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The “Can’t Change” Myth

November 5, 2011

Refuting the Distortions of the GLBTQ Activists

Distortion #2:  Persons with SSA can’t change

In 2003 Dr. Robert Spitzer, who had thirty years before been instrumental in the decision of the American Psychiatric Association to remove homosexuality from the Diagnostic and Statistical Manual of the APA, published a study of 200 men and women who had undergone therapy for SSA and reported change in their pattern of sexual attraction. At the time a major initiative had been launched by pro-SSA mental health professionals to ban therapy directed to changing SSA. Spitzer conducted phone interviews with 200 persons who had been in treatment for SSA. He concluded that although not all successfully became functioning heterosexuals, some did and the rest felt the therapy had benefited them.[1] The study was not designed to discover the percentage of those in therapy who experience a real change, only if anyone in therapy experienced a change of orientation. The conclusion they had.

Because of the controversial nature of the study the editors of Archives of Sexual Behavior and the Journal of Gay and Lesbian Psychotherapy solicited comments on the study which were published together with the original study. There were several repeated themes in the critiques: 1) the people who claimed change were either lying or deceiving themselves; 2) they weren’t really gay to begin with but bisexual[2]: 3) any effort to change sexual orientation is oppressive to those who try and fail and because it increases discrimination against entire gay and lesbian community[3]; 4) such studies will negatively affect the gay political agenda;  5) the interviewee may have had high levels of internalized homophobia, their motivation was religious and rather than changing their sexual orientation they should have changed their religion.[4]

In response it should be noted that:

1)         Reports from clients and from therapists using a wide variety of treatment protocols spanning the various schools of therapy go back over 125 years and it is difficult to believe that all these people are lying.[5]  The Journal of Human Sexuality provides a comprehensive review of the literature on therapy for unwanted SSA, which shows that almost every form of therapy had some success. There are also reports of spontaneous change[6]  and of change during treatment for other disorders.[7] It should be noted that some persons presenting themselves for treatment of SSA may actually have another disorder. For example, a significant minority of clients with “unwanted SSA” actually have “unwanted OCD”- they are more distressed by obsessive thoughts/ urges/images/etc. than attracted by/to them.

A number of studies have found that the percentage of persons with SSA is not stable over time.[8] Many young men who believed they were “gay” as teenagers become heterosexual in their twenties.[9] Women who thought they were lesbian in college go on to marry.[10] Married women with children decide in their 30’s that they are lesbians.[11] Lesbians who enter into relationships and acquire babies decide they are really heterosexual.[12] Even those who deny the possibility of total change admit that change of behavior is possible.[13]

2)         It does appear that men and women with some heterosexual experience have a better prognosis.[14] However, since a high percentage of persons with SSA have had some heterosexual experience this should be encouraging to those considering therapy. Change also appears to be more common among women than men.

3)         It is true that failing to achieve one’s goals in therapy is disheartening, but no one suggests that it is unethical to offer a therapy unless one can a guaranteed 100% total cure. Therapists treating depression don’t promise clients they will never have a relapse. [15]

4)         A careful reading of the articles opposing therapy for change reveals that the authors who see therapy for change as unethical[16] do so because they view such therapy as oppressive to those who do not want to change[17] and view those persons with same-sex attraction who express a desire to change as victims of societal or religious oppression.[18] Therapy should be guided by the best interests of clients not the political goals of a special interest group.[19]

5)         Forced to choose between sexual inclinations and religious faith, it is not surprising that some people should choose faith. They should certainly have that right and have the right to therapy that helps them live according to their conscience.[20]

It should be noted that almost without exception, those who want to ban therapy directed toward changing sexual orientation, also reject abstinence from non-marital sexual activity as a minimal goal.[21] Therapists who accept homosexual acts as normal also accept infidelity in committed relationships,[22] anonymous sexual encounters, general promiscuity, prostitution, auto-eroticism,[23] pornography addiction, sado-masochism, so-called “sex change” operations, and various paraphilias. Some even support a lessening of restrictions on sex between adults and minors[24] or deny the negative psychological impact of sexual child abuse.[25] Some of those who consider therapy unethical also challenge established theories of child development.[26] Almost without exception they place blame for the undeniable problems suffered by homosexually active adolescents and adults on societal oppression.[27]

