A Top Ten List of Resolutions for Parents Talking to Teens About Sex

Heather Corinna

Here are some suggestions on building a better bridge between you and your teen on sexuality issues...a top ten list for parents to hit it out of the park themselves in 2011.

Chances are, those ten pounds you’ve sworn you’d lose this year are likely your genetic destiny and aren’t going anywhere. Maybe you will send thank you notes by post instead of leaving Facebook thank you messages. But life probably won’t end or be massively changed if you don’t keep those resolutions.

This is one that really matters. It weighs a lot more than ten pounds, and unlike those little numbers on the scale, someone is going to be deeply impacted by whether you do this or not, now and through the whole of their lives.

In my work with young people and sexuality, with each year that passes, there’s something I hear from them with increasing urgency. That’s what parents aren’t doing, or could be doing a lot better than many are. While I can do a lot for young people, I’m not their parent or guardian. They need you far more and more often than they need someone like me. Even when I’m hitting the ball out of the park with them in their sex education and our discussions about sex, without you as their partner in this — without you being Babe Ruth and me being the relief hitter — what I can do is very limited.

I’ve been working in child and teen education of all ages and stages for around 20 years now and in sex education for over a decade. More young people have talked to me about sexuality than anyone else I’ve ever met in my field. I know a thing or two about parenting and certainly about the impact parents can and do have on young people, especially with sexuality. I’m acutely aware of where a lot of them are not getting their needs met, and also aware of how many parents want to do their best to meet those needs, but have a tough time identifying what they are and how to do it.

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I’m not a parent. I’d never suggest I could tell you how to parent your particular child or children or that I acutely understood what it is to parent: I can’t. But what I think I can do, for you and the young people we both care so much about, is help build a better bridge between you in this area by passing on some of what they tell and show me, filling you in on some ways to better parent around sexuality you may not have considered. Here’s my top ten list for parents to hit it out of the park themselves in 2011.

Encourage active consenting and healthy boundaries
Rates of intimate partner violence and/or sexual assault are high for young people. Sexual assault and abuse rates always have been — more sexual abuse and assault happens to people of all genders under the age of 18 than any other age group — and IPV rates among teens have been rising. I had a young woman the other day ask me from whom her sexual partners — who had been awful about her boundaries — could have learned anything about consent and boundaries if not from sexual partners. Her friends had shared with her that they, too, thought that the only way sexual partners could learn about boundaries, and that they matter at all, was from sex partners. The fact that I even had to explain that we learn the most about boundaries from our families growing up speaks volumes.

I counsel survivors of abuse and assault. One of the biggest things many mention is that they did not realize or feel they had a real right to their own physical and emotional space, to their own bodies. It’s hard to see danger coming, or even know when it’s happening, if you haven’t gotten clear messages that someone touching you in ways or at times you don’t want to be touched is never okay. It’s hard to understand how important consent is if you’ve grown up with yours dismissed or not taken very seriously or watched consent — in every respect — be a nonissue in your household.

A child who doesn’t want to kiss Aunt Mabel, but is told they have to and they’re rude or mean not to has been given a clear lesson that denying someone physical contact you don’t want but they do isn’t okay. A child whose parent doesn’t ask if they can snuggle with them in bed, or who doesn’t take no for an answer when a child doesn’t want to, gets the message that consent doesn’t matter. A child who’s touching their parent in a way the parent uncomfortable with, or when they just need some freaking space, and is silently tolerated or only shooed off with hands once you’ve hit your breaking point gets a very different message than one to whom a parent gently but firmly explains that sometimes people want space, and they’d like some for themselves now, please.

Talk about healthy boundaries and consent with them. But you have to show them in action, too. Do what you can to make sure you’re modeling and respecting active consent and healthy boundaries; to encourage and support them in setting and holding their own lines, even with you.

Privacy is part of this picture. When a child or teen wants privacy, and they will tend to want more and more as the years go by, denying it denies them bodily autonomy. If they want the bedroom door closed, let them close it. If they’d rather have a doctor look at their genitals than you, take them to the doctor. If and when they become less comfortable with you seeing them half-dressed, respect that boundary and allow them that privacy even if you don’t understand what the big deal is. Talk about privacy: find out what the young person or people in your home want and need when it comes to their privacy, and make clear that you want to respect whatever that is.

Never “If you ever…”
Many teens I talk with who aren’t asking parents for help when they need it, aren’t being honest with parents about their sex lives or are clearly drowning by trying to make sexual choices when they’re not ready to do that alone report statements parents have made in the past about how they’d react negatively to a hypothetical sexual future. They remember if you said you’d kick them out of the house if they got pregnant, or that you’d not let them see a boyfriend or girlfriend ever again if you found out they were having sex. They tend to interpret those statements as never-changing gospel truth. Not only are those statements scary, they also don’t tend to keep them from doing those things, or keep things from happening to them they don’t even have full control over in the first place. Those kinds of statements only assure they’ll shut you out and go it alone if and when they do.

The only productive “if you ever” statement I can think of around sex and teens is something like, “If X ever happens, I hope that you’ll come to me, knowing and trusting I will do my very best to be supportive of you, will help you as best as I can and will love you, no matter what.”

Help counter sexualization and stereotyping
There’s been increasing awareness about how children, tweens and teens can have external sexualities projected unto them by others and we’ve also been experiencing some cultural backlash around gender roles, status and norms. It’s easy to finger media and marketing for this — and valid — but that’s not the only place this stuff comes from.

