Sexual orientation change efforts (SOCE) are efforts to change the sexual orientation of a person from lesbian, gay, bisexual, transgender, intersex or questioning (LGBTIQ) to heterosexual through therapy or other treatments. SOCE does not refer to those undergoing gender reassignment therapy or treatment.
SOCE also does not refer to those people with paraphilic disorder1 (American Psychiatric Association, 2013). This group of people require specific advice, therapy and treatment that are not covered by this position statement.
The American Psychological Association published a report of a study that reviewed the results of 83 studies carried out between 1960 and 2007 on the controversial concept of SOCE (American Psychological Association, 2009). The report found that recent research demonstrates that there is no sound scientific evidence that sexual orientation can be changed, contrary to the claims of SOCE practitioners and advocates.
The harm such therapies can cause to individuals, the contribution they make to the misrepresentation of homosexuality as a mental disorder, and the prejudice and discrimination that can flourish through the use of such therapies has led all major medical organisations to oppose the use of sexual orientation change efforts.
In 1973 the American Psychiatric Association concluded there was no scientific evidence that homosexuality was a disorder and removed it from its diagnostic glossary of mental disorders. The International Classification of Diseases of the World Health Organisation followed suit in 1992.
The RANZCP Code of Ethics states that:
“Psychiatrists shall not discriminate against patients on grounds of age, gender, race, ethnicity, sexual orientation, disability, language, religious or political affiliation; they shall not impose their own values on patients and their families”
The RANZCP agrees with the view published by the Royal College of Psychiatrists (UK) that lesbian, gay, and bisexual people are equally valued members of society who have exactly similar rights and responsibilities as all other citizens. This includes equal access to health care, the rights and responsibilities involved in a civil partnership, the rights and responsibilities involved in procreating and bringing up children, freedom to practice a religion as a lay person or religious leader, freedom from harassment or discrimination in any sphere and a right to protection from therapies that are potentially damaging, particularly those that purport to change sexual orientation (RCP, 2014). The RANZCP further asserts that these same rights apply to transgender and intersex people.
- The RANZCP does not support the use of sexual orientation change efforts of any kind
- Mental health workers must avoid misrepresenting the efficacy of sexual orientation change efforts when providing assistance to people distressed by their own or others’ sexual orientation
- Mental health workers should assist people distressed by their sexual orientation by care and treatment approaches that involve acceptance, support, and identity exploration. These should aim to reduce the stigma associated with homosexuality and respect the person’s religious beliefs.
1 To be diagnosed with a paraphilic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires that this group of people: feel personal distress about their interest, not merely distress resulting from society’s disapproval; or have a sexual desire or behavior that involves another person’s psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.