A Review of “Sexual Orientation Change Efforts, Professional Psychology, and the Law”
April 25, 2018
by Andrè Van Mol, MD
Dr. Christopher Rosik, a California clinical and academic psychologist, has done remarkable work with his article “Sexual Orientation Change Efforts, Professional Psychology, and the Law: A Brief History and Analysis of a Therapeutic Prohibition,” recently published in the BYU Journal of Public Law.
Dr. Rosik examines the history of sexual orientation change effort/therapy (SOCE) bans and what they reveal about the interplay of professional psychology, political advocacy and cultural change. His stated goal is to expose the dangers of adjudicating differences of professional practice, and he succeeds. Dr. Rosik brings to the table his substantial expertise in the field as a past president of NARTH/Alliance for Therapeutic Choice and Scientific Integrity.
He starts with the 2012 California Senate Bill 1172, the ban on change therapy for minors, that got its start with the gay-rights group Equality California and sponsorship by Sen. Ted Lieu. After its approval, it survived legal challenges up to and through the Ninth Circuit. Dr. Rosik quotes Judge O’Scannlain’s “scathing rebuke of the majority’s decision” in which he foresaw its use as “a new and powerful tool to silence expression based on a political or moral judgment” which “the First Amendment precisely forbids.” The U.S. Supreme Court refused the subsequent appeal. Since becoming law in 2014, several states and municipalities have followed suit, but more than twice as many states have not approved such bans.
As a cautionary tale of how anti-SOCE laws can affect professionals, Dr. Rosik explains how highly esteemed Canadian psychologist Kenneth Zucker fell prey to Ontario’s 2015 ban on SOCE for minors. Dr. Zucker’s renowned Child and Youth Gender Identity Clinic in Toronto allowed the option of helping children with gender dysphoria simply adjust to their biological sex. A review, with little effort toward verification, accused Dr. Zucker of “conversion” or “reparative” therapy and claimed it was associated with youth suicide. By year’s end, he was shown the door.
A newer path to SOCE bans described by Dr. Rosik comes through invoking Section 5 of the Federal Trade Commission Acts and state-level consumer protection legislation barring “unfair and deceptive practices,” i.e. consumer fraud. All that is needed to trigger the violation is monetary exchange. This was done in New Jersey in 2015 to shut down JONAH (Jews Offering New Alternatives for Healing). Illinois passed such a law, and I would add that California is attempting the same with Assembly Bill 2943. In 2015, now Congressman Ted Lieu introduced the Therapeutic Fraud Prevention Act (HR 2450) to ban change (“conversion”) therapy for anyone.
Dr. Rosik points out that the public’s increasing approval of same-sex behavior from 11 percent in 1973 to 49 percent by 2014 helped make therapy prohibitions politically possible. Here he helpfully presents a primer on Moral Foundations Theory (MoFT), which distills the world’s moral frameworks down to six foundational principles/virtues: harm/care, fairness/reciprocity, liberty/oppression, in-group/loyalty, authority/respect and purity/sanctity. The first three make up individualizing foundations, concerned with the wellbeing and rights of the individual; and the latter three are binding foundations, prioritizing the virtues and institutions promoting group wellbeing through “roles, duties and mutual obligations”—call them the ties that bind. Though conservatives and liberals have certain moral principles in common, MoFT data suggests that liberals tend to emphasize the individualizing foundations and conservatives the binding ones. This means the language, moral arguments and—as Dr. Rosik goes on to show—the legal reasoning of the left and right are likely to go right past each other. The parlance of left will be “rights, equality (of outcomes) and justice” as guardians of the oppressed victims. Conservatives language will balance liberty, fairness and safety with focus on “the preservation of the institutions and traditions that sustain a moral community.” Per MoFT, modern societies become more individualistic and less ideologically diverse, as evidenced today in the more liberal stances of professional psychology, academia and the entertainment field.