For example, all relationships aren’t potential or actual romantic relationships: if your child cultivates a friendship with someone of a different gender, calling Joey their “boyfriend” or or Susie “their girlfriend” — a common oh-isn’t-that-so-cute adult response — not only sends a message everyone is heterosexual, it suggests that relationship is sexual in some way from the onset. People’s value as people shouldn’t be determined by who has or hasn’t had sex, or what someone’s sexual partners look like. Genitals aren’t just about sex (just like all the rest of the body isn’t just about not-sex). Wearing a miniskirt doesn’t mean someone must be advertising sexual availability; asking questions about sex doesn’t mean someone is having any or even wants to. How your daughter looks is only so meaningful, and isn’t only meaningful because of her potential attractiveness to men. These kinds of messages or responses, sent overtly or covertly, are some ways parents may inadvertently play a part in sexualizing.

If I had a nickel for every young person taught by a parent that boys are jerks who just want to get into someone’s pants (we hear this reported as coming from fathers far more than mothers, by the by), that women’s sexuality is only an answer to what men want or that women who have sex without marriage are the enemies of other women (both of which more often are messages from women), that men can’t get hurt, only women can, and women can’t do harm, only men can, that there are only two genders and two sexes and different rules both must follow based on biology, not cultural structures, inequities or ignorance, and a host of other terribly destructive falsehoods swarming around many households, I’d…well, I’d be really annoyed by a house where every room was full of nickels and I couldn’t get to the bathroom.

Stereotypes tend to be awfully self-perpetuating, something people so sure they’re true often seem to dismiss. If you tell a daughter all guys are jerks, and she dates guys, she’ll probably wind up with jerks because you’ve led her to believe that’s just how guys are. If you say that to a son, you’ve just told him no matter what he does, no matter who he is, what’s between his legs means he’s a jerk. If you tell your children everyone who isn’t straight is miserable or that they won’t be able to have a family as a queer person, you’re playing a big part is setting them up to be miserable and not feel empowered to make their own families.

That doesn’t mean you can’t address realities like the fact that some people (no matter their gonads) are self-serving jerks and our world is still homophobic and biphobic enough that it can be rough to be queer. But words like “some” and “can” are your pals. So is talking to them about all their choices and ways of managing their lives so they’re most likely to be happy and healthy, as is recognizing and qualifying your personal experiences as personal, not universal. You can be real without stereotyping and leading them to believe that they, others and their world are a lot more limited than they actually are.

Unpack your own baggage, including any sexual posturing
Sexuality isn’t just loaded and challenging for young people. It’s loaded and challenging for everyone.

It’s common to present adolescence as a sort of sexual convection oven: we go in with no sexuality, and come out fully baked; complete. Not only is it false that we don’t have a sexuality before then, it’s false that at any point in our lives we’re “done” sexually: always ready for a given kind of sex at any time or in any given relationship, and as far as we get in the process of finding out who we sexually are and where our sexuality may or may not take us. I don’t care how old you are, if you’re still breathing, you’re probably not done with your sexuality and it probably isn’t done with you.

Sometimes it’s fantastically exciting to realize we’re never done; other times it can be daunting. Maybe we’d like to feel done. Maybe we worry that if we’re not, our lives may radically change, and something we feel comfortable in will later feel uncomfortable. Maybe seeing how confused young people are, and seeing that we’re really not that much less confused makes us feel embarrassed. Or, we may want to overstate the differences between our sexuality at 40 or 50 and theirs at 16 to feel more expert, or even just seek to comfort them by letting them know that the phase of sexuality they’re in will not always feel so uncomfortable, and shortcut by positioning them as just starting and ourselves as finished.

Hearing that sexuality is a lifelong journey and process makes being in a dawn of that process less scary, and can really take the pressure off them and you. It’s easy for them to make less-than-great sexual choices or rush in if they get the idea that certain things will get them to a finish line. It’s easy to get the idea that having sex proves maturity when so many adults frame it that way. It’s also pretty hard to talk to someone about anything that’s new to you, but you get the message they know everything about and have no challenges with whatsoever. Young people need some agency in these conversations, rather than to feel like parents lord experience over them. Sure, you may have more life experience, but send the message that both your experiences and perspectives matter, especially since sexuality is so personal and so ever-evolving.

Those of us who work in sexuality know our own sexual stuff is going to come up and know we need to stay very aware of that and be mindful in always managing it. It’s clear many parents aren’t prepared for that and are often blindsided when it happens. You don’t have to be a sexual savant or done processing your own sexuality to help with theirs. They don’t need you to know everything about sex, to have seen it all, or to have your whole sexuality sorted. They just need you to be honest with yourself and honest with them, and to try and accept and understand where they are without projecting all of your own stuff onto them, whether that’s about your body image, your own sexual satisfaction, your own teen experiences or even missing some of the way sexuality was or seemed when you were their age. The honesty that you’re also still learning, that it’s still challenging for you, too, can be a real comfort and a great way to connect.

Don’t be a mythmaker
Young people get enough misinformation from peers and the media. Some have even gotten misinformation in school sex education. They don’t need more from you. Teens have shared such parent-generated gems with me as “Condoms don’t work,” “You need to douche or else you’re disgusting,” “HIV is the only STD you need to worry about but if you don’t have sex with gay men, you won’t get it,” “You can’t get pregnant if you have sex during your period,” “Most women only have sex to please their partners,” “You won’t get raped if you don’t dress like that,” and one of my all-time favorites, “Nothing bad will happen to you so long as you only have sex once you’re married.”

Sexuality and sexual health, and information about them, changes all the time. This is my job, so I get to focus on it all day, every day, and I still find it tough to keep up. If it’s not your job, at least some of what you think you know about sexuality and sexual health is probably outdated or incorrect. Your sexual history and sex life also aren’t usually sound sources for information about all of sex and sexuality: only for information about your unique sex life. As well, most people of all ages didn’t get good sexuality education. There are plenty of older adults who still believe things they were taught when they were teens that weren’t true then and still aren’t now.

