the U.S., the Royal College of Psychiatrists, and the Australian Psychological Society. The American Psychological Association and the Royal College of Psychiatrists expressed concerns that the positions espoused by NARTH are not supported by the science and create an environment in which prejudice and discrimination can flourish. The American Psychological Association states that "sexual orientation is not a choice that can be changed at will, and that sexual orientation is most likely the result of a complex interaction of environmental, cognitive and biological factors...is shaped at an early age...[and evidence suggests] biological, including genetic or inborn hormonal factors, play a significant role in a person's sexuality." They say that "sexual orientation identity—not sexual orientation—appears to change via psychotherapy, support groups, and life events." The American Psychiatric Association says "individuals maybe become aware at different points in their lives that they are heterosexual, gay, lesbian, or bisexual" and "opposes any psychiatric treatment, such as 'reparative' or 'conversion' therapy, which is based upon the assumption that homosexuality per se is a mental disorder, or based upon a prior assumption that the patient should change his/her homosexual orientation". They do, however, encourage gay affirmative psychotherapy. Similarly, the American Psychological Association is doubtful about the effectiveness and side-effect profile of sexual orientation change efforts, including conversion therapy. The American Psychological Association "encourages mental health professionals to avoid misrepresenting the efficacy of sexual orientation change efforts by promoting or promising change in sexual orientation when providing assistance to individuals distressed by their own or others' sexual orientation and concludes that the benefits reported by participants in sexual orientation change efforts can be gained through approaches that do not attempt to change sexual orientation". Parenting Scientific research has been generally consistent in showing that lesbian and gay parents are as fit and capable as heterosexual parents, and their children are as psychologically healthy and well-adjusted as children reared by heterosexual parents. According to scientific literature reviews, there is no evidence to the contrary. A 2001 review suggested that the children with lesbian or gay parents appear less traditionally gender-typed and are more likely to be open to homoerotic relationships, partly due to genetic (80% of the children being raised by same-sex couples in the US are not adopted and most are the result of previous heterosexual marriages.) and family socialization processes (children grow up in relatively more tolerant school, neighborhood, and social contexts, which are less