Sexual identity therapy: What it is and what it isn’t

There is lots of discussion occuring on various blogs/media sources about the sexual identity therapy framework. I want to link to a couple and comment.

Two threads at ExGayWatch involve the framework. One is an open forum triggered by my appearance on CNN with Dr. Benjamin McCommon and the other references Peterson Toscano’s statements about what change is and isn’t. It appears that many observers want to link the framework with reparative therapy which is a clear misunderstanding. I invite you to go on over and read the comments there. However, I will say here that if therapists tell clients why they have same-sex attraction as a precursor to therapy or engages in confirmatory questioning (e.g., “many men who are attracted to the same sex say they were distant from their fathers, what was your relationship with your father like?”), then they are not operating consistently with the framework. Furthermore, we do not focus on change of orientation, but rather living a valued and congruent life. Success is not measured by moment by moment assessments of attractions but rather by satisfaction with the help received. People may indeed change if there are clear links from past experience to present unwanted behavior (ask Joe Kort about this) but that is not initial focus of the framework.

Speaking of Joe Kort, he had a go at the framework as well. Beginning on a positive track, the train derailed quickly when he said:

The problem is that when you read on both Throckmorton and Yarhouse talk about homosexuality as being able to be changed. Like reparative therapy they promise to make straight soldiers out of homosexual men.

and then near the end of the post:

I do wish Throckmorton and Yarhouse would stop promising to change peoples sexual and romantic orientation.

Puzzled, I am. In fact, here is what we say in the framework:

Prior to outlining the recommendations, let us define what they are not. They are not sexual reorientation therapy protocols in disguise. Although some investigators (e.g., Spitzer, 2003) have attempted to examine sexual orientation change, numerous criticisms have been leveled at client self-report as a means of assessing such change. Currently, no other means of sexual orientation assessment has found wide acceptance. A consensus about accurate assessment and measurement of sexual orientation would be required in order to empirically test therapies purporting to produce sexual orientation change. At present, such consensus does not exist (Kinnish, Strassberg & Turner, 2005).

Current assessment methods do allow us to ask clients about their perceptions of sexual identity during psychotherapy. Furthermore, we have tools that assess overall client well-being, mental health and satisfaction with how therapy is conducted. To varying degrees, some clients may come to believe change has occurred in their sexuality while some will believe little or no change has occurred. These perceived changes can be examined but we do not view such change as a determinant for the success or failure of sexual identity therapy. Instead, client satisfaction and overall mental health improvement are more efficiently assessed. In any case, we believe guidelines are needed for therapy with clients who experience sexual identity conflict no matter what their beliefs are about sexual orientation and whether it can be altered.

Joe, you had your wish before you made it.