Text of VT S 132 (2016)

BILL AS INTRODUCED S.132 2015 Page 1 of 11 VT LEG #305917 v.1 S.132 1 Introduced by Senators Campion, Ayer, Baruth, Lyons, and McCormack 2 Referred to Committee on 3 Date: 4 Subject: Health; mental health; sexual orientation; conversion therapy 5 Statement of purpose of bill as introduced: This bill proposes to prohibit 6 mental health care providers from practicing conversion therapy on patients 7 younger than 18 years of age. 8 An act relating to the prohibition of conversion therapy on minors 9 It is hereby enacted by the General Assembly of the State of Vermont: 10 * * * Findings * * * 11 Sec. 1. FINDINGS 12 In recognition that being lesbian, gay, bisexual, or transgender is part of the 13 natural spectrum of human identity and is not a disease, disorder, illness, 14 deficiency, or shortcoming, the General Assembly finds: 15 (1) After conducting an evaluation of peer-reviewed journal literature on 16 sexual orientation change efforts, the American Psychological Association’s 17 Task Force on Appropriate Therapeutic Responses to Sexual Orientation 18 concluded that sexual orientation change efforts can pose critical health risks to 19 lesbian, gay, and bisexual persons. Specific risks include confusion, 20 BILL AS INTRODUCED S.132 2015 Page 2 of 11 VT LEG #305917 v.1 depression, guilt, helplessness, hopelessness, shame, social withdrawal, 1 suicidality, substance abuse, stress, disappointment, self-blame, decreased 2 self-esteem and authenticity to others, increased self-hatred, hostility and 3 blame toward parents, feelings of anger and betrayal, loss of friends and 4 potential romantic partners, problems in sexual and emotional intimacy, sexual 5 dysfunction, high-risk sexual behaviors, and a sense of having wasted time and 6 resources. 7 (2) The American Psychological Association issued a resolution on 8 Appropriate Affirmative Responses to Sexual Orientation Distress and Change 9 Efforts in 2009, which states: “[t]he American Psychological Association 10 advises parents, guardians, young people, and their families to avoid sexual 11 orientation change efforts that portray homosexuality as a mental illness or 12 developmental disorder and to seek psychotherapy, social support and 13 educational services that provide accurate information on sexual orientation 14 and sexuality, increase family and school support, and reduce rejection of 15 sexual minority youth.” 16 (3) The American Psychiatric Association published a position 17 statement in March 2000 stating: “[p]sychotherapeutic modalities to convert or 18 ‘repair’ homosexuality are based on developmental theories whose scientific 19 validity is questionable. Furthermore, anecdotal reports of ‘cures’ are 20 counterbalanced by anecdotal claims of psychological harm. In the last four 21 BILL AS INTRODUCED S.132 2015 Page 3 of 11 VT LEG #305917 v.1 decades, ‘reparative’ therapists have not produced any rigorous scientific 1 research to substantiate their claims of cure. Until there is such research 2 available, [the American Psychiatric Association] recommends that ethical 3 practitioners refrain from attempts to change individuals’ sexual orientation, 4 keeping in mind the medical dictum to First, do no harm.” 5 (4) The American School Counselor Association recognized in a 6 position statement on professional school counselors and lesbian, gay, 7 bisexual, transgendered, and questioning (LGBTQ) youth that sexual 8 orientation is not an illness and does not require treatment. The statement 9 further provided that while “[i]t is not the role of the professional school 10 counselor to attempt to change a student’s sexual orientation/gender identity,” 11 the counselor may provide individual student planning or responsive services 12 to LGBTQ students to promote self-acceptance, deal with social acceptance, 13 understand issues related to coming out, and identify appropriate community 14 resources. 15 (5) The National Association of Social Workers prepared a 1997 policy 16 statement in which it states: “[s]ocial stigmatization of lesbian, gay and 17 bisexual people is widespread and is a primary motivating factor in leading 18 some people to seek sexual orientation changes.” It further states that 19 “[s]exual orientation conversion therapies assume that homosexual orientation 20 BILL AS INTRODUCED S.132 2015 Page 4 of 11 VT LEG #305917 v.1 is both pathological and freely chosen. No data demonstrate that reparative or 1 conversion therapies are effective, and, in fact, they may be harmful.” 