California law defines normal, consensual, adolescent heterosexual behavior — and all same-sex sexual behavior — as child abuse. The law is discriminatory. It harms the therapeutic relationship. It needs to be changed.
Under California’s existing standards for child sexual abuse, if minors are having consensual sexual intercourse, their ages determine whether a therapist needs to report it as abuse to the local child protective agency. The math goes something like this(
1):
- One partner 13 or younger: If the other partner is also 13 or younger and both children are of similar maturity, report only if there is evidence of intimidation, coercion, bribery, or other exploitation. If the other partner is 14 or older, report.
- One partner age 14 or 15: If the other partner is under 14, report. If the other partner is 14 to 20 years old, do not report unless there is evidence of exploitation as described above. If the other partner is 21 or older, report.
- One partner age 16 or 17: If the other partner is under 14, report. If the other partner is 14 or older, do not report unless there is evidence of exploitation as described above.
That’s all fine and good, right? It is complex, sure, but it reasonably takes into account the ages of the partners, and the nature of their relationship (truly consensual versus exploitive). So far, that seems okay.
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The problem is that
the above guide only applies to heterosexual, vaginal intercourse.
Under the same law — officially the
Child Abuse and Neglect Reporting Act, or CANRA —
oral sex, anal sex, and object penetration (including fingers or any other part of the body) are always considered child abuse if either partner is under 18 years old, even when the activity was consensual and there is no evidence of coercion or exploitation of either partner. Similarity or difference in the ages of the partners does not matter.
This results in problems for three groups of adolescents in therapy: Normally-developing heterosexuals, normally-developing gays and lesbians, and religious adolescents seeking to preserve a specific notion of virginity. (Yes, those three groups cover just about everybody.) Let’s look at each.
- For normally-developing heterosexual teens, it is common to engage in oral sex before progressing to intercourse. Most of those who have had sex before age 18 have also had oral sex(2), and a 2006 review of national data showed that at almost a quarter of teenagers who had not had vaginal intercourse had engaged in oral sex. This sets up a backward reporting standard, where sex itself may not be considered abuse depending on the ages of the adolescents, but behavior that occurs earlier in development or as foreplay to intercourse is considered abuse.
- For normally-developing gays and lesbians, any sexual activity before reaching adulthood is classified as abuse in the eyes of the law. Remember, oral sex, anal sex, and object penetration are always considered abuse if either partner is under 18. If we have finally reached the point where consensual sex between gay or lesbian adults can no longer be criminalized, it seems a natural extension to treat consensual sexual activity among gay and lesbian teens on a par with consensual sexual activity among straight teens. If we say consensual, heterosexual sex between minors that meets specific criteria (not exploitive, and weighing the minors’ ages) is not abusive, shouldn’t that same treatment be given to similar consensual, homosexual behavior under the same conditions?
- Religious teens get caught in this mess too, as was pointed out by Dr. Judy Johnson, a Licensed Educational Psychologist who serves on California’s Board of Behavioral Sciences. It is not unusual for religious, heterosexual teens to engage in oral or anal sex instead of vaginal intercourse. These teens often specifically cite their religious beliefs as a reason for delaying intercourse. At an April committee meeting for the BBS, Dr. Johnson noted that these teenagers often say they are seeking to preserve their virginity. So, even in a consensual relationship, a teenager preserving their virginity on their own terms means engaging in what the state would consider child abuse.
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Therapists are caught in a terribly awkward place by the law. When working with adolescents who are experiencing normal development, the therapist has several options, all of them problematic:
- Direct the client not to share important sexual experiences. This usually starts with educating the client on the law’s limits to confidentiality, and may involve frequent reminders to the client about what cannot be discussed in therapy. This keeps the therapist from having to report, and thus keeps them compliant with the law, but it also closes potential conversation about a key area of adolescent growth and social development. Teenagers often want to discuss their relationships in the safe context of therapy precisely because they trust the therapist to have such conversation in private and without judgment. Stopping this conversation means that teenagers cannot have honest conversations with their therapists about sexual feelings and behaviors, including the risks and consequences of their actions. For teenagers who already distrust adults, this only further fuels that distrust. Finally, as should be obvious, directing teens not to talk about sexual experiences means directing them not to talk about experiences of real abuse that should be reported.
