Sexual Reparative (Conversion) Therapy Revisited
C. Richard Carlson, HR, is a Licensed Marriage and Family Therapist and has served the Presbytery of Mid-Kentucky as a member of the PJC and the Church Administration Committee.
On May 9th, 2001 the Associated Press reported that Dr. Robert Spitzer, who in 1973 was instrumental in helping the American Psychiatric Association remove homosexuality from its list of mental disorders, now had published “an explosive new study that says some gay people can turn straight if they really want to.”1
The story set off a media frenzy. Newspapers, TV reporters and talk show hosts featured the story. “Promoters of so-called ‘conversion therapies’ and organized opponents of gay and lesbian civil rights claimed that Spitzer’s study proved what they had been saying all along: that gays and lesbians ‘choose’ homosexuality and that they can be cured.”2
In fact the study did not draw this conclusion. The study said, in effect, that change in sexual orientation is unlikely. In Spitzer’s own words:
I anticipated some misuse of the study results, but I did not anticipate that some of the media would say such ridiculous things as that the study raised the issue of homosexuality and choice. Of course no one chooses to be homosexual and no one chooses to be heterosexual. I did anticipate, and in my presentation warn, that it would be a mistake to interpret the study as implying that any highly motivated homosexual could change if they were really motivated to do so. I suspect that the vast majority of gay people–even if they wanted to– would be unable to make substantial changes in sexual attraction and fantasy and enjoyment of heterosexual functioning that many of my subjects reported. I also warned against the study results being used to justify pressuring gay people to enter therapy when they had no interest in doing so and I have already heard of many incidents where this has happened.
None of the Medical and Professional Mental Health Organizations have changed their original position statements to be supportive of reparative therapies. The APA’s medical director, Dr. Steven Mirin, in a statement designed to distance the association from the Spitzer study said, “There is no scientific evidence supporting the efficacy of reparative therapy as a treatment to change one’s sexual orientation.” 4
Position statements of United States Medical and Professional Organizations are unanimous in their opposition to conversion therapies:
American Academy of Pediatrics (1993)
“Therapy directed specifically at changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation.”
American Academy of Child and Adolescent Psychiatry (1999)
“It has long been established that a homosexual orientation is not related to psychopathology, and there is no basis in which to assume that a parental homosexual orientation will increase likelihood of or induce a homosexual orientation in the child.”
American Medical Association (2003)
“Our AMA opposes the use of ‘reparative’ or ‘conversion’ therapy that is based on the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her homosexual orientation.”
American Psychoanalytic Association (2000)
“Psychoanalytic technique does not encompass purposeful efforts to ‘convert’ or ‘repair’ an individual’s sexual orientation. Such directed efforts are against fundamental principles of psychoanalytic treatment and often result in substantial psychological pain by reinforcing damaging internalized homophobic attitudes.”
American Psychiatric Association (1998)
“The American Psychiatric Association 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 the priori assumption that a patient should change his/her sexual homosexual orientation.” The APA removed homosexuality from its list of disorders in 1973. (In May 2000, the APA approved an expanded statement which said that the issue of changing sexual orientation needs to be seen in the light of what are referred to as the culture wars. Claiming that homosexuality is a mental disorder is an effort to discredit the social acceptance of homosexuality as a normal variant of human sexuality. The statement also said that this claim is not guided by rigorous scientific or psychiatric research, but by religious and political forces opposed to full civil rights for gay men and lesbians.5)
American Psychological Association (1997)
“No scientific evidence exists to support the effectiveness of any of the conversion therapies that try to change sexual orientation.” The association removed homosexuality from its list of disorders in 1975.
National Association of Social Workers (2000)
“No data demonstrate that reparative and conversion therapies are effective, and in fact they may be harmful….[S]uch treatment potentially can lead to severe emotional damage.” The association removed homosexuality from its list of disorders in 1977.
United States Surgeon General’s Report on Sexual Health (2000)
“Sexual orientation is usually determined by adolescence, if not earlier, and there is no valid scientific evidence that sexual orientation can be changed.”
There is one organization NARTH (the National Association for Research and Therapy of Homosexuality) which revived the discredited practice of reparative therapy. Such treatments include psychoanalysis, but also aversive behavioral conditioning (such as electric shock and noxious chemical therapy) as well as other potentially harmful treatments. Although many reparative therapists avoid such unconventional therapies, they are still employed more frequently than most will admit. The testimony of some who have horror stories suggest that nearly anything goes in the attempt to cure gays. 6
NARTH was formed in 1992 by psychiatrists who were embittered by the APA’s removal in 1973 of homosexuality as a disorder. In the words of former NARTH president Charles Socarides, “Homosexuality is a psychological and psychiatric disorder, there is no question about it. It is a purple menace that is threatening the proper design of gender distinction in society.” 7
NARTH exists to convert GLBT persons to heterosexuality, does not require any professional credentials to join, and claims to have 1,000 members. (The American Psychological Association has 151,000 licensed psychologists and the American Psychiatric Association has 40,000 licensed psychiatrists.)
So why, in light of such opposition to reparative therapy, is there still a market for this discredited therapy? Three reasons, all related, come forth immediately:
- The intensity of the internal conflict and the profound sense of isolation especially by self-loathing gays desperate to find acceptance in their churches and families and to find a panacea to end their same-sex attraction. 8
- The promotion of the conversion therapy model by the fundamentalist Christian right which says seductively, “You don’t have to be this way; you can change!” 9
- The political right wing organizations characterizing homosexuality as a “threat to society” or a threat to “family values” in order to keep gays out of the mainstream of society. 10
Unfortunately, the very therapies which offer essentially no hope (according to Spitzer’s study, a small minority—perhaps 3%—might have a ‘malleable’ sexual orientation (11) may well offer possible harmful side effects. But the practitioners of sexual conversion therapies have often overlooked or completely dismissed these psychological and social side effects. They ignore the medical dictum: First, do no harm.
- Besen, W.R. (2003) Anything but straight Unmasking the scandals and lies behind the ex-gay myth (p.234). Binghamton, NY: Haworth.
- Lund, S., Renna, C. (2003). ‘An analysis of the media response to the Spitzer study”. Journal of Gay and Lesbian Psychotherapy, 7 (3).
- Besen, p. 240.
- Besen, p. 235.
- American Psychiatric Association (2000). Commission on Psychotherapy by Psychiatrists (COPP): Position Statement on therapies focused on attempts to change sexual orientation (Reparative or conversion therapies). American Journal of Psychiatry, 159:1719-1721.
- Besen, p. 140.
- Besen, p. 138.
- Besen, pp. 61-62.
- Ford, J.G. (2001). Healing homosexuals: A psychologist’s journey through the ex-gay movement and the pseudo-science of reparative therapy. In A. Shidlo, PhD, M. Schroeder, PsyD, & J. Drescher, MD (Eds.). Sexual conversion therapy Ethical, clinical and research perspectives. (pp 148-162). New York: Haworth Medical.
- Drescher, J. (2001). Ethical concerns raised when patients seek to change same-sex attractions. In A. Shidlo, PhD, M. Schroeder, PsyD. & J. Drescher, MD (Eds.). Sexual conversion therapy Ethical, clinical and research perspectives. (pp. 185-187). New York Haworth Medical.
- Advocate (July 17, 2001).