I don’t have a problem with any of those points.

Just me, but I’d be more clear and ask that if a client presents with issues (such as major depression, substance abuse, a distorted view of how they think people live as gay, whatever) that these are dealt with first. Without tackling those, the very idea of obtaining “informed consent” is problematic.

At the end of the day people are entitled to be as ridiculous as they see fit, but we should expect more from a professional therapist.

At least, at work I mean 🙂

A brief summary of the APA history around reorientation therapy is here (it’s the article by Haldeman).

I think they’re still struggling to ensure good practice without being overly prescriptive in an environment of seemingly willful nonsense from many (most?)reorienation therapists (eg Hallman in Warren’s post after this one) and false “advertising” from groups like Exodus, Focus etc.

I guess RT advocates can’t really complain. Nothing wrong with a caution. It’s not like anything is being banned. I believe a few years ago, the APA attempted to ban all RT’s, but the resolution failed at the last minute.

I wouldn’t have any problems with so called “conversion” therapies to help people change if:

a) the therapist first takes a realistic look at the patient to see if he indeed is capable of adapting to a heterosexual life. (check to see if he has latent heterosexuality?)

b) the therapist helps boost the patient’s overall self esteem, beyond merely trying to turn them on to the opposite sex.

c) work towards alleviating the patient’s sense of shame, and help him get over feelings of internalized homophobia–of not measuring up, of feeling defective.

d) do NOT precede from the premise that homosexuality NEEDS to be changed in order for the patient to be happy

I believe that it is possible to simultaneously respect the client’s will to change AND fulfill the above criteria.

Perhaps it just takes a really, really good therapist

Spitzer’s estimate is a guess. He has acknowledged as much. It doesn’t seem scientific to make policy based on a guess and anecdotes (Drescher).

The policy they have is cautionary. It does not ban reorientation therapy, as you’ve said many times, but it does alert both professionals and potential clients. I imagine that comes under resonable informed consent, no?

Yes, Spitzer is guessing. Yes, Drescher is working from anecdotes (his, and that of many others). I do wonder how you would describe the basis used by reorientation advocates, such as yourself?

Given RTs are only dealing with a minority of gay men and women — and failing to change them the majority of the time — I’d suggest that their grip on the science is even less secure.

The anecdotes of harm, and the APAs caution, do at least align with very well established information. Without even needing to see a client, attempts at reorientation have the potential to increase negative feelings that the client has about themself. These feelings are why they seek reorientation in the first place (in nearly all cases). The vast bulk of the literature and practice aligns with (I say, was designed to align with) a virulent social prejudice, as the APA has noted.

The potential for great harm therefore exists, a priori; particularly if the therapist deliberately uses that negativity to raise the stakes in the mind of their client. And particularly when the client fails to change, as most will even by the exgay promo materials.

(I don’t know where you sit on all this, but Nicolosi comes immediately to mind — let alone the “counselors” in the religiously-inspired exgay groups).

I don’t think the APA is under any obligation to establish the research. They aren’t the ones encouraging or promoting the attempts. Surely, that research is your obligation?

I felt no pressure from admin to get kids to enter reorientation.

And what pressure does the admin place on GCC kids? I’ve seen the current GCC handbook, and it makes it perfectly clear. While sexual orientation itself is not grounds for removal, an “uncooperative” attitude to that orientation is where the student and GCC part company. While at GCC they must adopt, at least in public, a negative attitude to that sexuality. Homosexuality activity — very broadly defined at GCC — is grounds for immediate expulsion. CK remembers the environment all too well, and this is unrelated to how you professionally conduct yourself while in session.

But we’re not talking at about little GCC. I’m more interested to know how the reorientation attempts that you advocate for are to be reconciled against the potential for harm (and the known behaviour of some therapists) when considering the 97-99% that you don’t see.

Until those are resolved, and given there is no medical reason per se to not be gay or lesbian, the APA is correct to caution anyone considering an attempt. They are being responsible.

Spitzer’s estimate is a guess. He has acknowledged as much. It doesn’t seem scientific to make policy based on a guess and anecdotes (Drescher).

I would not ask the APAs to endorse anything related to reorientation. On the other hand, I do not think it is appropriate to take the advocacy position they have taken. I think there should be more research, and a task force created with proponents and opponents to come to consensus about what we know, and what we don’t.

Ck – I am no longer in the Counseling office. I am in professoring and public policy full time. I do continue a small private practice.

The counseling service has no obligation to alert admin about anything except suicide or homocidal students. It would be unethical to do anything else. I know of no student removed for homosexual orientation however defined.

