California Law Places Youth at Risk: An interview with Rick Fitzgibbons, M.D.

As a psychiatrist who has worked with youth with same sex attractions, what is your opinion of the California law that prohibits mental health professionals from treating such youth?

This law demonstrates a profound disregard for the medical and psychological health of youth. It is an egregious act of deliberately denying to youth the knowledge of the homosexual lifestyle and the serious health risks associated with it.

Youth have the legal right to be given informed consent by health professionals about behaviors that could be harmful to them such as smoking, drinking, and sexual hooking-up. This law acts against the very legal rights of youth.

The law demonstrates a clear ignorance of the serious health risks associated with the homosexual lifestyle. For example, an article published in the journal Cancer last year on the health of California men revealed that men with Same Sex Attractions (SSA) in California are twice as likely to report a cancer as heterosexual men. Most troubling was the median age of onset of cancer in these men – 41 years old.[1] Youth have the right to such information in order to make decisions to protect their health.

What is informed consent?

Following the Nazi Holocaust of World War II, the Nuremberg Code was devised as a way to protect and show respect for all persons. This Code was considered necessary because of the gravely unethical medical practices perpetrated on concentration camp victims. The Code was put in place so that never again will patients be subjected to a lack of information regarding medical procedures performed on them.

This ethical issue of full disclosure, what the patient faces and a free will assent or refusal by the patient, has come to be known as informed consent.  Informed consent is now standard practice in medical communities and research universities. People have a right to know what is likely to happen to them as they engage in certain practices with health implications.

California Gov. Jerry Brown

Today, youth who begin experimenting with same-sex attraction (SSA), are not being given sufficient information about the serious risks to their health associated homosexual lifestyle. The deliberate withholding of such information by medical and psychological professionals goes against the Nuremberg Code.

Youth who engage in the SSA lifestyle are at-risk for a host of medical complications necessitating informed consent by professionals responsible for a given youth’s well-being. The failure to provide the information is a breach of ethics. The relevant organizations that give credentials and licenses to such professionals need to take action so that all aspects of the Nuremberg Code are upheld.

What are medical and psychological issues that California youth have the right to know?

They have the right to the medical and mental health literature that demonstrates:

  • homosexual attractions are not caused by genetic or biological factors[2]
  • the predominance fluidity or sexual attraction in youth[3]
  • the presence of serious emotional conflicts in youth that influence the development of SSA – such as a lack of confidence in males[4]
  •  the SSA lifestyle is associated with significant partner abuse[5]
  •  the lack of fidelity and stability in SSA relationships[6]

Spitzer’s study of 200 men and women, who had sought professional help to deal with SSA and who were out of the lifestyle for five years, found that 64% of the men and 43% of the women subsequently identified themselves as being heterosexual.[7]

Contrary to the claims made by the opponents of therapy, they did not experience an increase in psychological conflicts as a result of therapy.

Youth also have the right to know that treatment is not associated with harmful outcomes. Spitzer commented on his study, “Depression has been reported to be a common side effect of unsuccessful attempts to change orientation. This was not the case for our participants, who often reported that they were ‘markedly’ or ‘extremely’ depressed [prior to treatment] (males 43%, females 47%), but rarely that depressed [after treatment] (males 1%, females 4%.). To the contrary [after treatment], the vast majority reported that they were ‘not at all’ or ‘only slightly’ depressed (males 91%, females 88%).”[8]

Additionally, participants in Spitzer’s study were presented with a list of several ways that therapy might have been “very helpful” (apart from change in sexual orientation).  Notable were feeling more masculine (males) or more feminine (females) (87%) and developing more intimate nonsexual relations with the same sex (93%).[9]

Are there other studies that demonstrate danger to youth from the homosexual lifestyle?

Well-designed research studies published in leading peer-reviewed journals have shown a number of psychiatric disorders to be far more prevalent in teenagers and adults with SSA.[10] These include: major depression, anxiety disorders, substance abuse, suicidal ideation, suicide attempts and sexual abuse victimization.

GLB youth who self-identified during high school report disproportionate risk for a variety of health risks and problem behaviors.[11]

Young men who have sex with men (MSM) are at extremely high risk for contracting a sexually transmitted infection. According to the CDC, the number of MSMs ages 13 to 24 with newly diagnosed HIV is increasing each year and almost doubled since 2000.[12]

A study of young men aged 17–22, who have sex with men, found that 22% reported beginning anal sex with men when aged 3 to 14; of these, 15.2% were HIV positive.[13]

Research has shown that the youth suicide risk decreases by delaying self-identifying as a homosexual.  One study demonstrated that suicide risk among youth with same-sex attractions decreases 20% each year they delay labeling themselves as gay.[14]

Why the silence in health professionals, legislators and educators about the serious risks to youth from SSA?

