New Ex-gay Group Kicking It Old Skool

A new-old ex-Exodus association will hold their first conference September 21-22, 2012 at Sunrise Community Church at Orangevale, CA. The keynote speakers will be Dr. Robert Gagnon, Frank Worthen and Andrew Comiskey. The group has a statement of principles which begins with: “Sexual purity is a life-and-death matter.”

You can also follow along the developments at Restored Hope’s Facebook page.

It is fascinating to watch these developments. My guess is that PFOX and NARTH will line up with this group as a replacement for Exodus. Will Restored Hope go political? My guess is that there will be overtures from social conservative groups to attend marriage rallies, testify on legislation, etc.

The conflict between the change and congruence paradigms has been brewing for awhile. This development just makes it explicit.

 

 

 

Reparative therapy and the power of an explanation

Yesterday, I posted a link to an article titled “My So-called Ex-gay Life” from the website of the American Prospect and written by Gabriel Arana. In that post, I focused on psychiatrist Robert Spitzer’s desire to retract his 2001 study of ex-gays. I also reported on my brief exchange with Bob about his study and his current views on sexual orientation.

Today, I want to comment about Arana’s description of Narth co-founder Joseph Nicolosi. Arana summarizes his three year therapy episode with Nicolosi which ended with Nicolosi’s prognosis to Arana’s parents that their son would never enter the gay lifestyle:

Late into my last year of high school, Nicolosi had a final conversation with my parents and told them that the treatment had been a success. “Your son will never enter the gay lifestyle,” he assured them.

I once had an experience with Nicolosi which is similar to what happened with Arana and his parents. I was in a meeting with several psychologists, including Nicolosi, debating the merits of his theory of paternal deficit as the sole cause for adult male homosexuality. I presented the basics of a clinical case involving a young adult who consulted me about his distress over his same-sex attractions. The young man told me that he came out to his father because he was closer to his father than to his mother. In addition, there were other indications of paternal warmth and closeness that I mentioned in the presentation. In the midst of some discussion over the case, Nicolosi abruptly interrupted me and said, “He’ll be fine. He’s not gay.” Nicolosi then explained that a boy like that who has such a close relationship with his father could not possibly remain attracted to the same sex. In fact, the young man did remain attracted to the same sex, although he did not come out as gay at that point. The only follow up I ever heard was that he had determined to live a celibate life. That case was presented as an illustration of other cases with the same basic narrative — gay men with close warm relationships with their fathers.

Nicolosi’s theoretical statements reveal the most obvious confirmation bias. Despite the fact that Nicolosi has been exposed to evidence which would invalidate his narrow theory, he persists in holding on. Witness what he said to Arana:

What about people who don’t fit his model? “After almost 30 years of work, I can say to you that I’ve never met a single homosexual who’s had a loving and respectful relationship with his father,” he says. I had heard it all before.

He said the same thing in the meeting where I introduced cases of gay males who had a loving and respectful relationship with their fathers. However, in the face of the disconfirming evidence, he simply changed the rules – those men weren’t gay, they couldn’t be because they were close to their dads. Even though the clients were attracted to the same sex; according to Nicolosi, they would not continue with those attractions because of their closeness to their dads.

Arana articulates well how different explanatory narratives can become inculcated into an identity. Arana describes how he perceived the therapeutic narrative:

Continue reading “Reparative therapy and the power of an explanation”

Robert Spitzer Retracts 2001 Ex-gay Study

Psychiatrist Bob Spitzer, author of a 2001 ex-gay study, told American Prospect journalist, Gabriel Arana, that he wants to retract his study:

Spitzer was growing tired and asked how many more questions I had. Nothing, I responded, unless you have something to add.

He did. Would I print a retraction of his 2001 study, “so I don’t have to worry about it anymore”?

Knowing this article was coming, I talked last evening with Bob and asked him what he would like to do about his study. He confirmed to me that he has regret for what he now considers to be errant interpretations of the reports of his study participants. He told me that he had “second thoughts about his study” and he now believes “his conclusions don’t hold water.” He added that he now believes that the criticisms of the study expressed in the 2003 Archives of Sexual Behavior issue are “more true to the data” than his conclusions were.

He told me that he had expressed these thoughts to Ken Zucker, editor of the Archives of Sexual Behavior several months ago. He wondered aloud to Dr. Zucker if there was some obligation to say the critics were right and that the study should be withdrawn. Although Spitzer said he did not recall Zucker’s exact reply, he did not feel encouraged to withdraw the paper. The Prospect article also references the issue of a formal retraction:

I asked about the criticisms leveled at him. “In retrospect, I have to admit I think the critiques are largely correct,” he said. “The findings can be considered evidence for what those who have undergone ex-gay therapy say about it, but nothing more.” He said he spoke with the editor of the Archives of Sexual Behavior about writing a retraction, but the editor declined. (Repeated attempts to contact the journal went unanswered.)

However, when I asked Zucker via email about his stance, he told me that Bob had not submitted anything for review, but he is free to submit a letter to the Editor or other communication expressing regret and his current views. The ball is in Bob’s court. My guess is that Bob will take him up on that offer.

There is much else to consider in this article which I will get to later today.  The material and personal experience with Joseph Nicolosi is well worth reading.

