BILL NUMBER: SB 1172	AMENDED
	BILL TEXT

	AMENDED IN SENATE  MAY 25, 2012
	AMENDED IN SENATE  APRIL 30, 2012
	AMENDED IN SENATE  APRIL 25, 2012
	AMENDED IN SENATE  APRIL 16, 2012
	AMENDED IN SENATE  APRIL 9, 2012

INTRODUCED BY   Senator Lieu
    (   Coauthor:   Assembly Member  
Ma   ) 

                        FEBRUARY 22, 2012

   An act to add Article 15 (commencing with Section 865) to Chapter
1 of Division 2 of the Business and Professions Code, relating to
healing arts.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1172, as amended, Lieu. Sexual orientation change efforts.
   Existing law provides for licensing and regulation of various
professions in the healing arts, including physicians and surgeons,
psychologists, marriage and family therapists, educational
psychologists, clinical social workers, and licensed professional
clinical counselors.
   This bill would prohibit  psychotherapists  
a mental health provider  , as defined, from  performing
  engaging in  sexual orientation change efforts,
as defined,  in the absence of informed consent of the
  with a  patient  under 18 years of age 
.  The bill would require a specified statement to be
included on the informed consent form. Informed consent would not be
effective for patients under 18 years of age. The bill would provide
for a cause of action against psychotherapists by patients, former
patients, or certain other persons in specified cases. 
   The bill would also declare the intent of the Legislature in this
regard.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a)  An individual's sexual orientation, whether
homosexual,   Being lesbian, gay, or  bisexual
 , or heterosexual,  is not a disease, disorder,
illness, deficiency, or shortcoming. The major professional
associations of mental health practitioners and researchers in the
United States have recognized this fact for nearly 40 years.
   (b)  Sexual   The American Psychological
Association convened a Task Force on Appropriate Therapeutic
Responses to Sexual Orientation. The task force conducted a
systematic review of peer-reviewed journal literature on sexual
orienta   tion change efforts, and issued a report in 2009.
The task force concluded 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, suicidality, 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.  This is documented by the
American Psychological Association's Task Force on Appropriate
Therapeutic Responses to Sexual Orientation in its 2009 Report of the
Task Force on Appropriate Therapeutic Responses to Sexual
Orientation.  
   (c) (1) The American Psychological Association, in its 1997
Resolution on Appropriate Therapeutic Responses to Sexual
Orientation, states: "We oppose portrayals of lesbian, gay and
bisexual youth and adults as mentally ill due to their sexual
orientation and support the dissemination of accurate information
about sexual orientation and mental health and appropriate
interventions in order to counteract bias that is based in ignorance
of unfounded beliefs about sexual orientation."  
   (2) The American Psychological Association also convened a Task
Force on Appropriate Therapeutic Responses to Sexual Orientation. The
task force conducted a systematic review of peer-reviewed journal
literature on sexual orientation change efforts. It concluded:
"Efforts to change sexual orientation are unlikely to be successful
and involve some risk of harm, contrary to the claims of sexual
orientation change efforts practitioners and advocates." 

   (c) The American Psychological Association issued a resolution on
Appropriate Affirmative Responses to Sexual Orientation Distress and
Change Efforts in 2009, which states: "T]he American Psychological
Association] 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 that
provide accurate information on sexual orientation and sexuality,
increase family and school support, and reduce rejection of sexual
minority youth." 
   (d) The American Psychiatric Association published a position
statement in March of 2000 in which it stated:  "The
 
