Review of Sheldon Helms' "Gay Conversion Therapy" SkepTalk (by Patrick O'Reilly)

Sheldon HelmsSheldon HelmsOn September 12th, 2012, Bay Area Skeptics was delighted to be present for Professor Sheldon Helms’ presentation entitled Gay Conversion Therapy: You Make Me Sick.

Sheldon’s presentation was particularly timely because on September 29th, Governor Jerry Brown signed into law Senate Bill 1172, which protects lesbian, gay, bisexual and transgender (LGBT) minors from "reparative" therapies administered by mental health professionals aimed at altering sexual orientation or gender identities and expressions.

Governor Brown was quoted as stating that such misguided an unscientific psychotherapy “will now be relegated to the dustbin of quackery…This bill bans non-scientific 'therapies' that have driven young people to depression and suicide.” As overdue as this new law was, it will sadly and tragically not prevent amateur therapists with a religiously rigid orientation on what constitutes “acceptable” sexual expression and sexual identity from inflicting their views on young people who are confused, guilty and frightened by being told that their self- identities are sinful.

In his presentation Sheldon clearly, and in a remarkably entertaining manner, demonstrated just how persistently a bad idea can flourish, particularly when it is solely faith-based and devoid of even a modicum of empirical evidence. In presenting a history of this topic, he pointed out that it was not until 1973 that the American Psychiatric Association, arbiters of The Diagnostic and Statistical Manual of Mental Disorders (DSM), removed homosexuality from its list of mental disorders. Even this action was met with protest and a petition was immediately circulated among psychiatrists protesting its removal. A compromise of sorts was reached when a new diagnosis, ego-dystonic homosexuality, was included in the DSM's third edition in 1980. Ego-dystonic homosexuality was defined as “(1) a persistent lack of heterosexual arousal, which the patient experienced as interfering with initiation or maintenance of wanted heterosexual relationships, and (2) persistent distress from a sustained pattern of unwanted homosexual arousal.” This diagnosis, however, was also removed completely from the DSM in 1986 because a consensus of psychiatrists concluded that the emotional difficulties related to ego-dystonic homosexuality could be better understood and treated by diagnoses already in the DSM and it because inclusion of this diagnosis in the manual reinforced antigay bias.

Sheldon pointed out that the origins of the idea that homosexuality is a mental illness can be found in the work of psychiatrist von Krafft-Ebing, who, in his book Psychophathia Sexualis, maintained that the purpose of the sexual act is procreation and in which he condemned homosexuality, comparing it to pedophilia. Freud, a protégé of sorts of Krafft-Ebing, was less strident. Freud did not consider homosexuality harmful. Although in certain circumstances he incorrectly believed it could be pathological, he saw no value in psychoanalyzing someone as a means of “curing” homosexuality.

The breakthrough on “de-pathologizing” homosexuality really occurred due to the research of Dr. Evelyn Hooker, author of the 1957 research paper "The Adjustment of the Male Overt Homosexual". This research paper conclusively demonstrated that there is no difference in the levels of neurosis between heterosexuals and homosexuals. When her research was subjected to double blind testing, her peers could also detect no difference. To quote Sheldon, “In terms of psychological adjustment, there were no differences between the members of each group.” Although one might assume, based on the changing attitudes of the American Psychiatric Association and the overwhelmingly conclusiveness of Dr. Hooker’s research, that the mental health profession would have recognized that sexual orientation is not a matter of choice and in itself not emotionally harmful. One might think that but one would be wrong; bad ideas die a slow death.

