REPARATIVE THERAPY:

STATEMENTS BY PROFESSIONAL ASSOCIATIONS AND THEIR LEADERS

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Although most of the following statements specifically mention reparative or conversion therapy, they would seem to be equally applicable to any attempt to change a person's sexual orientation, including efforts by transformational ministries. 

Overview:

The American Psychiatric Association removed homosexuality from its list of mental illnesses in 1973. The American Psychological Association followed suit in 1975; the National Association of Social Workers in 1977; the National Psychoanalytic Association finally followed suit in 1991, stating that homosexuality was not a disorder. ₁₆

The American Academy of Pediatrics, American Counseling Association, American Association of School Administrators, American Federation of Teachers, American Psychological Association, American School Health Association, Interfaith Alliance Foundation, National Association of School Psychologists, National Association of Social Workers, and National Education Association formed the "Just the Facts Coalition." They developed and endorsed "Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel" in 1999.

The primer says, in part: 

"The most important fact about 'reparative therapy,' also sometimes known as 'conversion' therapy, is that it is based on an understanding of homosexuality that has been rejected by all the major health and mental health professions. The American Academy of Pediatrics, the American Counseling Association, the American Psychiatric Association, the American Psychological Association, the National Association of School Psychologists, and the National Association of Social Workers, together representing more than 477,000 health and mental health professionals, have all taken the position that homosexuality is not a mental disorder and thus there is no need for a 'cure.'

"...health and mental health professional organizations do not support efforts to change young people's sexual orientation through 'reparative therapy' and have raised serious concerns about its potential to do harm." ₁₁

The primer includes a number of quotations from major professional organizations about reparative therapy and other methods of attempting to change individual's sexual orientation. One example is the American Academy of Pediatrics, which stated: "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." ₁₁

According to the National Association for Research and Therapy of Homosexuality, (NARTH) the only mental health professional organization that promotes reparative therapy, a number of organizations formed a coalition to oppose reparative therapy. The group includes:

1991:

In 1991, Gerald Davison, a former president of the Association for the Advancement of Behavior Therapy, argued that conversion therapy is ethically improper and that its existence only confirms professional and societal biases against homosexuality. ₁₈

1993:

The American Academy of Pediatrics published a policy statement in 1993 entitled "Homosexuality and Adolescence"  It was critical of any form of reparative therapy. They commented:

1994:

The American Psychiatric Association released a Fact Sheet in 1994-SEP which stated:  

There is no published scientific evidence supporting the efficacy of 'reparative therapy' as a treatment to change ones sexual orientation. It is not described in the scientific literature, nor is it mentioned in the APA's latest comprehensive Task Force Report, 'Treatments of Psychiatric Disorders (1989)'.

There are a few reports in the literature of efforts to use psychotherapeutic and counseling techniques to treat persons troubled by their homosexuality who desire to become heterosexual; however, results have not been conclusive, nor have they been replicated. There is no evidence that any treatment can change a homosexual person's deep seated sexual feelings for others of the same sex.₂

The American Psychological Association has published a brochure titled "Answers to Your Questions About Sexual Orientation and Homosexuality." It contains a section titled: "Can Therapy Change Sexual Orientation?" which reads: 

"No. Even though homosexual orientation is not a mental illness and there is no scientific reason to attempt conversion of lesbians or gays to heterosexual orientation, some individuals may seek to change their own sexual orientation or that of another individual (for example, parents seeking therapy for their child). Some therapists who undertake this kind of therapy report that they have changed their client's sexual orientation (from homosexual to heterosexual) in treatment. Close scrutiny of their reports indicates several factors that cast doubt: many of the claims come from organizations with an ideological perspective on sexual orientation, rather than from mental health researchers; the treatments and their outcomes are poorly documented; and the length of time that clients are followed up after the treatment is too short.

