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REPARATIVE THERAPY
 

Conversion Therapy for LGBTQ Youth is Bad

APA: Resolution on Reparative Therapy

HRC: Lies and Dangers of Reparative Therapy

ACA: Ethical Issues Related to Conversion Therapy

Policy and Position Statements on Reparative Therapy


Reparative Therapy Harmful to LGBTQ Clients

 

 Reparative or conversion therapy describe any attempt or process to change a person's sexual orientation, including efforts by transformational ministries. It is sometimes called sexual re-orientation.  Research does not support conversion therapy as an effective treatment modality. There have been no objective screening criteria, no consensus about outcome measurement, and no blinded or side-by-side studies and there is no article in a peer reviewed scientific journal stating that conversion therapy alters someone's sexual orientation.  More importantly, there is potential for harm when clients participate in conversion therapy. The American Psychological Association (APA), American Counseling Association (ACA), and American Medical Association (AMA), and other professional organizations have cited certain ethical concerns and considerations related to the ethics of this process.

 

 

Official Statements Regarding Reparative Therapy

 

“Aversion therapy (a behavioral or medical intervention which pairs unwanted behavior, in this case, homosexual behavior, with unpleasant sensations or aversive consequences) is no longer recommended for gay men and lesbians. Through psychotherapy, gay men and lesbians can become comfortable with their sexual orientation and understand the societal response to it. We oppose the use of ‘reparative’ or ‘conversion’ therapy that is based upon the assumption that homosexuality is a mental disorder or based upon the a priori assumption that the patient should change his/her homosexual orientation.”
-American Medical Association

“Therapy directed at specifically changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation.”
-American Academy of Pediatrics

“We not consider homosexuality a disorder that requires treatment, and as such, we see no basis for reparative therapy.”
-American Association for Marriage & Family Therapy

"We oppose the use of conversion, reorientation, or reparative therapy for the treatment of LGBTQ persons."
-American College of Physicians

“We oppose the belief that same-sex attraction and behavior is abnormal and in need of treatment. We oppose portrayals of lesbian, gay and bisexual individuals as mentally ill due to their sexual orientation. We oppose the promotion of reparative therapy as a cure for individuals who are homosexual."
-American Counseling Association

“Psychotherapeutic modalities to convert or ‘repair’ homosexuality are based on developmental theories whose scientific validity is questionable. The potential risks of reparative therapy are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient. Therefore, we oppose any psychiatric treatment such as reparative or conversion therapy which is based upon the assumption that homosexuality is a mental disorder or based upon the assumption that a patient should change his/her sexual homosexual orientation.”
-American Psychiatric Association

“We affirm that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality regardless of sexual orientation identity; We affirm that homosexuality is not a mental disorder and opposes portrayals of sexual minority youths and adults as mentally ill due to their sexual orientation; We conclude that there is insufficient evidence to support the use of psychological interventions to change sexual orientation; We encourage mental health professionals to avoid misrepresenting the efficacy of sexual orientation change efforts by promoting or promising change in sexual orientation when providing assistance to individuals distressed by their own or others’ sexual orientation; We conclude that the benefits reported by participants in sexual orientation change efforts can be gained through approaches that do not attempt to change sexual orientation."
-American Psychological Association

 

Conversion Therapy for LGBTQ Youth is Bad

APA: Resolution on Reparative Therapy

HRC: Lies and Dangers of Reparative Therapy

ACA: Ethical Issues Related to Conversion Therapy

Policy and Position Statements on Reparative Therapy


Conversion Therapy for LGBTQ Youth is Bad

 

In October 2015, the Substance Abuse and Mental Health Services Administration (SAMHSA) published the report Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth. The report marked the first time we had conclusive, universal data, federally, that conversion therapy for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth is not effective. In fact, conversion “therapy” has far more harmful repercussions than positive.

 

Children in the LGBTQ community, whether they understand or recognize their sexual orientation, seek understanding and acceptance. Forming a healthy identity is one of the most crucial parts of a child’s development. The problem is our society thinks of gender two ways: male or female. This leaves little room for variance for youth who have non-traditional identification with their genders assigned at birth. For example, elementary school teachers unintentionally introduce the idea of only two genders with which a child can identify. It can alienate children simply by asking them to line up based on gender—boys in one line, girls in the other. While this may not be the teacher’s intention, for a child confused about their gender orientation, this can be stressful. Physiological sex and gender are two very different things and we must recognize their impact on youth growing up in our modern world.

