Conversion Therapy Is Not a Viable Method of Treatment
Recently, Israel’s interim education minister, Rafi Peretz, publicly backed “conversion therapy” (CT), a generic name for therapy aimed at changing sexual orientation “from gay to straight” for members of the LGBT community.
I’m not sure how or where Peretz came up with this idea. The man was a prominent educator and should know better. Peretz’ speech caused a serious uproar in Israel, with calls for his resignation.
As a professional who has treated many patients from the LGBT community over the past 30 years, I’m shocked that anyone, especially an education minister, could publicly back something as arcane as CT—a technique which is not only ineffective but downright dangerous.
What Do We Know About Conversion Therapy?
A 950-word article isn’t the best place to deal with such a serious issue, but here, in brief, are some basic facts about CT, taken not from websites of interest groups or blogs, but from hard research published in peer-reviewed professional journals and the website of the American Psychiatric Association (APA). For those interested in reading more, there is no shortage of information.
It Doesn't Treat Any Real Disorder
In 1973 the American Psychiatric Association (APA) removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders. If there’s no disorder, there’s nothing to treat, so “conversion therapy” is basically a therapy for what some see as a moral problem, not for any recognized “disorder”. In 1975, the APA called on members “removing the stigma of mental illness that has long been associated with lesbian, gay and bisexual orientations”. That includes “removing” CT from the repertoire of any licensed professional.
It Has Negative Effects
According to the APA, prejudice and discrimination against LGBT individuals may have negative consequences, especially if lesbian, gay and bisexual people attempt to conceal or deny their sexual orientation. In my experience with sexual offenders, people who have been forced to repress their homosexual orientation are at much higher risk to offend and re-offend sexually than “straight” individuals or individuals who can freely express their LGBT orientation. Being lesbian, gay, bisexual or trans-sexual is not a risk factor for sex offending or for sexual recidivism when the individual is free to express his or her orientation freely and unhindered.
It Has Been Denounced by Medical Professionals
In 1991, A Seattle, Washington based psychologist named DC Haldeman published a paper entitled: “Sexual orientation conversion therapy for gay men and lesbians: A scientific examination”, in which, after reviewing the literature published until that year, he concluded unequivocally: “Psychological ethics mandate that mental health professionals subscribe to methods that support human dignity and are effective in their purpose. Conversion therapy qualifies as neither. It reinforces the social stigma associated with homosexuality and there is no evidence from any of the studies reviewed here to suggest that sexual orientation can be changed… At no point has there been empirical support for the idea of conversion”.
A 2015 survey of licensed marriage and family therapists found that 72.3% of those surveyed reported that it is unethical to practice CT. Almost 20% reported that they would consider providing CT in the future (which, the authors point out, is against the AAMFT code of ethics). The authors note a clear difference between therapists who believe CT is unethical and those who say they might use it: “Specifically, participants who believe in the ethical nature of conversion therapy and/or practice conversion therapy report significantly lower levels of clinical competence working with LGB clients and higher levels of negative beliefs about LGB individuals”—so advocating CT could be a result of ignorance and/or prejudice. Supporting use of CT is not a stance to be taken by a licensed, professional therapist.
Today, the official stance of the APA on CT is clear: “To date, there has been no scientifically adequate research to show that therapy aimed at changing sexual orientation (sometimes called reparative or conversion therapy) is safe or effective. Furthermore, it seems likely that the promotion of change therapies reinforces stereotypes and contributes to a negative climate for lesbian, gay and bisexual persons… Helpful responses of a therapist treating an individual who is troubled about her or his same sex attractions include helping that person actively cope with social prejudices against homosexuality, successfully resolve issues associated with and resulting from internal conflicts, and actively lead a happy and satisfying life…”.
It Is Ineffective
In 2002, a paper entitled “Changing Sexual Orientation: A Consumers’ Report” described the experiences of 202 people who had undergone CT several years before. Only 4% reported that it helped in any way change their sexual identity. Some (9%) reported that they learned techniques which help them control sexual behavior they themselves saw as inappropriate, but that their sexual orientation remained unchanged. The vast majority reported feeling more harm than good. CT caused depression, suicidal ideation, loss of self-esteem. In some, it led to impairment in intimate and non-intimate relationships. Some religious participants also reported experiencing spiritual harm as a result of CT. Only a small minority felt that the treatment was helpful and caused no harm.
- A 2004 study of Mormons who underwent CT found that in the patient’s eyes, “successful” therapy was not a decrease in homosexual orientation or an increase in heterosexual drive, but rather: “how well they were able to develop self-acceptance and consolidate an identity that matched their evolving needs, circumstances, and viewpoints”. In other words, positive change was in self-esteem and self-efficacy, not in sexual orientation.
- A 2008 study published in the Journal of Marital and Family Therapy found absolutely no valid empirical evidence supporting the use of CT.
To sum up: There is 0 empirical evidence supporting the use of conversion therapy. At best, CT does no good and no harm. In practice, however, it can cause substantial harm. Clinicians who are asked by LGBT individuals to help control ego-dystonic sexual orientation should help them learn to control their behavior using the same methods used with heterosexual patients. Professionals asked to provide CT specifically should just flat-out refuse.