In 1990, the American Psychological Association stated that scientific evidence does not show that conversion therapy works and that it can do more harm than good. Changing one's sexual orientation is not simply a matter of changing one's sexual behavior. It would require altering one's emotional, romantic and sexual feelings and restructuring one's self-concept and social identity. Although some mental health providers do attempt sexual orientation conversion, others question the ethics of trying to alter through therapy a trait that is not a disorder and that is extremely important to an individual's identity. ₃

A RealAudio recording of a reparative therapy report by Rick Karr of National Public Radio at the APA 1997 convention is available. ₄

A 1994 resolution was defeated by the American Psychiatry Association membership. It would have branded therapists engaged in reparative therapy as following unethical practice. A similar resolution was defeated by the American Psychological Association in 1995. However, the latter overwhelmingly passed a resolution on 1997-AUG-14 which stopped just short of calling this form of therapy unethical. Doug Haldeman, president of the APA's Society for the Psychological Study of Lesbian, Gay and Bisexual Issues helped to write the resolution. He said "In the past 10 years, Christian fundamentalists have enlisted a coalition of old-style psychologists, psychiatrists and social workers who have become very visible in this country and internationally, and who have as a mission to 'help' homosexuals get rid of their sexual orientation... Our aim is not to try to stop them per se or interfere with anyone's right to practice [therapy] but we want to expose the social context that creates this market." APA officials are concerned that some who enter therapy are being coerced by their families, employers, church members etc.

The APA resolution asks that the therapist obtains "informed consent" from the client. This includes:

1. a full discussion of the client's potential for happiness as a homosexual,
2. communication to the client that there is no sound scientific evidence that the therapy works,
3. raising the possibility that therapy may exacerbate the client's problems, and
4. an analysis of the client's true motivation for wanting to change.

A spokesperson for the National Association for Research and Therapy of Homosexuality (NARTH), C.W. Socarides, commented on the resolution. NARTH is a small group which promotes the use of reparative therapy: "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 distinctions in society." They complained that the resolution infringed on the rights of therapists, that it was passed without due process and that an open hearing should have been conducted in which NARTH and other organizations could have participated. They would like the APA to attempt to correct what they feel is the "very widely disseminated, popular misconception that homosexuality is genetic."

The resolution received the expected condemnation from Evangelical Christian groups and the anticipated positive support from at least one homosexual civil rights group.

1996:

The National Association of Social Workers (NASW) adopted a policy statement on Lesbian, Gay and Bisexual issues. It states, in part: "Social stigmatization of lesbian, gay, and bisexual people is widespread and is a primary motivating factor in leading some people to seek sexual orientation changes. Sexual orientation conversion therapies assume that homosexual orientation is both pathological and freely chosen. No data demonstrate that reparative or conversion therapies are effective, and in fact they may be harmful. NASW believes social workers have the responsibility to clients to explain the prevailing knowledge concerning sexual orientation and the lack of data reporting positive outcomes with reparative therapy. NASW discourages social workers from providing treatments designed to change sexual orientation or from referring practitioners or programs that claim to do so. ₁₄

1997:

On 1997-JAN-9, the Wall Street Journal published an editorial in support of reparative therapy, called "Don't forsake homosexuals who want help." A flood of highly critical letters to the editor resulted, from psychiatrists, sociologists, les/gay associations, and individual gays and lesbians. ₉

The American Psychological Association overwhelmingly passed a resolution  on 1997-AUG-14, directed against reparative therapy and affirming a number of basic principles when accepting homosexual or bisexual clients. these include:

Their resolution concluded: "...the American Psychological Association opposes portrayals of lesbian, gay, and bisexual youth and adults as mentally ill due to their sexual orientation and supports the dissemination of accurate information about sexual orientation, and mental health, and appropriate interventions in order to counteract bias that is based in ignorance or unfounded beliefs about sexual orientation." ₅

By way of contrast, as of 1997, the Chinese Psychiatric Association still classified homosexuality as a mental disorder. Most professional therapists in that country regard sexual orientation as a curable illness. Sometimes, electric shock treatments are used in a futile attempt to convert gays and lesbians to heterosexuality. The Association changed their description of homosexuality in the year 2000.