- Educate the client about what must be reported, and then allow them to use coded language. I have known some therapists who felt better using this as a middle-ground option, to at least give their adolescent clients some leeway to discuss sex. However, it (by design) leaves the waters of what is being discussed muddy on both sides, and leads to awkward, stilted conversations about sexual behavior. It also doesn’t really protect the therapist; regardless of what specific words the client is using, if the therapist reasonably believes the client is communicating that a reportable act took place, the therapist is legally obligated to report it.
- Choose not to follow the reporting law, accepting the liability that comes with that decision. A therapist who knowingly fails to report what the state considers child abuse can face up to six months in jail. However, taking on this risk allows for the most open and honest discussion of a client’s sexual behavior, and comfortable communication about sexual activity actually delays risky sexual behavior.
In practice, none of these options strikes an effective balance between protecting minors from actual abuse and allowing for an open and safe therapeutic environment. Therapists who want to provide appropriate clinical care to teenagers, which should include openly addressing sexual behaviors and the client’s thoughts and feelings about them, simply cannot do so under the current law. Few therapists today would disagree with the notion that truly abusive behavior should be reported, but requiring therapists to label behavior that is developmentally normal as “abuse” does far more harm than good.
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In 2010,
Gerry Grossman and a group of colleagues
pushed for clarifications to the law. While they were unsuccessful, their efforts did yield a number of
stories from practicing therapists about the damage CANRA does in its current form. One example (emphasis mine):
Because of this antiquated reporting law, I warn my adolescent clients not to talk to me about these things, as I am required by law to report it. As one of my grad students asked, “You mean, you have to tell a teen not to talk about something they most likely need to talk to someone about?” I sadly must explain, yes.
While I’m no lawyer, the fact that the law is discriminatory on its face would seem to make it unlikely to withstand a legal challenge. If I were the state of California, I certainly would not want to be defending the existing law in court. But why should the state wait to be sued by a 17-year-old reported as a child abuser for having consensual oral sex with his or her 17-year-old, same-sex partner? It would be far preferable to resolve the issue through legislation, but so far there has not been enough political will to make the needed changes. Because an amendment to make the law fair would necessarily reduce the mandated reporter’s obligations, it would look like a weakening of the child abuse reporting law — and in the wake of the
Jerry Sandusky scandal at Penn State, lawmakers have reflexively moved in the opposite direction. An analysis from the California Assembly Appropriations Committee lists no less than
seven bills in the state legislature this year that would expand mandated reporting and stiffen penalties for failure to report.
The Board of Behavioral Sciences has expressed interest into at least examining the issue. I brought this to them at their
April [page 27] and July Policy and Advocacy Committee meetings, and they have agreed to place it on a future agenda for discussion. What’s really needed, though, is a lawmaker with the nerve to stand up and say, “The current law is wrong, it discriminates against gay and lesbian youth, and it makes it harder to provide a safe therapeutic environment for normal, healthy adolescents. Let’s make the law do what we intended for it to do in the first place: protect vulnerable people from harm. Let’s stop requiring therapists to label normal teenagers as child abusers.”
References
1. Atkins, C. L. (2007).
Reporting consensual activity between minors: The confusion unraveled. The Therapist, 19(1), 32-35.
2. Halpern, C. T., & Haydon, A. A. (2012).
Sexual timetables for oral-genital, vaginal, and anal intercourse: sociodemographic comparisons in a nationally representative sample of adolescents. American Journal Of Public Health, 102(6), 1541-0048.
