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Tag: American Psychological Association

  • A discredited therapy for gay and trans youth is at the center of a Supreme Court case. Here’s what to know

    (CNN) — The US Supreme Court will hear a case Tuesday that will determine whether a Colorado law that prohibits licensed mental health professionals from providing conversion “therapy” to minors is constitutional.

    Conversion or reparative therapy promises to “convert” people from being gay, lesbian or bisexual to straight, or to change transgender and nonconforming individuals into people who identify with the sex they were labeled at birth. Research has found that the practice doesn’t work and can even be dangerous: It significantly increases a person’s risk of suicide and can cause other long-term health problems, such as depression, anxiety and high blood pressure. Children who undergo conversion therapy are more than twice as likely to run away.

    At least 23 states prohibit licensed providers from offering conversion “therapy” to minors, according to the independent think tank Movement Advancement Project, and leading professional medical and mental health associations disavow it.

    Despite state bans, a 2023 report found more than 1,300 conversion therapy practitioners working in 48 states and the District of Columbia. The report, from the Trevor Project, a suicide prevention organization for LGBTQ+ youth, found 600 practitioners hold active professional licenses and 700 operate in an official religious capacity. The number is likely an undercount since, the report said, because conversion therapy is “increasingly underground and conducted in secret with many practitioners not publicly advertising their services in a way that can be documented.”

    2023 national survey found that 1 in 20 LGBTQ+ young people had been subjected to conversion therapy in the US. Nearly 200,000 people who identify as transgender have gone through some form of conversion therapy, according to a 2019 study published in the American Journal of Public Health.

    Regardless of how the Supreme Court rules, the therapy may become even more common as the Trump administration pushes health care providers to offer a version of this therapy as the only kind of care for children who identify as transgender.

    “The government is paving the way for a lot of harm and a lot of damage,” said Dr. Meera Shah, a family medicine physician in New York and a national board member for the professional group Physicians for Reproductive Health.

    Drew, an ICU nurse in Central Valley, California, who identifies as a trans man, believes that his parents inadvertently brought him to a conversion therapist when he was 9. He asked that CNN not use his last name for his safety.

    When he was old enough to pick his haircut and clothes, Drew said, he knew what his gender identity was but didn’t have the words to explain.
    Choosing cowboy shirts and boots incorrectly signaled to his parents that he struggled with his gender identity.

    “So they put me in therapy to fix that,” Drew said. “I don’t know if my mom understood what she was signing me up for.”

    The experience still traumatizes Drew, he says, although the details of what happened in those sessions remain fuzzy. “Rather, I have traumatic flashbacks instead,” he said.

    What happens in conversion therapy?

    Professionals may have different methods to try to convince someone that they are not LGBTQ+. Some use traditional talk therapy, enforcing the idea that being transgender or being gay/bi is a pathology that can be “cured” and even arguing that peer pressure is to blame.

    Counselors may also use behavioral modification therapy as they frame non-heterosexual or non-stereotypical gendered behavior as an “addiction” or a “compulsion.” They might encourage patients to avoid “triggers” like going to an LGBTQ+-friendly club or wearing a certain outfit and praise them for engaging in stereotypical gendered activity like wearing certain clothing or hairstyles.

    They may also probe a patient’s past to determine whether an underlying issues like unprocessed trauma, abuse, mental illness or autism could have led to gender-nonconforming feelings.

    There’s also a long history of documented aversion practices, including electric shock, ice baths, burning with metal coils or giving nausea-inducing drugs. Using these techniques, some may try to shame the patient about their gender or orientation, pray with them or even use exorcism as a “cure.”

    When Dr. Morissa Ladinsky worked in Alabama, she said, trans patients told her that their parents put them in conversion therapy that tried to “turn the God that they loved against them.”

    The approach was traumatizing, said Ladinsky, a clinical professor of pediatrics at Stanford Medicine. But there was one exception: a patient who said, “the God that I’ve grown to love would never make me this way only to turn around and marginalize me.”

    Risks from conversion therapy

    The process can create lasting damage and may lead to depression, anxiety, sexual problems, substance use, low self-esteem, self-blame and a lifetime of physical health problems, including high blood pressure and increased systemic inflammation, studies show.