Dr. Robert Spitzer, professor of psychiatry at Columbia University, was Chair of the DSM task force in 1973 and was instrumental in removing homosexuality from the manual’s list of mental illnesses. It’s unfortunate that Dr. Spitzer did not stop there. He had withstood the criticism of a sizeable number of his peers and had done a brave and scientifically credible act. Unfortunately, a later study published by Dr. Spitzer did lasting harm. In 2003 a research article he wrote, published in the journal Archives of Sexual Behavior, maintained that homosexuals can change their sexual orientation. In other words, sexual orientation was a matter of choice. To quote from Dr. Spitzer’s journal article’s abstract:

The participants were 200 self-selected individuals (143 males, 57 females) who reported at least some minimal change from homosexual to heterosexual orientation that lasted at least 5 years. They were interviewed by telephone, using a structured interview that assessed same sex attraction, fantasy, yearning, and overt homosexual behavior. On all measures, the year prior to the therapy was compared to the year before the interview. The majority of participants gave reports of change from a predominantly or exclusively homosexual orientation before therapy to a predominantly or exclusively heterosexual orientation in the past year. Reports of complete change were uncommon. Female participants reported significantly more change than did male participants.

It was a terribly flawed study and even Dr. Spitzer acknowledged its weaknesses in the paper’s abstract. Why he went and ahead and published it anyway is a mystery to me and why the journal accepted it for publication is an even greater mystery. Succinctly: Dr. Spitzer relied only on self-reports. The difficulty with self-reports is that there is no way to determine if the person is lying – and clearly an awful lot of Dr. Spitzer’s subjects lied to him. Dr. Spitzer later publicly acknowledged the study’s serious flaws, although he did not recant its conclusions. But the acknowledgement was much too little and far too late; the damage had been done. Dr. Spitzer’s high status (psychiatrist, Columbia University professor) gave credence to an outlandish and scientifically unsupported belief system that opened the flood gates to a wide assortment of strange and religiously zealous characters, many of whom had little or no mental health training, but all of whom fervently believe that homosexuality is an abomination that can be “cured” by their assortment of odd and untested therapies, and of course by prayer. In his talk, Sheldon clearly described the behaviors of these fine and upright citizens who “love the sinner but not the sin.”

Sheldon then introduced his audience to the main players in the gay conversion movement. One of these is the National Association for Research and Therapy of Homosexuality (NARTH), an organization that purports to be scientifically based, and which states on its web site, “We are focused on the right of persons to deal with unwanted sexual attractions as well as the right of therapists to offer psychological care to those who wish to deal with these attractions by diminishing or eliminating them rather than just identifying with and acting upon them. We acknowledge and respect the right of individuals to claim a gay identity.” One of its founders, Joseph Nicolosi, Ph.D., claims on his personal website that “You Don’t Have to Be Gay: Diminish your unwanted homosexuality, Develop Your Heterosexual Potential.”

Although NARTH denies all religious affiliation, one of NARTH’s past presidents, Judith Hamilton, Ph.D., states on her web site that she “…conducts seminars for pastors and Christian leaders on the origins of homosexuality and how to minister to homosexuals. She has produced a video entitled ‘Homosexuality 101: Where Does it Come From, Is Change Possible, and How Should Christians Respond?’ ” The current president of NARTH, Christopher Rosik, Ph.D., published an article entitled “Change in Homoerotic Behavior and Feelings is Possible: Genetics Play Only a Weak and Indirect Role,” which is listed in Resources for Pastoral Ministry Concerning Sexuality in the Presbyterian Coalition. A former NARTH President, Jerry Harris, Ed.D. states on his web page that he “was a manager for LDS Family Services for many years.” Incidentally, the name of NARTH founder Dr. Nicolosi’s therapy clinic is Thomas Aquinas Therapy Clinic.

The efforts of Exodus International were also covered by Sheldon. Exodus was found in 1976 and is a “non-profit, interdenominational ex-gay Christian organization that seeks to limit homosexual desires.” The former Chairman of the Board of Directors of Exodus International, John Paulk, along with his wife, toured the United States, speaking at conferences and to the media about his successful heterosexual and religious conversions. The Paulks even appeared on the cover of Newsweek magazine. Alas, for Mr. Paulk’s credibility, he was spotted (and photographed) in a Washington D.C. gay bar. His excuses (that he didn't know it was a gay bar, later that he was using the bathroom, and later still that he was doing undercover research at the gay bar) fell on deaf ears, and he was soon fired by the Exodus board.

