I remember painfully my own experience of suffering in a silence that I suspect many people my age and older have experienced. Watching Brokeback Mountain helped to further regurgitate the taste of having had amazingly strong crushes on male peers while growing up, and then falling in love romantically with my best straight friend when I was 22-years old. I never uttered a word to anyone about how strong my feelings were. Instead, I tried my hardest to repress and deny my feelings. Meanwhile, my unconscious mind knew that I was heartbroken so as I fell deeper and deeper into an incapacitating depression, I reached out for help from a well-meaning, loving, Christian counsellor. I still love this person today – if there is one thing that I have learned, it is that unconditional love means accepting yourself and others as they are.

My counsellor attempted to help me feel better about my relationship with my deceased father. Actually, I had a good relationship with him before he died. Then he helped me grieve my father’s death. Actually, I had grieved his death when I was 10-years old...no wonder my depression sunk to a point where I could no longer get out of bed. Neither he nor I could deal with the real issue: I had a strong homosexual orientation, and I was heartbroken from an unrequited love.

Individuals who seek out conversion therapy do so because of having significant internalized homophobia [1], which is their self-hatred for having a same-sex affiliation. Between 96 and 97 percent of people who seek out conversion therapy have a strong religious or spiritual belief system that denigrates their same-sex orientation. [2]

Various attempts at turning a homosexual orientation into a heterosexual one have been attempted for a long time. Aversion behaviour therapy was common during the 1960s and 1970s. More men than women asked for help with conversion, and the aversive approach entailed something that would inspire a sequel to the movie Clockwork Orange. A device was attached to the guy’s penis that would measure increased blood flow. He was then shown nude pictures of men (yummy), but if the poor gaffer started becoming erect, he was given an electric shock to the finger, the hand, the forearm, or even the genitals! [3] Even these early “S&M“ psychologists began to realize that their barbaric measures did not actually shift sexual orientation. Instead, it reduced the compulsive urge of these guys to seek out sexual behaviour with other guys, but it did not create a desire to be sexual with women. [4]

Aversion therapy was not the only method used by early conversion therapists. Other methods included injecting men with male hormones (i.e., testosterone) – which made them hornier for sex with men; female hormones (i.e., estrogen) – which reduced their sex drive and helped them begin to look a little more like women, which still did nothing to increase their desire for women; the obviously painful castration, and lobotomies. You will be happy to know that today’s conversion therapists have since developed more civilized techniques to attempt a conversion.

Today’s conversion therapists are truly a mixed bag, most of whom are not licensed psychologists or psychiatrists. More of it is practiced by those who belong to the ex-gay movement. For a mind-opening look at what happens in some of the ministries associated with this, read reference 5. [5] Their training can range from nothing (especially in the self-help groups) to those with training in pastoral counselling. You should be aware that every mental-health association that has an ethical code for its members – including associations for psychiatrists, psychologists, and social workers, for example – strongly advises against offering conversion therapy.

You might wonder, as I do myself, why conversion therapy is not simply banned as a practice. Homosexuality has not been recognized as a mental disorder since 1973, so why do we allow therapy to occur when there is nothing to “cure” or “fix”?

The reason mental-health associations have not banned it, they argue, is that if we are to respect diversity, then we must also respect a person’s right to choose according to his or her own religious or spiritual belief system. Furthermore, there is some evidence produced by the conversion therapists that suggest their methods may be effective for some who are highly motivated to change. I will briefly review two studies below that suggest change in sexual orientation is possible.

1. Nicolosi, Byrd, and Pott’s (2000) Study [6]: These researchers received completed surveys by 669 men and 193 women (total=882). They found that between 20 and 30 percent of the participants said that they had shifted from a homosexual orientation to a heterosexual one. A further 30 to 40 percent reported that they continued to struggle with unwanted homosexual thoughts and behaviours. A final 35 percent said their sexual orientation was unchanged. The average length that participants received therapy was 3.4 years.

2. Spitzer (2003) Study [7]: Spitzer did telephone interviews with 143 men and 57 women (total=200) who claimed to have changed their sexual orientation from homosexual to heterosexual. The average length of each interview was 45 minutes. Male participants stated their same-sex sexual attraction was, on average, 91/100 before they started treatment, and that at 12 months before Spitzer’s interview, the participants rated their same-sex sexual attraction as decreased to 23/100. For the women, the before and after report was 88/100 down to 8/100, respectively. Other results included the finding that only three men and none of the women reported having good heterosexual functioning before their therapy commenced, whereas following treatment, 94 males and 25 females reported good heterosexual functioning.

Such results appear impressive, until you look deeper into how the researchers arrived at these findings:

1. These were retrospective studies, meaning that these individuals were not tested before therapy started and then again at regular intervals. Instead, the participants were reflecting from years ago about their experience. In Spitzer’s study, the participants received conversion therapy on average 12 years before they were interviewed. In the Nicolosi study, there was about a nine-year gap before they completed the survey.

2. Because these individuals’ sexual orientation was not assessed at the beginning of treatment, it is likely that many of them had a bisexual orientation to begin with. Therefore, the conversion therapists had some degree of heterosexual interest to build upon.

