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How are Reparative Therapists (those working with homosexuals who wish to change their sexual and romantic orientation) still able to provide treatment to those who want sexual re-orientation when the American Psychological Association, American Psychiatric Association, National Association of Social Workers and the American Counseling Associations all are against this form of psychotherapy? Do they received third party reimbursement from insurance companies?
The way these so called reparative therapists (RT) and treatment centers get around these organizations which do not support their work is by using a diagnosis known as Sexual Disorder Not Otherwise Specified (302.9). This is in the DSM-IV which is the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition in the mental health field. These RT's also use depression and anxiety and other mood disorder diagnoses which insurance companies will pay for.
In other words, if a client comes in and want to "change" from gay to straight many therapists would say this person is "depressed" or "anxious" and give them codes for those mood disorders. Insurances rarely check to see what is contributing to the depression they simply want to know what they are paying for and monitor the depressive symptoms.
In terms of Sexual Disorder NOS, this diagnosis applies to the following individuals according to the DSM IV:
- 2) Distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used.
- 3) Persistent and marked distress about sexual orientation.
- So you can see that number three would cover those who do Reparative Therapy. The Sexual Disorder NOS diagnosis is in the DSM IV for those gays and lesbians who are closeted and struggling with coming out. It is used wrongly by those doing RT for those trying to "behave as heterosexuals."
- It would be great to see a group of folks start challenging insurance companies demanding that they get more information on what Sexual Disorder NOS is being treated for.
Sadly, these RT's could still use depression, anxiety and other mood disorders claiming that these folks need RT because their sexual orientation is causing their mood disturbances. In truth it is not the sexual orientation that is causing them distress but rather what is "done to them" regarding their homosexuality. Reparative Therapists simply continue the homophobic and heterosexist acts on these poor people and make a living from it.