    Conversion therapy can also lead to suicideA 2019 study found that trans people who experienced gender identity change efforts were more than twice as likely to have attempted suicide than peers who had other therapy. For children under 10, the relative risk of attempted suicide was four times as high. And trans people were 1.5 times more likely than peers who went through other therapies to experience “severe psychological distress,” the study found.

    A 2020 report from the Williams Institute, a public policy research center focused on sexual orientation and gender identity at the University of California, Los Angeles School of Law, found that lesbian, gay and bisexual people who experienced conversion therapy were almost twice as likely to think about suicide and attempt suicide compared with peers who hadn’t had undergone such counseling.

    “Conversion therapy – which we know isn’t actually therapy – isolates and harms kids, it scapegoats parents, and it really does divide families through blame and rejection,” said Casey Pick, director of law and policy at the Trevor Project. “No amount of pressure or talk, including conversion practices, can make a transgender person not transgender.

    “This is a debunked, discredited fringe ideology.”

    Ahead of the Supreme Court argument, the Trevor Project, in conjunction with American Foundation for Suicide Prevention and the National Alliance on Mental Illness, filed a friend of the court brief presenting peer-reviewed data on the serious mental health harms that conversion therapy causes LGBTQ+ youth.

    Drew, the California ICU nurse, doesn’t remember much about his therapy sessions. But he does remember sobbing every Monday and Friday when his grandfather picked him up for his appointment at 2 p.m. on the dot.

    Even years later, Drew said, he’d shake uncontrollably when he’d visit his parents and drive past the building where his appointments had been.

    “It took me a long time to recognize why that was,” Drew said, his voice catching and pausing for deep breathing exercises to calm his nerves.

    “The experience was damaging beyond my ability to explain to you,” he said. “It was damaging in ways that, 40 years later, I’m still uncovering and working through with the help of a good therapist who is practicing a kind of therapy that is actually helpful and affirmative for myself as a whole human.”

    Trump administration actions

    The Supreme Court case is unfolding as President Donald Trump’s administration has put a new focus on LGBTQ people.

    US Health and Human Services Secretary Robert F. Kennedy Jr.
    said in a letter to health systems in May that they should not rely on science-based professional guidelines for transgender children but should instead follow a highly controversial HHS review of the evidence on current care practices for pediatric gender dysphoria — a term that mental health professionals use to describe the clinically significant distress that happens when a person’s sense of gender does not match their sex assigned at birth.

    The Trump administration report essentially says the only kind of care that health systems should provide children who identify as transgender are psychotherapeutic approaches including gender exploratory therapy, which discourages gender affirmation in favor of exploring the pathological roots of the young person’s trans identity. The review describes such a practice as “trying to help children and adolescents come to terms with their bodies” and equates the distress they feel related to their gender with normal “discomfort with the sexed body or with societal based expectations is common during puberty and adolescence.”

    Then, at the start of Pride Month in June, the FBI encouraged whistleblowers to report health providers that offered other kinds of care.

    The federal pressure on health systems worked. Among other programs, the Center for Transyouth Health and Development at Children’s Hospital Los Angeles announced in July it was shutting down. Children’s National in Washington, D.C, said in August that due to “escalating legal and regulatory risks” it would be “discontinuing the prescription of gender-affirming medications,” but would continue to offer mental health and other support services.

    Research shows that exploratory therapy is far from neutral. The practice views a trans identity as maladaptive, pathological or simply wrong, experts said, and sees a cisgender identity — a gender identity that aligns with the sex assigned at birth — as normative, “healthier, preferable, and superior to a transgender or gender nonbinary identity,” according to the American Psychological Association, which is highly critical of the practice.

    Gender diversity is not pathological, agrees the American Academy of Child & Adolescent Psychiatry, another organization that’s critical of the practice.

    The 400+ page review that Kennedy cited, whose authors remain anonymous, says it “is not intended to serve as a clinical practice guideline and does not aim to issue treatment recommendations,” but it claims that current practices are not safe and lack a scientific basis.

