Sexual Expression including Orientation and Identity:
Treatment and Education Foundations
It is the position of the American Association of Sexuality Educators, Counselors, and Therapists that we oppose any and all therapy models and interventions as well as any educational programs and curricula that seek to pathologize, dictate, or prescribe a person’s sexual orientation, identity, and/or consensual, sexual expression, whether or not it is conventional or atypical. Regardless of how such clinical interventions or educational programs are labeled or named, AASECT recommends all helping and educating professionals to utilize best practices and culturally relevant resources for foundation and reference.
Furthermore: AASECT affirms that sexuality is central to the human experience and sexual rights must be honored in order for sexual health and overall well-being to be obtained. Informed by the best empirical research, AASECT recognizes human sexual experiences as diverse and supports the acceptance of sexual diversity while embracing consensual sexual expression within the framework of human rights and social justice.
AASECT accepts the evidence that human sexual experience includes a vast spectrum of sexual expression, orientation, and identities. These sexualities, between consenting adults when agreed upon, with permission, and assenting, are typically not psychopathological behaviors. Indeed, recent peer-reviewed research on these sexual experiences shows no correlation to pathology.
AASECT further asserts that all people seeking treatment and education about consensual sexual behavior, identity, or orientation deserve accurate information. AASECT accepts that the empirical evidence is reasonably complete on reparative and conversion therapies that attempt to change sexual orientation or identity and shows that these techniques are experimental at best and overwhelmingly ineffective, with harmful consequences for clients widely documented.
AASECT takes the position that social justice plays an essential and foundational role in the organization’s mission. Individuals have the right to be free as possible from undue constraints (e.g. discrimination, stigmatization, oppression and violence) along with the freedom to consensual sexual expression. Destigmatizing human sexual expression and experiences as well as creating and maintaining safe space for those who have been traditionally marginalized are essential practices for AASECT members who are predominately mental health practitioners and educators. This overarching goal compels AASECT to disavow any therapeutic and educational effort that, even if unwittingly, violates or impinges on AASECT’s vision of human rights and social justice.
On November 12, 2015, the AASECT Board of Directors unanimously adopted this position statement as recommended by its Public Relations, Media, and Advocacy Steering Committee. I was one of a large group of interested people in AASECT who participated in this process. The policy statement is obviously the official position of the entire organization. The remarks immediately below are my interpretations, not official AASECT policy:
Alfred Kinsey (1894-1956). His pioneering research on American Sexuality revealed its diversity was far greater than conventionally imagined then, and even now. |
With this passage of this position, AASECT is officially on record as supporting BDSM, cross dressing, fetishism, erotic role play, polyamory and consensual non-monogamy as potentially sexually healthy lifestyle choices and behaviors. This constitutes full implementation of Kinsey’s ideas about the broad range of sexually healthy behaviors.
This statement does not mean that sexual variability is always healthy, and it does not mean that it is usually without risks, but it does mean that educators and clinicians have the responsibility to remain neutral about these possibilities until given clinical data to question otherwise. I would advise doing so even when sexual behavior is a specific axis of complaint in a client’s reasons for coming to treatment.
This statement also bars devising treatments or educational programs specifically designed or marketed to stigmatize, marginalize or derogate unconventional but consensual sexual choices. Society will continue to criminalize some forms of sexual conduct, and the clinical community must remain responsive to law, but the statement only applies to consensual activities.
The explicit target of this statement is reparative or conversion therapies, and it was crafted to include other therapies used for reparative purposes, regardless of how they are otherwise labelled or used. A great example would be any measure of compulsive sexual behavior or ‘sex addiction’ that uses assessment measures that list such activities as polyamory, swinging, or BDSM to generate a score used to confer a diagnostic label. While BDSM might be problem sexual behavior, any measure that automatically labelled it as such would be defective under the intent of this policy. This targets the same bias that changes in the DSM – 5, published in May of 2013, partially implemented in the Paraphilias section. There, a distinction was drawn between non-pathological variation, ‘paraphilias,’ and paraphilias that were non-consensual or the focus of client complaints; paraphilic disorders. Variant behavior is not pathological in and of itself.
Likewise, it would be an unethical and defective business practice to advertise that one changes sexual orientation, variant behavior, or sexual desire per se, even though one might ethically contract with an individual patient who complained that variant orientation or behavior was a problem. Such advertising is doubly defective, in that it is not only stigmatizing of behaviors or identities that deserve protection as sexual human rights, but it is scientifically defective given that reparative and conversion therapies have repeatedly been found ineffective in rigorous scientific evaluation. Thus it is also a violation of this statement to undertake a therapy to change orientation, desire or behavior without explicitly contracting up front with the client that such an attempt involves therapeutic techniques which are experimental and unproven for such purposes.
Note, however, that this is a position statement. It does not specify how AASECT might deal with the problems of dual certification if an individual practitioner affiliates with an organization which has members that do any of these unprofessional things. A Member might complain to AASECT Ethics Advisory Committee (EAC) about another Member who was perceived as violating the position statement, and the EAC might issue an advisory opinion to the Membership about such behavior. In serious cases that could not be resolved by negotiation, the Board might choose to discipline a member who was found to be violating our Code of Ethics or practice standards. This is an advocacy statement, not a disciplinary policy.
Anyone who encounters advertising, practitioners, or organizations that claim to be working in the fields of sexual health and education that seem to be violating this policy should contact them and request that they stop. If they persist, The National Coalition for Sexual Freedom, the Woodhull Foundation, and/or the major LGBTQ organizations should be contacted. All have reparative therapy policies in place, and actions they can take. A few states have passed legislation specifically barring gay reparative therapies, and the list is growing. Licensing and certifying bodies in those jurisdictions will be resources in stopping these practices. Similar legislation does not commonly protect consensual non-monogamy or BDSM practices.
Members and the public are correct to feel that such a position changes the practice landscape. The statement begs for extra care in making sure that kinks are the main problem that clients want to become the focus of treatment. It pushes us to check to see if problems of occupational and life functioning stem primarily from the kink itself, or are primarily the consequences of identity problems associated with assuming a stigmatized social status. It acknowledges that diagnostic labels function both ways; sometimes allowing access to treatment and as a source of reassuring meanings, yet also conferring shame, promoting dependency, and marginalizing some clients.
It is hoped that AASECT will challenge our partner sexual health organizations in the North American Federation of Sexuality Organizations (NAFSO) and The World Association of Sexual Health (WAS) to adopt this or similar language, and to bar sexuality organizations that decline to do so. For this is an excellent, and much needed step in advocacy efforts to promote quality sexual health care for kinky clients, but it is far from the last step necessary to secure these ends.
Thank you AASECT!
© Russell J Stambaugh, May 2015, Ann Arbor MI, All rights reserved, but permission is granted for sexual health advocacy purposes.
© Russell J Stambaugh, May 2015, Ann Arbor MI, All rights reserved, but permission is granted for sexual health advocacy purposes.