In 2003, Dr. Robert Spitzer published a paper in the prestigious journal Archives of Sexual Behavior claiming that therapy to change sexual orientation works with some individuals who are “highly motivated.” The study produced a blizzard of media attention because Dr. Spitzer was the same person who had led the charge in 1973 to remove homosexuality from the list of mental disorders in the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association. He was highly respected among scientists and clinicians for his courage in leading this difficult undertaking.
I recently received a copy of Dr. Spitzer’s letter from the editor of Archives of Sexual Behavior and the letter will soon be published online. In the letter, Dr. Spitzer writes, “I believe I owe the gay community an apology for my study making unproven claims of the efficacy of reparative therapy. I also apologize to any gay person who wasted time and energy undergoing some form of reparative therapy because they believed that I had proven that reparative therapy works with some ‘highly motivated’ individuals.”
In the letter, Dr. Spitzer described his driving question for the study as, “Can some version of reparative therapy enable individuals to change their sexual orientation from homosexual to heterosexual?” When Spitzer’s original article was published in 2003 it was accompanied by 26 commentaries, most them highly critical of the paper’s methods and conclusions. The study was based on interviews with 200 self-selected individuals (143 males, 57 females) who reported on the phone to Spitzer at least some minimal change from homosexual to heterosexual orientation that lasted at least 5 years. Based on these phone interviews, Spitzer concluded in the original paper that “Either some gay men and lesbians, following reparative therapy, actually change their predominantly homosexual orientation to a predominantly heterosexual orientation or some gay men and women construct elaborate self-deceptive narratives (or even lie) in which they claim to have changed their sexual orientation, or both. For many reasons, it is concluded that the participants’ self-reports were, by-and-large, credible and that few elaborated self-deceptive narratives or lied. Thus, there is evidence that change in sexual orientation following some form of reparative therapy does occur in some gay men and lesbians.”
Dr. Spitzer has now changed his mind about that credibility. In his letter, he now acknowledged that interviewing people would never be able to truly answer his research question because there is no way to judge the credibility of the participants’ reports of a change in their sexual orientation. This is essentially because many of the individuals would be highly motivated to say that their sexual orientation had changed to heterosexual due to guilt, shame, indoctrination, and possibly wishful thinking. Says Spitzer, “But the simple fact is that there was no way to determine if the subject’s accounts of change were valid.”
Because of the flaws in the design of the study, its conclusions were never widely accepted among scientists. Despite this fact, it was often used by anti-gay organizations to make claims that sexual orientation is a choice and that it can be changed through therapy. The reaction from anti-gay organizations to Spitzer’s apology has largely been to chalk it up to politics. No matter how they interpret it, Spitzer’s apology essentially represents a retraction of the conclusions he originally made and eliminates any (even weak) shred of scientific evidence that a persons’ sexual orientation can be changed through some kind of psychological intervention.
In related news, this week a bill was introduced in the California legislature to outlaw so called “conversion therapy.” The bill proposes to ban the practice for minors and requiring any therapist offering it to an adult to provide a written disclaimer that reparative therapy is not evidence-based and may be harmful. All major professional mental health organizations denounce this practice as ineffective and potentially very harmful.