A Critique of Jones And Yarhouse’s ‘Ex-gays?’ – Part 1
A guest post By Patrick M. Chapman, PhD
Introduction and Methods
As an academic with a PhD in biological anthropology, and as someone who tried for over a decade to change my sexual orientation, I approached with interest and skepticism the new Stanton L. Jones and Mark A. Yarhouse book, Ex-gays?: A Longitudinal Study of Religiously Mediated Change in Sexual Orientation. By studying participants in the Exodus International ex-gay ministries the authors intended to answer two questions: 1) can a homosexual orientation be “healed,” specifically can a person change their orientation using religious-based therapy, and 2) are attempts at change harmful (p. 15). Jones and Yarhouse indicate their interest in these questions stems from the conflicting views of science, which suggests change is impossible and attempts thereof are possibly harmful, and of their conservative Christian acquaintances who claim to have been “healed” from “homosexual orientation in favor of heterosexual experience” (p. 73).
I am suspicious when people claim to be no longer homosexual because they have “heterosexual experience”: the latter implies behavioral modification, not orientation change. Thus, in studies examining change of orientation it is important to explicitly define terms and concepts. Jones and Yarhouse define “sexual orientation” by the object of one’s attraction, desire or arousal (p. 209).
Every study involving homosexuality has flaws and the current one is no exception. Jones and Yarhouse attempt to limit the inherent problems with mixed results. To their credit they honestly acknowledge Exodus as a primary funding source for the project. They claim the ex-gay organization did not exert any control or power over their results and conclusions (p. 127), and there is currently no reason to believe otherwise.
To be included in the study participants had to be at least 18 years old, involved with Exodus due to same-sex attractions, and “involved in the change process for less than three years” at the start of the study (p. 126). Jones and Yarhouse claim this is a prospective study, involving 98 participants at the start of the change process (pp. 39, 366). One must be careful of this assertion for two reasons.
First, 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). This is important in that the authors claim these participants demonstrated higher levels of change than those who were in the change process for less than one year (p.276). In other words, the participants that relied on recollection for their original condition (a retrospective appraisal) reported the most change. The difference in change may have been influenced by the prospective or retrospective component, not whether change actually occurred.
Second, the claim that participants were at the start of their change process is misleading. Jones and Yarhouse report 54 of the participants had previously taken “concrete steps” to change their orientation through non-Exodus programs: 21 for three to five years, 18 for 5.5 to 12 years, and 15 individuals for 13 years or more (p. 150). To be clear, on page 126 the authors assert that to be included in the study participants had to be “involved in the change process for less than three years” but on page 150 they indicate 54 individuals, more than 50 percent, did not meet this criteria. Additionally, 49 of the 98 participants previously attempted to change their sexual orientation through other religious-ministry organizations (p. 151), while 56 previously used professional therapy in an effort to achieve the goal (p. 150). 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.” Nonetheless, when reporting the results the authors frequently, incorrectly, and misleadingly portray the individuals as being in the “change process” for either less than one year or three to four years at most (see pp. 232, 276, 353 for examples).
Part 2 will focus on the results examining if change is possible.
Patrick M. Chapman has a PhD in biological anthropology and is author of “Thou Shalt Not Love”: What Evangelicals Really Say to Gays (Haiduk Press: in press).
Excellent beginning! I’d commented on a previous post about the misleading claim that 1-3 years of experience did not constitute a separate sample from those just beginning the intervention, but as I’ve no desire to purchase this book I hadn’t known of the broader methodological flaws. Thank you! Memory is, at best, a constructive event, so when retrospection enters the picture in such an emotionally charged domain, one would expect that data to be quite unreliable.
I would say that their misrepresentation of the prospective nature of the sample is even slightly greater.
Their initial vision was to include those who had been involved for 3 months or less. This was broadened to a year. Then the second group of 1 – 3 years was added.
They do not report how many (or few) were surveyed within the first three months of Exodus initiation – but clearly it was not many at all. So even their most prospective segment of their sample were relying on memory of up to a year before.
Also this invalidates any claims to representative nature of the study. If you are allowing for up to a year to drop out before being counted by the study then you are eliminating perhaps a large segment. And skewing your “success rate”.