2 (6) In 1999, the American Counseling Association Governing Council 3 adopted a statement opposing reparative therapy as a cure for homosexual 4 individuals. 5 (7) The American Psychoanalytic Association issued a position 6 statement in June 2012 on attempts to change sexual orientation, gender, 7 identity, or gender expression, in which the Association states: “[a]s with any 8 societal prejudice, bias against individuals based on actual or perceived sexual 9 orientation, gender identity or gender expression negatively affects mental 10 health, contributing to an enduring sense of stigma and pervasive self-criticism 11 through the internalization of such prejudice.” The statement further explains 12 that “[p]sychoanalytic technique does not encompass purposeful attempts to 13 ‘convert,’ ‘repair,’ change or shift an individual’s sexual orientation, gender 14 identity or gender expression. Such directed efforts are against fundamental 15 principles of psychoanalytic treatment and often result in substantial 16 psychological pain by reinforcing damaging internalized attitudes.” 17 (8) A 2012 article published in the Journal of the American Academy of 18 Child and Adolescent Psychiatry, entitled “Practice Parameter on Gay, Lesbian 19 or Bisexual Sexual Orientation, Gender-Nonconformity, and Gender 20 Discordance in Children and Adolescents,” states: “[t]here is no empirical 21 BILL AS INTRODUCED S.132 2015 Page 5 of 11 VT LEG #305917 v.1 evidence adult homosexuality can be prevented if gender nonconforming 1 children are influenced to be more gender conforming. Indeed, there is no 2 medically valid basis for attempting to prevent homosexuality, which is not an 3 illness. On the contrary, such efforts may encourage family rejection and 4 undermine self-esteem, connectedness and caring, important protective factors 5 against suicidal ideation and attempts.” 6 (9) The Pan American Health Organization, a regional office of the 7 World Health Organization, issued a statement in May 2012 that: “[t]hese 8 supposed conversion therapies constitute a violation of the ethical principles of 9 health care and violate human rights that are protected by international and 10 regional agreements.” The organization also noted that reparative therapies 11 “lack medical justification and represent a serious threat to the health and 12 well-being of affected people.” 13 (10) Minors who experience family rejection based on their sexual 14 orientation face especially serious health risks. A 2009 article authored by 15 Caitlin Ryan, et al., entitled “Family Rejection as a Predictor of Negative 16 Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young 17 Adults,” found that lesbian, gay, and bisexual young adults who reported 18 higher levels of family rejection during adolescence were 8.4 times more likely 19 to report having attempted suicide, 5.9 times more likely to report high levels 20 of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more 21 BILL AS INTRODUCED S.132 2015 Page 6 of 11 VT LEG #305917 v.1 likely to report having engaged in unprotected sexual intercourse compared 1 with peers from families that reported no or low levels of family rejection. 2 (11) Vermont has a compelling interest in protecting the physical and 3 psychological well-being of children, including lesbian, gay, bisexual, and 4 transgender youth, and in protecting its children against exposure to serious 5 harms caused by conversion therapy. 6 * * * Conversion Therapy * * * 7 Sec. 2. 18 V.S.A. chapter 196 is added to read: 8 CHAPTER 196. CONVERSION THERAPY 9 § 8351. DEFINITIONS 10 As used in this chapter: 11 (1) “Conversion therapy” means any practice by a mental health care 12 provider that seeks to change an individual’s sexual orientation, including 13 efforts to change behaviors or gender expressions or to eliminate or reduce 14 sexual or romantic attractions or feelings toward individuals of the same sex. 15 “Conversion therapy” does not include psychotherapies that: 16 (A) provide support to an individual undergoing gender 17 transition; and 18 (B) provide acceptance, support, and understanding of clients or the 19 facilitation of clients’ coping, social support, and identity exploration and 20 development, including sexual-orientation-neutral interventions to prevent or 21 BILL AS INTRODUCED S.132 2015 Page 7 of 11 VT LEG #305917 v.1 address unlawful conduct or unsafe sexual practices and that do not seek to 1 change an individual’s sexual orientation or gender identity. 