012 declaration of dr michelle cretella college of pediatricians by Mauck Baker

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 1 of 13 PageID #:99

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DTSTRICT OF

ILLINOIS

PASTORS PROTECTING YOUTH, et al.

Plaintifs,

Honorablc Ronald A. Cuzman Case No:

l:16-cv-08034

FI LE

Lisa lVladigan, Illinois Attorney Ccneral, in her Official Capacity,

sEP

8 2016

THOMAS G. BRUTON

Defendants

cuiiK

DECLARATION OF DR. MICHELLE CRETELLA, Mq.,.F'CP THE PRESIDENT OF THE qOLLEGE OF PEDIATRI.CIANS [, Michclle Cretclla, declare under the penalty of perjury, pursuant to 28 USC sec. t746

a.s

follows:

I' I am the President of the American

College of Pediatricians. I am a rerired board certified

general pediatrician with a special interest in adolescent mental and sexual health. I am a retired

medical doctor who practiced pediatric medicine in the states of Connecticut, Virginia and Rhode Island between 1994 and 2013. I have been certified by the American Board of pediatrics since October 1997.1

' I graduated from the University of Connecticut School of Medicine in

U.S. DISTRICT COURT

1994; completed my internship and residency in general Pediatrics with honors at Connecticut Children;s Medical Center in 1997, and completed a College Health Fellowship at rhe University of Virginia Healrh Center in I999. I have served on the Board of the American College of Pediatricians since 2005 during which time I also Chaired the Adolescent Sexuality Commirree, rhe pediatric Psychosocial Development Committee and the Scienrific Policy Commitree. From 2010-2015 t served on the Board of Directors for the Alliance for Therapeutic Choice and Scientific Integrity (formerly the National Association for Research and Therapy of Homosexuality or NARTH). I continue to serve on the Medical Committee of the Alliance for Therapeutic Choice. My full time position as President of the American College of Pediatricians began in April of 2015. Avocations include personal training, youth ministry and serving as a certified ibstinence

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 2 of 13 PageID #:100

2. In addition to being

the President of the American College of Pediatricians, I served on the

Board of Directors of the Alliance for Therapeutic Choice and Scientific Integrity (formerly the

National Association for Research and Therapy of Homosexuality or NARTH) from 2010-201 5, and continue to serve on the Medical Committee

of the Alliance for Therapeutic Choice.

I have conducted a review of the scientific literature regarding whether sexual orientation is

changeable or immutable, and what follows are my findings and conclusions:

The Scientific and Medical Literature Demonstrates that Sexual Attractions ArF Fluid

4. Ronald Bayer in his well researched book, Homosexuality

and American Psychiatry: The

Politics of Diagnoses, notes that in reviewing the history of debate in both the American Psychiatric Association and the American Psychological Association, it is clear that the decision to remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM

II) was never

based on any new science concerning homosexuality or any re-evaluation of the

current research at that time. Instead, the impetus for removal was potitical pressure from homosexual activists and the desire to decrease discrimination and harassment sustained by gay-

identified individuals. Bayer essentially states that the declassification of homosexuality from the list of mental disorders should not be viewed as a "proximation of scientific truth" but rather as "an action demanded by the ideological temper of the times."l

5' Accordingly, Dr. Judd Marmor, a past president of the American Psychiatric Association who was instrumental in removing homosexuality from the DSM

II, acknowledged that

homosexuality had multiple roots and was in fact malleable. Even after homosexuatity was removed from the DSM

as a diagnosis he stated, "The fact that most homosexual preferences

educator for my local Catholic school. I live in Rhode Island with my husband of twenty-two years and our four children.

