Professionals for Fact Based Public Policy 18631 N. 19th Ave., Ste. 158, Box 428 Phoenix, Arizona 85027 April 27, 2018 Dear Senator/Representative: Based on science and research, and our concerns for the health and welfare of others we urge you to vote no on AB 2943. The following professional organizations among others are also opposed to this bill: The Association of American Physicians and Surgeons, the Catholic Medical Association, the American College of Pediatricians, the Christian Medical and Dental Association, and Alliance for Therapeutic Choice and Scientific Integrity. We believe that SB 2943 represents an inappropriate interference in the doctor patient relationship that may cause extreme or even fatal harm to those impacted by it. Furthermore censorship of published research, professional journals, or professional material and books is not seen as something appropriate for America where freedom of the press and speech are viewed as cherished underpinnings of our liberty and freedom. (Censorship brings to mind totalitarian governments.) This bill would ban professional therapy for unwanted same sex attraction (SSA) including bisexuals who represent the majority of individuals with SSA. Should the state deny bisexuals the freedom to choose which direction they want to take, whether it be to embrace a homosexual or a heterosexual path? If they want to move in the direction of heterosexuality, get married, and raise their own biological family should the state deny them the right to receive counseling to support their decision? If the state doesn’t deny bisexuals the right to get gay affirmative therapy for a gay lifestyle, why should it deny bisexuals the right to get counseling support for a heterosexual lifestyle? (According to the APA Handbook on Sexuality and Psychology (Vol. 1, pg 633) bisexuals are “indisputably the norm”, in regards to individuals who experience SSA while exclusive SSA is “the exception”.) Furthermore these efforts to ban professional therapy are without anything even approaching reasonable or adequate support in the scientific literature, and are often based on the false notion that homosexuality is genetically determined and that individuals are born gay. The multiple large identical twin studies show that this is clearly false. For example the Langstrom, et al (2010) 39 :75-80 study in Arch Sex Behav involving thousands of identical twins, found that if one of a twin pair was gay the other identical twin, with

exactly the same DNA or genes, was gay only 10% of the time, and if one was lesbian the other identical twin was lesbian only 14% of the time. Bearman and Bruckner (2002) 107, 5 :11789-1205 in AJS found in their identical twin study of adolescents with same sex attraction, that if one male twin experienced SSA, the other did 7.7% of the time, and if one female twin experienced SSA the other did only 5.3% of the time. They also found no fraternal birth order effect. Even the very liberal APA no longer supports the false notion that homosexuality is innate, and suggests the causes are mixture of environmental and genetic influences. APA Handbook on Sexuality and Psychology (2014) p.256-257 and 609-610 Dr. Francis Collins MD, PH.D., the former head of the Human Genome Project, and a very caring individual of gays personally, says (sexual orientation) is “not hardwired”. The Royal College of Psychiatrists in the United Kingdom in their Position Statement of April 2014 declares that “sexual orientation is determined by a combination of biologic and postnatal environmental factors.” Their statement goes on to say that “sexual orientation is not immutable” and may “vary to some extent in a person’s life.” (Emphasis added) We know of no credible scientific source that still holds to the false notion that homosexual attraction is hardwired, or innate. From identical twin studies it is clear that genetic predispositions are minor and indirect, and that environmental factors are primary factors in the development of SSA. If biologic contributions to SSA are only minor and postnatal factors are major contributing factors to the development of SSA what are these factors? A huge Danish 2006 study of the marriages of some 2,000,000 individuals 18 to 49 years old sheds some light on this. The study found that men who had older mothers, divorced parents, absent fathers, or were the youngest child were more likely to marry another male. The study found for women having a mother who died during their adolescence, being the only or youngest child or the only girl in the family were associated with them marrying another woman. Frisch and Hviid, Arch Sex Behav (2006) Oct; 35, 5:533-547) Also an article written by Tomeo et al, Arch Sex Behav (2001) 30, 5, Abstract reveals that while 7% of heterosexual males had experienced male on male sexual abuse as minors, 46% of male homosexuals had experienced this as minors. Among female heterosexuals 1% reported that they had experienced female on female sexual abuse as minors while 22% of lesbians reported this. A large survey of some 200 males who had or still experience homosexual attraction, revealed that their relationship with their fathers whether present or absent was considered to be the most important contributing factor in their experiencing SSA.