Besides the atrocities necessitating the Nuremberg Code, another reprehensible ethical violation in that context was silence—silence in the face of atrocity, lack of information, and failure to obtain informed consent of people who thus became victims. Silence is now being reinforced by the new California law that prohibits youth with SSA from seeking treatment.

California youth are warned about dangers to their health such as cigarette smoking and drug and alcohol abuse. They also have the right to know that engaging in homosexual behaviors will predispose them to acquire cancer at a young age and will increase their risk of developing psychiatric illnesses.

Given all of the research from so many different angles showing the negative consequences for both physical and psychological health, this silence is now showing itself, as it did prior to the development of the Nuremberg Code. This is an act that violates the rights of youth because it fails to respect the youth’s free will decisions to make an informed consent with as much information as possible.

This is an ethical violation toward youth that must stop.



[1] Boehmer, U., et al. (2011). Cancer Survivorship and Sexual Orientation. Cancer 117, 3796–3804.

[2] American Psychological Association ( 2008). “Answers to Your Questions for Better Understanding of Sexual Orientation and Homosexuality.” J. Michael Bailey, at al. (2000). Genetic and environmental influences on sexual orientation and its correlates in an Australian twin sample.  Journal of Personality and Social Psychology, 78, 524–536.

[3] Laumann, E. et al. (1994). The Social Organization of Sexuality: sexual practices in the United States. University of Chicago Press. Kennish, K. K., et al. (2005). Sexual differences in the flexibility of sexual orientation: a multi-dimensional retrospective assessment. Archives of Sexual Behavior, 34, 173–83.

[4] Sandfort, T.G., et al. (2003). Same-sex sexuality and quality of life: findings from the Netherlands Mental Health Survey and Incidence Study. Archives of Sexual Behavior, 32, 15-22. Rubinstein, G. (2010).  “Narcissism and Self-Esteem Among Homosexual and Heterosexual Male Students.Journal of Sex & Marital Therapy, 36:24–34. Parkes, A., et. al. (2011). Comparison of teenagers’ early same-sex and heterosexual behavior: UK data from the SHARE and RIPPLE studies. Journal of Adolescent Health, 48, 27-35.

[5] Greenwood, G. et al. (2002). Battering victimization among a probability-based sample of men who have sex with men. American Journal of Public Health, 92, 1964–69.

[6] McWhirter, D. and Mattison, A. 1985. The Male Couple: How Relationships Develop. Prentice Hall; Schumm, W. (2010). Comparative Relationship Stability of Lesbian Mother and Heterosexual Mother Families: A Review of Evidence. Marriage and Family Review, 46, 499-509; Gartrell, N. & Bos, H. (2010, July). US national Longitudinal Lesbian Family Study: Psychological Adjustment of 17-year-old Adolescents.” Pediatrics, 126 (1), 28-36.

[7] Spitzer, R.L. (2003). Can some gay men and lesbians change their orientation?.  Archives of Sexual Behavior, 32, 403–17.

[8] Ibid., 412.

[9] Ibid.

[10] Catholic Medical Association (2008) Homosexuality and Hope,

[11] Garofolo, R. et al. (1998). The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics, 101, 895–889.

[12] Centers for Disease Control (2008, June). Trends in HIV/AIDS Diagnoses among men who have sex with men. MMWR Weekly, 57, 681:686.

[13] Lemp, G. et al. (1994). Sero-prevalence of HIV and risk behaviors among young homosexual and bisexual men. JAMA, 272, 449–45.

[14] Remafedi, G., Farrow, J., & Deisher, R. (1991). Risk factors for attempted suicide in gay and bisexual youth. Pediatrics, 87, 869–875.

Richard Fitzgibbons, M.D., is the director of the Institute for Marital Healing, located outside Philadelphia, and has worked with several thousand couples over the past 35 years. In 2000, he co-authored the book, Helping Clients Forgive: An Empirical Guide for Resolving Anger and Restoring Hope, with Dr. Robert D. Enright, University of Wisconsin, Madison, for American Psychological Association Books. In 2011, he co-edited an issue of the Catholic Medical Association’s Linacre Quarterly on the sexual abuse crisis in the Church. Dr. Fitzgibbons has given many conferences on marriage in New York, Philadelphia and Washington, and numerous conferences to priests in various dioceses, religious communities, and to seminary spiritual formation teams.
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