By M. Alex Johnson Reporter
updated 6/29/2005 2:51:37 PM ET 2005-06-29T18:51:37

When advocates of reorientation therapy for gay men and lesbians talk about their discipline, their contentions fly in the face of more than 30 years of research that supports the belief that sexual orientation cannot be altered.

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“The reality is that homosexuality is not an illness. It does not require treatment and is not changeable,” according to the American Psychiatric Association, or APA.

But psychologists and researchers who practice reorientation therapy can point to a small number of studies that they say establish just the opposite. The most commonly cited research was conducted in 2001 by Dr. Robert L. Spitzer of Columbia University, one of the leading psychological authorities in sexual orientation.

The research, which was presented at the annual meeting of the APA that year and published in the Archives of Sexual Behavior in 2003, drew on the responses of 200 men and women who reported that they had once been homosexual but now were not.

Although the research relied on the self-reported testimony of the respondents, which Spitzer acknowledged made assessing their accuracy problematic, even critics agreed that he was able to devise a rigorous series of questions to zero in on the central question: “Can some gay men and lesbians change their sexual orientation?”

His answer: “Like most psychiatrists, I thought that homosexual behavior could not be resisted and that no one could really change their sexual orientation. I now believe that to be false. Some people can and do change.”

Heavy-hitting report
Spitzer was a highly credible authority: A professor of psychiatry at Columbia, he was chief of psychiatric research at the New York State Psychiatric Institute. Moreover, he could not be marginalized as a Christian opponent of gays and lesbians.

For one thing, Spitzer has said that he is an atheist, and he was for many years a leader in the movement to regard homosexuality as an innate characteristic, not a psychological condition. In 1973, he prodded the APA to drop homosexuality from its roster of mental disorders.

Reorientation therapists and Christian-oriented reparative therapists alike embraced the report.

“Historic Gay Advocate Now Believes Change is Possible,” said a press release from the National Association for Research and Therapy of Homosexuality, a leading secular proponent, which cites Spitzer’s study in several dozen articles on its Web site. Other pro-therapy organizations identified Spitzer as a “world-renowned researcher” and noted his influence within the APA.

Reaction from gay and lesbian activists was equally vocal. The National Gay and Lesbian Task Force called Spitzer’s report “snake oil,” while Wayne Besen, author of “Anything But Straight: Unmasking the Scandals and Lies Behind the Ex-Gay Myth,” wrote that Spitzer was either “an over-the-hill stage horse galloping toward the limelight or a court jester hoodwinked by a scheming religious right.”

What the study really discovered
Both sides distorted Spitzer’s findings. He did not prove that homosexuality could usually be reversed, but neither did he prove that reorientation therapy was invalid.

What Spitzer actually found was that “contrary to conventional wisdom, some highly motivated individuals, using a variety of change efforts, can make substantial change in multiple indicators of sexual orientation” along a 100-point scale. But complete reversal of sexual orientation, he said, “is generally considered an unrealistic goal in psychotherapy [and] is uncommon, particularly in male subjects.”

It was Spitzer himself who warned that his sample was not representative of the general gay population. He sought out only people who claimed to have changed their sexual orientation, many of whom were referred to him by prominent ex-gay ministries. A large majority said religion was “extremely” or “very” important in their lives.

Moreover, Spitzer noted, his study relied exclusively on the self-reported outcomes of the subjects — he had to take them at their word. “Of course the big question is, given that these are subjects highly motivated to provide support for the value of reorientation change efforts, to what extent are their reports merely self-deception, or gross exaggerations?” he asked.

But among this “unique sample,” Spitzer said he had indeed found that a statistically significant number had “achieved good heterosexual functioning.” And while depression was reported to be a common side effect of attempts to change sexual orientation, “this certainly was not the case for our subjects, who were often ‘markedly’ or ‘extremely’ depressed BEFORE, and rarely so depressed AFTER.”

Accordingly, he concluded, “mental health professionals should stop moving in the direction of banning therapy that has, as a goal, a change in sexual orientation.”

Giving up the battle
Two years later, after his report was formally published, Spitzer elaborated in a commentary in The Wall Street Journal.

“In reality, change should be seen as complex and on a continuum,” he wrote, citing four key indicators — arousal, fantasy, behavior and self-identity — that could be measured. “Change in all four is probably less frequent than claimed by therapists who do this kind of work; in fact, I suspect the vast majority of gay people would be unable to alter by much a firmly established homosexual orientation.”

Spitzer again said more research was needed, especially controlled longitudinal studies that tracked self-identified ex-gays over a long period of time. Last April, in an interview with Christianity Today, he said he was not the man for the job: The attacks on him by gay and lesbian activist groups had left him feeling “a little battle fatigue.”

“The second reason,” he said, is that “if somebody proposed that the National Institute of Mental Health do such a study, I think almost certainly any gays in the study section would say this is a total waste of time: They would say, ‘We already know it’s hokum, so why do it?’ ”

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