Text of MD SB 1028 (2018)

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW. [Brackets] indicate matter deleted from existing law. *sb1028* SENATE BILL 1028 J2, J1 8lr1806 CF HB 902 By: Senators Madaleno, Ferguson, Guzzone, Kagan, Lee, Manno, Pinsky, Smith, and Zucker Introduced and read first time: February 5, 2018 Assigned to: Education, Health, and Environmental Affairs A BILL ENTITLED AN ACT concerning 1 Health Occupations – Conversion Therapy for Minors – Prohibition 2 (Youth Mental Health Protection Act) 3 FOR the purpose of prohibiting certain mental health or child care practitioners from 4 engaging in conversion therapy with individuals who are minors; providing that a 5 certain mental health or child care practitioner who engages in conversion therapy 6 with an individual who is a minor shall be considered to have engaged in 7 unprofessional conduct and shall be subject to discipline by a certain licensing or 8 certifying board; prohibiting the use of State funds for certain purposes; requiring 9 the Maryland Department of Health to adopt certain regulations; defining certain 10 terms; making this Act severable; and generally relating to conversion therapy. 11 BY adding to 12 Article – Health Occupations 13 Section 1–212.1 14 Annotated Code of Maryland 15 (2014 Replacement Volume and 2017 Supplement) 16 Preamble 17 WHEREAS, Contemporary science recognizes that being lesbian, gay, bisexual, or 18 transgender (LGBT) is part of the natural spectrum of human identity and is not a disease, 19 a disorder, or an illness; and 20 WHEREAS, The American Psychological Association convened a Task Force on 21 Appropriate Therapeutic Responses to Sexual Orientation that conducted a systematic 22 review of peer–reviewed journal literature on sexual orientation change efforts and 23 concluded in its 2009 report that sexual orientation change efforts can pose critical health 24 risks to lesbian, gay, and bisexual people, including confusion, depression, guilt, 25 helplessness, hopelessness, shame, social withdrawal, suicidal intentions, substance abuse, 26 2 SENATE BILL 1028 stress, disappointment, self–blame, decreased self–esteem and authenticity to others, 1 increased self–hatred, hostility and blame toward parents, feelings of anger and betrayal, 2 loss of friends and potential romantic partners, problems in sexual and emotional intimacy, 3 sexual dysfunction, high–risk sexual behaviors, a feeling of being dehumanized and untrue 4 to self, a loss of faith, and a sense of having wasted time and resources; and 5 WHEREAS, The American Psychological Association issued a resolution on 6 Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts in 7 2009 stating that it “advises parents, guardians, young people, and their families to avoid 8 sexual orientation change efforts that portray homosexuality as a mental illness or 9 developmental disorder and to seek psychotherapy, social support, and educational services 10 that provide accurate information on sexual orientation and sexuality, increase family and 11 school support, and reduce rejection of sexual minority youth”; and 12 WHEREAS, The American Psychiatric Association stated in 2000 that 13 “psychotherapeutic modalities to convert or ‘repair’ homosexuality are based on 14 developmental theories whose scientific validity is questionable. Furthermore, anecdotal 15 reports of ‘cures’ are counterbalanced by anecdotal claims of psychological harm. In the last 16 four decades, ‘reparative’ therapists have not produced any rigorous scientific research to 17 substantiate their claims of cure. Until there is such research available, the American 18 Psychiatric Association recommends that ethical practitioners refrain from attempts to 19 change individuals’ sexual orientation, keeping in mind the medical dictum to first, do no 20 harm”; and 21 WHEREAS, The American Psychiatric Association also stated in 2000 that “the 22 potential risks of reparative therapy are great, including depression, anxiety, and 23 self–destructive behavior, since therapist alignment with societal prejudices against 24 homosexuality may reinforce self–hatred already experienced by the