HB 1876: Conversion Therapy; Sexual Orientation; Gender Identity; Talk Therapy; Age

A BILL FOR AN ACT

RELATING TO MENTAL HEALTH.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that conversion therapy includes a variety of techniques that seek to change a patient's sexual orientation by changing patient behaviors or familial, romantic, and other relationships.  In the context of gender identity, conversion therapy includes efforts to change demeanor, actions, and dress associated with gender roles and to suppress gender nonconforming behaviors for the purpose of changing gender identity.

     The legislature further finds that the professional consensus acknowledges that variations in sexual orientation and gender identity are normal, nonpathological parts of human identity, and that efforts to change these nonconforming identities, whether carried out through aversive or nonaversive techniques, are ineffective.  Furthermore, every major professional health care association in the country agrees that conversion therapy is not just ineffective and unnecessary but can be harmful to the patient.  Upon hearing that their sexual orientation or gender identity can and needs to be fixed, patients may experience chronic feelings of shame and guilt that compound into long-term emotional distress and lower levels of educational and vocational achievement.  Conversion therapy efforts are associated with increased isolation, self-hatred, internalized stigma, depression, anxiety, and suicidality.  For religious patients, conversion therapy inflicts additional harm by distancing them from their faith institutions, worsening family relationships, and undermining their faith.

     The legislature also finds that, pursuant to its longstanding authority to protect the residents of the State from substandard care, Act 13, Session Laws of Hawaii 2018, and Act 157, Session Laws of Hawaii 2019, were enacted to restrain the use of the ineffective and harmful practice of conversion therapy in the context of both sexual orientation and gender identity.

     However, the legislature acknowledges that the Supreme Court of the United States is anticipated to announce an exemption in the case of Chiles v. Salazar, No. 24-539 (U.S.), which involves a counselor challenging Colorado's prohibition on conversion therapy on the basis of protected free speech.

     Accordingly, the purpose of this Act is to provide for the conditional amendment of the existing prohibition on conversion therapy, which shall take effect only upon a final decision by the Supreme Court of the United States overturning the decision in Chiles v. Salazar, 116 F.4th 1178 (10th Cir. 2024).  The amendment provides an exemption for professionals engaged in talk therapy in the form of pure speech from the prohibition on conversion therapy, while explicitly maintaining a ban on aversive techniques.

     SECTION 2.  Section 453J-1, Hawaii Revised Statutes, is amended to read as follows:

     "§453J-1  Conversion therapy prohibited; advertising prohibited.  (a)  No person who is licensed to provide professional counseling shall:

     (1)  Engage in or attempt to engage in conversion therapy on a person under [eighteen] twenty-five years of age; or

     (2)  Advertise the offering of conversion therapy on a person under [eighteen] twenty-five years of age.

     (b)  Any person who is licensed to provide professional counseling who engages in or attempts to engage in the offering of conversion therapy on a person under [eighteen] twenty-five years of age shall be subject to disciplinary action by the appropriate professional licensing authority.

     (c)  For purposes of this section:

     "Advertise" means a communication made by or on behalf of a person who is licensed to provide professional counseling, made for the purpose of inducing or promoting a professional counseling relationship in which conversion therapy will be undertaken on a person under the age of [eighteen.] twenty-five.  "Advertise" includes oral, written, graphic, or pictorial statements or representations, including those made through any electronic or print medium.

     "Aversive techniques" means techniques that utilize unpleasant stimuli to induce changes in behavior, such as electric shocks, deprivation of food and liquids, chemically induced nausea, or other physical interventions.

     "Conversion therapy" means any practices or treatments that seek to change an individual's sexual orientation or gender identity, including efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender.

     "Conversion therapy" includes aversive techniques.

     "Conversion therapy" [shall] does not include [counseling]:

     (1)  Talk therapy in the form of pure speech; and

     (2)  Counseling that provides assistance to a person undergoing gender transition, or counseling that provides acceptance, support, and understanding of a person or facilitates a person's coping, social support, and identity exploration and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices, as long as such counseling does not seek to change an individual's sexual orientation or gender identity.

     "Person who is licensed to provide professional counseling" means a person who performs counseling as part of the person's professional training, including a physician, especially one practicing psychiatry, licensed pursuant to chapter 453; psychologist licensed pursuant to chapter 465; nurse licensed pursuant to chapter 457; social worker licensed pursuant to chapter 467E; licensed mental health counselor licensed pursuant to chapter 453D; or licensed marriage and family therapist licensed pursuant to chapter 451J."