Well, retrospective studies aren’t intrinsically useless, although for a dataset where you’re relying on the memory of something very emotionally charged, they might be. I guess the frustration is that this is a case where a spade is yet again being represented as something else entirely.
removed my own snarky comment 🙂
Isn’t there also a concern about selection bias in those retrospective reporters? It’s what psychologists call “the clinician’s illusion” of success. Those who have persisted for 1-3 years are more likely to perceive their treatment as successful than those who haven’t. This isn’t a huge problem if the question is whether ANYONE perceives their treatment as successful. However, we don’t need to answer that question. We’ve already got Alan Chambers, Stephen Bennett, James Phelan, and Melissa Fryrear, who all report that their treatment was successful. It is a problem if you hope to generalize the success rate to anyone else, though. I’ve seen a fair amount of generalization since this thing came out.
An informative start to what will hopefully be an excellent series.
Is there any idea yet of the total number of parts to this series we can exepct?
There is an illusory bias like you mention, Marcus – not only do these providers have more contact with those that stay in and report success, but participants who drop out (and, in fact, many psychotherapy clients) are unlikely to keep in touch with their old provider just to let them know they didn’t change.
There’s also the powerful social psychological phenomena of cognitive dissonance at work. Essentially, the more time, money, or energy we devote to a particular behavior, the stronger the psychological pressure to justify it. This makes it very difficult for a person (either therapist or client) to admit failure after the investment of years of treatment, and creates internal pressure to maximize or exagerate even minimal gains. For this reason, many gold-standard studies now base their analyses on an intent-to-treat sample (i.e. outcomes from everyone who started a treatment, regardless of follow-through), vs a survivor analysis (only those participants that remained), since the latter creates a biased idea re: treatment effectiveness.
I am a scientist by training. I do look forward to this analysis. My hope is that beside analysis of flaws, we will also derive as much benefit from the Jones/Yarhouse study as possible.
At this time in my current thinking, I believe the study was useful in setting more attainable expectations for the client. For example, a client that is LGB might be seeking a perfect reversal of sexual attraction/orientation – that is to change from homosexual to heterosexual orientation. The counselor (or religious advisor) may be tempted to agree that perfect reversal is highly possible, thus setting an expectation for the client that may be unattainable.
I understand the client’s view. When I found a 30-year well done study that showed the reversal for gender identity disorder (GID) was less than one percent, I went out and cried. God, how much I wanted to be that one percent! I was lucky to have a counselor that let me set the pace of reaching for the brass ring on the merry-go-round. In time, I tired of the reaching, got off the merry go round, and asked God to show me what was attainable. It took time to accept that I might have to revise my expectations. Then the counselor and I worked together for what was attainable.
In my mind, it is the repetitious pursuit of the unattainable that is damaging. In II Corinthians 12 God stops Paul the Apostle from seeking the unattainable healing. I offer that God has set a good example in that passage for the Christian counselor.
If we keep telling ‘prospectors’ that there is ‘gold in that mountain’, we are not lying. But we are then marketing. If we tell the hopeful seeker-of-gold that few find gold, that many can find peace half-way up the mountain, and that others can learn to live responsibly in the foothills, then we are poor marketers… we will sell few picks, axes, and shovels. But I really don’t want to ‘market’ God nor His many levels of ‘grace that is sufficient’. I rather want to represent Him as accurately as possible.
At times, I think that what the ‘car’ of ex-gay ministry seems to lack, is a set of brakes. It seems that some of the ex-gay sites I have reviewed are driving only towards ‘perfect reversal’ as God’s only will. This study is showing such ministries that it is ok to apply the brakes, and allow people to get off the counseling merry-go-round, and to walk with God… even in the foothills.
Moderated – Way off topic (as conceded by the commenter). This thread is too important to divert into a discussion about which translation of the Bible is better than the other. Bring it up in the next open forum thread if you like and provide substantiation there.
I’m not qualified to speak on specifics of behavior modification, per se. Dr. Skinta made an excellent point here.
I think what I’m most concerned with is the subject regarding aethetics.
For example, I have mentioned often that those who have ethnic features in a society that glorifies certain physical beauty standards or aethetics that are unnattainable without extraordinary or even risky means.
I place the issue of becoming ex gay on that plane. Plastic surgery addiction, severe dieting to the point of anorexia or other harmful results of reaching that results are extreme.
But main point is NECESSITY. Homosexuality is not a life threatening, disabling or dangerous condition. It is health and moral neutral, therefore the orientation aethetic is literally from an entirely heterosexual point of view.
