at risk of losing his or her license. The end effect would have been to scare therapists away from any therapeutic approach that is not “gay-affirming” or transgender-affirming—which is what the proponents intended.

The Family Development Foundation noted, “Imagine that a psychologist is working with an adolescent who is experiencing gender confusion and is thinking seriously about whether he wants to undergo gender ‘change’ procedures.  In the course of their discussions, the psychologist should address with the minor client (and his parents) the emotional and psychological risks and hazards of ‘gender change’ procedures.  Further, the psychologist should advise the minor client and his parents that they will need to discuss the medical and physical risks of chemical, hormonal, or surgical “gender change” procedures—which are many and serious, and often with permanent and irreversible effects—with a competent physician.  However, such discussions in a therapeutic context may well be regarded as having the ‘goal’ of changing the minor client’s “gender identity.” 

“Assume a situation in which a 10-year-old male tells his parents that he thinks he really should have been born as a girl, and wants to change his gender.  The parents then take the boy to a therapist (who does not take a transgender/gender-change-affirming approach) to help him address his feelings and confusion.  Under the proposed rule, addressing the feelings, emotions, or expressions related to the boy’s perceived gender “identity” would put the therapist at risk, because it might result in a change in those feelings, and thus potentially be regarded as having the ‘goal’ of changing the boy’s “gender identity.”  To remain safe, the therapist could only reduce the young boy’s internalized stigma, provide “acceptance [and] support,’ facilitate his “active coping, social support, and identity exploration and development,’ and assist him in ‘undergoing gender transition.””

The Foundation noted, “The proposed rule threatens a therapist with loss of their license (and their livelilhood) if they violate the sexual orientation change efforts or gender identity change efforts’ provision if they are working with any number of common adolescent sexual concerns:

“The likely practical result of the proposed rule would be to:

  1. Make it more difficult to effectively address trauma resulting from sexual abuse.
  2. Make it more difficult to address compulsive sexual behaviors.
  3. Prevent psychologists from addressing with minor clients feelings or emotions (e.g. depression or anxiety related to gender confusion or the risks of gender ‘change’ procedures.
  4. Impede minor clients’ ability to achieve their own self-determined goals
  5. When religious or personal values are in conflict with sexual or gender feelings of the client, therapists would be limited in their range of options to effectively help minors and thus potentially increase the risk of suicide in minors.”

What a hit to freedom of speech and self-direction this is for clients and therapists who would now find certain important topics completely off limits.

What This Ban is Not About

Disgraceful and discredited aversion techniques that were used decades ago are not what this is about. The Family Development Foundation noted, “Ethical and competent therapy does not involve physically aversive techniques (such as electroshocking genitals or inducing vomiting).  No licensed therapist in Utah has used such techniques for decades, as the proposed rule’s supporters concede.  Nor does ethical and competent therapy involve verbally abusive techniques such as bullying, intimidation, shaming, or humiliation.  Contrary to the impression the activists who support the proposed rule want people to have, the proposed rule is not directed either exclusively or even primarily at physically aversive practices.”

In fact, it is sad, this law did not directly address the use of aversion techniques used decades ago by counselors for a variety of behaviors. Techniques like shock treatments or being exposed to something unpleasant such as a bad taste or a foul smell need to be prohibited. It was aimed only at already heavily regulated mental health professionals who use talk therapy.

Bill Failed in Legislature 

That particular bill failed in a committee vote in the legislature this year however those who authored the legislation pledged to resubmit the same bill as often as needed, session after legislative session until it is passed. Now, Utah regulatory agencies considering implementing rules that govern mental health professionals that would basically impose the same ban the legislature rejected only months ago. It can be viewed here. https://dopl.utah.gov/laws/Prop_R156-61-OAR_43994%20(1).pdf

A public hearing will be held on this proposed rule change today, Sept. 26, and then written statements will be accepted until October 1 addressed to Larry Marx at the Utah department of Coommerce, Division of Occupational and Professional Licensing at e-mail: [email protected]  You can read a statement from one woman who said she used to be a “trans kid” here on Meridian today.

Why is this a Concern?

Why is this of concern to those who cherish freedom of expression and religious liberty? Imagine a law that would regulate what someone seeking counseling could talk about with their freely chosen therapist and actually punish that therapist if the result of that conversation might result in any reduction in the client’s same-sex sexual attractions or a modification in their current gender perception. And now imagine that these regulations were designed to eliminate counseling options for easily confused children or adolescents still in the early stages of emotional and identity development. It seems unthinkable and yet, here we are.