 

 

 Judith Glassgold, PsyD, American Psychological Association associate executive director and government relations office public interest directorate, made the point that it’s normal for children to explore gender identities. Binary definitions of gender are not a part of the normal human experience. These definitions are something that society dictates. So, if it is a societal problem, why do we blame people for gender exploration? This is an issue that parents, especially, must address.

 

 Dr. Caitlin Ryan, director of the Family Acceptance Project at San Francisco State University, pointed out that health care providers assume parents and educators know about the unique lived experiences of members of LGBTQ community. In reality, many parents are misguided about the stresses facing LGBTQ youth. Health care providers need to know how important it is for LGBTQ children to feel accepted by their families.

 

 The Family Acceptance Project study found LGBTQ youth whose families rejected them were six times more likely to develop a mental illness and eight times more likely to attempt suicide. This is astonishing. Most parents worry about what their children are exposed to, but in this case, it is particularly important parents be careful and act with care. It’s easy for a parent to indirectly tell their child that not conforming to societal standards is wrong. By telling a child, “this is just a phase,” or “you’ll grow out of it,” parents and guardians set a precedent that they don’t accept their children the way they are.

 

 

 A positive way to help affirm and show acceptance of LGBTQ youth is to teach healthy coping skills. This is not just applicable for parents with LGBTQ children, but for youth in general. Hate crimes and bullying occur in all pockets of this nation to all kinds of people—straight or gay. And this is especially true for members of the LGBTQ community. Teaching a child resiliency will strengthen their ability to form a confident identity and teach them they’re stronger than it may seem. These are the greatest skills a child can have in school… and in life.

 

 As Lin Manuel Miranda said in his 2016 Tony Award acceptance speech, “Love is love is love is love.” No amount of conversion therapy or prejudice will prevent that from being true. Thanks to SAMHSA’s conversion therapy study, we have scientific data detailing the dangers and ineffectiveness of these types of therapy and that acceptance is much stronger than rejection in building healthy children and adults.

 

[Source: Adam Swanson, National Council for Behavioral Health, June 2016]

 

Conversion Therapy for LGBTQ Youth is Bad

NBC: California Bans Controversial Ex-Gay Therapy for Minors
Advocate: California Officially Bans Ex-Gay Therapy for Youths
CNN: California Gov Calls Reparative Therapy Quackery

 

APA Takes Stand Against Reparative Therapy

 

The governing board of American Psychological Association passed a resolution, 125 to 4, declaring that mental health professionals should not tell gay clients they can become straight through therapy or other treatments.  The article goes on to say "Instead, the APA urged therapists to consider multiple options - that could range from celibacy to switching churches - for helping clients whose sexual orientation and religious faith conflict.  In the resolution, and in a comprehensive report based on two years of research, the 150,000 member association put itself firmly on record in opposition of so called "reparative therapy" which seeks to change sexual orientation. No solid evidence exists that such change is likely, says the report, and some research suggests that efforts to produce change could be harmful, inducing depression and suicidal tendencies."

 

 

The APA Council of Representatives expressed its ethical concerns of reparative therapy and issued these basic principles:

 

--Homosexuality is not a mental disorder and the APA opposes all portrayals of lesbian, gay and bisexual people as mentally ill and in need of treatment due to their sexual orientation;

 

--Psychologists do not knowingly participate in or condone discriminatory practices with lesbian, gay and bisexual clients;

 

--Psychologists respect the rights of individuals, including lesbian, gay and bisexual clients to privacy, confidentiality, self-determination and autonomy;

 

--Psychologists obtain appropriate informed consent to therapy in their work with lesbian, gay and bisexual clients.

 

--The resolution further states that the APA "urges all mental health professionals to take the lead in removing the stigma of mental illness that has long been associated with homosexual orientation."

 

Supporters of the resolution, which passed the APA Council overwhelmingly by a voice vote, believed that it was critical for the Association to make such a statement due to the questions of the ethics, efficacy and benefits of conversion therapy which are now being debated within the profession and within society as a whole. "Our concern," stated Douglas Haldeman, Ph.D., President of APA's Society for the Psychological Study Of Lesbian, Gay and Bisexual Issues, "is that a person, especially a young person, who enters into therapy to deal with issues of sexual orientation should be able to have the expectation that such therapy would take place in a professionally neutral environment absent of any societal bias.

