If you live in the United States, you are probably aware of the growing momentum of the movement to grant gay people the right to marry: the marriage equality movement. With eleven states and the District of Columbia now granting lesbian and gay people this right, a tipping point may have been reached. It feels as though there is no turning back.
But you may not be aware of a smaller, less-publicized movement—the growing efforts to ban what has been called reparative therapy, conversion therapy, “ex-gay therapy,” or SOCE: Sexual Orientation Change Efforts, as officially deemed by the American Psychological Association.
First, a bit of background. For decades homosexuality was considered a mental disorder, which gave legitimacy to social prejudice. The fact that gay people were automatically called “sick,” simply by virtue of their same-sex attractions, was used as a justification for criminalization of gay sex acts ad for discrimination against gay people in housing, employment, child custody decisions, and more. In addition, sometimes barbaric methods of psychiatric “treatment” were used to “cure” people of homosexuality, often forced upon minors after they were committed to mental institutions by their parents.
Breaking Ground for Civil Rights
So it was a major gay activist victory when, in 1973, homosexuality was deemed “not a mental illness” by the American Psychiatric Association (APA), the official keepers of the Diagnostic and Statistical Manual (DSM). It is hard to overestimate the importance of the APA decision. Some historians believe that it laid the groundwork for many of the lesbian, gay, bisexual, and transgender (LGBT) civil rights gains that followed over the next four decades. And, of course, it put an immediate end to the most flagrant excesses and abuses of SOCE methods, such as aversive conditioning and involuntary commitments to psychiatric hospitals.
In 1983, ten years after that momentous decision, I started the Institute for Personal Growth as one of the first gay affirmative therapy centers. I had many lesbian and gay clients, older than I, who had endured lasting mental damage from SOCE psychotherapy. Even if these men and women, coming of age in the 1950’s and 60’s, hadn’t suffered some of the more extreme techniques, like psychiatric commitment and electroshock, they had been told repeatedly by their therapists that they were sick and doomed to a life of loneliness and misery if they didn’t change.
But they COULDN’T change. Study after study shows SOCE may influence people to repress behavior and perhaps even same sex urges for a while, but nothing can eliminate an attraction that appears to be inborn. So gay people who endured SOCE back then experienced lack of support even from their therapists, on top of rejection by family and society. More often than not, SOCE therapists made their gay and lesbian clients less mentally healthy, not more. I and therapists like me thought that those heartbroken clients would become a thing of the past with the APA decision. After all, the treatments were ineffective, probably harmful, and, since the APA’s decision, unnecessary and unethical.
One Step Forward, Two Steps Back
But we underestimated the backlash against gay rights that took place in the 1980s and 90s, a backlash that included the re-emergence of the reparative therapy movement, this time driven primarily by the Religious Right. In a bizarre turn of events, the movement was bolstered in 2002 by Robert Spitzer, who had been a supporter of removal of homosexuality as a mental illness back in 1973. Spitzer maintained that some people apparently could change orientation, and his stance gave renewed credibility to the ‘ex-gay’ movement. In the years after Spitzer’s endorsement, the SOCE movement thrived.
And so the debate among mental health professionals about whether homosexuality could be ‘cured’ began again. More research was done, and most showed SOCE to be ineffective at best, and harmful at worst. For example, SOCE clients have elevated rates of depression and suicidal thoughts. Recently, the organization Beyond Ex-Gay, comprised of SOCE “survivors” posted a survey that, so far, has garnered over 400 responses, 80% of whom say they incurred personal harm from the treatment that lasts to this day. Professional health and mental health organizations worldwide have nearly universally deemed SOCE unethical. Nevertheless, it continues to be practiced, especially in the United States.
In April 2012, in a stunning turn-around, the same psychiatrist, Robert Spitzer, recanted his position of 2002, acknowledged the ineffectiveness of SOCE, and apologized to the gay community for the harm his public stance caused lesbians and gays. Just as his endorsement of conversion therapy efforts bolstered that movement, so did his recant and apology give more survivors the strength to go public. It also gave birth to the movement to make SOCE illegal for minors.
Progressive Action in the United States
Within months of Spitzer’s retraction, California passed such a law. Since then, New Jersey, New York, Massachusetts, and Pennsylvania have introduced bills to criminalize SOCE in their state legislators. It is rumored that federal legislation may follow.
The designers of this legislation have no quarrel with adults who may choose to undergo conversion therapy. The intent is to protect gay, lesbian, and gender nonconforming children. LGBT youth are already at higher risk for emotional problems like depression, posttraumatic stress (PTSD), and self-destructive behavior. They are more often bullied at school and rejected by their families. The harm done by bullying has also been well documented — as we see in the news too often lately — and it can last a lifetime. However, other studies indicate that parental support of the child’s identity and gender presentation can help to counteract those effects and provide a buffer for kids from the impact of bullying and the stress from school and peer rejection.
SOCE is especially harmful to children. First, it tells young LGBT clients that they are fundamentally defective for traits, feelings, and behaviors over which they have no control and cannot change, inculcating both self-hatred and a feeling of personal failure. And SOCE therapists advise parents to view their children’s orientation as a “disease” to be discouraged, or even punished, in the name of cure. Thus, already vulnerable young people are exposed to continued disapproval and shame from family, peers, and their own therapists.
The argument has been made that parents should have the right to choose this therapy for their children. I’m sure most of the parents who subject their children to SOCE are well-meaning and trusting of their SOCE therapist. Moreover, few of them know that change efforts have been discredited and deemed unethical by every major mental health professional organization in the world.
But in other situations — say, parents who want to deny life-saving treatment to their children because of religious beliefs — the state intervenes on behalf of the best interests of the children. Knowing the facts that we do about both the ineffectiveness of reparative therapy and the harm it can do to a young psyche, I would argue that this is a parallel situation. We need to protect all children, regardless of sexual orientation — even if that means protecting them from their own families.
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