Straight Talk

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 in 1973.

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 anymore.

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 problems.

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.