Legislative Matter

Miami-Dade Legislative Item
File Number: 171359

Printable PDF Format

File Number: 171359

File Type: Ordinance

Status: Second Reading

Version: 0

Reference:

Control: Board of County Commissioners

File Name: BANNING CONVERSION THERAPY

Introduced: 5/23/2017

Requester: NONE

Cost:

Final Action: 10/3/2017

Agenda Date: 10/3/2017

Agenda Item Number: 7D

Notes:

Title:

ORDINANCE RELATING TO CONVERSION OR REPARATIVE THERAPY FOR MINORS; CREATING ARTICLE XX, CHAPTER 21 OF THE CODE OF MIAMI-DADE COUNTY, FLORIDA; PROVIDING DEFINITIONS, PROVIDING FOR APPLICABILITY IN THE UNINCORPORATED AREAS OF MIAMI-DADE COUNTY AND ENFORCEMENT BY THE COUNTY; PROHIBITING CERTAIN LICENSED PROFESSIONAL THERAPISTS AND COUNSELORS FROM ENGAGING IN CONVERSION OR REPARATIVE THERAPY WITH A MINOR; AMENDING 8CC-10; PROVIDING PENALTIES; PROVIDING SEVERABILITY, INCLUSION IN THE CODE, AND AN EFFECTIVE DATE

Indexes:	MINORS
	CONVERSION
	THERAPY

Sponsors:	Sally A. Heyman, Prime Sponsor
	Daniella Levine Cava, Co-Sponsor
	Audrey M. Edmonson, Co-Sponsor
	Barbara J. Jordan, Co-Sponsor

Sunset Provision: No

Effective Date:

Expiration Date:

Registered Lobbyist:

None Listed

Legislative History
Acting Body	Date	Agenda Item	Action	Sent To	Due Date	Returned	Pass/Fail