Some forms of therapy encourage the patients to replace one form of sexual behavior with another.[28] Some therapists, for example, do not consider a patient “cured” until he can comfortably engage in sexual activity with the other sex, even if the patient is not married.[29] Others encouraged patients to masturbate using other-sex imagery.[30] Obviously none of this – even if it were effective – is acceptable for many therapists or clients. It should be noted that even when clients enter therapy with a willing therapist and with the expressed intention of changing their pattern of sexual attraction, most therapists focus on healing the childhood wounds and adolescent emotional conflicts and developing a healthy masculine or feminine identity and healthy same sex friendships, not on  stimulating opposite sex attraction.[31]

Some of those who have struggled with same-sex attractions believe that they are called to a celibate life. They should not be made to feel that they have failed to achieve freedom because they do not experience desires for the other sex. Others wish to marry and have children. There is every reason to hope that some will be able, in time, to achieve this goal. They should not, however, be encouraged to rush into marriage since there is ample evidence that marriage is not a cure for same-sex attractions.

Experienced therapists can help individuals uncover and understand the root causes of the emotional trauma that gave rise to their same sex attractions and then work in therapy to resolve this pain. Men experiencing same-sex attractions often discover how their masculine identity was negatively affected by feelings of rejection from father or peers or from a poor body image that result in sadness, anxiety, anger and insecurity. As this emotional pain is healed in therapy, the masculine identity is strengthened and same sex attractions regularly diminish.

Women with same sex attractions can come to see how conflicts with fathers and/or other significant males led them to mistrust male love, or how lack of maternal affection led to a deep longing for female love. Insight into causes of anger and sadness will hopefully lead to forgiveness and freedom. All this takes time. In this respect individuals suffering from same-sex attraction are no different than the many other men and women who have significant emotional pain and need to learn how to forgive. Forgiveness has been show to be affective in resolving the affects of painful experiences.[32]

A number of therapeutic strategies are available to those working with clients with unwanted SSA. For example, in an article entitled “The Primacy of Affect” Joseph Nicolosi discusses how Short Term Dynamic Psychotherapies and Accelerated Experiential Dynamic Psychotherapy has proven effective with some clients[33]:

“It is through this connectedness with the therapist that the client allows himself to feel the bodily sensations that are associated with his painful early experiences. Healing moments occur when the client feels seemingly ‘unbearable’ affect, while at the same moment, experiencing the support of the therapist. Thus, in a process of interactive repair, their attuned relationship actually changes the neurological structure of the brain.”[34]

There is every reason for hope that with time those who seek freedom will find it. However, while we can encourage hope, we must recognize that there are some who will not achieve their goals. We may find ourselves in the same position as a pediatric oncologist who speaks of how when he first began his practice there was almost no hope for children stricken with cancer. The physician’s duty was to help the parents accept the inevitable and not waste their resources chasing a “cure.” Today almost 70% of children recover, but each death leaves the medical team with a terrible feeling of failure. As the prevention and treatment of same-sex attraction improves, the individuals who still struggle will, more than ever, need compassionate and sensitive support.  Also, some persons who initially attempt- and fail- to develop their heterosexual potential, find serenity in living celibacy [35]


[1] Robert Spitzer, “Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation,” Archives of Sexual Behavior, 35, 5 (2003): 403-417.

[2]  Craig Hill, Jeannie DiClementi, “Methodological limitations do not justify the claim that same-sex attraction changed through ‘Reparative therapy,’” (in Ex-Gay Research): 143; Helena Carlson, “A methodological critique of Spitzer’s research on reparative therapy,” (in Jack Drescher, Kenneth Zucker, ed. Ex-Gay Research: Analyzing the Spitzer study and its relation to science, religion, politics, and culture, (Harrington Park: NY 2006) ):  92.

[3] Milton Wainberg et al, “Science and the Nuremberg Code: A Question of Ethics and Harm,” (in Ex-Gay Research): 197.

[4] Richard Friedman, “Sexual Orientation Change: A study of Atypical Cases,” in Ex-Gay Research): 116; Craig Hill, Jeannie DiClementi , “Methodological limitations,’” (in Ex-Gay Research ): 142.

