Psychotherapist Joe Kort wrote “Queer Eye for the Straight Therapist for the May/June issue of Psychotherapy Networker. The article traces Kort’s winding road from struggling same-sex-attracted college student; through ex-gay therapy, which negatively impacted him and his parents; onward through a futile effort to re-closet himself; his initial struggles working with gay client-patients; and his efforts to overcome professionals’ opposition to gay-affirmative therapy.
The following issue featured a letter in response to Kort’s article:
It seems to me it is just as unethical to tell someone with a gay sexual orientation that they “cannot change” as it is to tell them they “should” change!
I was surprised that Mr. Kort would state that therapists “must, from the beginning, strongly affirm the inherent naturalness and okay-ness of homosexuality. The clinician also has an obligation to educate clients about the large body of research disproving overall the idea that sexual orientation can be changed by psychotherapy.” On the contrary there is a large body of research attesting to the possibility of change that dates back to at least Anna Freud’s time (she had a 50 percent change rate with four homosexual clients). More recently, Dr. Robert Spitzer did a large study of individuals who at one time identified themselves as gay who now identify themselves as heterosexual, and his research has been published in the Archives of Sexual Behavior, Vol. 32, No. 5, October 2003, pp. 403-417.
I am concerned that Mr.Kort does not recognize the APA’s stance that if someone is seeking a change in orientation, therapists, within carefully laid out guidelines, should help the client move in that direction when possible. This is quite different than suggesting that orientation “should” change, but at least leaves the door open for those who choose to walk through it.
Patricia I. Curtis
West Richland, WA
Kort replied:
I’m sure Ms. Curtis would agree that it is not unethical to tell patients the truth, which decades of studies have shown is (1) that sexual orientation, whether homo-, hetero-, or bi-, is neither optional nor mutable, and (2) that the health of clients is best served by guiding them toward self-acceptance and a focus on leading balanced, productive and loving lives, whatever their orientation.
It is strange that she cites the American Psychiatric Association’s position to bolster her case, since the APA’s official statement on the subject, readily available on its Web site, states, “There are a few reports in the literature of efforts to use psychotherapeutic and counseling techniques to treat persons troubled by their homosexuality who desire to become heterosexual; however, results have not been conclusive, nor have they been replicated. There is no evidence that any treatment can change a homosexual person’s deep-seated sexual feelings for others of the same sex.” (Emphasis added)
I would add that there is also no evidence that any treatment can change a heterosexual person’s deep-seated sexual feelings for others of the opposite sex. It’s odd to me that the notion of change in sexual orientation is always from gay to straight, never the opposite, and that studies like Anna Freud’s or Dr. Spitzer’s are always skewed in that direction. Perhaps the basis for this fact is the bizarre notion that homosexual orientation is a matter of choice (which can always be changed) but heterosexual orientation is not. Yet, not a single author of any of these studies has ever claimed, to my knowledge, that his or her own sexual orientation was a matter of choice. Our human experience, regardless of where we are on the gay-straight continuum, is that our sexuality is discovered, not selected.
The APA’s position, entirely consistent with my own, is that “any person who seeks conversion therapy may be doing so because of social bias that has resulted in internalized homophobia, and that gay men and lesbians who have accepted their sexual orientation positively are better adjusted than those who have not done so.”
Joe Kort
I think both Curtis and Kort make valuable points: Patients need to be able to make informed choices. Is intentional change in one’s sexual attractions possible? Generally, I think not. But I think a person’s attractions sometimes drift naturally, and a person’s understanding of one’s sexual attractions or behaviors can change if one is recovering from abuse or compulsion.
Reparative therapy appears to be rooted in religious and political biases regarding sexuality. What might its boosters do to alleviate the fear that they steer patients toward their own values?
It is a difficult question: What should a professional therapist tell a client who is determined to change his/her sexual orientation? Patricia Curtis has a valid point that therapists should empower their clients to pursue their beliefs. However, Joe Kort and the APA are also correct to warn that ‘ex-gay’ treatments are not proven effective or helpful. What is the distinction between leaving “the door open” to and advocating/opposing efforts to change sexual orientation?
As a client, I expect a professional therapist to give me his/her expert and educated opinion while enabling me to pursue my own beliefs (excluding extreme distructive beliefs). I haven’t read Kort’s article yet, but I agree that telling someone they “cannot change” is too strong. Although I agree that efforts to change sexual orientation are mostly ineffective and can be harmful, definitely concluding that sexuality orientation is completely unchangeable falsely implies that human sexuality is fully known without mystery. However, telling someone they “can change” is also too strong or at least overstates the meaning of change (ex: “ex-gay homosexuals”).