    Evidence about providing therapy alone is “of very low certainty,” the review says, but it lauds countries that use “exploratory” therapy alone and claims this practice is at least a “noninvasive invention” that carries “little risk” and takes a “neutral” stand that may “effectively resolve the condition noninvasively.”

    “The concept of ‘noninvasive’ makes no sense here if we’re looking at mental health. What does that even really mean?” asked Florence Ashley, a Canadian law professor who wrote a book about laws banning transgender conversion practices. “If one of the things that we look at is suicidality, that’s pretty f**king invasive. You’re dead.”

    Dr. Carl Streed, a clinical researcher specializing in LGBTQ+ health and an assistant professor of medicine at Boston University School of Medicine, said it’s hypocritical of the Trump administration to say there isn’t enough evidence to justify the individually tailored care typically provided to transgender youth — which is backed by dozens of medical organizations and may include therapy, social and legal help, and for older patients, hormones or surgery — while acknowledging that therapy alone is “of very low certainty.”

    “The report really provides no other alternative other than conversion therapy, and because it is from the HHS, it is essentially going to be a ‘legitimizing report.’ And it’s going to be used to eventually change policies around the provision of care,” Streed added.

    HHS says in the report that exploratory therapy is not conversion therapy. But because the aim of the practice is to “resolve” the issue of gender rather than resolve the distress the person feels about their gender, experts say it is conversion therapy by a different name.

    “Honestly, whenever anybody says ‘gender exploratory therapy,’ they really are talking about conversion therapy,” Streed said. “They’re not talking about anything that acknowledges people’s full spectrum of gender.”

    In California, Drew said that while he’s still working through the trauma he experienced in conversion therapy, it hasn’t held him back from having a successful career, a happy marriage and kids. And even though it’s difficult to talk about, he wants parents to know about his experience.

    “I don’t want anybody else to go through what I went through, and if another parent out there can hear that conversion therapy will be harmful to their child and consider a different way to move forward, that Is worth any discomfort or pain that I have now talking about it,” Drew said.

    Despite the trauma, he bears no ill will toward his childhood therapist.

    “My parents eventually saw me for who I am, and they accepted me and loved me and had been extremely supportive of me,” Drew said. “So I’d like to give that therapist the grace that perhaps they could have learned and grown as a therapist and understood the harm that they were causing and learn to do better by trans youth.”

    Jen Christensen and CNN

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  • Can Gummies Bring Down Election Anxiety

    Can Gummies Bring Down Election Anxiety

    Tensions are high, but can hemp, CBD, or cannabis gummies help you relax – especially with microdosing?

    The American Psychological Association recent poll should 69% of American’s are experiencing anxiety about the election. Compared with the previous two presidential elections, stress related to the 2024 election was slightly higher than in 2020 (69% vs. 68%) but significantly higher than in 2016 (52%). Stress related to the current election appeared to be driven, in part, by the potential consequences from the election results.  The barrage of news, memes, friends complain is making it hard on people’s mind and body. Can gummies bring down election anxiety?

    Anxiety can cause feelings of fear, dread, or uneasiness, and can make it hard to concentrate or make decisions. People with anxiety may also feel irritable, tense, or restless, and may have a sense of impending danger, panic, or doom. Not only does it leave you feeling miserable, it can interfere with your job and relationships. A short term solution may come from the cannabis plant. Can gummies bring down election anxiety?

    Studies have shown the cannabis plant can help with a variety of medical ailments, including anxiety. A Johns Hopkins Medicine-led research team has added to evidence that a chemical found naturally in cannabis (also known as marijuana) can — in the right amounts — lessen the anxiety-inducing effects of tetrahydrocannabinol (THC), the primary psychoactive sister chemical found in cannabis.

    The cannabis plant produces marijuana (with THC), CBD, and hemp. Studies show all can help with anxiety at some level, but is dependent on dosage.  Microdosing a new trend to provide a very low dosage to take off the edge but to stay focused. Most gummies are either 5 or 10 mg. A microcode would be between 2.5 – 5 mg.  So a half or third and you can avoid the “high” while reducing the anxiety and moving into a better state of mind.

    Marijuana Gummies

    Marijuana gummies are a way for adults to cope with anxiety. But you should start with a low dose as you want to have a calming effect with out the extra bells and whistles.  Consider 2.5 mg and see how it goes from there….and recognize it will take 45 minutes to an hour for impact.

