Warren Throckmorton

In my recent article regarding the founders of Exodus, I made the following quote referencing a study of counseling with gays and lesbians:

“For instance, in a recent study of 2000 episodes of counseling with 600 gays, only 13 episodes were identified as involving sexual reorientation therapy.”

The reference for the study is: Jones, M.A., Botsko, M., & Gorman, B.S. (2003). Predictors of psychotherapeutic benefit of lesbian, gay, and bisexual clients: The effects of sexual orientation matching and other factors. Psychotherapy: Theory, Research, Practice, Training, 40, 289-301.

There were a number of factors examined but the authors asked 600 glb people who had been involved in any kind of counseling to report on their experiences with their counselors. The word episode refers to all the sessions with one counselor. So roughly we are talking about 600 people who consulted nearly 2000 counselors for an average of 3.3 episodes (counselors) each.

Of the nearly 2000 episodes of counseling reported on by these 600 clients, only 13 were with counselors who engaged in reorientation counseling. Remember this is more than 13 sessions but thirteen different counselors out of nearly 2000 reported on. So less than 1% of the episodes involved counseling situations that the gay and lesbian clients now see as being at odds with their current orientation. Remarkably, 48% of the clients were confused about their orientation at the time they went into counseling. These are the kind of clients that would seem to be vulnerable to therapists offering or attempting to impose reorientation interventions. However, less than 1% the counseling episodes included reorientation therapy. This does not sound like evidence of widespread harm done by counselors to vulnerable clients.

Also, on the point of widespread harm, the one other study (Shidlo and Schroeder) that surveyed clients who said they had been harmed by reorientation counseling took 5 years to find 176 people that experienced harm. This is a long period of time, despite the fact, that the effort was sponsored by gay and lesbian organizations and publicized widely in these circles. In contrast, Spitzer took less than 2 years to find 200 people who met his stringent criteria for change.

Those who have been harmed I do not doubt. What I think this evidence supports is that there are people doing things in the name of reorientation that are harmful and they need to be stopped. However, as evidence of widespread harm, I do not think the case is made.

In part two of their series on reparative therapy, Salon’s Mark Benjamin lies to Maryland therapist, Barry Levy to get his story.

The session with Mr. Levy sounds believable enough, although I would want to hear from Mr. Levy as well. Several aspects of the commentary on the story however are questionable. Benjamin writes:

The theory that homosexuality is a mental disorder that needs to be cured is the moral underpinning of the Christian right’s crusade against gay marriage, sodomy laws, gay adoption and sex ed curriculums in schools.

This is a theory that is based in the reaction of European psychiatry to the idea that homosexuality is a condition and not a behavior. Kertbeny and Ulrichs defined homosexuality as an inborn trait in the 1860s in a political effort to prevent the maintenance of sodomy laws in Prussia. European psychiatrists grasped this concept but looked for environmental causes. Freud came along and in the spirit of the day located the cause in the first six years of life. Freudian thinking about homosexuality dominated psychiatry for decades as it did on most other psychiatric issues. In the Salon article, Levy is not exactly off when he says psychoanalysts still consider homosexuality a treatable condition. Not officially, mind you, but there a number of them who were trained in this way and maintain that approach to practice. It should be noted that homosexuality is not the only issue they view this way. They are being consistent in their theoretical outlook when they consider homosexuality through Freudian lenses.

I wouldn’t call this theory the moral underpenning as Mr. Benjamin does. I don’t think the political opposition to gay marriage, for instance, is conditioned on the belief that homosexuality is a mental disorder.

Benjamin writes:

One study, often cited by conservative groups like Focus on the Family, shows incremental success from reparative therapy. But critics point out that the study was based solely on interviews with subjects arranged by ex-gay ministries; in fact, many of them worked at the ministries.

He is undoubtedly referring to Spitzer’s work. And the charge that the study was based solely on interviews “arranged” by ex-gay ministries is false. Spitzer says where his participants came from. About half were referred by a combination of NARTH and ex-gay ministries, but even then the interviews were not arranged. These groups put out the call for research participants and people answered.

It is worth pointing out that Mr. Levy cautioned Mr. Benjamin that change may take some time and that it didn’t work for everyone. While I personally go into much greater detail (and he may have as well, we don’t know), I think it speaks well of him that he was not coercive and did not over promise as reparative therapist are often accused of doing.

I think this article is detrimental in that it portrays reparative therapy as the only approach that holds that sexual orientation is flexible and that people can get real benefit from seeing a counselor for sexual orientation distress. I am not a reparative therapist but I do see clients that do not wish to integrate same sex attraction into a gay identity. And I do find that over time (not the same for all), some of the clients find that the same sex attractions go away and are replaced with opposite sex attractions. My approach is not to tell the client what might have caused their feelings but to allow the client to tell me via history taking. Not all same sex attraction is association with the reparative history as described by Mr. Levy in the Salon article. Many ex-gays have that background and the reason for this should continue to be researched but I have seen many who do not fit that Freudian based theory.

Here is a quote from the Salon article regarding the founders of Exodus International:

“Besen tracks down a dizzying array of former ex-gayleaders who later came out of the closet for good, including the two founders of Exodus.”

This is not true. Only one of the founders are gay today (Michael Bussee). His partner (Gary Cooper) was not a founder and died of AIDS several years ago. 80% of the founders are still ex-gay. I know; I have talked to all of them personally to research it. This should be corrected. Wayne Besen knows there were more than 2 founders of Exodus and he knows that Gary Cooper was not a founder but he still claims these things to anyone who will listen.

Here is a Salon article on reorientation therapy. The issue is getting a lot of press at the moment. Here is a place you can track the bloggers on the issue.

I am growing concerned serious therapists are going to be dismissed simply due to a belief in the flexibility of sexual feelings. There are so many serious questions about the nature of the science that are being ignored due to polarization on this issue. Gay activists in particular are loath to allow any serious questioning of the sexual orienation orthodoxy.