     SECTION 3.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 4.  This Act shall take effect on July 1, 3000; provided that the attorney general certifies to the revisor of statutes that the Supreme Court of the United States has overturned the holding of Chiles v. Salazar, 116 F.4th 1178 (10th Cir. 2024).

Report Title:

Conversion Therapy; Sexual Orientation; Gender Identity; Talk Therapy; Age

Description:

Amends the existing prohibition on conversion therapy by prohibiting the practice on persons under the age of twenty-five and the advertisement of such practice.  Explicitly provides that talk therapy in the form of pure speech is exempt from the prohibition on conversion therapy.  Takes effect upon the certification by the Attorney General that the Supreme Court of the United States has overturned the holding in Chiles v. Salazar, 116 F.4th 1178 (10th Cir. 2024).  Effective 7/1/3000.  (HD1)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

A BILL FOR AN ACT

relating to mental health.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that conversion therapy includes a variety of techniques that seek to change a patient's sexual orientation by changing patient behaviors or familial, romantic, and other relationships.  In the context of gender identity, conversion therapy includes efforts to change demeanor, actions, and dress associated with gender roles and to suppress gender nonconforming behaviors for the purpose of changing gender identity.

     The legislature further finds that the professional consensus acknowledges that variations in sexual orientation and gender identity are normal, nonpathological parts of human identity, and that efforts to change these nonconforming identities, whether carried out through aversive or nonaversive techniques, are ineffective.  Furthermore, every major professional health care association in the country agrees that conversion therapy is not just ineffective and unnecessary but can be harmful to the patient.  Upon hearing that their sexual orientation or gender identity can and needs to be fixed, patients may experience chronic feelings of shame and guilt that compound into long-term emotional distress and lower levels of educational and vocational achievement.  Conversion therapy efforts are associated with increased isolation, self-hatred, internalized stigma, depression, anxiety, and suicidality.  For religious patients, conversion therapy inflicts additional harm by distancing them from their faith institutions, worsening family relationships, and undermining their faith.

     The legislature also finds that, pursuant to its longstanding authority to protect the residents of the State from substandard care, Act 13, Session Laws of Hawaii 2018, and Act 157, Session Laws of Hawaii 2019, were enacted to restrain the use of the ineffective and harmful practice of conversion therapy in the context of both sexual orientation and gender identity.

     However, the legislature acknowledges that the Supreme Court of the United States is anticipated to announce an exemption in the case of Chiles v. Salazar, No. 24-539 (U.S.), which involves a counselor challenging Colorado's prohibition on conversion therapy on the basis of protected free speech.

     Accordingly, the purpose of this Act is to provide for the conditional amendment of the existing prohibition on conversion therapy, which shall take effect only upon a final decision by the Supreme Court of the United States overturning the decision in Chiles v. Salazar, 116 F.4th 1178 (10th Cir. 2024).  The amendment provides an exemption for professionals engaged in talk therapy in the form of pure speech from the prohibition on conversion therapy, while explicitly maintaining a ban on aversive techniques.

     SECTION 2.  Section 453J-1, Hawaii Revised Statutes, is amended to read as follows:

     "§453J-1  Conversion therapy prohibited; advertising prohibited.  (a)  No person who is licensed to provide professional counseling shall:

     (1)  Engage in or attempt to engage in conversion therapy on a person [under eighteen years of age]; or

     (2)  Advertise the offering of conversion therapy on a person [under eighteen years of age].

     (b)  Any person who is licensed to provide professional counseling who engages in or attempts to engage in the offering of conversion therapy on a person [under eighteen years of age] shall be subject to disciplinary action by the appropriate professional licensing authority.

     (c)  For purposes of this section:

     "Advertise" means a communication made by or on behalf of a person who is licensed to provide professional counseling, made for the purpose of inducing or promoting a professional counseling relationship in which conversion therapy will be undertaken [on a person under the age of eighteen].  "Advertise" includes oral, written, graphic, or pictorial statements or representations, including those made through any electronic or print medium.

     "Aversive techniques" means techniques that utilize unpleasant stimuli to induce changes in behavior, such as electric shocks, deprivation of food and liquids, chemically induced nausea, or other physical interventions.

     "Conversion therapy" means any practices or treatments that seek to change an individual's sexual orientation or gender identity, including efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender.

     "Conversion therapy" includes aversive techniques.

