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Anatomy of a pseudo-science.

IN SUMMER 2005, Zachary Stark wrote in a web log about his parents' forcing him to attend Refuge, an ex-gay outpatient program for adolescents aged thirteen to eighteen sponsored by an organization named Love In Action (LIA). While there, Zachary wrote: "[My parents] tell me that there is something psychologically wrong with me.... I'm a big screw-up to them, who isn't on the path God wants me to be on. So I'm sitting here in tears" (Associated Press, June 23, 2005). Public outcry and media attention led the state of Tennessee to investigate allegations of child abuse at Refuge. While it found no evidence of child abuse, the state investigated whether Refuge was providing mental health services without proper licensure. In February 2006, seventeen-year-old DJ Butler also reported that his parents had forced him to attend LIA's Refuge program. According to Butler, his father drove him to LIA's facilities in handcuffs.

Love In Action is one of many ex-gay organizations with new programs specifically targeted at youth. Exodus International, which claims to include over 170 ex-gay programs in seventeen countries, launched its Exodus Youth teen program in 2002. Parents and Friends of Ex-Gays and Gays (PFOX) was founded in 1998 and modeled after the pro-gay Parents and Friends of Lesbians and Gays (PFLAG). In 2005 PFOX successfully challenged a pro-gay sex education curriculum in Montgomery County, Maryland.

For almost three decades, the ex-gay movement has claimed that gay men and lesbians can become heterosexual through "reparative therapy" or "conversion therapy." Despite the fact that the American Psychiatric Association declassified homosexuality as a mental disorder in 1973, ex-gay programs operate under the premise that homosexuality is a mental illness. Over the past few years, however, the ex-gay movement has adopted a new approach, targeting youths viewed as exhibiting signs of "prehomosexuality" with recourse to both "preventive" measures and conversion techniques. "Conversion" to heterosexuality is allegedly achieved through embracing evangelical Christianity and being "born again."

Christian right leaders have promoted the "prehomosexuality" concept for over five years. In a June 2002 newsletter titled "Can Homosexuality Be Treated and Prevented?" James Dobson, founder of Focus on the Family, addressed "prehomosexuality" in children, warning parents that even if their sons are not "effeminate" or their daughters "masculinized," they may still be in danger of becoming gay or lesbian and should see a "professional." That same year, Joseph Nicolosi, cofounder of the National Association for the Research and Therapy of Homsexuals (NARTH), published A Parent's Guide to Preventing Homosexuality, in which he described how he administered conversion therapy to a five-year-old "prehomosexual" boy named Stevie. Ex-gay groups recruit students to spread the message that homosexuality is a treatable condition. For example, in 2005 the evangelical Alliance Defense Fund sponsored the first annual "Day of Truth ... to counter the promotion of the homosexual agenda" in schools by gay-straight alliances and other groups.

This focus of programming and resources toward youth and parents constitutes a "third wave of ex-gay activism." The first wave began in 1973 with the founding of the first conversion therapy treatment program in San Francisco. During the first wave, the message that sexual orientation could be changed became inextricably linked to the "special rights" argument used by leaders of the new religious Right to oppose equality for GLBT Americans.

The second wave of ex-gay activism began in 1998 when John and Anne Paulk, two self-proclaimed ex-gays who married each other, appeared on the cover of Newsweek claiming that homosexuals can heal themselves of their "lifestyle choice." Ex-gay groups ran full-page ads in major newspapers claiming that homosexuality is a choice. This period ended after John Paulk was caught in a Washington, D.C., gay bar and was forced to resign from his positions at Exodus International and Focus on the Family.

The third wave focuses less on "curing" adults of homosexuality than on preventing its development by targeting children and adolescents. Whether through counseling programs like Refuge or through traveling ex-gay conferences like Focus on the Family's Love Won Out, ex-gay programs recommend that parents commit their children to treatment regardless of their children's wishes.


To learn about this movement, one of the authors, Sean Cahill, attended Focus on the Family's Love Won Out (LWO) conference in Boston on October 29, 2005--the first-ever ex-gay LWO conference in New England. Focus on the Family produces several LWO conferences each year across the country. (Focus on the Family's state affiliate, the Massachusetts Family Institute, leads the effort to repeal same-sex marriage in that state.) NARTH's Nicolosi and other speakers offered a disease model of homosexual development. While anti-gay leaders have long characterized homosexuality as a "choice," these speakers argued that it resulted from environmental influences: 1) a dysfunctional relationship between parents and children, especially between fathers and sons and mothers and daughters; or 2) childhood sexual abuse. They also claimed that there's an intrinsic link between homosexuality and pedophilia, and that children raised by lesbian and gay parents are disadvantaged due to their parents' sexuality and/or gender.

There's an important contradiction in the ex-gay movement's claims. Dobson and others usually insist that homosexuality is an individual choice, and a bad one, which is how they justify treating gay people unequally. But now they were presenting homosexuality as a condition caused by dysfunctional same-sex parent-child relationships and childhood sexual abuse.