Board of County Commissioners	10/3/2017	7D	Adopted as amended				F
REPORT:	First Assistant County Attorney Geri Bonzon-Keenan read the foregoing proposed ordinance into the record. Assistant County Attorney Terrence Smith read the following proposed amendments into the record: On handwritten page 10, section 21-290, the words “or is not licensed” would be deleted. It was moved by Commissioner Heyman that the foregoing proposed ordinance be adopted as amended. This motion was seconded by Vice Chairwoman Edmonson, followed by discussion. Commissioner Sosa pointed out she had gay family members who were accepted without question. She opined conversion therapy was risky; noted most parents were unaware of the possible adverse effects their child could experience due to various types of hormone injections being given to them; and expressed concern with counseling provided by those without expertise on the subject matter that could cause depression and emotional duress. She stressed the importance of government not becoming involved in parental rights; however expressed her willingness to support the proposed legislation if it was amended to include a provision in section 21-290 that required written consent by a child’s parent or guardian be provided to the licensed professional engaging in that type of therapy; after the risks of possible side effects were disclosed to the parent or guardian by the licensed professional. In response to Commissioner Monestime’ inquiry regarding how conversion therapy was presently being administered, Assistant County Attorney Smith explained conversion therapy was referred to as “talk therapy” where a child was convinced that homosexuality was wrong, that they should not be having those feelings, and they needed to be converted. He also provided an historical overview of methods used on individuals exhibiting homosexual tendencies; which included forms of torture, castration, and isolation that was documented in the 1950’s and 1960’s, prior to homosexuality being removed by the American Psychiatric Association from the Diagnostic and Statistical Manual (DSM) on mental disorders. He further noted, by 1974, therapy for homosexuality was no longer practiced and ultimately removed as a disorder; however the recitals to the proposed ordinance contained statements made by professional organizations that documented conversion therapy and determined it to be ineffective and harmful to the youth. Commissioner Monestime noted he favored protecting children; however pondered the need to create a law that may not be necessary and questioned who determined whether “talk therapy” was good or bad. Assistant County Attorney Smith advised, for the record, the proposed ordinance did not regulate how parents discussed topics and/or counseled their children, either under a religious or secular basis; it was designed to regulate certain professionals. He clarified the ordinance was designed to protect children under the age of 18 and did not protect any individual over the age of 18 who sought such counseling. During discussion on the legal age a child could request therapy without parental consent and the maturity level of the youth today, Assistant County Attorney Smith spoke about a recent court case where a child sought to receive conversion therapy and the court concluded that, although parents had a constitutional right to deal with their children, the parent and minor child did not have the right to demand the government provide a particular type of treatment and the courts have upheld decisions of legislative bodies who adopted legislation banning conversion therapy. Assistant County Attorney Smith clarified the proposed ordinance regulated whether or not the therapist could offer conversion therapy and explained upon adoption of this legislation, that type of therapy would not be available even if one was voluntarily seeking it. Commissioner Monestime expressed concern with government getting involved in issues between parents and children and their ability to choose whatever type of therapy they wished to receive; opined it would be difficult to enforce; and said, based on his concerns, he could not support the proposed legislation. Commissioner Martinez pointed out the proposed ordinance only applied in Unincorporated Miami-Dade County and noted cities within the county and the state have passed their own legislation banning conversion therapy. He expressed concern with government infringing on parental rights. Commissioner Suarez spoke about his sister’s acknowledgment of being gay when she was in her 40’s; his familiarity with conversion therapy due to another family member having undergone that type of therapy; and noted 90% of psychologists did not support that type of therapy. He noted, however those psychologists that did support conversion therapy listed as many as eight factors involved, one of which was genetic pre-disposition. He also commented on sexual abuse cases of children that may have caused them to question their sexuality; expressed concern with the high rate of suicides by children who felt compelled to go through conversion therapy due to their parent’s religious beliefs; and noted he could support the proposed legislation if it incorporated Commissioner Sosa’s amendment. Commissioner Levine Cava thanked all those in attendance who spoke on this issue and opined the proposed ordinance protected children from a therapy that was determined to be dangerous to children. She pointed out it did not remove a parent or clergy’s ability to talk to a child and provide them with guidance; that the ordinance pertained to regulating a business; and expressed concern that other issues were being caught up in the proposed legislation that strictly prevent licensed professionals from conducting practices that were determined contrary to “best practices” according to professional organizations and the courts system. She noted, for those reasons, she supported and co-sponsored the proposed legislation. Commissioner Diaz opined the foregoing proposed ordinance should not be before the Board and said he could not support it at this time. He expressed concern with legislation that crossed over into the home and infringed on parental rights. In response to Commissioner Diaz’ question, Assistant County Attorney Smith read, for the record, the definition of conversion therapy as defined in the proposed ordinance. “Conversion therapy, also referred to as reparative therapy, means any counseling, practice, or treatment performed with the goal of changing a person’s sexual orientation or gender identity, including, but not limited to efforts to change behavior, gender expression, or to reduce or eliminate sexual or romantic attraction or feelings towards a person of the same gender.” During discussion on legislation enforcement, Assistant County Attorney Smith clarified that therapist’s who practiced conversion therapy within a municipality who adopted legislation banning such, the therapist or counselor would be in violation; however, if this proposed ordinance was not passed by the Board of County Commissioners, a therapist could continue to practice conversion therapy in Unincorporated Miami-Dade County. Commissioner Barreiro opined the ordinance aligned with legislation adopted by other cities throughout Florida and the state level and stated, after reading information from the American Psychological Association and the American Psychiatric Association, he would support the foregoing proposed ordinance. Chairman Bovo opined the proffered amendments made the legislation better; however, the issue should be legislated at the state level, not by local government. He commented about how far society had come; that the level of acceptance of gay individuals in the community was where it should be; and that a child going through this type of situation deserved understanding, compassion, and love. He stated he would not be supportive of the proposed ordinance. Vice Chairwoman Edmonson noted in addition to physical abuse, mental and emotional abuse existed; and opined, if a child was told they would not be accepted as they were, that constituted abuse. She argued that government was already inside the homes by banning parents from physically abusing their children and also opined a parent should not be able to mentally or emotionally abuse their child by telling them something was wrong with them and they were no good because they exhibited homosexual tendencies. She stressed the need to bring awareness and the need to ensure a child obtained the services of a professional therapist or counselor who provided assistance on this issue without trying to change the child. Vice Chairwoman Edmonson expressed her support for the proposed ordinance and named, for the record, the following professional organizations who opposed conversion therapy: The American Association of Child and Adolescent Psychiatry; American Academy of Pediatrics; American Association of Marriage and Family Therapy; American College of Physicians; American Counseling Association; American Medical Association; American Psychiatric Association; American Psychoanalytic Association; American Psychological Association; American School Health Association; and the National Association of Social Workers. Commissioner Sosa asked if the proposed ordinance could be deferred in order to work on and further discuss concerns expressed by her colleagues and the public. Commissioner Heyman thanked the County Attorney’s Office for the time and effort they put forth on the proposed legislation. She pointed out Miami-Dade County was a chartered county, home-ruled, and was larger than some states and that she sponsored this legislation after waiting two years for the state to address this issue. She stressed the need to protect children, in collaboration with various entities such as parents, clergy, and other organizations. She noted conversion therapy (aka reparative therapy), was proven to be harmful, dangerous, and ineffective to minors; that bans on conversion therapy passed legal challenges; and that the proposed ordinance was not intended to alienate or be divisive, but strictly applied to particular professionals who conducted that particular type of therapy. Commissioner Heyman thanked Vice Chairwoman Edmonson for pointing out all the professional organizations that opposed conversion therapy. There being no further questions or comments, the Board proceeded to vote on the foregoing motion to adopt the proposed ordinance as amended, which failed.

