Monday, September 11, 2006

The Pseudoscience of Religious-Based Sexual Re-orientation

I try to keep my posts at least somewhat related to archaeology and anthropology, and I realize that this makes two posts in a row that deviate from that formula, but this is a topic that I had the opportunity to debate in another place recently, so I decided to edit the information that I had and represent it as a blog post. I hope someone will find the information informative.


Several religious organizations exist that claim to offer the service of "re-orientating" homosexuals back to a heterosexual sexual orientation. This "therapy" variously referred to as "conversion therapy," "reparative therapy," or "reorientation therapy."

Organizations that claim to offer "therapy" to re-orientate homosexuals include the International Healing Foundation (IHF), Parents and Friends of Ex-Gays (PFOX), National Association for Research and Therapy of Homosexuals (NARTH), and Exodus International among others. One of their premises is that homosexuality is a decision that can be a habit. And, as a habit, homosexuality can be broken and gays and lesbians can be therapeutically "cured" to re-orientate them back to the "norm."

From the IHF website, they state, "[n]o one is born with same-sex attraction; [n]o one chooses to have same-sex attraction; [c]hanging from a homosexual to a heterosexual orientation is possible!"

PFOX claims, "[n]o one is born gay. All scientific studies, including those by gay scientists, have not found any gay gene or gay brain center. Ex-gays are living proof that homosexual orientation is not fixed permanently."

Exodus states that they "[uphold] heterosexuality as God's creative intent for humanity, and subsequently views homosexual expression as outside of God's will. [Exodus] cites homosexual tendencies as one of many disorders that beset fallen humanity."

Empirical Evidence to Support the Claim of 'Reorientation' of Homosexuals?

Only a few studies have been conducted that even attempt to provide some empiricism with regard to the notion that gays can be 'reorientated' to heterosexual. Most notably was Spitzer (2003) who used self-reported informants to document at least some "minimal" change over 5 years. Pseudo-therapy groups like NARTH base much of their claims on the work of studies like Spitzer's -and Spitzer is probably the most recent notable effort, but the pseudoscience of reparative therapy probably began with Moberly (1983), who used no study subjects at all! She based her entire book on her own opinions based on the ancient works of luminaries like Freud.

But it's the work of Spitzer and others that NARTH would like to cite as valid reason to assume their premises are true. The primary outcome of Spitzer's study was that, in general, some gay men and women can change their core behaviors and appear content to be heterosexual. The problem is that the very thing that a pseudoscience group like NARTH accuses gays of (pretending) is what may be happening in their 'reorientations!'

Criticisms of 'Reorientation' and 'Reparative' Therapy of Homosexuals

The only thing that can really be said about NARTH and other reorientation groups (assuming that even some of their anecdotes are valid) is that they are successful in getting homosexuals (or bisexuals) to favor religious pretense over sexual orientation. After all: people kill for religion; die for religion; and fuck for religion. Why wouldn't they switch genders of their sex-partners for religion?

In addition, as Carlson (2003) noted, "It may be possible that some of [Spitzer's] research participants might have a more fluid sexual orientation, such as bisexuality" (p. 427). Also, Spitzer's investigation was heavily weighted toward highly religious Christian, Caucasian, middle-class individuals, thus ignoring the diversity of individuals who might seek conversion therapy. Overall, the research on conversion therapies is heavily weighted toward a homogeneous, predominantly White, male, Christian population. Shidlo and Schroeder's (2002) participants were 90% male, 86% Caucasian, and of those who reported religious orientation, 89% Christian. Spitzer's study was 97% Christian and 95% Caucasian and was predominantly middle-class and middle-aged.

Assumptions Made by re-orientation Groups like NARTH

Religious re-orientation groups assume that the causes of homosexuality are known and that homosexuality is unnatural, mentally unhealthy, and sinful and should be changed (Morrow and Beckstead 2004) Each of these is pseudoscientific when applied to the field of mental health.

Methodological problems with studies like Spitzer's

(a) results were based on restricted, self-selected samples that represent a socially stigmatized population and thus capitalized on participants' vested interests to manage self-impressions, promote their values and lifestyles, over report successes, and underreport failures;

(b) outcomes are ambiguous because participants' idiosyncratic conceptualizations of sexual orientation, identity, attraction, and desire were not analyzed and research variables were not well conceptualized;

(c) some studies neglected to use fantasy and arousal to indicate sexual orientation;

(d) some results were based on therapists' subjective impressions;

(e) comparison or control groups were not used;

(f) long-term, objective outcome results are unavailable; and

(g) dynamic factors, such as time, maturation, and contextual factors, were not analyzed to account for participants' changes in sexuality and identity development process. Thus, the research base that supports the effectiveness of sexual reorientation is void of systematic, well-established methodologies that are needed to obtain valid scientific results (Wainberg et al. 2003 [Morrow and Beckstead 2004]).

