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from Social Issues
APA SYMPOSIUM SEEKS COMMON GROUND
Martin B. Koretzky, Ph.D., ABPP
The following is a description of the discussion of sexual-reorientation
therapy held recently at the annual meeting of the American
Psychological Association. The event was organized as a reading of
papers (not a debate). Two psychologists spoke for the "therapy can be
ethical and effective" position.
Two gay-activist psychologists approached the subject from a
gay-affirming position. Surprisingly, one of the two gay-affirming
psychologists actually defended the client's right to pursue such
therapy.
Psychologist Martin Koretzky attended the symposium as an observer. His
report is as follows:
A remarkable program took place on August 7th at the American
Psychological Association Annual Meeting for the Year 2000.
Held in Washington, D.C., the two-hour Symposium was entitled "Gays,
Ex-Gays, Ex-Ex-Gays--Examining Key Religious, Ethical, and Diversity
Issues." The event was co-sponsored by APA Division 36 (Psychology of
Religion), along with Division 44 (Society for the Psychological Study
of Lesbian, Gay and Bisexual Concerns) and the APA Public Interest
Directorate.
With a tone of mutual respect, the four speakers presented data,
observations and opinions originating from both sides of the divide
which usually separates proponents vs. opponents of sexual reorientation
therapies. A standing-room-only audience of approximately 200
psychologists listened with rapt attention throughout.
Symposium Chair Mark A. Yarhouse, Psy.D., of Regent University
introduced the session. He explained to a somewhat restless audience
the desire of all participants to seek common ground, guided by the
ethical principle of respect for the values and wishes of individuals
seeking treatment. With these words, and with the subdued and
professional tone of each presenter, the audience settled into quiet
attentiveness.
The first presentation consisted of preliminary results of a recent
study by Ariel Shidlo, Ph.D. of Columbia University and Michael
Schroeder, Psy.D. of The Schroeder Group. The study is entitled,
"National Study of Sexual Orientation Conversion: Empirical and
Conceptual Issues."
The methodology included interviews with former patients who answered
advertisements placed in gay publications, and former patients referred
through Exodus International contacts. The preliminary data indicated
several factors considered "helpful" in their lives by former patients,
and a larger number of factors considered "hurtful."
The next presenter was Warren Throckmorton, Ph.D. of Grove City College
with a paper entitled "Review of Empirical Findings Concerning Ex-Gays."
Dr. Throckmorton drew a distinction between two philosophical
perspectives: the "essentialist" position (that categories such as
homosexual, bisexual and heterosexual are fixed and unchangeable), and
the "social constructionist" position (that sexual proclivities are
socially constructed, and thus changeable). He also noted the vagueness
and definitional imprecision of the term "sexual orientation."
Those with an "essentialist" position tend to see sexual orientation as
intrinsic to "who a person really is." They believe that reorientation
therapy may succeed in changing self-identity, but they say it will
never change sexual orientation, because orientation is fixed and
immutable.
Other theorists, however, view sexual orientation as "socially
constructed." These theorists usually accept self-reports of change at
face value. If a person says he is "ex-gay," the social-constructionist
will tend to assume that his change in self-identity is equivalent to a
change in sexual orientation.
Building on these distinctions, Dr. Throckmorton reviewed empirical
studies of individuals seeking change, with particular focus on studies
which include ex-gay ministries as a treatment component. He cited a
number of studies which report successful sexual-orientation change, as
well as reports of individuals who did not change, and feel they were
harmed by therapy.
He noted the limitations of these studies, but then observed that
debating about their conflicting results may constitute a mistaken
focus. Instead, Dr. Throckmorton concluded, the mental-health
professions should investigate how therapists can reduce the likelihood
of negative therapeutic outcomes.
Next, Douglas C. Haldeman, Ph.D., an independent practitioner in
Seattle, WA, presented "Gay Rights, Patient Rights, Implications of
Sexual Orientation Conversion Therapy." Dr. Haldeman is a prominent
gay-affirmative theorist who has criticized reorientation therapies.
Dr. Haldeman said that studies which have investigated the effectiveness
of sexual-reorientation therapy lack scientific rigor. Thus it is
impossible, he said, to make meaningful generalizations about these
treatments. "From the perspective of gay theorists and activists,
however," Dr. Haldeman said, "the question of conversion therapy's
efficacy, or lack thereof, is irrelevant. It has been seen as a social
phenomenon, one that is driven by anti-gay prejudice in society..."
