Tennessee Bill Would Allow College Counselors to Refuse to Treat LGBT Students

A new bill proposed in the Tennessee state legislature would ban universities, including publicly funded ones, from taking any disciplinary action against graduate student counselors in training who refuse to treat clients with “goals, outcomes or behaviors that conflict with a sincerely held religious belief of the student.” The bill was inspired by the case of Julea Ward, who was expelled from Eastern Michigan University for refusing to counsel LGBT students. She sued the university with the help of the Alliance Defending Freedom, a Christian legal group, with EMU agreeing to a settlement of $75,000.                   

But what proponents of the bill ignore is that regardless of where one falls on the gay rights v. religious freedom debate this legislation would exacerbate an existing public health issue. Suicide is the third leading cause of death for Americans between the age of 15 - 24. New studies show that this problem is getting worse, with one study finding that 50% of college students have felt suicidal at some point in their lifetime. The responsibilities a university faces in dealing with this growing public health problem is the subject of debate, and several high profile lawsuits allege everything from negligence to discrimination against mentally ill students.

In the past these issues were considered best handled by families and mental health institutions, but that’s rapidly changing as the problem grows, according to the National Institute of Mental Health. Even Harvard, with its enormous endowment, is facing student protest over its alleged failures to counsel students facing mental health issues. As the national conversation about mental health care on college campuses grows, it is shocking that the Tennessee state legislature is considering a measure that would actually make it harder for students to access mental health treatment. Given the current data on college students and suicide, this bill is grossly irresponsible and would worsen a major public health problem.

Tennessee's bill becomes even more troubling when one considers that LGBT students are at a uniquely high risk of depression and suicide. The Center for Disease Control found that homosexual and bisexual youth were twice as likely to have attempted suicide as heterosexual youth, calling for further study of transgender youth and suicidal behavior. The statistics become even bleaker when LGBT youth reach college. One study found that homosexual and bisexual students were three times more likely than their heterosexual peers to have made a plan to attempt suicide in the last 12 months, and that homosexual and bisexual students were attempting suicide five times more frequently than their heterosexual peers.

These disturbing numbers make one thing very clear: College students are more likely to experience serious mental health crises that lead to suicide than the general population, and LGBT students are particularly vulnerable. The outcome of this bill would be forcing universities to deny mental health care to a population at high risk for suicide.

Proponents of the bill, including State Representative John DeBerry Jr. (D-Memphis) and former state senator and current president of the Family Action Council of Tennessee, argue that this is a religious freedom issue and that it's unreasonable to force Christian counselors to set aside their religious beliefs for a set of clinical guidelines. "Put the right caregiver with the right person. That’s how I see it,"stated Rep. DeBerry, arguing that Evangelical counselors are just not suitable to counsel LGBT students and should have the right to defer.

Representative DeBerry Jr. seems to be operating under the assumption that deferring from treating a client is not equivalent to denying them access to care. That may not always be the case. According to a study from the American College Counseling Association, there are not enough counselors to fill basic needs. The average counselor to student ratio is 1:1,600. The recommended ratio is 1 counselor for every 1,000-1,500 students enrolled.  

Proponents also assume that relationships between counselors and clients are somehow interchangeable. In reality, relationships between counselors and students takes time and trust to build. Proponents fail to acknowledge that issues pertaining to sexuality often only arise after many counseling sessions and that referrals can be extremely high stress for patients and cause further harm.

A Christian counselor who strongly believes that homosexual behavior is immoral may not be a good fit for an LGBT student. An argument can certainly be made that it would be better for the LGBT student to have a more sympathetic counselor. Given the frequency of depression and suicide among LGBT students, access to care must be considered first and foremost. Considering that the legislation would disproportionately affect LGBT students, it would make sense to amend the bill to have a mechanism that ensures universities provide adequate treatment for LGBT students regardless of counselor referrals based on religious beliefs.

Unfortunately, Tennessee does not recognize LGBT individuals as a protected class from discrimination, making the crafting such a mechanism, never mind enforcing it, extremely difficult. Until Tennessee recognizes LGBT individuals as a protected class, striking a compromise that suits both Christian counselors and at risk LGBT students will likely prove impossible. Furthermore, even if such a compromise were agreed to, the potential need for increased funding for student counselors could complicate matters.

The State Senate adopted SB 514 last week and a version has been introduced in the House. The legislation was adopted despite the fact that faculty members testifying against the bill have expressed grave concerns that this legislation would put the accreditation of Tennessee counseling programs in jeopardy, meaning ALL students could lose access to student counselor programs. 

While religious freedom is an important constitutional right, state representatives must consider the ramifications of this piece of legislation. College students are more prone to mental illness and suicide and could lose access to mental health care due to this hamfisted approach that may jeopardize student counselor programs for all students. Students already at a high risk for suicide may lose access to treatment at the time when they are most vulnerable —when finally opening up to their counselor about their sexual orientation or gender identity.

Tennessee should put the health of ALL students before the religious beliefs of student counselors in training. If student counselors truly believe they cannot follow the basic clinical guidelines and ethics codes of the counseling profession as outlined by the accrediting associations, then they have another option. They should pursue a career in Christian counseling as an alternative and look to seminaries, youth ministries and other faith based organizations for education and employment.

The stakes are too high to deny students access to treatment to appease the religious beliefs of individual counselors.