STATEMENTS OF POLICY
Title 49—PROFESSIONAL AND VOCATIONAL STANDARDS
STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS
[ 49 PA. CODE CHS. 47, 48 AND 49]
Conversion Therapy—Statement of Policy
[54 Pa.B. 3169]
[Saturday, June 8, 2024]The State Board of Social Workers, Marriage and Family Therapists and Professional Counselors (Board) adds §§ 47.5, 48.5 and 49.5 (relating to conversion therapy, sexual orientation change efforts and reparative therapy—statement of policy) to read as set forth in Annex A. This statement of policy is intended to provide guidance to Board-regulated social workers, marriage and family therapists and professional counselors and the general public.
Effective Date
This statement of policy will be effective upon publication in the Pennsylvania Bulletin.
Statutory Authority
Section 6(2) of the Social Workers, Marriage and Family Therapists and Professional Counselors Act (act) (63 P.S. § 1906(2)) provides that the Board shall have the authority ''[t]o adopt and, from time to time, revise such rules and regulations as may be necessary to carry into effect the provisions of this act. Such regulations may include, but shall not be limited to, standards of professional practice and conduct for licensed bachelor social workers, licensed social workers, licensed clinical social workers, licensed associate marriage and family therapists, licensed marriage and family therapists, licensed associate professional counselors and licensed professional counselors in Pennsylvania.'' Section 11(a)(2) and (3) of the act (63 P.S. § 1911(a)(2) and (3)) grants the Board authority to refuse, suspend, revoke, limit or restrict a license or reprimand a licensee for being guilty of immoral or unprofessional conduct and for violating standards of professional practice or conduct adopted by the Board.
Section 102 of the Commonwealth Documents Law (45 P.S. § 1102) defines ''statement of policy'' as ''any document, except an adjudication or a regulation, promulgated by an agency which sets forth substantive or procedural personal or property rights, privileges, immunities, duties, liabilities or obligations of the public or any part thereof, and includes, without limiting the generality of the foregoing, any document interpreting or implementing any act of Assembly enforced or administered by such agency.'' Statements of policy that are general and permanent in nature are required to be codified under 1 Pa. Code § 3.1 (relating to contents of Code).
Background and Purpose
The Commonwealth has a compelling interest in protecting the physical and psychological well-being of minors, including lesbian, gay, bisexual, transgender, queer/questioning, intersex and asexual (LGBTQIA+) youths, and in protecting minors against exposure to serious harms caused by conversion therapy. Likewise, the Board has an interest in and a duty to protect the public from practices that create a danger for patients and is dutybound to enforce the provisions of the act and its regulations. These duties compel the Board to take steps to guard against the dangers posed by conversion therapy.
Conversion therapy, also known as sexual orientation change efforts or reparative therapy, is a term that describes a wide range of interventions by mental health professionals that seek to change an individual's sexual orientation or gender expression, including efforts to change behaviors, gender identity or gender expressions, or to reduce or eliminate sexual or romantic attractions or feelings toward an individual of the same gender. The term does not include counseling for an individual seeking to transition from one gender to another, counseling that provides acceptance, support and understanding of an individual or facilitates an individual's coping, social support and identity exploration and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices, or counseling that does not seek to change sexual orientation.
Conversion therapy can pose critical health risks to LGBTQIA+ people, including suicidality, substance abuse, confusion, depression, guilt, helplessness, hopelessness, shame, social withdrawal, 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 with 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.
Due to the lack of scientific evidence supporting conversion therapy and the risk of harm to minors, the practice of conversion therapy is strongly opposed by the American Academy of Child Adolescent Psychiatry, American Academy of Pediatrics, American Association for Marriage and Family Therapy, American College of Physicians, American Medical Association, American Psychiatric Association, American Psychoanalytic Association, American Psychological Association, National Association of Social Workers, Pan American Health Organization and the World Psychiatric Association.
Under the Board's regulations in § 47.71 (relating to codes of ethical practice and professional conduct), social workers are required to adhere ''. . . to the codes of ethics and practice standards promulgated by the National Association of Social Workers (NASW). . . .'' The NASW's position statement on sexual orientation change efforts provides that the practice of sexual orientation change efforts ''violates the very tenets of the social work profession as outlined in the NASW Code of Ethics.'' Under the Board's regulations in § 48.71 (relating to code of ethical practice and professional conduct), licensed marriage and family therapists are required to adhere to the American Association for Marriage and Family Therapy (AAMFT) Code of Ethics. AAMFT does not consider homosexuality a disorder that requires treatment and does not see a basis for conversion therapy. Under the Board's regulations in § 49.71 (relating to code of ethical practice and professional conduct), licensed professional counselors (licensees) shall adhere to the American Counseling Association (ACA) Code of Ethics. ACA opposes the promotion of conversion therapy as a cure for LGBTQIA+ individuals and considers it to be ineffectual and harmful. ACA considers conversion therapy to be a significant and serious violation of the ACA Code of Ethics.
On June 15, 2022, President Joe Biden recognized the need to promote an end to the use of conversion therapies through the issuance of Executive Order 14075, which instructs Federal departments and agencies to formulate an action plan to prevent these therapies on a world-wide basis. On August 16, 2022, Governor Tom Wolf signed Executive Order 2022-02, which was published at 52 Pa.B. 5788 (September 10, 2022), to protect Pennsylvanians from conversion therapy by directing State agencies to discourage the practice of conversion therapy. See 4 Pa. Code §§ 7.921—7.924 (relating to protecting Pennsylvanians from conversion therapy and supporting LGBTQIA+ Pennsylvanians).
