So, when I last wrote, there was a disaster of a bill, SB 1482. It was a train wreck that would have essentially kneecapped the mental health professions from preventing the appalling practices known as “conversion therapy” or “reparative therapy” which peddle snake oil to families, youth and some adults. They claim that they can change people’s sexual orientation and gender identity, and they make these claims on the foundation of bogus “science” debunked and discredited by a laundry list of professional associations who actually know what they’re talking about. These “therapies” rip families apart, ruin lives, and even kill. Yes, kill.
Since then, Senator Leach, the bill’s sponsor, tried again twice more. First, he decided to toss the pieces about religious freedoms and claim “sexual freedom” instead in a Strike Everything amendment in SB 1325. The first striker was as horrible as the initial bill, except it would have opened people up to all sorts of harms related to sexuality and mental health, including but not limited to conversion “therapy”, spousal rape, puberty related concerns, sexual abuses of those who cannot speak for themselves, child sexual abuse media (why it’s not called “child p-nography”), trauma recovery endeavors, and self-harm brought on by these and other issues. But, owing to the hard work and unyielding voices of the communities who care and are affected, and the reckless lack of forethought, that one didn’t even come to the floor for a discussion, so let’s move onto SB 1269…
Then came crossover week. A meiosis of bills, if you will. Everything that failed is supposed to stay where it is and not move forward while everything that passed in one house moves over to the other. Unless, of course, there’s a Hail Mary pass to bring a dead bill or idea back to life…or try to. Let me introduce you to SB 1269:
Take SB 1482 and toss out everything that would kneecap the professions, and everything that gave a back door into hurting children to people claiming religious privilege. Oh, and take out the creepy sexual language from the striker that didn’t even make it out of the gate in SB 1325. And then pack it in as a stowaway on a land bill in the Criminal Justice Reform Committee of the House. What’s left is a bill that specifies that “political subdivisions”, which is a fancy way to say counties, incorporated cities or towns and school districts in this state, and any other political subdivision as defined in article XIII, section 7, Constitution of Arizona (read: licensure boards aren’t part of that), are not allowed to determine what is and isn’t “unprofessional conduct” in healthcare, including mental healthcare. The bill is a shell of its earlier self: the incredible result of hard work in advocacy, but still an understandable cause for concern at first glance. Thankfully, it literally has no power to harm Arizonans left.
We now have a bill that says that municipalities can’t decide what unprofessional conduct is. That’s not what any municipality was even doing, and they shouldn’t be able to anyway, because that’s within the domain of the Psychology and Behavioral Health boards already. Some people are really scared that the bill would serve to nullify Pima County’s ordinance that bans adults from performing conversion “therapy” on youth. Well, it’s likely that that it wouldn’t even apply. For everyone who hasn’t read the Pima County ordinance, it says nothing about therapy, licensure, or the regulation of professions. The exact words of 9.90.030 are, “No person may engage in sexual orientation change efforts with a minor in exchange for a fee.” It continues on to discuss that a violation would be a civil infraction and that a person who performs this behavior is subject to a civil penalty of $2,500 per instance. Tell a child that who they are is wrong ten times over the course of a season? $25K penalty, and so on.
The coolest, and most unique thing about the Pima County ordinance is that, unlike many similar ones around the country that target only the minority fraction of conversion “therapy” provders who (unfortunately) have a clinical license, this one doesn’t address who peddles this snake oil — it just says you can’t peddle the snake oil no matter who you are, and it’s irrelevant if you hold a license or not. This means that 100%, not < 30%, of the predatory people who harm youth and families like this are accountable.
This is why many of us who’ve sat with and studied the language have reached the conclusion that the current bill is totally fine, and, it has the added bonus of actually preventing fanatical and extremist leaders in some “political subdivisions” from trying to do what the original bill would have done by demanding our professions conduct ourselves based on outside interests making demands on our work. This new bill accomplishes this all while not touching Pima County’s right to hold accountable the people who sell snake oil that shatters families and harms our youth. Pima County’s ordinance says nothing about regulating the practice of therapy and, since conversion “therapy” isn’t an accepted or established practice in mental health, a therapist who puts those “services” out there can’t likely hide behind that credential to avoid recourse any more than they would be able to hide behind that credential if they would if they did something else that has such an established history of causing harm, and even death. Legislators, perhaps in haste, have written their own overreaching objective right out of the legislation!