2 (2) “Mental health care provider” means a person licensed to practice 3 medicine pursuant to 26 V.S.A. chapter 23, 33, or 81 who specializes in the 4 practice of psychiatry; a psychologist, a psychologist-doctorate, or a 5 psychologist-master as defined in 26 V.S.A. § 3001; a clinical social worker as 6 defined in 26 V.S.A. § 3201; a clinical mental health counselor as defined in 7 26 V.S.A. § 3261; a licensed marriage and family therapist as defined in 8 26 V.S.A. § 4031; a psychoanalyst as defined in 26 V.S.A. § 4051; any other 9 allied mental health professional; or a student, intern, or trainee of any such 10 profession. 11 § 8352. TREATMENT OF MINORS 12 A mental health care provider shall not use conversion therapy with a client 13 younger than 18 years of age. 14 § 8353. UNPROFESSIONAL CONDUCT 15 Any conversion therapy used on a client younger than 18 years of age by a 16 mental health care provider shall constitute unprofessional conduct as provided 17 in the relevant provisions of Title 26 and shall subject the mental health care 18 provider to discipline pursuant to the applicable provisions of that title and 19 of 3 V.S.A. chapter 5. 20 BILL AS INTRODUCED S.132 2015 Page 8 of 11 VT LEG #305917 v.1 * * * Physicians * * * 1 Sec. 3. 26 V.S.A. § 1354(a) is amended to read: 2 (a) The board Board shall find that any one of the following, or any 3 combination of the following, whether or not the conduct at issue was 4 committed within or outside the state State, constitutes unprofessional conduct: 5 * * * 6 (39) use of the services of a physician assistant by a physician in a 7 manner which is inconsistent with the provisions of chapter 31 of this title; or 8 (40) use of conversion therapy as defined in 18 V.S.A. § 8351 on a 9 client younger than 18 years of age. 10 * * * Osteopathy * * * 11 Sec. 4. 26 V.S.A. § 1842(b) is amended to read: 12 (b) Unprofessional conduct means the following conduct and conduct set 13 forth in 3 V.S.A. § 129a.: 14 * * * 15 (13) Use of conversion therapy as defined in 18 V.S.A. § 8351 on a 16 client younger than 18 years of age. 17 BILL AS INTRODUCED S.132 2015 Page 9 of 11 VT LEG #305917 v.1 * * * Psychologists * * * 1 Sec. 5. 26 V.S.A. § 3016 is amended to read: 2 § 3016. UNPROFESSIONAL CONDUCT 3 Unprofessional conduct means the conduct listed in this section and in 4 3 V.S.A. § 129a: 5 * * * 6 (11) Use of conversion therapy as defined in 18 V.S.A. § 8351 on a 7 client younger than 18 years of age. 8 * * * Clinical Social Workers * * * 9 Sec. 6. 26 V.S.A. § 3210(a) is amended to read: 10 (a) The following conduct and the conduct set forth in 3 V.S.A. § 129a by a 11 licensed social worker constitutes unprofessional conduct. When that conduct 12 is by an applicant or a person who later becomes an applicant, it may constitute 13 grounds for denial of a license: 14 * * * 15 (12) failing to clarify the clinical social worker’s role with the parties 16 involved and to take appropriate action to minimize any conflicts of interest, 17 when the clinical social worker anticipates a conflict of interest among the 18 individuals receiving services or anticipates having to perform in conflicting 19 roles such as testifying in a child custody dispute or divorce proceedings 20 involving clients; or 21 BILL AS INTRODUCED S.132 2015 Page 10 of 11 VT LEG #305917 v.1 (13) using conversion therapy as defined in 18 V.S.A. § 8351 on a client 1 younger than 18 years of age. 2 * * * Clinical Mental Health Counselors * * * 3 Sec. 7. 26 V.S.A. § 3271(a) is amended to read: 4 (a) Unprofessional conduct means the following conduct and conduct set 5 forth in 3 V.S.A. § 129a.: 6 * * * 7 (7) independently practicing outside or beyond a clinical mental health 8 counselor’s area of training, experience or competence without appropriate 9 supervision; or 10 (8) using conversion therapy as defined in 18 V.S.A. § 8351 on a client 11 younger than 18 years of age. 12 * * * Marriage and Family Therapists * * * 13 Sec. 8. 26 V.S.A. § 4042(a) is amended to read: 14 (a) Unprofessional conduct means the following conduct and the conduct 15 set forth in 3 V.S.A. § 129a: 16 * * * 17 (7) Using conversion therapy as defined in 18 V.S.A. § 8351 on a client 18 younger than 18 years of age. 19 BILL AS INTRODUCED S.132 2015 Page 11 of 11 VT LEG #305917 v.1 * * * Psychoanalysts * * * 1 Sec. 9. 