Try to keep up to date when you’re sharing information, and get some practice at saying, “I don’t know the answer to that, or am not sure what I think is right. Let’s look it up!” You can seek out current information together, using the library, the internet or your family healthcare provider. Not only does that assure you are only sharing accurate, current information, you’re showing a young person that it’s okay not to know the answers, but not smart to assume or guess, and you’re helping them develop skills and practice at finding good information.

Use the media for good
Conversations about our personal sexuality are always going to be emotionally tricky, especially in families. We have to have them sometimes, we want to have them sometimes, but we’re also often afforded much less intimidating ways to start talking about sexuality that can make for much more comfortable inroads.

In the last year alone, television has provided many opportunities to talk about intimate partner violence, abortion, gender politics, and sexual communication. Current events have provided excellent inroads to talk about rape, harassment, tolerance and fairness, teen pregnancy and parenting, reproductive coercion, gender identity and more. These are fantastic opportunities to get just with the click of a remote.

Use what comes up in media to talk with youth about sexuality. Ask them what they think, listen, give your own feedback, and engage deeply. Pay attention in those conversations to cues they’ll give you about where they need more education and information. Not only do conversations about sex in media develop important critical thinking skills with media, vital to young people in such a media-saturated world, it gives everyone much easier routes to crucial and often difficult conversations.

Support outside help
A lot of parents feel they’re failing if they can’t do everything for their kids all by themselves, or if there’s an area where someone else’s skills or role is better suited to serving a child best. If you’ve worked hard as a parent to be someone your kid can talk to, it can sting when they want to talk to someone else instead of you, especially around big issues where you really want to be that person for them. Sometimes parents may be scared of supporting outside help because it may mean you have to take responsibility for something you’re not ready to or come out of denial around something really big.

For instance, I’ve seen parents be nonsupportive of counseling for childhood sexual abuse that a teen who had been victimized wanted, likely because they didn’t feel ready to deal with their guilt abound their child being abused in their family. That feeling is understandable, but it also has done those young people a lot of additional harm by keeping them from help they needed to heal. I’ve heard from teens whose parents have explicitly told them they should never be asking anyone but them about sexuality and have discouraged them from getting a consultation with a healthcare provider or talking to a school counselor when that’s what they wanted and needed.

As a parent, you know things come up with your kids that you may not be ready to deal with, but you’ve got to deal with anyway because they’re in it regardless, and they can’t wait on you. Parenting asks you to be awfully good at a very wide range of things, but everyone has limits. The good news is, you don’t always have to be ready to handle everything yourself, because you can ask for help and give them permission to ask for help, and sometimes they’re going to be served a lot better if you do. If you’re not a healthcare provider, you can’t be their healthcare provider. Even if you are a therapist, it’s not sound for you to be their therapist. You, like all the rest of us, can’t be the expert of everything, and you shouldn’t try to be.

Supporting and encouraging them in asking for help from others who are qualified to give it and supporting and encouraging them to talk to safe people who they feel more comfortable talking to isn’t you not helping them: that is helping them. Plus, if they see you asking for help and supporting help they want, you model that asking for help when we need it is strong, sound and healthy, a powerful message that will benefit them immensely in the whole of their lives, not just their sex lives.

Don’t Be the Judge
When I ask young people in crisis or who are making big choices if they’ve talked to parents or guardians, one of the most common barriers they voice as to why they have not is fear of disappointing you or getting judgment from you. Your opinion of them matters tremendously to them: often it matters most of all.

I know how hard it is to be non-judgmental when it comes to people and sexuality, especially when young people are making sexual choices I don’t feel comfortable with, or which I know are not safe or sound for them. I know it’s very hard sometimes to avoid making judgments, and we all will fail at it sometimes. Our judgments can bleed out despite our best intentions, or we may voice something that we didn’t even realize was a judgment until it’s coming out of our mouths and we cringe at the sound of it. I also know that it’s even harder for parents than for someone like myself who has a very different, far less intense relationship with the young people who talk to me.

You won’t always be able to resist or contain judgment. That’s okay: you just need to try. This is another place where your intention can go a long way. Telling them that whenever you do talk about sexuality you will work hard not to make judgments, and to take responsibility for them when you do, both makes your intent not to judge clear, and gives both of you a way to unpack them if and when they do happen.

Dump “The Sex Talk”
Not only is trying to figure out the exact right time, place and way to have that singular, big “Sex Talk” enough to give you a coronary, sex is complex and far-reaching. It requires so much more than just one talk, one time. Young people need sex talks, and sex talking, not A Sex Talk.

As small children, they may have asked you the names for their genitals or what they’re for. They may have asked you about couples and their relationships, or even about your own. You may have talked with them about masturbation, when and where it’s okay to touch ourselves and when it is and isn’t okay for others to touch us. They may have asked about your adult body and why it looks different from theirs. These are all talks about sexuality, and ideally, they’ve been ongoing and relaxed, happening in real time as these issues come up. Hopefully, you’ve been willing to have those conversations even if they bring them up at the dinner table, or on the bus, rather than shutting down conversation unless it’s happening on your terms and within your own comfort zone.

The more you can normalize discussions about sexuality, and give the clear message it’s okay to talk about whenever they want to talk about it, the more talking about sex you’ll do with them at the times they’re most likely to really absorb the information and the more they’ll bring those talks to you, rather than you having to try and guess when they need them and what they need. Doing that also makes sex seem like less of a super hidey-hole secret, which means they’re less likely to feel ashamed about sexuality or keep sexual secrets from you.