    CBD Gummies

    While some CBD gummies products promise and don’t deliver, Epidiolex is the only FDA-approved prescription CBD medicine, which among many things, means that it has a safety and efficacy profile that has been thoroughly evaluated in clinical trials. CBD doesn’t have the THC high as with marijuana so this would completely avoid any high. It is also a popular aide to sleep issues.

    Other ways to reduce anxiety during this time is to focus on what you can control and what positive actions you can take. it is also important to set boundaries with how much information you will consume (including social media) and the conversations you will have.  Mostly, try to focus on things which help you relax.

     

    Amy Hansen

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  • The Moral Case Against Euphemism

    The Moral Case Against Euphemism

    The Sierra Club’s Equity Language Guide discourages using the words stand, Americans, blind, and crazy. The first two fail at inclusion, because not everyone can stand and not everyone living in this country is a citizen. The third and fourth, even as figures of speech (“Legislators are blind to climate change”), are insulting to the disabled. The guide also rejects the disabled in favor of people living with disabilities, for the same reason that enslaved person has generally replaced slave : to affirm, by the tenets of what’s called “people-first language,” that “everyone is first and foremost a person, not their disability or other identity.”

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    The guide’s purpose is not just to make sure that the Sierra Club avoids obviously derogatory terms, such as welfare queen. It seeks to cleanse language of any trace of privilege, hierarchy, bias, or exclusion. In its zeal, the Sierra Club has clear-cut a whole national park of words. Urban, vibrant, hardworking, and brown bag all crash to earth for subtle racism. Y’all supplants the patriarchal you guys, and elevate voices replaces empower, which used to be uplifting but is now condescending. The poor is classist; battle and minefield disrespect veterans; depressing appropriates a disability; migrant—no explanation, it just has to go.

    Equity-language guides are proliferating among some of the country’s leading institutions, particularly nonprofits. The American Cancer Society has one. So do the American Heart Association, the American Psychological Association, the American Medical Association, the National Recreation and Park Association, the Columbia University School of Professional Studies, and the University of Washington. The words these guides recommend or reject are sometimes exactly the same, justified in nearly identical language. This is because most of the guides draw on the same sources from activist organizations: A Progressive’s Style Guide, the Racial Equity Tools glossary, and a couple of others. The guides also cite one another. The total number of people behind this project of linguistic purification is relatively small, but their power is potentially immense. The new language might not stick in broad swaths of American society, but it already influences highly educated precincts, spreading from the authorities that establish it and the organizations that adopt it to mainstream publications, such as this one.

    Although the guides refer to language “evolving,” these changes are a revolution from above. They haven’t emerged organically from the shifting linguistic habits of large numbers of people. They are handed down in communiqués written by obscure “experts” who purport to speak for vaguely defined “communities,” remaining unanswerable to a public that’s being morally coerced. A new term wins an argument without having to debate. When the San Francisco Board of Supervisors replaces felon with justice-involved person, it is making an ideological claim—that there is something illegitimate about laws, courts, and prisons. If you accept the change—as, in certain contexts, you’ll surely feel you must—then you also acquiesce in the argument.

    In a few cases, the gap between equity language and ordinary speech has produced a populist backlash. When Latinx began to be used in advanced milieus, a poll found that a large majority of Latinos and Hispanics continued to go by the familiar terms and hadn’t heard of the newly coined, nearly unpronounceable one. Latinx wobbled and took a step back. The American Cancer Society advises that Latinx, along with the equally gender-neutral Latine, Latin@, and Latinu, “may or may not be fully embraced by older generations and may need additional explanation.” Public criticism led Stanford to abolish outright its Elimination of Harmful Language Initiative—not for being ridiculous, but, the university announced, for being “broadly viewed as counter to inclusivity.”

    In general, though, equity language invites no response, and condemned words are almost never redeemed. Once a new rule takes hold—once a day in history can no longer be dark, or a waitress has to be a server, or underserved and vulnerable suddenly acquire red warning labels—there’s no going back. Continuing to use a word that’s been declared harmful is evidence of ignorance at best or, at worst, a determination to offend.

