Pa. Gov. Tom Wolf signs executive order rebuking conversion therapy

• By Zack Hoopes/ PennLive

Gov. Tom Wolf signed an executive order Tuesday directing state agencies to do everything within their purview to discourage the practice of so-called conversion therapy, including having the state’s insurance authorities review any reimbursement claims that may involve the controversial practice.

LGBTQ advocacy groups have long sought such formal rebukes of conversion therapy, which refers to the practice of trying to change a person’s sexual orientation or gender identity through various means, often coercive in nature.

The order would apply to state administrative offices under Wolf’s control, with the governor describing the order as the strongest move he could make without legislation.

Wolf’s order directs state agencies to “explore and implement all options to ensure state funds, programs, contracts, and other resources are not used for the purposes of providing, authorizing, endorsing, reimbursing for, or referring for conversion therapy, to the extent permitted by law.”

The executive order specifically directs the Department of Human Services to investigate claims made through Pennsylvania’s Medicaid or Children’s Health Insurance Program (CHIP) funds that might have paid for conversion therapy.

The order also instructs the state’s Insurance Department to discourage commercial insurers from reimbursing claims for conversion therapy, and to review any issues of anti-LGBTQ discrimination that may arise from the provision of such services.

The Department of State is also charged under the order with informing the public about ways to report harm caused by licensed professionals who perform conversion therapy.

The practice of conversion therapy is often described as a pseudoscience and is “widely rejected by the medical and scientific communities,” Wolf noted at a Tuesday press conference.

Both the American Psychological Association and American Medical Association have found conversion therapy to be ungrounded and strongly correlated with bad outcomes; the AMA has said it is “clinically and ethically inappropriate” to practice.

According to survey data from The Trevor Project, a mental health advocacy group for LGBTQ youth, 17 percent of LGBTQ people ages 13 to 24 reported having been subjected to or threatened with conversion therapy.

Those individuals attempted suicide at more than twice the rate of other LGBTQ youth, according to The Trevor Project’s data; the correlation of conversion therapy to severe psychological distress and self-harm has been replicated elsewhere.

Wolf described conversion therapy as a “traumatic practice based on junk science that actively harms people, the very people it’s supposed to help. Conversion therapy does the opposite of what research shows helps improve mental health outcomes for LGBTQ youth.”

“Instead of starting from a place of acceptance, conversion therapy tells individuals that they are in fact wrong, that they need to be changed,” Wolf said.

The practical outcome of Wolf’s executive order is not yet clear. Asked if there are any practitioners of conversion therapy who are receiving state support, Wolf said he didn’t know of any, but “one of the things that this executive order will allow us to do is learn more about what is actually going on in Pennsylvania.”

Said Casey Pick, Senior Fellow for Advocacy and Government Affairs at The Trevor Project: “We know from across the country that [funding] flows frequently to licensed professionals who will claim they are treating depression or anxiety when what they are really attempting to do is change someone’s sexual orientation or gender identity.”

Prior examples have included foster care agencies or drug and alcohol rehabilitation centers that operate under state contracts, Pick said. A key part of orders like Wolf’s, she said, is to make it clear that the state will not be supporting those providers if they incorporate conversion therapy into their services.

Stories of conversion therapy’s adverse impact were not uncommon among the advocates gathered Tuesday.

Carla Christopher Wilson, a member of the Pennsylvania Commission on LGBTQ Affairs and a Lutheran minister who promotes LGBTQ inclusion in the church, recalled her own experience coming out in a college Bible study group, which then took her to a retreat that turned out to be a conversion attempt.

Wilson was kept in a dark room while others held her down on the floor or in a chair in series of traumatic experiences that Wilson, speaking after Tuesday’s press conference, likened to an attempted exorcism.

“It’s still practiced in the here and now of 2022 Pennsylvania and it must stop,” Wilson said. “We do not have years and we do not have resources to waste.”

Many LGBTQ adults might also be just now realizing that they were subjected to conversion therapy while they were younger, said Troy Stevenson, Senior Campaign Manager for Advocacy and Government Affairs with The Trevor Project.

“More people are realizing that it happened to them,” Stevenson said, recounting his own experience – his high school boyfriend died by suicide after being subjected to homophobia at school and conversion therapy. “There’s nobody doing this within ethical bounds. There’s nobody that teaches it, they’re making this up,” Stevenson said, which can make conversion therapy hard to quantify.

Efforts by government agencies to formally discourage or disavow conversion therapy, such as Wolf’s order, have been met with legal challenges arguing that they run afoul of Constitutional religious freedom rights.

The Pennsylvania Family Institute, a conservative advocacy group, cited such an argument in a rebuttal statement on Tuesday, saying Wolf’s order “threatens to punish those with convictions on sexuality and gender that differ from the governor’s.”

The institute’s senior counsel, Jeremy Samek, pointed to the U.S. Supreme Court Decision in National Institute of Family and Life Advocates v. Becerra that limited the restrictions California is able to place on anti-abortion pregnancy counseling centers.

A case more specific to conversion therapy may be coming to a higher court soon, after a federal appeals judge stayed a Florida conversion therapy ban, siding with the argument that conversion therapy is protected speech.

But more frequently, courts have sided with conversion therapy restrictions, typically finding the government has a compelling interest in restricting medical treatments that are demonstrably harmful, regardless of what religious motivations different individuals may or may not assign to them.

“The vast majority of courts that have reviewed this have recognized that conversion therapies are treatments,” Pick, of The Trevor Project, said. “You prescribe using written words, you prescribe medications with your voice, but that is still an action and a treatment. If we were to prohibit regulating anything because it requires speech incidentally to do it, we would find ourselves in a state of chaos.”