Additionally, if you have the idea that only a parent of the same sex or gender should talk about sex with a given child, think again. The more perspectives a young person can get, the better off they are, and giving them the message that they can’t or shouldn’t be talking to someone of a different gender than they are about sexuality issues can inadvertently discourage young people who do or will have partners of a different gender than they are from talking openly with them. Which parent or guardian a child or teen feels most comfortable talking to about sexuality or a given issue may also have nothing to do with gender. Bear in mind, too, that what gender identity a child has (or was assigned) at one time may not be the gender identity they always have, so you can also assume a gender “match” with a parent that may not be a match at all.

Figure they can — and probably will — have it better than you did
It’s easy to feel bleak about sexuality and adolescence, especially if your experiences as a young person were not positive or comfortable (and all the more so if they still aren’t). But I’d encourage you to elevate your expectations for their sexual selves and lives. Be optimistic and positive. Because you weren’t able to do things like advocate for yourself sexually with a partner, practice safer sex well, make sexual choices you felt good about or feel good about your sexual body doesn’t mean they can’t or won’t.
How sex or a given romantic relationship went for you in high school of college is not a sound benchmark for how it might go or is going for them. Their world isn’t your world, and they are not you.

Most likely, your experiences were the way they were for a host of reasons, few of them just because you were a young person, and a lot of them because the people raising you didn’t do serve you well with sexuality. But just like your kids and teens may do things better than their parents, the same is true for you. If you care enough to read pieces like this, it’s very likely your kids will have it better than you did. After all, they’ve got something you didn’t have: they have you as a parent.

You’re doing your best to do a better job in this for them than your parents or guardians did for you. You have resources they didn’t, information they didn’t and a much better understanding of how important this is.

You’re going to be there for them and will always make time for them if and when they want to talk to you and you will do your very best to listen and support them, even if it’s hard, upsetting or scary. Know that. Say that to them and mean it. Say it often, even if they don’t come to you or seem to blow that statement off. And if and when they take you up on it, make sure you step up to the plate and do just that. Even if that is all you do, know that you are serving them really well, and things really will probably go better for them than they did for you, thanks to you.

A piece like this is only the tip of the iceberg. If you want to find out more about doing a great job with, I highly recommend books like Logan Levkoff’s Third Base Ain’t What It Used to Be: What Your Kids Are Learning About Sex Today and How to Teach Them to Become Sexually Healthy Adults, Debra Haffner’s From Diapers to Dating: A Parent’s Guide to Raising Sexually Healthy Children, Evelyn Resh’s The Secret Lives of Teen Girls: What Your Mother Wouldn’t Talk about but Your Daughter Needs to Know, Pepper Schwartz’s Ten Talks Parents Must Have with Their Children about Sex and Character or So Sexy So Soon: The New Sexualized Childhood and What Parents Can Do to Protect Their Kids by Diane Levin and Jean Kilbourne. More visually inclined? Check out educator Amy Lang’s DVD series for parents here. The Moms in Babeland blog is also a great resource (I wish I had something similar to link to for Dads!).

Analysis Law and Policy

Do Counselors-in-Training Have the Right to Discriminate Against LGBTQ People?

Greg Lipper

Doctors can't treat their patients with leeches; counselors can't impose their beliefs on patients or harm them using discredited methods. Whatever their views, medical professionals have to treat their clients competently.

Whether they’re bakers, florists, or government clerks, those claiming the right to discriminate against LGBTQ people have repeatedly sought to transform professional services into constitutionally protected religious speech. They have grabbed headlines for refusing, for example, to grant marriage licenses to same-sex couples or to make cakes for same-sex couples’ weddings-all in the name of “religious freedom.”

A bit more quietly, however, a handful of counseling students at public universities have challenged their schools’ nondiscrimination and treatment requirements governing clinical placements. In some cases, they have sought a constitutional right to withhold treatment from LGBTQ clients; in others, they have argued for the right to directly impose their religious and anti-gay views on their clients.

There has been some state legislative maneuvering on this front: Tennessee, for instance, recently enacted a thinly veiled anti-LGBTQ measure that would allow counselors to deny service on account of their “sincerely held principles.” But when it comes to the federal Constitution, providing medical treatment—whether bypass surgery, root canal, or mental-health counseling—isn’t advocacy (religious or otherwise) protected by the First Amendment. Counselors are medical professionals; they are hired to help their clients, no matter their race, religion, or sexual orientation, and no matter the counselors’ beliefs. The government, moreover, may lawfully prevent counselors from harming their clients, and universities in particular have an interest, recognized by the U.S. Supreme Court, in preventing discrimination in school activities and in training their students to work with diverse populations.

The plaintiffs in these cases have nonetheless argued that their schools are unfairly and unconstitutionally targeting them for their religious beliefs. But these students are not being targeted, any more than are business owners who must comply with civil rights laws. Instead, their universities, informed by the rules of the American Counseling Association (ACA)—the leading organization of American professional counselors—merely ask that all students learn to treat diverse populations and to do so in accordance with the standard of care. These plaintiffs, as a result, have yet to win a constitutional right to discriminate against or impose anti-LGBTQ views on actual or prospective clients. But cases persist, and the possibility of conflicting court decisions looms.

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Keeton v. Anderson-Wiley

The first major challenge to university counseling requirements came from Jennifer Keeton, who hoped to receive a master’s degree in school counseling from Augusta State University. As detailed in the 2011 11th Circuit Court of Appeals decision considering her case, Keeton entered her professional training believing that (1) “sexual behavior is the result of personal choice for which individuals are accountable, not inevitable deterministic forces”; (2) “gender is fixed and binary (i.e., male or female), not a social construct or personal choice subject to individual change”; and “homosexuality is a ‘lifestyle,’ not a ‘state of being.'”

