Dr. Warren Throckmorton has written an article called “Sexual reorientation therapy clients rate their experience with psychotherapists” in which he discusses the results of a study he enacted to determine what type of therapy is preferred by people wishing to change their sexual orientation.

The premise behind Throckmorton’s study is that some reorientation therapy is harmful and some beneficial. He sought to determine which is which.

He found that people who identify as ex-gay were most appreciative of therapy that condemned a gay or lesbian identity as bad, sick, or inferior, among other practices.

Some excerpts from the article are:

Prior research has sought to determine if people experience benefit or harm from reorientation therapy in a general sense. Those studies have found that some participants feel benefit and some do not.

Dr. Throckmorton’s study focused on 28 people having experiences with 80 therapists and determined what practices were associated with overall ratings of helpfulness.

Ratings of helpfulness were associated with counselors who respected a client’s desire to change, helped clients reflect on factors associated with the emergence of same sex attractions, suggested that same sex attractions do not, of necessity, signal a gay identity, suggested techniques to minimize same sex attractions and enhance opposite sex attractions, suggested increased non-sexual, social contact with peers of the same sex, and who were knowledgeable about gay and lesbian issues. Preferred therapists focused on sexual orientation only when the clients considered it appropriate. Participants in the study did not judge as helpful therapists who were viewed as preferring that clients affirm and declare a gay identity in opposition to client wishes.

Dr. Throckmorton, an ardent activist for ex-gay therapy, provided a link to the pre-released study. In the summary, however, his listed findings were different than those expressed in the article:

Participants preferred counselors who were knowledgeable about gay and lesbian issues, did not over-focus on sexual orientation, helped affirm an ex-gay identity, helped clients examine their development for possible reasons relating to the emergence of same sex attractions, reframed the meaning of the emergence of same sex attraction for identity, and suggested techniques to minimize same sex attractions and enhance opposite sex attractions. They did not judge as helpful counselors who attempted to affirm a gay identity. This is the first study designed to examine the helpfulness of particular therapist practices with clients seeking sexual reorientation.

Though the two descriptions are similar, the actual report summary focuses on identity and redefining words while the one given for public consumption glosses over the identity change aspects and adds some political spin by adding the phrase “in opposition to client wishes”.

THE STUDY

Let’s look as Dr. Throckmorton’s study and see if it tells us anything.

First, Throckmorton in his summary states that “some participants feel benefit and some do not.” However, further reading shows that in any study which was somewhat representative of all clients, the vast majority experienced harm. Even when the studies were performed by ex-gay activists such as Nicolosi and the participants were all Exodus members, still some harm was identified.

If this new study were simply to identify what practices cause harm and those which benefit, it would be useful. It purports to do so. But does it? Does this study address the helpfulness of practices with clients seeking sexual reorientation?

A clue to that answer is found in the following quote from the article:

Most of the participants in the study viewed themselves as having changed their sexual orientation. Seventy percent of the participants who saw themselves as exclusively homosexual prior to therapy rated themselves as either exclusively or predominantly heterosexual at the time of the study.

Since Dr. Throckmorton makes no claim (to date) that 70% of those who seek sexual reorientation – or indeed any ratio even coming close to 70% — change their sexual orientation, this is clearly not a representative study of “clients seeking sexual reorientation”.

THE PARTICIPANTS

The participants, as reported, “had been in reorientation counseling with a professional therapist and currently viewed themselves as having reoriented or as being in the process of reorienting.”

Thus the study is not of the helpfulness of practices with client SEEKING sexual reorientation. This distinction is important because if one is seeking to reduce harmful practices one would have to include both those who succeeded as well as those who did not.

For example, suppose you heard that a large percentage of patients that took a particular drug found that drug to be helpful. That might suggest that the drug should be encouraged. Then suppose you found that the study only included 20% of those who took the drug and the other 80% were killed by the drug. It would change your opinion of the report.

Unfortunately, Throckmorton did not survey a selection of people entering counseling but used a post-therapy sample that was biased to support certain practices.

Next we find that 100% of the participants found religion either “extremely important” (89%) or “important” (11%). This too skews the findings. Obviously, those who are highly religious are going to “find” religion- affirming counseling to be “helpful”.

