Response to Part 1 of Dr. Patrick M. Chapman’s Review of “Ex-Gays”, posted on Ex-Gay Watch, November, 2007, by Stanton L. Jones and Mark A. Yarhouse.
The greatest compliment that be paid to any work of scholarship is for it to receive serious consideration and generate discussion. Thus, we are pleased to see the review by Dr. Chapman of our book, Ex-gays?: A Longitudinal Study of Religiously Mediated Change in Sexual Orientation. Chapman raises important issues, but in the end, we must conclude that his review fails to establish the serious flaws he claims in our study.
Response to “Part 1: Introduction and Methods”
We applaud Chapman for correctly summarizing the main questions we examined in the study, for a reasonable brief summary of the study’s methodology, and particularly for granting us some credulity in saying that “They claim the ex-gay organization [Exodus] did not exert any control or power over their results and conclusions (p. 127), and there is currently no reason to believe otherwise.” Minor points of disagreement with his summary and commentary include the following:
- Our interest was not triggered by “the conflicting views of science [versus the claims of our] conservative Christian acquaintances;” but rather by the conflict between a) the prevailing and hardening consensus of mental health opinion that change is utterly impossible, based on a very mixed scientific record, versus b) the actual scientific record and the anecdotal claims of people we know. Regarding the actual scientific record, note for instance the recent publication by a respected scholar of a report of some notable plasticity in “female same-sex sexuality” in a minority of women followed in a longitudinal study (Lisa Diamond, Perspectives on Psychological Science, 2(#2), 142-161. Diamond rightly concludes “the more we learn, the more we do not understand,” p. 142. She also, it must be said, would not regard her findings as providing support for change as understood in this study, but on the other hand, her results do challenge a simple “sexual orientation is utterly and always unchangeable” stance). And Chapman in his review gives weight to the anecdotes of people he knows, and his own story, so once again we raise the question why only certain anecdotes are privileged as worthy of consideration in this debate.
- Chapman implicitly dismisses “behavior modification” as trivial, but we see insufficient justification to take this step. Some of our subjects experienced more than mere behavior modification, and even behavior modification can be very meaningful if it empowers a person to live in closer accord with her freely chosen core values.
The core of Chapman’s criticism of the study in Part 1 is that our study is somehow not truly prospective. We would agree that if our study is not prospective then it is disingenuous to claim that it is, and the scientific value of the study is considerably weakened. This charge, in other words, is truly significant. Let’s look carefully, then, at the basis for Chapman’s claims.
First, Chapman claims that “technically the study is not prospective because 41 individuals were involved in the Exodus program for one to three years prior to the study (p. 121).” The logic of this argument is not compelling. We are utterly explicit that some of the subjects (the 41 “Phase 2 subjects” in the change process with their current Exodus ministry for 1 to 3 years) had been in the change process longer than others (the 57 “Phase 1 subjects” in the change process for less than 1 year). We continue to maintain that the results for the Phase 2 subjects are worthy of inclusion and consideration, but we always report analyses of the Phase 1 population by itself for precisely the concern Chapman articulates: If the reader insists on a tighter understanding of “prospective,” then you can narrow the focus to the Phase 1 results. These results were not as positive as those for the population as a whole, but were still statistically significant and meaningful, with Phase 1 subjects represented in all six categories of outcomes. Again, for Chapman to focus on the 41 Phase 2 subjects and then pronounce the whole study as not prospective makes no more sense than declaring that the results of our study are irrelevant for men because there were 26 women in the study.
Chapman’s second concern is more interesting and merits serious discussion. He argues that our study is not prospective because “the claim that participants were at the start of their change process is misleading.” He then cites several pieces of data indicating that subjects had previously tried to use other methods to change their sexual orientation before starting their current Exodus involvement (including through involvement in other religious ministries and professional therapy), and then concludes “Suggesting the individuals in this study are ‘starting the change process’ is incorrect. Perhaps this was their first attempt with Exodus ministries but that is not the same as ‘starting the change process.’”