It wasn’t those views alone, however, that sunk her educational plans. The problem, rather, was that Keeton wanted to impose her views on her patients. Keeton had told both her classmates and professors about her clinical approach at a university-run clinic, and it wasn’t pretty:

  • She would try to change the sexual orientation of gay clients;
  • If she were counseling a sophomore student in crisis questioning his sexual orientation, she would respond by telling the student that it was not OK to be gay.
  • If a client disclosed that he was gay, she would tell him that his behavior was wrong and try to change it; if she were unsuccessful, she would refer the client to someone who practices “conversion therapy.”

Unsurprisingly, Keeton also told school officials that it would be difficult for her to work with LGBTQ clients.

Keeton’s approach to counseling not only would have flouted the university’s curricular guidelines, but also would have violated the ACA’s Code of Ethics.

Her conduct would have harmed her patients as well. As a school counselor, Keeton would inevitably have to counsel LGBTQ clients: 57 percent of LGBTQ students have sought help from a school professional and 42 percent have sought help from a school counselor. Suicide is the leading cause of death for LGBTQ adolescents; that’s twice or three times the suicide rate afflicting their heterosexual counterparts. And Keeton’s preferred approach to counseling LGBTQ students would harm them: LGBTQ students rejected by trusted authority figures are even more likely to attempt suicide, and anti-gay “conversion therapy” at best doesn’t work and at worst harms patients too.

Seeking to protect the university’s clinical patients and train her to be a licensed mental health professional, university officials asked Keeton to complete a remediation plan before she counseled students in her required clinical practicum. She refused; the university expelled her. In response, the Christian legal group Alliance Defending Freedom sued on her behalf, claiming that the university violated her First Amendment rights to freedom of speech and the free exercise of religion.

The courts disagreed. The trial court ruled against Keeton, and a panel of the U.S. Court of Appeals for the 11th Circuit unanimously upheld the trial court’s ruling. The 11th Circuit explained that Keeton was expelled not because of her religious beliefs, but rather because of her “own statements that she intended to impose her personal religious beliefs on clients and refer clients to conversion therapy, and her own admissions that it would be difficult for her to work with the GLBTQ population and separate her own views from those of the client.” It was Keeton, not the university, who could not separate her personal beliefs from the professional counseling that she provided: “[F]ar from compelling Keeton to profess a belief or change her own beliefs about the morality of homosexuality, [the university] instructs her not to express her personal beliefs regarding the client’s moral values.”

Keeton, in other words, crossed the line between beliefs and conduct. She may believe whatever she likes, but she may not ignore academic and professional requirements designed to protect her clients—especially when serving clients at a university-run clinic.

As the court explained, the First Amendment would not prohibit a medical school from requiring students to perform blood transfusions in their clinical placements, nor would it prohibit a law school from requiring extra ethics training for a student who “expressed an intent to indiscriminately disclose her client’s secrets or violate another of the state bar’s rules.” Doctors can’t treat their patients with leeches; counselors can’t impose their beliefs on patients or harm them using discredited methods. Whatever their views, medical professionals have to treat their clients competently.

Ward v. Polite

The Alliance Defending Freedom’s follow-up case, Ward v. Polite, sought to give counseling students the right to withhold service from LGBTQ patients and also to practice anti-gay “conversion therapy” on those patients. The case’s facts were a bit murkier, and this led the appeals court to send it to trial; as a result, the student ultimately extracted only a modest settlement from the university. But as in Keeton’s case, the court rejected in a 2012 decision the attempt to give counseling students the right to impose their religious views on their clients.

Julea Ward studied counseling at Eastern Michigan University; like Keeton, she was training to be a school counselor. When she reviewed the file for her third client in the required clinical practicum, she realized that he was seeking counseling about a romantic relationship with someone of the same sex. As the Court of Appeals recounted, Ward did not want to counsel the client about this topic, and asked her faculty supervisor “(1) whether she should meet with the client and refer him [to a different counselor] only if it became necessary—only if the counseling session required Ward to affirm the client’s same-sex relationship—or (2) whether the school should reassign the client from the outset.” Although her supervisor reassigned the client, it was the first time in 20 years that one of her students had made such a request. So Ward’s supervisor scheduled a meeting with her.

Then things went off the rails. Ward, explained the court, “reiterated her religious objection to affirming same-sex relationships.” She told university officials that while she had “no problem counseling gay and lesbian clients,” she would counsel them only if “the university did not require her to affirm their sexual orientation.” She also refused to counsel “heterosexual clients about extra-marital sex and adultery in a values-affirming way.” As for the professional rules governing counselors, Ward said, “who’s the [American Counseling Association] to tell me what to do. I answer to a higher power and I’m not selling out God.”

All this led the university to expel Ward, and she sued. She claimed that the university violated her free speech and free exercise rights, and that she had a constitutional right to withhold affirming therapy relating to any same-sex relationships or different-sex relationships outside of marriage. Like Keeton, Ward also argued that the First Amendment prohibited the university from requiring “gay-affirmative therapy” while prohibiting “reparative therapy.” After factual discovery, the trial court dismissed her case.

On appeal before the U.S. Court of Appeals for the Sixth Circuit, Ward eked out a narrow and temporary win: The court held that the case should go to a jury. Because the university did not have a written policy prohibiting referrals, and based on a few troubling faculty statements during Ward’s review, the court ruled that a reasonable jury could potentially find that the university invoked a no-referrals policy “as a pretext for punishing Ward’s religious views and speech.” At the same time, the court recognized that a jury could view the facts less favorably to Ward and rule for the university.

