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Why People Seek to Change Sexual
Orientation
Since conversion therapies operate on the assumption
that homosexuality is a mental disorder, conversion
therapists assume that they understand why people
would wish to change it. No published study of
conversion therapy has asked why people would
seek to change something as profound and complex
as sexual orientation, however. As a result, most
conversion therapists incorrectly assume that
their clients are motivated by intrinsic negative
factors associated with homosexuality, and those
therapists ignore the influence of social pressure,
which is likely a central factor in individuals'
attempts to change their sexual orientation4
.
Lesbian, gay, and bisexual individuals may be
subjected to significant social stress in the
form of harassment, violence, and discrimination.
These stress factors have been extensively documented,
along with their tendency to cause high levels
of emotional distress in lesbian, gay, and bisexual
people5 . We do
not see a parallel interest on the part of heterosexuals
in changing their sexual orientation because they
enjoy social privilege6
. Given that homosexuality is not a mental illness,
and in light of the considerable stigma experienced
by many gay people, it is likely that people attempt
to change their sexual orientation because of
the aforementioned social stress factors, as well
as pressure from family, society, and church.7
Yarhouse8 contends
that some people simply find homosexuality at
odds with their "values framework" and so freely
seek to become heterosexual. But from where do
gay, lesbian, and bisexual people derive their
"values framework," if not the homophobic world
around them? This unsupportive social context
is why the argument that people freely seek to
change their sexual orientation is unconvincing.
Current psychological research on this issue confirms
that social factors bear a strong influence on
individuals who choose conversion therapy.9
The Concerns of Mainstream Mental Health Organizations
The prejudicial and scientifically inaccurate
view of homosexuality advanced by conversion therapists
has called for a response from mainstream mental
health organizations. Historically, most conversion
therapy occurred in religious settings, so it
was not necessary for mental health groups to
comment on the practice. That changed with the
emergence of the National Association for Research
and Therapy of Homosexuality (NARTH) in the early
1990's. NARTH disseminates material that promotes
discredited stereotypes and portrays all lesbian,
gay and bisexual people as troubled.
Mainstream mental health organizations in the
United States have responded to this challenge.
In 1997, the American Psychological Association
adopted a policy admonishing all practitioners
who deal with lesbian, gay and bisexual clients
to refrain from discriminatory practices and from
making unscientific claims about their treatments.
Therapists must also provide the client with information
about the treatment, alternatives, and reasonable
outcome expectations. Further, the policy affirms
the Association's commitment to the "dissemination
of accurate information about sexual orientation,"
and "opposes portrayals of lesbian/gay/bisexual
adults and youth as mentally ill." 10
In 1998, the American Psychiatric Association
took a stronger stand, officially opposing "all
forms of therapy based on the assumption that
homosexuality per se is a mental illness." Similar
policies opposing conversion therapy have been
adopted by the American Counseling Association,
the National Association of Social Workers, and
the American Academy of Pediatrics.
Conversion Therapy's Track Record
Conversion therapists have different views on
what constitutes effective treatment. Religious
groups often encourage celibacy for their "ex-gay"
followers, so lack of sexual contact is construed
as successful treatment. Most studies published
in the mental health literature use heterosexual
behavior as a treatment goal. Much of the effectiveness
of conversion therapies is asserted in clients'
testimonials or in articles in publications that
do not meet accepted research standards. A careful
analysis of other evidence of conversion therapy
effectiveness fails to justify these recent claims
The studies that have appeared in legitimate
journals are generally quite old and share common
methodological problems. Studies of conversion
therapy are not based upon a random sample of
homosexuals who are randomly assigned to different
treatments and are then compared, but on a group
of homosexuals who have sought treatment because
they are unhappy with their sexual orientation.
Furthermore, the studies all rely on clients'
self-reported outcomes or on therapists' post-treatment
evaluations. As a result, all conversion therapy
studies are biased in favor of "cures" because
clients of conversion therapy are likely to believe
that homosexuality is an undesirable trait to
admit and may feel pressure to tell their therapist
that the treatment has been successful. Similarly,
conversion therapists have an interest in finding
that their treatments are successful
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2, 3, 4
NOTES:
4. Haldeman, D. (1994). ãThe Practice and Ethics
of Sexual Orientation Conversion Therapy,ä Journal
of Consulting and Clinical Psychology.Ê Vol.
62, 1994;Ê Davison, G. ãConstructionism and Morality
in Therapy for Homosexuality.ä In J. Gonsiorek
and J. Weinrich (see note
2).
5. DiPlacido, J. ãMinority Stress Among Lesbians,
Gay Men and Bisexuals: A Consequence of Heterosexism,
Homophobia, and Stigmatization.ä In G.
Herek (Ed.), Stigma and sexual orientation:
Understanding prejudice against lesbians, gay
men and bisexuals.Ê Thousand Oaks, CA: Sage
Publications, 1998.Ê Herek,
G. ãStigma, Prejudice and Violence Against
Lesbians and Gay Men.ä In J.Gonsiorek and J. Weinrich,
1991(see note 2).Ê Bradford, J., Ryan, C., & Rothblum,
E.Ê ãNational Lesbian Health Care Survey: Implications
for Mental Health Care,ä Journal of Consulting
and Clinical Psychology, Vol. 62, 1994.Ê Ross,
M. (1990). ãThe Relationship Between Life Events
and Mental Health in Homosexual Men,ä Journal
of Clinical Psychology, Vol. 46, 1990.
6. See Haldeman, 1994 (note 4).Ê
7. American Psychological
Association. ãAppropriate therapeutic responses
to sexual orientation. Proceedings for the legislative
year 1997.ä American
Psychologist, Vol.53, 1998.Ê Haldeman, 1994;
Davison, 1991. (See note 4.)
8. Yarhouse, M. ãWhen Clients Seek Treatment for
Same-sex Attraction: Ethical Issues in the ãRight
to Chooseä Debate,ä Psychotherapy, Vol. 35, 1998.
9. Beckstead, A. ãGay is not meä: Seeking Congruence
Through Sexual Reorientation Therapy.ä (Unpublished
masterâs thesis, University
of Utah, 1999).Ê Shidlo, A. & Schroeder, M.
ãChanging Sexual Orientation: Does Counseling
Work?ä Paper presented at the American
Psychological Association, Boston, MA, 1999.Ê
10. APA, 1998 (note 7)
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