In addition, O'Donohue and Plaud (1994) reviewed the evidence for learning and unlearning of sexual arousal responses and concluded that the empirical support for the conditioning or reconditioning of sexual arousal is weak. Barbaree, Bogaert, and Seto (1995) also concluded that substantive changes in the direction of one's underlying sexual orientation might be difficult or impossible to achieve once established.

Tozer & Hayes (2004) further note that 'reorientation' therapy lacks empirical validation and also suggest that the main focus is to provide derisive messages about same-sex attractions. They found that most who seek "conversion therapy" are do so as an "expression of introjected messages about unacceptable aspects of homosexuality and an extension of one's being in the early stages of gay or lesbian identity development."


The "work" that groups like NARTH claim to do *is* pseudoscience since they base it on false premises and assumptions. Moreover, they use bad science and refuse to acknowledge the lack of empirical data to support their premises and assumptions. In doing so, they wrap their supernatural beliefs in a thin veil of "scientific-sounding" terminology and misquoted research of others.

If gays want to pretend to be heterosexual to fit into their other social groups and cults, I've no problem with that. That's their prerogative. The response here, in this post, is to refute the unsubstantiated claims of NARTH et al, which are based on false premises and assumptions - an endeavor that can be called fraud.

What's the Real Motivation for Re-Orientation?

Perhaps there are gays that are dissatisfied with their sexual orientation. I'm sure there are. Another flaw in Spitzer's research, which I have not discussed yet, is that it doesn't fully take into consideration the dissatisfaction that may exist in his study group because of the stigma and pressure that may be applied by their social group. In short, they may be victims of gay-bashing, homophobic bigots who belittle homosexuality because of religious superstitions with hate-filled rhetoric. In Shidlo and Schroeder's sample (2002), they found that of the gays that went through so-called 'reorientation therapy' did so because of homophobic attitudes toward them. Among their sample were individuals who had initially sought therapy for depression and anxiety only to be instructed to attend 'conversion therapy.'

Some participants were motivated to pursue treatment with the hope of saving their heterosexual marriage and keeping their children. Others entered conversion therapy through force and coercion. For example, some students in religious universities were told that noncompliance with the mandated treatment would be followed by academic expulsion or the termination of financial aid. One participant reported the following:

I am being forced to be in therapy [by a large religious university]. I sit there and agree with what he [the therapist] has to say to avoid confrontation. He is pushing me to marry a woman. My goal is basically just to graduate. (Shidlo and Schroeder 2002).

Of the 87% of the sample they studied (a full 176 individuals) reported that they failed to 'convert' back to a heterosexual identity. Only 13% perceived themselves as successful. Of that 13% (26 individuals), 6 refused to put a self-label on their sexual identity and 3 of this 6 were celibate!

This is the only study that I know of that bothers to attempt a quantitative look at so-called 'conversion therapy.' Clearly, such 'therapies' are problematic. Not only do psuedoscientific groups like NARTH fail to consider such data or discuss it with their consumers, but they flat out refuse to conduct any meaningful research of their own. Instead, they rely on one of the hallmark indicators of pseudoscience: anecdotal testimony.

Shidlo & Schroeder conclude with:

We found evidence that many consumers of failed sexual orientation therapies experienced them as harmful. Areas of perceived psychological harm included depression, suicidality, and self-esteem. In the case of aversive conditioning and covert sensitization, harm included intrusive flashback-like negative imagery that was associated with serious long-term sexual dysfunction. Areas of perceived social harm included impairment in intimate and nonintimate relationships. Some religious participants also reported experiencing spiritual harm as a result of religious therapy.

We found that some participants also reported feeling helped. For a minority (4%), conversion therapy provided help in shifting their sexual orientation. Others (9%) found help in HBM techniques and were content with being celibate or else accepted an ongoing struggle to contain their same-sex desire. Participants also reported other therapeutic benefits, including an increased sense of belonging, improved insight, improved self-esteem, improved communication skills, and relief from talking about sexuality for the first time. Surprisingly, some participants who failed to change reported that their failure had been a needed proof, which freed them to embrace their gay/lesbian identity with less guilt.