   "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.  
   "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. 
    "Therefore, the  American Psychiatric Association
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."
   (e) The American School Counselor Association's position statement
on professional school counselors and lesbian, gay, bisexual,
transgendered, and questioning (LGBTQ) youth states: "It is not the
role of the professional school counselor to attempt to change a
student's sexual orientation/gender identity but instead to provide
support to LGBTQ students to promote student achievement and personal
well-being. Recognizing that sexual orientation is not an illness
and does not require treatment, professional school counselors may
provide individual student planning or responsive services to LGBTQ
students to promote self-acceptance, deal with social acceptance,
understand issues related to coming out, including issues that
families may face when a student goes through this process and
identify appropriate community resources."
   (f) The American Academy of Pediatrics in 1993 published an
article in its journal, Pediatrics, stating: "Therapy 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."
   (g) The American Medical  Association's  
Association  Council on Scientific Affairs prepared a report in
1994 in which it stated: "Aversion 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. Through psychotherapy,
gay men and lesbians can become comfortable with their sexual
orientation and understand the societal response to it."
   (h) The National Association of Social Workers prepared a 1997
policy statement in which it stated: "Social stigmatization of
lesbian, gay and bisexual people is widespread and is a primary
motivating factor in leading some people to seek sexual 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." 
   (i) The American Counseling Association Governing Council issued a
position statement in April of 1999, and in it the council states:
"We oppose 'the promotion of "reparative therapy" as a "cure" for
individuals who are homosexual.'"  
   (j) The Pan American Health Organization, a regional office of the
World Health Organization, issued a statement in May of 2012 and in
it the organization states: "These supposed conversion therapies
constitute a violation of the ethical principles of health care and
violate human rights that are protected by international and regional
agreements." The organization also noted that reparative therapies
"lack medical justification and represent a serious threat to the
health and well-being of affected people."  
   (i) 
    (k)  Minors who experience family rejection based on
their sexual orientation face especially serious health risks. In one
study, 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 compared with peers from families that
reported no or low levels of family rejection. This is documented by
Caitlin Ryan et al. in their article entitled Family Rejection as a
Predictor of Negative Health Outcomes in White and Latino Lesbian,
Gay, and Bisexual Young Adults (2009) 123 Pediatrics 346. 
   (j) 
    (l)  California has a compelling interest in protecting
the  lives and health of   physical and
psychological well-being of minors, including  lesbian, gay,
 and  bisexual  people   , and
transgender youth, and in protecting its minors against exposure to
serious harms caused by sexual orientation change efforts  .

   (m) Nothing in this act is intended to prevent a minor who is 12
years of age or older from consenting to any mental health treatment
or counseling services, consistent with Section 124260 of the Health
and Safety Code, other than sexual orientation change efforts as
defined in this act. 
  SEC. 2.  Article 15 (commencing with Section 865) is added to
Chapter 1 of Division 2 of the Business and Professions Code, to
read:

      Article 15.  Sexual Orientation Change Efforts


   865.  For the purposes of this article, the following terms shall
have the following meanings: 
   (a) "Informed consent" means consent that is voluntarily provided
in writing by a patient to a psychotherapist with whom the patient
has a therapeutic relationship. The informed consent must explicitly
manifest the patient's agreement to sexual orientation change efforts
and include a statement as set forth in Section 865.1. Consent that
is provided as a result of therapeutic deception or duress or
coercion is not informed consent.  
   (b) "Psychotherapist" 
    (a)    "Mental health provider"  means
a physician and surgeon specializing in the practice of psychiatry,
a psychologist, a psychological assistant, a  licensed 
marriage and family therapist, a registered marriage and family
therapist, intern, or trainee, an educational psychologist, a
licensed clinical social worker, an associate clinical social worker,
a licensed professional clinical counselor, or a registered clinical
counselor, intern, or trainee. 
   (c) "Psychotherapy" means the professional assessment, evaluation,
treatment, or counseling of a mental or emotional illness, symptom,
or condition by a psychotherapist.  
   (d) 
    (b)  "Sexual orientation change efforts" means 
psychotherapy aimed at altering the sexual or romantic desires,
attractions, or conduct of a person toward people of the same sex so
that the desire, attraction, or conduct is eliminated or reduced or
might instead be directed toward people of a different sex. It does
not include psychotherapy aimed at altering sexual desires,
attractions, or conduct toward minors or relatives or regarding
sexual activity with another person without that person's consent
  practices by mental health providers that seek to
change orientation or reduce or eliminate sexual or romantic
attractions, feelings, or behaviors because those attractions,
feelings, or behaviors are directed toward persons of a particular
  sex or both sexes. "Sexual orientation change efforts"
does not include psychotherapies that aim to provide acceptance,
support, and understanding of clients or the facilitation of clients'
coping, social support, and identity exploration and development,
without seeking to change orientation or reduce or eliminate sexual
or romantic attractions, feelings, or behaviors because those
attractions, feelings, or behaviors are directed t   oward
persons of a particular sex or both sexes . 
   (e) "Therapeutic deception" means a representation by a
psychotherapist that sexual orientation change efforts are endorsed
by leading medical and mental health associations or that they can or
will reduce or eliminate a person's sexual or romantic desires,
attractions, or conduct toward another person of the same sex.
 
