ANALYSIS OF DR. SPITZER'S  STUDY OF REPARATIVE THERAPY

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Professional organizations and conversion therapy:

Various professional organizations, including the American Academy of Pediatrics, American Psychiatric Association, American Psychological Association, and the National Association of Social Workers have stated that a person's sexual orientation cannot be changed by reparative therapy. _1,2

The one exception is the very small group: National Association for Research and Therapy of Homosexuality (NARTH). NARTH was founded in 1992 as a "non-profit, educational organization dedicated to the research, therapy and prevention of homosexuality." It currently consists of "more than 1,000 mental-health professionals." -- fewer than 1% of the therapists who belong to either of the APA's. _3,4 NARTH strongly advocates the use of reparative therapy, believing it to be very effective and safe. They regard homosexual behavior as a treatable disorder.

Background of Dr. Spitzer's study:

Dr. Robert Spitzer is a Professor of Psychiatry at Columbia University. During his three decades of psychiatric research, he has specialized in the topic of human sexual orientation. In 1973, he was one of the members of the American Psychiatric Association who was instrumental in removing homosexuality from their list of mental illnesses. The APA was the first major mental-health agency to do so. 

For their annual conference in 2000-MAY, the American Psychiatric Association had scheduled a panel discussion to debate whether there is any hard evidence that an adult's sexual orientation can be altered through reparative therapy.  Dr. Robert Spitzer was scheduled to be the moderator. Two psychiatrists withdrew from the panel, stating that the topic is too politically charged to permit scientific discussion. The debate was then cancelled. According to the APA: "The doctors who were to debate on the topic decided there was not enough scientific information to have a proper debate. They felt that any debate would turn into a political debate and not a true scientific debate. While there is information on reorientation therapy, there have been no controlled research studies." ₆ Dr. Spitzer said: "I think we ought to be able to talk about anything in a dispassionate way."  Referring to the speakers who dropped out, he said, "I think they [the psychiatrists who withdrew] felt that to even debate it was to legitimize the topic and they felt that since the groups that they regard as their enemy were kind of salivating over having the debate, they didn't want it."

Exodus International, a Fundamentalist Christian group who tries to help gays and lesbians change their sexual behavior, protested the cancellation. Their national board chairman, John Paulk of Colorado Springs, CO, said: "I'm here as one representative for a virtually unseen but sizable population. I once lived as a gay man, but now I'm heterosexual, something the American Psychiatric Association says does not exist." ₁₀ It is notable that he did not say that he was once gay; he said that he "lived as a gay man." We have a hunch that he has had a bisexual orientation during all of his adult life, engaging first in homosexual behavior, and more recently in heterosexual behavior.

At the time of the proposed debate, Dr. Spitzer suspected that an adult's sexual orientation is fixed. He said: "There is no documentary evidence showing someone’s sexual preference can be changed by therapy.

The term "sexual preference" is normally only meaningful when used to refer to persons with a bisexual orientation -- adults who are attracted to both men and women. Bisexuals are often attracted to one gender more that the other. They can thus be described as having a "preference." who The vast majority of adults have either a heterosexual or homosexual orientation. They are attracted to only one gender, and thus cannot accurately be said to have a "preference."  Dr. Spitzer appears to have used the term here in place of the more generally used term "sexual orientation." 

He continued: "There is only anecdotal evidence, mostly from the therapists themselves, claiming that what they do works. That’s not very scientific. On the other hand, there’s no scientific evidence to show that this is impossible...It hasn’t been studied."

Before the scheduled debate, Dr. Spitzer had decided to conduct a study of "ex-gays" and "ex-lesbians,"  These are individuals who:

Almost all are Evangelical Christians.

