Gov. Walz’s executive order on conversion therapy explained

The order can not change the law, but it can change the rules.

The+Minnesota+State+Capitol+on+Nov.+18%2C+2018.

Tony Saunders

The Minnesota State Capitol on Nov. 18, 2018.

Emalyn Muzzy

On July 15, Gov. Tim Walz signed an executive order that created new rules about conversion therapy across Minnesota.

The order is not a law, meaning it cannot ban conversion therapy across Minnesota. Instead, it prevents deceptive practices and takes away public funding, which helps block the “torturous” practice from happening in mental health clinics.

Only a governor can overturn an executive order, so these rules will remain in place unless Walz or another governor overturns them.

The new rule will apply to mental health practitioners and public insurance companies. Walz asked private insurance companies to no longer cover the practice, but without a law change, he cannot force them to, said James Darville, the policy organizer for Out Front, an LGBTQ rights group.

These restrictions mainly use prohibited practice laws, which include preventing health practitioners from misrepresenting their services. Although these laws have been able to include conversion therapy, no lawmaker had given directions to do so until now, Darville said.

Working with existing laws

The order defined conversion therapy as “any practice by a mental health practitioner or mental health professional that seeks to change a person’s sexual orientation or gender identity.” It lists several examples that do not count as conversion therapy, including counseling to help someone accept their sexuality or gender identity.

Gov. Walz changed the use of prohibited practice statutes to include conversion therapy. Minnesota statute states that “no health maintenance organization or representative thereof may cause or knowingly permit the use of advertising or solicitation which is untrue or misleading, or any form of evidence of coverage which is deceptive.”

When a licensed therapist performs conversion therapy, they may not code it as such, Darville said. Coding is how medical staff let insurance companies know what services they performed on a patient. For example, a transgender minor may have a conversion therapy session, but their therapist will code it as a regular therapy visit.

“Any licensed health care practitioner out there that [is] providing something akin to conversion therapy [is] probably masking it under a false claim … which is fraudulent,” said Scott Dibble, the Democratic-Farmer-Labor state senator for the 61st District.

Because conversion therapy is “outside of the accepted national standards,” Dibble said many insurance companies do not see it as a practice that should be covered, so often times therapists may not code it as conversion therapy.

Many health organizations, including the American Medical Association and American Psychiatric Association, as well as professional education organizations, have said they do not support conversion therapy because of the harm it causes children. Dibble said that licensed practitioners may not want to admit to using conversion therapy because it is looked down upon in a multitude of communities.

Walz’s executive order also clarified that conversion therapy is not medically necessary. Under Minnesota statute, for a mental health practice to be considered a medical necessity, it must “help restore or maintain the enrollee’s health” or “prevent deterioration of the enrollee’s condition.”

Conversion therapy often results in trauma that follows a person through life. The Trevor Project reports that youth who went through conversion therapy are more likely to attempt suicide and more likely to have multiple suicide attempts.

The governor’s executive order protects minors and vulnerable adults, said Out Front’s policy organizer Darville. Adults have the autonomy to choose conversion therapy, while minors and vulnerable adults do not, Darville said.

The future of conversion therapy in Minnesota

Darville has been working on the Minnesota Mental Health Protections Bill, which would ban licensed practitioners from practicing conversion therapy on minors and vulnerable adults. He said Out Front and other legislators wanted to present the bill during the 2021 session but ran out of time. Because they were unable to pass any legislation, Walz put out the executive order.

The Minnesota Mental Health Protections Bill has been brought up several times since 2017, but has yet to pass due to a lack of Republican support. Darville and Dibble are hoping that hearing testimonies from people who have undergone conversion therapy will change legislator’s minds.

“The most important thing for the public to know is that conversion therapy is dangerous and discredited,” said Sarah Warbelow, the legal director for the Human Rights Campaign. “There’s nothing wrong with being an LGBTQ person. The best way to support LGBTQ people is just let them thrive.”