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In response to the continuing polarizations regarding same-sex attractions and a non-traditional gender, including the continued debates surrounding banning or offering "conversion" therapies, we propose an alternative approach. We call upon families, mental health professionals, lawmakers, professional organizations, religious communities and individuals to move beyond the familiar adversarial strategies and to focus instead on collaborative efforts that foster respectful dialogue and a shared commitment of two core principles of ethical mental health services: 1) facilitate individual self-determination and 2) do no harm.

The ethical principle of self-determination requires that each individual is seen as a whole person and supported in their right to explore, define, articulate and live out their own identity. For that reason, it is essential to acknowledge the broad spectrum of sexual and gender identities and expressions. In order to do so, it is necessary to have an equal understanding of and respect for sexual and gender minorities as well as the religious, spiritual and other ideological values of individuals and communities.

To reduce the risk of harm, it is essential to understand that a person is not mentally ill or developmentally delayed simply because they experience same-sex attractions or a non-traditional gender. While acknowledging that shifts in sexuality and gender identity can and do occur for some people, we believe it is unethical to focus treatment upon an assumption that a change in sexual orientation or gender identity will or must occur. It is also unethical to devalue the religious and other ideological values of others.

We believe the focus of treatment should be on exploring with individuals the source(s) of their distress, their beliefs and values about sexuality/gender, the nuances of their experience with sexuality/gender and realistic outcomes that might occur based on their unique experience. Therapies to help those in distress with their sexual orientation or gender expression are only ethical if each individual is guaranteed a safe environment in which to discover and express their whole authentic self.

Our call to action is for all interested parties in this debate to move beyond the battle lines of exclusion, legislation and litigation. We challenge all parties to create bridges for collaborative engagement with those who are perceived as the "other." We believe that this respectful process will provide more hope and be a more effective route to resolve the distress associated with same-sex attractions or a non-traditional gender.

Lee Beckstead, Ph.D., Aspen Grove Counseling; Jerry Buie, LCSW, Pride Counseling; Shirley Cox, DSW, PhD., BYU School of Social Work; Ty Mansfield, Ph.D. candidate and president, North Star; David Matheson, CMHC; Candice Metzler, Ph.D. candidate and president, Transgender Education Association of Utah; David Pruden, M.A., executive director, Alliance for Therapeutic Choice & Scientific Integrity; Marybeth Raynes, LCSW, Crossroads Psychotherapy; Jim Struve, LCSW, coordinator, LGBTQ-Affirmative Psychotherapy Guild of Utah.