26 V.S.A. § 4062(a) is amended to read: 2 (a) Unprofessional conduct means the following conduct and the conduct 3 set forth in 3 V.S.A. § 129a: 4 * * * 5 (7) Using conversion therapy as defined in 18 V.S.A. § 8351 on a client 6 younger than 18 years of age. 7 * * * Naturopathic Physicians * * * 8 Sec. 10. 26 V.S.A. § 4132(a) is amended to read: 9 (a) The following conduct and conduct set forth in 3 V.S.A. § 129a by a 10 person licensed under this chapter or an applicant for licensure constitutes 11 unprofessional conduct: 12 * * * 13 (11) Using conversion therapy as defined in 18 V.S.A. § 8351 on a 14 client younger than 18 years of age. 15 * * * Effective Date * * * 16 Sec. 11. EFFECTIVE DATE 17 This act shall take effect on July 1, 2015. 18

No. 138 Page 1 of 7 2016 VT LEG #317444 v.1 No. 138. An act relating to the prohibition of conversion therapy on minors. (S.132) It is hereby enacted by the General Assembly of the State of Vermont: * * * Findings * * * Sec. 1. FINDINGS In recognition that being lesbian, gay, bisexual, or transgender is part of the natural spectrum of human identity and is not a disease, disorder, illness, deficiency, or shortcoming, the General Assembly finds: (1) Vermont has a compelling interest in protecting the physical and psychological well-being of children, including lesbian, gay, bisexual, and transgender youth, and in protecting its children against exposure to serious harms. (2) A 2015 report published by the U.S. Substance Abuse and Mental Health Service’s Administration states “conversion therapy . . . is a practice that is not supported by credible evidence and has been disavowed by behavioral health experts and associations . . . [m]ost importantly, it may put young people at risk of serious harm.” (3) The American Academy of Pediatrics, the American Counseling Association, the American Psychiatric Association, the American Psychological Association, the American School Counselor Association, and the National Association of Social Workers, together representing more than No. 138 Page 2 of 7 2016 VT LEG #317444 v.1 477,000 health and mental health professionals, have all taken the position that homosexuality is not a mental disorder and thus there is no need for a “cure.” * * * Conversion Therapy * * * Sec. 2. 18 V.S.A. chapter 196 is added to read: CHAPTER 196. CONVERSION THERAPY § 8351. DEFINITIONS As used in this chapter: (1) “Conversion therapy” means any practice by a mental health care provider that seeks to change an individual’s sexual orientation or gender identity, including efforts to change behaviors or gender expressions or to change sexual or romantic attractions or feelings toward individuals of the same sex or gender. “Conversion therapy” does not include psychotherapies that: (A) provide support to an individual undergoing gender transition; or (B) provide acceptance, support, and understanding of clients or the facilitation of clients’ coping, social support, and identity exploration and development, including sexual-orientation-neutral or gender-identity-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices without seeking to change an individual’s sexual orientation or gender identity. (2) “Mental health care provider” means a person licensed to practice medicine pursuant to 26 V.S.A. chapter 23, 33, or 81 who specializes in the practice of psychiatry; a psychologist, a psychologist-doctorate, or a No. 138 Page 3 of 7 2016 VT LEG #317444 v.1 psychologist-master as defined in 26 V.S.A. § 3001; a clinical social worker as defined in 26 V.S.A. § 3201; a clinical mental health counselor as defined in 26 V.S.A. § 3261; a licensed marriage and family therapist as defined in 26 V.S.A. § 4031; a psychoanalyst as defined in 26 V.S.A. § 4051; any other allied mental health professional; or a student, intern, or trainee of any such profession. § 8352. TREATMENT OF MINORS A mental health care provider shall not use conversion therapy with a client younger than 18 years of age. § 8353. UNPROFESSIONAL CONDUCT Any conversion therapy used on a client younger than 18 years of age by a mental health care provider shall constitute unprofessional conduct as provided in the relevant provisions of Title 26 and shall subject the mental health care provider to discipline pursuant to the applicable provisions of that title and of 3 V.S.A. chapter 5. * * * Physicians * * * Sec. 3. 