独立法医专家组关于“扭转治疗”的声明。
Statement of the Independent Forensic Expert Group on Conversion Therapy.
机构信息
IFEG. Correspondence to:
出版信息
Torture. 2020;30(1):66-78. doi: 10.7146/torture.v30i1.119654.
Conversion therapy is a set of practices that aim to change or alter an individual's sexual orientation or gender identity. It is premised on a belief that an individual's sexual orientation or gender identity can be changed and that doing so is a desirable outcome for the individual, family, or community. Other terms used to describe this practice include sexual orientation change effort (SOCE), reparative therapy, reintegrative therapy, reorientation therapy, ex-gay therapy, and gay cure. Conversion therapy is practiced in every region of the world. We have identified sources confirming or indicating that conversion therapy is performed in over 60 countries. In those countries where it is performed, a wide and variable range of practices are believed to create change in an individual's sexual orientation or gender identity. Some examples of these include: talk therapy or psychotherapy (e.g., exploring life events to identify the cause); group therapy; medication (including anti-psychotics, anti- depressants, anti-anxiety, and psychoactive drugs, and hormone injections); Eye Movement Desensitization and Reprocessing (where an individual focuses on a traumatic memory while simultaneously experiencing bilateral stimulation); electroshock or electroconvulsive therapy (ECT) (where electrodes are attached to the head and electric current is passed between them to induce seizure); aversive treatments (including electric shock to the hands and/or genitals or nausea-inducing medication administered with presentation of homoerotic stimuli); exorcism or ritual cleansing (e.g., beating the individual with a broomstick while reading holy verses or burning the individual's head, back, and palms); force-feeding or food deprivation; forced nudity; behavioural conditioning (e.g., being forced to dress or walk in a particular way); isolation (sometimes for long periods of time, which may include solitary confinement or being kept from interacting with the outside world); verbal abuse; humiliation; hypnosis; hospital confinement; beatings; and "corrective" rape. Conversion therapy appears to be performed widely by health professionals, including medical doctors, psychiatrists, psychologists, sexologists, and therapists. It is also conducted by spiritual leaders, religious practitioners, traditional healers, and community or family members. Conversion therapy is undertaken both in contexts under state control, e.g., hospitals, schools, and juvenile detention facilities, as well as in private settings like homes, religious institutions, or youth camps and retreats. In some countries, conversion therapy is imposed by the order or instructions of public officials, judges, or the police. The practice is undertaken with both adults and minors who may be lesbian, gay, bisexual, trans, or gender diverse. Parents are also known to send their children back to their country of origin to receive it. The practice supports the belief that non-heterosexual orientations are deviations from the norm, reflecting a disease, disorder, or sin. The practitioner conveys the message that heterosexuality is the normal and healthy sexual orientation and gender identity. The purpose of this medico-legal statement is to provide legal experts, adjudicators, health care professionals, and policy makers, among others, with an understanding of: 1) the lack of medical and scientific validity of conversion therapy; 2) the likely physical and psychological consequences of undergoing conversion therapy; and 3) whether, based on these effects, conversion therapy constitutes cruel, inhuman, or degrading treatment or torture when individuals are subjected to it forcibly2 or without their consent. This medico-legal statement also addresses the responsibility of states in regulating this practice, the ethical implications of offering or performing it, and the role that health professionals and medical and mental health organisations should play with regards to this practice. Definitions of conversion therapy vary. Some include any attempt to change, suppress, or divert an individual's sexual orientation, gender identity, or gender expression. This medico-legal statement only addresses those practices that practitioners believe can effect a genuine change in an individual's sexual orientation or gender identity. Acts of physical and psychological violence or discrimination that aim solely to inflict pain and suffering or punish individuals due to their sexual orientation or gender identity, are not addressed, but are wholly condemned. This medico-legal statement follows along the lines of our previous publications on Anal Examinations in Cases of Alleged Homosexuality1 and on Forced Virginity Testing.2 In those statements, we opposed attempts to minimise the severity of physical and psychological pain and suffering caused by these examinations by qualifying them as medical in nature. There is no medical justification for inflicting on individuals torture or other cruel, inhuman, or degrading treatment or punishment. In addition, these statements reaffirmed that health professionals should take no role in attempting to control sexuality and knowingly or unknowingly supporting state-sponsored policing and punishing of individuals based on their sexual orientation or gender identity.