Heterosexuals on the whole, don’t tend to listen to what gay people report on regarding feelings and objects of desire as being the same, only towards the opposite sex.
The hetersexual aesthetic has the same failures, relationship difficulties and insecurities. However in the gay person they are understandably amplified.
But this is used as the marketing tool, and placing the powerful influence of one’s religious background into the mix, and social experience in the margins, amplifies the marketing tool.
Ask black women what painful and stress inducing situation they’ve gotten into over changing the texture or color of their hair, and you’ll find a litany of sorry stories with it.
Most haven’t had the means to afford plastic surgery and there are no treatments for lightening the skin, but were someone to ask, there are many who likely in childhood, struggled with the aesthetic of their afrocentric looks.
Social norming of black hair, skin and features has made life easier, but what if the images and objects of success were still more white oriented than black?
The most important issue on homosexuality is the aesthetic. The heterocentrist view that homosexuality disqualifies a gay person from happiness, security and social and emotional function is strictly aesthetic to a HETEROSEXUAL.
One’s relationship with their religious community is an extension of what the aesthetic for males and that for females happens to be.
And gender aesthetics are extremely important to religious communities, but get distorted in extreme ways, much to the detriment of those who just happen to be female or gay.
Sometimes to the point of impossibly twisted or convoluted logic.
Which the ex gay industry is very capable of.
The ex gay industry can only measure being no longer homosexual by aethetics. A truly superficial and fluid situation which is usually unstable.
And they have no interest in their subjects or clients not having the experiences that don’t fit their template.
So from the beginning the APPROACH is inappropriate towards a situation that doesn’t require their intervention but for a religious belief.
Which is also fluid….
They are mixing all the wrong ingredients into a situation they don’t understand, and don’t want to.
And they also don’t have to take or will deny the responsibility if the results are bad or even tragic.
Indeed, they are very quick to deny exactly what terms or pressure was exacted on their clients or subject.
All you have to do is look at the article on the sexual abuse template in the previous thread, and it’s easy to see that the ex gay industry are more like bulls in a china shop, than competent therapists.
And gay people need them like a china shop needs a bull to rearrange the displays.
“There’s also the powerful social psychological phenomena of cognitive dissonance at work. Essentially, the more time, money, or energy we devote to a particular behavior, the stronger the psychological pressure to justify it. ”
Regan, I couldn’t agree more. I have always thought that the ex-gay industry is somewhere between snake oil salesman (“It’s a miracle drug!”) and the extreme makeovers we see on tv and in movies.
I recall seeing on MTV this documentary about this woman. She had exercised herself to the point of perfection. But of course, as is the case for anyone so obsessed with aesthetic appeal, her best wasn’t good enough. At the point where her butt met her thigh she had this little roll, this hardly noticeable bit where the transition from backside to leg wasn’t as smooth as she’d like it to be. So she went to a plastic surgeon.
Well the procedure to “correct” this imperfection left her with multiple lumps and brusing on her leg. She developed odd fat distribution in this area, and strangely shaped scar-tissue. She nearly committed suicide over it, and she no longer feels pretty enough to be seen in a bathing suit. I forget whether she was able to sue the surgeon, but really nothing can give her back what she has lost. And for what? To fix something that wasn’t really broken to begin with?
I don’t think there’s any real difference between these two websites:
Thank you Jason.
If the damage to the gay psyche that’s done by the ex gay industry or committed religious communities could be photographed and reveal the scar tissue, so to speak. …
I wonder if that would make an impression. That’s the problem, such a thing isn’t visible and women (most plastic surgeon or cosmetic procedure clients are women), are under more pressure.
It’s no accident that each and every wrinkle product features women models.
And wrinkles and small breasts are normal, right?
So, one could argue that the ex gay industry, just like the aesthetic beauty industry couldn’t care less about normal.
Or care about the INNER aesthetics, like intelligence, compassion and the talent for nurturing or training in certain professions.
Gay and lesbian younsters are under more pressure, but still succeed at seeking inner truth and positive aesthetics DESPITE the attacks on them.
Yet, we know that in many ways, to do reveal a strong aesthetic is ridiculed or not acknowledged, or treated as wrongly acquired (as if the gay person were a changling).
Such inner aesthetics in women are vilified as not feminine or undue as well.
Hence the overcompensation on physical aspects and underdevelopment of the inner ones.
It’s all over but the mocking of non gender specific aesthetics, and the ex gay industry likes to call it something else.
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