1998:

In 1998-MAR, the Governing Council of the American Counseling Association (ACA) approved a motion that the association, "opposes portrayals of lesbian, gay, and bisexual youth and adults as mentally ill due to their sexual orientation; and supports the dissemination of accurate information about sexual orientation, mental health, and appropriate interventions in order to counteract bias that is based in ignorance or unfounded beliefs about same-gender orientation." Many counselors and therapists who work in reparative therapy perceive homosexuality as an mental illness or disorder. The Southern Region asked that the resolution be modified to acknowledge that counselors possess freedom of conscience and hold divergent religious views. Apparently, some ACA members attempt to help clients change their sexual orientation through reparative therapy, and they were concerned that gays or gay rights groups could use any statement by the ACA to launch lawsuits against them. Also, some counselors were affiliated with religious denominations which condemn homosexuality as a sin. Those ACA members were concerned that their Association holds a position that, in effect, condemns their religious beliefs. In 1998-SEPT, the ACA Advisory Council discussed resolutions from the Southern and Western regions to rescind or modify the March motion. The resolutions were rejected by a 17 to 4 vote. Robert Mate, a counselor in the office of the dean of students at Purdue University, and co-advisor of the LesBiGay Network on campus, said: "Many times, religion is used to justify hatred and discriminatory practices against gays. If mental health professionals are using their own religious beliefs to justify efforts to change sexual orientation, that, in itself, is a horrible ethical violation."

On 1998-DEC-14, the American Psychiatric Association rejected reparative therapy as ineffective and potentially destructive. _{6, 13} Their Board of Trustees unanimously adopted a position statement opposing reparative therapy. APA President, Rodrigo Munoz, commented: "It is fitting that this position opposing reparative therapy is adopted on the 25th anniversary of the removal of homosexuality as a mental disorder from the DSM [in 1973] There is no scientific evidence that reparative or conversion therapy is effective in changing a person's sexual orientation. There is, however, evidence that this type of therapy can be destructive." The Human Rights Campaign (HRC) responded positively to this stance. ₇

The APA statement said, in part:

"The potential risks of 'reparative therapy' are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient."

"Many patients who have undergone 'reparative therapy' relate that they were inaccurately told that homosexuals are lonely, unhappy individuals who never achieve acceptance or satisfaction."

"The possibility that the person might achieve happiness and satisfying interpersonal relationships as a gay man or lesbian is not presented, nor are alternative approaches to dealing with the effects of societal stigmatization discussed."

"Therefore, 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 a prior assumption that the patient should change his/her homosexual orientation. The American Psychiatric Association recognizes that in the course of ongoing psychiatric treatment, there may be appropriate clinical indications for attempting to change sexual behaviors."

Also in 1998-DEC, the American Counseling Association published an article on reparative therapy. Mary Bart, a former editor of Counseling Today, wrote:

1999:

On 1999-JAN-15, the American Psychiatric Association's Board of Trustees "endorsed a position statement at its December meeting that opposes therapeutic techniques some psychiatrists and mental health professionals claim can shift an individual's sexual orientation from homosexual to heterosexual. The Board acknowledged that there is no evidence that these so-called 'reparative therapies' have any efficacy in converting someone from one sexual orientation to another." ₈ The statement points out that "potential risks of 'reparative therapy' are great, including depression, anxiety, and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by a patient." APA President Rodrigo Muñoz, M.D. stated: "There is no scientific evidence that reparative or conversion therapy is effective in changing a person's sexual orientation...there is, however, evidence that this type of therapy can be destructive."

During 1999-APR, at its World Conference, the American Counseling Association adopted a position opposing the promotion of "reparative therapy" as a "cure" for individuals who are homosexual. ₁₂

2000:

The board of directors of the National Association of Social Workers (NASW) adopted a statement on therapy designed to change a person's sexual orientation. It said, in part:

"The increase in media campaigns, often coupled with coercive messages from family and community members, has created an environment in which lesbians and gay men often are pressured to seek reparative or conversion therapies, which cannot and will not change sexual orientation.

"Aligned with the American Psychological Association's (1997) position, NCLGB believes that such treatment potentially can lead to severe emotional damage..."

"No data demonstrate that reparative or conversion therapies are effective, and in fact they may be harmful..."

