Chicago - 12:00 PM - 12:45 PM
Scott Leibowitz, MD
Attending Psychiatrist, Ann & Robert H. Lurie Children s Hospital of Chicago
Head Child and Adolescent Psychiatrist, Gender and Sex Development Program
Assistant Professor of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
Sexual Orientation Conversion "Therapy:" Ethical Considerations of Applying A Fixed Outcome Behavioral Health Approach to Minors
Efforts to change or alter the sexual orientation of a child or adolescent are also more commonly known as conversion therapy. Legislative efforts to ban such interventions have recently picked up steam, including here in Illinois, and such a bill is currently sitting on Governor Rauner's desk awaiting his decision to sign it into law. An American Psychological Association 2009 Taskforce reviewed the existing literature and concluded that such efforts- regardless of how subtle the modality- are harmful to individuals, as they work off the false premise that homosexuality is pathological (removed from the DSM in 1973) and promote further shame and isolation for individuals with same-gender attractions, particularly when the efforts do not work as they purport to. The concept of a fixed-outcome behavioral health intervention (defining an achievable specific endpoint) is incongruent in psychiatric practice as clinicians typically need to address the multiple aspects of identity and behavioral health factors that might be contributing to psychopathology and cannot make definitive promises that treatment would lead to an elimination of a certain illness. To apply such an intervention towards an aspect of identity that is a normal variant of the human experience, such as sexual orientation, is even further unethical. Many even argue that referring to these efforts as a "therapy" risks legitimizing the interventions, when they are not rooted in science, do not withstand the ethical principle of "do no harm" as dictated by the modern medical community, and have zero backing by any major professional medical organization. For minors- who lack the autonomy to choose a behavioral health provider- these types of interventions prey on the fears of families seeking to fix something that is not inherently psychopathological in their child or adolescent. This presentation will review these concepts, explore how they extend to gender identity and expression, and raise awareness to the complex issues.