Chapman seems to be arguing for an extremely literalistic understanding of “starting the change process.” Our research question was the possibility of change through involvement in an Exodus ministry, and so we focused on persons between zero and 3 years into that change process. Chapman is arguing for a much more rigorous standard: that the only proper way to study change is to locate and study what we might call “change virgins,” people who had never attempted change at all. We would argue that such a standard is unreasonable for several reasons:
- First, such a standard is rarely applied in the study of other intervention methods with other targets of intervention. We urge that our study be examined according to the standards applied to all psychological studies of change, and not by ad hoc standards with few parallels in the general literature. We compare our results in the book with the pattern of results for the STAR*D treatment study of chronic depression, but the very idea that you would screen out all subjects who had previously sought help to change their depressive patterns to get a sample of “change virgins” is not credible. If your goal is to study the effectiveness of a particular intervention method, why would you screen out of your study persons who had previously sought change by other means, especially when it is common in these ministries to work with people who have attempted to change before?
- Second, to erect such a requirement for the validity of a study of change of sexual orientation would be to make such a study impossible to conduct. How would you find a pure sample of “change virgins” who had never attempted change? If people are distressed by their sexual orientation for religious, moral or other reasons, isn’t it likely that those person would try a variety of formal and informal means to change that orientation?
- Most importantly, if our research question is that of the possibility of change through involvement in an Exodus ministry, why would prior or even concurrent involvement in other methods of change serve as a barrier to involvement in the study? If we are studying the effectiveness of anti-depressants in treatment of depression or of interpersonal therapy on marital relationships, what is the relevance of the subjects having previously received pastoral counseling for depression or having attended a marriage encounter weekend to enhance marital satisfaction?
So in the end, in response to Chapman’s criticism that “Perhaps this was their first attempt with Exodus ministries but that is not the same as ‘starting the change process,’” we would simply reply that by our saying that these subjects were “starting the change process,” we were implicitly and explicitly saying “starting the change process in this particular Exodus ministry.” Hence, we believe that this study meets reasonable standards as a prospective study of individuals seeking sexual orientation change through the Exodus change process. Chapman’s criticisms fail to establish the contrary.
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Following the organization of the original series, Part 2 of the response will address a focus on the results, examining if change is possible (covered in the second part of Chapman’s critique).
These are very good points. However, I am still having trouble with the problems with Chapman’s claim that, “Suggesting the individuals in this study are ‘starting the change process’ is incorrect.”
I have to agree with him that your claim seems a bit too broad. To give an example, if someone like Peterson Toscano, who spent decades in ex-gay groups, didn’t join Exodus for 10 years, it’d be misleading for me to see him included in a group of people that were purported to have been starting the change process.
And saying that you are looking at the effectiveness of a particular method change process seems a bit vague to me. The title of the study itself leads me to believe that the method of change is religious based ex-gay therapy, rather than just specifically Exodus ministry.
Exodus and other religious-based ministries don’t seem that distinct to me in many cases, and the title of the study doesn’t even make a distinction, so I agree with Chapman that including people that have spent years in other very similar programs as “new” to this seems hard to swallow.
Well that’s not quite true, Drs., is it?
Looking at the qualitative results for Phase 1 we find:
Kinsey 1 – no relative effect
Kinsey 2 – no relative effect
Kinsey Expanded – no relative effect
Shively and DeCecco (adding “emotional attraction” questions)
Heterosexual change – no relative effect
Homosexual change – from 3.92 to 3.42 – small relative effect
Klein Grid (adding “emotional preference” and “social preference” questions)
From 5.17 to 4.77 – small relative effect
Yarhouse Thermometers
Heterosexual – no relative effect
Homosexual – no relative effect
When viewed as a whole, Dr. Jones and Dr. Yarhouse, one can only conclude that the quantitative results of the prospective sample show little to no statistically significant movement in sexual orientation.
And even more interesting, Dr. Jones and Dr. Yarhouse, is how the Phase 1 participants graded themselves and their orientation.
When asked about what “they” were, there was change from 4 heterosexuals to 18 and from 27 homosexuals to 13.
But when asked about what their orientation was, heterosexual went from 5 to 4 and homosexual went from 25 to 24 with only “other” having any increase.
In other words, Drs., if your study proved anything it was that when looking at your prospective sample, it is very convincing that one cannot change one’s sexual orientation from homosexual to heterosexual through Exodus minitries.
