Re: CA SB 1172 banning SOCE for minors: Dr. Christopher Rosik Rebuttal Declaration


DAVID PICKUP, et al. v. EDMUND G. BROWN, Jr., Governor of the State of California, in his official capacity, et al.

Case NO.:2: 12-cv-04297-KJM-EFB

1 I, Dr. Christopher Rosik, hereby declare as follows:
2 l. I am over the age of eighteen years and am one of the Plaintiffs in this action. The
3 statements in this Declaration are true and correct and if called upon to testify to them I would
4 and could do so competently.
5 2. I am submitting this Declaration in rebuttal to the Declarations submitted by the
6 State of California when filing their Memorandum in opposition to Plaintiffs Motion for a
7 Preliminary Injunction.
8 3. I am a Phi Beta Kappa graduate of the University of Oregon's honors college and
9 graduated with a Bachelor of Arts in Psychology in 1980. I also studied one semester at the
10 University of Copenhagen, Denmark while completing my undergraduate work. I received my
11 Master of Arts degree in Theological Studies from the Fuller Graduate School of Psychology,
12 Fuller Theological Seminary in 1984. I received a Doctor of Philosophy degree in Clinical
13 Psychology from the Fuller Graduate School of Psychology, Fuller Theological Seminary in
14 1986. I am a clinical psychologist licensed by the State of California and have been so licensed
15 since 1988. (A copy of my curriculum vitae is attached as Exhibit A).
16 4. My practice is located at the Link Care Center, which is a religious non-profit
17 foundation in Fresno, California. Link Care Center employs a staff of twelve clinicians, which
18 include psychologists, marriage and family therapists, a social worker, and an intern, and it
19 employs two pastoral counselors. The majority of Link Care Center's clients come to the facility
20 because of its Christian identity and their trust that their Christian values and beliefs will be
21 represented in treatment. I served as the Clinical Director for Link Care Center Counseling
22 Center from 1996-1999.
1 5. Since 2001, I have also been on the clinical faculty of Fresno Pacific University,
2 and I teach psychology research practicum every year. I have published over 40 articles and book
3 chapters in peer reviewed journals, many of them on the subject of homosexuality. I am a
4 member of the American Psychological Association and have been a member in good standing
5 since 1984; a member of the International Society for the Study of Trauma and Dissociation and
6 have been a member in good standing since 1992; and member and former-president and board
7 member of the Christian Association of Psychological Studies, Western Region; and am the
8 current President of the National Association for Research and Therapy of Homosexuality.
9 The Objectivity of the APA Task Force Report on SOCE is Demonstrably Suspect;
10 Therefore the Task Force's Representation of the Relevant Literature Concerning the
 11 Efficacy of and Harm from SOCE is neither Complete nor Definitive.
13 6. Although many qualified psychologists were nominated to serve on the Task
14 Force, they were rejected because they did not align with the one-sided view of the Task Force.
15 This fact was noted in a book co-edited by a past-president of the American Pyschological
16 Association (APA) (Yarhouse, 2009) (A copy of a bibliography of all cited studies is attached as
17 Exhibit B). The director of the APA's Lesbian, Gay and Bisexual Concerns Office, Clinton
18 Anderson, offered the following defense: "We cannot take into account what are fundamentally
19 negative religious perceptions of homosexuality-they don't fit into our world view." (Carey,
20 2007). It appears that the APA operated with a litmus test when considering Task Force
21 membership-the only views of homosexuality that were tolerated are those that uniformly
22 endorsed same-sex behavior as a moral good. Thus from the outset of the Task Force, it was
23 predetermined that religious or other viewpoints would only be acceptable when they fit within
24 their pre-existing worldview. One example of this is the Task Force's failure to recommend any
25 religious resources that adopt a traditional or conservative approach to addressing conflicts
1 between religious beliefs and sexual orientation. This bias can hardly be said to respect religious
2 diversity and had predictable consequences for how the Task Force addressed its work.
3 7. This bias was particularly evident in the Task Force's highly uneven
4 implementation of standards of scientific rigor in the utilization and evaluation of published
5 findings pertaining to SOCE (Jones, et aI., 2010). Of particular note is the contrast between the
6 exceptionally rigorous methodological standards applied to SOCE outcomes and the
7 considerably less rigorous and uneven standards applied to the question of harm. With regard to
8 SOCE outcomes, the Task Force dismisses most of the relevant research because of
9 methodological limitations, which are outlined in great detail (Task Force, 2009, pp. 26-34).
10 Studies pertaining to SOCE outcomes that fall short of the Task Force's rigorous standards are
11 deemed unworthy of examination and dismissed as containing no evidence of value to the
12 questions at hand. Meanwhile, the Task Force appears to adopt very different evidentiary
13 standards for making statements about harms attributed to SOCE. The standard as regards
14 efficacy is to rule out substandard studies as irrelevant; however, no such standards are employed
15 in considering studies purporting to document harm. In addition, the Task Force uses the absence
16 of evidence to argue that SOCE is unlikely to produce change and thus strongly questions the
17 validity of SOCE, but shows no parallel reticence to endorse affirmative therapy despite
18 acknowledging that, " ... it has not been evaluated for safety and efficacy" (Task Force, 2009, p.