patient. Many 25 patients who have undergone reparative therapy relate that they were inaccurately told 26 that homosexuals are lonely, unhappy individuals who never achieve acceptance or 27 satisfaction. The possibility that the person might achieve happiness and satisfying 28 interpersonal relationships as a gay man or lesbian is not presented, nor are alternative 29 approaches to dealing with the effects of societal stigmatization discussed”; and 30 WHEREAS, The American Psychiatric Association further stated in 2000 that it 31 “opposes any psychiatric treatment such as reparative or conversion therapy which is based 32 upon the assumption that homosexuality per se is a mental disorder or based upon the a 33 priori assumption that a patient should change his/her sexual homosexual orientation”; and 34 WHEREAS, The American Academy of Pediatrics in 1993 published an article in its 35 journal “Pediatrics” stating “[t]herapy directed at specifically changing sexual orientation 36 is contraindicated, since it can provoke guilt and anxiety while having little or no potential 37 for achieving changes in orientation”; and 38 WHEREAS, The American Medical Association Council on Scientific Affairs 39 prepared a report in 1994 in which it stated “[a]version therapy (a behavioral or medical 40 intervention which pairs unwanted behavior, in this case, homosexual behavior, with 41 SENATE BILL 1028 3 unpleasant sensations or aversive consequences) is no longer recommended for gay men 1 and lesbians”; and 2 WHEREAS, The American Medical Association Council on Scientific Affairs further 3 stated in its 1994 report that “[t]hrough psychotherapy, gay men and lesbians can become 4 comfortable with their sexual orientation and understand the societal response to it”; and 5 WHEREAS, The National Association of Social Workers prepared a 1997 policy 6 statement in which it stated “[s]ocial stigmatization of lesbian, gay, and bisexual people is 7 widespread and is a primary motivating factor in leading some people to seek sexual 8 orientation changes. Sexual orientation conversion therapies assume that homosexual 9 orientation is both pathological and freely chosen. No data demonstrates that reparative or 10 conversion therapies are effective, and, in fact, they may be harmful”; and 11 WHEREAS, The American Counseling Association Governing Council issued a 12 position statement in April 1999 that stated it opposed the promotion of reparative therapy 13 as a “cure” for homosexual individuals; and 14 WHEREAS, The American School Counselor Association issued a position paper in 15 2014 in which it stated that “[i]t is not the role of the professional school counselor to 16 attempt to change a student’s sexual orientation or gender identity” and that “[p]rofessional 17 school counselors do not support efforts by licensed mental health professionals to change 18 a student’s sexual orientation or gender as these practices have been proven ineffective and 19 harmful”; and 20 WHEREAS, The American Psychoanalytic Association issued a position statement 21 in June 2012 regarding attempts to change sexual orientation, gender identity, or gender 22 expression, and in the position statement the Association states “as with any societal 23 prejudice, bias against individuals based on actual or perceived sexual orientation, gender 24 identity or gender expression negatively affects mental health, contributing to an enduring 25 sense of stigma and pervasive self–criticism through the internalization of such prejudice”; 26 and 27 WHEREAS, The American Psychoanalytic Association also stated in June 2012 that 28 “psychoanalytic technique does not encompass purposeful attempts to ‘convert,’ ‘repair,’ 29 change or shift an individual’s sexual orientation, gender identity or gender expression. 