26 V.S.A. § 1354(a) is amended to read: (a) The board Board shall find that any one of the following, or any combination of the following, whether or not the conduct at issue was committed within or outside the state State, constitutes unprofessional conduct: * * * No. 138 Page 4 of 7 2016 VT LEG #317444 v.1 (39) use of the services of a physician assistant by a physician in a manner which is inconsistent with the provisions of chapter 31 of this title; or (40) use of conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age. * * * Osteopathy * * * Sec. 4. 26 V.S.A. § 1842(b) is amended to read: (b) Unprofessional conduct means the following conduct and conduct set forth in 3 V.S.A. § 129a.: * * * (13) Use of conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age. * * * Psychologists * * * Sec. 5. 26 V.S.A. § 3016 is amended to read: § 3016. UNPROFESSIONAL CONDUCT Unprofessional conduct means the conduct listed in this section and in 3 V.S.A. § 129a: * * * (11) Use of conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age. No. 138 Page 5 of 7 2016 VT LEG #317444 v.1 * * * Clinical Social Workers * * * Sec. 6. 26 V.S.A. § 3210(a) is amended to read: (a) The following conduct and the conduct set forth in 3 V.S.A. § 129a by a licensed social worker constitutes unprofessional conduct. When that conduct is by an applicant or a person who later becomes an applicant, it may constitute grounds for denial of a license: * * * (12) failing to clarify the clinical social worker’s role with the parties involved and to take appropriate action to minimize any conflicts of interest, when the clinical social worker anticipates a conflict of interest among the individuals receiving services or anticipates having to perform in conflicting roles such as testifying in a child custody dispute or divorce proceedings involving clients; or (13) using conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age. Sec. 7. 26 V.S.A. § 3210(a) is amended to read: (a) The following conduct and the conduct set forth in 3 V.S.A. § 129a by a person licensed under this chapter constitutes unprofessional conduct. When that conduct is by an applicant or a person who later becomes an applicant, it may constitute grounds for denial or discipline of a license: * * * No. 138 Page 6 of 7 2016 VT LEG #317444 v.1 (12) failing to clarify the licensee’s role with the parties involved and to take appropriate action to minimize any conflicts of interest, when the clinical social worker anticipates a conflict of interest among the individuals receiving services or anticipates having to perform in conflicting roles such as testifying in a child custody dispute or divorce proceedings involving clients; or (13) using conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age. * * * Clinical Mental Health Counselors * * * Sec. 8. 26 V.S.A. § 3271(a) is amended to read: (a) Unprofessional conduct means the following conduct and conduct set forth in 3 V.S.A. § 129a.: * * * (7) independently practicing outside or beyond a clinical mental health counselor’s area of training, experience, or competence without appropriate supervision; or (8) using conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age. * * * Marriage and Family Therapists * * * Sec. 9. 26 V.S.A. § 4042(a) is amended to read: (a) Unprofessional conduct means the following conduct and the conduct set forth in 3 V.S.A. § 129a: * * * No. 138 Page 7 of 7 2016 VT LEG #317444 v.1 (7) Using conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age. * * * Psychoanalysts * * * Sec. 10. 26 V.S.A. § 4062(a) is amended to read: (a) Unprofessional conduct means the following conduct and the conduct set forth in 3 V.S.A. § 129a: * * * (7) Using conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age. * * * Naturopathic Physicians * * * Sec. 11. 26 V.S.A. § 4132(a) is amended to read: (a) The following conduct and conduct set forth in 3 V.S.A. § 129a by a person licensed under this chapter or an applicant for licensure constitutes unprofessional conduct: * * * (11) Using conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age. * * * Effective Dates * * * Sec. 12. EFFECTIVE DATES This act shall take effect on July 1, 2016, except Sec. 7 shall take effect on July 1, 2017. Date Governor signed bill: May 25, 2016