An analysis of Dr. Spitzer's 2001 study
whether adults can change their sexual orientation
Responses to the study. Conclusions. APA
presentations. Spitzer interview. Author's note.
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. 1
Other comments were:
The then APA president, Lawrence Hartmann, a professor at Harvard
Medical School, called Spitzer's study "too flawed to publish." A
Washington Post article stated that:
"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." 2
On 2001-SEP-23, Jack Drescher, M.D., FAPA Chair
Committee on Gay, Lesbian and Bisexual Issues of the American
Psychiatric Association wrote a letter to the Finish Parliament which
discussed the Spitzer study:
"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
David Elliot, spokesperson for the National Gay and Lesbian
Task Force said, "The sample is terrible, totally
tainted, totally unrepresentative of the gay and lesbian community."
Psychologist Douglas Haldeman of the University of Washington
commented that there is no credible scientific evidence that
sexual orientation can be changed, "and this study doesn't
prove that either." He noted that the participants
appeared unusually skewed towards religious conservatives and
people treated by therapists "with a strong anti-gay bias."
Joan Gerry of the Gay and Lesbian Alliance Against Defamation
(GLAAD) referred to the subjects as:
"... a self-selected sample of people
who are so troubled by their sexual orientation that they will go to any
lengths to attempt to 'change' it. ...These are people who live in a
world where gays, lesbians and bisexuals are treated like second-class
The CNN.com report on the study claim that "some gay
people can turn straight if they really want to." The
implication is that the vast majority of people who try reparative therapy
or transformational ministry and fail to change their sexual orientation
were lazy; they just didn't try hard enough. The CNN report also implies that
the study showed that people can change their sexual orientation. There is
no evidence that any of the 200 subjects were able to do that; many probably had a bisexual orientation in the past and remained bisexuals at the time
of the study and afterwards; they just decided to stick with opposite-sex partners. Others probably had a homosexual orientation in the past and remained homosexual during therapy and afterwards; they just decided to be celibate.
Doug Nave of Covenant Network of Presbyterians commented:
"...the subjects did not have any anonymity that might help them candidly report
unfavorable outcomes; Spitzer could not assess their credibility
face-to-face; and the findings were based entirely on the subjects'
self-report (rather than, e.g., physiological measures of arousal),
which research has shown is often very misleading. In addition,
Spitzer's study has not been subject to any peer review or other normal
professional tests of validity. Some therefore believe that the study
merits no credit at all." 4
[Actually, after peer review, Dr. Spitzer's
paper was published in the 2003-OCT issue of the Archives of Sexual
Barbara Pogue, reporter at the Lone Star Citizen, wrote: "Spitzer concluded
that sexual orientation shifts are definitely possible, albeit rare,
unusual and difficult." 5
Joe Nicolosi, president of the National Association for Research
and Therapy of Homosexuality (NARTH), said that the study is "an
historic event in the history of psychiatry's understanding of
Family Research Council, a fundamentalist Christian group,
simply reported that:
"Dr Robert Spitzer's study of 200 former
homosexuals found that change is possible... [He] found that 66 percent
of the men and 44 percent of the women had achieved 'good heterosexual
functioning.' The vast majority of the study participants reported that
they were bothered only slightly, or not at all, by unwanted homosexual
The implication is that the subjects were chosen at
random from among homosexuals who had gone through therapy, and that
most homosexuals would have the same success rate if they tried to change their orientation. This is either inaccurate
Family Research Council, another fundamentalist Christian group, reported that the Spitzer study was
not widely reported in the media. However, Exodus International,
the largest evangelical Christian umbrella group of transformational
ministries stated that:
"The Spitzer study is reported in today's
issue of USA Today, The Washington Post, The New York Times, and was
released to hundreds of local newspapers by the Associated Press. The
story is also being widely reported on the World Wide Web through such
prominent news sites as foxnews.com, cbsnews.com, abcnews.go.com, and
msnbc.com. Dr. Spitzer was featured on this morning's edition of 'Good
Morning America.' " 8
ABC News interviewed Dr. Spitzer about the hazards of "change
therapy." He replied:
"There's no doubt that many homosexuals
have been unsuccessful and, attempting to change, become depressed and
their life becomes worse. ... I'm not disputing that. What I am disputing
is that is invariably the outcome."
He later told ABC news that some
of his subjects had become despondent and even depressed after having
been told "...by many mental health professionals that there was no
hope for them, they had to just learn to live with their homosexual
His assessment is probably accurate. There are anecdotal stories of individuals who had struggled with their homosexual or bisexual orientation all their life, and had finally tried reparative therapy or transformational ministry. When that failed, they realized that they had done everything possible to change and had been unsuccessful. They finally accepted their sexual orientation as fixed, came to terms of themselves as lesbian, gay or bisexual, and were finally at peace.
There are at least four fatal flaws in the study. in our opinion, any one of them
seriously weakens the validity of the study, in our opinion:
Most of the 200 subjects interviewed were referred by
reparative therapists or by Christian transformational ministries. Some were in leadership roles in such groups.