Drs. Stanton and Yarhouse wrote:
I would have to agree with the Drs. on this point. I would guess that they would try and try and try until they gave up or got a job with Exodus.
So, Chapman’s allegation that the study isn’t prospective is false because… the researchers admit that close to half of their population had been in Exodus for 1-3 years? Being up-front about their flawed mechanism doesn’t mitigate the flaws at all, it just makes them sorta honest.
But that also wouldn’t be true–recall the fact that 41 of them were in Exodus for one to three years.
Two points:
This might make sense if there were consistency to the methods of all Exodus affiliates with regards to “changing” sexual orientation. When a new drug is test for the market, clinical trials often include individuals who may have tried and failed a variety of other treatments; however, because the individuals are all trying a novel treatment, it is a level and comparable playing field.
It is my understanding, however, that there is no standard, Exodus-approved, system of “treatment” for those who want to alter their sexual orientation. It is not as if there are Clinical Practice Guidelines, as there are for nearly every significant mental illness, governing the conduct and actions of an Exodus ministry. I will admit to not having read the book based on this study, but it is again my understanding that there was no comparison of the methods used in the various Exodus ministries consulted by the participants and their past attempts at change. Thus, it is not clear whether any novel “treatment” is being considered here at all.
Secondly, I note the potential straw man argument of:
I have never heard any of the leading medical and/or behavioral health organizations ever claim that change was “utterly impossible.” That is simply not how science works – there is always the remote possibility that even something apparently disproven by a study may still be a factor (in my own training in psychology and economics – and I am a published author in both fields – references to these remote possibilities were referred to by one of my professors as the “anti-ego” clauses because they required one to admit he might be wrong).
Claims of sexual orientation change, being largely anecdotal, have been taken with the proverbial grain of salt, but IIRC, the leading medical and behavioral health organizations have come out against reparative therapy because, at best, change is exceedingly rare and difficult, and focused on a facet of one’s nature that, absent anti-gay teachings, it is not necessary to change. That is a far cry from “utterly impossible.”
As for the scientific record, let us be frank. There has never been any study, whether from the modern “ex-gay” movement or from earlier (and IMHO unethical) experimentation on gays and lesbians (from the pre-1973 period, when GLBT individuals could still be committed against their will for “treatment”), that demonstrated a physiologic change from homosexual to heterosexual. No one has ever demonstrated that any brain patterns, hormone levels, autonomic nervous system functioning, etc. has ever been altered by alleged “change” programs.
Yes, but behavior modification, which comprises the largest number of the “success” stories is far different from actual physiologic change. A lefty forced to write with their right hand will still be a lefty (throw something at them and see which hand they deflect it with), just as a celibate priest is still a sexual being, even if he has decided, and is successful, not to act on his feelings.
Agreed. And if these ex-gay organizations would be upfront with all their potential clients and claim that for the most part a person’s sexual orientation “may not change” but do in fact tell them that most clients only experience a “change” in their behaviour we wouldn’t be haven’t this discussion at this moment. The problem is saying yes change is possible but failing to define what change would most likely occur.
But then again if Exodus admits to clients that most changes may only occur in their behaviour patterns I would think it would make potential clients for Exodus further question these ex-gay orgainzations before entering them.
Of course they don’t believe we have a homosexual orientation. We are just heterosexuals with a homosexual problem. 😉
Gentlemen,
I think if you read the book you will realize that even behavior did not change statistically within the prospective subgroup (I don’t put much stock in change that is reported in feelings or behaviors as recalled from three years ago so I’ll focus on Phase 1).
The measures that showed minimal change were those which incorporated “emotional preference” and “social preference”.
that’s the thing that never quite makes sense to me.
Homosexuals, at least myself and the ones I know, do not define ourselves by our behavior. It’s not like we think if someone doesn’t get laid for two months they have to give up their gay card. There certainly isn’t a sex act that’s mandated in order to be considered homosexual. There’s no rule that says if you don’t perform _____ in the _____ position, you’re not really gay.
Isn’t a heterosexual still heterosexual if he never has sex, or never has sex again?
It’s fairly simple to me, a car is still a car even when no one drives it. A doctor is still a doctor even when he’s not at the hospital. The President is still the President when he’s fast asleep in the middle of the night.