Public Safety and Health Committee	7/12/2017	1G1	Forwarded to BCC with a favorable recommendation				P
REPORT:	Assistant County Attorney Gerald Sanchez read the foregoing proposed ordinance into the record. Chairwoman Heyman relinquished the chair to Vice Chairwoman Jordan. Commissioner Heyman proceeded to explain the intent of the foregoing proposed ordinance. Vice Chairwoman Jordan opened the public hearing. The following persons appeared before the Committee: House Representative David Richardson, District 11 – 1701 Meridian Ave, Suite 402A Miami Beach, FL 33139, noted when he was approached about the initiation of the conversion therapy. At this time it was only one local ordinance related in the United States. He stated Miami Beach was the first city in the State of Florida that passed the first local ordinance relating to reverse therapy and this made other cities to take initiatives as well. Now, there are a number of cities that had passed the ordinance banning the reverse therapy as a treatment. He encouraged the commissioners to support this initiative in the unincorporated area of Miami-Dade County. Commissioner Heyman asked if there was a possibility of passing this ordinance countywide, noting the state may not pass this type of legislation. Jason King – 700 S.E 3rd Ave #400 Fort Lauderdale, FL 33316, spoke in favor of the ordinance and stated that their medical providers had observed the damage that converse therapy can cause in children and adolescents. This therapy was never indicated and not medical recommended, and causes internal stigma, distress, and depression. Maidember Guemez – 1175 N.E 125 St North Miami, FL 33161, spoke in support of the ordinance and stated she believed the therapy did nothing for individuals in the lesbian, gay, bisexual and transgender community (LGBT) who were, damage or broken. She noted reversion therapy creates psychological disorders and increases depression. Commissioner Heyman asked the speaker to provide the list of clinical groups to other cities and jurisdictions as well. Justin Clench – 6630 S.W 64th St, South Miami, FL 33143, spoke in support of the ordinance as well. Tony Lima – 750 N.E 90 St # 803, Miami, FL 33132, spoke in favor of the ordinance. He encouraged the commissioners to support this proposal for the entire county because the younger generation was in need. He mentioned various organizations such as the American Medical Association, American Psychiatric Association, the World Health Organization, the American Counseling Association, the American Academy of Pediatrics, the American College of Physicians, the School of Health Association, the National Association of Social Workers and the National Education Association, that could help also with the dialogue in supporting the ordinance. Gladys Duran – 1501 N.E 2nd Ave Miami, FL, spoke in favor of the ordinance and expressed her hoped that the commissioners as well all the municipalities would approve this ordinance. Rowena Iliesco – 1037 S.W 15 Terra, Miami, FL 33312, spoke in favor of the ordinance. Landon Woolston – 6360 N.E 4th Ct Miami, FL 33138 spoke in favor of the ordinance. Lesala Monica – 1344 S.W 181 Ave Pembroke Pines, FL 33029 spoke in favor of the ordinance and thanked Commissioner Heyman for sponsoring this ordinance. Madame Renita Holmes (Address exception) spoke in favor of the ordinance. She noted the inequity in the black gay community, and encouraged these individuals be also considered. Commissioner Heyman thanked all the speakers who appeared in support of the ordinance. She said this was about respecting differences, personal freedom, and most important, humans rights. Commissioner Heyman noted she wanted to make sure the other municipalities were engaged and participated in supporting this ordinance as well. After hearing no one else wishing to speak on the proposed ordinance, Vice Chairwoman Jordan closed the public hearing. Commissioner Levine Cava suggested a separate proposed ordinance be prepared to address this same issue countywide with Commissioner Heyman and Vice Chairwoman Jordan as co-sponsors on that proposed ordinance. Commissioner Jordan requested to be listed as a co-sponsor on the foregoing proposed ordinance. The Committee proceeded to vote on the foregoing proposed ordinance as presented.

