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REPARATIVE AND SIMILAR THERAPIES:

STUDIES OF THEIR EFFECTIVENESS & SAFETY

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Sponsored link.

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Overview:

Reparative and similar therapies are a group of experimental therapeutic techniques which attempt to change a client's sexual orientation from homosexual to heterosexual, or perhaps bisexual. It has been condemned by major professional associations as ineffective and/or unsafe. The American Psychological Association comments:

Can Therapy Change Sexual Orientation?

"No; even though most homosexuals live successful, happy lives, some homosexual or bisexual people may seek to change their sexual orientation through therapy, often coerced by family members or religious groups to try and do so. The reality is that homosexuality is not an illness. It does not require treatment and is not changeable..." 4

These therapies is strongly supported by many conservative Christian ministries as both effective and safe. Most believe that homosexual behavior in adulthood is caused by poor parenting received as a child, by sexual molestation of children or some other environmental factor. There are two main therapies being promoted:

bulletReparative therapy which involves non-sexual intimacy with members of the same gender.
bulletPrograms of Transformational ministries which involves prayer, various types of therapy, salvation, and religious conversion.

Few studies have been made into the effectiveness and safety of these therapies. One study is incomplete as of the spring of 2001; the others appear almost worthless. This situation has happened before within the mental health community. In the past, thousands of individual psychologists, psychiatrist and other therapists have occasionally adopted unproven, experimental forms of patient treatment. They have used it on tens of thousands of uninformed clients, some of whom have been driven to suicide. Recovered memory therapy is one such therapeutic technique; Multiple personality disorder (a.k.a. Dissociative Identity Disorder) is another.

It would appear from the available data that mental health professional organizations are correct: these therapies is ineffective, contraindicated and unsafe. In our opinion, therapists and conservative Christian ministries have an ethical responsibility to discontinue these therapies until such a time as they can be demonstrated to be safe. As a minimum therapists and ministries would appear to have a responsibility to inform their patients and clients (and the parents or guardians of non-adult patients and clients) that counselling geared to changing sexual orientation has no proven value and can lead to serious depression and suicide in some individuals. 

Dean Klinkenberg, PhD, a postdoctoral fellow in clinical psychology at the Missouri Institute of Mental Health commented: "Nobody has ever had any real success in changing sexual identity...Is it ethical to offer therapy that has a long history of being ineffective?" 7

Of the many studies to evaluate the safety and effectiveness of reparative therapy, none are particularly illuminating: 

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Exodus International (1978):

They claim a success rate of 71.6%. However, they do not maintain follow-up data on individuals who have been through their program. Two outside psychiatrists, were allowed to interview members of Exodus International in 1978. Of the ministry's 800 members at the time, 30 were selected by the ministry staff as having changed from exclusively homosexual to exclusively heterosexual in orientation. The researchers interviewed the 30 and determined that only 11 had really been largely "cured" of their homosexual behavior; they had remained celibate. Eight of the 11 continued to have a homosexual or bisexual orientation; they still reported homosexual dreams, fantasies and/or impulses. However, they have chosen to be celibate. If the rate of success is defined as the percentage of clients with a homosexual orientation who became heterosexual, then this survey found a less than 0.4% success rate. 

Two of the 11 should not be counted among their successes. They were Michael Bussee and Gary Cooper, who were among the many founders of Exodus in 1976. They fell in love and were united in a commitment ceremony after the above study was completed. As shown in the documentary movie One Nation Under God they later criticized their own organization and other ministries for gays as fraudulent. They said that the Exodus program was "ineffective...not one person was healed." They stated that the programs tend to increase guilt and a sense of personal failure among those who are trying to "sexually re-orient" themselves through reparative therapy. Many had suicidal ideation after they failed.

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Masters and Johnson (1979):

Masters and Johnson claimed an impressive conversion rate of 50 to 60% which was maintained for 5 years after treatment. There were a number of unusual factors in this study: 1

bulletthe conversion rate refers to behavior, not orientation or feelings
bulletthe 67 clients were not randomly selected; they had to be highly motivated to change their behavior
bulletall subjects had to have a partner of the opposite gender with whom to attempt heterosexual sex during the program
bullet40 of the clients were already married to persons of the opposite sex
bulletall clients were given a test to determine their sexual orientation, ranging from 0 (purely heterosexual) to 6 (exclusively homosexual). Only five of the subjects (7%) were given the latter classification. Presumably there were no "0's" in the study. This means that 93% of the subjects were bisexual. 55 (82%) were rated 2, 3 or 4 and were more or less equally attracted to men and women.
bulletthe client's own definition of success was used to determine how many subjects changed behavior. Some of the clients had very limited objectives.

This study basically concluded that many bisexuals are able to decide to confine their sexual activity to members of the opposite sex, and to not act on their continuing attraction to members of the same sex. The results say nothing about homosexuals. It is not known whether any of the exclusively homosexual subjects were able to convert to heterosexual behavior.

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Sponsored link:

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National Association for Research and Therapy of Homosexuality (NARTH) (1997) 2

NARTH is a small group of about 500 mental health professionals. They are alone among mental health professional associations in believing that a homosexual orientation is a curable mental health disorder caused by poor parenting. They beieve that it can be overcome with reparative therapy. On 1997-MAY-17, they announced the results of a two year study of 860 clients and their more than 200 psychologists and therapists.

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Schroeder & Shidlo:

Two psychiatrists conducted a study to determine the experiences of people who have been treated by either ex-gay ministries or individual therapists with reparative therapy. "Changing Sexual Orientation: Does Counseling Work?" is sponsored by the National Lesbian and Gay Health Association; it is funded by the H. van Ameringen Foundation; it is being conducted by Drs. Michael Schroeder & Ariel Shidlo, 412 6th Ave., Suite 602, New York, NY 10011.

