Mental Health Protection Act.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 382

Short Title: Mental Health Protection Act. (Public)
Sponsors: Senator Grafstein (Primary Sponsor).
Referred to: Rules and Operations of the Senate
March 24, 2025
*S382-v-1*
A BILL TO BE ENTITLED 1
AN ACT CONCERNING TH E PROTECTION OF MINO RS AND ADULTS WHO HA VE 2
DISABILITIES FROM ATTEMPTS TO CHANGE SEXUAL ORIENTATION, GENDER 3
IDENTITY, AND GENDER EXPRESSION. 4
Whereas, contemporary science recognizes that being lesbian, gay, bisexual, or 5
transgender is part of the natural spectrum of human identity and is not a disease, disorder, or 6
illness; and 7
Whereas, the American Psychological Association convened a Task Force on 8
Appropriate Therapeutic Responses to Sexual Orientation (Tas k Force). The Task Force 9
conducted a systemic review of peer -reviewed journal literature on sexual orientation change 10
efforts and issued a report on those efforts in 2009. The Task Force concluded that sexual 11
orientation change efforts can pose critical he alth risks to lesbian, gay, and bisexual people, 12
including confusion, depression, guilt, helplessness, hopelessness, shame, social withdrawal, 13
suicidality, substance abuse, stress, disappointment, self -blame, decreased self -esteem and 14
authenticity to others, increased self-hatred, hostility and blame toward parents, feelings of anger 15
and betrayal, loss of friends and potential romantic partners, problems in sexual and emotional 16
intimacy, sexual dysfunction, high -risk sexual behaviors, a feeling of being deh umanized and 17
untrue to self, a loss of faith, and a sense of having wasted time and resources; and 18
Whereas, in 2009, the American Psychological Association issued a resolution on 19
Appropriate Affirmative Responses to Sexual Orientation Distress and Change E fforts, stating: 20
"[T]he [American Psychological Association] advises parents, guardians, young people, and their 21
families to avoid sexual orientation change efforts that portray homosexuality as a mental illness 22
or developmental disorder and to seek psycho therapy, social support, and educational services 23
that provide accurate information on sexual orientation and sexuality, increase family and school 24
support, and reduce rejection of sexual minority youth."; and 25
Whereas, the American Psychiatric Association published a position statement in 26
March of 2000 in which it stated the following: 27
"Psychotherapeutic modalities to convert or 'repair' homosexuality are based on 28
developmental theories whose scientific validity is questionable. Furthermore, anecdotal reports 29
of 'cures' are counterbalanced by anecdotal claims of psychological harm. In the last four decades, 30
'reparative' therapists have not produced any rigorous scientific research to substantiate their 31
claims of cure. Until there is such research available, [the American Psychiatric Association] 32
recommends that ethical practitioners refrain from attempts to change individuals' sexual 33
orientation, keeping in mind the medical dictum to first, do no harm." 34
"The potential risks of reparative therapy are great, in cluding depression, anxiety and 35
self-destructive behavior, since therapist alignment with societal prejudices against 36
General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 382-First Edition
homosexuality may reinforce self-hatred already experienced by the patient. Many patients who 1
have undergone reparative therapy relate tha t they were inaccurately told that homosexuals are 2
lonely, unhappy individuals who never achieve acceptance or satisfaction. The possibility that 3
the person might achieve happiness and satisfying interpersonal relationships as a gay man or 4
lesbian is not p resented, nor are alternative approaches to dealing with the effects of societal 5
stigmatization discussed." 6
"Therefore, the American Psychiatric Association opposes any psychiatric treatment such as 7
reparative or conversion therapy which is based upon the assumption that homosexuality per se 8
is a mental disorder or based upon the a priori assumption that a patient should change his or her 9
sexual homosexual orientation."; and 10
Whereas, in 2013, the American Psychiatric Association expanded on that position, 11
stating: "The American Psychiatric Association does not believe that same-sex orientation should 12
or needs to be changed, and efforts to do so represent a significant risk of harm by subjecting 13
individuals to forms of treatment which have not been scientific ally validated and by 14
undermining self-esteem when sexual orientation fails to change. No credible evidence exists 15
that any mental health intervention can reliably and safely change sexual orientation; nor, from 16
a mental health perspective does sexual orientation need to be changed."; and 17
Whereas, in 1993, the American Academy of Pediatrics published an article in its 18
journal, Pediatrics, stating: "Therapy directed at specifically changing sexual orientation is 19
contraindicated, since it can provoke guilt and anxiety while having little or no potential for 20
achieving changes in orientation."; and 21
Whereas, in 1994, the American Medical Association Council on Scientific Affairs 22
prepared a report, stating: "Aversion therapy (a behavioral or medical intervention which pairs 23
unwanted behavior, in this case, homosexual behavior, with unpleasant sensations or aversive 24
consequences) is no longer recommended for gay men and lesbians. Through psychotherapy, gay 25
