On Ethical Treatment

June 1st, 2010


Last month the San Francisco chapter of the California Association of Marriage of Family Therapists (SFCAMFT) approved a Statement on the Ethical Treatment of Sexual Orientation and Gender. The statement addresses when a therapist’s personal, cultural or religious beliefs conflict with evidence-based practice, particularly in regard to working with sexual minority clients and clients with non-conforming gender identifications.

As a member of SFCAMFT, I’m pleased to share the whole statement with you below. The statement is in line with similar ones adopted by the American Association of Marriage and Family Therapists, the American Psychological Association, and many other mental health and medical organizations.

Statement on the Ethical Treatment of Sexual Orientation and Gender

San Francisco chapter of CAMFT

Recent events regarding the debate over marriage equality have raised larger concerns about ethical treatment in areas where the personal, cultural or religious beliefs of the clinician conflict with evidence-based practices and the standards of care accepted by our profession. Nowhere has this conflict been more profound than in matters concerning the treatment of sexual minorities (i.e., LGBT clients) and people with non-conforming gender identifications.

We recognize that some clinicians feel bound to offer treatments that are line with their personal, cultural and religious convictions, even when these beliefs conflict with evidence-based research. We also recognize that some clients feel compelled to try and change aspects of themselves to better fit into cultural and religious norms that privilege heterosexuality and certain stereotypes of masculinity and femininity.

Recognizing these pressures, the board of the San Francisco chapter of CAMFT wants to clarify that it is unethical for clinicians to recommend or support treatments that seek to alter a person’s sexual orientation or mode of gender expression. Rather, we believe that therapeutic treatments should be aimed at helping clients come to terms with their sexual orientation and discover authentic modes of gender expression rather than try to change them.

This ethical position is consistent with the empirical research accepted by our profession, which holds that sexual orientation change efforts (SOCE) do not lead to effective, enduring or beneficial change. Moreover, much of the literature emphasizes the harm to clients that can result from such efforts (Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation, 2009; Serovich, et. al., Journal of Marital and Family Therapy, 2009). Likewise, therapeutic approaches that force a person to conform to culturally expected modes of gender expression can result in harm to the person’s identity formation (APA Policy Statement: Transgender, Gender Identity, and Gender Expression Non-Discrimination, 2008).

photograph copyright Susannah Conway

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