19 91).
20 8. The six studies deemed by the Task Force to be sufficiently methodologically
21 sound to merit the focus of the Task Force targeted samples that would bear little resemblance to
22 those seeking SOCE today and used long outdated methods that no current practitioner of SOCE
23 employs. This brings into question the Task Force's willingness to move beyond scientific
1 agnosticism (i.e., that we do not know the prevalence of success or failure in SOCE) to argue
2 affirmatively that sexual orientation change is uncommon or unlikely. The Task Force seems to
3 affirm two incompatible assertions: (a) we do not have credible evidence on which to judge the
4 likelihood of sexual orientation change and (b) we know with scientific certainty that sexual
5 orientation change is unlikely. However, the absence of conclusive evidence of effectiveness is
6 not logically equivalent to positive evidence of ineffectiveness (Altman & Bland, 1995).
7 9. There are places where the Task Force does seem to acknowledge that, given their
8 methodological standards, we really cannot know anything scientifically definitive about the
9 efficacy of or harms attributable to SOCE. For example, the Task Force states, "Thus, we cannot
10 conclude how likely it is that harm will occur from SOCE." (Task Force, 2009, p. 42). Similarly
11 the Task Force observes, "Given the limited amount of methodologically sound research, we
12 cannot draw a conclusion regarding whether recent forms of SOCE are or are not effective"
13 (Task Force, p. 43). The Task Force argues at length that only the most rigorous methodological
14 designs can clearly establish a causal relationship between SOCE methods and subsequent
15 change, but the Task Force does not hesitate to make such causal attributions consistently
16 regarding harm while repudiating any such claims for efficacy. From this highly uneven
17 application of literature review methodology, the Task Force goes on to assert confidently that
18 success of SOCE is unlikely and that SOCE has the potential to be harmful. It is also telling that
19 in subsequent references to the Task Force the potential for harm has morphed into "the potential
20 to cause harm to many clients" (APA, 2012, p. 14) (emphasis added) and a "substantial risk of
21 harm" (Beckstead Decl, p. 10) (emphasis added). The harms from SOCE appear to grow greater
22 the farther away one gets from the original Task Force's conclusions.
1 10. That the Task Force utilized a far lower methodological standard in assessing
2 harm and other aspects of the science than it did in assessing SOCE outcomes can be
3 demonstrated by a few examples. Echoing the Task Force, Herek (Herek Dec!., pp. 12-13)
4 references the many varieties of methodological problems deemed sufficient to render useless
5 most of the SOCE research. Yet the Task Force and scholars such as Herek seem ready to
6 overlook such limitations when the literature addresses preferred conclusions. Consider the work
7 of Hooker (1957), which is routinely touted as groundbreaking in the field and affirmed by the
8 Task Force and other APA publications as evidence indicating no differences in the mental
9 health of heterosexual and gay men. However, this research contains such serious
10 methodological flaws that it is inconceivable an even-handed methodological evaluation by the
11 Task Force would have not have mentioned these problems. Among the many methodological
12 problems noted by Schumm (2012), the control group was told the purpose of the study in
13 advance, clinical experts were not blind to the objectives of the study, imperfect matching of
14 participants, low scale reliability, the use of a small and recruited control group rather than
15 existent national standardized norms, the post hoc removal of tests that actually displayed
16 differences, and the screening out of men from the study if they appeared to have pre-existing
17 psychological troubles. As she wrote many years later (Hooker, 1993), "I knew the men for
18 whom the ratings were made, and I was certain as a clinician that they were relatively free of
19 psychopathology." Despite these serious methodological problems, which would never be
20 tolerated by the Task Force were this SOCE research, Herek described this Hooker's study as
21 part of the "overwhelming empirical evidence" that there is no association of sexual orientation
22 with psychopathology (Herek, 1991, p. 143; see also Herek, 2010). The point here is not to argue
23 for such an association, but to underscore that a consistent application of the Task Force
1 standards Herek affirms should have led to the dismissal of the Hooker study as supportive of the
2 no differences hypothesis.
3 11. Perhaps the most egregious example of the Task Force's methodological double
4 standard is evidenced in their heavy reliance on the Shildo and Schroeder (2002) and Schroeder
5 and Shidlo (2003) research in conclusions about harm from SOCE. Several methodological
6 problems cited to dismiss the SOCE outcome literature complicate these studies. These studies
7 were conducted in association with the National Gay and Lesbian Task Force, with the explicit
8 mandate to find clients who had been harmed and document ethical violations by practitioners.
9 This was abundantly clear in the study's original title: "Homophobic therapies: Documenting the
10 damage" (See Exhibit C). In addition, over 50% of the 202 sample participants were recruited
11 through the GLB media, hardly a random or generalizable sampling procedure. Only 20
12 participants in this study were women, creating significant skew toward gay male accounts.