Supporters of change therapy often root their reasoning in appeals to the rights of parents, religious freedom and free speech rights (aka, First Amendment protections), in keeping with binding foundations. But these do not connect as validating reasons by SOCE opponents. Rosik explains that “heterosexuality and traditional religious institutions” can be viewed by liberals as dominant, privileged and oppressive to sexual minorities. When ideological tribalism replaces impartial reasoning, shared “morality binds and blinds.” Judges are likewise affected by their moral perspectives and vulnerable to emotional appeals. In this environment, pro-SOCE conservatives might “not sufficiently recognize the welfare and rights of individuals,” while anti-SOCE liberals may “underplay the importance and fragility of the institutions and groups, e.g., church, family, marriage, upon which societies have been built….” MoFT author Haidt called modern psychology such a “tribal-moral community” of shared “sacred values.”
When a profession is thus beset with such viewpoint uniformity—read lack of diversity—as Dr. Rosik details, there is considerable hazard of committing or enabling “the misrepresentation and misuse of research by advocacy groups for their own advocacy and political purposes,” aka “woozling.” With the woozle effect “a claim or belief is asserted as definitive but is in fact based on data that is inaccurate or only partially accurate.” When a woozled claim is repeatedly and authoritatively put forth, legislators and the general public tend to believe it. As Rosik explains with clear examples, anti-SOCE assertions provide a grand example of woozle formation through “evidence by citation, generalizing from small or non-representative samples, differential emphases on the significance and limitations of findings, the use of dramatic portrayals, failing to contextualize research findings, and questionable research practices (QRP).” The details Dr. Rosik provides in this section are worth the read of the paper alone.
Enter the Leona Tyler Principle adopted by the American Psychological Association in 1973 directing that public policy advocacy must have firm scientific grounding. Past APA President Cummings is quoted as protesting that “….with the growth of political correctness, somehow the Leona Tyler principle, which was never repealed, was increasingly ignored….” Examples given by Rosik include exaggeration regarding the thin empirical record of SOCE harms while ignoring recent studies suggesting benefits for some. A woozle is a woozle.
Dramatic anecdotes of SOCE harm claims being presented as standard SOCE methods are common, despite the fact that SOCE therapists have rejected such practices as unethical and unhelpful for decades. Rosik’s section on failure to contextualize research findings documents that general (non-SOCE) psychotherapy results in deterioration in 5 to 10 percent of adults and 14 to 24 percent of minors, and that up to 50 percent of minors fail to improve in their chief complaint. Unless opponents can empirically demonstrate that SOCE patients in the care of licensed therapists fare worse than that, bans seem unmerited.
Dr. Rosik then helpfully delineates recommendations for the conduct of research, legislative and judicial deliberation and professional psychology as a whole to help climb out of this mess. He offers a three-step approach toward reforming research practices:
- Professional journals should require disclosure statements and QRP-checklists regarding data production.
- Encourage research data sharing among researchers of opposite sides of controversy by journals making publication contingent upon authors submitting their databases. He notes that less than one-third of researchers even provide data when asked.
- Full disclosure of research funding sources. Did an advocacy group fund the study or have close association with the author? Conflicts of interest and compromised objectivity should be revealed.
To guide legislative and judicial processes, Dr. Rosik has three recommendations:
- Establish criteria for research rigorous enough to justify legislative intrusions into psychological practice.
- Standardize the reporting of research to politicians and judges.
- Deemphasize anecdotal accounts, and verify “dramatic or fantastical stories” or let them be dismissed as unreliable.
Finally for professional psychology, Dr. Rosik encourages:
- Increasing ideological diversity at all professional levels lest it lose credibility and public trust for having become essentially a leftist think tank.
- Restoring the previously mentioned Leona Tyler Principle.
Dr. Rosik summarizes that advocacy movements with a solid cultural tailwind can compromise the objectivity of the psychological and legal professions—the path of California’s SB 1172 being the case in point—creating an environment ripe for stifling viewpoint diversity in which the public perception of both the psychological and legal fields suffers.