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Landmark Federal Report Condemns Efforts to Change Trans, LGBQ Youth

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The Obama administration has joined the medical community and LGBTQ advocates in demanding an end to conversion therapy for LGBTQ youth. Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth, a new report by the Substance Abuse and Mental Health Administration (SAMHSA), says that so-called “therapeutic” attempts to change young people’s gender identity or sexual orientation are ineffective, unethical, and potentially harmful. SAMHSA recognizes that LGBTQ youth don’t need to change who they are—what they need is a supportive environment and affirming care.

Conversion therapy, sometimes known as reparative therapy or ex-gay therapy, is the discredited practice of trying to change someone’s sexual orientation or gender identity. There’s no dispute in the mainstream medical community that conversion therapy doesn’t work. In fact, it can cause serious harm. Conversion therapy can be a traumatic experience that inflicts long-lasting scars. It can make people—especially young people—more vulnerable to depression, substance abuse and other long-term health problems, often leading to tragic results.

SAMHSA makes it clear that the problem isn’t the gender identities of trans youth—it’s the rejection and discrimination many of them face. Rather than forcing them to suppress who they are, their families and healthcare providers need to create an environment where they can feel supported and accepted. The report explains how parents, school officials and health care providers can provide trans youth with the social support and affirmation they need, recognizing that this support is “a life-changing and potentially life-saving intervention.” SAMHSA also joins numerous medical organizations that recognize that transgender youth need affirmative care. That can include a support network to help them transition socially, the medical interventions that are right for them, and therapy to promote resilience in the face of stigma and discrimination.

Building on earlier position statements from health professional associations, the SAMHSA report contains important Statements of Professional Consensus  developed by an American Psychological Association expert panel. The statements recognize that diversity in sexual orientation and gender identity “are a part of the normal spectrum of human diversity,” that no research indicates that any intervention can change them, and that attempts to do so “are coercive, can be harmful, and should not be part of behavioral health treatments.” The statements continue to say that it is “clinically inappropriate” for behavioral health professionals to try to change a young person’s gender identity, gender expression or sexual identity.

Instead, the consensus statements say therapy should focus on supporting young people explore their identities, helping them deal with distress and stigma, and improve their support network in their communities and at home, as well as supporting social transition and medical intervention when appropriate. And the statements conclude that withholding medical interventions such as puberty suppression, hormone therapy, or surgeries for some older teens, when those interventions are clinically appropriate, “prolongs gender dysphoria and exacerbates emotional distress.”

Four states and the District of Columbia have passed laws banning conversion therapy for minors, and many similar conversion therapy bills have been introduced at the state and federal levels. By taking a stand against conversion therapy, the Obama administration has provided an opportunity to expand the reach of these laws and help protect trans youth from suffering the harms of this practice in the future. 

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