13 These subjects reported their experiences came from a mix of licensed therapists, nonlicensed
14 peer counselors, and religious counselors, leaving open the reasonable suspicion that negative
15 therapeutic experiences might differ significantly by level of training. The study results are thus
16 based on a non-representative sample likely to be heavily biased in the direction of
17 retrospectively reporting negative therapy experiences, some of which occurred decades ago.
18 The Task Force appears to have ignored the warnings from the study'S authors: "The data
19 presented in this study do not provide information on the incidence and prevalence of failure,
20 success, harm, help, or ethical violations in conversion therapy" (Shildo & Schroeder, 2002, p.
21 250, emphases original). It is difficult to understand how this research can be cited without
22 qualification or context as demonstrating likely harm from SOCE conducted by licensed
23 professionals. Again, what we can say with confidence is that some SOCE clients report harm
1 and others report benefit, and we do not know from the literature how often either outcome
2 occurs.
3 12. A third example of the Task Force's uneven application of methodological
4 standards concerns their conclusion that, "Studies failed to support theories that regarded family
5 dynamics, gender identity, or trauma as factors in the development of sexual orientation" (Task
6 Force, 2009, p. 23). Of the ten studies cited in support of this conclusion, three were not readily
7 accessible on databases and one was a review article, which is an interpretation and not an
8 empirical study. An examination of the remaining six studies (Bell, Weinberg, & Hammersmith,
9 1981; Freund & Blanchard, 1983; McCord, McCord, & Thurber, 1962; Peters & Cantrell, 1991;
10 Siegelman, 1981; Townes, Ferguson, & Gillem, 1976) revealed many of the same
11 methodological flaws cited in the Task Force critique of SOCE (Rosik, 2012). For example,
12 Beckstead (Dec!., p. 3) cites the Freud & Blanchard (1983) study as evidence against any role of
13 family dynamics or trauma in the origin of same-sex attractions but fails to mention this study's
14 methodological problems, including unclear scale reliability, participants being known to the
15 researchers as patients, the use of a convenience sample, and a narrow and therefore non-
16 generalizable sample composition of psychiatric patients. All these problems were considered to
17 be fatal flaws in the Task Force's appraisal of the SOCE outcome literature.
18 13. Given that many of the methodological limitations used by the Task Force to
19 assail the SOCE research existing in the etiological literature, questions have to be raised as to
20 why they chose to definitively dismiss this literature as "failing to support" developmental
21 theories. It appears, based on the same criteria they used to dismiss SOCE, that their own
22 conclusions have little basis in the literature. A fairer rendering of the etiological literature they
23 reference would appear to be that this research is so methodologically flawed that we cannot
1 make any conclusive statements concerning the applicability of developmental factors in the
2 origin of homosexuality. Thus by the Task Force's own methodological standards, the literature
3 they cite fails to support or rule out a role for these potential developmental influences in the
4 genesis of sexual orientation. If such ambiguity exists in the SOCE literature on methodological
5 grounds, then by the Task Force's own criteria, this ambiguity also is present in the referenced
6 etiological research. It appears that the Task Force has been inconsistent in the application of
7 their methodological critique to the broader literature on homosexuality and they have been
8 willing to offer more definitive conclusions about theories they wish to dismiss than is warranted
9 by their own standards. In a word, there is again the appearance of substantial bias.
10 14. Contra to the repeated claims of Beckstead and the Task Force that it is an
11 established "scientific fact" that "no empirical studies or peer-reviewed research supports
12 theories attributing same-sex sexual orientation to family dysfunction or trauma" (Task Force,
13 2009, p. 86), there currently exists recent, high quality, and large-scale studies that provide
14 empirical evidence consistent with potential familial or traumatic contributions to sexual
15 orientation (Bearman & Bruckner, 2002; Francis, 2008, Frisch & Hviid, 2006; Wilson & Widom,
16 2009). Despite their significant relevance for scientific discussions on the etiology of same-sex
17 attractions, these studies were ignored by the Task Force.
18 15. A fOlllth example of uneven methodological implementation of standards is the
19 Report's treatment of the "grey literature," which is dismissed in favor of only peer-reviewed
20 scientific journal articles in the assessment of SOCE. No developed rationale is offered for this
21 choice. Consequently, a highly scholarly study on SOCE supportive of change for some
22 individuals is dismissed in a footnote (Jones & Yarhouse, 20007; the footnote is found on page
23 90 of the Report). Yet the Task Forces appears to have no compunction in citing the grey
1 literature on other subjects, such as demographics relating to sexual orientation (Laumann,
2 Gagnon, Michael, & Michaels, 1994) or the issue of psychological and familial factors in the
3 development of sexual orientation (Bell, et aI., 1981), even though the latter book utilizes a
4 sample of questionable representativeness.