Surprisingly, though, Dr. Haldeman went on to say that such therapy is
not necessarily harmful or unethical: "There appear to be many
dissatisfied homosexually-oriented individuals who seek psychological
guidance or spiritual intervention to achieve a goal they identify as a
change in sexual orientation...some...particularly those who have
experienced less invasive styles of conversion therapy, seem not to have
been affected adversely..."
He went on to reiterate strongly the well-known APA position that
mental-illness-based views of homosexuality lack all scientific merit,
and therefore should not be discussed in a scientific symposium. He
also stated his conviction that historically, the conversion therapy
movement appears to be intimately associated with anti-gay prejudice.
But he granted that the client with strong religious convictions about
sexuality has the right to pursue change. He said, "A corollary issue
for many is a sense of religious or spiritual identity that is sometimes
as deeply felt as is sexual orientation. For some it is easier, and
less emotionally disruptive, to contemplate changing sexual orientation,
than to disengage from a religious way of life that is seen as
completely central to the individual's sense of self and purpose."
"However we may view this choice," Dr. Haldeman said, "or the
psychological underpinnings thereof, do we have the right to deny such
an individual treatment that may help him to adapt in the way he has
decided is right for him? I would say we do not."
The final paper, delivered by Dr. Yarhouse, was entitled "Respecting
Religious Diversity: Possibilities and Pitfalls." Dr. Yarhouse stressed
that religion is a legitimate, though often overlooked expression of
diversity. True respect for diversity requires tolerance of
conservative religious expression, as well as liberal expression.
He identified ways in which gay-affirmative theorists and conservative
religious persons fail to appreciate each other's perspective. He
placed special emphasis on religious vs. sexual priorities in organizing
one's core identity.
Finally, Dr. Yarhouse identified a continuum of service options for
clients who experience same-sex attraction, including
reorientation/reparative therapy, chastity/celibacy, sexual-identity
management, and gay-affirmative therapy. Respect for client values and
wishes, he said, should guide the choice of service selected.
Several areas of agreement seemed to emerge from the presentations.
First, all agreed that respect for client diversity must include the
right of conservative religious persons to receive interventions in
keeping with their deeply-held values.
Second, "best practice" approaches to be encouraged are those which are
humane and voluntary. Coercive techniques, all agreed, should be
avoided.
Finally, all seemed to agree that there are no conclusive answers
possible at this time about treatment efficacy, given existing research
and methodology.
Naturally, many highly contentious areas of disagreement remain. Two of
these areas were highlighted by questions from audience members near the
end of the program.
A gay-affirmative psychologist from a rural area expressed heated
objection to the notion that sexual reorientation ministries could be
tolerant and non-punitive, based on her own experiences. Dr. Yarhouse
responded that a range of options are available in his own area, and
urged her to look beyond her immediate experience.
A psychologist asked why NARTH has not been allowed a presence at APA
meetings. Dr. Haldeman responded that NARTH's position that
homosexuality constitutes a developmental disorder goes against APA
policy, and therefore cannot be included in the discussion.
More impressive than particular findings, in my opinion, was the simple
fact that such a symposium was held at all--especially with such a tone
of mutual respect and lack of rhetorical excess.
According to Dr. Yarhouse (private communication), the program began
with a conversation between Dr. Haldeman and himself at the previous
year's APA conference in Boston. The two agreed that the purposes of
the symposium should be to:
- discuss the empirical research and implications through the lenses
of gay theorists and conservative religious persons, with an eye toward
any possible areas of mutual agreement, and
- do so in a way that
modeled for the audience respect and mutual regard for each other's
perspectives, despite areas of disagreement.
The composition of the psychologist audience seemed quite diverse, with
representatives of various religious backgrounds (e.g., Jewish,
Christian, Mormon), including liberal and conservative expressions of
each of these. More than half seemed to be gay/lesbian supporters, some
of whom were also religious--with a significant, though considerably
smaller number of religious conservative persons.
To this observer, the symposium fully accomplished the purposes noted
above. One can only hope that this effort will become a model for
future thoughtful discussion of all issues surrounding sexual
orientation, identity and change.
Martin B. Koretzky, Ph.D. is a licensed psychologist in independent
practice in Lutherville, Maryland. He is Board Certified in Clinical
Psychology by the American Board of Professional Psychology (ABPP) and
was formerly Chief of Psychology Service at the Veterans Affairs Medical
Center, Fort Howard, MD. Dr. Koretzky has been a member of the American
Psychological Association for 23 years.
Updated: 2 September 2008
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