[EDIT TO ADD: A Quick Statutes, Rules and Codes 101: Licensed professionals are responsible to follow Statutes, Rules and (to a large extent) Codes of Ethics. They’re nested a bit like Russian matryoshka dolls. First, there are the Statutes, which you can find for all of the professions, in Title 32, here. You can see that Psychologists and Behavior Analysts are covered in Article 19.1 while Counselors, Marriage and Family Therapists, Social Workers and Substance Abuse Counselors are covered in Article 33. Now, within those statutes, the “Definitions” sections for the professions, there are specific mandates not to harm clients and they specify the following of an ethical standard adopted by the Board (32–2061(dd) for Psychologists, 32–2091(dd) for Behavior Analysts, and then 32–3251(k) for the four Behavioral Health professions). And those standards are generally the Codes of Ethics for each profession, the applicable piece of one of which is shown a few paragraphs down. Then, of course, each profession has rules under the Boards as well, which can be modified by each of the Boards by their own documented processes. Okay, back to the show…]
The best thing about the Pima County Ordinance is actually that it does not specify the profession or affiliation of the adult(s) who inflict this kind of harm on a child or teen and their family. This means that anyone doing “therapy” without a license, offering this kind of service through a church, “treatment” facility, summer camp, life coaching center, or fraudulent counseling center (there’s a lot of misrepresentation out there) doesn’t get to escape consequences. Casey Pick, Esq., of The Trevor Project testified (before getting cut short by the chair of the committee) that ~30% of reports of conversion “therapy” harm was done at the hands of people the folks who’ve been hurt said were licensed clinicians. That means that the vast majority of reports about conversion “therapy” harm is being committed by people who are totally outside of the purview of regulation and ethical standards. In seeing how unscrupulous the people who prey on youth and families can be, I would wonder how many of the 30% that victims thought were licensed therapists actually misrepresented themselves, but that statistic is not available.
Pima County’s ordinance makes it a civil violation to engage in this kind of predatory behavior against youth, and those who love them, no matter in what venue or under what pretext it is done, so long as it is done “for a fee” (which means these people who hurt children still have a loophole we must close, but I digress). The legislature’s thrice revised bill won’t get in the way of that any more than a county ordinance that banned objectively harmful practices within any other healthcare domain would be undermined.
Okay, so where does that leave us? Well, we still have a ton of work to do, as professionals and as advocates. The Trevor Project’s statistics, while demonstrative of the fact that the vast majority of harmful conversion “therapy” practices take place outside the purview of the licensed and regulated professions, show that there are still licensed individuals out there who are running aground of their professional ethics and hurting youth and families despite having all of the information that should lead them in the exact opposite direction. These people need to be brought to task!
Rep. Raquel Terán (LD 30) brought up a crucial point: despite the fact that there is nothing forbidding people under 18 years of age from filing a board complaint, youth who are being harmed cannot be expected to pursue complaints on their own. Of course, youth are just as unlikely to report to Pima County officials about ordinance violations, but this isn’t about that. Adults often don’t even know how the complaint processes work either.
We as licensed professionals who loudly proclaim, “Not in our name!” need to take a stand that we will use our literacy around our Professional Statutes, Rules of Practice, and various Codes of Ethics and help empower youth and families who have been harmed to understand the risks and possible outcomes of the complaint profess and to file competent, comprehensive reports. And we need to own the fact that anyone (yes, anyone) is allowed to file a complaint even if the client/patient chooses not to do so (which is their right). If we know harm is being done, we need to put our selfish interests (not making waves, being seen as betraying “our own”, etc.) aside in furtherance of the public’s health and safety, the trust we need to continue earning with the public, and especially for the youth who are most vulnerable. And we need to help those in authority in municipalities that do have these ordinances and an investigative process learn how to file these complaints too, so that they can help safeguard the public from the ~30% of people violating the order who may be licensed clinicians. And we need to be there to help lay, advocacy-centered members of the public learn how to be available to steward this process as well.
So, in closing, after thorough analysis of the actual words of these measures, let’s consider taking this amazing, incredible momentum and solidarity with our brave youth and their families who deserve real support, and putting it into the needed efforts of strengthening accountability, helping the public understand their rights and how to amplify their voices, and building the bridges so that anyone else out to hurt our youth and destroy families won’t get very far at all.
PS: In the spirit of standing behind my words, I want to offer this: if you or someone you know experienced the harm of “conversion therapy” by a licensed therapist in the last four years, please comment or contact me through LinkedIn. I would be honored to volunteer my time help support you through understanding and making an informed choice about filing a complaint, whether you’ve been harmed, or you want to learn how to help empower people who have been. And remember, while you only have four years after the harm to file a complaint, if they’re still practicing, they might be doing this to others. Reaching out to me for the reasons described in this paragrpah affirmatively acknowledges that you know this is just one Arizonan to another and does not constitute therapy services.