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Notes -
[disclaimer: I'll try to keep personal feelings and experiences out of this one, simply because I don't think most readers here are going to want to hear it, but it will inevitably color my takes.]
LGBT Talk / Conversion Therapy: Chiles v. Salazar
SCOTUS holds:
The opinion, by Gorsuch and joined by a somewhat surprising seven other justices, is pretty standard free speech fare: the statute bans one view and not the other, the state offers little if any historical or legal support for its ban, and it's both an outlier and a recent outlier. The state tried to compare the ban here to requirements to disclose factual, noncontroversial speech during commercial activities, and ran into a brick wall when the case formalizing that standard did a Solomon-level splitting to start with.
The concurrence, by Kagan and joined by Sotomayor, tries to cabin this ruling to its four corners, and saying that viewpoint-neutral restrictions on medical speech would have a much lower bar to pass. Where the state here banned only one side of a controversial topic, but encouraged the other, a law that merely banned this topic in this context entirely could merely need evidence that the state's interests were significant enough and connected enough. Given that we're talking Colorado, here - home of Masterpiece Cakeshop - it's not impossible that the state will try to squeak a neutral-in-theory rule under this view.
It's... somewhat difficult to imagine what that would look like, though. Kagan, during oral arguments, motioned toward a theoretical law that prohibited violating the standard of care, but that would be so wide as to revive the nondelegation doctrine, not least of all because that can range from a creature of statute to a PDF thrown together by randos to five competing and conflicting opposing philosophies. A genuine universal ban by counselors on LGBT-related talk therapy would impact the LGBT movement far more than it would social conservatives. The Colorado statute here specifically excluded "Assistance to a person undergoing gender transition" for several reasons, but the necessity for such therapy before most reasonable doctors would recommend surgical or serious chemical interventions is no small part of it. Restrictions on types of therapy might be more easily be tailored to only hit one side or the other, but while aversive- or confrontational-focused conversion therapy are common focuses for progressive outrage (whether the underlying incident was genuine or not), they're both little-used and little-liked even by social conservatives now, and a restriction that leaves sexual orientation change talk therapy on the table is likely to be seen as an unacceptable compromise.
The dissent is, no surprise, Jackson, and it's a doozy:
There are steelmen to the Colorado law. Chiles does not contest it as applied to aversives, and even if they did work, they're well-within the bounds of behaviors that states have long-regulated (and which social-conservatives have argued for regulating as recently as Skrmeti). A lot of these programs don't work, don't seem to care that they don't work, and are unwilling to consider alternative approaches that would fit their goals or the goals of their patients but would not match expectations (caveat: not all of them, and some like the SF Kaiser clinic might have been a little more open-minded than the already-libertine-seeming publicly-disclosed records). There are a mass of complicated First Amendment caselaw, epicycle on epicycle, that have left too many opportunities for motivated justice to find outlier or non-representative historical support for hilariously unconstitutional arguments.
Jackson's dissent bulldozes them. She tries to draw the statute here as merely incidentally restricting speech coincidental to restrictions on conduct, by defining conduct to include wide varieties of speech so long as the regulators motivations were pure. Her view of the First Amendment and this statute do not merely condone prohibitions far broader than cruel or harmful ones. One note compares the law here to the speech requirements in Casey, where abortion providers were required to give 24-hour notice of the possible risks and complications of procedures - but the law in Casey specifically required providers to give both the risks of abortion and carrying the fetus to term (and other alternative procedures).
It's just a mess, and it's not just me saying that: Kagan and Jackson have dueling footnotes over it.
I'm genuinely confused what Jackson's goal is, here. Bulverism's a fun sin, and all, but for all I've been unimpressed by her Munsingwear asides, I'd at least expect some sort of deep strategic or tactical focus, and it's not just me finding it jank at best (cw: ai analysis of legal documents, aka worth about as much as you paid for it). If the best she's aiming for is to throw the First Amendment to the proverbial wolves of whatever third-party organization can define professional standards, it seems a dissent like this will only motivate people to burn those orgs down faster, and damn whatever happens to the commons in the process.
Some smaller notes:
A bigger note: Even on the strict law-of-the-case matter, this is going to be a mess. There's been active lawsuits dating back to at least California's SB 1172 in 2012, which was upheld by the Ninth Circuit in 2013, in a case that SCOTUS named and shamed in 2017. There's been a circuit split since 2020's Otto v. City of Boca Raton; cases had reached SCOTUS as far back as 2014, and as recent as 2023, only to have cert denied. 23 states have laws that are near mirrors of this one, another 4 states have partial variants. One was overturned days after SCOTUS granted cert in this case. I... do not expect clarity from the First, Second, Third, or Ninth Circuit in the next year, outright. We might not know for the Tenth Circuit, or just the bounds of Colorado, specifically, in a year.