The National Association for Research and Therapy of Homosexuality (NARTH) is the only professional group in the West that considers homosexuality to be a "sexual disorder." Some of the following beliefs are derived from NARTH's Statement of Policy. Others are derived from a speech that NARTH's founder, Dr. Nicolosi, gave to a OneByOne meeting on 2000-JUN-26. ₁₀ 

2005:

Jack Drescher is a New York psychiatrist and chairperson of the American Psychiatric Association's committee on gay, lesbian and bisexual issues. He has treated about a dozen men who have undergone conversion therapy. Drescher said: "Reparative therapy is the laetrile of mental health." Laetrile was the quack cancer cure banned in the United States in the 1970s. He compares it with creationism and intelligent design. In an interview with the Washington Post, he said:

"Many people who try this treatment tend to be desperate, very unhappy and don't know other gay people. I see people who've been very hurt by this. They spend years trying to change and are told they aren't trying hard enough."

Dr. Nicolosi, a conservative Roman Catholic, is a founder of NARTH. He coined the term "reparative therapy." He said that this form of therapy: "...can only be damaging if the agenda of the therapist supersedes that of the patient." He claims that:

It would seem that he is admitting that reparative therapy has an almost 100% failure rate in terms of converting persons with a homosexual or bisexual orientation to heterosexual. He commented: "We say to patients, 'Your true self is heterosexual'." He tells male patients: "Look at your body: It was designed to fit a woman, not a man." ₂₀

Related essays on this web site:

References:

1. Policy statement, "Homosexuality and Adolescence," American Academy of Pediatrics, Pediatrics, 1993-OCT.
2. The American Psychiatric Association has a fact sheet on homosexuality at: http://www.thebody.com/apa/apafacts.html
3. The American Psychological Association has a fact sheet on homosexuality at: http://www.apa.org/pubinfo/orient.html
4. Rick Karr, "Gay Cure Controversy," NPR 1997-AUG-14, RealAudio recording at: http://www.npr.org/news/health/970814.gay.html
5. "Resolution on appropriate therapeutic responses to sexual orientation," American Psychological Association, 1997-AUG-14, at: http://www.hrc.org/feature2/apares.html
6. M.S. Katz, "American Psychiatric Association rebukes reparative therapy," APA, 1998-DEC-14. Text and news release on line at: http://www.psych.org/news_stand/rep_therapy.html
7. "APA bolsters condemnation of 'Reparative Therapy' to 'change' gays," Human Rights Campaign, at: http://www.hrc.org/feature1/apa22.html
8. "APA maintains reparative therapy not effective," 1999-JAN-15, at: http://www.psych.org/ 
9. "Letters to the editor: Homosexuality doesn't need a 'cure'," Wall Street Journal, 1997-JAN-23. See: http://www.aidsinfobbs.org/articles/wallstj/97/26 
10. "Homosexuality starts as a developmental disorder that can end with therapy," PCUSA NEWS, 2000-JUN-27; news release GA00064
11. "APA Online: Public Interest: Just the facts about sexual orientation and youth: A primer for principals, educators and school personnel," See: http://www.apa.org/pi/lgbc/publications/justthefacts.html 
12. "Action by American Counseling Association Governing Council," 1999-APR.
13. "Position Statement: Psychiatric Treatment and Sexual Orientation," American Psychiatric Association, 1998.
14. "Policy Statement: Lesbian, Gay, and Bisexual Issues." Approved by Delegate Assembly, NASW, 1996-AUG. Published in Social Work Speaks, 4th ed., NASW, 1997.
15. A more complete text of the NASW statement, along with a rebuttal by Exodus International, is available at: http://www.exodusnorthamerica.org/
16. Doug Nave, "Organizations of US Mental Health Professionals are unanimous," at: http://www.covenantnetwork.org/chgther.html
17. "American Counseling Association Passes Resolution to Oppose Reparative Therapy," NARTH, at: http://www.narth.com/docs/acaresolution.html
18. Mary Bart, "Counselors say conversion therapy claims are groundless and prejudicial," Counseling Today magazine, 1998-DEC, at: http://www.counseling.org/site/
19. Joseph and Linda Nicolosi, "A parent's guide to preventing homosexuality," InterVarsity Press, (2002). Read reviews or order this book safely from Amazon.com online book store. This book has been given a poor rating (2 stars out of 5) by Amazon.com reviewers.
20. Sandra G. Boodman, "Vowing to Set the World Straight: Proponents of Reparative Therapy Say They Can Help Gay Patients Become Heterosexual. Experts Call That a Prescription for Harm," Washington Post, 2005-AUG-16, at: http://www.washingtonpost.com/