California has become the first US state to ban unfounded therapies that attempt to turn gay teenagers straight.
"These practices have no basis in science or medicine and they will now be relegated to the dustbin of quackery," said state governor Jerry Brown in a statement to the San Francisco Chronicle. He signed a bill outlawing the therapies on 29 September.
Brown's conclusions are in line with those reached a few years ago by a task force of psychologists who were commissioned by the American Psychological Association to assess all published research on the therapies. The group, led by Judith Glassgold, found no evidence that the treatment was effective.
"The scientific evidence does not support such therapies," says Clinton Anderson, director of the APA's Lesbian, Gay, Bisexual and Transgender Concerns office.
"They were not helpful and could be harmful," says Glassgold, who is based in Washington DC. "Most people became more depressed and anxious, and could become suicidal."
"Usually these talk therapies are based on the assumption that homosexuality is a mental illness caused by poor parenting and confused gender roles," she adds. "They attempt to explain that to the patient, and try to get them to act and behave in a heterosexual manner."
Conversion therapies
It's unclear exactly how many teenagers will be affected by the ruling. The most recent research into the prevalence of these "conversion therapies" was conducted in the UK in 2009. A survey of 1300 psychotherapists revealed that 1 in 6 had attempted to treat homosexuality in the past, and 4 per cent said they would do so again (BMC Psychiatry, DOI: 10.1186/1471-244X-9-11).
"We believe that in some religious circles, for example evangelical Christians in the US, it may be higher," says Glassgold.
Some organisations oppose the ruling. The California-based National Association for Research and Therapy of Homosexuality claims that the bill's intent is to "intimidate therapists and supplant the rights of parents".
But such groups form the minority opinion. Even Robert Spitzer, the psychiatrist behind one of the most influential studies backing the "therapies", admitted his work was fatally flawed earlier this year. He went on to issue an apology to the gay community.
"We understood the methodological problems from the beginning, but many people, primarily through conservative and religious media, did make a lot of the study," says Anderson.
Glassgold's task force suggest that there are other, evidence-based approaches to helping teenagers deal with any conflict between their sexual orientation and religious beliefs. Therapies that involve teaching coping strategies and encouraging family members to be supportive are much more beneficial, the team concluded.
Glassgold thinks that California's ruling is merely a first step, and that more needs to be done. "These therapies exist because there is demand for them. We have to do more to end stigma," she says. "Fundamentally, homosexuality is not a mental illness, and you don't need a treatment to fix it."
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