30 Such directed efforts are against fundamental principles of psychoanalytic treatment and 31 often result in substantial psychological pain by reinforcing damaging internalized 32 attitudes”; and 33 WHEREAS, The American Academy of Child and Adolescent Psychiatry published 34 in 2012 an article in its journal entitled “The Journal of the American Academy of Child 35 and Adolescent Psychiatry”, stating “[c]linicians should be aware that there is no evidence 36 that sexual orientation can be altered through therapy, and that attempts to do so may be 37 harmful. There is no empirical evidence adult homosexuality can be prevented if gender 38 nonconforming children are influenced to be more gender conforming. Indeed, there is no 39 medically valid basis for attempting to prevent homosexuality, which is not an illness. On 40 4 SENATE BILL 1028 the contrary, such efforts may encourage family rejection and undermine self–esteem, 1 connectedness and caring, important protective factors against suicidal ideation and 2 attempts. Given that there is no evidence that efforts to alter sexual orientation are 3 effective, beneficial, or necessary, and the possibility that they carry the risk of significant 4 harm, such interventions are contraindicated”; and 5 WHEREAS, The Pan American Health Organization, a regional office of the World 6 Health Organization, issued a statement in May 2012 that states “[t]hese supposed 7 conversion therapies constitute a violation of the ethical principles of health care and 8 violate human rights that are protected by international and regional agreements”; and 9 WHEREAS, The Pan American Health Organization also noted that reparative 10 therapies “lack medical justification and represent a serious threat to the health and 11 well–being of affected people”; and 12 WHEREAS, The American Association of Sexuality Educators, Counselors, and 13 Therapists issued a statement in 2014 that states “same sex orientation is not a mental 14 disorder and that [it] opposes any ‘reparative’ or conversion therapy that seeks to ‘change’ 15 or ‘fix’ a person’s sexual orientation”; and 16 WHEREAS, The American Association of Sexuality Educators, Counselors, and 17 Therapists further stated in 2014 its belief that sexual orientation is not “something that 18 needs to be ‘fixed’ or ‘changed’” and provided as its rationale for this position that 19 “[r]eparative therapy (for minors, in particular) is often forced or nonconsensual[,]”, has 20 “been proven harmful to minors[,]”, and that “[t]here is no scientific evidence supporting 21 the success of these interventions”; and 22 WHEREAS, The American Association of Sexuality Educators, Counselors, and 23 Therapists also stated in 2014 that “[r]eparative therapy is grounded in the idea that 24 non–heterosexual orientation is ‘disordered’” and that “[r]eparative therapy has been 25 shown to be a negative predictor of psychotherapeutic benefit”; and 26 WHEREAS, The American College of Physicians wrote a position paper in 2015 27 stating that it “opposes the use of ‘conversion,’ ‘reorientation,’ or ‘reparative’ therapy for the 28 treatment of LGBT persons[,]”, that “[a]vailable research does not support the use of 29 reparative therapy as an effective model in the treatment of LGBT persons[,]”, and that 30 “[e]vidence shows that the practice may actually cause emotional or physical harm to LGBT 31 individuals, particularly adolescents or young persons”; and 32 WHEREAS, Minors who experience family rejection based on their sexual 33 orientation face especially serious health risks; and 34 WHEREAS, In a study published in 2009 in the journal “Pediatrics”, lesbian, gay, 35 and bisexual young adults who reported higher levels of family rejection during adolescence 36 were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to 37 report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times 38 more likely to report having engaged in unprotected sexual intercourse when compared 39 SENATE BILL 1028 5 with peers from families that reported no or low levels of family rejection; and 1 WHEREAS, Maryland has a compelling interest in protecting the physical and 2 psychological well–being of minors, including LGBT youth, and in protecting minors 3 against exposure to serious harm caused by sexual orientation change efforts; now, 4 therefore, 5 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 6 That the Laws of Maryland read as follows: 7 Article – Health Occupations 8 1–212.1. 