In 2000, I presented a paper at the annual conference of the American Psychological Association outlining studies which referred to ex-gays, i.e., people who rejected gay as an identity for religious reasons. That presentation was part of a larger symposium organized by Mark Yarhouse and Doug Haldeman on religious and GLB issues. In 2002, that paper was published in the APA journal Professional Psychology: Research and Practice.* That was the same year I was given the Freud Award at the NARTH conference.
In that paper, I summarized a study by psychiatrist E. Mansell Pattison and his wife Myrna Loy Pattison, titled “‘Ex-gays’: Religiously Mediated Change in Homosexuals.” The Pattisons interviewed 11 men in the Melodyland church in Anaheim, CA who claimed to have changed from gay to straight. One of those men was frequent commenter here Michael Bussee. Another was Gary Cooper, the man who left that ministry and Exodus with Bussee when they both acknowledged that they had not changed their orientation. In other words, two of the 11 had not changed at all.
Today, on the Religion Dispatches website, I describe that study in more detail and interview Michael Bussee about his participation. I encourage you to go read it and comment here or there.
The study continues to be used by NARTH as well as other groups to claim sexual reorientation works. The problems with the study provide more evidence that NARTH’s use of old data (125 year landscape review) is flawed.
*Throckmorton, W. (2002). Initial empirical and clinical findings concerning the change process for ex-gays. Professional Psychology: Research and Practice, 33, 242-248.
Category: ex-ex-gay
The Jones and Yarhouse study: What does it mean?
Let me begin by saying that I endorsed the book, Ex-Gays, A Longitudinal Study of Religiously Mediated Change in Sexual Orientation, by Stanton Jones and Mark Yarhouse which contained the first report of their longitudinal study. Since the publication of the book, Jones and Yarhouse have released results of their final follow up, first in 2009 at the annual convention of the American Psychological Association, and then most recently in the Journal of Sex and Marital Therapy. With the follow up, I believe the study remains an important investigation into the interplay of religion, sexual orientation and personal identity. I give them credit for the perseverance required to explore a topic which is highly controversial and to report their findings in detail.
Since the release of the peer-reviewed article, socially conservative groups have described the study as proof that gays can change orientation. For instance, the American Family Association’s Bryan Fischer, one of the worst offenders, claims that the study proves gays can change and that they weren’t born gay. Also, Citizenlink, an affiliate of Focus on the Family reported:
Of the 98 subjects, more than half were reported as successful; 23 percent reported a complete change in orientation after six years. Also, 20 percent reported giving up the struggle to change.
This claim is misleading. Jones and Yarhouse did not report “complete change in orientation.” Instead they cautioned against misinterpreting their findings by saying
These results do not prove that categorical change in sexual orientation is possible for everyone or anyone, but rather that meaningful shifts along a continuum that constitute real changes appear possible for some. The results do not prove that no one is harmed by the attempt to change, but rather that the attempt does not appear to be harmful on average or inherently harmful. The authors urge caution in projecting success rates from these findings, as they are likely overly optimistic estimates of anticipated success. Further, it was clear that “conversion” to heterosexual adaptation was a complex phenomenon.
Regarding the changes reported by their participants, the authors offer two related explanations. One is that some of the participants changed sexual orientation to some degree and the other is that the participants changed their sexual identity. Sexual identity involves placing more emphasis on behavioral conformity to prohibitions on homosexual behavior as a means of self definition. For the Exodus participants, less temptation to engage in homosexual behavior might be taken as a signal that orientation has changed, thus allowing a different attribution about their sexuality than once believed. The authors raise these two possibilities in the abstract for the most recent paper:
The authors conducted a quasi-experimental longitudinal study spanning 6–7 years examining attempted religiously mediated sexual orientation change from homosexual orientation to heterosexual orientation. An initial sample was formed of 72 men and 26 women who were involved in a variety of Christian ministries, with measures of sexual attraction, infatuation and fantasy, and composite measures of sexual orientation and psychological distress, administered longitudinally. Evidence from the study suggested that change of homosexual orientation appears possible for some and that psychological distress did not increase on average as a result of the involvement in the change process. The authors explore methodological limitations circumscribing generalizability of the findings and alternative explanations of the findings, such as sexual identity change or adjustment.