'Bayer, Ronald. Homosexuality and American Psychiatry: The Politics of Diagnoses, princeton U. Press (1987), p.4

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 3 of 13 PageID #:101

are probably learned and not inborn means that, in the presence

of strong motivation to change,

they are open to modification, and clinical experience confirms this."l 6. Dccade.s ol'research and clinical experience confirms that homosexuality is not a biologically determined trait like race. Environment - who we interact with and horv, and the culture at large play a major role in l'orming one's sexual orientrtion. Sexual orientation is not tixed at birth but rather is environmentally shaped and unfolds slowly across childhood, adolescence and even into

adutthood for some individuals.{ Francis Collins, MD, fornrer director of the Human Genome Project and currcnt director of the NlH. hos concluded that "there is an inescapable cornponent of

heritability to many hulnan behavioral traits. For virtually none of thenr is herrdity ever clo.se to predictive." Regarding ltomosexuality, he states "se.\ual orientation is genetically influenced but not hardwired by DNA ... whatever genes are involved represe nt predispositions, not

Marmor, J. Homosexual Behavior: A Modern Reappraisal. New York: Basic Books, 1980, p. 276-277.

Whitehead, Neit. My Genes Made Me Do It! accessed 5/6/13 from http://www.mygenes.co.n/download.htm; Langstrom, N, Rahman Q, Carlstrom, E, Lichtenstein, P. (2008). Genetic and environmental effects on same- sexual behavior: A population study of twins in Sweden. Archives of Sexual Belmvior, DOI I 0. l007ls 10508-008- 9386- I ; Santilla P, Sandnabba NK, Harlaar N, Varjonen M, Alanko K, von der Pahlen B. (2003). Potentiat for homosexual response is prevalent and genetic . Biotogical Psychology,77, lA2-105; Bailey, J.M., Dunne, M.P., & Martin, N.G. (2000). Genetic and environmental influences on sexual orientation and its correlates in an Australian twin sample. Jounwl of Personality ancl Social Psychologl,, 78 (3), 524-536; Bearman, P.s., & Bruckner, H. (2002). opposite-sex twins and adolescent same-sex attrac(ion. Americort Jounrul af Sociology, 107 (5), I 179- 1205; Frisch, M. & Hviid, A. (2006). Childhood family correlates of heterosexual and homosexual marriages: A national cohort study to two million Danes. Archives of Se.wnl Behavior,3s, 533-547. Satinover, Jeffery. "How Might Homosexuality Develop? Putting the pieces Together." http:l/www.narth.comldocs/pieces.html; Whitehead, Neil "20A2 Study Shows The Importance of Social Factors, Cannot Detect Genetic Factors in SSA." http:l'www.narth.com/docs/detect.html

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 4 of 13 PageID #:102

predeterminations."' Environmcnt und frec wilt decisions interact with

the.se predisposition.s and

play an intportant role in the developnrent of same-.sex ilttraction (SSA). In 2008 the American Psychological Association noted thut a rnajority of researchcrs agree thut sexual orientation dcvelops from a comtrination of environmental and biologicat inl'luences.6 The debate concerns whether or not change of sexual orientation is enduring or even possible.

7. Homosexuality aflirming

researchcrs believc tlrat inborn biological l'actors trump any

environmental contribution. Therefore, they consider sexual orientation to be imntutable. These researchers

tnd therapists view SSA as a normal variant of human sexual development. Any

effort to alter or eliminate SSA is equated with trying to change a person's ethnicity. Homo.sexuality affirnring therapists therefore oppose re-orienration therapy in nllcase.s, arguing

lhut those who ure arnbivalent about their same-sex attractions actually suffer from "internalized hornophobia" and require counseling that rvill allorv them to accepl their innate homosexuality. However, as noted above, tlre.scientific literature does not support thi.s innate/essentialist view of homoscxuality. 8. Consecluently, other researchers maintain that .science tells a very clifferent story -, one ol'

minimal biological influence, and a high degree of sexual fluiclity. They argue thut nn objective review ol'tlre data strongly suggests that unwanted SSA is changeable for many rvho desire that otltcotne. These therapists considcr all SSA to he a developmental psychosexual adaptation.

Collins F.The Language ofGod: A Scientist Presents Evidence for Belief. New York. Free Press.2AO7 {p.260) 6

American Psychological Association 2008 Task Force Report on the origins of homosexuality accessed May 14, 2013 from: http:/lwww,apa.org/topics/sexuality/orientation.aspx, p.4.