    Like any prescribed usage, equity language has a willed, unnatural quality. The guides use scientific-sounding concepts to lend an impression of objectivity to subjective judgments: structural racialization, diversity value proposition, arbitrary status hierarchies. The concepts themselves create status hierarchies—they assert intellectual and moral authority by piling abstract nouns into unfamiliar shapes that immediately let you know you have work to do. Though the guides recommend the use of words that are available to everyone (one suggests a sixth-to-eighth-grade reading level), their glossaries read like technical manuals, put together by highly specialized teams of insiders, whose purpose is to warn off the uninitiated. This language confers the power to establish orthodoxy.

    Mastering equity language is a discipline that requires effort and reflection, like learning a sacred foreign tongue—ancient Hebrew or Sanskrit. The Sierra Club urges its staff “to take the space and time you need to implement these recommendations in your own work thoughtfully.” “Sometimes, you will get it wrong or forget and that’s OK,” the National Recreation and Park Association guide tells readers. “Take a moment, acknowledge it, and commit to doing better next time.”

    The liturgy changes without public discussion, and with a suddenness and frequency that keep the novitiate off-balance, forever trying to catch up, and feeling vaguely impious. A ban that seemed ludicrous yesterday will be unquestionable by tomorrow. The guides themselves can’t always stay current. People of color becomes standard usage until the day it is demoted, by the American Heart Association and others, for being too general. The American Cancer Society prefers marginalized to the more “victimizing” underresourced or underserved—but in the National Recreation and Park Association’s guide, marginalized now acquires “negative connotations when used in a broad way. However, it may be necessary and appropriate in context. If you do use it, avoid ‘the marginalized,’ and don’t use marginalized as an adjective.” Historically marginalized is sometimes okay; marginalized people is not. The most devoted student of the National Recreation and Park Association guide can’t possibly know when and when not to say marginalized; the instructions seem designed to make users so anxious that they can barely speak. But this confused guidance is inevitable, because with repeated use, the taint of negative meaning rubs off on even the most anodyne language, until it has to be scrubbed clean. The erasures will continue indefinitely, because the thing itself—injustice—will always exist.

    In the spirit of Strunk and White, the guides call for using specific rather than general terms, plain speech instead of euphemisms, active not passive voice. Yet they continually violate their own guidance, and the crusade to eliminate harmful language could hardly do otherwise. A division of the University of Southern California’s School of Social Work has abandoned field, as in fieldwork (which could be associated with slavery or immigrant labor) in favor of the obscure Latinism practicum. The Sierra Club offers refuse to take action instead of paralyzed by fear, replacing a concrete image with a phrase that evokes no mental picture. It suggests the mushy protect our rights over the more active stand up for our rights. Which is more euphemistic, mentally ill or person living with a mental-health condition? Which is more vague, ballsy or risk-taker? What are diversity, equity, and inclusion but abstractions with uncertain meanings whose repetition creates an artificial consensus and muddies clear thought? When a university administrator refers to an individual student as “diverse,” the word has lost contact with anything tangible—which is the point.

    The whole tendency of equity language is to blur the contours of hard, often unpleasant facts. This aversion to reality is its main appeal. Once you acquire the vocabulary, it’s actually easier to say people with limited financial resources than the poor. The first rolls off your tongue without interruption, leaves no aftertaste, arouses no emotion. The second is rudely blunt and bitter, and it might make someone angry or sad. Imprecise language is less likely to offend. Good writing—vivid imagery, strong statements—will hurt, because it’s bound to convey painful truths.

    Katherine Boo’s Behind the Beautiful Forevers is a nonfiction masterpiece that tells the story of Mumbai slum dwellers with the intimacy of a novel. The book was published in 2012, before the new language emerged:

    The One Leg’s given name was Sita. She had fair skin, usually an asset, but the runt leg had smacked down her bride price. Her Hindu parents had taken the single offer they got: poor, unattractive, hard-working, Muslim, old—“half-dead, but who else wanted her,” as her mother had once said with a frown.