     "Conversion therapy" [shall] does not include [counseling]:

     (1)  Talk therapy in the form of pure speech; and

     (2)  Counseling that provides assistance to a person undergoing gender transition, or counseling that provides acceptance, support, and understanding of a person or facilitates a person's coping, social support, and identity exploration and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices, as long as such counseling does not seek to change an individual's sexual orientation or gender identity.

     "Person who is licensed to provide professional counseling" means a person who performs counseling as part of the person's professional training, including a physician, especially one practicing psychiatry, licensed pursuant to chapter 453; psychologist licensed pursuant to chapter 465; nurse licensed pursuant to chapter 457; social worker licensed pursuant to chapter 467E; licensed mental health counselor licensed pursuant to chapter 453D; or licensed marriage and family therapist licensed pursuant to chapter 451J."

     SECTION 3.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 4.  This Act shall take effect upon its approval; provided that the attorney general certifies to the revisor of statutes that the Supreme Court of the United States has overturned the holding of Chiles v. Salazar, 116 F.4th 1178 (10th Cir. 2024).

Report Title:

Conversion Therapy; Sexual Orientation; Gender Identity; Talk Therapy; Age

Description:

Amends the existing prohibition on conversion therapy by prohibiting the practice on persons of all ages and the advertisement of such practice.  Explicitly provides that talk therapy in the form of pure speech is exempt from the prohibition on conversion therapy.  Takes effect upon the certification by the Attorney General that the Supreme Court of the United States has overturned the holding in Chiles v. Salazar, 116 F.4th 1178 (10th Cir. 2024).

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

STAND. COM. REP. NO.  687-26

Honolulu, Hawaii

                , 2026

RE:   H.B. No. 1876

      H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2026

State of Hawai

Madame:

     Your Committee on Consumer Protection & Commerce, to which was referred H.B. No. 1876 entitled:

"A BILL FOR AN ACT RELATING TO MENTAL HEALTH,"

begs leave to report as follows:

     The purpose of this measure is to amend the existing prohibition on conversion therapy by:

     (1)  Extending the prohibition on the practice of conversion therapy to patients of all ages, rather than just patients under eighteen years of age; and

     (2)  Exempting talk therapy in the form of pure speech.

     Your Committee received testimony in support of this measure from the Department of Health; Hawaiʻi State Lesbian, Gay, Bisexual, Transgender, Queer Plus Commission; HOKU PAC; Pride at Work – Hawaiʻi; Imua Alliance; Hawaiʻi State Democratic Women's Caucus; Lambda Law Hawaiʻi; and numerous individuals.  Your Committee received testimony in opposition to this measure from Hawaii Family Forum.

     Your Committee finds that conversion therapy refers to any practice, treatment, or sustained effort that seeks to change, suppress, or eliminate a person's sexual orientation, gender identity, or gender expression, or to enforce rigid gender norms.  These practices may be framed as counseling, spiritual guidance, behavioral modification, or "reparative" treatment, but they share a common goal:  to deny the legitimacy of LGBTQIA+ identities and coerce individuals into conformity.

     Your Committee further finds that there is no credible scientific or medical evidence that conversion therapy works to change a person's sexual orientation or gender identity.  The consensus of every major medical, psychiatric, and psychological association rejects conversion therapy and finds it ineffective and potentially harmful, including the American Psychological Association, the American Medical Association, the American Academy of Pediatrics, and the American Psychiatric Association.  The use of conversion therapy has been shown in research to be consistently linked with negative physical and mental health outcomes, including depression, anxiety, substance use, self-harm, and suicidality.  For these reasons, the practice of conversion therapy on minors was prohibited in the State through Act 13, Session Laws of Hawaii 2018, and Act 157, Session Laws of Hawaii 2019.

     However, your Committee notes that a case, Chiles v. Salazar, No. 24-539 (U.S.), is before the Supreme Court of the United States in which a counselor is challenging the legality of a substantially similar law enacted in Colorado based on protected free speech.  This measure provides a conditional amendment on the existing prohibition on conversion therapy that will be effective only upon a final decision in Chiles v. Salazar that carves out an exemption for talk therapy.

     Your Committee has amended this measure by:

     (1)  Limiting the prohibition on the practice of conversion therapy to patients under the age of twenty-five years, rather than prohibiting the practice regardless of the age of the patient; and

     (2)  Changing the effective date to July 1, 3000, to encourage further discussion.

     As affirmed by the record of votes of the members of your Committee on Consumer Protection & Commerce that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 1876, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 1876, H.D. 1, and be referred to your Committee on Judiciary & Hawaiian Affairs.

Respectfully submitted on behalf of the members of the Committee on Consumer Protection & Commerce,