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 5 of 13 PageID #:103

They are also unitcd in the delense of a client's right to infbrmed consent and self deterrnination.?"8

This divergence of opinion regarding homo.sexuality and sexual orientation change el'lbrrs is

recognized in sonte current rnedical textbooks, including the 2009 edition of Essential

Psychopathology and lts Treatment. On page 468 ol'this text the currenr science regarding the nature of homosexuality and its fluidity is..;ummarized as follows:

"While nrany mental health care providers and professional associations have expressed considerable skepticism that sexual orientation could be chunged through psychotherapy and ulso assumed tlrat therapeul.ic attempts at reorientiltion would produce harm, recent

empirical evidence dentonstrates that honrosexual orientation can indeed be therapeutically changed in motivated clients lnd that reorientation therilpy does not producc emotional l'lann."l)

Adventitious Chanse 10. Before reviewing some of the literature regarding therapeutic attempts to change sexual orientation, it is appropriate to note thc evidence for spontaneous change of sexual orientation. Thc American P.sychiatric Association acknowledge.s the existence of sexual fluiclity: "Sonte people believe that sexual oricntation is innate ancl fixed; however, sexual orientution clevelops across a person's lifetime. lndividuals may become arvare at different points in their lives that

they are hetcrosexual, gay, lcsbian. transgender, or bisexual."l0 That enduring change ol'sexuul

Satinover, Jeffery. Homosexuality and the Politics of Truth. Baker Book House Company, Crand Rapids, MI,1996.

I Nicolosi, J. and Nicolosi, L. A Parent's Cuide to Preventing Homosexuality. Intervarsity press, Downers Crove, IL, 2002. s

Maxmen, J. S., et al. (2009). Essential Psychopathology and its Treatment, 3rd edition, New York: Norton and Co. 10 American Psychiatric Association 2008 On-line Fact Sheet Regarding FAQs about sexual orientation available at: http:l/www.psychiatry.org/mental-health/people/lgbt-sexual-orienration (accessed May I 7, 2013).

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 6 of 13 PageID #:104

attractions and behaviors may occur adventitiously has been recognized and documented lor decacles.r' In his book

1,1.v

Geues lvlude lvla

It!

scientiJic

lrx*

trt Sexuul Orientatiotr,Dr.

Neil Whitehead writes extensively about this point, noting that: "Ncutral academic surueys shorv there is suhstantial change. About half of the homosexuallbisexual populution (in a non-therapeutic environment) move.s towards heterosexuality over a lil'etime. About 37o ol'the prcsent heterosexual population once

lirmly helieved themselves to be homosexual or bisexull.

Sexualorientation is not set in concrete."'lThi.s has been well documentecl among rvomen in recent years by Dr.s. Lisa Diamond, Elisabeth Thonrp.son and Elizabeth Morgun.ls I

. Additionally,

the period of adolescence is well recognized for its sexual

fluiility

and

instability of sanre-sex attractions. The most detailed.studies to dute regarding spontaneous cltange in sexualorientation in adolescents wereconducted in 2007 und 2010. The first, by

Savin-Williams and Ream, is a very large longitudinal study that clocumented chunges in attraction so greut even betrveen lhe ages of l6 and l7 that the authors questionecl whether the concept of sexual orientation had any meaning lbr adolescents with same-sex attractions.

Seventy-five percent o{'adolescents rvho had some initial same-sex ilttraction betrveen the age.s

17"21 chungcd to expcrience opposite sex attrilction

only.l'The

seconcl highly cletailecl sturly

dentonstrating.significant changc away ltom same-sex atractions in adolescents involvecl an 11

Whitehead, Neil" My Genes Made Me Do It - Honrosexualitt,antl the Scientific Evidence. Retrieved on 21261 I 3 : http:l/www. mygenes.c a.nzJ . '2 13

Ibid. Retrieved an

21261 13:

http://www.mygenes .co.nzJ.