Apparently most of the clients were evangelical Christians.
They probably would have defined "homosexuality" in terms of
behavior, not orientation.
Any results would not necessarily be representative of
Dr. Spitzer seems to have asked the subjects whether they rated
themselves as "homosexual" before therapy. Being conservative Christians,
they probably would have answered this question in terms of their
behavior, not their sexual orientation. Dr. Spitzer did not include
"bisexuality" as an option. "Spitzer told Extra! he did not include
a category for bisexuality in his study 'because there's no accepted
definition of what bisexuality is'." Thus it is not known what percentage
of the 200 subjects initially had a homosexual orientation, and what
percentage had a bisexual orientation. The difference between the two groups is
massive. It is much easier to confine ones relationships to members of the
opposite sex if one is bisexual and thus sexually attracted to both men and women. We suspect that
most of the subjects had a bisexual orientation and had previously engaged in at least
some homosexual activity. After therapy, we suspect that they
remained bisexual, chosen to confine relationships with members of the
opposite sex, and feel that they have successfully developed such
relationship. Others had a homosexual orientation, still have that
orientation, and decided to be celibate.
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:
17% of American adults say that they tithe (i.e. give 10 to 13% of their income to their church). Only 3% really do.
Many polls indicate that the percentage of adults who
say that they regularly attend religious services is about 44% in the U.S.,
and a little under 20% in Canada and perhaps 10% or less in Europe. But when
noses are actually counted, the true figures are about half
the stated North American figures (about 20% in the U.S. and 10% in Canada.)
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, and were heavily motivated to show that
transformational ministry and reparative therapy works.
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 thousands or tens of thousands of other gays, bisexuals and lesbians who were
seeking change. Yet, Dr. Spitzer was only able to find 200 potential subjects
for his study in all of America. This alone indicates that reparative
therapy is almost always a failure.
Presentation of studies to the APA:
Although the panel discussion at the 2000-MAY annual conference of the American Psychiatric
Association never materialized, two studies were presented at the APA's
Dr. Robert Spitzer presented a paper described above and titled: "200 Subjects Who Claim to
Have Changed Their Sexual Orientation from Homosexual to Heterosexual."
Two psychotherapists from New York City, Ariel Shidlo and Michael
"... 202 randomly recruited subjects who had tried to change their sexual
orientation through therapy. 88 percent failed completely, while 9 percent
considered themselves successful but were celibate or still struggling with
same-sex behavioral "slips"; only six people (3 percent) were actually
"Additionally, Shidlo and Schroeder found that a great number of their
subjects suffered 'significant harm' due to instances in which reparative
therapists appeared 'not to be practicing in a manner consistent with the APA
Ethics Code'--encouraging patients to remember childhood abuse as the 'cause'
of their homosexuality when no such abuse occurred; insisting that lesbians
and gays can never live happy, healthy or monogamous lives; or practicing
coercion (for example, students at religious universities were sometimes
required to attend conversion therapy in order to graduate or receive
financial aid." 10
An article in Wikipedia speculated:
"Of the 8 respondents (out of a sample of 202) who reported a change in sexual orientation, 7 were employed in paid or unpaid roles as 'ex-gay' counselors or group leaders, something which has led many to question whether even this small 'success' rate is in fact reliable." 11
This study also has deficiencies. The subjects were self-selected, and thus may not represent the experiences of all gays, lesbians, and bisexuals.
Dr. Spitzer's comments on his study:
Dr. Warren Throckmorton interviewed Dr Spitzer in 2006 in which he gave his candid views on the meaning and value of his study:
I am personally enraged at the irresponsibility of the large professional mental
health organizations. I believe that it is close to depraved indifference. Such
organizations have not had a good record with emerging therapies. They took little effort
in the 1980's and 1990's to curb recovered memory therapy
(RMT) which generated false "memories" of incest, Satanic ritual abuse,
abuse in former lifetimes and abuse onboard UFOs. RMT, a therapy that was both experimental and untested, caused the destruction of tens or hundreds of thousands of families of
origin, and probably triggered many hundreds or perhaps thousands of suicides.
Thankfully, there are few therapists still conducting reparative therapy.
many dozens of fundamentalist or other evangelical 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 eventually peer-reviewed and published. However, it was confined to a small
number of carefully selected subjects who were interviewed by telephone. It is
a deeply flawed study as described above and in a book devoted to the study.
There are anecdotal stories of suicide attempts following failure of reparative
therapy. There is a general impression among secular therapists that the therapy is dangerous and has a miniscule success rate at changing sexual orientation. There is a general impression among reparative therapy counselors that it is safe and has a high success rate if the client is committed to change. However, there is still no accurate and 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 2010, 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 and ministry had been
directed to fund a meaningful study, then we would now be aware of the therapy's
safety and effectiveness. It could then be either abandoned or promoted.
The following information sources were used to prepare and update the above
essay. The hyperlinks are not necessarily still active today.
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/
Jack Drescher, "Letter from the
American Psychiatric Association to the Finnish Parliament,"
2001-SEP-23, at: http://www.finnqueer.net/