from Books & Reviews
(Volume 7, Number 3, 2003)
by A. Dean Byrd, Ph.D., MBA, MPH
"...an over-the-hill stage horse galloping toward the limelight, or a court jester hoodwinked by a scheming religious right"--Characterization of Robert Spitzer
by gay activist Wayne Besen
A recent issue of the Journal of Gay and Lesbian Psychotherapy was entirely devoted to Robert L. Spitzer and his study, recently published in the prestigious Archives of Sexual Behavior. One author after another, the Journal authors--all gay activists-- devoted their efforts to a critical analysis of the Spitzer study.
The opening editorial by psychiatrist Jack Drescher set the tone for this issue of the journal. Drescher couched the malleability of homosexuality as a question central to the "cultural wars," but not to science. And it's the cultural wars, not science, that seemed to occupy center-stage in all the ensuing articles.
Another commentator, Theo Sandfort, suggested that Spitzer should not have published the study at all because of the delicacy of the topic, because the issue of homosexuality is "charged" in cultural debates, and because of the limitations of the study (Sandfort lists his concerns in that order).
Psychiatrist Charles Silverstein, author of The Joy of Gay Sex, devoted his commentary to a scorching criticism of religious-faith traditions, accompanied by accusations of bias in Spitzer's subject selection. Silverstein has a preference for the Shidlo-Schroeder study, which sought to document the harm experienced by some reorientation-therapy clients. The Shidlo-Schroeder study was conducted by researchers who at least initially, selected their participants through an advertisement in gay publications that said, "Help Us Document the Damage of Homophobic Therapies."
An analysis of the media response to the Spitzer study was provided in the Journal of Gay and Lesbian Psychotherapy by Lund and Renna. They offer a "conspiracy" theory of the Spitzer study, noting how "media routines dictate that coverage of scientific issues which intersect with political or cultural ones tend to minimize the science, and focus instead on the political or cultural 'conflict.'" They fail to note, however, that a long series of gay-friendly media stories during the past ten years--stories about "gay genes," "gay brains," and children raised in gay-headed households--has been heralded almost uncritically, on a scientific level, by the popular media as evidence to prove the merit of gay social causes.
Much of the rest of the Lund-Renna commentary is basically a critique of the validity of the ex-gay movement, and an attempt to de-legitimize the efforts of ex-gays to change.
The article in the Journal by Wayne Besen could only be characterized as polemical; such polemics were justified by the journal's editor, Jack Drescher, because they were said to be a "representative sample of the political reception" of the Spitzer study within the gay community.
The commentary is vintage Wayne Besen. He concludes his diatribe with the following:
"In the end, however, the real loser is Dr. Spitzer. Whether he was an over-the-hill stage horse galloping toward the limelight or a court jester hood-winked by a scheming religious right is unimportant.In another article, Stalstrom and Nissinen provided a commentary on the role of the Spitzer study in the legal recognition of same-sex partnerships in Finland. The Spitzer study had been offered as evidence (by supporters of traditional marriage) in the Finnish same-sex partnerships debate. Consistent with his historical and current political views supportive of gay-activist social causes, Spitzer made a clarification to the Finnish Parliament on the distinct--and non-intersecting-- spheres of science and ethics; i.e., that scientific studies can never settle matters of social ethics; but then in closing, he offered his personal support for both anti-discrimination laws and civil unions for homosexuals.
"What matters is that Spitzer's embarrassing travesty of scholarship will surely go down as his defining work, a professional pockmark that will indelibly taint his once splendid career."
The final article in the Journal of Gay and Lesbian Psychotherapy is a dialogue between two colleagues: gay-activist psychiatrist Jack Drescher, and Robert Spitzer. It is difficult to determine how much of the interview was scripted. But Spitzer, in spite of being subjected to hate mail from the gay community and rage from colleagues, concluded, "I'm glad I did the study."
It's tempting to provide my own commentary on this issue of the Journal of Gay and Lesbian Psychotherapy. But beyond simply laying out the facts, I am not sure there is a need; surely, most professionals will be able to glean for themselves the differences between legitimate scientific criticisms and political rhetoric. However, because I am acquainted with Robert Spitzer, perhaps the following information will come closer to the truth of the matter.
My acquaintance with Robert Spitzer began in May, 2000, when I responded to a dinner invitation from him. Though discouraged from doing so by some of my colleagues, I accepted the invitation. Having spent three decades in clinical practice, I had learned to trust my judgment about people more than depending on the appraisals of others.
I was greeted by a mild-mannered man who was quite engaging. He was reasonable and open to hearing my opinion as he posed questions about the malleability of homosexuality. I was impressed with his genuineness and sincerity. At the risk of insulting him, I noted a kind of searching depth, almost approaching spirituality. By the evening's end, I had learned much about the 1973 decision to remove homosexuality from the diagnostic manual, and much more about Robert L. Spitzer, the man.