Most ‘ex-gay’ advocates are religiously motivated. Therefore, they can side-step the professional accountability issue with religious disclaimers (“We’re faith-based”). Professional therapist have to determine if a client seeking change is motivated by their religious/philosophical beliefs or internal hatred/social pressure.
Norm!
As someone who received counseling to change my sexual orientation and as one who has also offered counseling and therapy to others, I don’t find Mr. Kort’s position unethical or necessarily troubling.
I suppose to be “really” comprehensive, one might offer that there are options to living a different life (i.e. celibacy) versus changing one’s sexuality in toto. Or, perhaps one can discuss the idea that for some individuals sexuality is changeable while for others it is not.
But, I agree with Mike A. that sexuality is something that an individual discovers, but is not necessarily something that can be changed ala one’s clothes or one’s job. That the letter writer refers to Anna Freud’s success rate is truly curious given that I don’t think I’ve seen Anna Freud cited in such a way except in the most psychoanalytic oriented journals or in articles that are reviewing the history of psychotherapy treatment modalities. Much of psychoanalysis has been scrutinized and even undermined by subsequent research, (and thus, it doesn’t surprise me that Reparitive Therapists often borrow or cite from these ideas, etc.) but that’s a whole other kettle of fish so… 🙂
I’m floored. I really am. From Curtis’s letter
>On the contrary there is a large body of research attesting to the possibility of change that dates back to at least Anna Freud’s time (she had a 50 percent change rate with four homosexual clients).
A 50% change rate with a sample size of four purported homosexuals. Oh, wow. That means two changed. Or they changed half-way.
FWIw, one wonders whether the members of the sample were really bisexual. And, more to the point, one wonders whether they really changed, or whether they just made Freud believed they had changed.
And people wonder about my cynicism regarding social “science.”
Actually, Joe, I had to laugh at the Anna Freud reference – 50% “success” rate with 4 patients? Any statistician knows there must be a minimum number of subjects in a study to make any statistically valid assessment of it – and 4 patients is well below the minimum.
In fact, nearly all the research on the supposed ability to “change” sexual orientation was done before 1973, when homosexuality was still considered a mental illness. In those cases, the subjects were invariably those who either a) decided they wanted to change (which means they suffer from the same selection bias as Dr. Spitzer’s survey of “ex-gays” from a few years ago) or b) were committed involuntarily to mental institutions and often subjected to inhumane “treatments” like electric shocks to their genitals or toxic chemicals to cause uncontrollable vomitting. As we learned after Mengele in WWII, data gathered under torture is seldom useful, and these treatments, not to mention the involuntary commitment, were forms of torture.
The only modern “study” on the subject is Spitzer’s, and like all too many researchers, he created a survey paradigm that guaranteed him a positive result (no one cares if you disprove something, journals tend to publish only papers that prove something.
Spitzer used a 100 point scale from complete heterosexuality to complete homosexuality, and used a 10-point change as a measure of “success.” Thus someone who was at 100 (totally homosexual) before their “reparative therapy” but characterized themself as a 90 after would be a “success” case.
If complete change to heterosexuality is the guage of “success” however, only about 20% of Spitzer’s subjects (who were culled from the leading anti-gay hate groups) qualified, and it is unclear how homosexual they were before the “treatment” began (fully 20% of Spitzer’s subjects, I believe, had only fantasized about gay sex, they had never done “it”). Hardly an unqualified success.
I do want to add to this discussion as it is a good one. I have had clients come to me and want to change their lifestyle from gay to straight. Or I have had clients tell me that while they know they are “homosexual”, (gay is too affirmative for them), they do not want to live their lives as openly gay or lesbian. So I have, in fact, supported them and assisted them to create a life of heterosexuality for themselves. However, I do not believe in any way that one can change their sexual and romantic orientation. While you might be able to fall in love with someone, that does not make you that orientation.
I liken this to people who think that if you engage in gay sex that makes you gay! I cannot believe that people believe that a behavior is indicative of who you are as a person. Certainly, gays can have heterosexual sex and straights can have homosexual sex not making them gay or straight or converting their orientation.
Even in my writings and my book I use examples of gay men who come to see me for whom I have supported and helped create a heterosexual lifestyle for themselve while still knowing their innate sexual and romantic orientation is homosexual.
There are simply many people who cannot allow themselves to live their lives as gay or lesbian due to their own religious, moral and/or various other reasons and therefore deserve the right to live differently than who they are.
They should be warned of potential dangers such as depression as I feel it important to let them know that there are no good studies or findings that anyone has really changed their sexual and romantic orientation. They change behavior, not orientation.
Warmly, Joe Kort
>There are simply many people who cannot allow themselves to live their lives as gay or lesbian due to their own religious, moral and/or various other reasons and therefore deserve the right to live differently than who they are.
