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
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.”
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?