Recently, a group of Republicans in Texas, came out in support of reparative therapy for gay and lesbian people. It is worth noting that conversion therapy has been banned in California and also right here in my home state of New Jersey. It is also important to recognize that the professional organizations of most mental health providers, namely the National Association of Social Workers, the American Psychological Association, the American Association of Marriage and Family Therapy, and the American Psychiatric Association consider such therapy unethical, and some of these organizations prohibit its members from performing it. Nevertheless, opponents argue that such a ban violates the First Amendment rights of young people by preventing them from getting the help they need. Practitioners of reparative, reorientation, or conversion therapies claim that a gay sexual orientation is either an illness or is in some ways unhealthy and unnatural and therefore amenable to cure. Others argue that, whether or not homosexuality is illness, such a ban interferes with self-determination—that people have the right to try to change their sexual orientation if they so choose. .
However, there are several flaws in these tired arguments. First of all, homosexuality is not a disease or a dysfunction and this has been officially acknowledged by mental health professionals since 1974 when it was removed as a diagnosis from the Diagnostic and Statistical Manual. Secondly, there are repeated research findings that such therapy, some of which has included electroshock to clients’ genitals and nausea induction, is ineffective. Some of this research is based on a misguided definition of homosexuality as exclusive of heterosexual behavior and thus success is claimed if participants engage in heterosexual relationships. However, same-sex attractions have been repeatedly shown to be largely impervious to extinction, and a large proportion of research participants who have undergone this type of therapy still report being drawn sexually to those of the same sex. If a person is acting heterosexually are they therefore no longer gay? Many gay or lesbian persons can and do function sexually (without counseling) with opposite sex partners—but that doesn’t mean that their same-sex attractions are extinguished when they do. If you want to see what some men do when they are married heterosexually but are sexually attracted to males, I invite you to go to the Personals section of your local Craigslist.org and peruse the listings of married men looking for sex with men (M4M).
Thirdly such therapy can be harmful. Wayne Besen is a veteran of such treatment and in his book entitled Anything But Straight: Unmasking the Scandals and Lies Behind the Ex-Gay Myth he describes stories of people who had become distraught, depressed, even suicidal due to the hopelessness and religious confusion they experienced when these “treatments” did not work.
Finally, in terms of free will, it is important to recognize that, within reason, people’s personal freedoms should not be curtailed and clients have a right to pursue effective treatments. However, as mental health service providers we play a crucial role in establishing and sustaining norms about what is healthy and functional—and what is not--and by engaging in conversion therapy we are communicating that there is something wrong with homosexuality. Thus, we must exercise this enormous responsibility with thoughtful prudence so that we can provide appropriate leadership in defining dysfunction. Therapists and social workers in particular need to be committed to be conscious and conscientious as we perform our roles as agents of social control because the damage done is considerable when we get it wrong. It is worth remembering that earlier in our history, mental health professionals diagnosed slaves who sought to escape their owners as suffering from the mental disorder draptomania.
I have learned that to be a happy and healthy gay, lesbian, bisexual, or transgender person, sooner or later you must recognize that society’s norms around sexuality, gender, and relationships are simply wrong. Instead of shoe-horning people to fit in, psychotherapists need to challenge unhealthy and restrictive norms that oppress segments of the population and teach our clients how to harness their own resilience. Thus when someone seeks help: “I think I am gay and I need to change.” we need to reply. “No, you’re not the one who is sick—it’s the world around you. So let’s figure out how to make you self-loving and strong enough to cope with it.”