That’s nice. I’ve known more than a few people who have changed what appeared to be their sexual orientations over the years. And they didn’t need therapists or religious instruction to do so. My first boyfriend–from college in the early 1970s–went from (apparently) straight to (apparently) gay, to (apparently) straight, back to (apparently) gay again. All without any therapy or religious instruction.
I doubt that many gay people would give a tinkers’ damn about these so-called “ex-gay” people, except for the fact that they campaign against equal rights for people who are comfortable with expressing the “gay” side of their orientation. None of the people that I have known who transition between gay & straight would consider doing such a thing. The fact that the so-called “ex-gay” people feel a need to do so is very telling.
> JK: It’s odd to me that the notion of change in sexual orientation is always from gay to straight, never the opposite
What a crock. We’ve all heard dozens of anecdotes about women who have left thier husbands for other women, and what the heck is this whole “curious” business about anyway, if not exploring the possibility for change? Please.
> JK: I liken this to people who think that if you engage in gay sex that makes you gay! I cannot believe that people believe that a behavior is indicative of who you are as a person.
Only someone creating a “personal identity” out of their sexual behavior is making such a statement. Gays are the one’s saying “you hate me as a person” whenever someone criticizes their behavior — and (aside from Phred Phelps) it’s simply not true.
From where i sit, people could care less about your self-esteem labels or your personal identity politics: it’s the sexual behavior — and the normalization of it — that is at issue.
Marty- to you it is a sexual behavior issue only because you are trying to belittle the idea of homosexuality into its most insignificant, and maybe even carnal, pieces. Because, if you were to say it were about attraction, love, etc. you would be giving up a lot of ground on your side of the issue.
If you were to poll the US population asking if gay anal sex was ok, most would say no.
If you were to ask them if it were ok to be attracted to the same sex or be in love with someone of the same sex, the numbers would be hugely difference.
you know this, and that is the only reason you refuse to acknowledge homosexuality on terms of attractions.
Marty, when people equate what they call a “behavior” (e.g., engaging in gay sex – which BTW is a host of behaviors, and includes at least minimal emotional involvement) and a political movement (e.g, “destroying the family”), they are clearly expressing contempt and disgust at me, as a person. After all, a specific sex act can have no effect on the structure of the heterosexual nuclear family, particularly when those same sex acts (albeing between those of different genders) can be part of building a strong foundation of love and intimacy between parents in a family.
TA, thanks but no thanks. This whole concept of Orientation is a “brand new thing”. It is an invention deliberately created to coincide with the whole “me movement” of the past 30 or 40 years.
My problem with homosexuality is the same as it has been for thousands of years: same-sex sex is an abomination. It doesn’t mean in the least that i don’t love or respect you as a human being.
No, this idea of orientation is just a way for you to become offended by pretending that it is YOU that i dissaprove of, instead of your chosen behavior.
Regarding attraction, it doesn’t take a flaming homosexual to admit that of the two, Brad Pitt is far more attractive than Jennifer Anniston. That admission however has nothing to do with who i’d rather sleep with…
Well, now… that’s just plain interesting, as I find Jennifer more attractive, interesting to look at, easy on the eyes; sleeping with either of them wouldn’t be a problem at all, just doze right off because sex with either of them is just not at all appealing. Ewww to both of them … ix-nay on the ex-say.
Marty- you saying you disapprove of my behavior really isnt an insult at me as a person, and I don’t take it that way. Although, I will say that I was pretty sure I was gay well before I had any physical activity with another male.
What it says to me, though, is that you would rather call it chosen behavior than non-chosen attractions because of your personal beliefs, not because of some appeal to a moral authority. I find that excuse hard to swallow.
Anyway, where it hits me personally is not when someone disagrees with my being gay (unless we are talking about a close friend or family member that decides to disown me as a result–this hasn’t happened to me luckily). Where it hits me personally is, as CPT said, with this Anti-family absurdity that too many people to try throw out. Anti-family attacks at gays are nothing more than attempts by conservatives to push their own agenda and stir up their own voter/money base. Nothing more. Anyone that thinks otherwise isnt being objective, or even pretending to be (or is too blinded to realize as such).
Ah hate to even answer this Marty. However, while woman have left their husbands for other woman and men have left their wives for other men, It is far more likely that your wife/husband will dump you for someone of the opposite sex than of the same. You are making the assumption that everyone is heterosexual (find the other sex romantically as well as physically attractive) by default. It is a bit like that annoying relative/friend that assumes everyone likes his or her favorite dish at gatherings and keeps offering you a piece of something that you do not enjoy at all. You might nibble at the item, or even force it down to please the other person…but you probably won’t like it and sure as heck won’t ask for it.
You are right in a sense it is about labeling. People label themselves or others all the time. It would be impossible to discuss anything without labels. Labels give you an idea of content. I mean Irish and coffee drinker is just as much a label as heterosexual/homosexual. Labels give you an idea of what some group of items has in common.
