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Sex Orientation Change Therapy: Back in the Headlines

Sex Orientation Change Therapy: Back in the Headlines

Gender identity and sex orientation change therapy are back in the newsA bill banning mental health providers from engaging in sexual orientation change efforts with patients younger than 18 years recently passed the California Senate just weeks after prominent psychiatrist Robert Spitzer, MD, apologized to the gay community for his 2003 study “making unproven claims” of reparative therapy’s efficacy for homosexuality. Those events coincide with the Pan American Health Organization’s charges that sexual orientation change therapies lack medical justification and threaten health.1

Recently, Spitzer wrote Kenneth Zucker, PhD, editor of the Archives of Sexual Behavior, that he now judged the major critiques of his study, published in that journal 9 years ago, as largely correct.2,3 The “fatal flaw” of my study, Spitzer wrote, was that there “was no way to judge the credibility of subject reports of change in sexual orientation.”

In the early 1970s, Spitzer opposed the “prevailing orthodoxy” in psychiatry by leading the efforts to remove homosexuality from the official list of psychiatric disorders. The APA removed it from DSM-II and replaced it with the category of “sexual orientation disturbance.” Spitzer, who went on to chair the DSM-III task force, was lauded for his contributions to the gay/lesbian cause.

Yet 30 years later, he found himself perceived as the “enemy of the gay community and of many in the psychiatric and academic communities” because of his study presented at the APA’s 2001 annual conference and as a later journal article examining whether some homosexuals can change their sexual orientation. His primary motivation for doing the study, he told Psychiatric Times, was curiosity as to whether homosexuals could, in fact, change their sexual orientation with reparative therapy as some have claimed.

In his 2003 article, he wrote that in the self-selected sample of 200, there was evidence “that change in sexual orientation following some form of reparative therapy does occur in some gay men and lesbians” and that almost “all participants reported substantial changes in the core aspects of sexual orientation, not merely overt behavior.”

Because of the controversy, Spitzer’s study was published as a “target article,” accompanied by 26 peer commentaries and followed by Spitzer’s reply.

Since then, some mental health professionals (eg, psychologist Joseph Nicolosi, PhD, originator of reparative therapy) and organizations (eg, Parents and Friends of Ex-Gays and Gays) have used Spitzer’s study as evidence to support the efficacy of reparative therapy, sometimes called “sexual reorientation” or “conversion therapy.”

Spitzer’s reversal

Over the years, Spitzer became increasingly concerned about his study conclusions. Last March, he talked with Gabriel Arana, a reporter with the American Prospect, who confided to him about his own damaging experiences with reparative therapy.

“That [conversation] tipped me over,” Spitzer said. “I realized it wasn’t enough for me to just quietly have my own doubts. I had to face up to questions of whether the study conclusions were justified in any way. I decided they were not, and decided it was up to me . . . to make clear that my views had changed.”

Spitzer discussed his views in an interview with Arana, in an interview with and also The New York Times,in a video interview with the nonprofit organization Truth Wins Out.4-6

Reader comments on the Times’ article generally have been extremely positive, Spitzer told Psychiatric Times. He has read about 400 of the 622 comments and said the majority congratulated him for being flexible enough to admit mistakes at the age of 80. Spitzer is upset with such groups as Parents and Friends of Ex-Gays for failing to delete his study and videos from their Web sites, when they know he has changed his views.

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