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As I said, I’m not a lawyer. The above information should not be construed as legal advice when determining whether a child abuse report is required. Consult with a supervisor and/or an attorney about your specific situation.
What are your thoughts about the law and how to best fix it? Post a comment below, email me at ben[at]bencaldwell[dot]com, or post a message to
my Twitter feed.
Updated 9/30/12 – Governor Brown signed the bill into law. It takes effect January 1, 2013.
Senate Bill 1172, a proposed California law that would prevent licensed therapists from offering so-called “reparative therapy” to minors, has passed the state Assembly and Senate and is currently on Governor Jerry Brown’s desk. The Governor has until the end of this month — less than a week away — to sign or veto the bill.
If he signs it, California would be the first state in the US to take such action. Other states are eyeing the California bill closely, with some planning to propose similar bills. Gay rights organizations are also paying close attention to the bill, and have been pushing the Governor to sign it.
“Reparative therapy,” also sometimes known as “conversion therapy” and referred to in the bill as “sexual orientation change efforts,” is a form of therapy that aims to help people distressed by same-sex attraction change those attractions and ultimately become more heterosexual. The therapy was pioneered by Dr. Joseph Nicolosi, who suggests in his original book on the topic that same-sex attractions are unhealthy.
All the major professional associations in mental health have issued statements discouraging their members from using reparative therapy, though none has gone so far as to declare the practice inherently unethical. (See statements from the AAMFT, ACA, APA, CAMFT, and NASW; there’s a nice history of associations’ stances on the topic here.) These statements typically cite the lack of research support for any therapy succeeding in altering sexual orientation, and the serious risk of harm that comes to gay and lesbian clients when a therapist tells them that their sexuality is wrong or unhealthy.
However, the therapy remains practiced by a number of mental health professionals, who offer anecdotal reports of clients who say they were helped by the approach.
While professional associations are usually loath to accept government intrusion into clinical practice, it is noteworthy that all of the major professional associations in mental health in California are now either neutral on the bill or actively supporting it. All were initially opposed, but as the language of the bill has been amended, all have dropped their opposition. Here is where the major mental health professional associations currently stand:
AAMFT-CA: Support
The American Association for Marriage and Family Therapy, California Division was (with NASW-CA) one of the first associations to move from opposition to support. (Full disclosure: I’m the current Legislative and Advocacy Committee Chair for AAMFT-CA, and I’ve worked a great deal on this bill.)
NASW-CA: Support
The National Association of Social Workers, California Division was (with AAMFT-CA) one of the first associations to move from opposition to support.
CPA (Psychologists): Support
The The California Psychological Association had initially joined three other organizations (Psychiatrists, CAMFT, and CALPCC) in jointly oposing the bill. While all four organizations have since dropped their opposition, CPA appears to be the only one of the four to move to a position of support.
CALPCC: Neutral
The California Association of Licensed Professional Clinical Counselors has dropped its opposition, though the bill is not currently mentioned anywhere on the group’s web site.
CAMFT: Neutral
The California Association of Marriage and Family Therapists has dropped its opposition to the bill. The CAMFT web site includes a relatively soft caution to its members about the use of reparative therapy (referred to here as “sexual orientation change efforts”) but otherwise does not address the bill.
CPA (Psychiatrists): Neutral
The California Psychiatric Association has officially withdrawn its opposition to the bill, citing a 1998 statement of the American Psychiatric Association which reads in part, “The American Psychiatric Association opposes any psychiatric treatment, such as ‘reparative’ or ‘conversion’ therapy, which is based upon the assumption that homosexuality per se is a mental disorder.”
Whatever your stance on the bill, both sides are suggesting you contact Governor Brown’s office directly to let him know. The Governor’s office can be reached by phone at 916-445-2841, by email here, or on Twitter at @JerryBrownGov.
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Your comments are welcome. You may post them in the comments section below, via email to ben [at] bencaldwell [dot] com, or to my Twitter feed.