9 (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 10 INDICATED. 11 (2) (I) “CONVERSION THERAPY” MEANS A PRACTICE OR 12 TREATMENT BY A MENTAL HEALTH OR CHILD CARE PRACTITIONER THAT SEEKS TO 13 CHANGE AN INDIVIDUAL’S SEXUAL ORIENTATION OR GENDER IDENTITY. 14 (II) “CONVERSION THERAPY” INCLUDES ANY EFFORT TO 15 CHANGE THE BEHAVIORAL EXPRESSION OF AN INDIVIDUAL’S SEXUAL ORIENTATION, 16 CHANGE GENDER EXPRESSION, OR ELIMINATE OR REDUCE SEXUAL OR ROMANTIC 17 ATTRACTIONS OR FEELINGS TOWARD INDIVIDUALS OF THE SAME GENDER. 18 (III) “CONVERSION THERAPY” DOES NOT INCLUDE A PRACTICE 19 BY A MENTAL HEALTH OR CHILD CARE PRACTITIONER THAT: 20 1. PROVIDES ACCEPTANCE, SUPPORT, AND 21 UNDERSTANDING, OR THE FACILITATION OF COPING, SOCIAL SUPPORT, AND 22 IDENTITY EXPLORATION AND DEVELOPMENT, INCLUDING SEXUAL 23 ORIENTATION–NEUTRAL INTERVENTIONS TO PREVENT OR ADDRESS UNLAWFUL 24 CONDUCT OR UNSAFE SEXUAL PRACTICES; AND 25 2. DOES NOT SEEK TO CHANGE SEXUAL ORIENTATION 26 OR GENDER IDENTITY. 27 (3) “MENTAL HEALTH OR CHILD CARE PRACTITIONER” MEANS: 28 (I) A PRACTITIONER LICENSED OR CERTIFIED UNDER TITLE 29 14, TITLE 17, TITLE 18, TITLE 19, OR TITLE 20 OF THIS ARTICLE; OR 30 (II) ANY OTHER PRACTITIONER LICENSED OR CERTIFIED 31 6 SENATE BILL 1028 UNDER THIS ARTICLE WHO IS AUTHORIZED TO PROVIDE COUNSELING BY THE 1 PRACTITIONER’S LICENSING OR CERTIFYING BOARD. 2 (B) A MENTAL HEALTH OR CHILD CARE PRACTITIONER MAY NOT ENGAGE IN 3 CONVERSION THERAPY WITH AN INDIVIDUAL WHO IS A MINOR. 4 (C) A MENTAL HEALTH OR CHILD CARE PRACTITIONER WHO ENGAGED IN 5 CONVERSION THERAPY WITH AN INDIVIDUAL WHO IS A MINOR SHALL BE 6 CONSIDERED TO HAVE ENGAGED IN UNPROFESSIONAL CONDUCT AND SHALL BE 7 SUBJECT TO DISCIPLINE BY THE MENTAL HEALTH OR CHILD CARE PRACTITIONER’S 8 LICENSING OR CERTIFYING BOARD. 9 (D) NO STATE FUNDS MAY BE USED FOR THE PURPOSE OF: 10 (1) CONDUCTING, OR REFERRING AN INDIVIDUAL TO RECEIVE, 11 CONVERSION THERAPY; 12 (2) PROVIDING HEALTH COVERAGE FOR CONVERSION THERAPY; OR 13 (3) PROVIDING A GRANT TO OR CONTRACTING WITH ANY ENTITY 14 THAT CONDUCTS OR REFERS AN INDIVIDUAL TO RECEIVE CONVERSION THERAPY. 15 (E) THE DEPARTMENT SHALL ADOPT REGULATIONS NECESSARY TO 16 IMPLEMENT THIS SECTION. 17 SECTION 2. AND BE IT FURTHER ENACTED, That, if any provision of this Act or 18 the application thereof to any person or circumstance is held invalid for any reason in a 19 court of competent jurisdiction, the invalidity does not affect other provisions or any other 20 application of this Act that can be given effect without the invalid provision or application, 21 and for this purpose the provisions of this Act are declared severable. 22 SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 23 October 1, 2018. 24

LAWRENCE J. HOGAN, JR., Governor Ch. 685 – 1 – Chapter 685 (Senate Bill 1028) AN ACT concerning Health Occupations – Conversion Therapy for Minors – Prohibition (Youth Mental Health Protection Act) FOR the purpose of prohibiting certain mental health or child care practitioners from engaging in conversion therapy with individuals who are minors; providing that a certain mental health or child care practitioner who engages in conversion therapy with an individual who is a minor shall be considered to have engaged in unprofessional conduct and shall be subject to discipline by a certain licensing or certifying board; prohibiting the use of State funds for certain purposes; requiring the Maryland Department of Health to adopt certain regulations; defining certain terms; making this Act severable; and generally relating to conversion therapy. BY adding to Article – Health Occupations Section 1–212.1 Annotated Code of Maryland (2014 Replacement Volume and 2017 Supplement) Preamble WHEREAS, Contemporary science recognizes that being lesbian, gay, bisexual, or transgender (LGBT) is part of the natural spectrum of human identity and is not a disease, a disorder, or an illness; and WHEREAS, The American Psychological Association convened a Task Force on Appropriate Therapeutic Responses to Sexual Orientation that conducted a systematic review of peer–reviewed journal literature on sexual orientation change efforts and concluded in its 2009 report that sexual orientation change