And although the decision appeared to sympathize with Ward’s desire to withhold service from certain types of clients, the court flatly rejected Ward’s sweeping arguments that she had the right to stray from the school curriculum, refuse to counsel LGBTQ clients, or practice anti-gay “conversion therapy.” For one, it said, “Curriculum choices are a form of school speech, giving schools considerable flexibility in designing courses and policies and in enforcing them so long as they amount to reasonable means of furthering legitimate educational ends.” Thus, the problem was “not the adoption of this anti-discrimination policy, the existence of the practicum class or even the values-affirming message the school wants students to understand and practice.” On the contrary, the court emphasized “the [legal] latitude educational institutions—at any level—must have to further legitimate curricular objectives.”

Indeed, the university had good reason to require counseling students—especially those studying to be school counselors—to treat diverse populations. A school counselor who refuses to counsel anyone with regard to nonmarital, nonheterosexual relationships will struggle to find clients: Nearly four in five Americans have had sex by age 21; more than half have done so by the time they turn 18, while only 6 percent of women and 2 percent of men are married by that age.

In any event, withholding service from entire classes of people violates professional ethical rules even for nonschool counselors. Although the ACA permits client referrals in certain circumstances, the agency’s brief in Ward’s case emphasized that counselors may not refuse to treat entire groups. Ward, in sum, “violated the ACA Code of Ethics by refusing to counsel clients who may wish to discuss homosexual relationships, as well as others who fail to comport with her religious teachings, e.g., persons who engage in ‘fornication.'”

But Ward’s approach would have been unethical even if, in theory, she were permitted to withhold service from each and every client seeking counseling related to nonmarital sex (or even marital sex by same-sex couples). Because in many cases, the need for referral would arise well into the counseling relationship. And as the trial court explained, “a client may seek counseling for depression, or issues with their parents, and end up discussing a homosexual relationship.” No matter what the reason, mid-counseling referrals harm clients, and such referrals are even more harmful if they happen because the counselor disapproves of the client.

Fortunately, Ward did not win the sweeping right to harm her clients or otherwise upend professional counseling standards. Rather, the court explained that “the even-handed enforcement of a neutral policy”—such as the ACA’s ethical rules—”is likely to steer clear of the First Amendment’s free-speech and free-exercise protections.” (Full disclosure: I worked on an amicus brief in support of the university when at Americans United.)

Ward’s lawyers pretended that she won the case, but she ended up settling it for relatively little. She received only $75,000; and although the expulsion was removed from her record, she was not reinstated. Without a graduate counseling degree, she cannot become a licensed counselor.

Cash v. Hofherr

The latest anti-gay counseling salvo comes from Andrew Cash, whose April 2016 lawsuit against Missouri State University attempts to rely on yet murkier facts and could wind up, on appeal, in front of the more conservative U.S. Court of Appeals for the Eighth Circuit. In addition to his range of constitutional claims (freedom of speech, free exercise of religion, equal protection of law), he has added a claim under the Missouri Religious Freedom Restoration Act.

The complaint describes Cash as “a Christian with sincerely-held beliefs”—as opposed to insincere ones, apparently—”on issues of morality.” Cash started his graduate counseling program at Missouri State University in September 2007. The program requires a clinical internship, which includes 240 hours of in-person client contact. Cash decided to do his clinical internship at Springfield Marriage and Family Institute, which appeared on the counseling department’s list of approved sites. Far from holding anti-Christian bias, Cash’s instructor agreed that his proposed class presentation on “Christian counseling and its unique approach and value to the Counseling profession” was an “excellent” idea.

But the presentation itself revealed that Cash intended to discriminate against LGBTQ patients. In response to a question during the presentation, the head of the Marriage and Family Institute stated that “he would counsel gay persons as individuals, but not as couples, because of his religious beliefs,” and that he would “refer the couple for counseling to other counselors he knew who did not share his religious views.” Because discrimination on the basis of sexual orientation violates ACA guidelines, the university determined that Cash should not continue counseling at the Marriage and Family Institute and that it would be removed from the approved list of placements. Cash suggested, however, that he should be able to withhold treatment from same-sex couples.

All this took place in 2011. The complaint (both the original and amended versions) evades precisely what happened between 2012 and 2014, when Cash was finally expelled. You get the sense that Cash’s lawyers at the Thomas More Society are trying to yadda-yadda-yadda the most important facts of the case.

In any event, the complaint does acknowledge that when Cash applied for a new internship, he both ignored the university’s instructions that the previous hours were not supposed to count toward his requirement, and appeared to be “still very much defend[ing] his previous internship stating that there was nothing wrong with it”—thus suggesting that he would continue to refuse to counsel same-sex couples. He continued to defend his position in later meetings with school officials; by November 2014, the university removed him from the program.

Yet in challenging this expulsion, Cash’s complaint says that he was merely “expressing his Christian worldview regarding a hypothetical situation concerning whether he would provide counseling services to a gay/homosexual couple.”

That’s more than just a worldview, though. It also reflects his intent to discriminate against a class of people—in a manner that violates his program’s requirements and the ACA guidelines. Whether hypothetically or otherwise, Cash stated and reiterated that he would withhold treatment from same-sex couples. A law student who stated, as part of his clinic, that he would refuse to represent Christian clients would be announcing his intent to violate the rules of professional responsibility, and the law school could and would remove him from the school’s legal clinic. And they could and would do so even if a Christian client had yet to walk in the door.