From a legal realism perspective, it doesn't 'matter'. This specific law hadn't been enforced yet, and indeed (despite that decade-plus legal limbo and wide spread), I couldn't find any clear cases of legal enforcement. If a licensing board was going to pull a therapist's card over this sorta thing, they can readily and rapidly find other
fig leafscauses, even while focusing on the exact same therapy.From a more pragmatic one than even that, though, the court's intransigence seems likely to have a longer-term impact. At minimum, this points to a no-go-zone for a philosophy, and one that's been allowed to sit for well over a decade: whatever natural resistance the psychiatric world might have toward social conservatives, this one there on top of that, and coincidentally no one in good standing with the APA will ever argue in favor of these policies, a note that should be relevant even or especially if they are clearly wrong. Therapists are more law-abiding than average (at least on the job), and even a purely illusory law will lead the marginal therapists to be just that little bit more cautious, even if only in extreme outlier cases.
I benefited from conversion talk therapy. Nobody claimed a particularly high success rate, but I got the impression that most of these therapists thought a majority of people improved somewhat. I never heard discussion of aversive practices, I didn't get the impression it was common or normal, or even really part of the same world. Everybody was religious and had strong views about family systems and the like. It was, mostly, fairly standard therapy with some unusual homework exercises centered around a self conception as a man/woman designed by God for that role. These therapists took other, non-conversion therapy clients and cases, I suspect the bulk of their clientele were dealing with trauma or whatever. The list I was given was, overwhelmingly, male, and a few women were highlighted for those that preferred a woman to talk to(this was, clearly, intended for women who don't feel comfortable discussing certain things with men). Unlike with most therapists, they freely and frequently recommended talking to someone else, changing therapists often, etc, as it was thought that different people specialized on different specific issues within the complex that causes homosexual ideation. The theory of treatment was based on a book written by some Dutch reactionary psychiatrist, this was freely shared with me and I read it out of curiosity(unfortunately, I purchased it on an old kindle account which I no longer have access to).
I should note that it did, factually, work in my case. I not only lost disordered urges but also became more stereotypically masculine, developed a greater interest in sports and the like. I'm happier for it.
As far as the vote pattern goes, it seems like the most intelligent liberal justice is attempting to mitigate the damage done to state mandation of official social liberalism. This is an issue in which I am, of course, keenly interested in given my ideological views, but it does seem like Kagan and Sotomayor recognize at least some constitutional limitations, whereas KJB simply rambles in favour of whatever the current dem party line is. No wonder Kagan is reportedly tired of her.
Most of the information I've seen suggests that formal use of 'hard' aversive stimuli (eg, electric shocks, physical impacts, harsh chemicals) fell out of favor by the mid 1980s. There's claims of it since, but they tend to revolve around extremely marginal cults and/or really sketchy political activist backstories. Even before it was marginalized in the social conservative sphere, it was considered (probably reasonably!) as likely to backfire, end up with asexual or otherwise less-sexually-functional-than-before outcomes, or trigger even weirder behaviors in the Nicholas Cummings side of the sphere.
(Although I was under the impression van den Aardweg himself was prone to flirting closer than most talk therapy-focused groups: there's always some fuzzy edges between exercise as process versus exercise and punishment, but the whole Failed Male and Failed Social Relationship framework seemed prone to leaping off that edge, in addition to just being hilariously wrong in a number of cases I know firsthand.)
Yeah, that's not unprecedented or unbelievable. I was trying to keep to the legal arguments above, but the factual side of this is an ungodly mess.
My impression is that there's a small portion of people (either bisexual or malleable for other reasons like their approach to sexuality or very pressing in the 'every hole is a goal' sense sex drives) for whom even the 'standard' form of Man Up works, or could probably even work themselves into a pretty wide variety of results in the Dodo Bird Verdict sense. There have been a few bihackers that were successful going the other direction, and happy with it, and I kinda do have to mention that there's a ton of guys who were perfectly straight and then spent some time in the furry fandom and discovered Oh No He's Hot.
But the flip side is that a lot don't, even within the small group who seek this out the hardest: a large portion who try are only able to shove down same-sex interests for short periods, or they're able to function with women but still crave men in ways that they're not really comfortable with. Likewise, you get bihackers that aren't grossed out by gay sex anymore, but wouldn't actually look out for the stuff, or might struggle to even top (or even top the 'most gay lite' guy available, cw: furry comic).
I'm not kidding when I say Cumming's 14% number seems really optimistic.
The flip side to that is that we've got a lot more tooling available, now. At the moderate level, there was a long-standing theory that gay guys just needed to have a couple good rounds of 'healthy' sex with a woman to Become A Man, and contra the invasive therapies and wireheading from erwgv3g34's older example, these days some gay guys can do it with a Little Blue Pill and a weekend in Vegas. It doesn't work -- a few still can't get it up or keep it up, and a much larger number can pump away and just don't really feel satiated at the end -- but it seems like it should be something that redefines how a lot of frameworks around everything here should go, and it really hasn't.
People having widespread changes to their sexuality as a result of hormonal supplementation is common, if not universal.