As I read all of the literature, including my own work, I first want to disagree with the way that Citizenlink characterized the results as “complete change.” That is not at all what Jones and Yarhouse reported. Considering the dichotomy proposed by Jones and Yarhouse — change in orientation or identity – I lean toward their alternative explanation – “sexual identity change or adjustment.” However, I believe the discussion of what their results mean needs to be broadened beyond those two possibilities. In addition to considering orientation and identity as important constructs, I believe there are other ways to account for the changes Jones and Yarhouse report which are not sufficiently addressed in their published accounts. First, I want to make some observations about the study which influence my opinions about what the results mean.
First, and most basically, the Jones and Yarhouse study did not examine in any systematic way the efficacy of reparative therapy or any other kind of psychological therapy as a means of altering sexual orientation. The participants in the study were involved in religiously based support groups which primarily had as a goal to reinforce a traditional moral view of sexuality. Clearly, the participants hoped they would change and engaged in various religious interventions to assist that end. However, the study did not assess the role of professional therapy and cannot legitimately be used to say such therapies work.
Second, there were quite a few dropouts six to seven years into the study. While true of all longitudinal studies, the final percentages being reported should also take into account the distinct possibility that many if not most of the drop outs were not successful in their efforts to change. The study began with 98 participants and ended up with 65 who were followed up for six to seven years. Some reported that they were healed of homosexuality and just didn’t want to participate, while others said they were gay and stopped trying to change. I don’t know for sure what the dropouts mean but the fact that so many failed to complete the study needs to be a part of any discussion.
Third, ratings from men and women were combined. Given the low number of people involved I understand why this was done but the practice may inflate the assessments of change for the group. It has become well accepted that the sexuality of women is more fluid than for men. A few women experiencing large shifts could influence the group averages. Continue reading “The Jones and Yarhouse study: What does it mean?”
NARTH Touts Jones and Yarhouse Study
I was wondering when NARTH would weigh in on the Journal of Sex and Marital Therapy publication of the Jones and Yarhouse study. Dated October, 2011, the title of the post — Change in Sexual Orientation is Possible — immediately spins the study. Here is what the press release about the Jones and Yarhouse study says:
WHEATON, Ill., Sept. 27, 2011 /Standard Newswire/ — Many professional voices proclaim that it is impossible to change homosexual orientation, and that the attempt to change is commonly and inherently harmful. Psychologists Stanton L. Jones (Wheaton College, IL) and Mark A. Yarhouse (Regent University) have just published in the respected, peer-reviewed Journal of Sex and Marital Therapy the final results of their longitudinal study of individuals seeking sexual orientation change through involvement in a variety of Christian ministries affiliated with Exodus International. The results show change to be possible for some, and the attempt not harmful on average. These results stand in tension with the supposed professional consensus; more information is available at www.exgaystudy.org.
In prior studies, in the words of the American Psychological Association, “treatment outcome is not followed and reported over time as would be the standard to test the validity of any mental health intervention.” This study assessed evolving sexual attractions and psychological distress levels of 98 individuals seeking sexual orientation change beginning early in the change process, and then followed them with five additional assessments over a total span of 6 to 7 years. The researchers used standardized, respected measures of sexual orientation and of emotional distress to test the study’s hypotheses.
Of the original 98 subjects, 61 were successfully categorized for general outcome at the last assessment. 53% were categorized as successful outcomes; specifically, 23% reported success in the form of successful “conversion” to heterosexual orientation and functioning, while an additional 30% reported stable behavioral chastity with substantive dis-identification with homosexual orientation. At the 6 year mark, 20% reported fully embracing gay identity. Modest but statistically significant changes were reported on average for decreases in homosexual orientation. The measure of psychological distress did not, on average, reflect increases in psychological distress associated with the attempt to change.
These results do not prove that categorical change in sexual orientation is possible for everyone or anyone, but rather that meaningful shifts along a continuum that constitute real changes appear possible for some. The results do not prove that no one is harmed by the attempt to change, but rather that the attempt does not appear to be harmful on average or inherently harmful. The authors urge caution in projecting success rates from these findings, as they are likely overly optimistic estimates of anticipated success. Further, it was clear that “conversion” to heterosexual adaptation was a complex phenomenon.