But maybe this was just a big misunderstanding, and Cash would, in practice, be willing and able to counsel same-sex couples? Not so, said Cash’s lawyer from the Thomas More Society, speaking about the case to Christian news outlet WORLD: “I think Christians have to go on the offensive, or it’s going to be a situation like Sodom and Gomorrah in the Bible, where you aren’t safe to have a guest in your home, with the demands of the gay mob.” Yikes.

Although Cash seems to want a maximalist decision allowing counselors and counseling students to withhold service from LGBTQ couples, it remains to be seen how the case will turn out. The complaint appears to elide two years’ worth of key facts in order to present Cash’s claims as sympathetically as possible; even if the trial court were to rule in favor of the university after more factual development, Cash would have the opportunity to appeal to the U.S. Court of Appeals for the Eighth Circuit, one of the country’s most conservative federal appeals courts.

More generally, we’re still early in the legal battles over attempts to use religious freedom rights as grounds to discriminate; only a few courts across the country have weighed in. So no matter how extreme Cash or his lawyers may seem, it’s too early to count them out.

* * *

The cases brought by Keeton, Ward, and Cash not only attempt to undermine anti-discrimination policies. They also seek to change the nature of the counselor-client relationship. Current norms provide that a counselor is a professional who provides a service to a client. But the plaintiffs in these cases seem to think that counseling a patient is no different than lecturing a passerby in the town square, in that counseling a patient necessarily involves expressing the counselor’s personal and religious beliefs. Courts have thus far rejected these attempts to redefine the counselor-patient relationship, just as they have turned away attempts to challenge bans on “reparative therapy.”

The principles underlying the courts’ decisions protect more than just LGBTQ clients. As the 11th Circuit explained in Keeton, the university trains students to “be competent to work with all populations, and that all students not impose their personal religious values on their clients, whether, for instance, they believe that persons ought to be Christians rather than Muslims, Jews or atheists, or that homosexuality is moral or immoral.” Licensed professionals are supposed to help their clients, not treat them as prospective converts.

News Law and Policy

Texas Lawmaker’s ‘Coerced Abortion’ Campaign ‘Wildly Divorced From Reality’

Teddy Wilson

Anti-choice groups and lawmakers in Texas are charging that coerced abortion has reached epidemic levels, citing bogus research published by researchers who oppose legal abortion care.

A Texas GOP lawmaker has teamed up with an anti-choice organization to raise awareness about the supposed prevalence of forced or coerced abortion, which critics say is “wildly divorced from reality.”

Rep. Molly White (R-Belton) during a press conference at the state capitol on July 13 announced an effort to raise awareness among public officials and law enforcement that forced abortion is illegal in Texas.

White said in a statement that she is proud to work alongside The Justice Foundation (TJF), an anti-choice group, in its efforts to tell law enforcement officers about their role in intervening when a pregnant person is being forced to terminate a pregnancy. 

“Because the law against forced abortions in Texas is not well known, The Justice Foundation is offering free training to police departments and child protective service offices throughout the State on the subject of forced abortion,” White said.

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White was joined at the press conference by Allan Parker, the president of The Justice Foundation, a “Christian faith-based organization” that represents clients in lawsuits related to conservative political causes.

Parker told Rewire that by partnering with White and anti-choice crisis pregnancy centers (CPCs), TJF hopes to reach a wider audience.

“We will partner with anyone interested in stopping forced abortions,” Parker said. “That’s why we’re expanding it to police, social workers, and in the fall we’re going to do school counselors.”

White only has a few months remaining in office, after being defeated in a closely contested Republican primary election in March. She leaves office after serving one term in the state GOP-dominated legislature, but her short time there was marked by controversy.

During the Texas Muslim Capitol Day, she directed her staff to “ask representatives from the Muslim community to renounce Islamic terrorist groups and publicly announce allegiance to America and our laws.”

Heather Busby, executive director of NARAL Pro-Choice Texas, said in an email to Rewire that White’s education initiative overstates the prevalence of coerced abortion. “Molly White’s so-called ‘forced abortion’ campaign is yet another example that shows she is wildly divorced from reality,” Busby said.

There is limited data on the how often people are forced or coerced to end a pregnancy, but Parker alleges that the majority of those who have abortions may be forced or coerced.

‘Extremely common but hidden’

“I would say that they are extremely common but hidden,” Parker said. “I would would say coerced or forced abortion range from 25 percent to 60 percent. But, it’s a little hard be to accurate at this point with our data.”

Parker said that if “a very conservative 10 percent” of the about 60,000 abortions that occur per year in Texas were due to coercion, that would mean there are about 6,000 women per year in the state that are forced to have an abortion. Parker believes that percentage is much higher.

“I believe the number is closer to 50 percent, in my opinion,” Parker said. 

There were 54,902 abortions in Texas in 2014, according to recently released statistics from the Texas Department of State Health Services (DSHS). The state does not collect data on the reasons people seek abortion care. 

White and Parker referenced an oft cited study on coerced abortion pushed by the anti-choice movement.

“According to one published study, sixty-four percent of American women who had abortions felt forced or unduly pressured by someone else to have an unwanted abortion,” White said in a statement.

This statistic is found in a 2004 study about abortion and traumatic stress that was co-authored by David Reardon, Vincent Rue, and Priscilla Coleman, all of whom are among the handful of doctors and scientists whose research is often promoted by anti-choice activists.

The study was cited in a report by the Elliot Institute for Social Sciences Research, an anti-choice organization founded by Reardon. 

Other research suggests far fewer pregnant people are coerced into having an abortion.