 

 

 Additionally, therapists should be providing clients with accurate information about same-sex sexual orientation. This resolution reasserts the profession's commitment to those two principles."  The APA Council of Representatives is the major legislative and policy-setting body of the organization. The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 151,000 researchers, educators, clinicians, consultants and students. Through its divisions in 50 subfields of psychology and affiliations with 58 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

 

Policy and Position Statements on Reparative Therapy

Conversion Therapy for LGBTQ Youth is Bad

APA: Resolution on Reparative Therapy

ACA: Ethical Issues Related to Conversion Therapy

 

ACA: Ethical Concerns of Reparative Therapy

 

The Ethics Committee of the American Counseling Association have offered consultation regarding the practice of conversion therapy based on their Code of Ethics. They shared their formal interpretation of specific sections of the ACA Code of Ethics concerning the practice of conversion therapy and the ethics of referring clients for this practice.

 

The basic goal of reparative/conversion therapy is to change an individual's sexual orientation from homosexual to heterosexual. Counselors who conduct this type of therapy view same-sex attractions and behaviors as abnormal and unnatural and, therefore, in need of "curing." The belief that same-sex attraction and behavior is abnormal and in need of treatment is in opposition to the position taken by national mental health organizations, including ACA.

 

ACA opposes portrayals of lesbian, gay and bisexual individuals as mentally ill due to their sexual orientation. In addition, their resolution supports dissemination of accurate information about sexual orientation, mental health and appropriate interventions and instructs counselors to "report research accurately and in a manner that minimizes the possibility that results will be misleading.” They adopted a statement "opposing the promotion of reparative therapy as a cure for individuals who are homosexual." In fact, according to the DSM-IV-TR, homosexuality is not a mental disorder in need of being changed. With this in mind, ACA has a difficult time discussing the appropriateness of conversion therapy as a treatment plan.

 

 

ACA has found no scientific evidence published in psychological peer-reviewed journals that conversion therapy is effective in changing an individual's sexual orientation from same-sex attractions to opposite-sex attractions. They find no longitudinal studies conducted to follow the outcomes for those individuals who have engaged in this type of treatment. They conclude that research published in peer-reviewed counseling journals indicates that conversion therapies may harm clients.

 

Conversion therapy assumes that a person who has same-sex attractions and behaviors is mentally disordered and that this belief contradicts positions held by the American Counseling Association and other mental health and biomedical professional organizations. Additionally, the ACA does not endorse reparative therapy as a "cure" for homosexuality.

 

Conversion therapy as a practice is a religious, not psychologically-based, practice. The premise of the treatment is to change a client's sexual orientation. The treatment may include techniques based in Christian faith-based methods such as the use of "testimonials, mentoring, prayer, Bible readings, and Christian weekend workshops.”

 

It may also use cognitive-behavioral techniques such as aversion therapy (stopping clients from masturbating to same-sex images; encouraging imagery of getting AIDS paired to same-sex arousal), reinforcement techniques that emphasize traditional gender role behavior (for men to "engage in team sports, to go the gym, and for women "to learn how to cook, sew, and apply make-up"), and use of sexual surrogates. However, there is no training offered or condoned by the American Counseling Association to educate and prepare a professional counselor wishing to engage in this type of treatment.

 

 Research does not support conversion therapy as an effective treatment modality. There have been "no objective screening criteria, no consensus about outcome measurement, and no blinded or side-by-side studies" and there is "no article in a peer reviewed scientific journal" stating that conversion therapy alters someone's sexual orientation. Further, no long-term studies have been conducted to discern whether research participants who reported a change in their behaviors maintained these changes over time.  And, most importantly, there is potential for harm when clients participate in conversion therapy.

 

[Source: Joy S. Whitman, Harriet L. Glosoff, Michael M. Kocet, and Vilia Tarvydas]

   

Huff Post: Ex-Gay Christian Groups Continue Their Efforts

Family Research Council: Ex-Gay Pride Month Dinner

 

Gay Cure Ministry Shuts Down and Apologizes

 

In June 2012, after 37 years, Exodus International, an organization whose mission was to "help" gay Christians become straight, is shutting down. But not before issuing an apology.  "We're not negating the ways God used Exodus to positively affect thousands of people, but a new generation of Christians is looking for change -- and they want to be heard," Tony Moore, an Exodus board member, said Wednesday. The announcement comes less than a day after Exodus issued a wide-ranging apology to the gay community for "years of undue judgment by the organization and the Christian Church as a whole," a statement from the group says.

 

 

"Exodus is an institution in the conservative Christian world, but we've ceased to be a living, breathing organism," said Alan Chambers, the president of Exodus. "For quite some time, we've been imprisoned in a worldview that's neither honoring toward our fellow human beings, nor biblical."  Chambers, who has a wife and children and previously identified as gay, has acknowledged that he has "ongoing same-sex attractions."  Exodus, which has promoted "freedom from homosexuality through the power of Jesus Christ," has de-emphasized conversion therapy in recent years as more of the counselors in its network have abandoned the practice.