men and lesbians can become comfortable with their sexual orientation and understand the 26
societal response to it."; and 27
Whereas, the National Association of Social Workers prepared a 1997 policy 28
statement, stating: "Social stigmatization of lesbian, gay, and bisexual people is widespread and 29
is a primary motivating factor in leading some people to seek sexual orientation changes. Sexual 30
orientation conversion therapies assume that homosexual orientation is both pathological and 31
freely chosen. No data demonstrates that reparative or conversion therapies are effective, and, in 32
fact, they may be harmful."; and 33
Whereas, the American Counseling Association Governing Council issued a position 34
statement in April of 1999, stating: "We oppose 'the promotion of "reparative therapy" as a "cure" 35
for individuals who are homosexual.'"; and 36
Whereas, in 2014, the American School Counselor Association issued a position 37
statement, stating: "It is not the role of the professional school counselor to attempt to change a 38
student's sexual orientation or gender identity. Professional scho ol counselors do not support 39
efforts by licensed mental health professionals to change a student's sexual orientation or gender 40
as these practices have been proven ineffective and harmful."; and 41
Whereas, the American Psychoanalytic Association issued a pos ition statement in 42
June 2012 on attempts to change sexual orientation, gender identity, or gender expression, 43
stating: "As with any societal prejudice, bias against individuals based on actual or perceived 44
sexual orientation, gender identity or gender expr ession negatively affect mental health, 45
contributing to an enduring sense of stigma and pervasive self -criticism through the 46
internalization of such prejudice." The American Psychoanalytic Association further stated: 47
"Psychoanalytic technique does not encompass purposeful attempts to 'convert,' 'repair,' change 48
or shift an individual's sexual orientation, gender identity or gender expression. Such directed 49
efforts are against fundamental principles of psychoanalytic treatment and often result in 50
substantial psychological pain by reinforcing damaging internalized attitudes."; and 51
General Assembly Of North Carolina Session 2025
Senate Bill 382-First Edition Page 3
Whereas, in 2012, the American Academy of Child and Adolescent Psychiatry 1
published an article in its journal, Journal of the American Academy of Child and Adolescent 2
Psychiatry, stating: "Clinicians should be aware that there is no evidence that sexual orientation 3
can be altered through therapy, and that attempts to do so may be harmful. There is no empirical 4
evidence adult homosexuality can be prevented if gender nonconforming children are influenced 5
to be more gender conforming. Indeed, there is no medically valid basis for attempting to prevent 6
homosexuality, which is not an illness. On the contrary, such efforts may encourage family 7
rejection and undermine self -esteem, connectedne ss and caring, important protective factors 8
against suicidal ideation and attempts. Given that there is no evidence that efforts to alter sexual 9
orientation are effective, beneficial or necessary, and the possibility that they carry the risk of 10
significant harm, such interventions are contraindicated."; and 11
Whereas, in 2012, the Pan American Health Organization, a regional office of the 12
World Health Organization, issued a statement, stating: "These supposed conversion therapies 13
constitute a violation of the ethical principles of health care and violate human rights that are 14
protected by international and regional agreements." The organization also noted that reparative 15
therapies "lack medical justification and represent a serious threat to the health and wel l-being 16
of affected people."; and 17
Whereas, in 2014, the American Association of Sexuality Educators, Counselors, and 18
Therapists (AASECT) issued a statement, stating: "[S]ame sex orientation is not a mental 19
disorder and we oppose any 'reparative' or convers ion therapy that seeks to 'change' or 'fix' a 20
person's sexual orientation. AASECT does not believe that sexual orientation is something that 21
needs to be 'fixed' or 'changed.' The rationale behind this position is the following: Reparative 22
therapy (for minors, in particular) is often forced or nonconsensual. Reparative therapy has been 23
proven harmful to minors. There is no scientific evidence supporting the success of these 24
interventions. Reparative therapy is grounded in the idea that non -heterosexual orien tation is 25
'disordered.' Reparative therapy has been shown to be a negative predictor of psychotherapeutic 26
benefit."; and 27
Whereas, in 2015, the American College of Physicians issued a position paper, 28
stating: "The College opposes the use of 'conversion,' 'r eorientation,' or 'reparative' therapy for 29
the treatment of LGBT persons…Available research does not support the use of reparative 30
therapy as an effective method in the treatment of LGBT persons. Evidence shows that the 31
practice may actually cause emotiona l or physical harm to LGBT individuals, particularly 32
adolescents or young persons."; and 33
Whereas, minors who experience family rejection based on their sexual orientation 34
face especially serious health risks. In one study, lesbian, gay, and bisexual young adults who 35
