"Like most psychiatrists," says Dr. Robert Spitzer, "I thought that homosexual behavior could be resisted, but sexual orientation could not be changed. I now believe that's untrue--some people can and do change."
Most mental-health professional associations have recently issued warnings about therapy to change sexual orientation. Homosexual fantasies and feelings can be renounced or resisted, clinicians tend to agree --but not transformed.
But in a new study announced May 9, 2001 at the annual meeting of the American Psychiatric Association, Columbia University's Dr. Robert L. Spitzer released the evidence for his conclusions in an historic panel discussion.
He interviewed 200 subjects (143 men and 57 women) who were willing to describe sexual and emotional histories, including their self-reported shift from homosexual to heterosexual.
Dr. Spitzer is currently Chief of Biometrics Research and Professor of Psychiatry at Columbia University. But he is better known for his scientific role in 1973--when he was "the" instrumental figure in the American Psychiatric Association's decision to remove homosexuality from its diagnostic manual of mental disorders.
But on the opening day of the American Psychiatric Association's annual conference two years ago, he was drawn to a group of ex-gays staging a demonstration at the entrance to the conference building.
The picketers were objecting to the A.P.A.'s recent resolution discouraging therapy to change homosexuality to heterosexuality. They carried placards saying, "Homosexuals Can Change---We Did---Ask Us!" Others said, "Don't Affirm Me into a Lifestyle that was Killing Me Physically and Spiritually," and "The APA Has Betrayed America with Politically Correct Science."
Some of the psychiatrists tore up the literature handed out to them by the protesters. But others stopped to offer the protestors a few quiet words of encouragement.
Dr. Spitzer decided to find out for himself if homosexuality might be changeable. He developed a 45-minute telephone interview which he personally admistered to all the subjects. Most had been referred to him by The National Association of Research and Therapy of Homosexuality (NARTH), and by Exodus, a ministry for homosexual strugglers. To be eligible for the study, the subjects had to experience a significant shift from homosexual to heterosexual attraction which had lasted for at least five years.
Most of the subjects said their religious faith was very important in their lives, and about three-quarters of the men and half of the women had been heterosexually married by the time of the study. Most had sought change because a gay lifestyle had been emotionally unsatisfying. Many had been disturbed by promiscuity, stormy relationships, a conflict with their religious values, and the desire to be (or to stay) heterosexually married.
Typically, the effort to change did not produce significant results for the first two years. Subjects said they were helped by examining their family and childhood experiences, and understanding how those factors might have contributed to their gender identity and sexual orientation. Same-sex mentoring relationships, behavior-therapy techniques and group therapy were also mentioned as particularly helpful.
To the researchers' surprise, good heterosexual functioning was reportedly achieved by 67% of the men who had rarely or never felt any opposite-sex attraction before the change process. Nearly all the subjects said they now feel more masculine (in the case of men) or more feminine (women).
What, then, was Dr. Spitzer's conclusion? "Contrary to conventional wisdom," he says, "some highly motivated individuals, using a variety of change efforts, can make substantial change in multiple indicators of sexual orientation, and achieve good heterosexual functioning."
He added that change from homosexual to heterosexual is not usually a matter of "either/or," but exists on a continuum--that is, a diminishing of homosexuality and an expansion of heterosexual potential that is exhibited in widely varying degrees.
But, Dr. Spitzer said, his findings suggest that complete change--cessation of all homosexual fantasies and attractions (which is generally considered an unrealistic goal in most therapies) is probably uncommon. Still, when subjects did not actually change sexual orientation--for example, their change had been one of behavioral control and self-identity, but no significant shift in attractions--they still reported an improvement in overall emotional health and functioning.
This study is believed to be the most detailed investigation of sexual orientation change to date, in that it assessed a variety of homosexual indicators. Previous studies have usually assessed only one or two dimensions of sexual orientation, such as behavior and attraction. The assessment tool was developed with the assistance of Dr. Richard C. Friedman.
Dr. Spitzer used a structured interview so that others could know exactly what questions were asked, and what response choices were offered to the subjects. The full data file is now available to other researchers, including tape-recordings of about a third of the interviews, which (with the subjects' permission and without any reference to their names) can be listened to by investigators who wish to carry such research further.
He also expressed his gratitude to the National Association of Research and Therapy of Homosexuality (NARTH), and to the ex-gay ministry Exodus, "without which this study would not have been possible."
In closing, he cautioned that this study should not be used to justify coercive treatment, or as a basis for the denial of civil rights. "But I believe patients should indeed have the right," he concluded, "to explore their heterosexual potential."