Pittsburgh became the latest city to ban "conversion therapy" for minors on Tuesday, joining a number of cities and states with similar laws in place.
In a unanimous 9-0 vote, the Pittsburgh City Council approved legislation outlawing mental health professionals in the city from using controversial treatment methods intended to change sexual orientation or gender identity on anyone under the age of 18.
"With the incoming [presidential] administration, with the history Mike Pence has, we thought it was a good time to make a stand and to make certain on the books here in Pittsburgh it states loud and clear we’re opposed to conversion therapy being performed on minors," Council president Bruce Kraus, the city’s first openly gay councilor, told the Pittsburgh City Paper. "They’re saying that LBGTQIA people are flawed, that we’re inherently damaged. I think that’s dangerous and offensive."
While similar bans have existed in states and cities across the country for years – currently, five states, Washington, D.C., and a number of cities including Miami, Cincinnati, and Seattle prohibit conversion therapy for minors – the election of President-elect Donald Trump and Vice-President-elect Mike Pence has opened up fresh debate on the topic and prompted new legislation in some cities and counties across the United States. Pence has been accused of advocating for conversion therapy in the past, although a spokesperson for Mr. Pence has denied that he supports such practices. Critics point to his 2000 congressional campaign, during which he called for resources to be directed toward "institutions which provide assistance to those seeking to change their sexual behavior."
"It is vitally important that states and cities start to implement these kinds of bans, because we are not likely to see that from the federal level given the incoming administration's platform," says David W. Bond, LCSW, vice president of programs at The Trevor Project, a leading national organization providing crisis intervention and suicide prevention services to LGBTQ youth. Now, he tells The Christian Science Monitor in a phone interview, "advocacy groups across the country are mobilizing to make sure this kind of torture is prohibited."
Lesbian, gay, bisexual, and transgender advocates and mental health professionals alike say that conversion therapy tactics are at best ineffective and at worst dangerous, citing a lack of concrete evidence that conversion methods work and a heightened risk of suicide for young people required to go through it.
But the constitutionality of legally banning such practices has been questioned, both by defenders of conversion therapy and those who say the legislation in Pittsburgh and elsewhere violates the First Amendment and gives the government too much say in the personal lives of its citizens.
The legal question comes down to this, says Clay Calvert, director of the Marion B. Brechner First Amendment Project at the University of Florida: "Is the counseling itself speech protected by the First Amendment? Or is it conduct?"
That decision is an "important" one, he tells the Monitor in a phone interview, "because if it is merely regulating the medical profession, that can be regulated much more easily than if it involves a First Amendment right such as free speech."
Conversion therapy bans have been upheld in California and New Jersey, where federal courts ruled that the issue at hand was not freedom of speech, but rather the regulation of a medical profession.
"Surely, the fundamental rights of parents do not include the right to choose a specific medical or mental health treatment that the state has reasonably deemed harmful or ineffective," wrote United States District Court Judge Freda L. Wolfson in a 2013 ruling rejecting a New Jersey couple's claims that their constitutional rights were violated by the law preventing them from seeking conversion therapy treatment for their teenage son.
The US Supreme Court rejected challenges to rulings in both states in 2014 and 2015. But, Dr. Calvert notes, while the courts have thus far upheld conversion therapy bans, "that First Amendment argument of free speech that has been raised before could be raised again, and maybe flip over, if a new conservative justice comes under Trump."
Beyond the legal constitutionality of conversion therapy bans, some critics argue that the laws represent an amoral form of government censorship.
"Laws like this go above and beyond regulating and forbidding practices that are scientifically certain to be harmful (like prescribing inappropriate and dangerous medicine) to actually censoring and forbidding types of discussion," wrote Scott Shackford, an associate editor for libertarian Reason magazine, in January in response to a bill proposing a conversion therapy ban in Hawaii. "These kinds of laws should be resisted not because one supports trying to convert gay people or transgender people, but because it's an intrusion of artificial government certainty into a field of treatment that is anything but."
The First Amendment prevents conversion therapy bans from extending to churches, which are often the venues where forms of faith-based conversion therapy are offered. Still, advocates say they hope the legislation may send a message to parents considering faith-based therapy for their children by raising awareness of the damage that such therapy can cause.
"These families often have no idea how to react when they find out their child is gay or transgender, and often do turn to their own faith leaders," Shannon Minter, a civil rights attorney and legal director of the National Center for Lesbian Rights in San Francisco, told the Pittsburgh City Paper. "These parents have no idea that they are directly causing their children harm. We’ve got to do absolutely everything we can to make sure parents have access to this information."