efforts can pose critical health risks to lesbian, gay, and bisexual people, including confusion, depression, guilt, helplessness, hopelessness, shame, social withdrawal, suicidal intentions, substance abuse, stress, disappointment, self–blame, decreased self–esteem and authenticity to others, increased self–hatred, hostility and blame toward parents, feelings of anger and betrayal, loss of friends and potential romantic partners, problems in sexual and emotional intimacy, sexual dysfunction, high–risk sexual behaviors, a feeling of being dehumanized and untrue to self, a loss of faith, and a sense of having wasted time and resources; and WHEREAS, The American Psychological Association issued a resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts in 2009 stating that it “advises parents, guardians, young people, and their families to avoid sexual orientation change efforts that portray homosexuality as a mental illness or developmental disorder and to seek psychotherapy, social support, and educational services Ch. 685 2018 LAWS OF MARYLAND – 2 – that provide accurate information on sexual orientation and sexuality, increase family and school support, and reduce rejection of sexual minority youth”; and WHEREAS, The American Psychiatric Association stated in 2000 that “psychotherapeutic modalities to convert or ‘repair’ homosexuality are based on developmental theories whose scientific validity is questionable. Furthermore, anecdotal reports of ‘cures’ are counterbalanced by anecdotal claims of psychological harm. In the last four decades, ‘reparative’ therapists have not produced any rigorous scientific research to substantiate their claims of cure. Until there is such research available, the American Psychiatric Association recommends that ethical practitioners refrain from attempts to change individuals’ sexual orientation, keeping in mind the medical dictum to first, do no harm”; and WHEREAS, The American Psychiatric Association also stated in 2000 that “the potential risks of reparative therapy are great, including depression, anxiety, and self–destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self–hatred already experienced by the patient. Many patients who have undergone reparative therapy relate that they were inaccurately told that homosexuals are lonely, unhappy individuals who never achieve acceptance or satisfaction. The possibility that the person might achieve happiness and satisfying interpersonal relationships as a gay man or lesbian is not presented, nor are alternative approaches to dealing with the effects of societal stigmatization discussed”; and WHEREAS, The American Psychiatric Association further stated in 2000 that it “opposes any psychiatric treatment such as reparative or conversion therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that a patient should change his/her sexual homosexual orientation”; and WHEREAS, The American Academy of Pediatrics in 1993 published an article in its journal “Pediatrics” stating “[t]herapy directed at specifically changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation”; and WHEREAS, The American Medical Association Council on Scientific Affairs prepared a report in 1994 in which it stated “[a]version therapy (a behavioral or medical intervention which pairs unwanted behavior, in this case, homosexual behavior, with unpleasant sensations or aversive consequences) is no longer recommended for gay men and lesbians”; and WHEREAS, The American Medical Association Council on Scientific Affairs further stated in its 1994 report that “[t]hrough psychotherapy, gay men and lesbians can become comfortable with their sexual orientation and understand the societal response to it”; and WHEREAS, The National Association of Social Workers prepared a 1997 policy statement in which it stated “[s]ocial stigmatization of lesbian, gay, and bisexual people is widespread and is a primary motivating factor in leading some people to seek sexual LAWRENCE J. HOGAN, JR., Governor Ch. 685 – 3 – orientation changes. Sexual orientation conversion therapies assume that homosexual orientation is both pathological and freely chosen. No data