(At the more extreme, I'd expect rTMS to have some impact, and while I think experimenting like that is a terrible idea regardless of what you're trying to change your mind on, it's far from the most terrible idea to get massive support and grants. On the flip side, I can understand why both social conservatives and LGBT advocates think it's a really dumb weapon to invent and then leave around for someone else to mandate!)
On the flipside, with the possible exclusion of the Kaiser SF program, it's weird how messy "improved somewhat" is as a term of art. Does that mean they were still gay, just got perceived hypersexuality under control? Still gay, but could run on the masc4masc side of grindr? Still gay, but less conflicted about it? Could they now have sex with their wives, and if so did they enjoy it or see it as a chore? Or did they have reduced same-sex attraction, in the sense that they jorked it to gay porn instead of cheating on their significant other? Because some of these endpoints -- even and maybe especially if they are desirable for the patients in question -- seem like they could be confronted in ways that don't revolve around 'changing orientation' as the central result, rather than a rare side effect.
Even assuming as a given the whole progressive mainstream philosophy as true, there’s a lot of this stuff that could be relevant and interesting and important, completely divorced from sexual orientation change, and they’re not looking into it deeply either.
I think using positive punishment in order to create a conditioned response is just a very, very bad idea to do to people and can mess them up in ways that we don't fully understand. #JusticeForLittleAlbert
Ok, this is one of your sentences I had to read thrice before I got it. I thought you were talking about the straight-to-gay people here (I guess you call them the 'bihackers'?) and I was genuinely confused for a few minutes because I thought you were saying "they could only shove down" in the sense of "avoid throwing up because of" same-sex interests for short periods, and I was trying to discern how that was different from your next sentence about the guys who were no longer grossed out by gay sex. It took me longer than I care to admit to understand you meant "repress" and not "keep a full stomach on", which are very much the opposite thing.
I thought about making a matrix joke, but then I realized that making a matrix joke about gender and sexuality wasn't particularly original.
Wait, is the point that the 'most gay lite guy available' is a trans man with a vagina? I will admit that I've found some people who call themselves trans men attractive, but this is on the "I have changed literally nothing about my appearance--I am now wearing masculine clothing but I've done nothing irreversible--I am a proud trans-masc-femboy and this is a masculine pink skirt I'm wearing" spectrum of trans men, or in other words the ones where they could just say 'I am a woman' and no one would think anything of it. When male-pattern hair or surgeries start getting involved that's where my brain nopes out. I suppose that's a long-winded way of saying I'm not attracted to trans men.
I mean, this doesn't not sound like someone's kink. We already live in a world in which gay hypnosis pornography exists.
Yeah. There's still some small groups trying it for smoking cessation and addiction therapy, but even in that specific context it's controversial, and for a reason. When using it with sexual arousal, it seems like giving people really unpleasant BDSM kinks is kinda the best-case scenario, and broad hangups or extreme social discomfort more likely. But like the lobotomy, it was popular for a time.
My apologies. This last interpretation is the correct one: of the small group of gay men who actively search out therapy to become less gay or more straight, a large majority either only find themselves 'less gay' in that they're able to go more time without a strong hunger for gay sex, or 'more straight' in the sense of having the ability to have sex with women but not the ability to enjoy it or to find it preferential to sex with men, and in both cases not being any more comfortable with their same-sex attraction.
This is separate from bihackers (mostly straight-to-bisexual-seeking), where there are a small number of unequivocal success stories who aren't sure if they became bisexual or just became comfortable being bisexual, a tiny number who had organic changes cause overt and undeniable differences in attraction (mostly trans people on hormones, kontextmashine's brain tumor), and then a large majority where it couldn't change their likely romantic (or grindr) focuses even as they became comfortable.
Uh... I was kinda trying to motion around really-really-feminine guys, regardless of the anatomical side; that's just a comic that's really explicit about it without being actual porn on the same page.
But it does apply there, too. I'd kinda naively expected trans men with vaginas to maybe be less psychologically difficult for a 'straight' man trying out gay sex, (and a lot of trans guys reasonably don't like being seen as training wheels), if only in a 'it's nothing you haven't
seenfucked before' sorta way, but your specific reactions seem fairly common for guys who strongly prefer women. Even well before male pattern baldness or mastectomy, most normally-straight guys, no matter how much they've gotten used to the idea of men having sex, aren't into a bit of even soft and downy chest hair. Go figure on that one!For that specific comic, with the warning that it's almost certainly too much information :
Fair. And since I do have an actual orientation play kink, if one that doesn't overlap much with conversion therapy or orientation change (or mind control), so that also makes this whole matter complicated to talk about. I definitely don't want to mix real-world advice and smut-world logic, or pretend that pulling psychoanalysis from smut is going to give some broad and consistent view of human thought.
But I also have to recognize the limits of my introspection, so I can't just say I'm looking at the topic completely dispassionately, either for or against.
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