Diamond, Lisa. Sexual Fluidity: Understanding Women's Love and Desire, 2009, Harvard University Press; Elisabeth Morgan Thornpson and Elizabeth M. Morgan, "Mostly Straight Young Women: Variations in Sexual Behavior and Identity Development." Developmental Psychology, 2008, 44 (l), l5-21 1a savin-williams, R. c., & Ream, G. L. (2007), Prevolence and stability, of sexual oriertrttiott Conrponents During Adolescence and Yowtg Adulthood, Archives of Sexual Behavior, 36, 385-394.

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enormou.s sample oF 13.840 youth i.lnd was published by Ott et. al. in

20l0. Ol'those inirially

"unsure" of tlreir se.xtral orientaiion, 66Vo ended exclusively heterosexual,ls

Assisted Chanse

12. Itstandstoreasonthatil'.spontilneou.schungeofsexualorientationoccur.\rthcnatleastsonrc of those who :rre rnol.ivilted to seek therapeutically assisted chtnge shoulcl succeecl. Most therapy utilized to alleviate same-sex attractions involves conventional therapeutic approaches. Thus, several different p.sychological upproaches to help someone overconre SSA are in use in today's

psychiatric community. Although opponents ol'the therlpy attempt to lump all proces.ses usecl

simply

a.s

"reparative/conversion therapy", in fact, there is no one therapeutic rnodel used and lhe

modalities practiced involve conventional therapeutic approaches. For exunrple, some miry utiliz-e a purely psychoanalytic approach, others u.se psychodynamic merhocls, cognirive

behavioral therapy (CBT), Ernotionally Focused therapy (EFT1, Eye Movemenr Desensitization and Reproce.ssing (EMDR), non--aversive classical conclitioning, as.sertiveness training and social

skill buildinB, and other.s. There rre also at least two

sets

of ethicul guidelines l'or mental

health professionals regarding how to proceed with sexual orientation change el'forts.li'

Ott, M. Q., Corliss, H. L., Wyprj, D., Rosario, M., Change in Setf-Reported Sexual Orientation ldentity

& Austin, S. B. (2010), Srabiliry arul in Young People: Applicatiort of Mobititl'

Metrics, Archives of Sexual Behavior

Throckmorton, W. and Jones, S. "sexual Identity Therapy: Guidelines for Managing Sexual Identity Conflicts" accessed May 14, 2013 from http://www.drthrockmorton.com/sexualidentitytherapyframework0506.pdf, and NARTH Practice Cuidelines for the Treatment of Unwanted Same-Sex Attractions and Behavior," accessed May 14, 2013 from http://www.scribd.com I doc I I I 55088 I I /NARTH-Practice-Gu idelines

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 8 of 13 PageID #:106

13. That a diver.sity

ol therapeutic approaches are successl'ully employed rellecls the fact that all

therupy isconccrned with behavioraland attitudinal changeol'some kind. Consequently, it is nor surprising that tlre success rate.s forclrunge ol'orientation arc in the same mnge of success rates

lor treating other similar beltavioral challenges. Forexamplc, the overull

succe.ss rate

tbr

Alcoholics Anonymous is a mere 25 percent,lT ancl the composite success r;rte fbr rehabititating criminal behavior, for exanrpte, is at best 40 percent.ls Regarc.ling change of .sexual orientation, Dr. Judd Marmor said "There is llttle doubt that a genuine shift in preferential sex object can unit does tuke place in somewhere tretween 20 and 50 percent of patients with homosexual behavior

who seek psychotherapy with thisend in mincl."le Simitarly, Dr. Jelfrey Satinover, a nored psychiatrist, researcher, and autlrorof Homo.sexuality and the Politics of Truth, reviewed the

scientillc literature regarding sexualorientation change eftorts and lound a conrpositc success rate o[ 50'/<,.21t Factor.s that predict .success have ulso been iclenrifiecl. The.se inclucle seeking treatn'tent prior to initiating homosexual activity, age under 35, the presence of past or coexisting heterosexual atlraction.s, a high motivltion to chtnge, and working witlr a therapist rvho believes that change is po.ssible. are ull associated with a greater likelihoccl ol'success.ll