Jones and Yarhouse argue that implications of their findings include respect for the integrity and autonomy of persons seeking to change unwanted sexual attractions for moral, religious, or other reasons, just as we respect those who for similar reasons desire to affirm and embrace their sexual orientation. Full information should be offered to consumers about the options and their potential risks. The results also suggest that it would be premature for professional mental health organizations to invalidate efforts to change sexual orientation and unwanted same-sex erotic attractions.
Some might argue that the press release is not appropriately clear because it speaks of change of orientation in the same release as it says this:
These results do not prove that categorical change in sexual orientation is possible for everyone or anyone, but rather that meaningful shifts along a continuum that constitute real changes appear possible for some.
Most of the reviews of this study have missed this statement. Categorical change — moving from a homosexual orientation to a heterosexual one — is not what has been reported by the Jones and Yarhouse. Clearly some people reported changes which allowed them to make an attribution change to themselves – they feel more straight and so they identify with the label. However, the absolute shifts on average were modest, leading to the assessment from Jones and Yarhouse that “meaningful shifts along a continuum that constitute real changes appear possible for some.”
The NARTH article does not link to the press release and does not mention the assessment that the study does not prove categorical change to be possible for anyone. The review is not as skewed as some I have seen, but it does shade the picture.
I have a more focused post about the study planned, but for now, let me add that the concept of bisexuality is not satisfactorily addressed by the study or by reviewers. Bisexuals I have spoken to describe their lives as a series of shifts. For whatever reason, the direction of their attractions shifts with time and/or with relationships. From their point of view, they are not changing orientation when they fall in love with an opposite sex person after a period of same-sex relationships. Instead, they are flexing along a continuum, all of which is understood to be within their essential orientation.
The other group of people which I worked with are the mixed orientation couples. Some of them believe they have become straight because they have fallen in love with an opposite sex spouse. However, these folks do not plan this, nor does it appear to be subject to manipulation or ministry.
Another issue not addressed well by the study or the reviewers is the difference between men and women. Women are probably more likely to report big changes than men. However, Jones and Yarhouse have mixed groups. Separating men and women in the analyses would clarify the possibility that women change more than men.
In all, I am disappointed that the study has re-ignited the “change is possible” political machine. There is fluidity for some people in their sexual attractions, however this says very little about the experience of people who don’t experience that fluidity. Change of orientation for a small group of people is one hypothesis. However, there are other explanations. I think explanations incorporating the reality of bisexuality, cross orientation relationships, and male-female differences are also plausible. In fact, I think they are more plausible.
As an aside, the NARTH review ends with the obligatory slap at the APAs:
Unfortunately, however, the major mental-health associations appear to be moving further away from a purely scientific approach and toward one apparently directed by activists, whereby the purpose of their science does not seem to be understanding those who report change, but rather debunking, dismissing, and ignoring them.
All I can say is: takes one to know one.
NARTH does the same thing they accuse “major mental-health associations” of doing, just on the other side of the ideological perspective. The purpose of NARTH’s “science” seems to be to debunk, dismiss and ignore those who report no change. Regarding activism, NARTH is featuring anti-gay activist Michael Brown in a plenary session at this year’s conference. Brown has no scientific credentials but will be there as an activist, decrying the “homosexual agenda.”
Even more ominous is the presence of Sharon Slater at this year’s conference. Slater runs Family Watch International, a group who lobbies foreign governments at the UN and internationally to maintain laws criminalizing homosexuality. Slater uses NARTH materials in her work. Slater has no scientific credentials, she is there as an activist. I have asked NARTH but gotten no answer as to what scientific benefit Brown and Slater bring to the NARTH audience.
NARTH’s approach may not be “directed by activists.” Perhaps, it is more of a partnership.
Blog post at US News & World Report: Does the APA advise a church switch?
Here’s the blog post over at Dan Gilgoff’s US News and World Report blog, God and Country.
The backdrop: The initial article about the APA sexual orientation and therapy report to hit the wire was by David Crary at the AP. However, some (many?) papers truncated the article in such a way that it seemed as though the APA was recommending either celibacy or a church switch as a way to resolve sexual orientation conflict.
