Dr. Robert Spitzer, one of the leading psychiatrists in the US, recently did something remarkable. In a letter published in the Archives of Sexual Behavior on May 19th he humbly wrote, “I owe the gay community an apology.”
He was apologizing for a study -- first presented in 2001 and published in the Archives of Sexual Behavior in 2003 -- that examined at whether or not therapy could make gay people straight. Dr. Spitzer concluded that it could, based on interviews of 200 men and women recruited from centers that offered so called “reparative” or “conversion” therapy.
Conservative groups immediately heralded the study’s findings. After all, Dr. Spitzer was also one of the psychiatrists who lead the charge in the early 1970s to remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official system for classifying mental disorders in the United States. No one could thus accuse Dr. Spitzer of anti-gay bias. If his study found that being gay was a lifestyle choice, that must be true. And if being gay is a choice, then it is not something worthy of legal protection. It is something that should be treated, not tolerated.
In the 11 years since Dr. Sptizer’s study was published, it has been used by right-wing politicians and groups to argue against anti-discrimination and anti-bullying laws, as well as civil union and gay marriage statutes. The number of so-called “ex-gay” groups that offer reparative therapy has also surged. Exodus International, a religious organization whose mission is to promote “freedom from homosexuality through the power of Jesus Christ”, now provides referrals to over 250 reparative therapy groups throughout the country. The husband of US Congresswoman and Presidential candidate Michelle Bachmann runs one such faith-based therapy group, and even bills Medicaid for counseling sessions designed to turn gay people straight.
The problem with Dr. Spitzer’s study, however, is that it is inherently flawed. Most of the participants in the study were recruited through faith-based organizations like Exodus International or through groups like the National Association for Research and Therapy of Homosexuality (NARTH), which actively promotes the use of reparative therapy. Most of the participants also described themselves as deeply religious. Some were politically active ex-gay advocates.
The study also did not objectively measure same-sex attraction but simply asked participants about their sexual feelings and behaviors before and after reparative therapy. On average, the study participants underwent reparative therapy over 10 years prior to the interview but nevertheless were asked to describe “how gay they felt” before and after treatment.
Put simply, the study population thus was not representative of the vast majority of gay men and women in the US. The approach used to recruit participants was biased in favor of a small group of individuals who were likely to be ardent supporters of reparative therapy, and thus likely biased in their reporting of same-sex attraction after undergoing treatment. Recognizing these flaws, Dr. Spitzer has retracted his study. Moreover, unlike Mitt Romney and Dharun Ravi, he has expressed genuine remorse for the harm that he caused.
Despite what groups like Exodus International and NARTH claim, reparative therapy is ineffectual and even cause psychological harm. In 2009, for example, the American Psychological Association engaged in a comprehensive review of all of the available research on reparative therapy, including Dr. Spitzer’s study. They concluded that a person’s sexual orientation could not be changed with therapy. While some people might be able to change their sexual behaviors -- for example, by becoming celibate rather than having a relationship with an partner of the same gender -- their physical and emotional attraction to members of the same sex remained.
The erroneous belief that people can (and need) to be cured of their homosexuality also contributes to the continued stigmatization of gay men and women in our society. As a result of that discrimination, sexual minorities are more likely to be the victims of harassment, bullying and violence. They are also likely to have higher rates of anxiety, depression and suicide. This is particularly true of those who undergo reparative therapy.
Because of this, professional organizations like the American Psychological Association, the American Counseling Association, the American Academy of Pediatrics, and the National Association of Social Workers have all condemned reparative therapy. The American Psychiatric Association goes so far as to state that, "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."
Simply put, reparative therapy is wrong and should be banned. A bill before the California state legislature would do just that. It would prohibit reparative therapy for children under 18; parents would no longer be able to forcibly ship their teenager off to “straight camp”. The California bill require adults voluntarily seeking such treatment to be adequately informed of the risks of reparative therapy.
Being gay is not an illness. It doesn’t need to be treated through therapy. California's move to restrict the unethical promotion and practice of reparative therapy is a good one, and it is time for our state legislators to consider doing the same.