May 10 - The debate over whether sexual orientation is a choice was reignited
this week with the release of two new-and opposing-studies on the outcome of
"reparative" therapies, which purport to convert gays and lesbians
into heterosexuals. Both papers were released in New Orleans on Wednesday at the
annual meeting of the American Psychiatric Association, the group that ruled in
1973 that homosexuality is not a mental disorder that requires treatment.
Neither study has been peer-reviewed or published.
IN THE FIRST STUDY, Columbia University psychiatrist Dr. Robert Spitzer
interviewed 145 gay men and 57 lesbians who had been referred to him by groups
doing "conversion therapy." Sixty-six percent of them said that
through the therapy, they had achieved satisfying heterosexual relationships,
although some said they continued to have some homosexual fantasies or feelings.
Forty-four percent of the 57 lesbians in the study also said they had been
successfully converted. Spitzer described his subjects as very religious and
highly motivated to change. Spitzer sat on the committee that set the APA policy
However, a similar study-conducted by Columbia psychologist Ariel Shidlo
and Michael Schroeder, a psychologist in private practice in
Manhattan-studied 202 participants and found 178 failures. In fact, only six
said they had successfully completed a "heterosexual shift"; another
18 described themselves as currently asexual or confused about their
orientation. For this study, the doctors also wanted participants who had gone
through conversion therapy-but this time they looked for them randomly, via the
Internet, newspaper ads and groups offering reparative counseling. The
interviews were 90 minutes long, twice the length of Spitzer's.
NEWSWEEK's Pat Wingert talked to Shidlo and Schroeder
after their APA presentation.
NEWSWEEK: Based on the results of these two studies, is it possible for a
gay man or a lesbian to change their sexual orientation through therapy?
|Schroeder: Of the 202 individuals we interviewed, only six people-or 3
percent-achieved what you and I would think of as a successful shift. They
were functioning heterosexuals, they were happy, content, had little
difficulty with fleeting homosexual desire.... That tells me that this kind
of heterosexual shift is difficult and extremely rare.|
|Shidlo: And I should add, five of those six made their living as
conversion counselors and do a lot of speaking on this topic.|
Some people argue that heterosexuals change all the time. For example,
when they're sent to prison.
|Shidlo: If someone who started out as a heterosexual is sent to prison,
they might change their behavior, but they haven't changed their
orientation. For thousands of years, gay people have changed their behavior
in order to adapt and hide-and that's feasible. If therapists say they can
help people become celibate, that's a very different thing. But changing
desire, that's difficult, and I don't think there's evidence that when
heterosexuals leave prison, they don't resume being heterosexuals.|
Your results seems to be directly at odds with Spitzer's findings. Why?
|Shidlo: Spitzer only sought successes - he wasn't looking for failures.
What's surprising is that only 66 percent [of those in Spitzer's study]
turned out to be true successes.|
|Schroeder: You also have to be really careful about defining what success
means. In addition to our six, there were an additional 18 people who deemed
themselves successes, but they were continuing to struggle with homosexual
desire, or were celibate, or didn't know how to describe themselves. Some
were still in therapy - but considered themselves a success. That's like
saying you succeeded at losing weight while on a liquid diet. The real
question is, when you stop the diet, will the results last over the long
term? We had a number of people who said that at one point, they were
hopeful and happy and thought the therapy was a success. But later, they
realized it hadn't worked. We had one person referred to us as a success.
But 14 months after he stopped therapy, he did not see himself as a success
Your research seems to indicate that this kind of therapy can be harmful.
Talk about that.
|Schroeder: That's right. Everyone is focusing on whether there were
successes, but what we thought was more important were the overwhelming
number of those who experienced failure and reported a broad range of harm.
[Some were] provided fraudulent information that gay people are all sick,
can't live happy lives and were victims of child abuse. Some said that their
therapists even tried to convince them that they must have been abused. Some
therapists blamed the parents.... There were also many people who invested a
lot of time-10, 15 years - in this therapy and really worked hard at it, and
they expressed an inordinate sense of loss when it didn't work, and they had
to begin to rebuild who they were socially.|
|Shidlo: The other thing was that those who failed weren't counseled about
how to cope with it. They felt stuck with something that they had been
indoctrinated to hate and had been told was the key to solving all their
Did you find these subjects needed therapy for their therapy?
|Shidlo: A lot of them were very hurt by it and required therapy to come to
terms with their failure, who they were and the impact of their future and
self-esteem. Many said they had a hard time forming relationships and
suffered a lot of sexual dysfunction.... Another group felt very suspicious
of all therapists. They felt deceived and betrayed. And a third group seemed
to be psychologically resilient; their view was that the therapy had been a
positive thing because it had helped them come to terms with the fact that
they couldn't change, and this was who they truly were, and that it was time
to stop fighting with themselves inside.|
Any surprises in the results?
|Schroeder: Yes, we asked whether they had withheld any information from
their therapists, and it was not uncommon for them to say that they had lied
to their therapists to please them.|
|Shidlo: Many said the only way to quit was to pretend that they had
succeeded. That explains why some surveys have shown that these therapists
have a very high success rate.|
|Schroeder: We also had students at religious universities tell us that
they had been mandated into therapy as a requirement of completing their
education or continuing to receive financial aid. Some of them said they had
to mislead their therapist in order to graduate or get their checks. This
was especially true at Mormon institutions.|
Did the patients indicate whether their therapists had strong moral
positions on homosexuality? Or were they neutral on the topic?
|Shidlo: Empirically, we found the majority of the therapists these
consumers saw were very anti-gay and thought homosexuality was really
horrible and disgusting.|
The bible of the psychotherapeutic world-the Diagnostic and Statistical
Manual of Mental Disorders, or DSM-hasn't listed homosexuality for decades. So
why do therapists still offer conversion help?
|Shidlo: For one thing, there's a demand for the service. Secondly, there's
a sizable group of people in our field [psychiatry] whose religious and
moral beliefs tell them that a homosexual orientation is sinful or socially
bad - and those are the therapists offering these services. We asked our
subjects if their therapists had discussed the APA position with them, and
the majority said no. The ones who said yes said their therapists spoke
about it with contempt and told them it wasn't based on science but the
activism of gays. There are a group of professionals out there who refuse to
look at the empirical basis for these changes in the field.|
Do you expect the APA to reconsider its position opposing conversion
therapy as a result of these studies?
|Shidlo: No-but we should consider doing a lot more studies with a lot of
different samples. This kind of research is very hard to do, and it's hard
to find a representative sample. We need to do more longitudinal studies
that follow people from the beginning to the end of their therapy and for
significant periods after that.|
Do these two studies get us any closer to an answer about whether
homosexuality is a choice?
|Shidlo: When you hear that something's a choice, that means someone can
choose it or "unchoose" it-and from our results, it's very clear
that that is false. We interviewed 182 people who tried very hard to change.
The stakes were really high for them. Some really thought that if they
didn't change, they would literally find themselves in hell. Many were very
religious. And they still failed.|