demonstrates that reparative or conversion therapies are effective, and, in fact, they may be harmful”; and WHEREAS, The American Counseling Association Governing Council issued a position statement in April 1999 that stated it opposed the promotion of reparative therapy as a “cure” for homosexual individuals; and WHEREAS, The American School Counselor Association issued a position paper in 2014 in which it stated that “[i]t is not the role of the professional school counselor to attempt to change a student’s sexual orientation or gender identity” and that “[p]rofessional school counselors do not support efforts by licensed mental health professionals to change a student’s sexual orientation or gender as these practices have been proven ineffective and harmful”; and WHEREAS, The American Psychoanalytic Association issued a position statement in June 2012 regarding attempts to change sexual orientation, gender identity, or gender expression, and in the position statement the Association states “as with any societal prejudice, bias against individuals based on actual or perceived sexual orientation, gender identity or gender expression negatively affects mental health, contributing to an enduring sense of stigma and pervasive self–criticism through the internalization of such prejudice”; and WHEREAS, The American Psychoanalytic Association also stated in June 2012 that “psychoanalytic technique does not encompass purposeful attempts to ‘convert,’ ‘repair,’ change or shift an individual’s sexual orientation, gender identity or gender expression. Such directed efforts are against fundamental principles of psychoanalytic treatment and often result in substantial psychological pain by reinforcing damaging internalized attitudes”; and WHEREAS, The American Academy of Child and Adolescent Psychiatry published in 2012 an article in its journal entitled “The Journal of the American Academy of Child and Adolescent Psychiatry”, stating “[c]linicians should be aware that there is no evidence that sexual orientation can be altered through therapy, and that attempts to do so may be harmful. There is no empirical evidence adult homosexuality can be prevented if gender nonconforming children are influenced to be more gender conforming. Indeed, there is no medically valid basis for attempting to prevent homosexuality, which is not an illness. On the contrary, such efforts may encourage family rejection and undermine self–esteem, connectedness and caring, important protective factors against suicidal ideation and attempts. Given that there is no evidence that efforts to alter sexual orientation are effective, beneficial, or necessary, and the possibility that they carry the risk of significant harm, such interventions are contraindicated”; and WHEREAS, The Pan American Health Organization, a regional office of the World Health Organization, issued a statement in May 2012 that states “[t]hese supposed conversion therapies constitute a violation of the ethical principles of health care and Ch. 685 2018 LAWS OF MARYLAND – 4 – violate human rights that are protected by international and regional agreements”; and WHEREAS, The Pan American Health Organization also noted that reparative therapies “lack medical justification and represent a serious threat to the health and well–being of affected people”; and WHEREAS, The American Association of Sexuality Educators, Counselors, and Therapists issued a statement in 2014 that states “same sex orientation is not a mental disorder and that [it] opposes any ‘reparative’ or conversion therapy that seeks to ‘change’ or ‘fix’ a person’s sexual orientation”; and WHEREAS, The American Association of Sexuality Educators, Counselors, and Therapists further stated in 2014 its belief that sexual orientation is not “something that needs to be ‘fixed’ or ‘changed’” and provided as its rationale for this position that “[r]eparative therapy (for minors, in particular) is often forced or nonconsensual[,]”, has “been proven harmful to minors[,]”, and that “[t]here is no scientific evidence supporting the success of these interventions”; and WHEREAS, The American Association of Sexuality Educators, Counselors, and