Conversion Therapy and Tattoos

The Supreme Court is currently hearing arguments challenging Colorado’s ban on conversion therapy for minors. Conversion therapy is a nonscientific practice that attempts to change one’s sexual or gender identity. The Shapiro Administration has taken the stand that counseling to do this is antithetical to what therapists are taught. This approach has been underscored by bioethics since counseling requires one to be empathetic and treat the patient with unconditional positive regard. This is the road to validation but not agreement. One’s personal values should not interfere with the counseling or someone else should be chosen as counseling should be supportive and compassionate.

The basic premise of conversation therapy does not meet the right of the patient to have an unbiased view. One of the guidelines of bioethics is found in the Hippocratic Oath. “First, do not harm.” There is no scientific proof that there can be change in one’s sexuality or one’s sexual orientation. Notice that the term “sexual preference” has been changed to sexual orientation (which doesn’t imply choice). Choice is a key word here for in ethics if you can’t choose something, you are not morally culpable of the issue. Lady Gaga put it this way in one of her songs, “I was born this way!”

Recall Trump’s vision was to only allow men and women labels and nothing else as a description of a persons’ sexuality. At the same time, this demeaned gay and transgender people. When I heard him say this at the very beginning of his presidency, I knew that something like this Colorado ban on Conversion therapy would be somewhere down the road as well as gay marriage to continue to remain the law of the land as well as transgender considerations. Recall that the gay community, in turn, had concerns about sexual orientation as well. I still refer to those who think their sexuality is not a preference but part of who they are to a comment made by Rosie O’Donnell when she said, “Yeah, most people who are gay wake up and say, “I think I will be gay today.” She was referring to the toxic culture that still exists through our society against gay rights.

Conversion Therapy is counter to every best practice of a therapist’s ethics. We know what heals, and we know what danger there is in having one’s personal views put on the client.

But there is more, and I turn to something that every bioethics counselor does. You try to find another example that is close to this to guide your thinking. There are two examples that would make my point. The first was handedness. We are born this way. Try to change what your dominant hand is to the other hand. They used to try to change the handedness of left-handed people, of which I am one.

The second seems trivial but it can be informative in acting ethically and responsibly to put forward to the Supreme Court. It is based on my years of working with adolescents. Another example in terms of not doing physical changes to one’s body is seen, of all places, in the world of tattoos. It is difficult to reverse getting a tattoo or changing your gender.

The tattoos that people get are the following: most tattoos are tribal such as a cultural statement, the second most gotten is a heart, and third in the list is roses. 42 % of tattoos are placed on the upper arm. But after several years %36 regret that they got them. 60% of people who regret that the tattoo was planned to get one with just after a few weeks of reflection. In 2023, 26% of adolescents regretted it and did it out of impulsive behavior.

The one thing that is true for many adolescents is that they do stupid things and impulsive actions and need second chances. The life of the adolescent is filled with challenges regarding who they are, their primary identity. They want to blend in, and they also want to stand out.

I believe that medical operations to change their identity does not have “a second chance” attached to it.  You can’t do a redo or removal of conversion therapy or physical change as someone who has made physical changes. I believe that their sexual identity should be affirmed and supported through their adolescent years as this very affirmation can help them to feel that they belong and their self-esteem will rise for the parent to see a smile for the first time. One EA parent described the smile in glowing terms about their daughter.

They should also find a therapist who could help them through this journey, but eventually the parents should be involved when he or she is considering such an important decision as a surgical change when they are eighteen.  Keep in mind that adolescents are working hard to arrive at their identity. Remember my comment that they are attempting a heroic journey. Use the same guideline as a therapist would use, nourish with a sense of belonging and a rise in their self-esteem. Adolescents are the best lawyers in town. You will lose a great many arguments if you tangle with them. I also have dealt with many parents of adolescents who call me because they think their child is “crazy.” They don’t know who is going to show up at breakfast. Hormones are raging. Guideline number one is keeping the conversation and dialogue open.

Patricia Hearst wrote a book, A Tribe Apart, where she studied the struggles of eight adolescents growing up in Reston, Virginia. She found if the student had just one adult friend, they could navigate the seas of adolescence best. I have found her premise to be my experience in working with kids. But if I were counseling a student, I always tried to open the line of communication with their parents because they are the ultimate change agent. Students talk to their peers for support when they feel that parents don’t know what their life is like, but peers do.

I don’t know who said to kids that adolescence are the best days of their lives! No mortgage, no worrying to earn money to support their family. Whoever said that never was immersed in the world of kids.

In essence, I believe that minors should not have physical changes made to their body or conversion therapy during adolescence, but they need SUPPORT AND HONORING THEIR ORIENTATION with ongoing conversation with their parents until they are eighteen, an age where their identities are more completely formed. I know first-hand in working with families that it is a life changing moment when perception is turned to orientation and parents see the result in a happy young person.