Seems to me that the ex-gay world has an entirely different dictionary than the rest of us. They’ve completely redefined all sorts of words including, “love”, “homosexual”, and “change”, just to name a few.
Gay people define themselves by the gender we’re attracted to, not by what we do or don’t do with them. What we do or don’t do with our partners is merely the expression of that emotional and physical attraction. If we never find someone to have that expression with, that doesn’t mean we don’t have those thoughts or feelings.
Why is it that a straight celibate priest is still considered heterosexual, but a celibate homosexual is now magically not gay anymore?
The only thing I’ve seen evidence of is that they’ve been able to change people’s reactions to being gay, but the people themselves are essentially still gay —at least by the definition that gay people commonly use.
Wait a minute. Chapman does seem to be arguing for an extremely literalistic understanding of “starting the change process.”
What kind of a person would “argue” for an extremely literalistic understanding of the words used to describe something?
For that matter, what kind of a person would characterize the desire for accuracy as an argument?
Jones and Yarhouse wrote:
Don’t they mean “credibility”? Is that, by any chance, an example of what is known as a “Freudian slip”?
Jason remarks,
Jim Burroway has the post, “Love Won Out”: A Whole New Dialect which addresses this issue. From the intro:
Later on:
The entire post is well worth reading.
In his book Language in Thought and Action, S. I. Hayakawa talks about payments people who are laid off receive to tied them over until they are rehired or find other work. If these are referred to as insurance payments that would be one thing. If they were referred to as welfare payments, that would mean something quite different. So we have the “Unemployment Insurance Act.”
Instead of the “Bill to repeal Don’t Ask, Don”t Tell”, we have the “Military Readiness Enhancement Act.” Isn’t politics wonderful?
While Hayakawa’s book is decades old, a similar book would be well worth reading.
Yeah, Bill, I’ve read that article before. Just thought it was worth mentioning again.
One thing I’ve never seen addressed in any of the research so far is that Exodus et al are not making one claim but two. As a bisexual man, I can happily concede the possibility that my sexual attraction might vary over time from favouring the same sex towards favouring the opposite sex, or vice versa. Some bisexual people I’ve encountered have claimed that this has happened to them. But the way they describe it, the change is not a conscious, directed process.
So attempting to prove the efficacy of “ex-gay” therapy requires demonstrating both (1) that “change is possible”, as well as (2) that the change came about specifically through the application of an “ex-gay” therapy. I don’t think any study has ever even attempted to resolve the second one.
Which study was it that said some individuals in an ex-gay program became “more homosexual” during their stay? Was it the Jones and Yarhouse one?
William said:
You seem to be arguing for an extremely literalistic understanding of “credulity.” 😉
This entire response by Jones and Yarhouse is attacking a straw man argument. While the exact meaning of “start” is slightly worth investigating, the real criticisms of the Jones-Yarhouse study are much more significant:
*The lack of peer review
*Clients’ responses only measure the clients’ own subjective perception at best and their lies at worst yet not recognizing this might make the entire study inconclusive
*Disregarding the reasons that ~25% of the original participants left Exodus and disregarding any possibility that they felt harmed
*Disregarding the change or lack thereof of the same 25% (whom, common sense would say, did not change)
*Regarding chastity as “success” in a study measuring changing “orientation”
*Not keeping track (or refusing to publish?) of which clients identified as bisexual at the beginning, implying that change from bi to hetero is the same as changing from homo to hetero
*And more . . .
I’m interested in hearing Jones and Yarhouse answer these major criticisms, not the minor criticisms discussed here.
Ephilei, I’m not sure I would characterize the discussion to this point as “minor” but there is nothing keeping you from adding your own concerns, as you just did 😉
Did you read the entire critique by Dr. Chapman, to which the Jones and Yarehouse response is addressed?
I’m going to agree with Ephilei, here. Of the major concerns and weaknesses of this manuscript, only some very superficial points have been responded to, and at that, responded to poorly and only after objections are reduced into less-than-honest strawpersons.
I would strongly recommend that, in the future, they considering hiring a methodological consultant with less invested in their dogmatic vision. This “study” is entirely inappropriate to reject the null hypothesis that change is impossible.