Board of County Commissioners	6/6/2017	4A	Adopted on first reading		7/12/2017		P
REPORT:	County Attorney Abigail Price-Williams read into the record the title of the foregoing proposed ordinance. There being no objections or comments, the members of the Board proceeded to take a vote on this ordinance as presented. The foregoing proposed ordinance was adopted on first reading and scheduled for public hearing before the Public Safety and Health Committee (PSHC) meeting on Wednesday, July 12, 2017, at 1:30 p.m.

Board of County Commissioners	6/6/2017		Tentatively scheduled for a public hearing	Public Safety and Health Committee	7/12/2017

County Attorney	5/23/2017		Assigned	Terrence A. Smith

County Attorney	5/23/2017		Referred	Public Safety & Healthcare Admin Cmte	7/12/2017

Legislative Text

TITLE
ORDINANCE RELATING TO CONVERSION OR REPARATIVE THERAPY FOR MINORS; CREATING ARTICLE XX, CHAPTER 21 OF THE CODE OF MIAMI-DADE COUNTY, FLORIDA; PROVIDING DEFINITIONS, PROVIDING FOR APPLICABILITY IN THE UNINCORPORATED AREAS OF MIAMI-DADE COUNTY AND ENFORCEMENT BY THE COUNTY; PROHIBITING CERTAIN LICENSED PROFESSIONAL THERAPISTS AND COUNSELORS FROM ENGAGING IN CONVERSION OR REPARATIVE THERAPY WITH A MINOR; AMENDING 8CC-10; PROVIDING PENALTIES; PROVIDING SEVERABILITY, INCLUSION IN THE CODE, AND AN EFFECTIVE DATE