Not long afterwards, OneNewsNow picked up that point and ran with it. From the US News blog post:
A news report from OneNewsNow, the information arm of the American Family Association, said the APA report “suggests that if a person with same-gender attractions has problems because of their religious beliefs, they should just change churches.” About the APA report, spokesperson for the National Association for the Research and Therapy of Homosexuality (NARTH) and executive director of Evergreen International, a ministry to homosexuals of the LDS Church, David Pruden, told OneNewsNow:
“The suggestion was as a Christian, when your conscience comes in conflict with what’s going on in your life — temptations, attractions, concerns, whatever they happen to be — that what you simply do is jettison your standards so that it becomes easier to live with your temptations.”
Both OneNewsNow and Mr. Pruden stand by their statements. But is it accurate to say that the APA report advises that conflicted people switch churches or “jettison” beliefs?
Of course it is not accurate. In the US News & World Report post, I quote Rhea Farberman who directly denies the claim. I then quote from the APA report which finds benefit in social support groups even if not gay affirming.
This is not to say that the APA discourages someone from changing churches if the client feels it is best. I suspect this goes in any direction. For instance, a client might decide to leave a gay affirming church if this seemed more in keeping with identity development. According to this report, psychologists would not try to prevent such a move, but neither would they encourage it.
I approached both NARTH and OneNewsNow with no change.
World Magazine on the APA sexual orientation task force report
Alisa Harris at World Magazine has a web only article out today discussing the APA task force report. I am quoted along with David Pruden at NARTH. There are a couple of points in the NARTH information that are incorrect.
Psychologist Warren Throckmorton once met a woman who was in a lifelong lesbian relationship and suddenly, with no prefaced desire to leave her lesbian lifestyle, fell in love with a guy at work. She left her lesbian partner and married the man.
The American Psychological Association just published a report on whether therapists can make this change happen. In examining change therapy, which claims that people with homosexual desires can switch to heterosexual desires, the report says there is insufficient evidence that the therapies work.
This kind of story is a good argument for control groups if you really want to rule out spontaneous change from the claims that therapy produced it. If this woman and others I know like her were in therapy, perhaps they would have attributed the change to the therapy.
NARTH of course is skeptical:
The panel surveyed 83 peer-reviewed studies, most of which occurred before 1978 and had methodological flaws, according to the panel. But the 138-page report left out certain key studies by Jones and Yarhouse, Karten, and Spitzer, said Pruden, adding that there was no minority report and a lack of ideological diversity on the task force. In a response to the APA report, NARTH argued that “homosexuality is more fluid than fixed” and that there’s substantial evidence someone can change his sexual orientation.
This comes from the NARTH press release in response to the APA report:
NARTH appreciates that the APA stressed the importance of faith and religious diversity. Unfortunately, however, the report reflects a very strong confirmation bias; that is, the task force reflected virtually no ideological diversity. No APA member who offers reorientation therapy was allowed to join the task force. In fact, one can make the case that every member of the task force can be classified as an activist. They selected and interpreted studies that fit within their innate and immutable view. For example, they omitted the Jones and Yarhouse study, the Karten study, and only gave cursory attention to the Spitzer study. Had the task force been more neutral in their approach, they could have arrived at only one conclusion: homosexuality is not invariable fixed in all people, and some people can and do change, not just in terms of behavior and identity but in core features of sexual orientation such as fantasy and attractions.
At least one problem here is that the task force report did consider Jones and Yarhouse, Karten and Spitzer. I would have preferred that the criticisms of the Jones and Yarhouse study would have been considered in a different manner (not in a footnote) but I do not think the outcome would have been much different given the APA distinction between orientation and identity.
On the claims of omission, a quick search of the APA report demonstrates how misleading the NARTH press release is. The Jones & Yarhouse study is referenced 17 times, Karten’s dissertation is mentioned three times, and Spitzer’s study is referenced 19 times.
I was glad Ms. Harris included the following:
The idea that people develop homosexual tendencies because of sexual abuse or distant parents is “one of the easiest theories to falsify,” he argues. “There are many gay people who have perfectly fine relationships with their parents and are not sexually abused.” Instead of telling his gay clients that they can become straight, Throckmorton helps them figure out how they want to live and then helps them get there.