I think the APA pessimism is warranted. Where are the controlled studies showing levels of change (not satisfaction) is likely?

I give, Warren. Where are they?

And some persons have also reported positive results from reorientation therapies.

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Timothy: Are you talking about published studies or anecdotal reports? How do these persons describe the “positive results”? Did they report that they had changed their sexual reorientation? Or did they mean some other sort of postive change?

“Mine is a more gay-affirming approach. If the person says I don’t want to be gay or lesbian, I don’t do those therapies,” she said.

I don’t either. Is there somewhere a therapist could go to learn how to do the “other” approach? By that I mean the approach that helps a client refrain from all gay sex, that supports the clien’ts belief that homosexuality is broken and sinful, and that helps a client build a non-gay identity?

What if the client was a Christian and wanted my help to renounce Christ and become Atheist — and I were a also Christian? Do I help him do it? How do I help him do it? Am I professionally obligated to help him do it? Must I help a client do something that is contrary to my own deeply held values?

Or for example, should a devoutly Chgristian, Bible-believing therapist (one who believes that folks who persist in “homosexual sin” are thereby placing themselves in eternal danger) help a gay client affirm his gayness? To improve his gay sex life? Is the therapist obligated to do so?

I agree with Dr. Revell. There is nothing unethical about telling a client what you can — and cannot do. Sometimes, the most therapeutic thing to do is to refer. But where?

I suspect the professor was relying on Shidlo and Schroeder’s 2001 paper in which they found that many reorientation patients reported that were harmed by the process. This has also been confirmed by anecdotal evidence through ex-ex-gay individuals and groups.

While Shidlo and Schroeder are important, at this point we have to consider that they did not identify which methods caused harm and which did not. Nor does it, or the anecdotal reports, provide data to allow us to know, on average, the severity of harm, the lasting impact, or the exact nature of the harm.

This area is one in which one should be cautious.

I think it is clear that some people within reorientation therapy have experienced harm and to me it’s easy to see how such harm might even be endemic to the entire process. After all, reparative therapy (the basis for most reorientation therapy) relies for its central core on pitting the patient against his parents in a blame game.

But we shouldn’t assume that this is always the case. And some persons have also reported positive results from reorientation therapies.

This post reminds me of an exchange I had during medical school with a lecturer during the sexuality unit who spent considerable effort emphasizing that reorientation therapy of any kind was unethical and was proven to harm patients. I asked him for the data, which he could not provide. He eventually referred me to a dated statement from the APA which substantially differed from the way he paraphrased, but when I pointed that out there was no response to the e-mail (and definitely no clarification to the class as a whole). I suspect that the current generation of medical students are being strongly indoctrinated with a politically motivated view that is not evidence-based.