BODY
WHEREAS, being lesbian, gay, bisexual, or transgender is not a disease, disorder, illness, deficiency, or shortcoming; and
WHEREAS, numerous major professional associations of mental health practitioners and researchers in the United States have recognized this fact for nearly 40 years; and
WHEREAS, for instance, the American Psychological Association convened a Task Force on Appropriate Therapeutic Responses to Sexual Orientation (�Task Force�), which conducted a systematic review of peer-reviewed journal literature on sexual orientation change efforts commonly known as conversion or reparative therapy; and
WHEREAS, the Task Force issued a report in 2009 in which it concluded that efforts to change a person�s sexual orientation can pose critical health risks to lesbian, gay, bisexual or transgender people, including confusion, depression, guilt, helplessness, hopelessness, shame, social withdrawal, suicidality, substance abuse, stress, disappointment, self-blame, decreased self-
esteem and authenticity to others, increased self-hatred, hostility and blame toward parents, feelings of anger and betrayal, loss of friends and potential romantic partners, problems in sexual and emotional intimacy, sexual dysfunction, high-risk sexual behaviors, a feeling of being dehumanized and untrue to self, a loss of faith, and a sense of having wasted time and resources; and
WHEREAS, the Task Force�s findings are supported by overwhelming scientific consensus that these practices have no scientific basis, contradict the modern scientific understanding of sexual orientation, and put young people at risk of serious harm, including severe depression and suicide; and
WHEREAS, moreover, according to one study entitled Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults (2009), minors who experience family rejection based on their sexual orientation face especially serious health risks; and
WHEREAS, the study found that lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection; and
WHEREAS, the American Psychological Association issued a resolution on Appropriate Affirmative Responses to Sexual Orientation Distress and Change Efforts in 2009, which advises parents, guardians, young people, and their families to avoid sexual orientation change efforts that portray homosexuality as a mental illness or developmental disorder and to seek psychotherapy, social supports, and educational services that provide accurate information on sexual orientation and sexuality, increase family and school support, and reduce rejection of sexual minority youth; and
WHEREAS, the American Psychiatric Association also published a position statement in March of 2000 which concluded that Psychotherapeutic modalities to convert or �repair� homosexuality are based on developmental theories whose scientific validity is questionable, and such attempts to do so result in psychological harm; and
WHEREAS, in the last four decades, �reparative� therapists have not produced any rigorous scientific research to substantiate their claims of cure; and
WHEREAS, until there is such research available, the American Psychiatric Association recommends that ethical practitioners refrain from attempts to change individuals� sexual orientation; and
WHEREAS, the American Psychiatric Association, therefore, opposes any psychiatric treatment such as reparative or conversion therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon the a prior assumption that a patient should change their sexual orientation; and
WHEREAS, the American School Counselor Association's position statement on professional school counselors and lesbian, gay, bisexual, transgendered, and questioning (LGBTQ) youth concludes that: �It is not the role of the professional school counselor to attempt to change a student�s sexual orientation/gender identity but instead to provide support to LGBTQ students to promote student achievement and personal well-being�; and
WHEREAS, the American Academy of Pediatrics in 1993 also published an article in its journal, Pediatrics, stating: �Therapy directed at specifically changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation�; and
WHEREAS, similar findings have been made by other professional associations, including but not limited to the American Medical Association Council on Scientific Affairs, the National Association of Social Workers, the American Counseling Association Governing Council, the American Psychoanalytic Association, and the American Academy of Child and Adolescent Psychiatry; and
WHEREAS, based on these studies, there is no evidence that sexual orientation can be altered through therapy, and attempts to do so may be harmful; and
WHEREAS, numerous jurisdictions in Florida and across the United States have passed legislation banning conversion or reparative therapy, including but not limited to the cities of Miami Beach, Miami, Wilton Manors, North Bay Village, Boynton Beach, El Portal, West Palm Beach, Cincinnati, and Seattle; and the states of New York, New Jersey, California, Oregon, New Mexico, and Illinois; and
WHEREAS, in fact, such laws, which have been challenged in the courts, have been upheld as constitutional; and
WHEREAS, for instance, in California, a lawsuit was filed challenging the state�s law banning reparative or conversion therapy; and
WHEREAS, the United States Court of Appeals for the Ninth Circuit ruled in Welch v. Brown that the law is not unconstitutional and does not violate religious freedom; and
WHEREAS, on May 1, 2017, the United States Supreme Court rejected a petition to review the decision in Welch v. Brown, thus leaving the California law intact; and
WHEREAS, this is the fourth time the Supreme Court has declined to review challenges to laws banning conversion therapy; and
WHEREAS, this Board has a compelling interest in protecting the public safety, health and general welfare as well as the physical and psychological well-being of minors, including lesbian, gay, bisexual, and transgender youth, and in protecting its minors against exposure to serious harms caused by sexual orientation change efforts such as conversion or reparative therapy,
BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF MIAMI-DADE COUNTY, FLORIDA:
Section 1. Article XX of Chapter 21 of the Code of Miami-Dade County, Florida, is hereby created to read as follows:1
ARTICLE XX- CONVERSION THERAPY

Sec. 21-288. Policy.