I have worked with gay couples in a variety of contexts, although as you might imagine, very few come to see me. I have also worked with clients who do not pursue reorientation and those who are deciding what to do. I felt no pressure from admin to get kids to enter reorientation. In fact, it has never come up about any student in the 11 years I have been here. Say what you want about GCC, this is a place that respected ethics (counseling ethics at least). When I came here I told them what the professional ethics were regarding the counseling services and admin has always respected it. I am glad for that environment.

In reference to the “unique individual” as coined by you, and described by Drescher below:

Dr. Spitzer and myself are of the opinion that there is a small group of people whose sexual orientation can change, sometimes even without any therapy. But neither of us believe that everyone’s sexual orientation can change. To claim that everyone can change or that everyone should change is simply not true. To scientifically argue for that position in opposition to gay and lesbian civil rights is not only a misuse of Dr. Spitzer’s study but a travesty of science itself.”

I’d agree with you, Spitzer, and Drescher that to use these rare, special individuals to drive a political movement is not right. It’s pathetic, its almost like they are grasping at straws to drive their own specific ideology.

However, with regards to the concept of wanting to change one’s sexual orientation, I can’t say that I’d wish it would be illegal, after all, patient’s have a right to do what they want. One of my biggest problem with such therapy is the lack of selection criteria (as well as other things which you can probably guess).

In some interviews, Drescher further states that there is no selection criteria for conversion therapies–anyone who tries will be told that they can do it if they try harder. He seems to imply that IF this type of therapy is to continue existing, there needs to be a screening test for those who apply, to see if they do indeed have that special trait to be able to change.

This is very important. However, I don’t see how such a thing would work out. After all, how would you test someone to see if they are indeed a unique individual?

Furthermore, in my mind, conversion therapy needs to be separated from fundamental Christianity. It needs to get over its own self importance, if that makes any sense. It needs to be Post Modern, and respect the diversity of forms of life, as well as cultural and contextual sensibilities. Otherwise, it’s dangerous.

The therapist must be able to equally and happily support a gay man trying to improve a gay relationship, as well as a gay man who would like to explore the possibility of change.

I’d be please to converse with “conversion therapists” who fulfill the above criteria.

U.M.

You are correct. Drescher has dealt with hundreds of gay clients over the years (not just ones recovering from reorientation therapy). His comment was related to how many of those gay men have displayed a flexible sexuality — namely, just the one.

As Jerry Springer has long known, and which Drescher doesn’t dispute, if you wait long enough some rare individual will eventually present themself.

Unfortunately, it is this unique individual that is being touted as proof that “some”, “many”, “most” or “any” gay man or lesbian can change into a heterosexual.

Spitzer himself estimated that a flexible sexuality only applied to 3% of people. Drescher’s experience suggests even less, although he is specifically talking about men.

All the professional bodies are concerned about the other 97%-99% (who cannot and do not change) and the implications for their health should reorientation therapy continue to be aggressively marketed as a suitable final solution.

That is why they do not endorse any promotion of reorientation therapy.

But you then mention that these 20 people are, mostly, still attempting exgay therapy.

Given this, are they yet in a position to gauge any harm done to themselves? Do you imagine they will return to you for a reversal if (or when) they come to understand that they have been?

Drescher’s personal dozen were already well past the position of your own clients. His clients were once doing what yours now are — and only LATER sought out a therapist to repair the damage. How many clients have you seen that fit that category?

Apart from that, Drescher speaks on behalf of a professional body; not just himself. As Chair of the APA’s Committee on Gay, Lesbian and Bisexual Issues he has had access to the large number of collegues that have their own experience with former clients of reorientation therapy. Hence, current APA policys on the matter.

As tempting as it is to reduce this to “I say, he says” — that could be too easily turned…

> How many gay men or women have you affirmed in their homosexuality after they sought help in overcoming an anti-gay background (often conservatively religious)?

> How many gay couples have you positively supported through a rough patch in their relationship?

Given these are the overwhelming bulk of the work undertaken by therapists working specifically on gay sexuality issues, where exactly does this place yourself with regard to homosexuality as a subject?

“There are probably a small number of people with some flexibility in their sexual identity who can change,” he said. “Out of the hundreds of gay men I’ve treated, I’ve had one.”

So is he saying that he’s treated hundreds of gay men who’ve been harmed by conversion therapy, or just that he’s treated 100’s of gay men in general?

My hunch is that it’s the latter, and for now, it would appear you are right about the amount of patient’s he’s treated. I don’t mean to be nit picky, but its important to get these things straight (no pun intended).

It would be interesting to see how you and him differ in your treatment of your patients.

U.M.