First study to refer to ex-gays discredited

In 2000, I presented a paper at the annual conference of the American Psychological Association outlining studies which referred to ex-gays, i.e., people who rejected gay as an identity for religious reasons. That presentation was part of a larger symposium organized by Mark Yarhouse and Doug Haldeman on religious and GLB issues. In 2002, that paper was published in the APA journal Professional Psychology: Research and Practice.* That was the same year I was given the Freud Award at the NARTH conference.
In that paper, I summarized a study by psychiatrist E. Mansell Pattison and his wife Myrna Loy Pattison, titled “‘Ex-gays’: Religiously Mediated Change in Homosexuals.” The Pattisons interviewed 11 men in the Melodyland church in Anaheim, CA who claimed to have changed from gay to straight. One of those men was frequent commenter here Michael Bussee. Another was Gary Cooper, the man who left that ministry and Exodus with Bussee when they both acknowledged that they had not changed their orientation. In other words, two of the 11 had not changed at all.
Today, on the Religion Dispatches website, I describe that study in more detail and interview Michael Bussee about his participation. I encourage you to go read it and comment here or there.
The study continues to be used by NARTH as well as other groups to claim sexual reorientation works. The problems with the study provide more evidence that NARTH’s use of old data (125 year landscape review) is flawed.
*Throckmorton, W. (2002). Initial empirical and clinical findings concerning the change process for ex-gays. Professional Psychology: Research and Practice, 33, 242-248.

The Jones and Yarhouse study: What does it mean?

Let me begin by saying that I endorsed the book, Ex-Gays, A Longitudinal Study of Religiously Mediated Change in Sexual Orientation, by Stanton Jones and Mark Yarhouse which contained the first report of their longitudinal study. Since the publication of the book, Jones and Yarhouse have released results of their final follow up, first in 2009 at the annual convention of the American Psychological Association, and then most recently in the Journal of Sex and Marital Therapy. With the follow up, I believe the study remains an important investigation into the interplay of religion, sexual orientation and personal identity. I give them credit for the perseverance required to explore a topic which is highly controversial and to report their findings in detail.

Since the release of the peer-reviewed article, socially conservative groups have described the study as proof that gays can change orientation. For instance, the American Family Association’s Bryan Fischer, one of the worst offenders, claims that the study proves gays can change and that they weren’t born gay. Also, Citizenlink, an affiliate of Focus on the Family reported:

Of the 98 subjects, more than half were reported as successful; 23 percent reported a complete change in orientation after six years. Also, 20 percent reported giving up the struggle to change.

This claim is misleading. Jones and Yarhouse did not report “complete change in orientation.” Instead they cautioned against misinterpreting their findings by saying

These results do not prove that categorical change in sexual orientation is possible for everyone or anyone, but rather that meaningful shifts along a continuum that constitute real changes appear possible for some. The results do not prove that no one is harmed by the attempt to change, but rather that the attempt does not appear to be harmful on average or inherently harmful. The authors urge caution in projecting success rates from these findings, as they are likely overly optimistic estimates of anticipated success. Further, it was clear that “conversion” to heterosexual adaptation was a complex phenomenon.

Regarding the changes reported by their participants, the authors offer two related explanations. One is that some of the participants changed sexual orientation to some degree and the other is that the participants changed their sexual identity. Sexual identity involves placing more emphasis on behavioral conformity to prohibitions on homosexual behavior as a means of self definition. For the Exodus participants, less temptation to engage in homosexual behavior might be taken as a signal that orientation has changed, thus allowing a different attribution about their sexuality than once believed. The authors raise these two possibilities in the abstract for the most recent paper:

The authors conducted a quasi-experimental longitudinal study spanning 6–7 years examining attempted religiously mediated sexual orientation change from homosexual orientation to heterosexual orientation. An initial sample was formed of 72 men and 26 women who were involved in a variety of Christian ministries, with measures of sexual attraction, infatuation and fantasy, and composite measures of sexual orientation and psychological distress, administered longitudinally. Evidence from the study suggested that change of homosexual orientation appears possible for some and that psychological distress did not increase on average as a result of the involvement in the change process. The authors explore methodological limitations circumscribing generalizability of the findings and alternative explanations of the findings, such as sexual identity change or adjustment.

As I read all of the literature, including my own work, I first want to disagree with the way that Citizenlink characterized the results as “complete change.” That is not at all what Jones and Yarhouse reported. Considering the dichotomy proposed by Jones and Yarhouse — change in orientation or identity – I lean toward their alternative explanation – “sexual identity change or adjustment.”  However, I believe the discussion of what their results mean needs to be broadened beyond those two possibilities. In addition to considering orientation and identity as important constructs, I believe there are other ways to account for the changes Jones and Yarhouse report which are not sufficiently addressed in their published accounts.  First, I want to make some observations about the study which influence my opinions about what the results mean.

First, and most basically, the Jones and Yarhouse study did not examine in any systematic way the efficacy of reparative therapy or any other kind of psychological therapy as a means of altering sexual orientation. The participants in the study were involved in religiously based support groups which primarily had as a goal to reinforce a traditional moral view of sexuality. Clearly, the participants hoped they would change and engaged in various religious interventions to assist that end. However, the study did not assess the role of professional therapy and cannot legitimately be used to say such therapies work.

Second, there were quite a few dropouts six to seven years into the study. While true of all longitudinal studies, the final percentages being reported should also take into account the distinct possibility that many if not most of the drop outs were not successful in their efforts to change. The study began with 98 participants and ended up with 65 who were followed up for six to seven years. Some reported that they were healed of homosexuality and just didn’t want to participate, while others said they were gay and stopped trying to change. I don’t know for sure what the dropouts mean but the fact that so many failed to complete the study needs to be a part of any discussion.

Third, ratings from men and women were combined. Given the low number of people involved I understand why this was done but the practice may inflate the assessments of change for the group. It has become well accepted that the sexuality of women is more fluid than for men. A few women experiencing large shifts could influence the group averages. Continue reading “The Jones and Yarhouse study: What does it mean?”