The convenience sample was derived from calls for participants on ex-gay Internet list servs and discussion groups. Data was collected via a 90 minute phone interview with the first author [Throckmorton].

We can see from this that not only did the participants identify as ex-gay but were also those that most closely associated with this aspect of their identity (just as it could be said that those who participate at exgaywatch or are on HRC’s e-mail list more closely associates with being gay).

Interesting, and corresponding with what has been said on this site, all but one were Caucasian. 54.6% were or had been married, and all had at least a bachelors’ degree.

THE RESULTS

Dr. Throckmorton based part of his questioning on a previous study which researched the more general question of what counseling gay and lesbian people find to be helpful. Not surprisingly, the ex-gay study did not completely correlate to the gay study.

The practices that Throckmorton’s study found to be useful but which gay persons found to be harmful were:

Your therapist indicated that he/she believed that a gay or lesbian identity is bad, sick, or inferior.

Your therapist did not recognize the importance of lesbian and gay relationships and/or did not appropriately support these relationships.

The practice that gay people found helpful but the ex-gays found harmful was:

Your therapist tried to help you feel good about yourself as a gay man or lesbian.

Throckmorton added several new practices and, not surprisingly, they were helpful to the ex-gays. They included

  • Looking for the cause of same sex attractions
  • Indicating that same-sex attractions doesn’t mean you’re gay
  • Strategies to minimize same sex attractions and behavior
  • Strategies to enhance heterosexual attractions
  • Helping you feel good about identifying as ex-gay
  • Encouraging non-sexual friendships with same sex peers

The participants were encouraged to volunteer other practices they found helpful or unhelpful. Interesting selected results include:

  • 4 said that dropping gay friends was helpful
  • 3 said reading the Bible was helpful
  • Only one said that resolving sexual abuse was helpful
  • 5 said that rigid gender stereotypes was unhelpful

CONCLUSION

Dr. Throckmorton’s study in not “the first study designed to examine the helpfulness of particular therapist practices with clients seeking sexual reorientation” as it purports to be. However some useful information can be gleaned from the study.

First, participants in ex-gay studies have found that adherence to rigid stereotypes (sports for boys, makeup for girls) don’t benefit them. These practices should be eliminated from reorientation efforts. The possible potential benefits do not seem to be significant and do not justify the risk of harm.

Second, it must be recognized that this sample was biased. Further study must be done to determine whether the practices that were helpful to the “successful” ex-gays (those in this study) but that were also harmful to gay people (those not included in this study) are justified. In other words, does the potential success of the therapy by using these methods outweigh the potential harm?

Obviously, not all persons will agree. Some will believe that ANY success in reorienting a tiny number of persons justifies ANY damage done to a large group of others, no matter how severe (i.e. saving a few souls from hell justifies any amount of damage, pain, destruction and misery caused along the way). Others will believe that ANY harm done to a single person invalidates the practice, no matter how effective to others (i.e. it isn’t needed anyway).

My fear is that this study will be used solely to say that “these practices work” without any thought to the damage they could cause. That would, however, be immoral.

Third, some practices are agreed upon (both helpful and unhelpful) by both gay and ex-gay participants and should be standard for all reorientation therapy.

In conclusion, and Throckmorton appears to agree, the study is inconclusive.

FUTURE WORK

Throckmorton laments that it isn’t easy to find participants for studies of this sort. However, I believe that an after-the-fact study tells you very little, in any case.

It would be valid and useful to find the therapists that do this work (there aren’t many) and the various ex-gay groups (they are networked) and establish an entry questionnaire. This could allow a start point, measure again at a set time (one year, five years, whatever) and give some useful information that can allow those seeking reorientation to know what are their chances of success and also to allow therapists to learn how to maximize the chances of success while minimizing harm.

Further, I think that the only way any such study would be considered credible would be if the criteria, the questions, the protections for confidentiality, the analysis of results, and the reporting was performed by collective effort of parties on both sides of the debate.

Unfortunately, while I think some ex-gay therapists would welcome a thorough study (I will assume this includes Throckmorton) I suspect a great many in the ex-gay community would oppose such a study. I believe that they fear it would conflict with a political or religious agenda.

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