Denver, CO - A position statement opposing any psychiatric treatment such as "reparative" or "conversion" therapy designed to change a person's sexual orientation from homosexual to heterosexual was adopted by unanimous vote at the December 11-12 meeting of the American Psychiatric Association Board of Trustees.
The APA removed homosexuality as a mental disorder from the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1973 after reviewing evidence that revealed it did not fit necessary criterion to be categorized as a mental illness.
"It is fitting that this position opposing reparative therapy is adopted on the 25th anniversary of the removal of homosexuality as a mental disorder from the DSM," said Rodrigo Munoz, M.D., APA President. "There is no scientific evidence that reparative or conversion therapy is effective in changing a person's sexual orientation. There is, however, evidence that this type of therapy can be destructive."
The position states that reparative therapy runs the risk of harming patients by causing depression, anxiety, and self-destructive behavior. The APA joins the American Psychological Association, the American Association of Social Workers, and the American Academy of Pediatrics in making a policy against reparative therapy.
Other policies adopted by the APA this week include approval or adoption of:
- A joint amicus brief filing in the Supreme Court in Lewis v. K-Mart, a
prominent disability-discrimination case, with the National Alliance for the
Mentally Ill (NAMI).
- A "Practice Guideline for the Treatment of Delirium" to be published in
the American Journal of Psychiatry in the second quarter of 1999.
- Approval to publish a "Manual of Nursing Home Care for the
Psychiatrist" by the American Psychiatric Press, Inc.
- "Principles of Abuse and Misuse of Psychiatry" policy stating 1.) The
use of psychiatric knowledge, practices, and institutions is only for purposes
consistent with ethical evaluation and treatment, research, consultation, and
education. Abuse and misuse of psychiatry occurs when psychiatric knowledge,
assessment, or practices is used to further morally illegitimate organizational,
social, or political objectives. 2.) It is psychiatrists' primary responsibility
to use their clinical skills and knowledge for the benefit of their patients.
External social, political, management and economic forces should not be the
primary consideration. 3.) Psychiatrists shall not allow their professional
opinions to be inappropriately influenced by illegitimate outside factors. It
is essential for psychiatrists to consider biopsychosocial factors in their
assessment of patients.
- A position statement on the "Exchange of Medical Information Between Physicians and Patients" stating, "Effective patient care requires the free and unfettered exchange of information on treatment alternatives; discussion of these alternatives between physicians and patients should not subject either party to criminal or professional sanctions."
Position Statement on Psychiatric Treatment and Sexual Orientation
Adopted by the American Psychiatric Association
Board of Trustees
December 11, 1998
The Board of Trustees of the American Psychiatric Association removed homosexuality from the DSM in 1973 after reviewing evidence that it was not a mental disorder. In 1987, ego-dystonic homosexuality was not included in the DSM-IIIR after a similar review.
The American Psychiatric Association does not currently have a formal position statement on treatments that attempt to change a person's sexual orientation, also known as "reparative or conversion therapy." There is an APA 1997 Fact Sheet on Homosexual and Bisexual Issues which states that "there is no published scientific evidence supporting the efficacy of 'reparative therapy' as a treatment to change one's sexual orientation."
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 a prior assumption that the patient should change his/her homosexual orientation. The American Psychiatric Association recognizes that in the course of ongoing psychiatric treatment, there may be appropriate clinical indications for attempting to change sexual behaviors.
Several major professional organizations including the American Psychological Association, the National Association of Social Workers, and the American Academy of Pediatrics have all made statements against "reparative therapy" because of concerns for the harm caused to patients. The American Psychiatric Association has already taken clear stands against discrimination, prejudice and unethical treatment on a variety of issues including discrimination the basis of sexual orientation.