3. In neither study did the researchers inquire about the most important aspect of sexual orientation, that being which sex they have the propensity to fall in love with romantically – the same, opposite, or both sexes. [8] Instead, sexual orientation was largely trivialized to what the early measures of sexual orientation focused on (such as the Kinsey scale), which was mostly targeted at sexual behaviour and sexual attraction.

By the way, I do believe that the conversion therapists have shown that (a) some highly motivated individuals can become more heterosexual in their functioning and (b) that some people who initially self-define as gay probably don’t know themselves well enough yet to realize they actually have a bisexual orientation. But this is not why I see conversion therapy as potentially very destructive.

The research is replete with examples where conversion therapy has caused psychological harm to homosexually-inclined individuals, including (a) depression, suicidal ideation, and attempts; (b) self-esteem and internalized homophobia; (c) distorted perception of homosexual orientation; (d) intrusive imagery and sexual dysfunction; (e) monitoring of gender-deviant mannerisms; (f) social and interpersonal harm; (g) family of origin; (h) alienation, loneliness, and social isolation; (i) interference with intimate relationships; (j) loss of social supports when entering and leaving the ex-gay community; (k) fear of being a child abuser; (l) delay of developmental tasks due to not coming out as gay or lesbian earlier; and (m) spiritual harm. [9]

When I offer therapy to a client, the worst case scenario is that the person does not improve or receive the desired results. My interventions are not potentially fatal, however! In medical practice, the common axiom is “First, do no harm.” If researchers could demonstrate to me that conversion therapy does no harm, I would have to ethically conclude that it should be provided as a freely-chosen option by people who wish to convert. However, as this is not what the bulk of research studies to date have concluded, I believe conversion therapy should be treated like an experimental drug, or at least be tested scientifically as a potentially new psychological treatment. That would include, at minimum:

1. Informed Consent – Potential participants would be given comprehensive information about the potential risks and benefits that may result from taking part in this study.

2. Thorough Assessment – Potential participants would be properly assessed as to their mental health and their sexual orientation before being admitted into the study.

3. Random Assignment – Participants would then be randomly assigned to either the experimental group (i.e., conversion therapy) or a control group.

4. Rigorous Evaluation – The participants would be carefully monitored throughout the treatment to ascertain whether the benefits are outweighing the risks. Participants would be immediately removed from the study should the treatment be shown to be hurting their psychological, spiritual, or physical well being.

Only through careful study will we ever be able to determine if conversion therapy is advisable for some people under some conditions, and for which people and for which conditions. Until then, I fear that we will continue to allow well-meaning “helpers” to continue their practices of instilling yet greater guilt and greater shame for something that perhaps is as God-given as the blessed heterosexually to which they are oriented. As I have written in my previous books and articles, sexual minorities have been emotionally abused and spiritually raped for at least 2,000 years. I believe it is now time to end the abuse.

Let me finish now with a quote from “Bobbie” who was raised by fundamentalist Christians:

Why did you do this to me, God? Am I going to go to Hell? That’s the knawing question that is always drilling little holes in the back of my mind. Please don’t send me to Hell. I’m really not that bad, am I? I want to be good. I want to amount to something. I need your seal of approval. If I had that I would be happy. Life is so cruel and unfair.

Bobbie committed suicide on August 27, 1983, leaving his aforementioned words in his suicide note. [10]

Dr. Alderson is an assistant professor of counselling psychology at the University of Calgary who specializes in gay and lesbian studies. He also maintains a private practice. He can be contacted by confidential email at alderson@ucalgary.ca, or by confidential voice mail at 605-5234.

References:
1) 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.
2) Nicolosi, J., Byrd, A. D., & Potts, R. W. (2000). Retrospective self-reports of changes in homosexual orientation: A consumer survey of conversion therapy clients. Psychological Reports, 86, 1071-1088.
3) Murphy, T. (1992). Redirecting sexual orientation: Techniques and justifications. Journal of Sex Research, 29, 501-523.
4) McConaghy, N., Armstrong, M. S., & Blasczynski, A. (1981). Controlled comparison of aversive therapy and covert sensitization in compulsive homosexuality. Behavior Research & Therapy, 19, 425-434.
5) Ford, J. G. (2001). Healing homosexuals: A psychologist’s journey through the ex-gay movement and the pseudo-science of reparative therapy. Journal of Gay & Lesbian Psychotherapy, 5(3-4), 69-86.
6) Nicolosi, Byrd, & Potts (2000) – see reference above.
7) Spitzer, R. L. (2003). Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation. Archives of Sexual Behavior, 32(5), 403-417.
8) Money, J. (1993). Sin, sickness, or status? Homosexual gender identity and psychoneuroendocrinology. In L. D. Garnets & D. C. Kimmel (Eds.), Psychological perspectives on lesbian and gay male experiences (pp. 130-167). New York: Columbia University Press.
9) Shidlo, A., & Schroeder, M. (2002). Changing sexual orientation: A consumers’ report. Professional Psychology: Research and Practice, 33(3), 249-259.
10) McDonald, H. B., & Steinhorn, A. I. (1990). Homosexuality: A practical guide to counseling lesbians, gay men, and their families [p. 54]. New York: Continuum..