More importantly, my gut-level response told me that Robert Spitzer's motivations were honorable, and that he had integrity. He genuinely wanted to know if some homosexual men and women could change from homosexual to heterosexual, and that he wanted science to guide him. Certainly, with more than 275 publications to his credit, this esteemed scientist at Columbia University was more than able to conduct such a study.
With the limitations that are inherent to all such studies, Spitzer employed the best rigor available for such research protocols. I am certain that Spitzer would have received accolades from the scientific community had he studied a less controversial topic, employing the exact same methodology as in this study. His sample size was larger than those in previous studies. He was very detailed in his assessment and carefully considered the affective components of the homosexual experience. Any bias in interview coding was virtually eliminated by near-perfect interrater scores. He limited his pool of applicants to those reporting at least 5 years of sustained change from a homosexual to a heterosexual orientation. His structured interview clearly described how the participants were evaluated. His entire set of data is available for scrutiny by other researchers.
Spitzer's conclusions are simply this: based on his study, there is evidence to suggest that some gay men and lesbians are not only able to change self-identity, but are able to modify core features of sexual orientation, including fantasies.
One of the few rational, scientific commentaries on the Spitzer study was offered by Scott L. Hershberger. Dr. Hershberger, a distinguished scholar and statistician, elected to respond in a Commentary to the Spitzer research (Hershberger's article was published in the same issue of the Archives of Sexual Behavior as the Spitzer study was) by conducting a Guttman scalability analysis. This is a scalogram to determine whether or not reported changes occur in a cumulative, orderly fashion.
"The orderly, law-like pattern of changes in homosexual sexual behavior, homosexual self-identification, and homosexual attraction and fantasy observed in Spitzer's study is strong evidence that reparative therapy can assist individuals in changing their homosexual orientation to a heterosexual orientation.What I find most intriguing, and somewhat ironic is that Spitzer did in 2001 what he did in 1973: he challenged the prevailing orthodoxy. He challenged the assumption that "every desire for change in sexual orientation is always the result of societal pressure and never the product of a rational, self-directed goal."
"Now it is up to those skeptical of reparative therapy to provide comparably strong evidence to support their position. In my opinion, they have yet to do so."
In the particular sample he studied, Dr. Spitzer concluded that many participants "... made substantial changes in sexual arousal and fantasy--not merely behavior." Even subjects who made less substantial change believed it to be extremely beneficial.
"Like most psychiatrists," says Dr. 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."
Perhaps one of the valued characteristics of the good scientist is the amenability to form different opinions based on the data. This is precisely what Robert Spitzer has done. He came to the study skeptical, but open to new data. And with new data, he has formed a different opinion.
What is also clear from the Spitzer study is that more data is needed, because his study was very hypothesis-generating (as such studies should be).
In spite of the complaints from activists, the Spitzer study has managed to lift the thirty-year moratorium on the scientific investigation of homosexuality. Within the last year, I have had nine graduate students contact me about thesis or dissertation topics on homosexuality. Other colleagues report similar inquiries.
Activists suggest that there is no need to study change from homosexuality, and that even research on this subject will cause harm to self-identified homosexuals. In spite of a political climate where activism often trumps science, and where activist claims go uncritically examined, there is no rational basis for the speculation that studying homosexuality will harm gay-identified individuals.
In responding to this concern, Michael Bailey noted, in his recent book The Man Who Would Be Queen, "...it is difficult to argue that good scientific studies, or rational, open discussions" will harm homosexuals.
When sociopolitical agendas prevent scientists from studying even controversial topics like homosexuality, no one wins. In fact science can only progress by asking questions and seeking answers. When research is discouraged and scientists are intimidated, we begin down a slippery slope that approximates the censorship of scientific investigation, a very dangerous slope indeed.
The tone of this issue of the Journal of Gay and Lesbian Psychotherapy was not one that valued the scientific spirit of investigation and openness, but rather one of suppression and personal attack.
It's unfortunate that attempts are made to hold Spitzer's study to a higher standard than other similarly-conducted research. Spitzer's study was peer-reviewed and the limitations noted. It appears that the activist-authors of the Journal of Gay and Lesbian Psychotherapy were outraged that the study was published at all, a sad commentary for a professional journal. Spitzer's motives were questioned, his credibility attacked and his research subjected to a kind of scrutiny unparalleled in any scientific arena.
As a scientist, I find the journal's approach in this issue to be both disingenuous and intolerant. Disagreement among scientists is healthy. Name-calling and intimidation tactics are not. It is unfortunate that the journal's editorial board, some of whom are respected scientists, would lend credibility to this issue by their affiliation with the journal.