Nicolosi argued that mothers of "prehomosexual" boys are "overly emotionally involved, dominant," with a "strong personality." Their fathers are "quiet, withdrawn, nonexpressive and/or hostile." Prehomosexuality is "a gender identity problem ... a masculine inferiority" in boys, and a striving for male bonding. The prehomosexual boy "never gets dirty when he goes out and plays. His mother parts his hair and puts on hairspray." Implicitly making the link between homosexuality and pedophilia, Nicolosi concluded, "We tell fathers, 'If you don't hug your son, some other man will.'" Melissa Fryrear, a self-proclaimed ex-lesbian now employed by Focus on the Family, said that "Sexual abuse among lesbians is incredibly high.... I've worked with ex-homosexuals, and I have never met one woman who had not been sexually violated in her life."

The ex-gay movement relies heavily on outdated gender stereotypes. Ex-gays who stop "living in homosexuality" can prove their newfound heterosexuality by adhering to rigid, stereotypical gender behaviors. Fryrear joked about eyelash curlers and "how expensive it is to be a woman." She said she had a hard time fitting her large body into pantyhose each morning. Ex-gay Mike Haley said that after he decided to become heterosexual, he stopped crossing his legs "the gay way" and now did so as a real man does.

Nicolosi, Fryrear, and other speakers offered research in support of their claims--none of which, however, was published in respected, peer-reviewed journals. In fact, the consensus within the scientific and professional communities (psychology, child welfare, etc.) is that such anti-gay claims are false.

Some LWO speakers portrayed gay activists as a vast threat to freedom of religion and freedom of conscience, akin to the Nazis. The media, schools, professional organizations such as the American Psychiatric Association, and the government were portrayed as having been taken over by "special interests," i.e. gay activists. In contrast, ex-gay activists and therapists were depicted self-servingly as brave dissenters from conventional wisdom and political correctness.


"Change is possible" has long been the slogan of Exodus International. However, analysis of the statements made by ex-gay programs and their leaders reveals a shifting definition of what it means to "change." For example, Rev. John Smid, director of Love In Action, now says, "There isn't a cure for homosexuality." LWO speakers compared homosexuality to alcoholism, something people struggle with throughout their lives.

A study by renowned psychiatrist Dr. Robert L. Spitzer, published in 2003 in Archives of Sexual Behavior, renewed the debate about the effectiveness of conversion therapy. Spitzer found that in a study of 143 men and 57 women who participated in ex-gay therapy, eleven percent of the men and 37 percent of the women reported having changed from homosexual to heterosexual. However, analysis of Spitzer's study by his peers revealed significant problems with its methodology and interpretations. For example, 43 percent of Spitzer's subjects were referred by ex-gay organizations, and 23 percent were referred by Nicolosi's NARTH. Nearly four in five had spoken publicly in favor of ex-gay therapy.

While research does not support the ex-gay movement's claims, there is a growing body of research indicating that conversion therapy is psychologically harmful to the individual, not to mention a violation of standard psychotherapeutic ethics. Ariel Shidlo and Michael Schroeder conducted a seven-year study based on interviews with people involved with conversion therapy. The article summarizing Shidlo and Schroeder's findings, "Changing Sexual Orientation: A Consumer's Report," was published in 2002 in Professional Psychology: Research and Practice, a peer-reviewed journal published by the American Psychological Association. Shidlo and Schroeder surveyed 202 individuals who had participated in conversion therapy. Thirteen percent of the participants reported believing that they successfully changed post treatment (self-perceived success), but only eight people reported that they weren't experiencing "slips" or needed to frequently use coping mechanisms in order to control their same-sex behavior or attractions. Of those, seven were providers of ex-gay counseling and four actually had paid positions as ex-gay counselors.

Of the 176 participants in the self-perceived failure group, 155 reported significant long-term harm from conversion. Many participants reported depression and suicidal ideation, while many more reported damage to their self-esteem. Some male participants reported sexual dysfunction, including impotence. Eighteen participants who were forced to endure aversive conditioning, a form of behavioral therapy in which a pleasurable stimulus is paired with a noxious one in order to suppress the power of the former, experienced highly disturbing and disruptive ideation. The interventions experienced by these eighteen included electric shock therapy and the use of inhalable or injectable emetics to induce vomiting.

Many participants complained that conversion therapy harmed their relationships with family members and friends, particularly with parents, who were often blamed by their therapists for their homosexuality. Many reported loneliness and an inability to commit to long-term relationships with same-sex partners with whom they were in love. Many therapists instructed them to break off amorous same-sex relationships, as well as relationships with lesbian and gay friends. Similar losses occurred when those participants ended conversion therapy and left the ex-gay community. Some said that the years spent in conversion therapy delayed a number of experiences, including intimate relationships and the development of social skills. According to one participant, the treatment "added more years to my time in the closet. I lost a lot of my life as a result of this."

Sixty-six percent of participants considered themselves to be religious. Those in the perceived failure category reported a negative impact on their beliefs, including a complete loss of faith, a sense of betrayal by their religious leaders, anger at the therapists who told them God was ashamed of them in the first place, and excommunication from their churches.