Homosexuals generally do not find the other sex romantically or physically attractive. It isn’t about sex or sex acts. It is about the attractions that can lead to sex acts. Being curious is not about changing from heterosexual to homosexual trust me on that. It is about exploring who you are as a person. It isn’t about sex, although it can include it. It is about attraction and all the feelings that encompass it. For most people it isn’t the sex act that draws them to one another. It is the attraction. People usually don’t ask out/date/marry people they do not consider attractive. Society gives the message that everyone is supposed to like the opposite sex therefore you are supposed to like the opposite sex. However at some point in life something happens to make some people question that assumption. For everyone it is different, for me it was those continuing feelings that I had towards members of the same sex (deep friendships, crushes, as well as plain old lust) and the general lack of them towards the opposite sex that made me question.
Also as for the sex parts of it, well hate to break it to you Marty, but I would probably enjoy hugging or holding hands with a guy more than a night of passion with a woman. Yes sex is a part of it, but the only the only difference between homosexual sex acts and heterosexual ones are the genders of the people involved. You can certainly do all the typical homosexual acts in a heterosexual context not to mention not every guy likes the same things even in a homosexual one.
Some people try out same sex relationships and realize it is just not their “thing”. They might have had a deep friendship with someone of the same sex, but they lacked the sexual attraction. You can be emotionally close to someone and not want to have sex with them. Others like me realize that although they could have a deep friendship with someone of the opposite sex, the physical aspects of the relationship would either be missing or directed at someone of the same sex. A few others are bisexual, capable of having romantic attractions to either (although this seems rather rare esp. in guys).
As for the Jennifer Anniston, Brad Pitt bit that is one thing I do not understand. I don’t find Jennifer Anniston any more or less attractive than the average woman cause I don’t find her attractive at all. I mean is she that ugly? I can’t tell. She seems to do just about as much to me as most other woman nada. About the only famous woman I can think of that I find even slightly attractive is Sandra Bullock and I do mean slightly between Sandra Bullock and just about any male actor I would greatly prefer the male. Brad Pitt on the other hand I usually do find attractive depending on how he does his hair but then again I am gay. I find a heck of a lot of male actors attractive so what is new there?
Norm said: “I haven’t read Kort’s article yet, but I agree that telling someone they “cannot change” is too strong”
What about them saying something like “A majority of peer reviewed scienftific study shows that you have little chance of getting rid of your attraction to people of the same sex.”
I see the statements as essentially equivalent but perhaps the 2nd is “more true”.
The questions was: What might reparative therapists do to alleviate the fear that they steer patients toward their own values? (which are rooted in religious and policital biases regarding sexuality).
I think their fear is just the opposite. They fear that they will not be successful in steering the patient toward their own values. That is their only goal. How else can they make the individual feel that he/she can change their sexual orientation? The bottom line is that they only see it from a religious/political perspective. In that regard, they will never offer the patient an option of truly accepting their sexual orientation. And they will never tell them the truth: that there is little or no hope of you ever changing your sexual orientation.
Shane Wealti: “What about them saying something like “A majority of peer reviewed scienftific study shows that you have little chance of getting rid of your attraction to people of the same sex.”
I agree that the above statement is more accurate than simply than dismissively telling a client s/he “cannot change” their sexual orientation. I would even argue that the above statement does not go far enough in at least telling a client of the existence of alternative therapists and ‘ex-gay’ therapies.
Let me assure you, that I’m NOT advocating ‘reparative’ therapy. As a former ‘ex-gay’ participant, I’m know firsthand of the harmful and potentially destructful effects of these types of therapies. But I believe it is important for clients to know that they are determining the direction of their therapy. Although I’m not in the health field, I would still refer someone to an ex-gay program if I felt s/he sincerely does not want to accept their same-sex attractions. Of course, I would also relate my own experience and try to disuade him/her from that direction.
BTW, does anyone know what article Patricia Curtis is quoting in her letter? I did not find the “cannot change” quote or the other quotes she attributed to Kort in the on-line version psychotherapynetworker.org version of his article.
Norm!
Here’s the link to the abstract of the journal article being quoted. There’s a lot of qualifiers in this abstract and I’m sure that there are a lot more in the actual article. The qualifiers I saw in the abstract make me think this study requires a lot more work to flesh out what is really going on.
This article in severely distorted form will probably become the basis for a lot more religious bashing of the “gay lifestyle”.
Oh well, what do you do when folks insist on hearing what they want to hear?
>Oh well, what do you do when folks insist on hearing what they want to hear?
Um, that is an expression of why I have little use for what passes for social “science.” Unlike the physical sciences, the social “sciences” do not appear to have any standards under which the veracity of their “theories” can be judged.