A national society of physician assistants (PA) this week rejected a resolution that would have banned all efforts to alter sexual orientation. Instead, it passed one that would not restrict PAs from helping those with unwanted homosexual desires.
PAs, health care professionals who are licensed or credentialed to practice medicine with physician supervision, function as the Primary Care provider for many patients in the United States. And while they rarely perform reparative therapy, they typically refer patients struggling with same-sex attraction to mental health professionals.
"PAs ... are very likely to have a patient at some point come to them asking for help in aligning their social, outward lifestyle with their inner, spiritual center of gravity," said John Fields, chairman of the Force on Ethics and Policy of Fellowship of Christian Physician Assistants. "A patient struggling with this issue needs to be able to ask for and obtain a referral to a source of help as they struggle with what must be a very painful issue."
There had been no policy regarding reparative therapy before the House of Delegates of the American Academy of Physician Assistants on Monday passed the resolution opposing therapies which are based on the premise that homosexuality per se represents a mental disorder that should be cured.
"What the whole thing boils down to is that the resolution passed does not oppose all types of therapy that would help somebody align their actions with their religious beliefs," explained Dr. Warren Throckmorton, a noted expert in sexuality counseling. "What it does oppose is a therapy that would view homosexuality per se as a mental disorder … that all homosexuality stems from a mental disorder."
The resolution also opposes physicians assistants who impose their beliefs about homosexuality on a patient.
The resolution was in part prompted by a 2005 court case in Kissimmee, Fla., in which Jamie Beiler, a lesbian, was given a packet on altering sexual orientation by a PA at the end of one of her routine medical visits. Southern Legal Counsel and the National Center for Lesbian Rights filed complaints on behalf of Beiler, alleging that PA Dawn Pope-Wright and Dr. John R. Hartman falsely presented their personal beliefs as medical information and provided her with unwanted treatment.
The AAPA's recently approved resolution now sets a policy for physician assistants regarding homosexual patients.
"Health care professionals should not coerce patients into reorientation but neither should they discourage patients from bringing their sexuality into accord with their religious convictions," said Dr. Robert Spitzer, professor of Psychiatry at Columbia University in New York City. "Even though I am not religious, I do believe it to be hubris for health care professionals to use our position to promote one set of beliefs over another."
While Spitzer noted that change among homosexuals in sexual orientation is infrequent, he also acknowledged that change does occur. Such change, however, is "probably most relevant to very religious patients."
The passed resolution was a compromise to the original resolution that some felt was restrictive and would essentially oppose all reparative therapy. The AAPA Committee of Diversity – dominated by members of the Lesbian, Gay, Bisexual PA Caucus – had proposed a resolution that "opposes the practice of treatments intended to alter sexual orientation."
The Fellowship of Christian Physician Assistants (FCPA) raised concern, arguing against the original resolution which the group believed would have restricted conservatively religious patients and practitioners to the care that is available.
The Christian PA group proposed a substitute resolution that would recognize religious diversity, but the resolution was not considered, according to Fields.
Nevertheless, Christians commended the compromise resolution which does not oppose therapy to those who request it, especially patients who are troubled by same-sex desires.
"I commend the Academy for visiting the issue of safe and ethical mental health practice," said Throckmorton. He further urged the Academy to "add language to their current policy in order to also insure respect for religious and viewpoint diversity."
Fields plans to continue to make the case for religious and value diversity in the Academy during the next year.