California's legislature has voted to ban therapies which seek to the change sexual orientation of minors. The law, which will become effective January 1, has Christian groups worried that parents of teenagers with unwanted homosexual attractions will be deprived of an important means of providing for the psychological health of their children. Legislators claim that the law is necessary to protect children from abusive interventions which may cause lasting harm.
Conversion therapies are psychological treatments which purport to be able to alter a person's sexual orientation. Proponents of these therapies believe that homosexuality is a mutable condition which has psychological roots, usually arising as a result of wounds in early childhood. Reparative therapy, one of the popular variants, seeks to alter the homosexual condition by helping the client to repair broken relationships with their father and with same-sex peers.
It is hard to judge the effectiveness of these treatments.
The first difficulty lies in what people mean by “sexual orientation”. Many Christians who hold the traditional position on homosexuality see someone who abandons homosexual activity and achieves a stable heterosexual marriage as “straight”, even if that person continues to experience some degree of same-sex attraction. Most people within the LGBTQ community would see such a person as bisexual, or as a gay person who only has cross-orientation sex. The first view makes sexual orientation a question of behaviour; the second a question of feelings.
In popular discourse, sexual orientation is generally understood as a pattern of physical attraction. This is problematic because it conflates involuntary physical arousal with a capacity for on-going emotional intimacy, fidelity and sustainable desire. Most people will recognize that there is not necessarily a direct relationship between immediate attraction and success in long-term relationships. A man who prefers blondes may happily marry a brunette, and a woman who is attracted to aggressive, dominating types may find it impossible to sustain an emotionally fulfilling relationship with such men.
Unfortunately, prominent reparative and conversion therapists are often unclear about what they are promising to change. Sometimes they merely claim that their treatments will help homosexually attracted individuals deal with their unwanted attractions; but in other contexts they seem to be offering complete remission from all homosexual thoughts and impulses. This can be very confusing for potential clients, and for the parents of children with same-sex attractions.
Organizations offering these therapies also tend to give confusing reports concerning rates of success. When someone like Dr Joseph Nicolosi, a therapist with NARTH, claims that a third of his clients are successfully treated by reparative therapy, the casual listener will naturally form the impression that a very significant percentage of clients are able to go on to have successful heterosexual relationships. This is highly misleading. Most people who are successfully treated by conversion therapies achieve chastity, not heterosexuality.
There are no controlled, longitudinal, peer-reviewed studies examining the likelihood of long-term heterosexual functioning amongst former clients of conversion therapies. However, the best available study, published by Jones and Yarhouse in 2007, followed a group of homosexuals seeking orientation change through the supports offered by Exodus International. The study findings were modest: 15 percent of respondents reported “orientation change”, with a larger group reporting that the program helped them to be chaste. It is not known what percentage of these respondents have gone on to enjoy successful heterosexual marriages.
That said, it is not impossible for a homosexual to have a happy marriage with an opposite-sex spouse. My own experience speaks to that: I am same-sex attracted, but have chosen heterosexual marriage for a combination of religious and personal reasons. I would not say, however, that I have achieved orientation change. I am not attracted to men, I am in love with a man. This is typical of the real experience of “ex-gays”: usually what changes is not the underlying pattern of attraction but rather the sort of relationship that a person chooses to pursue.
It's important to make this distinction. A lot of anger within the gay community stems from those who have suffered because of false expectations, including people who entered into heterosexual marriages in the mistaken belief that they were “cured.” My own marriage has been successful and continues to be deeply fulfilling because both my husband and myself have been willing to engage honestly and authentically with the issues surrounding my sexual identity. This has allowed me to exercise moral freedom with respect to my sexuality without having to alter my personality or practice self-deception.
There are some homosexual people who have found therapy helpful in overcoming obstacles that prevent them from having successful opposite sex relationships. These obstacles are usually much the same as the difficulties which exclusively heterosexual people experience: difficulty trusting, poor relationship role-modelling within the family of origin, unresolved traumas, deep-seated insecurities, emotional barriers and so forth. These are psychological difficulties which any secular therapist would happily treat. In so far as conversion therapies address issues of this sort they may be helpful – though they may not ultimately lead to the elimination of homosexual desires or to heterosexual marriage.
Clients must, however, have the right to receive accurate information about treatment in order to form realistic expectations and goals. I have tried diligently to uncover ex-gay success stories, and have so far not found anyone who has experienced a complete elimination of same-sex desires over the long haul. Chambers and other Exodus leaders have recently distanced themselves from conversion therapies because they have found the same thing within their ministry.
While it is generally not possible to eliminate homosexual desire, there are people who have found therapy helpful in learning to integrate their same-sex attractions with their religious convictions. Others have found that by resolving issues in their past, they are able to have increased self-awareness and greater moral autonomy when it comes to their sexuality. Therapeutic models which concentrate on helping people achieve chastity and self-possession are less controversial and seem to be more effective than models which focus on changing people's underlying pattern of attraction.
Some therapists acknowledge this. They are very conscientious, deal honestly with their clients, will not work with patients who are unable to fully consent, and use only responsible means. These therapists do not harm their patients. Other therapists, however, use morally questionable means, make false claims about the efficacy of treatment, and blame the client when treatment fails. Former clients of such therapies report that treatment increased feelings of shame, guilt, self-loathing and depression without in any way allaying homosexual desire.
Adults who have chosen to undergo therapy are in a position to change therapists or to abandon treatment if they find that the therapy does more harm than good. Minors who are forced into therapy by adult authority figures do not have this option. Even if young people are theoretically seeking treatment under their own power, many feel intense pressure to overcome homosexual desires in order to please their parents, and some fear punishment or recrimination if they fail. Unscrupulous therapists often market their services primarily to parents and guardians, preying on the hopes and fears of those who have the ability to place adolescents in treatment.
Moreover, conscientious therapists openly state that conversion therapy does not have any real chance of working unless it is freely chosen by the client. Teenage dependants are not in a position to make a free choice of this kind.
The more legitimate forms of conversion therapy rely on the theory that homosexuality arises as a result of other psychological causes. If these theories are accurate, then the benefits of treatment should be accrued by patients who are treated for the underlying condition, even if homosexuality is not directly addressed. If parents are concerned that their child's homosexuality might be evidence of problems within the dynamics of the family, they should seek family counselling to remedy those dynamics. If they fear that their child may be suffering the long-term effects of early childhood bullying or rejection by same-sex peers, they should seek help to heal those wounds.
Treatment which focuses on the overall psychological health of the child or of the family is not prohibited by law in any jurisdiction; neither is it likely ever to be. Additionally, such treatment avoids the risk of placing a child in a therapeutic situation where they may suffer harm as a result of unscrupulous or dishonest practices.
Melinda Selmys is the author of Sexual Authenticity: An Intimate Reflection on Homosexuality and Catholicism. She is a homeschool mother with six children, writes for the National Catholic Register, and has published articles in numerous other venues. Her blog, sexualauthenticity.blogspot.com, explores issues surrounding faith and sexuality.
Related reading: Growing Up Weird; Gender Neutral Toys; Sexual Orientation and the Possibility of Change