Executive Directive 2021 - 3

 

Diversity is a source of strength for the State of Michigan. LGBTQ+ youth are cherished community members who make important contributions to this state and are deserving of a safe place to reach their full potential. The State of Michigan has a compelling interest in the protection of their health, safety, and welfare.  

 

LGBTQ+ youth face significant health disparities compared to their peers. See CDC, Health Disparities Among LGBTQ Youth (Dec. 20, 2019); Am. Acad. of Pediatrics, Adolescent Sexual Health, Lesbian, Gay, Bisexual, Transgender & Questioning (LGBTQ) Youth. So-called "conversion therapy" is particularly harmful to LGBTQ+ youth, who may be unable to refuse or resist interventions sought by their parents or guardians. Also known as "reparative therapy," conversion therapy refers to any intervention that attempts to change an individual's sexual orientation or gender identity. Conversion therapy rests on the premise that an LGBTQ+ individual's identity is pathological and can be "repaired" or "fixed." Methods include aversion therapy, talk therapy, shaming, hypnosis, and other techniques.

 

The assumptions underlying the practice of conversion therapy are not supported by medicine or science. Being LGBTQ+ is not a disorder, disease, or deficiency. Treating it as such through conversion therapy is not only ineffectual, but may cause significant long-term harm, including anxiety, depression, internalized homophobia, lowered self-esteem, and self-blame, as well as alienation, loneliness, social isolation, loss of social supports, and suicidal behaviors. See Am. Med. Ass'n, LGBTQ Change Efforts (So-called "Conversion Therapy"), Issue Brief (Dec. 2019). A 2021 survey found that LGBTQ+ youth who were subjected to conversion therapy reported more than twice the rate of suicide attempts in the past year compared to those who were not subjected to conversion therapy. The Trevor Project, 2021 Nat'l Survey on LGBTQ Youth Mental Health (2021).

These dangerous effects on LGBTQ+ youth are why the nation's leading medical and mental health organizations, including the American Medical Association, the American Academy of Child and Adolescent Psychiatry, the American Counseling Association, the American Psychiatric Association, the American Psychological Association, and the National Association of Social Workers oppose the practice of conversion therapy on minors. See Press Release, Am. Med. Ass'n, AMA Adopts New Policies During First Day of Voting at Interim Meeting (Nov. 19, 2019); Am. Acad. of Child & Adolescent Psychiatry, Conversion Therapy (Feb. 2018); Am. Counseling Ass'n, Resol. on Reparative Therapy/Conversion Therapy/Sexual Orientation Change Efforts (SOCE) as a Significant & Serious Violation of the ACA Code of Ethics, Governing Council Motion (Dec. 19, 2017); Press Release, Am. Psychiatric Ass'n, APA Reiterates Strong Opposition to Conversion Therapy (Nov. 15, 2018);  Am. Psych. Ass'n, APA Resol. on Sexual Orientation Change Efforts (Feb. 2021); Nat'l Ass'n of Soc. Workers, Sexual Orientation Change Efforts (SOCE) and Conversion Therapy with Lesbians, Gay Men, Bisexuals, & Transgender Persons, National Comm. on Lesbian, Gay Bisexual, & Transgender Issues Position Statement (May 2015).

Notwithstanding the consensus of the medical community, conversion therapy is still practiced on LGBTQ+ youth. A 2019 study estimated that more than 698,000 LGBTQ+ individuals had received conversion therapy, with more than half receiving it as adolescents. Mallory, Christy et al., Conversion Therapy & LGBT Youth Update, The Williams Inst., UCLA Sch. of Law (June 2019). In a more recent survey of LGBTQ+ youth, 13% of respondents reported being subjected to conversion therapy, with 83% reporting it occurred when they were under age 18. The Trevor Project, 2021 Nat'l Survey on LGBTQ Youth Mental Health (2021).

Increasingly, states, local jurisdictions, and professional licensing boards across the nation are recognizing the harms of conversion therapy and banning the practice. As of the date of this directive, twenty states and the District of Columbia have instituted a ban.

The State of Michigan too has a responsibility to protect LGBTQ+ youth from the harms of conversion therapy and ensure taxpayer dollars are only spent on evidence-based medical and mental health services. This directive affirms the executive branch's commitment to supporting the health, safety, and welfare of Michigan's LGBTQ+ youth.

Acting under sections 1 and 8 of article 5 of the Michigan Constitution of 1963, I direct the following:
 

1.  As used in this directive:

 

1. "Conversion therapy" means any practice, treatment, or intervention that seeks or purports to change an individual's sexual orientation or gender identity, including efforts to change behaviors or gender expressions or eliminate or reduce sexual or romantic attractions or feelings towards individuals of the same gender.

 

2. "Conversion therapy" does not include:

 

1. Any practice, treatment, or intervention that provides acceptance, support, or understanding to an individual, or any practice, treatment, or intervention that facilitates an individual's coping, social support, or identity exploration and development, so long as such practice, treatment, or intervention does not seek to change sexual orientation or gender identity.

 

2. Any practice, treatment, or intervention that is neutral with regard to sexual orientation or gender identity and seeks to prevent or address unlawful conduct or unsafe practices.

 

3. Any practice or treatment that assists an individual seeking to undergo a gender transition or an individual who is in the process of undergoing a gender transition.

 

3. "Minor" means an individual under age 18.

 

2. The Michigan Department of Health and Human Services must take actions necessary to prohibit the use of state and federal funds for the practice of conversion therapy on minors. This includes without limitation funding related to Medicaid and the Children's Health Insurance Program (CHIP), child welfare services, and juvenile justice programs.

 

3. All departments and autonomous agencies subject to supervision by the governor that regulate, provide, procure, or pay for medical or mental health services on behalf of Michigan residents must explore what further actions they can take to protect minors from the practice of conversion therapy as permitted by law.

 

4. Executive Directive 2020-3 is rescinded.

 

This directive is effective immediately.

 

Thank you for your cooperation in implementing this directive.