    Translated into equity language, this passage might read:

    Sita was a person living with a disability. Because she lived in a system that centered whiteness while producing inequities among racial and ethnic groups, her physical appearance conferred an unearned set of privileges and benefits, but her disability lowered her status to potential partners. Her parents, who were Hindu persons, accepted a marriage proposal from a member of a community with limited financial resources, a person whose physical appearance was defined as being different from the traits of the dominant group and resulted in his being set apart for unequal treatment, a person who was considered in the dominant discourse to be “hardworking,” a Muslim person, an older person. In referring to him, Sita’s mother used language that is considered harmful by representatives of historically marginalized communities.

    Equity language fails at what it claims to do. This translation doesn’t create more empathy for Sita and her struggles. Just the opposite—it alienates Sita from the reader, placing her at a great distance. A heavy fog of jargon rolls in and hides all that Boo’s short burst of prose makes clear with true understanding, true empathy.

    The battle against euphemism and cliché is long-standing and, mostly, a losing one. What’s new and perhaps more threatening about equity language is the special kind of pressure it brings to bear. The conformity it demands isn’t just bureaucratic; it’s moral. But assembling preapproved phrases from a handbook into sentences that sound like an algorithmic catechism has no moral value. Moral language comes from the struggle of an individual mind to absorb and convey the truth as faithfully as possible. Because the effort is hard and the result unsparing, it isn’t obvious that writing like Boo’s has a future. Her book is too real for us. The very project of a white American journalist spending three years in an Indian slum to tell the story of families who live there could be considered a gross act of cultural exploitation. By the new rules, shelf upon shelf of great writing might go the way of blind and urban. Open Light in August or Invisible Man to any page and see how little would survive.

    The rationale for equity-language guides is hard to fault. They seek a world without oppression and injustice. Because achieving this goal is beyond anyone’s power, they turn to what can be controlled and try to purge language until it leaves no one out and can’t harm those who already suffer. Avoiding slurs, calling attention to inadvertent insults, and speaking to people with dignity are essential things in any decent society. It’s polite to address people as they request, and context always matters: A therapist is unlikely to use terms with a patient that she would with a colleague. But it isn’t the job of writers to present people as they want to be presented; writers owe allegiance to their readers, and the truth.

    The universal mission of equity language is a quest for salvation, not political reform or personal courtesy—a Protestant quest and, despite the guides’ aversion to any reference to U.S. citizenship, an American one, for we do nothing by half measures. The guides follow the grammar of Puritan preaching to the last clause. Once you have embarked on this expedition, you can’t stop at Oriental or thug, because that would leave far too much evil at large. So you take off in hot pursuit of gentrification and legal resident, food stamps and gun control, until the last sin is hunted down and made right—which can never happen in a fallen world.

    This huge expense of energy to purify language reveals a weakened belief in more material forms of progress. If we don’t know how to end racism, we can at least call it structural. The guides want to make the ugliness of our society disappear by linguistic fiat. Even by their own lights, they do more ill than good—not because of their absurd bans on ordinary words like congresswoman and expat, or the self-torture they require of conscientious users, but because they make it impossible to face squarely the wrongs they want to right, which is the starting point for any change. Prison does not become a less brutal place by calling someone locked up in one a person experiencing the criminal-justice system. Obesity isn’t any healthier for people with high weight. It’s hard to know who is likely to be harmed by a phrase like native New Yorker or under fire; I doubt that even the writers of the guides are truly offended. But the people in Behind the Beautiful Forevers know they’re poor; they can’t afford to wrap themselves in soft sheets of euphemism. Equity language doesn’t fool anyone who lives with real afflictions. It’s meant to spare only the feelings of those who use it.

    The project of the guides is utopian, but they’re a symptom of deep pessimism. They belong to a fractured culture in which symbolic gestures are preferable to concrete actions, argument is no longer desirable, each viewpoint has its own impenetrable dialect, and only the most fluent insiders possess the power to say what is real. What I’ve described is not just a problem of the progressive left. The far right has a different vocabulary, but it, too, relies on authoritarian shibboleths to enforce orthodoxy. It will be a sign of political renewal if Americans can say maddening things to one another in a common language that doesn’t require any guide.


    This article appears in the April 2023 print edition with the headline “The Moral Case Against Euphemism.” When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.

    George Packer

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