In the very same issue (October 2003) of Archives of Sexual Behavior in which Spitzer published, there were many sound criticisms of his work along with some support. In addition, Spitzer himself said (2003):

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.

The only thing Spitzer demonstrated is that, given sufficient motivation, gays can at least pretend to change their sexual orientation. In his methodology, Spitzer reveals that his sample included individuals who self-reported with at least a rank of 60 with 0 being completely heterosexual and 100 being completely homosexual.

What!? 60!? So his cut-off for "gay" is someone who thinks they're attracted to the same sex more often than not? Where is the control for the anxiety driven, depressed man or woman that is simply scared of their androgenous thoughts and occasional curiosity about the same sex? Why didn't Spitzer study so-called ex-gays who were once completely homosexual?

Finally, the homosexual re-orientation movement was discredited by the American Psychological Association (APA) on August 11, 2006:

For over three decades the consensus of the mental health community has been that homosexuality is not an illness and therefore not in need of a cure. The APA's concern about the positions espoused by NARTH and so-called conversation therapy is that they are not supported by the science. There is simply no sufficiently scientifically sound evidence that sexual orientation can be changed. Our further concern is that the positions espoused by NARTH and Focus on the Family create an environment in which prejudice and discrimination can flourish.



Barbaree, H. E., Bogaert, A. F., & Seto, M. C. (1995). Sexual reorientation therapy for pedophiles: Practices and controversies. In L. D. & R. D. McAnulty (Eds.), The psychology of sexual orientation, behavior, and identity: A handbookGreenwood.

Carlson, H. M. (2003). A methodological critique of Spitzer's research on reparative therapy. Archives of Sexual Behavior, 32, 425-427.

Haldeman, D. C. (2001). Therapeutic antidotes: Helping gay and bisexualmen recover from conversion therapies. Journal of Gay and Lesbian Psychotherapy, 5(3-4), 117-130.

Moberly, Elizabeth (1983) Homosexuality: A New Christian Ethic. Cambridge: James Clarke Company. (pp. 357-383).Westport, CT:

Morrow, Susan L.; Beckstead, A. Lee (2004). Conversion Therapies for Same-Sex Attracted Clients in Religious Conflict: Context, Predisposing Factors, Experiences, and Implications for Therapy. The Counseling Psychologist, 32 (5), 641-650.

O'Donohue, W., & Plaud, J. J. (1994). The conditioning of human sexual arousal. Archives of Sexual Behavior, 23, 321-344.

Shidlo, A., and Schroeder, M. (2002). Changing sexual orientation: A consumers' report. Professional Psychology: Research and Practice, 33, 249-259.

Spitzer, R. L. (2003). Can some gay men and lesbians change their sexual orientation? 200 subjects reporting a change from homosexual to heterosexual orientation. Archives of Sexual Behavior, 32, 403-417.

Tozer, E. E. & Hayes, J. A. (2004). Why do individuals seek conversion therapy? The role of religiosity, internalized homonegativity, and identity development. The Counseling Psychologist, 32(5), 716-740.

Wainberg, M. L., Bux, B., Carballo-Dieguez, A., Dowsett, G.W., Dugan, T., Forstein, M., et al. (2003). Science and the Nuremberg Code: A question of ethics and harm. Archives of Sexual Behavior, 32, 455-457.

5 Epigraphic Artifacts:

Anonymous said...

A kind word for Dr. Spitzer, please. As far as I understand, his research says that yes, people can change how they report their sexuality, and may change how they express it. He doesn't seem to be making prescriptive, but rather naturalistic claims, and is acknowledging the weaknesses in the data. If it's worth anything, he has been thinking about sexual identity issues fo rover 30 years, having been a part fo the movement to remove homosexuality from the status of a mental disorder back in 1973. Of course some advocacy groups will remove all the caveats and qualifications from the research - that's what they do. For spitzer's own views, this might be a good place to go.

CFeagans said...

There were those who said, well, I know now that I am heterosexual because God made me this way, but I still have homosexual feelings.

With regards to Dr. Spitzer, I certainly don't fault his wanting to examine the question of whether or not homosexuals can change their behavior. The deeper question, however -which he has not answered, is whether this change in behavior really changes sexual orientation.

My main criticism is of the religious nutbar organizations that misuse his study (an incomplete study, in my opinion) to propagandize their bigotry and beliefs.