Definitions of terms:

Since essentially all "ex-gays" and "ex-lesbians" are conservative Christians, they generally use the same definitions of words as do Fundamentalist and other Evangelical Christians. That is:

About the study:

According to Parul Varnell of the Chicago Free Press, "Spitzer admits that he had 'great difficulty' finding people who claimed to have changed their orientation from gay to straight. Ex-gay groups regularly claim to know of 'thousands' of people who have 'changed' or 'left homosexuality.' But after searching for nearly a year and a half, Spitzer could only find 274 possibilities." ₈

Dr. Robert Spitzer finally studied 143 "ex-gays" and 57 "ex-lesbians" who had reported that they had become "straight." During 45 minute telephone interviews with each subject, they were asked 60 questions about their "feelings and behavior before and after their efforts to change orientation. They discussed their motives for change; their strategies, which included counseling, support groups, prayer and mentoring; and their current relationships with the opposite sex". ₇

Dr. Spitzer reported:

Of the 200 subjects, 86 had been referred to Dr. Spitzer by conservative Christian groups specializing in converting homosexuals.  NARTH referred 46 subjects. Some other sources provided 68. It is apparent that the individuals that Dr. Spitzer interviewed were hand-selected from a very large group of persons who had either a homosexual or a bisexual orientation. Those who had been unable to change their sexual behavior would not have become subjects in the study.

There are more than 1,000 professional therapists who belong to NARTH. Assume that the average member has treated 50 clients a year for the past five years. That means that there are over 250,000 clients from which NARTH could select subjects for this study. Assuming that reparative therapy had a "cure" rate of 0.02%  then NARTH would have been able to provide the approximately 50 "successful" clients to this study. But a cure rate of 0.02% can be expressed as a failure rate of 99.98% -- not a promising form of therapy! If one considers the anecdotal accounts of gays and lesbians who have committed suicide after failed reparative therapy, then it becomes even less attractive.

Dr. Spitzer reported his findings at a meeting of the American Psychiatric Association on 2001-MAY-9.

In later interviews, Dr. Spitzer said:

"It bothers me to be their knight in shining armor because on every social issue I totally disagree with the Christian right...What they don't mention is that change is pretty rare."

He noting that the subjects of his study were not representative of the general population because they were considerably more religious. He calls as "totally absurd" the beliefs that everyone is born straight and that homosexuality is a choice. ₂₀

Responses to Dr. Spitzer's study:

In response to Dr. Spitzer's study, the APA issued a statement affirming its position and cautioning that "there is no published evidence supporting the efficacy of reparative therapy as a treatment to change one's sexual orientation." _{Quoted in Ref. 2}

Other comments were:

"Hartmann noted the study was retrospective, that it lacked controls or independent measurements, and was based entirely on self-reports by people who were motivated to say they had changed because of their affiliation with ex-gay or anti-gay groups." ₂₀

"As for the scientific merits of his study, I believe it is significantly flawed. One flaw is that the majority of subjects in the study had one 45-minute telephone interview with Dr. Spitzer and no follow-ups. Other than Dr. Spitzer, I can find no reputable researcher who will agree that this is an accurate way to assess whether a person has changed their sexuality. That point was underscored in another study presented at the same symposium. Schroeder and Shidlo's study (in press) found that many individuals who claimed to have changed sexual orientation during a first telephone interview changed their story at a second, follow-up interview." ₂₁

Conclusions:

We have not been able to find any information on the subjects' original sexual orientation. We suspect that most or all had a bisexual orientation and had previously engaged in at least some homosexual activity. After therapy, we suspect that they remained bisexual, and feel that they have successfully developed a relationship with a person of the opposite gender.

Telephone interview data on behavior and practice are notoriously unreliable. Individuals often answer questions according to what they think others expect of them. For example:

On a topic as incendiary as changing one's sexual orientation, a lack of honesty can be expected on the part of many of the participants. This problem is even more severe in this study because so many of the subjects were so closely associated with ex-gay or anti-gay groups.

Assuming that the more than 1,000 therapists in NARTH each have had 50 clients per year over the previous five years, then they have treated over 250,000 homosexuals and bisexuals with reparative therapy. Various transformational ministries have treated other gays, bisexuals  and lesbians who were seeking change. Yet, Dr. Spitzer was only able to find 274 potential subjects for his study in all of America. This data alone indicates that reparative therapy is almost always a failure.