17whitehead,

Neil My Genes Made Me Do rtt p.247 accessed May 14,2013 from

http ://www.myge nes.co. nzJdown load.htm

Cummings, Nicholas and Wright, Rogers [eds.] Destructive Trends in Mental Health: The Well-lntentioned Path To Harm. Routledge, NY (2005) p. Xxvii. te

Marmor, J. ( 1975) "Homosexuality and Sexual Orientation Disturbance" in A. Freedman, H. Kaplan and B. Sadock (eds.) Comprehensive Textbook of Psychiatry II (2d ed.) Baltimore, Lippincott Williams and Wilkins, p. l5l. ?0

Satinover, Jeffery. Homosexuality and the Politics of Truth. Baker Book House Company, Crand Rapids, MI,l996 (Table 7, p. 186). 21

Kaplan, H. and Sadock, 8., Synopsis of Psychiatry Behavioral Sciences Clinical Psychiatry, sixth edition, Williams & Wilkins, l99l (p.752).

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14. ln 1998, Dr. Warren Throckmorton conducted an extcnsive review ol'reorientation reports puhlished in the Journal of Mental Hellth. He documented that multiple forms ol'.standard, ethical therapeutic interventions had successlully el'l'ected change oI sexual orientation, and

con[inned that the po.ssibility for successlul change exists at alt ages.2] Throckmorton reaffinned the.se findings seven

yetrs later in 2002 concluding, "My literature review contradicts the

policies ol'mujor mental health organizations because it suggesr.s thar sexual orientation, once thought to be an unchanging sexual trait, is actually quite flexible for many people, changing as a result o[ therapy lbr some. ministry for others, and spontaneously lbr still others."31

15. Possiblythemostimpressivestudyofchange,duetothelurqenunrberofsubjectsstuctieil and to the many facets of sexual orientation investigated, is that published by Dr. Robert Spitzer

in 2003. ln 1973, Dr. Spitzer was instrumental in declassifying lrolnosexuality as a mental disorder and today remains a "gay rights" supporter. For decades he fimrly believed that change

ol'orientation was irnpo.ssible, In 2003, after studying a group of 200 "ex-gay" men and wotnenr he reversed his stance,

All participants gave evidence of achieving

degrces of long-term change

in their sexual orientation up to and including complete heterosexuality without suffering tny negative cc,nsequences from therapy.?J 16.

Shortly afier puhlication, Dr. Hershbergcr, a researcher highly skeprical of change therapies,

questioned the legitirnacy of the subjects' responsL's in the Spitzer study and decidcd to subject

Throckmodon, Warren "Attempts to Modiff Sexual Orientation: A Revierv of Outcome Literafure and Ethical Issues." lournal of Mental Health, Vol.20, October 1998 (pp.283-304).

ht t p

l/w ww.

n a rt

h.c

om/docs/al

te m p

to mod i fy. ht m I

Throckmofion, Initial Empirical and Clinical Findings Concerning the Change process for Ex-Gays, Professional Psychology: Re.search and Practice, Vol. 33 (June, 2002), p. 242-8. See also Gay to Straight Research Published in APA Journal, h t tp

l i_ i',

ti{*ii:Lit 1}ilS:,i*i*:t=1t ;:i:',Iu ti.

2' Spitzer, Roberl L., "Can Some Cay Men and Lesbians Change Their Sexual Orientation?," Archives of Sexual Behavior, Vol. 32, No. 5, Ocr. 2003: 4A3-417.

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 10 of 13 PageID #:108

the data to a Guttman scalability analy.sis to unswer this question. The Cutlmun tc.st is a sculagram that

i.s used

to determine where or not reported changes occur in a cunrulative, orderly

fashion.