转换疗法是一组旨在改变或改变个体的性取向或性别认同的实践。它基于一种信念,即个体的性取向或性别认同可以改变,并且这种改变对个体、家庭或社区是理想的结果。其他用来描述这种做法的术语包括性取向改变努力(SOCE)、修复疗法、再整合疗法、再定向疗法、出柜疗法和同性恋治疗。转换疗法在世界的每个地区都有实施。我们已经确定了一些来源,这些来源证实或表明,在 60 多个国家都进行了转换疗法。在那些实施这种疗法的国家,人们相信各种广泛而不同的实践可以改变个体的性取向或性别认同。其中一些例子包括:谈话疗法或心理疗法(例如,探索生活事件以确定原因);团体疗法;药物治疗(包括抗精神病药、抗抑郁药、抗焦虑药和精神药物,以及激素注射);眼动脱敏和再处理(个体在同时经历双侧刺激的同时专注于创伤性记忆);电击或电休克疗法(ECT)(在头部连接电极,在它们之间传递电流以诱导癫痫发作);厌恶治疗(包括电击手和/或生殖器,或在呈现同性恋刺激时给予引起恶心的药物);驱魔或仪式净化(例如,在阅读圣句或燃烧个体的头部、背部和手掌时,用扫帚殴打个体);强制喂食或禁食;强迫裸体;行为矫正(例如,强迫个体以特定的方式穿衣或行走);隔离(有时时间很长,包括单独监禁或阻止与外界互动);言语虐待;羞辱;催眠;住院;殴打;和“纠正”强奸。转换疗法似乎由包括医生、精神科医生、心理学家、性学家和治疗师在内的健康专业人员广泛实施。它也由精神领袖、宗教从业人员、传统治疗师以及社区或家庭成员进行。转换疗法在国家控制的背景下进行,例如医院、学校和少年拘留设施,以及在家庭、宗教机构或青年营和 retreats 等私人环境中进行。在一些国家,转换疗法是由公职人员、法官或警察的命令或指示强制实施的。这种做法适用于可能是女同性恋、男同性恋、双性恋、跨性别或性别多样化的成年人和未成年人。父母也知道将孩子送回原籍国接受治疗。这种做法支持非异性恋取向是偏离常态的观点,反映了一种疾病、障碍或罪恶。从业者传达的信息是,异性恋是正常和健康的性取向和性别认同。本医疗法律声明的目的是为法律专家、裁决者、医疗保健专业人员和政策制定者等提供以下方面的理解:1)转换疗法在医学和科学上缺乏有效性;2)接受转换疗法可能会产生的身体和心理后果;3)根据这些影响,当个人被迫或未经同意接受转换疗法时,转换疗法是否构成残忍、不人道或有辱人格的待遇或酷刑。本医疗法律声明还涉及国家在规范这种做法方面的责任、提供或实施这种做法的道德影响,以及卫生专业人员和医疗及精神健康组织在这方面应发挥的作用。转换疗法的定义各不相同。有些包括任何试图改变、抑制或转移个体的性取向、性别认同或性别表达的尝试。本医疗法律声明仅涉及那些从业者认为可以真正改变个体性取向或性别认同的实践。旨在仅仅为了施加痛苦和痛苦或惩罚个人而进行的身体和心理暴力或歧视行为,不包括在本声明中,但完全予以谴责。本医疗法律声明遵循我们之前关于涉嫌同性恋的肛门检查的声明和关于强迫处女检查的声明。在这些声明中,我们反对将这些检查定性为医学性质,从而试图减轻这些检查造成的身体和心理痛苦的严重程度。没有任何医学理由对个人进行酷刑或其他残忍、不人道或有辱人格的待遇或惩罚。此外,这些声明重申,卫生专业人员不应在试图控制性行为方面发挥作用,并且不应在知情或不知情的情况下支持国家支持的对个人进行监督和惩罚,因为他们的性取向或性别认同。