   (f) "Therapeutic relationship" means the relationship that exists
during the time the patient receives psychotherapy. 

   (g) "Leading medical and mental health associations" means the
American Psychiatric Association, the American Psychological
Association, the American Counseling Association, the National
Association of Social Workers, the American Association for Marriage
and Family Therapy, and the American Academy of Pediatrics. 

   865.1.  (a) No psychotherapist shall engage in sexual orientation
change efforts without first obtaining the patient's informed consent
to therapy as prescribed in subdivision (b).
   (b) To obtain informed consent, a treating psychotherapist shall
provide a patient with a form to be signed by the patient that
provides informed consent. The form shall include the following
statement in size 14 font:


   "Having a lesbian, gay, or bisexual sexual orientation is not a
mental disorder. Sexual orientation change efforts have not been
shown to be safe or effective and can, in fact, be harmful. The risks
include, but are not limited to, depression, anxiety,
self-destructive behavior, and suicide.
   The American Psychological Association convened a Task Force on
Appropriate Therapeutic Responses to Sexual Orientation and it
concluded:
   "Efforts to change sexual orientation are unlikely to be
successful and involve some risk of harm, contrary to the claims of
sexual orientation change efforts practitioners and advocates."
   The American Academy of Pediatrics states:
   "Therapy 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."
   The American Medical Association's Council on Scientific Affairs
prepared a report in which it stated:
   "Aversion 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. Through psychotherapy, gay men
and lesbians can become comfortable with their sexual orientation and
understand the societal response to it."
   The National Association of Social Workers states:
   "Social stigmatization of lesbian, gay and bisexual people is
widespread and is a primary motivating factor in leading some people
to seek sexual 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."


    865.2.   865.1.    (a)
   Under no circumstances shall  a
mental health provider engage in sexual orientation change efforts
with  a patient under 18 years of age  undergo sexual
orientation change efforts  , regardless of the willingness
of a  patient,  patient's parent, guardian, conservator, or
other person to authorize such efforts. 
   (b) The right to refuse sexual orientation change efforts is not
waived by giving informed consent and that consent may be withdrawn
at any time prior to, during, or between sessions of sexual
orientation change efforts.  
   (c) Any act of duress or coercion by any person or facility shall
invalidate the patient's consent to sexual orientation change
efforts.  
   865.3.  (a) (1) A cause of action may be brought against a
psychotherapist by a patient, former patient, or deceased former
patient's parent, child, or sibling if the sexual orientation change
efforts were conducted without first obtaining informed consent or by
means of therapeutic deception, or if the sexual orientation change
efforts were conducted on a patient who was under 18 years of age at
any point during the use of the sexual orientation change efforts.
   (2) The patient, former patient, or deceased former patient's
parent, child, or sibling may recover actual damages, or statutory
damages in the amount of five thousand dollars ($5,000), whichever is
greater, in addition to costs and reasonable attorney's fees.
   (3) The time for commencement of the action shall be within eight
years of the date the patient or former patient attains the age of
majority or within five years of the date the patient, former
patient, or deceased former patient's parent, child, or sibling
discovers or reasonably should have discovered that the patient was
subjected to sexual orientation change efforts in violation of this
article.
   (b) Nothing in this article precludes or limits the right of a
patient, former patient, or deceased former patient's parent, child,
or sibling to bring a civil action against a psychotherapist arising
from other legal claims.