5 16. A fifth example of differential application of methodological critique highlights
6 the systemic nature of this problem within the broader literature pertaining to homosexuality. A
7 recent analysis of the 59 research studies cited in the APA's brief supporting same-sex parenting
8 (Marks, 2012) in essence applied methodological standards of similar rigor to those the Task
9 Force applied to the SOCE literature. The study concluded that,
10 " ... some same-sex parenting researchers seem to have contended for an
11 'exceptionally clear' verdict of 'no difference' between same-sex and
12 heterosexual parents since 1992. However, a closer examination leads to the
13 conclusion that strong, generalized assertions, including those made by the APA
14 Brief, were not empirically warranted. As noted by Shiller (2007) in American
15 Psychologist, 'the line between science and advocacy appears blutTed'" (p. 748).
17 While Marks' analysis does not focus on SOCE, it is relevant in that it underscores that APA's
18 worldview regarding homosexuality appears to result in public policy conclusions and
19 development (whether right or wrong) that go beyond what the data can reasonably support. This
20 is appears to be precisely what is occurring in the linking of the Task Force with the banning of
21 professional SOCE as represented in SB 1172.
22 l7. A final example of this problem of differential rigor in methodological critique
23 can in fact be found in SB 1172 itself. The bill cites a study by Ryan, Huebner, Diaz, and
24 Sanchez (2009) in the respected journal Pediatrics, presumably as its best support for claims that
25 SOCE with minors results in serious harms. It is evident that this study also contains many of the
26 methodological limitations cited by the Task Force to invalidate the SOCE literature, including
27 participants not being blind to the study purposes, likely biases in the participant recruitment
1 process, and the reliance on self-report measures that had participants recalling experiences from
2 the distant past. Generalization difficulties are also created by the sample composition of Ryan,
3 et al. (2009). The sample is limited to young adult non-Latino and Latino LGB persons. The
4 Task Force (2009) noted that research on SOCE has "" . limited applicability to non-Whites,
5 youth, or women" (p. 33) and, "No investigations are of children and adolescents exclusively,
6 although adolescents are included in a very few samples" (p. 33). This means that even had Ryan
7 and colleagues assessed for SOCE backgrounds among participants, it would be inappropriate to
8 generalize their findings in a manner that would cast aspersions on all SOCE expeliences of
9 minors, which again is precisely what AB 1172 is determined to do. In addition, Ryan, et al.
to (2009) acknowledge that "" .given the cross-sectional nature of this study, we caution against
11 making cause-effect interpretations from these findings" (p. 351). Presumably, this caution alone
12 should have been enough to prevent the authors of SB 1172 from employing the Ryan study.
13 Even had the study findings been generalizable, they would have not been able to indicate
14 whether SOCE caused the negative health outcomes or if youth with negative health markers
15 disproportionately sought SOCE. Based on this analysis, there appears to be no scientific
16 grounds for referencing the Ryan study as justification for a ban on SOCE to minors. The study's
17 findings, while likely reflecting some underlying connection between family rejection and
18 mental health outcomes, are not reliable and have no scientific justification for being generalized
19 to minors who engage in SOCE with licensed therapists. It is troubling that SB 1172 would
20 utilize Ryan, et al.'s work when the internal and external validity limitations of the study make
21 such claims profoundly misguided, as underscored by the Task Force.
22 18. The Task Force's concludes that, "None of the recent research (1999-2007) meets
23 methodological standards that permit conclusions regarding efficacy or safety" (Task Force,
1 2009, p. 2). Taking this statement at face value, which is arguable as noted above, nevertheless
2 only serves to underscore the enduring validity of comments from Zucker (2003), long-time
3 editor of the Archives of Sexual Behavior, who observes:
4 From a scientific standpoint, however, the empirical database remains rather
5 primitive and any decisive claim about benefits or harms really must be taken
6 with a grain of salt and without such data it is difficult to understand how
7 professional societies can issue any clear statement that is not contaminated by
8 rhetorical fervor. Sexual science should encourage the establishment of a
9 methodologically sound database from which more reasoned and nuanced
10 conclusions might be drawn (p. 400).
12 A scientific response as opposed to a response based largely on advocacy would pursue research
13 that wi II allow for more nuanced conclusions about SOCE, not create new law that sets the
14 precedent of placing a blanket prohibition on an entire form of psychological care.
15 Spitzer's Reassessment of His 2003 Study on SOCE
16 19. Herek understandably pointed out that Robert Spitzer, M.D., author of one of the
17 primary studies conducted on SOCE (Spitzer, 2003), has recently changed his assessment of the
18 study and believes that it does not provide clear evidence of sexual orientation change (Spitzer,
19 2012; Herek Declaration, p. 14). ). It appears that he may have originally wished to retract the
20 2003 study, but the editor of the journal in which the study was published, Kenneth Zucker,
21 Ph.D., denied this request. Zucker has been quoted regarding his exchange with Spitzer as
22 observing:
23 You can retract data incorrectly analyzed; to do that, you publish an erratum. You
24 can retract an article if the data were falsified-or the journal retracts it if the
25 editor knows of it. As I understand it, he's [Spitzer] just saying ten years later that
26 he wants to retract his interpretation of the data. Well, we'd probably have to
27 retract hundreds of scientific papers with regard to interpretation, and we don't do
28 that. (Dreger, 2012)
30 What Zucker is essentially saying is that there is nothing in the science of the study that warrants
31 retraction, so all that is left for one to change is his interpretation of the findings, which is what
1 Spitzer appears to have done. Spitzer's change of interpretation hinges on his new belief that
2 reports of change in his research were not credible, an assertion made by others at the time of the
3 study. Instead, he now asserts that participant's accounts of change were "self-deception or
4 outright lying" (Spitzer, 2012).
