Sexual Orientation or Gender Identity Change Efforts

The American Council opposes SB 934 and urges every legislator who has not yet acted to vote against it, and urges the Governor to veto it. The bill has passed both chambers and is enrolled, but a veto remains available, and constituent voices matter at every remaining stage.

Section 2 of the bill amends Business and Professions Code section 865(b)(1) to replace the existing defined term 'sexual orientation change efforts' with 'sexual orientation or gender identity change efforts,' which the bill defines as 'any practices of a licensed mental health provider that seek, during the provision of mental health services, to direct a patient toward a predetermined sexual orientation or gender identity outcome.' This is not a narrow technical rename. The new definition carries a substantive expansion: where prior law addressed only a provider's attempt to alter sexual orientation, the new definition brings gender identity squarely within the regulated category.

The bill specifies that prohibited efforts include, 'regardless of the direction of the intended change,' either of two enumerated forms: (A) 'efforts to direct a patient toward a particular sexual orientation by reducing or increasing sexual or romantic attractions or feelings toward individuals of a particular sex,' or (B) 'efforts to direct a patient toward a particular gender identity by suppressing or constraining the patient's gender identity or expression.' The 'regardless of direction' clause is significant: the prohibition applies to any directional outcome, not only efforts to move a patient away from an LGBTQ+ identity. Provision (A) carries forward the prior law's sexual-orientation prohibition. Provision (B) is new, and it is the bill's central substantive addition.

The definition of 'mental health provider' is carried forward without substantive change from prior law and covers a broad range of licensed and registered professionals: physicians specializing in psychiatry, psychologists, psychological assistants, interns and trainees, licensed marriage and family therapists, registered associate marriage and family therapists, marriage and family therapist trainees, licensed educational psychologists, credentialed school psychologists, licensed clinical social workers, associate clinical social workers, clinical social work interns, licensed professional clinical counselors, registered associate clinical counselors, professional clinical counselor trainees, and any other person designated as a mental health professional under California law or regulation.

Section 2 also enumerates three categories of practice that are expressly excluded from the definition of prohibited efforts. First, 'nondirective psychotherapies that facilitate a patient's coping, identity exploration, and self-understanding without seeking to achieve any particular outcome regarding sexual orientation or gender identity' are excluded. Second, 'age-appropriate interventions to address unlawful conduct or unsafe practices that do not seek to direct the patient toward any particular sexual orientation or gender identity' are excluded. Third, 'counseling, psychotherapy, or other supportive services, provided in a manner consistent with the applicable standards of care, that respects the gender identity of the patient, as experienced and defined by the patient' are excluded. Each of these carve-outs contains its own limiting conditions, and the American Council notes that the third exclusion is conditioned on consistency with 'applicable standards of care' and on respecting 'the gender identity of the patient, as experienced and defined by the patient.' Those conditions do real work: a provider whose approach does not meet those conditions cannot rely on this exclusion. The Council's concern is precisely that these carve-outs, while present, are drafted in ways that leave significant clinical judgment calls unresolved, and that the line between a prohibited 'directing' practice and a permitted 'nondirective' one will be contested in licensing proceedings, leaving conscientious providers exposed to discipline while the statutory text offers insufficient clarity.

Section 3 amends Business and Professions Code section 865.1 to prohibit a mental health provider from engaging in sexual orientation or gender identity change efforts 'with a patient under 18 years of age under any circumstances.' The phrase 'under any circumstances' is drawn directly from the bill text and forecloses any contextual or consent-based defense for work with minors.

Section 4 amends Business and Professions Code section 865.2 to classify 'any sexual orientation or gender identity change efforts attempted on a patient under 18 years of age by a mental health provider' as 'unprofessional conduct' that 'shall subject the mental health provider to discipline by the licensing entity for that mental health provider.' The bill does not specify the form or severity of discipline; that determination is left to each licensing entity under its existing authority. There is no civil penalty provision and no private right of action created by the bill's text; enforcement runs through the professional licensing system.

Section 5 includes a standard severability clause providing that if any provision or application of the act is held invalid, that invalidity does not affect other provisions or applications that can be given effect independently.

The American Council opposes this bill because we believe it imposes government regulation on the content of clinical conversations in ways that threaten the conscience and professional integrity of licensed counselors and therapists who hold sincerely reasoned views about human identity, flourishing, and the proper ends of therapeutic care. The definitional expansion to include gender identity, the 'regardless of direction' clause, and the 'under any circumstances' prohibition together create a framework in which a provider who, in good faith, explores with a minor patient whether a presented gender identity is stable or well-grounded may face licensing discipline. The exclusions, while real, require the provider's approach to conform to 'applicable standards of care' as determined by bodies whose positions are cited approvingly in the bill's own legislative findings. We do not dispute that harmful practices exist; we dispute that this bill draws the line in a place that respects the clinical, ethical, and religious commitments of every conscientious provider. Legislators should vote no, and the Governor should veto.