 

CCN: Exodus International Shuts Down and Apologizes

LA Times: From Pray Away the Gay to Acceptance

ABC News: Exodus International has Change of Heart

LGBTQ Nation: Purveyors of Ex-Gay Therapy Closing Down

 

The American Psychological Association defines conversion therapy as aimed at changing sexual orientation, but adopted a resolution in 2009 condemning the practice.  In it, the organization said "mental health professionals should avoid telling clients that they can change their sexual orientation through therapy or other treatments."  But the same resolution also encouraged therapists to consider the religious beliefs of clients who say such beliefs are important to their views of homosexuality.  The APA removed homosexuality from its Diagnostic and Statistical Manual of Mental Disorders in 1975.  But yet with the apology, some things have not changed, according to Chambers.  "I cannot apologize for my deeply held biblical beliefs about the boundaries I see in scripture surrounding sex, but I will exercise my beliefs with great care and respect for those who do not share them," he said. "I cannot apologize for my beliefs about marriage. But I do not have any desire to fight you on your beliefs or the rights that you seek."

 

[Source: CNN]

 

LGBTQ Nation: Purveyors of Ex-Gay Therapy Closing Down

CBS News: Exodus International Shuts Doors

NY Daily News: Ex-Gay Ministry Apologizes and Closes

Former Exodus Chair Apologizes

 

Prominent Psychiatrist Apologizes

 

 Dr. Robert Spitzer is a major architect of the modern classification of mental disorders.  He is considered by some to be the father of modern psychiatry. In May 2012, he apologized to the gay community for his decade-old study that concluded some gay people can go straight through what's called reparative therapy.  He now says he no longer believes his work showed that.

 

"I believe I owe the gay community an apology for my study making unproven claims of the efficacy of reparative therapy.  I also apologize to any gay person who wasted time and energy undergoing some form of reparative therapy because they believed that I had proven that reparative therapy works with some 'highly motivated' individuals."

 

 

 

For the study, Spitzer had interviewed 200 people who'd claimed some degree of change. The "fatal flaw" is that there is no way to judge the credibility of their accounts, Spitzer says in a letter he submitted last month to a journal that published his work in 2003.  The work made headlines when he presented it at a 2001 meeting of the American Psychiatric Association. One reason for the attention was that Spitzer had played a leading role 30 years before in removing homosexuality from the list of mental disorders in the association's diagnostic manual. Spitzer's study was attacked by critics who questioned the reliability of the accounts from the people he interviewed. At the time, Spitzer acknowledged that he had no proof their stories were accurate, but said several aspects of their accounts suggested their statements could not be dismissed out of hand.

 

NY Times: Psychiatry Giant Apologizes to Gay Community
Atlantic Wire: Spitzer Trying to Do Right

Truth Wins Out: Apology for Infamous Ex-Gay Study

 

In 1973, Dr. Spitzer, a Columbia University professor, helped spearhead the removal of homosexuality as a mental disorder from the American Psychiatric Association’s Diagnostic and Statistical Manual. So, it was quite a media sensation when Spitzer unveiled a controversial new study in May 2001 suggesting that some very motivated homosexual study subjects provided by anti-gay organizations could switch sexual orientations.  At that time, LGBT leaders and many researchers pointed to methodological flaws in the study. Despite his differences with scientists, Spitzer made it clear that he did not want his study used to justify discrimination. He also strongly emphasized the fact that he did not think most gay people could become heterosexual and that change was extremely rare.

 

Unfortunately, anti-gay organizations repeatedly misused his study to claim that all gay people could go from gay to straight through prayer or therapy. His study results were deliberately misinterpreted so often, that Spitzer has been forced to repeatedly set the record straight. Here are examples of Spitzer saying either that change was highly improbable or that right wing organizations had misapplied his work to fit their political agenda.

 

Now he says his reasoning was wrong, and that "there was no way to determine if the subject's accounts of change were valid," he wrote in a letter to the editor of the Archives of Sexual Behavior. Spitzer, who is 80 years old and lives in Princeton, NJ, sent a copy to The Associated Press after a reporter interviewed him about his change of heart.   "I believe I owe the gay community an apology for my study making unproven claims of the efficacy of reparative therapy," Spitzer wrote. "I also apologize to any gay person who wasted time and energy undergoing some form of reparative therapy because they believed that I had proven that reparative therapy works with some 'highly motivated' individuals."

 

 

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