5 20. It is curious that Spitzer's (2012) apology seems to imply that he earlier claimed
6 his researched proved the efficacy of SOCE. As was understood at the time, the design of
7 Spizter's study ensured his research would not definitively prove that SOCE can be effective.
8 Certainly it did not prove that all gays and lesbians can change their sexual orientation or that
9 sexual orientation is simply a choice. The fact that some people inappropriately drew such
10 conclusions appears to be a factor in Spitzer's reassessment. Yet the fundamental interpretive
11 question did and still does boil down to one of plausibility: Given the study limitations, is it
12 plausible that some participants in SOCE reported actual change?
13 21. Since nothing has changed regarding scientific merit of the Spitzer's study, the
14 interpretive choice one faces regarding the limitations of self-report in this study also remains.
15 Either all of the accounts across all of the measures of change across participant and spousal
16 reports are self-deceptions andlor deliberate fabrications, or they suggest it is possible that some
17 individuals actually do experience change in the dimensions of sexual orientation. Good people
18 can disagree about which of these interpretive conclusions they favor, but assuredly it is not
19 unscientific or unreasonable to continue to believe the study supports the plausibility of change.
20 22. In fact, the reasonableness of this position has been bolstered recently by the
21 willingness of some of the participants in Spitzer's research to speak up in defense of their
22 experience of change (Armelli, Moose, Paulk,& Phelan, in press). They expressed clear
23 disappointment in Spitzer's new claims:
1 Once thankful to Spitzer for articulating our experience and those of others, we
2 are now blindsided by his "reassessment," without even conducting empirical
3 longitudinal follow-up. We know of other past participants who also feel
4 disappointed that they have been summarily dismissed. Many are afraid to speak
5 up due to the cunent political climate and potential costs to their careers and
6 families should they do so.
8 It seem clear, then, that unless one postulates initial and ongoing self-deception and fabrication
9 by participants to an incredulous degree, Spitzer's study still has something to contribute
10 regarding the possibility of change in sexual orientation.
11 How Enduring is Sexual Orientation?
12 23. Herek contends that sexual orientation is an enduring trait (Herek Decl., pp. 5-6),
13 and by implication that it cannot be changed, which would indicate the futility of change
14 attempts, including among minors. However, there is solid data to suggest this understanding is
15 by no means universally accurate. The definitive study by Laumann, et al. (1994), cited by both
16 the Task Force and Herek, involved hundreds of thousands of American adults between the ages
17 of 18 and 60. This report contains the most careful and extensive database ever obtained on the
18 childhood experiences of matched homosexual and heterosexual populations.
19 24. One of the major findings of the Lauman, et al. study, which even surprised the
20 authors, was that homosexuality as a fixed trait scarcely even seemed to exist (Laumann,
21 Michael, and Gagnon, 1994). Sexual identity is not the least fixed at adolescence but continues to
22 change over the course of life. For example, the authors report
23 ... this implies that almost 4 percent of the men have sex with another male
24 before turning eighteen but not after. These men, who repOlt same-gender sex
25 only before they turned eighteen, not afterward, constitute 42 percent of the total
26 number of men who report ever having a same-gender experience. (Laumann,
27 Gagnon, et aI., p. 296)
29 They also note that their findings comport well with other large-scale studies.
1 [O]verall we find our results remarkably similar to those from other surveys of
2 sexual behavior that have been conducted on national populations using
3 probability sample methods. In particular two very large-scale surveys ... one in
4 France [20,055 adults] and one in Britian [18,876 persons]. (p. 297)
6 25. This data seem to suggest that heterosexuality is normative even for those who at
7 one point in the past reported minority sexual orientation. Heterosexuality appears to exert a
8 constant, normative pull throughout the life cycle upon everyone. While admittedly Laumann
9 attributes this reality to American society, the same findings have been found in other societies
10 where it has been studied. A simpler explanation might look to human physiology, including the
11 physiology of the nervous system, which is overwhelmingly sexually dimorphic, i.e,
12 heterosexual. Therefore it is not surprising that the brain would self-organize behavior in large
13 measure in harmony with its own physiological ecology, even if not in a completely
14 deterministic fashion. Whether measures by action, feeling, or identity, Laumann, Gagnon, et
15 al.'s (1994) data concerning the prevalence of homosexuality before age 18 and after age 18
16 reveal that its instability over the course of life was unidirectional and reflected significant
17 decline. This evidence of spontaneous change with the progression of time among both males
18 and females is hardly a picture of sexual orientation stasis in adolescence that SB 1172 assumes.
19 To be fair, we cannot tell from this data how many, if any, of those reporting change pursued
20 SOCE. However, the data do provide a developmental context for the plausibility that SOCE
21 could aide some individuals (including minors) in modifying same-sex attractions and behavior.
