A discussion of sexual orientation and the possibilities of change
This article formed a part of Anglican Mainstream's presentation to the Pilling Commission.
A discussion of sexual orientation and the possibilities of change
Dermot O’Callaghan
1. Sexual orientation is not genetically determined
(i) A highly regarded study by EO Laumann et al states that if homosexuality were randomly (and uniformly) distributed in the population, this would fit a genetic/ biological explanation (similar to left-handedness). But, they say (p 307), “that is exactly what we do not find.” On the contrary, they find (p 309) that the hypothesis that the environment in which people grow up “affects their sexuality in very basic ways” is “exactly one way to read many of the patterns that we have found throughout this research.”[1]
(ii) An important twin study by J Michael Bailey et al in 2000 acknowledged that the data presented in his earlier work with Richard Pillard in 1991 – which appeared to give support to a genetic theory of causation and has had immense influence on the media and on public opinion – were “inflated” and thus misleading.[2] Bailey said that the later study “did not provide statistically significant support for the importance of genetic factors [for sexual orientation]”.
(iii) A study of two million Danish people (an exceptionally large sample) found that childhood experiences (environmental factors) can be so powerful as to influence whether a person will later marry (or choose as civil partner) a man or a woman.
“Our study provides population-based, prospective evidence that childhood family experiences are important determinants of heterosexual and homosexual marriage decisions in adulthood.”[3]
This is a remarkable statement with profound implications for the ‘born gay’ debate.
2. Change is possible
(i) The leading textbook Essential Psychopathology and its Treatment[4] states that “homosexual orientation can be therapeutically changed in motivated clients and that reorientation therapies do not produce harm when attempted”
(ii) Dr Robert Spitzer (the lead scientist in the 1974 delisting of homosexuality as a mental disorder by the American Psychiatric Association) interviewed 200 people who reported experiencing some change away from homosexuality[5]. He found that 66% of males and 44% of females reported “good heterosexual functioning”. (nb This was a study of claimed ‘successes’ and so these results do not indicate expected outcomes for the average person.) Under pressure from gay activists, Spitzer has recently sought to ‘retract’ his study. But Dr Ken Zucker, the editor of the journal in which it was published, is quoted as saying, “As I understand it, he’s just saying ten years later that he wants to retract his interpretation of the data. Well, we’d probably have to retract hundreds of scientific papers with regard to re-interpretation, and we don’t do that.” http://psychologyandchristianity.wordpress.com/2012/04/13/on-spitzers-change/
(iii) Jones and Yarhouse conducted a study of religiously-mediated change efforts (ie within a church context) and found that 38% of participants classified themselves as ‘successes’
(15% ‘substantial conversion to heterosexual attraction’, and 23% ‘success: chastity without distress’). Others were classified as Continuing (29%), Nonresponse (15%) or Failure (12%).[6]
(iv) In 2008 the American Psychological Association issued a report entitled Appropriate Therapeutic Responses to Sexual Orientation Change Efforts (SOCE)[7]. Using a demanding definition of the quality of evidence required to determine the question of the effectiveness of SOCE, it found (p.28) that, “there is little in the way of credible evidence that could clarify whether SOCE does or does not work in changing same-sex sexual attractions.” Rather than faithfully reflecting this inconclusive judgement, however, the report’s executive summary declared that “the results of scientifically valid research indicate that it is unlikely that individuals will be able to reduce same-sex attractions or increase other-sex attractions through SOCE.” This statement, which is not justified by the evidence in the report itself, demonstrates a bias in the APA which does a disservice to good science.