17. Follorving this analysis, Hershberger concludcd, "The orderly, law-like pattern ol'changes in homosexual sexual beluvior, homosexual sell'-identil'ication. and homosexual attraction and fantasy observed in Spitzer's study is strong evidence that reparative thcrapy can assist

individuals in changing their homosexual orientation to a hererosexual orientation. Now it is up to those skeptical o[ reparative therilpy to provide .strong evidence to support tlreir position. In my opinion, they have yet to do so."ls

18. Despite Dr. Spitzer's "apology" to the homose xual comrnunity lbr publishing this study,l(' there has becn no new data to contradict his original results. Dr. Spitzer's research remains

scientifically sound, and his original conclusiorr - that sonre highly ntol.ivared inrlivicluirls with unwanted homosexual attractions can change - still stancls.?? Tl'ris is why Dr. Kenneth Zucker,

editor ol'the Archives ol'Sexual Behovior, never published an official retraction ol'spitzer's study.

Ex'gay Research: Analyzing the Spitzer Stutly ancl hs Relationship to Science, Religion, Palitics, and Culture was edited by Jack Drescher and Kenneth Zucker (2006, Harrington Park Press, an Imprint of Haworth Press, Inc.) as cited at:

http://narth.com/2010/l l/yet-another-attempt-to-discredit-the-spitzer-study-fails/

(accessed

5t9n3) 26

Benedict Carey, "Psychiaffy Giant Sorry for Backing Gay'Cure,"' Health Section, New York Times (May l8,2Al2), accessed July I ,2A12, at www.nytimes.com/2012105119/health/dr-robert-l-spitzer-noted-psychiatristapologi zes-for-study-on-gay-cure.htm I ?pagewanted=all. E7

Rosik, Christopher. "spitzer's 'Retraction': What Does It Really Mean?" (June i:ll::.iir:rL* ,;ii:",',:-j.t; ;1;1;; : ' ....t.; .

Accessed July I ,2012, at

,2An).

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 11 of 13 PageID #:109

19. ln 2007, Drs. Jones and Yarhouse published a long-tenn study of

a cohort

of "cx-gays" who

participilted in religiously mediated therapy to change their sexual orientation. Jones anrl Yarhouse establi.shed through a scientific, longitudinul study thar chunge of sexual orienration is possihle forsome individuals tlrrough involvement in religious ministrics, und that the attempt to change on average does not oppear lrarm[ul.]8

20. In 2010, Elan Karten examined the sexual reorientation expericnce.s of a convenience sumple

of I l7

men using u survey-based correlationaldesign. His srudy, like Spitzer's, fincls that change

occurs on a continuum: ranging l'rom the elimination of lromo.sexual attrxctions to the

diminishing/management of homosexual attroctions. Significantly, on averitge, thrl men in this study reported po.sitive changes w/ respect to psychological well-being as a re.,;ult ot'their change ef[or"t.c. In particular,lUAVo

oItltc

men reported increa..ie.,i in selliesteem ancl 9g.lVo in social

{unctioning, rvhile 9?.3Vo reported decreases in clepression,T2.6Va in self--harmfhl hehavior, 58.9Vo in suicidal ideation

attempts, and 35.97o in alcohol and substance abuse.s The,se

linclings of satisl'action with and benelitting in a variety o[ ways fronr sexual orientation change

efforts replicates those ol'an earlier study by Dr.s. Nicolosi, Byrd and potts.s{}

'8 Jones, Stanton and Mark Yarhouse, Ex-Gays? A Longitudinal Study Of Religiously Mediated Change in Sexual Orientation. lntervarsity Press, Downers Crove, lL,?007. SeL also their more recent article: Stanton L. Jones & Mark A. Yarhouse (201 l), "A longitudinal study of attempted

religiously -mediated sexual orientation change" Journal of Sex and Marital Therapy, Vol. 3i,

40442

Karten, E. Y, & Wade, J. C. (2010). Sexualorientation change efforts in men: A client perspective. Journal of Men's Studies. 18,84-102. 30

Nicolosi, J., Byrd, A. D., & Potts, R. w. (2000). Retrospective self-reports of changes in homosexual orientation: A consumer survey of conversion therapy clients. Psyclplo[,rn, Reports, 86, 107 I - 1088.

Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 12 of 13 PageID #:110

21. In summory, while sexual attrilctions may not be consciously chosen, one can choose rvhat to do rvith these atlractions once recognized. No one is "bom gay." Biological and cnvironmental influence.s may be fostered or lbiled. Therefore, SSA is indecd changeahle to varying degrees for

milny - but not all - who desire this outcome. Sexual oricntation chunge el'forts including gender

affirrning proce.sses are no diff'erent I'ronr any other p.sychological therapy. Every lbrrn ol'therapy is an attempt to aflect ilttitudinal and trehaviorul clrange ol'some sort. No therapy - whether

pharmacologic, surgical or psychological - is without risk of htrm. No therupy has a 1007o gulrantee of succe.ss. Parents, psychosocially mature adolescents and adults have the right to make infonned healthcare decisions based on ilccurate and unbiased inlbrmation.

22. I attest under the penalty of perjury that the above mentioned statements are true and accurate.

J(rus llopliitrs Scieolisls Ollcr .\bsolulc l'}r(bf Gal ngeilda's 'Born'l

his

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Case: 1:16-cv-08034 Document #: 12 Filed: 09/08/16 Page 13 of 13 PageID #:111

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Join us on our podcast each weekday for an interesting story, well told, from Charisma News. Llsten at charismapodcastnetwork.com ( http l/ww w. c h a r i s m a p o d c a stn etw o r k. c o m /s h ows / c h a ri s m a n ews?

utm_source=charismanews.com&utm_medium=articlelo20beginning&utm_campaign=article).

The New Atlanfls published a major report, "Sexuality and Gender: Findings from the Biological, Psychological, and Social Sciences." The report focuses on the higher rates of and explanations for mental health problems among the LGBT community and scientifically addresses some of the most frequently heard claims about sexuality and gender. lt can be found here (http://www.TheNewAtlantis.com/sexualityandgender). Written by Lawrence S. Mayer, M.B., M.S., Ph.D. and Paul R. McHugh, M.D., both of Johns Hopkins University, the report explores research from more than 200 peer-reviewed studies across a variety of scientific fields including epidemiology, genetics, endocrinology, psychiatry, neuroscience, embryology and pediatrics. The reporl finds that:

. . . .

The belief that sexual orientation is an innate, biologically fixed human

prope(y-that people are "born that way"-is not supported by scientific

evidence. The proposition that gender identity is an innate, fixed human property independent of biological sex is not supported by scientific evidence. Only a minority of children who experience cross-gender identification will continue to do so into adolescence or adulthood. There is little scientific evidence for the therapeutic value of medical interventions that delay puberty or modify the secondary sex characteristics of adolescents. Non-heterosexual and transgender subpopulations have higher rates of mental health problems (anxiety,trpgpwArnclg$flhfiJggftpg[gf.ravioral and social problems (substance abuse, inlimate partner violence), compared to the general population.

"This report is about science and medicine, nothing more and nothing less," writes Dr. Mayer, biosl "Cultural and political trends should not influence the reality of the importance of dealing with these difficult clinicians concerned with the problems facing LGBT people, we should not be dogmatically committed to any gender identity; rather, we should be guided first and foremost by the needs of struggling patients, and we them lead meaningful, dignified lives."

Lawrence S. Mayer, M.B., M.S., Ph.D. is a scholar in resrdence in the Department of Psychiatry at the professor of statistics and biostatistics at Arizona State University. Paul R. McHugh, M.D. is a professor of psychiatry and behavioral sciences at the Johns Hopkins University psychiatrist-in-chief at the Johns Hopkins Hospital. "l dedicate my work on this report, first, to the LGBT community, which bears a disproportionate rate o1 as a whole. We must find ways to relieve lheir suffering," writes Dr. Mayer. "And above all, I dedicate it to ty

The New Atlantis is published by the Center for the Study of Technology and Society and can be found at ttp : //www.th e n ew a tl a n ti s. c o m /).

3 Reasons Why you should read Life in the Spirit. 1) Get to know the Holy Spirn. 2) Learn to enter God's

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