Ex-gay therapy also raises ethical concerns. Unlike most organizations and individuals offering counseling and mental health services, most ex-gay programs market themselves as religious ministries and are therefore not governed or overseen by professional associations, licensing boards, or state departments of health. D. C. Haldeman (1994) found that conversion therapists fail to uphold the dignity and welfare of their patients because their treatments are predicated on the devaluation of homosexual identity and behavior. According to Haldeman, there would be no conversion therapy in the first place if not for the assumption that homosexuals are mentally ill and require treatment. This is contrary to the positions taken by nearly every major medical and mental health association, representing 477,000 professionals.

Schroeder and Shidlo reported the following ethical concerns and violations in their sample of 202 consumers of ex-gay therapy: 1) Lack of informed consent. Many conversion therapists provided "false and prejudicial" information disguised as science to prospective clients in order to convince them that they needed treatment. 2) Use of religion in therapy. Is it ever ethical to use the threat of religious consequences, such as going to hell or living outside of God's will, to convince clients to change? 3) Lack of pre-termination counseling. Many clients who failed to change were not provided with proper assistance to help them after treatment. Clients blamed themselves and were even blamed by their therapists for failing to change, and were not provided with help to deal with the internalized homophobia that results from being indoctrinated into believing that homosexuality is a psychological disorder. 4) Lack of information about negative side-effects. Many conversion therapists failed to inform their clients about the possible harmful side-effects of this therapy. For decades, former clients have been sharing stories of pain, depression, internalized hatred, and other forms of life-altering damage that resulted from their conversion experience.

Shidlo and Schroeder have added to the preponderance of evidence against conversion therapy. Nevertheless, ex-gay leaders continue to tout the "success" of their programs and the hundreds of thousands of ex-gays who allegedly exist as evidence that sexual orientation is a choice. The peer-reviewed research published by Haldeman, Shidlo, and Schroeder, among others, tells a much different story.

YOUNG PEOPLE are now being used as ammunition in the Christian Right's war against equality for GLBT Americans. Ex-gay organizations have taken what used to be an intensely personal process (coming out to oneself, to friends, and to family) and have created programs and conferences that link the personal lives of young people to battles over same-sex marriage and the election of conservative political leaders.

While we find the experiences of five-year-old "Stevie" and Zack Stark disturbing, it is important not to demonize parents for their decisions to send their children to conversion therapy programs. Joe Stark's statement--that he sent his son Zack to the program because he was afraid Zack would die by the age of thirty if he were gay--revealed an important and tragic reality of the third wave of ex-gay activism: Parents are being lied to by ex-gay and religious leaders they trust.

In books, through advertisements, and at traveling political road shows like Focus on the Family's Love Won Out conference, parents are being told that homosexuality is a mental illness, caused primarily by their inability to be good parents and curable through conversion therapy. This is presented to parents as fact, even though homosexuality is not a mental illness in the eyes of nearly every medical and mental health professional association, while, in contrast, conversion therapy is expressly opposed by these same organizations. Parents are told that if their sons and daughters are in the "homosexual lifestyle," they are destined to lead short lives characterized by depression, anger, substance abuse, and domestically violent relationships. This information is likewise presented as fact even though it is based on flawed, ideologically driven research that has yet to be published in respected, peer-reviewed academic journals.

Most parents would do anything they could to protect their children from harm and to help ensure that they lead the longest and healthiest lives possible. Sadly, ex-gay and evangelical Christian Right leaders are instructing parents to do something more likely to harm than help their sons and daughters. What they need to understand is that homosexuality is not a mental illness. There is a growing body of evidence that conversion therapy not only doesn't work but can also be actively harmful. Conversion therapy also gives rise to a growing body of ethical concerns.

If ex-gay programs and conversion therapists are promoting treatment that is unethical and harmful, what can be done to protect people, particularly minors? According to Hayley Gorenberg, deputy legal director at Lambda Legal, there's a variety of legal theories under which ex-gay programs and conversion therapy practitioners could be shut down and even held liable for the harm they cause to clients. There could be standing to sue based on malpractice, consumer fraud, false advertising, contract, or child abuse and neglect laws for minors forced to attend an ex-gay program. Former conversion therapy clients who feel they've been harmed by their therapist or ex-gay program are encouraged to contact Lambda Legal's youth hotline at 1-800-LGBTEEN.


Besen, Wayne. Anything But Straight: Unmasking the Scandals and Lies Behind the Ex-Gay Myth. Harrington Park Press, 2003.

Haldeman, D. C. "The Practice and Ethics of Sexual Orientation Conversion Therapy." Journal of Consulting and Clinical Psychology, 62(2), 1994.

Nicolosi, J. & Nicolosi, L. A. A Parent's Guide to Preventing Homosexuality. InterVarsity Press, 2002.

Shidlo, A. & Schroeder, M. "Changing Sexual Orientation: A Consumer's Report." Professional Psychology: Research and Practice, 33(3), 2002.

Spitzer, R. L. "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), 2003.

Jason Cianciotto is research director, and Sean Cahill is director of the National Gay and Lesbian Task Force Policy Institute.
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Author:Cianciotto, Jason; Cahill, Sean
Publication:The Gay & Lesbian Review Worldwide
Article Type:Essay
Geographic Code:1USA
Date:Jul 1, 2007
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