22 It appears that the most common natural course for a young person who develops a homosexual
23 identity is for it to spontaneously disappear unless that process is discouraged or interfered with
24 by extraneous factors. Conceivably, therapies unlike SOCE that obstruct this process could be
25 interfering with normal sexual development.
1 26. A New Zealand study by Dickson, Paul, and Herbison (2003) further brings into
2 question the claim that change might affect same-sex behavior but not same-sex attraction. This
3 study found large and dramatic drops in homosexual attraction that occurred spontaneously for
4 both sexes. Interestingly, the results also indicated a slight but statistically significant net
5 movement toward homosexuality and away from heterosexuality between the ages of 21 and 26,
6 which suggests the influence of environment on sexual orientation, particularly for women.
7 Specifically, it appears likely that the content of higher education in a politically liberal
8 environment contributed to the upswing in homosexuality in this educated sample of twenty-
9 somethings. This notion is further supported by the fact that this increase in homosexuality
10 follows a much larger decrease that would have had to taken place in the years prior to 21 in
11 order to account for the above findings. Furthermore, once the educational effect wears off, the
12 expected decline in homosexual identification resumed. The authors conclude that their findings
13 are consistent with a significant (but by no means exclusive) role for the social environment in
14 the development and expression of sexual orientation.
15 27. A large longitudinal study by Savin-Williams and Ream (2007) is also
16 noteworthy as it focuses on the stability of sexual orientation components for adolescents and
17 young adults. Three waves of assessment began when participants were on average just under 16
18 years of age and concluded when participants were nearly 22 years old. The authors observed a
19 similar decline in homosexuality over the time of the study: "All attraction categories other than
20 opposite-sex were associated with a lower likelihood of stability over time" (p. 389). For
21 example, 16 year olds who reported exclusive same-sex attractions or a bisexual pattern of
22 attractions are approximately 25 times more likely to change toward heterosexuality at the age of
23 17 than those with exclusively opposite sex attractions are likely to move towards bisexual or
1 exclusively same-sex (Whitehead & Whitehead, 2010). Ninety-eight percent of 16 to 17 year
2 olds moved from homosexuality or bisexuality towards heterosexuality over the course of the
3 study. To be fair, such changes were more pronounced among bisexuals and women. But keep in
4 mind that SB 1172 does not discriminate in its prohibition between SOCE provided for
5 exclusively same-sex attracted minors and those whose unwanted same-sex attractions are part of
6 a bisexual attraction pattern. Nor does SB 1172's ban distinguish between boys and girls. Savin-
7 Williams and Ream observed that, "The instability of same-sex attraction and behavior (plus
8 sexual identity in previous investigations) presents a dilemma for sex researchers who portray
9 non heterosexuality as a stable trait of individuals" (p. 393). They acknowledge that
10 developmental processes are involved even as they focus mostly on problems with measurement.
11 The reality of such spontaneous changes in sexual orientation among teenagers is not in accord
12 with SB 1172 whose defenders contend sexual orientation is a universally enduring trait. In fact,
13 these data suggest it is irresponsible to legally prevent access to SOCE and only allow
14 affirmation of same-sex feelings in adolescence on the grounds that the feelings are intrinsic,
15 unchangeable, and therefore the individual can only be homosexual.
16 28. Finally in this regard, it is instructive to observe what Herek did not tell us about
17 his 2005 survey findings (Herek et aI., 2006; Herek Decl., p. 6). He reported that "only" 7% of
18 gay men reported experiencing a small amount of choice about their sexual orientation and
19 slightly more than 5% reported having a fair amount or great deal of choice. Lesbian woman
20 reported rates of choice at 15% and 16%, respectively. It is worth noting that these statistics,
21 which are not inconsequentially small, do suggest that sexual orientation is not immutable for all
22 people and again suggest the plausibility that modification of same-sex attractions and behaviors
23 could occur in SOCE for some individuals. Even more important, however, is what Herek failed
1 to disclose: 22% of male bisexuals and 15% of female bisexuals report having a small amount of
2 choice about their sexual orientation and 40% of bisexual males and 44% of bisexual females
3 reported having a fair amount or great deal of choice. These numbers create a significantly
4 different impression about the enduring nature sexual orientation than the picture painted by
5 Herek. If such a large minority of individuals (albeit mostly bisexuals) experience a self-
6 determinative choice as being involved in the development of their sexual orientation, why
7 would it not be conceivable that SOCE might augment this process for some individuals with
8 unwanted same-sex attractions and behaviors?
