Executive Order 21-25: Not a ban on conversion therapy, but an important step towards one

Reporting by Tina Monje, Freelance Community Journalist

On July 15th of 2021, Gov. Tim Walz signed Executive Order 21-25, an order aimed at “protecting Minnesotans from conversion therapy.” Important to note about this order is that it is not an outright ban on the discredited and harmful practice. While seven Minnesota cities have implemented bans, including Duluth, Minneapolis, Red Wing, Robbinsdale, Saint Paul, West Saint Paul, and Winona, there is no state-level ban.

Instead, the executive order is a list of directives aimed at state-governed health and service agencies, to evaluate and change their own policies and procedures as they relate to, allow, and support the use of conversion therapy. 

According to the official news release from the govoner’s office, the order will require Minnesota Department of Health (MDH) and Minnesota Department of Commerce to “request attestations from health maintenance organizations (HMOs) and health plan companies that they do not cover conversion therapy,” and will implement any rules within their powers to “restrict [financial] coverage of conversion therapy.” 

Additionally, the Minnesota Department of Human Services (DHS) will no longer pay for conversion therapy through Medicaid, and “will pursue recovery for payment for conversion therapy services;” the Minnesota Department of Human Rights (MDHR) will “investigate and pursue civil enforcement actions against” providers or professionals who are found to be practicing or engaging with conversion therapy. 

In sum, and practically speaking, public insurance programs will no longer pay for conversion therapy, and the state has been called on to investigate any facilities or providers who are practicing this harmful therapy and fraudulently billing the service under more medically-acceptable billing codes. This executive order seeks specifically to protect youth and vulnerable adults, however, it does not apply to private insurance companies. . 

According to James Darville, Outfront Minnesota’s Policy & Organizing Director , this executive order is a small but important step toward encouraging the Minnesota House of Representatives to pass The Mental Health Protections Act, a bill that would ban conversion therapy.

A Brief on Conversion Therapy

Lucas Ramón Mendos, author of “Curbing Deception: A world survey on legal regulation of so-called ‘conversion therapies,’” says “there is no one single term consistently and universally adopted to denote attempts to modify a person’s sexual orientation, gender identity or gender expression.” The term “conversion therapy” is used as an umbrella to encompass many different forms of coercive methods to pathologize and change the identities of queer people. The most common method is talk therapy, either with a licensed therapist or an unlicensed religious advocate. Other names include, but are not limited to, reparative therapy, ex-gay ministries, gender critical therapy, sexual orientation and gender identity change efforts (SOGICE), or sexual orientation change efforts (SOCE). 

Conversion therapy is often seen as a thing of the past but The Trevor Project’s 50 Bills 50 States campaign suggests otherwise. Even though it has no credible scientific studies to support its efficacy, and its harmfulness is undisputed among major medical institutions. The Trevor Project sees more survivors of the therapy coming forward each year, “especially as proponents rebrand and shift their focus to ‘treating’ transgender and nonbinary youth.”

The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health shows that 13% of LGBTQ youth reported that they were made subject to conversion therapy; 83% of those reporting experienced the therapy before the age of 18. Youth who reported being subject to conversion therapy also “reported more than twice the rate of attempting suicide in the past year compared to those who were not.” The survey found that gay, lesbian and bisexual youth from rejecting families are “8 times more likely to attempt suicide” than youth of accepting families. Transgender and nonbinary youth were subjected to conversion therapy “at twice the rate of cisgender LGBQ youth.” Those reporting were an average age of 15 years. 

The negative impacts of using any kind of conversion therapy are widely agreed upon and deeply understood across many authoritative institutions. In 2009, the American Psychological Association (APA) published the Report on the APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation, wherein researchers confirmed that any therapy that attempts to change one’s sexuality is not only ineffective, but harmful and may cause or exacerbate negative mental health symptoms. The American Medical Association (AMA) also opposes use of the pseudoscientific treatment. 

Despite vast agreement on its inefficacy, Movement Advancement Project’s equality map shows that there are only 20 states that outright ban the practice for youth. Three states – Alabama, Georgia and Florida – are in a “preliminary injunction currently preventing enforcement of conversion therapy bans.” There are six states who have “partial bans” or some state-level restriction, including Minnesota. Remaining states have no state law or policy addressing the practice.

The Mental Health Protections Act

James Darville, a key figure in moving this legislation forward, describes Walz’s Executive Order 21-25 as a small push toward passing the bill during the next legislative session. The Mental Health Protections Act is not the first of its kind. In the 2019 legislative session, a similar bill never made it past the House of Representatives.

Because 2020’s legislative session addressed an unusually high number of bills, the Mental Health Protections Act was introduced but did not make it to the committee. However, it will be carried over into Minnesota’s next legislative session. 

“We have this bill” said Darville, and “we think we have a great shot.” His confidence in the bill’s passing  is inspired by the executive order, and by recent changes made to the bill’s language. In a strategic move, the bill exclusively addresses the medical concerns associated with conversion therapy, in addition to medical research findings about the therapy’s inefficacy, while making no mention of religion or religious freedom. “We cannot police religious institutions,” Darville said. Any mention of religious freedom and the “bill cannot make it.” If passed, The Mental Health Protections Act will “prevent mental healthcare providers in Minnesota from practicing conversion therapy.” 

The bill will not make conversion therapy punishable, only unfunded by licensed clinicians. This  means that the state has no way of restricting religious groups or leaders from practicing the therapy. 

 “As long as we still have homophobia and transphobia in our world, just having affirmative spaces is life-saving,” said Sam Doten, Development & Communications Manager at Reclaim! This bill “will not make therapy suddenly more available,” he said, nor will it produce mental health professionals who are competent with sexual identity, gender identity and gender expression. Instead, it will provide protection to the lives of LGBTQIA+ youth and vulnerable adults in medical and mental health spaces.

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