Very telling are a few passages in the interview you linked:

I remember one woman said that, in the middle of having sex with her lesbian partner, and all of the sudden, she heard Jesus say, .What are you doing?!.

As I said in my post, the only thing that Spitzer seems to have empirically demonstrated is that there may be societal pressures that can override sexual identity, particularly religious superstition.

For many, it was that they wanted to stay married or get married; for many, it was a religious conflict, they felt that their religious values conflicted with homosexuality.

Even the example that followed, of not wanting to continue a perceived (perhaps rightly so) "promiscuous lifestyle" is consistent with submitting to societal pressures.

I think that the work of others that has both preceded and followed Spitzer is significant enough to conclude that "conversion" therapy is even dangerous, particularly in the hands of bigoted faith-based "therapists" and "counselors."

Finally, I'm skeptical of any study that in which the majority of the study group may have been hand-picked by the organization that has a vested interest in the outcome. Moreover, Spitzer's study group was not a longitudinal one, but rather one that was selective. Religious nutbar groups use Spitzer's work as propaganda. They are more than willing to cite science that agrees with their conclusions, however limited that science may be (Spitzer), but not willing to consider science that is critical of their conclusions (Shidlo & Schroeder; Tozer; et al).

I'd like to see the study of NARTH, Exodus, and other faith-based groups that claim to offer "conversion" therapy, which looks at a random sample of participants who completed the "therapy" over 10 years ago and what their current sexual orientation is. Surely this cannot be a difficult survey.

Anonymous said...

(sorry - I posted as anonymous earlier).
I think several issues get packed into one, and the 'religious nutbar' types are very happy to do the packing, so we have to keep them unpacked.
a) do/can people change their sexual preference/behaviour?
b) how common is this?
c) why is this?
d) should this be encouraged?
Spitzer presented on point a only, noting it is possible, though infrequent. No major surprise, it's a big universe, and we certainly have a lot of evidence for people demonstrating GLB preferences after years of heterosexual behaviour, so the converse is conceivable.
Point b is answered by studies such as Barbaree, Bogaert and Seto; it's uncommon, quite difficult, and comprehensive change involving beliefs, behaviours, attitudes, arousals, etc. is much less common than change in one or two domains, or redefining identify and goals to reduce distress. Again, no surprise, given the number of GLBT folks and ongoing social/religious disapproval and discrimination. If it was easy to change, they all would have changed.
Point c, why? Several whys, in fact. Why do people change, why is it so hard to change. These are the tough questions and underlie lots of things. I expect that religious/close emotional motivations
underlie most of why people try to change (nothing like believing in eternal torment to either make you want to change or else alter your religious beliefs)
Point d is not a scientific question, it's a normative question. No scientific paper can give an answer to that. On the other hand, many religious groups have already provided their own answer - change or burn in hell. The science can only say that people are unlikely to change, for most the change is limited and temporary, the mothods used by these religious groups are going to be generally ineffective at doing more than causing emotional distress and in some cases driving people away from their religious supports. Scientific/professional groups such as the American Psychological and Psychiatric Associations can meet, discuss these issues and issue statements about the ethics of these activities, and have done so, identifying these as inappropriate and having little or no link to current knowledge (see That won't stop the misrepresentations, though it might stop some professionals from getting involved.
I'm interested in how Spitzer has commented about how his views have been misrepresented, or what his views actually are. Here's one quote, from an interview with the Wall Street Journal (from the Religious Tolerance website).

"It bothers me to be their knight in shining armor because on every social issue I totally disagree with the Christian right...What they don't mention is that change is pretty rare."
The Dr. Throckmorton piece is also pretty useful.
So fundamentalist advocacy groups misrepresent the research, ignore all the caveats, etc. Of course, why should they treat this topic differently? Call them on their lies and misrepresentations, educate your friends, families and the public, and continue working tooward knowledge, humanity and humility. By the way, a good discussion of 'reparative therapy' and Spitzer's work (i.e., what he did and did not say, and how he's presented it) is on the Religious Tolerance website ( Don't let fundamentalist organizations set the agenda and pick our fights for us.
Stewart Longman

Helena said...

A very nice peice.

I hope that next week you will debunk the assertion by so many Gay activitsts (as well as Ann Landers) that homosexuals are born that way, i.e. that homosexual desire is the result of genetic coding.

CFeagans said...

Perhaps you can point me in the direction of the data that says that so such a 'debunking' might be forthcoming.

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