It is hereby declared to be the policy of Miami-Dade County, in the exercise of its police power for the public safety, health and general welfare, to protect minors, including lesbian, gay, bisexual, and transgender youth against exposure to serious harms caused by sexual orientation change efforts such as conversion or reparative therapy.

Sec. 21-289. Definitions.

Unless otherwise expressly stated, the following terms shall, for the purpose of this section, have the meanings indicated in this section:

(a) �Conversion therapy� also referred to as �reparative therapy,� means any counseling, practice, or treatment performed with the goal of changing a person's sexual orientation or gender identity including, but not limited to, efforts to change behaviors, gender expression, or to reduce or eliminate sexual or romantic attraction or feelings toward a person of the same gender. "Conversion therapy" does not include counseling that:
(i) Provides support to a person undergoing gender transition; or

(ii) Provides acceptance, support, or understanding of a person, or facilitates a person's coping, social support, identity exploration, and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices, if such counseling is not conducted with the goal of changing the person's sexual orientation or gender identity.

(b) �Minor� means a person less than 18 years of age.

Sec. 21-290. Conversion therapy prohibited.

A person who is licensed or is not licensed by the state to provide professional counseling, or who performs counseling as part of their professional training under Chapters 458, 459, 490, or 491, Florida Statutes, as such chapters may be amended, including, but not limited to, medical practitioners, osteopathic practitioners, psychologist, psychotherapists, social workers, marriage and family therapists, and licensed counselors, shall not engage in conversion therapy or reparative therapy with a minor.
Sec. 21-291. Applicability and Enforcement

This article shall be applicable in all the unincorporated areas of Miami-Dade County with the enforcement of the provisions of this article being the responsibility of the County. The County Mayor or the County Mayor�s designee shall designate a County department to monitor and enforce the provisions of this article.

Sec. 21-292. Penalties. �

The first�violation of the provisions of this article shall result in a fine of $500.00.�Second and subsequent violations shall result in a fine of $1,000.00.�Each conversion therapy session with a minor shall constitute a separate offense, and any session that purports to extend from one day to another shall constitute separate offenses for each day in which a session takes place.�These penalties shall not preclude any other remedies available at law or in equity, including injunctive relief in the circuit court.

Section 2. Section 8CC-10 of the Code of Miami-Dade County, Florida, is hereby amended to read as follows:�

Sec. 8CC-10. Schedule of civil penalties.�

The following table shows the sections of this Code, as they may be amended from time to time, which may be enforced pursuant to the provisions of this chapter; and the dollar amount of civil penalty for the violation of these sections as they may be amended.�

The "descriptions of violations" below are for informational purposes only and are not meant to limit or define the nature of the violations or the subject matter of the listed Code sections, except to the extent that different types of violations of the same Code section may carry different civil penalties. For each Code section listed in the schedule of civil penalties, the entirety of that section may be enforced by the mechanism provided in this Chapter 8CC, regardless of whether all activities proscribed or required within that particular section are described in the "Description of Violation" column. To determine the exact nature of any activity proscribed or required by this Code, the relevant Code section must be examined.�
Code
Section
Description of Violation
Civil Penalty

* * *

21-287
Rafting
250.00
>>21-288, et. Seq.
Conversion Therapy

First offense

Second or subsequent offense

500.00

1,000.00<<

* * *

Section3. If any section, subsection, sentence, clause or provision of this ordinance is held invalid, the remainder of this ordinance shall not be affected by such invalidity.
Section 4. It is the intention of the Board of County Commissioners, and it is hereby ordained that the provisions of this ordinance, including any sunset provision, shall become and be made a part of the Code of Miami-Dade County, Florida. The sections of this ordinance may be renumbered or relettered to accomplish such intention, and the word "ordinance" may be changed to "section," "article," or other appropriate word.
Section 5. This ordinance shall become effective ten (10) days after the date of enactment unless vetoed by the Mayor, and if vetoed, shall become effective only upon an override by this Board.

1 Words stricken through and/or [[double bracketed]] shall be deleted. Words underscored and/or >>double arrowed<< constitute the amendment proposed. Remaining provisions are now in effect and remain unchanged.