3. Change Attempts not Harmful on average
(i) The study often quoted as showing that SOCE are likely to cause harm is Shidlo & Schroeder (2002)[8]. Usually omitted are the facts that:
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- the initial recruitment of participants involved an advertisement (adjacent) which was clearly biased against SOCE - yet the study found that, “After the first 20 interviews we discovered that some participants reported having been helped as well as harmed” (p.251) - indeed of 304 treatment experiences, the majority (185) were reported as being either helpful (44) or both helpful and harmful (141), with only 117 (38.5%) being described as ‘harmful only’ - the authors propose that, “If a clinician pursues conversion therapy, detailed informed consent is essential”. We agree. |
(ii) The Jones & Yarhouse study cited above6 says, “Contrary to our hypothesis that ‘harm’ would be demonstrated, we find here little evidence of harm, but instead mostly evidence of little change on average. Where we did detect evidence of statistically significant change occurring, it is towards improvement, not harm.” (p344)
(iii) Note also again the above quote from Maxmen, Ward and Kilgus, that “reorientation therapies do not produce harm when attempted”.
(iv) The APA report referenced above refers no fewer than eleven times to a paper by Scott Lilienfeld[9], a leading expert on psychological treatments that cause harm, hinting that his paper warns that SOCE are dangerous. In fact, Lilienfeld presents two lists of potentially dangerous treatments:
- treatments possibly harmful for some people, and
- treatments probably harmful for some people.
He does not include SOCE on either list, or make any reference at all in his paper to attempts to reduce same-sex attractions, let alone suggest that such interventions carry any particular risk of harm. The APA has used the title of his work – ‘Psychological Treatements that cause Harm’- to suggest danger where he himself does not do so.
4. Clients have the right to choose
Dr Robert Perloff, a former President of the American Psychological Association and Fellow of APA's Lesbian and Gay division, has said,
"I am … the champion of one's right to choose … It is my fervent belief that freedom of choice should govern one's sexual orientation … If homosexuals choose to transform their sexuality into heterosexuality, that resolve and decision is theirs and theirs alone, and should not be tampered with by any special interest group – including the gay community…"[10]
By contrast, psychologists accredited by the UK Council for Psychotherapy are bound by a document called UKCP’s Ethical Principles and Codes of Professional Conduct: Guidance on the Practice of Psychological Therapies that Pathologise and/or Seek to Eliminate or Reduce Same Sex Attraction.
This guidance claims that, “Research has shown that offering, or agreeing to the client’s request for, therapy for the reduction of same sex attraction is not in a client’s best interests (Drescher, Shidlow and Schroeder, 2002).” It further states, inter alia, that
“the following are incompatible with UKCP’s Ethical Principles and Code of Professional Conduct …
Offering ‘Sexual Orientation Change Efforts’ (also called SOCE, ‘reparative’, ‘conversion’ or ‘reorientation’ therapy) or similar therapies by other names.”
Perloff robustly challenges such a position:
(i) "The individual has the right to choose whether he or she wishes to become straight. It is his or her choice, not that of an ideologically driven interest group.
(ii) "To discourage a psychotherapist from undertaking a client wishing to convert, … [is] anti-research, anti-scholarship, and antithetical toward the quest for truth.
The client’s right to choose his or her own sexuality is a fundamental right. In turn it necessitates a corresponding right for practitioners to be permitted to offer appropriate assistance, delivered according to high professional standards. These rights are being denied to people in the
[1] EO Laumann et al (1994). The Social Organization of Sexuality: Sexual Practices in the
[2] JM Bailey et al, Journal of Personality and Social Psychology 78, 525-36 (p.530)
[3] M Frisch et al (2000). Childhood Family Correlates of Heterosexual and Homosexual Marriages: A National
Cohort Study of Two Million Danes. Archives of Sexual Behavior 35, 533-47
[4] JS Maxmen, NG Ward, M Kilgus (2009). Essential Psychopathology and its Treatment
[5] RL Spitzer (2003). Can some gay men and lesbians change their sexual orientation? Archives of Sexual Behavior, 32(5), 403-417.
[6] SL Jones, MA Yarhouse (2007) Ex-Gays?, Inter-Varsity Press, p.369
[8] A Shidlo, M Schroeder, Changing Sexual Orientation: A Consumers’ Report Professional Psychology: Research and Practice 2002, Vol. 33, No. 3, 249–259
[9] SO Lilienfeld (2007). Psychological treatments that cause harm. Perspectives on Psychological Science, 2, 53-70
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