[5] In addition to several reviews of the literature (R. Goetze, Homosexuality and the Possibility of Change: A Review of 17 Published Studies, (Toronto Canada: New Directions for Life, 1997); W. Throckmorton, “Efforts to modify sexual orientation: A review of outcome literature and ethical issues,” Journal of Mental Health and Counseling, 20, 4 (1996): 283-305), there are numerous reports from therapists of success in treatment: Ruth Barnhouse, Homosexuality: A Symbolic Confusion  (NY: Seabury Press, 1977); E.  Bergler, Homosexuality: Disease or Way of Life, (NY: Collier Books, 1962). Bieber, Homosexuality; D. Cappon,  Toward an Understanding of Homosexuality, (Englewood Cliffs NJ: Prentice-Hall, 1965); F. Caprio, Female Homosexuality: A Psychodynamic Study of Lesbianism, (NY: Citadel, (1954); S. Hadden, “Male homosexuality,” Pennsylvania Medicine (February1967): 78; J. Hadfield, “The cure of homosexuality,” British Medical Journal, 1 (1958): 1323-1326: L. Hatterer, “Changing Homosexuality in the Male,” (NY: McGraw-Hill, 1970); H.  Kaye et al., “Homosexuality in Women,” Archives of General Psychiatry, 17 (1967): 626-634; R. Kronemeyer,  Overcoming Homosexuality, (NY: Macmillian, 1980);  J. Nicolosi, Dean Byrd, R. Potts, Towards the Ethical and Effective Treatment of Homosexuality,  (Encino CA: NARTH, 1998); Carl Rogers et al.,  “Group psychotherapy with homosexuals: A review,” International Journal of Group Psychotherapy, 31, 3(1976): 3; Jeffrey Satinover, Homosexuality and the Politics of Truth, Grand Rapids MI: Baker, (1996). Mention of Stanton Jones. Mark Yarhouse book, Ex-Gays: A longitudinal study of religiously mediated change in sexual orientation, (Downers Grove,IL: IVP Academic, 2007):

http://www.narth.com/docs/APA2009SymposiumReport.pdf

[6] Elaine Siegle, Female Homosexuality: Choice without Volition, (Hillsdale, NJ: Analytic Press, 1988):

[7] Dean Byrd “The malleability of homosexuality: A debate long overdue,” (in Ex-Gay Research): 83 -87.

[8] Edward Lauman et al., The Social Organization of Sexuality: Sexual Practices in the United States, (Chicago: University of Chicago, 1994): Lisa Diamond “Sexual identity, attractions, and behavior among young sexual-minority women over a two-year period,” Developmental Psychology, 36, 2 (2000): 241-250

[9] Warren Throckmorton, “Hiding truth from school Kids: It’s Elementary Revisited,” June 16, 2004,www.drthrockmorton.com/article.asp?id=78.

[10]Lesbian until graduation,” Wikipedia, July 2007.; Lisa M. Diamond, Sexual Fluidity: Understanding Women’s Love and Desire (Boston, MA: Harvard UP, 2009) http://www.narth.com/docs/diamond.html:

[11] “Feminism Turned Happy Hetero Woman Toward Homosexuality,” WorldNetDaily.com (July 1, 2007); Janelle Hallman, The Heart of Female Same-Sex Attraction: A comprehensive Counseling Resource, (IVP:Downers Grove,IL, 2008)

[12] Dale O’Leary, One Man, One Woman, (ManchesterNY: Sophia Institute Press, 2007)

[13] The APA Task Force Report declares that sexual behavior, attraction, and orientation identity are fluid — i.e., changeable. “Recent research on sexual orientation identity diversity illustrates that sexual behavior, sexual attraction, and sexual orientation identity are labeled and expressed in many different ways, some of which are fluid” (p. 14; cf. p. 2, 63, 77); Eli Coleman, “Toward a new model of treatment of homosexuality: A review, “Journal of Homosexuality. 3, 4(1978): 345 – 357; W. Herron et al., “Psychoanalytic psychotherapy for homosexual clients: New concepts,” (in J. Gonsiorek, ed., Homosexuality and Psychotherapy, NY:Haworth, 1982).

[14] F. Acosta, “Etiology and treatment of homosexuality: A review,” Archives of Sexual Behavior, 4 (1975): 9-29.

[15]  Neil Whitehead, Christopher Rosik, ”Practice guidelines for therapists”, Journal of Human Sexuality, 2010, Vol. 2.

[16] G. Davison, “Politics, ethics and therapy for homosexuality,” (in W. Paul et al., Homosexuality: Social, Psychological and Biological Issues,Beverly HillsCA: Sage, 1982): 89-96; B. Gittings, “Gay, Proud, Healthy,”PhiladelphiaPA: Gay Activists Alliance (1973).

