Sexual orientation change efforts

Introduction

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) presents this position statement to affirm its opposition to the use of sexual orientation change efforts of any kind.

Key messages

• The RANZCP does not support the use of sexual orientation change efforts of any kind.
• There is no scientific evidence that sexual orientation can be changed.
• Sexual orientation change efforts risk causing significant harm to individuals as well as contributing to the misrepresentation of alternative sexualities as mental disorders, and to the broader prejudice and discrimination faced by people with alternative sexualities.

Definitions

Sexual orientation change efforts (SOCE) are efforts to change the sexual orientation of a person to heterosexual through therapy or other treatments. Sexual orientation is different to gender identity and SOCE does not refer to those undergoing gender reaffirmation therapy or management.

SOCE also does not refer to those people with paraphilic disorder (American Psychiatric Association, 2013). This group of people require specific advice, therapy and treatment that are not covered by this position statement.

Evidence

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 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 alternative expressions of sexuality as mental disorders, and the prejudice and discrimination that can flourish through the use of such therapies has led all major medical organisations to oppose their use. 
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.

RANZCP position

The RANZCP Code of Ethics (2018) states that:

Psychiatrists shall not discriminate against patients on any grounds such as age, sex, gender, race, ethnicity, sexual orientation, disability, language, religious or political affiliation, or socio-economic status; neither shall they attempt to impose their own values on patients and patients’ families.

The RANZCP recognises that people with alternative sexualities are valued members of society with rights to equal access to health care, marriage and procreating and bringing up children as well as 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. The RANZCP further asserts that these same rights apply to transgender, intersex and genderqueer identified people.

Recommendations

The RANZCP does not support the use of sexual orientation change efforts of any kind. Furthermore, the RANZCP notes that:

• the efficacy of sexual orientation change efforts when providing assistance to people distressed by their or others’ sexual orientation should not be misrepresented
• people distressed by their sexual orientation should be assisted with treatment approaches that involve acceptance, support, and identity exploration, and aim to reduce the stigma associated with alternative sexual identities, and demonstrate respect for the person’s religious, spiritual and/or cultural beliefs.

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edition. Washington DC, American Psychiatric Press.

American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation (2009) Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation. Washington DC.

Royal Australian and New Zealand College of Psychiatrists (2018) Code of Ethics. Available at: https://www.ranzcp.org/Files/Resources/College_Statements/Practice_Guidelines/Code-of-Ethics.aspx (accessed 21 September 2018).

Royal Australian and New Zealand College of Psychiatrists (2018) Position Statement 83: Recognising and addressing the mental health needs of the LGBTIQ+ population. Available at: https://www.ranzcp.org/news-policy/policy-submissions-reports/document-library/recognising-and-addressing-the-mental-health-needs  (accessed 17 October 2018).

References

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edition. Washington DC, American Psychiatric Press.

American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation (2009) Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation. Washington DC.

Royal Australian and New Zealand College of Psychiatrists (2018) Code of Ethics. Available at: https://www.ranzcp.org/Files/Resources/College_Statements/Practice_Guidelines/Code-of-Ethics.aspx (accessed 21 September 2018).

Royal Australian and New Zealand College of Psychiatrists (2018) Position Statement 83: Recognising and addressing the mental health needs of the LGBTIQ+ population. Available at: https://www.ranzcp.org/news-policy/policy-submissions-reports/document-library/recognising-and-addressing-the-mental-health-needs  (accessed 17 October 2018).

Disclaimer: This information is intended to provide general guidance to practitioners, and should not be relied on as a substitute for proper assessment with respect to the merits of each case and the needs of the patient. The RANZCP endeavours to ensure that information is accurate and current at the time of preparation, but takes no responsibility for matters arising from changed circumstances, information or material that may have become subsequently available.