Taking Sexuality in for Repairs, Part 1

You may or may not be aware of the dra­mat­ic turn of events at a ma­jor in­ter­sec­tion of psy­chi­atry, re­li­gion, and cul­ture. Truth be told, plenty of com­plaints were re­gistered ask­ing for a stop sign at that spe­cif­ic in­ter­sec­tion, but no one heeded the warn­ing. And like a skunk loosed in an el­ev­at­or, every­one was sprayed. “Bless me fath­er, but I can’t change…”

Re­par­at­ive ther­apies, some­times re­ferred to (and that would be lim­ited to un­scru­pu­lous at­tempts to de­ceive) as sexu­al ori­ent­a­tion change ef­forts (SOCE), are the man­u­fac­tured ef­forts of re­li­gious “clini­cians” to as­sist ho­mo­sexu­als “in con­flict” with their per­ceived sexu­al ori­ent­a­tion, to change; to “reori­ent” them­selves as het­ero­sexu­als. Most im­port­antly, they claim a sig­ni­fic­ant suc­cess with these ther­apies. While I will re­turn to this, I have al­ways felt the ac­cus­a­tion that ho­mo­sexu­als “re­cruit­ing” our young in­to their ranks be­cause they them­selves can­not “re­pro­duce” – and thereby establish­ing that sexu­al ori­ent­a­tion is a learned, and per­haps “co­erced” be­ha­viour – would pro­mote an am­ic­able, tech­nic­al col­lab­or­a­tion between sides: those who teach “to be” might oc­ca­sion­ally be will­ing to as­sist those who teach “not to be.” Once the num­bers have been met on both sides.

I have writ­ten ex­tens­ively my thoughts re­gard­ing ho­mo­sexu­al­ity – thought it would seem equally fair to say I have writ­ten more ex­tens­ively on what I have not thought – and I may re-post those thoughts here. But for pur­poses purely his­tor­ic­al and to pro­vide con­text, I will note that the longest held mod­ern the­or­ies of the eti­ology of ho­mo­sexu­al­ity rest in an ex­tens­ive psy­cho­ana­lyt­ic sys­tem pro­vided by you-know-whom, and are sum­mar­ized in a sin­gle word: par­ents. Spe­cific­ally, a moth­er with a lack of ap­pro­pri­ate emo­tion­al bound­ary – the in­vas­ive and hu­mi­li­at­ing “moth­er in the sky” of Woody Al­len’s “Oed­ipus Wrecks” in NY Stor­ies, and the moth­er of renowned Stand­ford Pro­fess­or Irvin D. Ya­lom, MD’s Momma and the Mean­ing of Life; cou­pled with a cold, emotion­ally dis­tant, and de­tached fath­er. All told, it is not a sexu­al prob­lem, but a psy­cho-at­tach­ment mashup of Harry Chap­in and John May­er. And, in the full­ness of time, ho­mo­sexu­al­ity found it­self in­cluded in the Dia­gnost­ic and Stat­ist­ic­al Manu­al of Men­tal Dis­orders One , the play­book/“pay­book” of the Amer­ic­an Psy­chi­at­ric As­so­ci­ation un­til 1973, un­til Robert Spitzer, MD.

Robert Spitzer is an em­in­ent re­tired Pro­fess­or of Psy­chi­atry from Colum­bia Uni­versity, in­flu­en­tial, of­ten-quoted, and well-re­spec­ted. In 1973, Spitzer led the com­mit­tee re­spons­ible for re­vis­ing the DSM, and is gen­er­ally cred­ited for lead­ing the move­ment to re­move ho­mo­sexu­al­ity as a men­tal dis­order by coin­ing a con­cept “ego-dy­ston­ic ho­mo­sexu­al­ity” 1 While it should be noted that this de­cision of the Amer­ic­an Psy­chi­at­ric As­so­ci­ation has been the source of a rich and of­ten ag­gress­ive dis­sen­sion – the in­ter­sec­tion I de­scribed above – it is not par­tic­u­larly per­tin­ent to my dis­cus­sion, oth­er than to ap­pre­ci­ate the drama that is Dr. Spitzer.