9 Stigma, Discrimination, and SOCE
10 29. Defenders of SB 1172 frame a significant degree of their arguments concerning
11 harm and SOCE on the negative consequences of stigma and discrimination. While these factors
12 certainly can have deleterious consequences for those with minority sexual orientation, this
13 possibility must be balanced by additional considerations. First, stigma and disclimination alone
14 do not appear to be the complete explanation for greater psychiatric and health risks. Several
15 examples can illustrate this point. Mays and Cochran (2001) reported that discrimination
16 experiences attenuated but did not eliminate associations between psychiatric morbidity and
17 sexual orientation. Men with same-sex attractions and behaviors were found to have a higher risk
18 for suicidal ideation and acute mental and physical health symptoms than heterosexual men in
19 Holland, despite that country's highly tolerant attitude towards homosexuality (Sandfort, Bakker,
20 Schellevis, & Vanwesenbeeck, 2006; de Graaf, Sandfort, & ten Have, 2006). Differential rates of
21 health problems resulted from sexual orientation-related differences in coping styles among men,
22 with an emotion-oriented coping style mediating the differences in mental and physical health
1 between heterosexual and homosexual men (Sandfort, Bakker, Schellevis, & Vanwersenbreeck,
2 2009).
3 30. Second, some health risks, such as HIV transmission among gay men, may be
4 influenced by stigma but are ultimately grounded in biological reality. A recent comprehensive
5 review suggested just this conclusion, finding an overall 1.4% per-act probably of HIV
6 transmission for anal sex and a 40.4% per-partner probability (Beyer, et aI., 2012). The authors
7 noted, "The 1.4% per-act probability is roughly 18-times greater than that which has been
8 estimated for vaginal intercourse" (p. 5). Recent CDC statistics indicate the rate of new HIV
9 diagnoses in the United States among men who have sex with men is more than 44 times that of
10 other men (CDC, 2011). Sharing such information with prospective SOCE clients is not
11 inherently manipulative but rather, when balanced with other considerations, constitutes an
12 ethically obligated aspect of informed consent.
13 31. Third, and perhaps most importantly, the lessening of stigma associated with
14 "coming out" need not imply an affirmation of a gay, lesbian, or bisexual identity or the
15 enactment of same-sex behavior. SOCE practitioners often encourage the client's acceptance of
16 his or her unwanted same-sex attractions and the disclosure of this reality with safe others as a
17 potential aid in the pursuit of change or, in cases where change does not occur, behavioral
18 management of sexual identity. This typically occurs when clients desire to live within the
19 boundaries of their conservative religious values and beliefs. SB 1172 would eliminate this
20 potential means of reducing the effects of stigma and consequently prevent clients from one
21 means of prioritizing their religious values above their same-sex attractions when these factors
22 are in conflict. The contention that a desire to modify same-sex attractions and behaviors can
1 only be an expression of self-stigma reflects a serious disregard for and misunderstanding of
2 conservative religious and moral values (Jones, et al., 2010).
3 32. While stigma and discrimination are real concerns, they are not universal
4 explanations for greater psychiatric and health risks among sexual minorities, some of which are
5 likely to be grounded in the biology of certain sexual practices. Moreover, the effects of stigma
6 and discrimination can be addressed significantly within SOCE for many clients, though this is
7 no doubt hard for those not sharing the religious values of SOCE consumers to comprehend.
8 There is no longitudinal research involving consumers of SOCE that link the known effects of
9 stigma and discrimination to the practice of SOCE. SOCE is simply ipso facto presumed to
10 constitute a form of stigma and discrimination. This is in keeping with the unfavorable manner in
11 which SOCE is portrayed by the mental health associations. SOCE practitioners and consumers
12 are associated with poor practices as a matter of courses (Jones, et aI, 2010; APA, 2009), despite
13 that fact that they have developed their own set of practice guidelines that, when followed, can
14 be expected to reduce the risk of harm to SOCE consumers (NARTH, 2010).
15 Concluding Statements
16 33. There should be no doubt that licensed mental health professionals who practice
17 some form SOCE care deeply about the well-being of sexual minority youth and see SOCE as a
18 valid option for psychological care, while simultaneously affirming as well the client's right to
19 pursue gay affirmative forms of psychotherapy. While it is not possible here to respond to all the
20 accusations that have been made regarding SOCE, the information in the present declaration
21 should be sufficient to question the scientific (not to mention constitutional) merits of SB 1172.
22 34. As outlined above, there is evidence to reasonably suggest that professional
23 associations such as the APA do not approach the SOCE literature in an objective manner but
1 rather with an eye to their advocacy interests. This is seen in the purposeful exclusion of
2 conservati ve and SOCE sympathetic psychologists from the AP A Task Force as well as the
3 clearly uneven application of methodological standards in assessing evidence of SOCE efficacy
4 and harm. As the Task Force noted, the prevalence of success and harm from SOCE cannot be
5 determined at present. Anecdotal accounts of harm, which are a focal point of attention by
6 supporters of SB 1172, cannot serve as a basis for the blanket prohibition of an entire form of
7 psychological care, however meaningful they may be on a personal level. Furthermore, such
8 accounts cannot tell us if the prevalence of reported harm from SOCE is any greater than that
9 from psychotherapy in general, where research demonstrates 5-10% of clients report
10 deterioration while up to 50% experience no reliable change during treatment (Hansen, Lambert,
11 & Forman, 2002; Lambert & Ogles, 2004).