Therapists also stated in 2014 that “[r]eparative therapy is grounded in the idea that non–heterosexual orientation is ‘disordered’” and that “[r]eparative therapy has been shown to be a negative predictor of psychotherapeutic benefit”; and WHEREAS, The American College of Physicians wrote a position paper in 2015 stating that it “opposes the use of ‘conversion,’ ‘reorientation,’ or ‘reparative’ therapy for the treatment of LGBT persons[,]”, that “[a]vailable research does not support the use of reparative therapy as an effective model in the treatment of LGBT persons[,]”, and that “[e]vidence shows that the practice may actually cause emotional or physical harm to LGBT individuals, particularly adolescents or young persons”; and WHEREAS, Minors who experience family rejection based on their sexual orientation face especially serious health risks; and WHEREAS, In a study published in 2009 in the journal “Pediatrics”, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse when compared with peers from families that reported no or low levels of family rejection; and WHEREAS, Maryland has a compelling interest in protecting the physical and psychological well–being of minors, including LGBT youth, and in protecting minors against exposure to serious harm caused by sexual orientation change efforts; now, therefore, SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, LAWRENCE J. HOGAN, JR., Governor Ch. 685 – 5 – That the Laws of Maryland read as follows: Article – Health Occupations 1–212.1. (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS INDICATED. (2) (I) “CONVERSION THERAPY” MEANS A PRACTICE OR TREATMENT BY A MENTAL HEALTH OR CHILD CARE PRACTITIONER THAT SEEKS TO CHANGE AN INDIVIDUAL’S SEXUAL ORIENTATION OR GENDER IDENTITY. (II) “CONVERSION THERAPY” INCLUDES ANY EFFORT TO CHANGE THE BEHAVIORAL EXPRESSION OF AN INDIVIDUAL’S SEXUAL ORIENTATION, CHANGE GENDER EXPRESSION, OR ELIMINATE OR REDUCE SEXUAL OR ROMANTIC ATTRACTIONS OR FEELINGS TOWARD INDIVIDUALS OF THE SAME GENDER. (III) “CONVERSION THERAPY” DOES NOT INCLUDE A PRACTICE BY A MENTAL HEALTH OR CHILD CARE PRACTITIONER THAT: 1. PROVIDES ACCEPTANCE, SUPPORT, AND UNDERSTANDING, OR THE FACILITATION OF COPING, SOCIAL SUPPORT, AND IDENTITY EXPLORATION AND DEVELOPMENT, INCLUDING SEXUAL ORIENTATION–NEUTRAL INTERVENTIONS TO PREVENT OR ADDRESS UNLAWFUL CONDUCT OR UNSAFE SEXUAL PRACTICES; AND 2. DOES NOT SEEK TO CHANGE SEXUAL ORIENTATION OR GENDER IDENTITY. (3) “MENTAL HEALTH OR CHILD CARE PRACTITIONER” MEANS: (I) A PRACTITIONER LICENSED OR CERTIFIED UNDER TITLE 14, TITLE 17, TITLE 18, TITLE 19, OR TITLE 20 OF THIS ARTICLE; OR (II) ANY OTHER PRACTITIONER LICENSED OR CERTIFIED UNDER THIS ARTICLE WHO IS AUTHORIZED TO PROVIDE COUNSELING BY THE PRACTITIONER’S LICENSING OR CERTIFYING BOARD. (B) A MENTAL HEALTH OR CHILD CARE PRACTITIONER MAY NOT ENGAGE IN CONVERSION THERAPY WITH AN INDIVIDUAL WHO IS A MINOR. (C) A MENTAL HEALTH OR CHILD CARE PRACTITIONER WHO ENGAGED IN Ch. 685 2018 LAWS OF MARYLAND – 6 – CONVERSION THERAPY WITH AN INDIVIDUAL WHO IS A MINOR SHALL BE CONSIDERED TO HAVE ENGAGED IN UNPROFESSIONAL CONDUCT AND SHALL BE SUBJECT TO DISCIPLINE BY THE MENTAL HEALTH OR CHILD CARE PRACTITIONER’S LICENSING OR CERTIFYING BOARD. (D) NO STATE FUNDS MAY BE USED FOR THE PURPOSE OF: (1) CONDUCTING, OR REFERRING AN INDIVIDUAL TO RECEIVE, CONVERSION THERAPY; (2) PROVIDING HEALTH COVERAGE FOR CONVERSION THERAPY; OR (3) PROVIDING A GRANT TO OR CONTRACTING WITH ANY ENTITY THAT CONDUCTS OR REFERS AN INDIVIDUAL TO RECEIVE CONVERSION THERAPY. (E) THE DEPARTMENT SHALL ADOPT REGULATIONS NECESSARY TO IMPLEMENT THIS SECTION. SECTION 2. AND BE IT FURTHER ENACTED, That, if any provision of this Act or the application thereof to any person or circumstance is held invalid for any reason in a court of competent jurisdiction, the invalidity does not affect other provisions or any other application of this Act that can be given effect without the invalid provision or application, and for this purpose the provisions of this Act are declared severable. SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect October 1, 2018. Approved by the Governor, May 15, 2018.