Some 97% felt it was a contributing factor for them. Also 48% of the males had been sexually abused by an older or more powerful male or female. Usually it was a male, in which case 96% felt it contributed to their SSA. But, if homosexual attraction is not innate, is it immutable? The answer is NO, even apart from any therapy spontaneous change to heterosexuality occurs as described in the research material below. Dr. Neil Whitehead, and Dr. Satinover comment on the significant degree of fluidity of SSA. Dr. Whitehead notes in his interview with Mark Ellis, May 13, 2013 that this is especially true in the teenage years. A large portion of minors who at some time experienced same sex attraction, will later adopt a heterosexual lifestyle or orientation. Most of those shifting to a heterosexual orientation will do so without any sexual orientation change efforts (SOCE) therapy. Ivy league academic Jeffrey Satinover MD, Ph.D in “The Trojan Couch” (p. 11, 17, 18, 19, 23-24) discusses the research indicating changes in homosexuality to heterosexuality over time in the U.S., New Zealand, and Australia. In related comments authors Laumann and Gagnon et al. of the landmark 706 page book The Social Organization of Sexuality (1994), p 283, … “assert that estimating a single number for the prevalence of homosexuality is a futile exercise because it presupposes assumptions that are patently false: that homosexuality is a uniform attribute across individuals, that it is stable over time, and that it can be easily measured.” (Emphasis added) But, even if homosexual attraction is not genetically predetermined, and quite often spontaneously changes to heterosexuality in a significant number of people, is it changeable through therapy? Yes, a number of studies have shown the positive effects of therapy in helping individuals change from a homosexual lifestyle to a heterosexual lifestyle. In pioneering therapeutic efforts between 1959 -1979, Dr. Nicolas Cummings, a former American Psychological Association President, and former Chief of Mental Health with Kaiser-Permanente Health Maintenance details their results in helping some 18,000 distressed or troubled homosexually attracted clients, who came to them for various reasons. Only 10% or less (1800 or less) came to them wanting to change their sexual orientation, but in receiving therapy for other complaints some 2400 hundred actually changed their sexual orientation. Dr. Cummings reported that “approximately 67%” had successful outcomes; the majority of these were able to attain more happy and sane homosexual life style with stable relationships. A third of the 18,000 had unsuccessful outcomes “that included continued promiscuity, unhappiness, and addictive behaviors.” J Human Sexuality 1:17

Two of the best studies are by Masters and Schwartz published in 1984 and one by Jones and Yarhouse published in 2007. In the first of these two studies published in Am J Psychiatry ( 1984)141, 2 :173 by Masters and Schwartz, from the then world famous Masters and Johnson Institute, it was reported that after the intensive phase of their treatment in attempting to help dissatisfied homosexuals establish a heterosexual lifestyle, only 20.9% failed to do so while 79.1% were successful. Five years later their failure rate was still only 28% or a 72% success rate. More recently Jones and Yarhouse in the book Ex-Gays ?, (2007) p.284-285, found success rates for those wanting help changing their SSA similar to the success rates for antidepressant treatment of depression in the STAR*D study. This 406 page study has been praised as clearly the best research on sexual orientation change therapy ever done. Dr. Robert Spitzer in his study of change efforts published in the Arch Sex Behav (2003) 32, 5:403-417 found “The majority of participants gave reports of change from a predominantly or exclusively homosexual orientation before therapy to a predominantly or exclusively heterosexual orientation in the past year.” p.403 “Even participants who only made a limited change nevertheless regarded the therapy as extremely beneficial.” p. 413 None of their studies study found any unusual harm resulting from the SOCE therapy. In fact in addition to Spitzer’s study, Masters and Schwartz noted that even some of those who were not successful in regards to developing a heterosexual lifestyle, still found the therapy to be beneficial. For further information on psychological studies assessing the effectiveness of SOCE please see Byrd and Nicolosi (2002) “A Meta-Analytic Review of Treatment of Homosexuality” Psychological Reports (2002) 90 :1139-1152. or C. Pela and J. Nicolosi 2016 presentation of their research to the Christian Association for Psychological Studies (CAPS). As the American Psychological Association has taken very liberal positions on some matters we thought the following information might be helpful. It should be noted that the 2009 APA task force (which provided a less than enthusiastic assessment of sexual orientation change therapy) was made up of hand picked members by the gay, lesbian and bisexual caucus of the APA. This group has for years been opposed to these therapies. It should then not be a surprise that no psychologist who actually did sexual orientation change therapy was allowed to be a part of the task force. One might have expected that the APA would have tried to avoid at least the appearance of bias and formed a more neutral task force, but such was not the case.