Sheldon also addressed the therapy work done by the International Healing Foundation, founded by Richard Cohen, M.A. Mr. Cohen believes that he was “healed” of his homosexuality through therapy and his new found religious faith. The International Healing Foundation maintains on its website that “No one is born homosexual, No one chooses to have same-sex attractions, Anyone can choose to change, What was learned can be unlearned, and It's not gay, nor bad, it's SSAD (Same Sex Attachment Disorder).” SSAD, incidentally, is a diagnosis exclusive to the International Healing Foundation. Mr. Cohen, by the way, is not a licensed psychotherapist.

Mr. Cohen advocates a therapeutic technique he calls “holding therapy,” which involves physical touch, with the client often being held in a sitting or reclining position –and sometimes in the lap, by the male therapist, who repeats kind, affirming phrases to the client, which Mr. Cohen believes will instill the healthy, non-sexual same sex bonding that was absent during the client’s childhood. Mr. Cohen is also a strong believer in aversion therapy, a therapeutic model that is defined as “associating a negative, often traumatic, experience with an unwanted behavior with the goal of decreasing the behavior’s frequency.” Aversion therapy is particularly odious because it can and does cause genuine emotional damage and there is absolutely no credible evidence at all that the healing claims made by such organizations as International Healing Foundation, NARTH and Exodus International are true. In fact, there is substantial empirical research proving that they are not. In an in-depth report, the American Psychological Association concluded that the “limited published literature on these programs suggests that many do not present accurate scientific information regarding same-sex sexual orientations to youth and families, are excessively fear-based and have the potential to increase sexual stigma.” The APA report also noted that there is "no evidence that sexual orientation change efforts work."

Alas, science has done nothing to sway the members of these organizations whose convictions rely totally and solely on a higher authority. That higher authority is their belief in the inerrant and infallible words of the Bible. Professor Helms cited three quotes from the Old Testament that serve as the guiding principle of Gay Conversion aficionados, one being “If a man also lie with mankind, as he lieth with a woman, both of them have committed an abomination: they shall surely be put to death; their blood shall be upon them.” (Leviticus 20:13)

As all good skeptics should be, Sheldon is an optimist with a belief that reason and truth ultimately win out. This is not always easy given the reactionary views on homosexuality (and science) among many reactionary politicians. In particular, Sheldon cited the efforts of teenagers to eradicate the bullying and stigmatizing that so often occurs in high schools against gay and lesbian students. On its webpage the Gay-Straight Alliance defines its mission as “a student-run club in a high school or middle school that brings together LGBTQ and straight students to support each other, provide a safe place to socialize, and create a platform for activism to fight homophobia and transphobia.” As of 2007, there were 3,577 clubs in the United States, representing Washington D.C. and every state in the country –and the number continues to grow.

Sheldon also spoke about PFLAG (Parents, Families and Friends of Lesbians and Gays) as an organization that has done truly remarkable work in educating the public about gay, lesbian, bisexual and transgender issues. In its mission statement, PFLAG’S states that it “promotes the health and well-being of lesbian, gay, bisexual and transgender persons, their families and friends through: support, to cope with an adverse society; education, to enlighten an ill-informed public; and advocacy, to end discrimination and to secure equal civil rights. Parents, Families and Friends of Lesbians and Gays provides opportunity for dialogue about sexual orientation and gender identity, and acts to create a society that is healthy and respectful of human diversity.”

Sheldon urged the audience to pay attention to pronouncements by politicians more focused on their elections and faith-based beliefs than they are to reason and tolerance and to support worthy organizations that seek to promote tolerance and knowledge over ignorance and divisiveness. His talk was education and remarkable entertaining and a good time was had by all.

Patrick O’Reilly, Ph.D. is a past Chair of Bay Area Skeptics.