Sick again: when the editor in chief of Psychology Today reveals his support for so-called conversion therapies to turn gays straight, what does that say about the state of American psychology? (News Commentary).

Noted lesbian psychotherapist and author Betty Berzon, Ph.D., was momentarily jarred when she opened a copy of the November-December issue of Psychology Today. There among the ads for menopause treatments and books on how to overcome depression was an ad for a book rifled A Parent's Guide to Preventing Homosexuality, cowritten by longtime "conversion therapy" promoter Joseph Nicolosi, Ph.D., who views homosexuality as a "condition" that can be treated.

The American Psychiatric Association not only stopped listing homosexuality as a disorder in 1973 but stated in 1990 that supposed therapies to control or change sexual orientation "do more harm than good." But Nicolosi, a psychologist rather than a psychiatrist, is president of the National Association for Research and Therapy of Homosexuality, a group that gay activists have long charged is an arm of the antigay religions right, using dubious science to disguise its moralism. Indeed, some of NARTH's past leaders have been involved in political attempts to criminalize homosexuality.

"They have tried for years to legitimize themselves within the American Psychological Association," says Doug Haldeman, Ph.D., who is part of the American Psychological Association's Division 44, a professional society dedicated to the psychological study of lesbian, gay, and bisexual issues. "But they are more than ever regarded as being on the fringes."

Berzon decided to call Robert Epstein, Ph.D., the highly visible editor in chief of Psychology Today, to inquire about the magazine's standards regarding advertising (although that is typically the domain of the publisher rather than the editor in chief), which led to a conversation about his views on conversion therapy. What followed over the next few days was a flurry of E-mails, many posted on gay and lesbian Internet bulletin boards, in which Berzon presented her account of their telephone conversation, Epstein responded with a conflicting version, and other notables chimed in.

What Epstein and Berzon do agree on about their heated conversation, however, is this: Epstein defended conversion therapy as a legitimate means to help people who are unhappy being homosexual. And to many mental health professionals, such as Berzon and Haldeman, that defense is highly troubling, particularly coming from the editor of such a well-known mainstream publication.

The current stature of Psychology Today rests largely on its impressive past. During the 1970s, when therapy gurus like Dr. Joyce Brothers became household names, Psychology Today was at the vanguard of America's emerging pop psychology culture, peaking with a monthly circulation of 1.2 million. Like any publication riding a trend, however, the magazine faced a downturn. After a rough patch in the '80s, when it almost went bankrupt, the publication today is a comparatively slim bimonthly (circulation: 325,000) that mostly coasts on its former reputation.

Epstein, a research psychologist and author of 11 books, has brought some renewed attention to Psychology Today since becoming its editor three years ago. He's a seemingly shrewd promoter who has used the magazine to advance his own career as well. Thumbing through the issue with the Nicolosi book ad, one quickly realizes this is Epstein's magazine: There's his editor's letter discussing his latest experiences; his interview with cover girl Laura Bush, the "therapist in chief"; his Q&A with renowned author M. Scott Peck; his Ask Dr. E. column, in which readers send in their questions; and the large portion of the letters page devoted to one of Epstein's previous editorials that, he explains, "continues to generate considerable interests"

That was from June, when the 49-year-old unattached father of four launched an "experiment," asking women who had an interest in falling in love with him (and in coauthoring a book about the experience) to write in; he claims that two people can "learn to love each other." (On that basis, he defends arranged marriages in the piece.) In these days of reality TV, it was a pretty gimmicky project, bound to get attention--even though Epstein insists that "this isn't just a publicity stunt." The editor was soon sitting on CBS's The Early Shaw and giving interviews to the likes of USA Today. Salon.com dubbed him "Dr. Bachelor," and both CBS and NBC talked to him about the possibility of developing a reality TV series.

It's perhaps not so difficult to understand why a man who believes people can learn to love anyone they choose might also believe that people, if they so desire, can and should learn to live a heterosexual life even if they are homosexual. It's also easy to see how someone who stokes media attention so well might view such a position as an attention grabber, perhaps not realizing that the last celebrity "doctor" who stepped into the homosexuality debate with dubious assertions--Laura Schlessinger--soon saw her multimillion-dollar career deflate as gay activists supported successful advertiser boycotts of her radio show amid a bruising campaign against her.

Unlike Schlessinger, however, Epstein doesn't mil against homosexuality, and he says he is supportive of gays and lesbians "who do come out and are happy." He has even criticized Schlessinger in the past, calling her "hateful."

In an interview Epstein acknowledges that "the way [Nicolosi] frames his services" is "objectionable" and is "counter to what the data say about the naturalness of homosexuality." Still, noting that "therapists help people control all types of natural behaviors, such as eating," Epstein continues to defend conversion therapies for "people who are living a gay lifestyle but don't want to" and claims to have seen "interesting dam" from longtime conversion therapy promoters.

Indeed, a few reports touting some successes from conversion therapy--usually individual anecdotes rather than larger, more-authoritative studies following scientific procedures--have appeared in psychology journals. But critics insist that these reports get ink only because of intense pressure put on the journals by the few conversion therapy promoters in the field.

"They're never published in isolation," says Jack Drescher, MD, chairman of the American Psychiatric Association's Committee on Gay, Lesbian, and Bisexual Concerns. "They're always published with a series of articles that are against [conversion therapy]. They're often done by people with Ph.D.s and other degrees [who] have no other specialties beyond this area."

Conversion therapy supporters typically present the mere fact of their occasional publication in a peer-reviewed journal as validation of their methods, failing to mention the evidence against them or the American Psychiatric Association's positions. That's the approach of Nicolosi's Parent's Guide to Preventing Homosexuality. The "science" is limited to the slim reports that support the author's argument that being gay is a disorder that can be avoided or "cured."

Defending his publication's running of the Nicolosi book ad, Epstein observes that "we all subject ourselves to treatments that are only partly effective and controversial, things like herbal remedies." And he dismisses claims that conversion therapies have been shown to be that harmful. A five-year study of 150 people published in the Journal of Gay & Lesbian Psychotherapy in 2001, however, strongly concluded that "participants in conversion therapies are plagued by serious psychological and interpersonal problems after termination." These findings were consistent with several other papers published in journals during the 1990s.

Epstein sloughs off the highly regarded American Psychiatric Association and its opinions on conversion therapies. While the American Psychological Association passed a resolution in 1975 endorsing the psychiatrists' finding that homosexuality is not a disorder, the psychologist' organization "has different concerns" than the American Psychiatric Association, Epstein says. The psychologists' group "is a much, much larger" organization, he adds, and it has so far not offered any resolution specifically about conversion therapy.

But both psychologist Haldeman and psychiatrist Drescher say that the psychologists' group has been less definitive on the issue simply because psychologists believed that the psychiatric association's early and continued resolutions have adequately addressed the situation. "There was an incorrect assumption that conversion therapy was a thing of the past," says Haldeman. "This current controversy makes us realize we [in the American Psychological Association] need to revisit this."

With religious right-backed "ex-gay" groups promoting conversion therapies in full-page newspaper ads for several years now--and recently in ads in Washington, D.C., subway stations--the time for the vast majority of psychologists to take a stand would seem to be at hand. Says Drescher. "I think the battle on this issue was won a long lime ago. But I think this is what we might call a rear-guard action [by conversion supporters] to undermine the victory."

Signorile writes a nationally syndicated column for the New York Press.