reported higher levels of family rejection during adolescence were 8.4 times more likely to report 36
having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times 37
more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected 38
sexual intercourse compared with peers from families that reported no or low levels of family 39
rejection. This is documented by Caitlin Ryan, et al., in their article entitled "Family Rejection 40
as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual 41
Young Adults" (2009) 123 Pediatrics 346; and 42
Whereas, a 2018 study by the Family Acceptance Project found the following: 43
"Rates of attempted suicide by LGBT young people whose pare nts tried to change their 44
sexual orientation were more than double (48%) the rate of LGBT young adults who reported no 45
conversion experiences (22%). Suicide attempts nearly tripled for LGBT young people who 46
reported both home-based efforts to change their sexual orientation by parents and intervention 47
efforts by therapists and religious leaders (63%)." 48
"High levels of depression more than doubled (33%) for young people whose parents tried to 49
change their sexual orientation compared with those who reported n o conversion experiences 50
(16%), and more than tripled (52%) for LGBT young people who reported both home -based 51
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Page 4 Senate Bill 382-First Edition
efforts to change their sexual orientation by parents and external sexual orientation change efforts 1
by therapists and religious leaders." 2
"Sexual orientation change experiences during adolescence by both parents and caregivers 3
and externally by therapists and religious leaders were associated with lower young adult 4
socioeconomic status, less educational attainment, and lower weekly income."; and 5
Whereas, North Carolina has a compelling interest in protecting the physical and 6
psychological well-being of minors, including lesbian, gay, bisexual, and transgender youth, and 7
in protecting its minors against exposure to serious harms caused by conversio n therapy; Now, 8
therefore, 9
The General Assembly of North Carolina enacts: 10
SECTION 1. Chapter 90 of the General Statutes is amended by adding a new Article 11
to read: 12
"Article 1O. 13
"Mental Health Protection Act. 14
"§ 90-21.160. Short title. 15
This Article shall be known as the "Mental Health Protection Act." 16
"§ 90-21.161. Definitions. 17
The following definitions apply in this Article: 18
(1) Adult who has a disability . – A "disabled adult " as defined in 19
G.S. 108A-101(d). 20
(2) Conversion therapy. – Any practices or treatments that seek to change an 21
individual's sexual orientation or gender identity, including efforts to (i) 22
change behaviors and gender expressions or (ii) eliminate or reduce sexual or 23
romantic attractions or feelings toward individuals of the same gen der. 24
Conversion therapy shall not include counseling that provides assistance to an 25
individual undergoing gender transition or counseling that provides 26
acceptance, support, and understanding of an individual or facilitates an 27
individual's coping, social support, and identity exploration and development, 28
including sexual -orientation-neutral interventions to prevent or address 29
unlawful conduct or unsafe sexual practices, as long as such counseling does 30
not seek to change an individual's sexual orientation or gender identity. 31
"§ 90-21.162. Conversion therapy prohibited. 32
(a) The following professionals shall not engage in conversion therapy with an individual 33
under 18 years of age or an adult who has a disability: 34
(1) Fee-based practicing pastoral counselor as defined in G.S. 90-382. 35
(2) Licensed clinical social worker as defined in G.S. 90B-3. 36
(3) Licensed marriage and family therapist as defined in G.S. 90-270.47. 37
(4) Licensed professional counselor as defined in G.S. 90-330. 38
(5) Psychiatrist licensed in accordance with Article 1 of Chapter 90 of the General 39
Statutes. 40
(6) Psychologist as defined in G.S. 90-270.2. 41
(b) Conversion therapy practiced by any licensed professional in subsection (a) of this 42
section shall be considered unprofessional conduct and shall subject each licensed professional 43
who engages in the practice of conversion therapy to discipline under the licensed professional's 44
respective licensing entity. 45
(c) The Department of Health and Human Services shall have concurrent authority to 46
initiate proceedings for violations of this section. The Department shall promulgate rules in 47
accordance with this section. 48
"§ 90-21.163. Prohibited State funding. 49
No State funds, nor any funds belonging to a municipality, agency, or political subdivision 50
of this State, shall be expended for the purpose of conducting conversion therapy, referring an 51
General Assembly Of North Carolina Session 2025
Senate Bill 382-First Edition Page 5
individual for conversion therapy, health benefits coverage for conversion therapy, or a grant or 1
contract with any entity that conducts conversion therapy or refers individuals for conversion 2
therapy." 3
SECTION 2. If any provision of this act or its application is held invalid, the 4
invalidity does not affect other provisi ons or applications of this act that can be given effect 5
without the invalid provisions or application and, to this end, the provisions of this act are 6
severable. 7
SECTION 3. This act is effective when it becomes law and applies to acts on or after 8
that date. 9