Author's note:

I am personally enraged at the irresponsibility of the large professional mental health organizations. They have not had a good record about emerging therapies. They took little effort in the 1980's and 1990's to curb recovered memory therapy which generated false memories of incest, Satanic ritual abuse, abuse in former lifetimes and abuse onboard UFOs. This experimental and untested therapy caused the destruction of tens or hundreds of thousands of families of origin, and probably triggered many hundreds or perhaps thousands of suicides.

Today, there are at least a 1,000 therapists conducting reparative therapy. There are many dozens of Fundamentalist Christian ministries also attempting to convert clients' sexual orientation. Yet no statistically valid, long term, peer-reviewed study in this field has ever been attempted that might give some indication of the therapy's safety and effectiveness. Dr. Spitzer's study was peer-reviewed and published. However, it was  confined to a small number of carefully selected subjects who were interviewed by telephone.

There are anecdotal stories of suicide attempts following failure of reparative therapy. With the information available in 2002, there was no reliable data on the therapy's safety and efficacy.

The situation is similar to that during the 1980s and 1990s with recovered memory therapy (RMT) and multiple personality disorder therapy (MPD). We now know that both were dangerous, responsible for the destruction of tens of thousands of families, created enormous numbers of false memories -- images of events that never happened. They drove some clients to suicide.

In 2006, the world is still waiting for a peer reviewed study of reparative therapy and transformational ministry therapy. If less than 1% of the millions of dollars spent on therapy had been directed to fund a meaningful study, then we would now be aware of the therapy's safety and effectiveness.

References:

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

1. "Answers to your questions about sexual orientation and homosexuality," American Psychological Association, at: http://helping.apa.org/daily/answers.html 
2. Doug Nave, "Organizations of US Mental Health Professionals are unanimous," at: http://www.covenantnetwork.org/chgther.html
3. The National Association for Research and Therapy of Homosexuality (NARTH) has a home page at: http://www.narth.com/
4. As of 2001-JAN, NARTH can be reached at: 16633 Ventura Boulevard, Suite 1340, Encino, CA 91436-1801. Phone: (818) 789-4440. Fax: (805) 373-5084
5. "Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel," at: http://www.apa.org/pi/lgbc/publications/
6. APA response copied from a reader's Email
7. Ethan Campbell, "Score one for politics," Boundless Webzine, at: http://www.boundless.org/2000/features/
8. Paul Varnell, "Those Not Very 'Ex' Gays," Chicago Free Press. 2001-MAY-16. Online at: http://www.indegayforum.org/articles/varnell65.html
9. See our essay on Christian practices in the U.S.
10. Psychiatrists cancel gay debate," Associated Press, 2000-MAY-18, at: http://cobrand.salon.com/news/wire/
11. Queer Resource Directory has an ex-gay section at: http://abacus.oxy.edu/qrd/www/rrr/exgay.html 
12. Doug Nave, "Organizations of US Mental Health Professionals are unanimous," at: http://www.covenantnetwork.org/chgther.html
13. CNN, 2001-MAY-9. Cited in Reference 12.
14. Wall Street Journal, 2001-MAY-23. Cited in Reference 12.
15. Advocate, 2001-JUL-17. Cited in Reference 12.
16. Barbara Pogue, "My Brother's Keepte - Part II," Lone Star Citizen, 2001-SEP issue. Online at Focus on the Family, at: http://www.family.org/cforum/
17. Pete Winn, "A life-changing study," Focus on the Family, at: http://www.family.org/cforum/
18. "Spitzer study is news but doesn't make the news," Family Research Council, at: http://www.frc.org/get/
19. " 'Some Gays Change," prominent Psychiatrist Says," Press release, Exodus International, at: http://www.exodusnorthamerica.org/
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/

21. Jack Drescher, "Letter from the American Psychiatric Association to the Finnish Parliament," 2001-SEP-23, at: http://www.finnqueer.net/

This essay was based partly on a number of information sources which are no longer online, including:

Copyright © 2002 to 2006 by Ontario Consultants on Religious Tolerance
Originally written: 2002-FEB-16
Latest update: 2006-JUN-04
Author: B.A. Robinson