12 35. The normative occurrence of spontaneous change in sexual orientation among
13 youth, the nontrivial degree of choice reported by some in the development of sexual orientation,
14 and the questionable blanket application of the literature on stigma and discrimination to SOCE
15 further bring into question the appropriateness of SB 1172. Sexual orientation is not a stable and
16 enduring trait among youth, and this lends plausibility to the potential for professionally
17 conducted SOCE to assist in change in unwanted same-sex attraction and behaviors with some
18 minors. Granted, research is needed to confirm this suspicion. However, it should be mentioned
19 in this regard that SB 1172 would make further research on SOCE with minors impossible in
20 California, despite the APA Task Force's clear mandate that such research be conducted (Task
21 Force, 2009).
22 36. Any genuine harm that results from SOCE practice with mmors can most
23 appropriately be remedied by the application of ethical principles of practice, including informed
1 consent, and addressed through the existing oversight functions of state regulatory boards and
2 state mental health associations. One has to wonder: if the tangible, prosecutable harms from
3 SOCE are as widespread as SB 1172 sponsors claim, why have we heretofore not seen SOCE
4 practitioners losing their licenses and mental health association memberships? SB 1172 is a
5 legislative overreach (LA Times, 2012) that takes an overly broad and absolute approach to
6 SOCE harm and success despite evidence suggesting age, gender, and sexual minority
7 orientation differences in the experience and degree of change in sexual orientation. In particular,
8 it is fair to ask whether bisexual youth are well served by SB 1172, a distinction the bill does not
9 make.
10 37. The religiously conservative faith community will not be well served if SOCE
11 among minors is judged never to be an appropriate modality for psychological care, especially
12 when the affirmative interventions include the "correction of the client's false assumptions."
13 (Beckstead Decl., p. 6). Should the court agree with this line of argument, then the court is
14 unconstitutionally taking a stand on the validity of certain forms of religious belief. By implying
15 that there is always a better method than any form of SOCE, backers of SB 1172 presume to
16 know what form of psychological care for unwanted same-sex attractions and behaviors is best
17 for the religiously motivated minor clients and their parents. Neither the courts nor the APA
18 should be substituting their judgment for that of a 17-year old who is calculating a cost-benefit
19 analysis in deciding whether to undergo SOCE despite the risks. The APA is quite clear that it
20 supports the competence of a 17-year old girl to give consent to an abortion. Why does the 17-
21 year old lose competence when it comes to SOCE? Similarly, the APA is on record as supporting
22 the availability of sexual reassignment surgery for adolescents (APA, 2008). Should one 17-year
23 old be allowed to surgically remove genitalia while another with unwanted same-sex attractions
1 and behavior not be allowed to seek change in the dimensions of sexual orientation? This
2 question is especially relevant in light of recent high quality longitudinal research that suggests
3 such surgery does not remedy high rates of morbidity and mortality among these individuals
4 (Dhejne, et al., 2011).
5 38. The Task Force Report (Task Force, 2009), and the mental health associations
6 that subsequently relied on it for their resolutions on SOCE, provide one viewpoint into research
7 and reasoning that may some merit but must be considered incomplete and therefore not
8 definitive enough to justify a complete ban on SOCE with minors. Currently, there is a lack of
9 sociopolitical diversity within mental health associations (Redding, 2001), which has an
10 inhibitory influence on the production of scholarship in controversial areas such as SOCE that
11 might run counter to preferred worldviews and advocacy interests. An authentically scientific
12 approach to a contentious subject must proceed in a different direction in order to give
13 confidence that the relevant database is a sufficiently complete one on which to base public
14 policy:
15 Fostering hypothesis competition and a heterogeneity of views and methods can
16 simultaneously serve the search for the truth and the search for the good. But
17 there is a pressing need to better articulate the boundary between adversarialism
18 and what might be called heterogeneous inquisitorialism-a partnership of
19 rigorous methodological standards, a willingness to tolerate uncertainty, a
20 relentless honesty, and the encouragement of a diversity of hypotheses and
21 perspectives" (MacCoun, 1998, pp.281-282)
23 A truly scientific response to the concerns of the sponsors of SB 1172 would be to encourage
24 bipaJ1isan research into SOCE with minors that could provide sound data to answer questions of
25 harm and efficacy that currently are only primitively understood. SOCE practitioners would
26 assuredly embrace such an opportunity (Jones, et al., 2010). Unfortunately, the approach taken
27 by SB 1172 sponsors represented only one (political and legislative) perspective on how to best
1 address the challenges that come with the psychological care of unwanted same-sex attractions
2 and behaviors. It is therefore a scientifically premature curtailment of the rights of SOCE
3 consumers, their parents, and their therapists and should not be allowed to stand.
4 39. I declare under penalty of perjury of the laws of the United States and California
5 that the foregoing statements are true and accurate.
7 Executed this 16th day of November, 2012

See also: Re: CA SB 1172 banning SOCE for minors: Dr. Joseph Nicolosi Rebuttal Declaration

Tom Usher

About Tom Usher

Employment: 2008 - present, website developer and writer. 2015 - present, insurance broker. Education: Arizona State University, Bachelor of Science in Political Science. City University of Seattle, graduate studies in Public Administration. Volunteerism: 2007 - present, president of the Real Liberal Christian Church and Christian Commons Project.