There are many legal and psychological implications that arise from these suggested laws and regulations that could be addressed in future articles, this article will briefly consider how these proposals would eliminate a religious client’s right to explore and discuss principles that are essential to the gospel as understood by members of the Church of Jesus Christ of Latter-day Saints. Principles that are also sacred to many other citizens from various denominations and faith traditions.

As an American it is our divine right and as a Christian it is our divine obligation to nurture, temper, and change many facets of our character over our lifetime. If psychological counseling and counselors cannot or will not support a client’s own desires to grow in congruence with their own understanding of their divine destiny, then certainly we must ask of what value is therapy to the followers of Christ? If the laws and regulations governing professional counseling undermine Christian values, either intentionally or unintentionally, mental health resources that are often vital for troubled children and teens become a hazard for individuals and families who cherish their religious convictions.    

The choices we make when addressing life’s challenges provide us with the opportunity to explore and expand our divine potential. As Elder David Bednar reminds us in his book Act in Doctrine, “Line upon line and precept upon precept gradually and almost imperceptibly, our motives, our thoughts, our words, and our deeds become aligned with the will of God. Continuing conversion unto the Lord requires both persistence and patience.”

For a Christian, discussing and even adjusting our motives, thoughts, words and deeds would constitute an essential component in any useful or productive counseling process. The important and eternal issues of behaviors, thoughts and feelings related to sexuality or gender would not be exceptions.  President David O. MacKay reminded us, “Your thoughts are the architects of your destiny” and in the wonderfully simple translation offered in the International Children’s Bible of Proverbs 4:23 we are counseled, “Be very careful about what you think. Your thoughts run your life.”

Regulations that would outlaw “therapy that seeks to change, eliminate, or reduce behaviors, expressions, attractions, or feelings” conflict with our goals as we seek to grow to live the commandments.  

Conversations, counseling, and change in our thoughts, feelings and behaviors is foundational to mortal progress and eternal life. Sexual and gender concerns are an essential element of those conversations for many of our fellow citizens. Of course we should all be interested in eliminating specific abusive practices where they exist, but the solutions currently being considered are the equivalent of solving the problem of drunk driving by outlawing automobiles. Protecting teens from harm does not require us to eliminate self-determination and religious liberty. We can do better!  

Fortunately we have a successful model to emulate. In 2015 the Utah legislature was challenged to balance various divergent interests by passing legislation that would protect people in the LGBT community from employment and housing decisions based on their gender identity or sexual orientation, while still shielding religious institutions that stand against homosexuality. The passage of that legislation, which has since been called the “Utah compromise,” was hailed by both religious liberty advocates and sexual minority supporters as an example of what thoughtful citizens could accomplish when both sides work together.

Now, Utah citizens are facing a challenge that will test our ability to balance the concerns of our LGBT neighbors and the preservation of the basic religious liberties of the clients of professional counseling; the desire to safeguard sexual and gender minority teens from unethical, coercive “change efforts” and still protect the right of all teens to receive mental health therapy that is congruent with their personal goals and values.

Sadly, in the four years that have passed since the Utah “fairness for all” efforts produced the housing and employment compromise, our national conversation has become far more polarized. Using the term “conversion therapy” to suggest to citizens that you are banning aversive, harmful and clearly unethical practices and then actually outlawing the simple exploration or even reduction of what for some individuals are unwanted or unhelpful behaviors and feelings, goes far beyond protecting sexual minorities.

As we address these difficult issues that highlight the balance needed to respect both religious liberty and protecting all youth from potential coercive or abusive practices, let us remember that the daily practice of Christianity necessitates faith and courage because it often requires believers to do what’s counterintuitive and utterly contrary to current worldly trends. As much as we may wish that these difficult issues would just “go away” the wisdom of the world will always live in tension with the word of God.  That will require us to make difficult, even unpopular choices. “Woe to them that go down to Egypt for help; and stay on horses, and trust in chariots, because they are many; and in horsemen, because they are very strong; but they look not unto the Holy One of Israel, neither seek the Lord!” (Isaiah 31:1 KJV)

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For those who are interested there is a very helpful section on the Church website addressing Seeking Professional Help that can inform our understanding of this topic. The clear message is “When one seeks therapy, the Church recommends approaches that respect “client self-determination.”(https://mormonandgay.churchofjesuschrist.org/articles/seeking-professional-help)

David Clarke Pruden, M.S. is the founder of the Family Development Foundation and the coordinator of the Protect All Teens project (www.ProtectAllTeens.com)