We also believe it would be important for decision makers to be aware of the landmark book Destructive Trends in Mental Health edited, endorsed, and written by twenty leaders in the field of psychology including three past presidents of the American Psychological Association. In this book the flyleaf reads “Psychology, psychiatry and social work have been captured by an ultra-liberal agenda”, and “…that special interest groups have used faulty—even false—science to promote political agendas”. In the preface of the book it also states that “the APA has chosen ideology over science.” In addition it is mentioned that “censorship exists.” (etc.) p. xiv While we respect the rights of those who want to live a gay or lesbian lifestyle, we would strongly affirm it is only fair and reasonable to allow those who want to live a heterosexual lifestyle to also be given the same freedom and opportunity to select therapy consistent with their life’s goals. Those who are wrongly and unethically forced to live with unwanted same sex attraction will unfortunately face the same well documented medical and psychological problems faced by those in the gay lifestyle which include: 

Tremendously increased rates of HIV infection which can lead to AIDS and premature death. The U.S. Center for Disease Control (CDC) has reported that men who have sex with men have 79 times the rate of HIV infection. CDC “Lifetime Risk of HIV Diagnosis in the United States” Feb. 2016

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They also have extremely high rates of syphilis. CDC

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Increased rates of Hepatitis A, B and C (Hepatitis B and C can be fatal as a result of an extremely severe initial infection or by increasing the rate of primary liver cancer years later.) GLMA

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Increased rates of testicular, prostate, anal and colon cancers. GLMA

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Increased rates of drug abuse, depression, suicidal ideation and suicidal behavior Arch of Gen Psychiatry (1999) 56:883.

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Increased rates of eating disorders

We do not know of any therapist in the U.S who in the last 25 years has used aversion therapy in attempting to modify homosexual attraction, but if the goal is to get rid of aversive or coercive therapies in the treatment of minors why limit it just to SOCE? Why not limit AB 2943 to a ban on aversive and coercive therapeutic approaches to any psychiatric problem unless there is a court order? If the goal is truly to protect the health of those with unwanted same-sex attraction then banning SOCE therapy is a huge step in the wrong direction and will clearly lead to extreme harm and even death for some over the years. Others will continue to suffer from the untreated issues related to the sexual abuse they suffered as minors. Clearly

limiting freedom and increasing the likelihood of disease and death is not something that the State of California should be promoting. Based on our desire to be as helpful as possible in providing relevant material, we would like to call your attention to an excellent and very informative 32 minute documentary “Understanding Same Sex Attraction”. In it 6 leading therapists discuss treatment for unwanted homosexual attraction and four ex-gays share their stories of what led to their SSA and of what led to the changes in their life’s journey. http://www.youtube.com/watch?v=jJhyzqdzpnM

Also for those who are interested, there is an excellent website called “Voices of Change” which provides the stories of numerous individuals who have experienced change in their sexual orientation. www.voices-of-change.org Respectfully and with Best Wishes, Karl Benzio, M.D., Monica Breaux, Ph.D., MSW, Michelle Cretella, M.D., Anthony Duk, M.D., F. Earle Fox, D. Phil., Laura Haynes, Ph.D., Al Howsepian, M.D., Ph.D., Sharon Quick, M.D., John Raney, M.D., Andre Van Mol, M.D., Keith Vennum, M.D., Russ Yost, LMFT