The LGBT Health & Development Program

Research Blog > Conversion / Reparative Therapy Debated by Lawmakers


Posted on May 30th, 2013 by SteveDuBois in Featured, Research Blog. No Comments

Two men walking down a street holding handsCalifornia has adopted legislation banning licensed therapists from providing sexual orientation change efforts, a.k.a. conversion therapies, to individuals expressing homosexual urges or behaviors. New York’s legislators are debating a similar law currently. The debate over conversion therapies is not new, but the extent to which legislation relates to it is increasing.

For centuries, groups of individuals have thought homosexuality is a disease that can be cured. Treatments that attempt to cure homosexual urges and behaviors are called conversion, or reparative, therapies. These include bicycling, to help restore health and vitality; hypnosis, to increase self-control of same-sex attraction and impulses; drinking alcohol and visiting a brothel; “overdosing” men on homosexuality by making them physically ill as they listened to recordings of men having sex; Electroconvulsive Therapy; exorcism; and transplants of “heterosexual” testicles into homosexual men. There is even an iPhone app to help someone change their homosexual urges and behaviors.

Despite the persistence of the above treatments, there is no scientifically adequate evidence that they are effective or safe for the individuals being treated. For each treatment that is proposed, anecdotes of successful delivery and reduction of homosexual urges and behaviors are reported, but no research studies exist that have investigated these treatments in a controlled, scientific setting and shown them to be effective. In fact, the opposite has been found – these treatments likely make an individual who thinks he or she may be gay feel worse about him or herself [1]. We already know that compared to heterosexuals, LGBT individuals experience things like internalized homophobia [2], high prevalence of anxiety [3] and depression [4], and an increased risk for thinking about and attempting suicide [5]. This means that conversion therapies run the risk of adding stress to an LGBT individual’s already stressful life experience.

For those who do not want to change their same-sex attraction, conversion therapies represent a threat to developing a positive self-image and personal identity as a LGBT individual. Conversion therapies may emphasize the negative aspects of being homosexual, e.g., religious and moral conflicts, separation from family members, and risky sexual behavior [6]. These topics can create a fear associated with being LGBT, instead of an appreciation for oneself as unique and empowered. Additionally, conversion therapies ignore years of research indicating that sexual orientation is due, at least in part, to biological factors [7].

For these reasons and more, conversion therapies have been strongly discouraged by the American Psychological Association since the 1990s [8]. Importantly, other types of therapy, e.g., Gay Affirmative Psychotherapy, are empirically-supported to be useful for improving the mental health and well-being of LGBT individuals [9]. These do not attempt to convert or repair the individual because he/she is LGBT; in fact, they are supportive of one’s gay identity. We advocate increased use of these therapies, decreased proliferation of conversion therapies, and continued research on how empirically-supported, gay-affirmative therapies can improve the lives of LGBT individuals. Our hope is that legislation catches up to science on this topic, and that additional laws are passed that prohibit using a treatment we know to be ineffective, and potentially harmful, to LGBT individuals.

References:

1. Rubio-Aurioles, E., & Wylie, K. (2008.) Continuing Medical Education: Sexual Orientation Matters in Sexual Medicine (CME). The journal of sexual medicine, 5(7), 1521-1533.

2. Meyer, I. H., & Dean, L. (1998). Internalized homophobia, intimacy, and sexual
behavior among gay and bisexual men. In G. Herek (Ed.), Stigma and sexual orientation (pp. 160–186). Thousand Oaks, CA: Sage.

3. Cochran, S. D., & Mays, V. M. (2005). Estimating prevalence of mental and substance-using disorders among lesbians and gay men from existing national health data. In A. M. Omoto & H. S. Kurtzman (Eds.), Sexual orientation and mental health: Examining identity and development in lesbian, gay, and bisexual people (pp. 143–165). Washington, DC: American Psychological Association.

4. Salomon, E. A., Mimiaga, M. J., Husnik, M. J., Welles, S. L., Manseau, M. W., Montenegro, A. B., et al. (2009). Depressive symptoms, utilization of mental health care, substance use and sexual risk among young men who have sex with men in EXPLORE: Implications for age-specific interventions. AIDS and Behavior, 13, 1–11.

5. Garofalo, R., Wolf, R. C., Wissow, L. S., Woods, E. R., & Goodman, E. (1999). Sexual orientation and risk of suicide attempts among a representative sample of youth. Archives of Pediatrics & Adolescent Medicine, 153, 487–493.

6. Rosik, C. H. (2003). Motivational, ethical, and epistemological foundations in the treatment of unwanted homoerotic attraction. Journal of Marital and Family Therapy, 29(1), 13-28.

7. Mustanski, B. S., Chivers, M. L., & Bailey, J. M. (2002). A critical review of recent biological research on human sexual orientation. Annual review of sex research, 13(1), 89-140.

8. Nel, J. (2009.) Same-sex sexuality and health: Psychosocial scientific research in South Africa. From Social Silence to Social Silence, 32.

9. Johnson, S. D. (2012). Gay affirmative psychotherapy with lesbian, gay, and bisexual individuals: Implications for contemporary psychotherapy research. American Journal of Orthopsychiatry, 82(4), 516-522.





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