Many of their subjects applied via the Internet. They published a survey form which gays and lesbians who have undergone reparative therapy could fill out. Subjects were able to remain anonymous, or could enter their Email address at the bottom of the form.  Unfortunately, this study may be of limited usefulness. The data probably came from people who were sufficiently motivated to report on their experiences with reparative therapy; this may or may not be a representative sample of the total population involved in this form of therapy.

In 1997-SEP-26, the Detroit News published an article about their tentative results up to that date. The researchers were then halfway towards their goal of 200 subjects. Shidlo reported that:

bulletAfter reparative therapy, clients: "Frequently... become very, very depressed." This commonly triggers self-destructive behaviors (e.g. unsafe sex, drug abuse, attempted suicide, self-hatred).
bulletThe stability of the client's family of origin can be harmed by teaching the concept that homosexuality is caused by poor parenting.
bulletSome religious gays and lesbians felt a profound sense of failure when they cannot attain what they felt God expected of them.
bulletOne common result of the failure of reparative therapy is that it finally convinces some clients that their sexual orientation is truly unchangeable. The client may consider this to be a positive result as it this can lead to their final acceptance of homosexuality as an integral part of what they are.
bulletThe researchers had not yet found any "cures" as a result of reparative therapy. Two male subjects initially reported that they had been cured, but later admitted that they had simply chosen to be celibate; their sexual orientation was unchanged.

Shidlo said: "If it were changeable, I think we would have seen it by now. There's been so much effort expended on it -- so many tears, so many dollars, so much energy, so many promises -- that it would have happened to someone. And if there is such a person out there, I'd love to talk to them...They tell me in retrospect, it was a sham. They were fooling themselves, or they were fooling others or both.

They presented their paper at the annual meeting of the American Psychiatric Association on 2001-MAY-9. They found that eight of the 202 subjects studied reported that they were able to change their sexual orientation. However, seven of the eight were involved in the ex-gay movement as counselors or group leaders. Some have suggested that their stories may not be accurate. There is a good chance that one of the 202 was telling the truth, making the reported failure rate for reparative therapy equal to 99.5%.

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Dr. Robert Spitzer (2001)

Dr Spitzer is a psychiatry professor at Columbia University. He conducted a study of 143 ex-gays and 57 ex-lesbians who reported that they have become "straight." 2 He reported his findings at the same meeting of the APA as mentioned above. He concluded, as a result of 45 minute interviews with each subject, that 66% of the males and 44% of the females had arrived at "good heterosexual functioning." According to Cnn.com, that term is defined as having been "in a sustained, loving heterosexual relationship within the past year, getting enough satisfaction from the emotional relationship with their partner to rate at least seven on a 10-point scale, having satisfying heterosexual sex at least monthly and never or rarely thinking of somebody of the same sex during heterosexual sex." 

The CNN.com report on the study claim that "some gay people can turn straight if they really want to." 

Unfortunately, there appear to be serious flaws in the study, and in its reporting in the media:

bulletThe reports in the media imply that most of the subjects have a homosexual orientation. This is not true. All but 11% of the men and 37% of the women report that they still have some indicators of homosexual orientation, including same-sex attraction. That is, after therapy they are bisexuals, not heterosexuals.
bulletMost of the subjects referred to Dr. Spitzer were referred by conservative Christian sources and appear to have been hand-picked from a very large number of homosexual and bisexual individuals. 
bulletNo information source that we have been able to find described the original sexual orientation of the subjects. We suspect that most or all had a bisexual orientation and engaged in at least some homosexual activity. After therapy, we suspect that they remain bisexual.

More details on this study.

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Anecdotal information:

bulletA representative of the Honolulu, HI Gay and Lesbian Education and Advocacy Foundation (at HawaiiGay1@aol.com ) discussed two local Fundamentalist Christian groups dedicated to "curing" homosexuality: Exodus International and Homosexual Anonymous. He made a posting to the religion@cpp.critpath.org mailing list on 1996-DEC-5. He said: "In Honolulu we have 25 year old group called the Honolulu Gay Support Group. Over the years we have had hundreds of individuals who tried either of those programs and finally came to honestly deal with their Gayness. I can honestly say, I have never seen one of them claiming they were cured or felt better until they began to accept their goodness as a Gay person."
bulletMel White is a prominent Evangelical Christian. He ghost-authored many books for Evangelical Christian leaders. He had fought his gay sexual orientation for years. When he finally came out of the closet, all of his contracts were canceled and his former clients refused to speak with him. He describes his multi-decade experience with reparative therapy in his book "Strangers at the Gate." It is a profoundly moving book that will change the lives of many of its readers. 3

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References:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. Masters and Johnson, "Homosexuality in Perspective", 1979.
  2. The National Association for Research and Therapy of Homosexuality (NARTH) has a home page at: http://www.narth.com/
  3. Mel White, Stranger at the Gate: To be Gay and Christian in America", Simon & Schuster, New York, NY, (1994)  Read reviews and/or order a copy
  4. "Answers to your questions about sexual orientation and homosexuality," American Psychological Association, at: http://helping.apa.org/ 
  5. "Ex.Ex" examines and explores "the reality of the Ex-Gay movement." See: http://hometown.aol.com/
  6. Queer Resource Directory has an ex-gay section at: http://abacus.oxy.edu/ 
  7. Randall Edwards, "Can sexual orientation change with therapy?" APA Monitor. Online at: http://www.apa.org/

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Copyright © 1996 to 2006 by Ontario Consultants on Religious Tolerance
Latest update: 2006-MAY-15
Author: B.A. Robinson

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