Given the lack of evidence to support the use of psychological interventions to change sexual orientation as well as the overwhelming opposition within the medical and psychological professions, the Board adopted this statement of policy as a public safety measure and to ensure that its licensees are aware of the Board's position on using conversion therapy on minors.
Description of this Statement of Policy
This statement of policy clarifies that it is the position of the Board that being LGBTQIA+ is not a disease, disorder, illness, deficiency or shortcoming. This statement of policy notifies licensees that the Board may find the use of conversion therapy on an individual under 18 years of age to be unethical, immoral and unprofessional conduct. Additionally, under this statement of policy, a licensee who uses conversion therapy on an individual under 18 years of age may be subject to discipline by the Board.
Fiscal Impact and Paperwork Requirements
This statement of policy will have no adverse fiscal impact on the Commonwealth or its political subdivisions and will impose no additional paperwork requirements upon the Commonwealth, political subdivisions or the private sector.
Sunset Date
A sunset date is not being established for this statement of policy. Its need and efficacy will be periodically monitored by the Board.
Additional Information
Persons who require additional information about this statement of policy may submit inquiries to the Counsel, State Board of Social Workers, Marriage and Family Therapists and Professional Counselors, P.O. Box 6923, Harrisburg, PA 17106-9523, (717) 783-7200, RA-STRegulatoryCounsel@pa.gov.
Order
The Board acting under the authority statutes, orders that:
(a) Chapters 47, 48 and 49 of 49 Pa. Code are amended by adding a statement of policy in §§ 47.5, 48.5 and 49.5 to read as set forth in Annex A.
(b) The Board shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.
(c) This order shall take effect upon publication in the Pennsylvania Bulletin.
MICHELLE SANTIAGO, PsyD, NCC, CCMHC, LPC,
ChairpersonFiscal Note: 16A-6926. No fiscal impact; recommends adoption.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 47. STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS
STATEMENT OF POLICY § 47.5. Conversion therapy, sexual orientation change efforts and reparative therapy—statement of policy.
(a) Background. Conversion therapy, also known as sexual orientation change efforts or reparative therapy, poses critical health risks to lesbian, gay, bisexual, transgender, queer/questioning, intersex and asexual individuals, including suicidality, substance abuse, confusion, depression, guilt, helplessness, hopelessness, shame, social withdrawal, 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 with 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. Due to the lack of scientific evidence supporting conversion therapy and the risk of harm to minors, the practice of conversion therapy is strongly opposed by the American Academy of Child Adolescent Psychiatry, American Academy of Pediatrics, American Association for Marriage and Family Therapy, American College of Physicians, American Medical Association, American Psychiatric Association, American Psychoanalytic Association, American Psychological Association, National Association of Social Workers, Pan American Health Organization and the World Psychiatric Association.
(b) Board authority. The Board has statutory authority to license, regulate and discipline social workers, marriage and family therapists and professional counselors. Under section 11(a)(2) and (3) of the act (63 P.S. § 1911(a)(2) and (3)), the Board is authorized to discipline a licensee for being guilty of immoral or unprofessional conduct and for violating professional practice or conduct standards adopted by the Board, including §§ 47.71, 48.71 and 49.71 (relating to codes of ethical practice and professional conduct; code of ethical practice and professional conduct; and code of ethical practice and professional conduct).
(c) Guidelines. The following conversion therapy guidelines should be considered by licensees to ensure compliance with the act and the Board's regulations.
(1) Being lesbian, gay, bisexual, transgender, queer/questioning, intersex or asexual is not a disease, disorder, illness, deficiency or shortcoming.
(2) Conversion therapy includes the following conduct:
(i) A practice or treatment that seeks to change an individual's sexual orientation or gender identity.
(ii) An effort to change the behavioral expression of an individual's sexual orientation, change gender expression, or eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender.
(3) Conversion therapy does not include a practice or treatment that provides counseling for an individual undergoing gender transition, counseling that provides acceptance, support, and understanding, or the facilitation of coping, social support, and identity exploration and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices. Conversion therapy does not include a practice that does not seek to change sexual orientation or gender identity.
(4) In a disciplinary action brought against a licensee, the Board may find the use of conversion therapy on an individual under 18 years of age to be unethical, immoral and unprofessional conduct. A licensee who uses conversion therapy on an individual under 18 years of age may be subject to discipline by the Board.
CHAPTER 48. STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS—LICENSURE OF MARRIAGE AND FAMILY THERAPISTS
STATEMENT OF POLICY § 48.5. Conversion therapy, sexual orientation change efforts and reparative therapy—statement of policy.
Section 47.5 (relating to conversion therapy, sexual orientation change efforts and reparative therapy—statement of policy) applies to this chapter.
CHAPTER 49. STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS—LICENSURE OF PROFESSIONAL COUNSELORS
STATEMENT OF POLICY § 49.5. Conversion therapy, sexual orientation change efforts and reparative therapy—statement of policy.
Section 47.5 (relating to conversion therapy, sexual orientation change efforts and reparative therapy—statement of policy) applies to this chapter.
[Pa.B. Doc. No. 24-796. Filed for public inspection June 7, 2024, 9:00 a.m.]
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