[17] D. Begelman, “Ethical and legal issues of behavior modification,” (in  M. Hersen, R. Eisler, P. Miller, Progress in Behavior Modification, NY: Academic, 1975); T. Murphy, “Redirecting sexual orientation: Techniques and justifications,” Journal of Sex Research. 29, (1992): 501 – 523; S. Sleek, Concerns about conversion therapy. APA Monitor, (October, 281997): 16; J. Smith, “Psychopathology, homosexuality, and homophobia,” Journal of Homosexuality, 15, 1/2(1988): 59-74.

[18] D. Begelman, “Homosexuality and the ethics of behavioral intervention,” Journal of Homosexuality, 2, 3(1977): 213-218; Charles Silverstein, “Behavior Modification and the Gay community,” Paper presented at the annual convention of the Association for Advancement of Behavior Therapy. NY, (Oct. 1972).

[19] Summary of the Symposium: APA Task Force on Sexual Orientation: Science, Diversity and Ethicality http://www.narth.com/docs/symposium2010.html.

[20] Philip M. Sutton, “Historic APA Symposium on Religiously Mediated Change in Homosexuality,” . http://www.narth.com/docs/APA2009SymposiumReport.pdf

[21] R. Barrett, R. Barzan, “Spiritual experiences of gay men and lesbians,” Counseling and Values, 41 (1996): 4-15.

[22] James Nelson, “Religious and moral issues in working with homosexual clients,” (in J. Gonsiorek, Homosexuality and Psychotherapy, NY:Haworth, 1982): 163-175.

[23] Marcel Saghir, E. Robins, Male and Female Homosexuality: A Comprehensive Investigation, (Baltimore MD: Williams & Wilkins, 1973).

[24] H. Mirkin, “The pattern of sexual politics: Feminism, homosexuality, and pedophilia,” Journal of Homosexuality, 37, 2 (1999): 1-24.

[25] Bruce Rind, R. Bauserman, P. Tromovitch, “A meta-analytic examination of assumed properties of child sexual abuse using college samples,” Psychological Bulletin, 124, 1 (1998): 22-53; Smith 1988

[26] Davison, Op. Cite.; E. Menvielle, “Gender identity disorder,” (Letter to the editor in response to Bradley and Zucker article). Journal of the American Academy of Child and Adolescent Psychiatry. 37, 3 (1998): 243-244.

[27] American Psychological Association, Lesbian, Gay and Bisexual Concerns, “Guidelines for psychotherapy with lesbian, gay, and bisexual clients,” www.apa.org/pi/lgbc/publications/guidelines.html; Kristin Hancock, “Psychotherapy with lesbians and gay men,” (in Anthony D’Augelli, Charlotte Patterson, eds., Lesbian, Gay, & Bisexual Identity over the Lifespan, NY:Oxford, U. Press, 1995) 398-432.

[28] M. Schwartz, W. Masters, “The Masters and Johnson treatment program for dissatisfied homosexual men,” American Journal of Psychiatry. 141(1984): 173-181.

[29] William Masters, V. Johnson, Homosexuality in Perspective.Boston: Little Brown, Co., (1979).

[30] J. Blitch, S. Haynes, “Multiple behavioral techniques in a case of female homosexuality,” Journal of Behavior Therapy and Experimental Psychiatry. 3(1972): 319-322; S. Conrad, J. Wincze, “Orgasmic reconditioning: A controlled study of its effects upon the sexual arousal and behavior of adult male homosexuals,” Behavior Therapy, 7 (1976): 155-166.

[31] Elizabeth Moberly, Homosexuality: A New Christian Ethic) Cambridge, England: James Clarke, 1983); Joseph Nicolosi, Reparative Therapy of Male Homosexuality, (Northvale NJ: Aronson, 1991).

[32] Robert Enright , Richard Fitzgibbons, Helping Clients Forgive (Washington, DC: American Psychological Association Books, 2000).

[34] Joseph Nicolosi, “The Primacy of Affect,” http://www.narth.com/docs/affect.html

[35] Stanton Jones. Mark Yarhouse book, Ex-Gays: A longitudinal study of religiously mediated change in sexual orientation, (Downers Grove,IL: IVP Academic, 2007);

http://www.narth.com/docs/APA2009SymposiumReport.pdf

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