By Guanaco, Gustavb [Public domain], via Wikimedia Commons
LGBT affirmative healthcare is ethical healthcare
Source: By Guanaco, Gustavb [Public domain], via Wikimedia Commons

So-called “Conversion” or “Reparative” therapies are pseudo-therapeutic efforts to change the sexual orientation of people with same sex attractions. I call them “pseudo-therapeutic” as these efforts are not intended to result in positive or healthy changes, and violate core ethical principles of healthcare, namely, “Do no harm.” Extensive research demonstrates that not only do these efforts fail to change sexual orientation, but they often result in significant emotional damage. The tragic suicide of a transgender teen who was forced by their parents into such treatment has resulted in a great deal of media attention to this issue.  President Obama recently took a stand against this practice, most professional medical associations have specifically rejected it, and multiple states are now banning these treatments. Unfortunately, clinicians and programs who provide these sex orientation change efforts are now using a new treatment justification, claiming that homosexuality is an addictive disorder.

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Two states currently ban conversion therapy
Source: By SPQRobin (Own work; based on File:Blank_US_Map.svg) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

At recent legislative hearings in Oregon, a law banning reparative therapies for children or teens was challenged by Colorado therapist Jayson Graves. Graves’ website proclaims “You’ve arrived at a site dedicated to Sexual Addiction Recovery and help for Unwanted Same Sex Attraction.” Graves, a licensed psychotherapist, goes on to describe his services for teens, saying he is “Guiding teens out of compulsive sexuality including internet pornography, unwanted same sex attractions, and/or compulsive masturbation.”

Graves is far from alone in this approach. Texas psychologist Karla Austin, Ph.D. provides sexual therapies, including attempts to change sexual orientation, and treatments for sexual addiction. She declines to endorse the terms reparative or conversion treatment, but says: “Some people struggle with thoughts and feelings of a homosexual nature, that is against their values. When those people ask for help, it is my position, that help should be available.” She then goes on to describe her approach to sex addiction treatment, saying: “Pornography and compulsive masturbation are the fast tracks to sex addiction.”

Marcus Bachman Ph.D. is a psychologist and husband of legislator Michelle Bachman. He denies being involved in reparative therapies, but has described his clinical services thusly: “The fact is — and we get this at our Christian counseling clinic — … encourage them and really allow them to see what changes could occur from the inside out for a person who has been struggling for probably years from some addiction that has led to their same-sex attraction.”

People Can Change is an organization committed to promoting efforts to change sexual orientation. Stories on their website include statements such as: “Alan lived a secret double life for years before he took the classic "A.A. step" of totally surrendering his life to God. That surrender brought a dramatic change of heart. His attraction to men was miraculously de-eroticized, his sexual addiction was lifted, and he fell deeply in love with his wife” and “After trying in vain for years to overcome his secret homosexual sex addiction, Dan finally "came out" enough to ask others for help. Work with a spiritual counselor, new friends, inner-child therapy, a Twelve Step group, the Evergreen support group and the New Warrior Training Adventure all brought together important pieces of healing.”

Traditional sex addiction treatments have pathologized gay and bi men. Study after study has demonstrated that same-sex attracted men are heavily overrepresented in sex addiction treatment. It is not by accident that the sex addiction concept took root in American pop psychology, just as the HIV/AIDS crisis created tremendous fear of male homosexuality. A gay man in sex addiction treatment once shared with me that: “Most of the men who attend SAA meetings are heterosexual...their ‘acting out’ behaviors are often their homosexual behaviors.  The five men in my therapy group are all straight as is my therapist. I am not heterophobic but I am not feeling any better as a result of all this treatment and accountability.”

Tragic stories of rape, shock therapies and horrible abuse recently emerged from conversion therapies in Ecuador. People were subjected to forced treatments to “dehomosexualize” them. These programs use an addiction model, explicitly derived from 12-step programs and “adopted the use of Narcotics Anonymous and Alcoholics Anonymous as their primary or only treatment model.”

Perceiving homosexuality as a disease is not new. Until the 1970’s, it was classified as a mental disorder. Groups who classify homosexuality as an abnormality, as a disease, do so from the base assumption that homosexual attractions reflect a disturbance. But modern American society no longer perceives homosexual desires as an illness.

Some people do struggle with their sexual desires. There are many complex reasons why same-sex attracted people might want to make these desires go away. But the core reason is the conflict between a person’s sexual desires and their religious/cultural beliefs. All of the programs and clinicians cited above explicitly identify themselves as religious counselors and programs, using an addiction model of homosexuality to support a moral attack on homosexuality.

Moral and religious groups have the right to identify that they see homosexuality as “wrong,” and to campaign about their views. But it is deceptive and insidious for such groups to use medical language in their moralizing. This suggests that their proselytizing is about compassion for people suffering from a disease, and masks that they are being judgmental about their choices.

It is unethical for licensed medical professionals to endorse the idea that homosexuality is an addiction. Doing so reveals the intrusion of morality into their clinical actions. Healthcare is based on science and medical standards, not morality. Science and medicine have been clear that homosexuality is not a disease. These clinicians may be in violation of their professional ethics, and even subject to sanction by their professional licensing boards.  

I encourage the sex addiction industry and its’ leaders to join the APA, AMA, ACA and multiple other professional organizations and reject the practice of conversion therapy. It would be ethical and just for sex addiction therapy training groups such as IITAP and SASH to take a stand, and assert that homosexuality should not be treated as an addiction. This would demonstrate a commitment to the health of their clients, and to preventing harm by people who are using their concepts of sex addiction to hurt people.

Advocates for LGBTQ rights must also take an equivalent stand. As long as we allow sexual orientation to be portrayed as an addiction, we tacitly permit the stigma which leads to shame, exclusion, harm and even death.

If our society is committed to our belief that sexual orientation is not a disease, and that efforts to change sexual orientation are harmful, we must prevent these purveyors of harm from rebranding themselves as addiction therapists. Attempts to hide moralistic shaming behind medical concepts must be challenged in order to preserve the integrity of healthcare.

Follow David on Twitter.

(All websites quoted herein were viewed on May 8, 2015)

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Proud LGBTQ advocates must challenge the notion that homosexuality is an addiction.
Source: By Har1224 (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

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