Less than 2 percent of women surveyed in 1987 and 2004 reported that a partner or parent wanting them to abort was the most important reason they sought the abortion, according to a report by the Guttmacher Institute.

That same report found that 24 percent of women surveyed in 1987 and 14 percent surveyed in 2004 listed “husband or partner wants me to have an abortion” as one of the reasons that “contributed to their decision to have an abortion.” Eight percent in 1987 and 6 percent in 2004 listed “parents want me to have an abortion” as a contributing factor.

‘Flawed research’ and ‘misinformation’  

Busby said that White used “flawed research” to lobby for legislation aimed at preventing coerced abortions in Texas.

“Since she filed her bogus coerced abortion bill—which did not pass—last year, she has repeatedly cited flawed research and now is partnering with the Justice Foundation, an organization known to disseminate misinformation and shameful materials to crisis pregnancy centers,” Busby said.  

White sponsored or co-sponsored dozens of bills during the 2015 legislative session, including several anti-choice bills. The bills she sponsored included proposals to increase requirements for abortion clinics, restrict minors’ access to abortion care, and ban health insurance coverage of abortion services.

White also sponsored HB 1648, which would have required a law enforcement officer to notify the Department of Family and Protective Services if they received information indicating that a person has coerced, forced, or attempted to coerce a pregnant minor to have or seek abortion care.

The bill was met by skepticism by both Republican lawmakers and anti-choice activists.

State affairs committee chairman Rep. Byron Cook (R-Corsicana) told White during a committee hearing the bill needed to be revised, reported the Texas Tribune.

“This committee has passed out a number of landmark pieces of legislation in this area, and the one thing I think we’ve learned is they have to be extremely well-crafted,” Cook said. “My suggestion is that you get some real legal folks to help engage on this, so if you can keep this moving forward you can potentially have the success others have had.”

‘Very small piece of the puzzle of a much larger problem’

White testified before the state affairs committee that there is a connection between women who are victims of domestic or sexual violence and women who are coerced to have an abortion. “Pregnant women are most frequently victims of domestic violence,” White said. “Their partners often threaten violence and abuse if the woman continues her pregnancy.”

There is research that suggests a connection between coerced abortion and domestic and sexual violence.

Dr. Elizabeth Miller, associate professor of pediatrics at the University of Pittsburgh, told the American Independent that coerced abortion cannot be removed from the discussion of reproductive coercion.

“Coerced abortion is a very small piece of the puzzle of a much larger problem, which is violence against women and the impact it has on her health,” Miller said. “To focus on the minutia of coerced abortion really takes away from the really broad problem of domestic violence.”

A 2010 study co-authored by Miller surveyed about 1,300 men and found that 33 percent reported having been involved in a pregnancy that ended in abortion; 8 percent reported having at one point sought to prevent a female partner from seeking abortion care; and 4 percent reported having “sought to compel” a female partner to seek an abortion.

Another study co-authored by Miller in 2010 found that among the 1,300 young women surveyed at reproductive health clinics in Northern California, about one in five said they had experienced pregnancy coercion; 15 percent of the survey respondents said they had experienced birth control sabotage.

‘Tactic to intimidate and coerce women into not choosing to have an abortion’

TJF’s so-called Center Against Forced Abortions claims to provide legal resources to pregnant people who are being forced or coerced into terminating a pregnancy. The website includes several documents available as “resources.”

One of the documents, a letter addressed to “father of your child in the womb,” states that that “you may not force, coerce, or unduly pressure the mother of your child in the womb to have an abortion,” and that you could face “criminal charge of fetal homicide.”

The letter states that any attempt to “force, unduly pressure, or coerce” a women to have an abortion could be subject to civil and criminal charges, including prosecution under the Federal Unborn Victims of Violence Act.

The document cites the 2007 case Lawrence v. State as an example of how one could be prosecuted under Texas law.

“What anti-choice activists are doing here is really egregious,” said Jessica Mason Pieklo, Rewire’s vice president of Law and the Courts. “They are using a case where a man intentionally shot his pregnant girlfriend and was charged with murder for both her death and the death of the fetus as an example of reproductive coercion. That’s not reproductive coercion. That is extreme domestic violence.”

“To use a horrific case of domestic violence that resulted in a woman’s murder as cover for yet another anti-abortion restriction is the very definition of callousness,” Mason Pieklo added.

Among the other resources that TJF provides is a document produced by Life Dynamics, a prominent anti-choice organization based in Denton, Texas.

Parker said a patient might go to a “pregnancy resource center,” fill out the document, and staff will “send that to all the abortionists in the area that they can find out about. Often that will stop an abortion. That’s about 98 percent successful, I would say.”

Reproductive rights advocates contend that the document is intended to mislead pregnant people into believing they have signed away their legal rights to abortion care.

Abortion providers around the country who are familiar with the document said it has been used for years to deceive and intimidate patients and providers by threatening them with legal action should they go through with obtaining or providing an abortion.

Vicki Saporta, president and CEO of the National Abortion Federation, previously told Rewire that abortion providers from across the country have reported receiving the forms.

“It’s just another tactic to intimidate and coerce women into not choosing to have an abortion—tricking women into thinking they have signed this and discouraging them from going through with their initial decision and inclination,” Saporta said.

Busby said that the types of tactics used by TFJ and other anti-choice organizations are a form of coercion.

“Everyone deserves to make decisions about abortion free of coercion, including not being coerced by crisis pregnancy centers,” Busby said. “Anyone’s decision to have an abortion should be free of shame and stigma, which crisis pregnancy centers and groups like the Justice Foundation perpetuate.”

“Law enforcement would be well advised to seek their own legal advice, rather than rely on this so-called ‘training,” Busby said.