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from What do clinical studies say?
Spitzer Study Published:
Evidence Found for Effectiveness of
Reorientation Therapy
By Roy Waller and Linda A. Nicolosi
The results of a study conducted by Dr. Robert L. Spitzer
have just been published in the Archives of Sexual Behavior,
Vol. 32, No. 5, October 2003, pp. 403-417.
Spitzer's findings challenge the widely-held assumption that
a homosexual orientation is "who one is" -- an intrinsic
part of a person's identity that can never be changed.
The study has attracted particularly attention because its
author, a prominent psychiatrist, is viewed as a historic
champion of gay activism. Spitzer played a pivotal role in
1973 in removing homosexuality from the psychiatric manual
of mental disorders.
Testing the hypothesis that a predominantly homosexual
orientation will, in some individuals, respond to therapy
were some 200 respondents of both genders (143 males, 57
females) who reported changes from homosexual to
heterosexual orientation lasting 5 years or more. The
study's structured telephone interviews assessed a number of
aspects same-sex attraction, with the year prior to the
interview used as the comparative base.
In order to be accepted into the 16-month study, the 247
original responders had to meet two criteria. First, they
had to have had a predominantly homosexual attraction for
many years, including the year before starting therapy (at
least 60 on a scale of sexual attraction, with 0 as
exclusively heterosexual and 100 exclusively homosexual).
Second, after therapy they had to have experienced a change
of no less than 10 points, lasting at least 5 years, toward
the heterosexual end of the scale of sexual attraction.
Although examples of "complete" change in orientation were
not common, the majority of participants did report change
from a predominantly or exclusively homosexual orientation
before therapy to a predominantly or exclusively
heterosexual orientation in the past year as a result of
reparative therapy.
These results would seem to contradict the position
statements of the major mental health organizations in the
United States, which claim there is no scientific basis for
believing psychotherapy effective in addressing same-sex
attraction. Yet Spitzer reports evidence of change in both
sexes, although female participants reported significantly
more change than did male participants.
The statistical and demographic details of the respondents
include the following:
- The study did not seek a random sample of reorientation
therapy clients; the subjects chosen were volunteers.
- Average ages: men, 42, women, 44.
- Marital status at time of interview: 76% men were married
as were 47% of the female respondents. 21% of the males and
18% of the females were married before beginning therapy.
- 95% were Caucasian and 76% were college graduates.
- 84% resided in the United States, the remaining 16% lived
in Europe.
- 97% were of a Christian background, 3% were Jewish, with
an overwhelming 93% of all participants stating that
religion was either "extremely" or "very" important in their
lives.
- 19% of the participants were mental health professionals
or directors of ex-gay ministries.
- 41% reported that they had, at some time prior to the
therapy, been "openly gay." Over a third of the
participants (males 37%, females 35%) reported that at one
time, they had had seriously contemplated suicide due to
dissatisfaction with their unwanted attractions. 78% had
publicly spoken in favor of efforts to change homosexual
orientation.
Employing a 45-minute telephone interview of 114 closed end
questions, each requiring either a yes/no answer or calling
for a scaled rating of between 1 and 10, Spitzer's study
focused on the following areas: sexual attraction, sexual
self-identification, severity of discomfort with homosexual
feelings, frequency of gay sexual activity, frequency of
desiring a same-sex romantic relationship, frequency of
daydreaming of or desiring homosexual activity, percentage
of masturbation episodes featuring homosexual fantasies,
percentage of such episodes with heterosexual fantasizing,
and frequency of exposure to homosexually-oriented
pornographic materials.
In addition, participants were asked to react to a series of
possible reasons for desiring change from homosexual
orientation to heterosexuality as well as being asked to
assess their marital relationships.
Some of the findings of the Spitzer study, particularly
regarding motivations for change, included:
- The majority of respondents (85% male, 70% female) did not
find the homosexual lifestyle to be emotionally satisfying.
79% of both genders said homosexuality conflicted with their
religious beliefs, with 67% of men and 35% of women stated
that gay life was an obstacle to their desires either to
marry or remain married.
- Although all of the participants had been sexually
attracted to members of the same sex, a certain percentage
(males 13%, females 4%) had never actually experienced
consensual homosexual sex. More of the male respondents
(34%) than females (2%) had engaged in homosexual sex with
more than 50 different partners during their lifetime.
Further, more of the men than women (53% to 33%) had never
engaged in consensual heterosexual sex before the therapy
effort.
- Dr. Spitzer said the data collected showed that, following
therapy, many of the participants experienced a marked
increase in both the frequency and satisfaction of
heterosexual activity, while those in marital relationships
noted more emotional fulfillment between their spouses and
themselves.
As for completely reorienting from homosexual to
heterosexual, most respondents indicated that they still
occasionally struggled with unwanted attractions--in fact,
only 11% of the men and 37% of the women reported complete
change. Nevertheless this study, Spitzer concludes, "clearly
goes beyond anecdotal information and provides evidence that
reparative therapy is sometimes successful."
Spitzer acknowledges the difficulty of assessing how many
gay men and women in the general population would actually
desire reparative therapy if they knew of its availability;
many people, he notes, are evidently content with a gay
identity and have no desire to change.
Is reorientation therapy harmful? For the participants in
our study, Spitzer notes, there was no evidence of harm. "To
the contrary," he says, "they reported that it was helpful
in a variety of ways beyond changing sexual orientation
itself." And because his study found considerable benefit
and no harm, Spitzer said, the American Psychiatric
Association should stop applying a double standard in its
discouragement of reorientation therapy, while actively
encouraging gay-affirmative therapy to confirm and solidify
a gay identity.
Furthermore, Spitzer wrote in his conclusion, "the mental
health professionals should stop moving in the direction of
banning therapy that has, as a goal, a change in sexual
orientation. Many patients, provided with informed consent
about the possibility that they will be disappointed if the
therapy does not succeed, can make a rational choice to work
toward developing their heterosexual potential and
minimizing their unwanted homosexual attractions."
Is reorientation therapy chosen only by clients who are driven by guilt--that
is, what's popularly known as "homophobia"? To the contrary, Spitzer
concludes. In fact, "the ability to make such a choice should be considered
fundamental to client autonomy and self-determination."
Updated: 8 February 2008
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