On May 9, 2001, a pre­lim­in­ar­ily re­port of a study en­titled, “Can Some Gay Men and Les­bi­ans Change Their Sexu­al Ori­ent­a­tion?” was presen­ted at the an­nu­al meet­ing of the APA be­ing held in New Or­leans. What was news­worthy was not the top­ic, but who de­livered it: Robert Spitzer. Con­clu­sion: “This study pro­vides evid­ence that some gay men and les­bi­ans are able to also change the core fea­tures of sexu­al ori­ent­a­tion.” This was a “bomb­shell” in that while it was not un­usu­al to claim suc­cess in be­ha­vi­our­al ther­apies – which Spitzer later re­ferred to as “con­trolling their ho­mo­sexu­al be­ha­viour, which made it pos­sible for them to live more in tune with their own value sys­tem” 2 – Spitzer was re­port­ing ac­tu­al change in at­trac­tion, arous­al, and fan­tasy. For prac­ti­tion­ers of Re­par­at­ive/SOCE ther­apies, this was like wak­ing up to Christ­mas morn­ing, your birth­day, the last day of school, and your first kiss (with whomever) all rolled in­to one, and they util­ized it as a hun­dred times its weight in gold.

Spitzer did not ac­tu­ally pub­lish the study un­til Oc­to­ber, 2003, in the Archives of Sexu­al Be­ha­vi­or, at the time ed­ited by his friend, KJ Zuck­er, him­self an ac­know­ledged ex­pert in the area of Gen­der Dys­phor­ia. Oddly, the pa­per was not “ref­er­eed” in the tra­di­tion­al sense (dis­trib­ut­ing sub­mis­sions an­onym­ously to qual­i­fied re­search­ers who, quite lit­er­ally, dis­mantle in search of meth­od­o­lo­gic­al er­ror, de­mand­ing cla­ri­fic­a­tion and/or cor­rec­tion, of­ten re­peatedly, be­fore it would ever see the light of pub­lic­a­tion), but Zuck­er chose to at­tach twenty-six de­tailed “com­ments” – most harsh, some bru­tally so – fo­cus­ing on faulty meth­od­o­logy: lack of any con­trol group, but much more im­port­antly, two years after the last face-to-face con­tact, Spitzer was re­ly­ing solely on the “truth­ful­ness” of a pa­tient’s self-re­port in a sin­gle 45-minute phone in­ter­view. Giv­en the enorm­ity of the po­ten­tial im­pact of the study find­ings, as well as the weight of the repu­ta­tion of the in­vest­ig­at­or, I found this quite amaz­ing. Ap­par­ently in the time between de­liv­er­ing his pre­lim­in­ary re­port and ac­tu­ally pub­lish­ing, Spitzer ap­pears to have heard the rumble:

Are the par­ti­cipants’ self-re­ports of change, by-and– large, cred­ible or are they biased be­cause of self-de­cep­tion, ex­ag­ger­a­tion, or even ly­ing? This crit­ic­al is­sue de­serves care­ful ex­am­in­a­tion in light of the par­ti­cipants’ and their spouses’ high mo­tiv­a­tion to pro­vide data sup­port­ing the value of ef­forts to change sexu­al ori­ent­a­tion. Again, it is im­possible to be sure, but com­par­ing the ac­tu­al res­ults to the res­ults that might be ex­pec­ted if such sys­tem­at­ic bi­as were present sug­gests (at least to the au­thor) that, by– and-large, this is not the case. 3

NEXT: What else can I be? All apologies.


Down­load Tak­ing Sex­u­al­ity in for Repairs, Part 1 as a PDF file


Notes:

  1. Dis­tinct from a dis­order be­ing “ego-sy­ston­ic,” where there is no con­scious ac­know­ledg­ment of con­flict e.g. Ob­sess­ive Com­puls­ive Dis­order is dis­tin­guished from Ob­sess­ive Com­puls­ive Per­son­al­ity Dis­order in that the for­mer is a con­scious source of dis­tress. If you are dis­tressed over your ho­mo­sexu­al­ity, you’re out of the book, and good to go.
  2. Video in­ter­view attrib­uted to W. Throck­mor­ton dated 2004
  3. Spitzer, RL. Can some gay men and les­bi­ans change their sexu­al ori­ent­a­tion? 200 par­ti­cipants re­port­ing a change from ho­mo­sexu­al to het­ero­sexu­al ori­ent­a­tion. Archives of Sexu­al Be­ha­vi­or, Vol. 32, No. 5, Oc­to­ber 2003, p. 412

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