I.
The subject of homosexuality has
almost always, in various cultures and in different ages, been
a controversial one; and although tolerance and acceptance have
become more widespread in the Western world in the past decades,
there are still negative sentiments in large segments of the population,
and, notably, there is a rather vociferous and hostile minority
(comprised of political conservatives, some religious groups,
and neo-Nazis) which actively tries to combat homosexuality in
various ways. This essay deals with one such line of attempts,
namely, so-called reparative therapy, which asserts (i)
that homosexuality is a mental disorder which is undesirable,
and (ii) that it is possible to alter a person's sexual orientation
through therapy.
Below, I will critically analyze
this way of thinking in three sections. The first will discuss
the underlying normative assessment of homosexuality, which pervades
this sort of therapy; the second will take a look at the claim
that "it is possible to change from gay to straight";
and the third will offer some reflections on the politics, or
the ideology, involved in this issue. Lastly, some concluding
remarks are given, and the main point, which I will support through
my overall reasoning, is that homosexuality is a natural phenomenon
which is perfectly compatible with a rewarding and fulfilling
life, and reparative therapy is - with this insight - to be
strongly discouraged.
II.
Although seldom stated explicitly,
reparative therapy rests on a normative foundation which essentially
views homosexuality as an undesirable thing - both on the individual
and on the social level. (Here, I will mainly focus on the former
level; for a discussion of the effects of homosexuality on society,
I recommend my essay "Does Homosexuality Pose a Threat to Society?")
It is averred that homosexuality is a mental disorder which stems
from some sort of psychological problem in the childhood of the
homosexual, and this condition is thought to entail a quality
of life which is inferior to that which would have followed had
the person in question been heterosexual.
To this, one might offer several
replies. First, to avoid criticism, most reparative therapists
claim that they have no desire to interfere with anyone who does
not himself wish to change and that it should be permitted, for
those who wish, to (try to) alter their sexual orientation. However,
there is a monumental problem involved here, namely, a lack of
understanding of what, exactly, it is that causes some people
to want to change in this respect. An obvious fact: when a homosexual
person enters puberty and begins to discover his sexual attraction
to persons of the same sex, he oftentimes experiences strong internal
feelings of disapprobation and, when he discloses his orientation
to others, strong external disapproval. I think most homosexuals
can identify with this phase, and this leads us to realize that
it is often not homosexuality per se which is the rationale
for a wish to change but rather the negative attitudes of the
surrounding culture. Hence, as we live in a culture which still
sends the message that heterosexuality is what is expected and
desired for all, it is unethical, in my view, for a therapist
to simply take a wish to change as a given basis for starting
therapy. What a responsible therapist should do, if he is scientific
and not ruled by ideological concerns, is to try to make his (potential)
patient feel genuinely happy, and clearly such happiness most
naturally comes through if a person who is discontent with being
a homosexual is helped to realize that the negative attitudes
(probably internalized) are, indeed, not rational. Attempts to
change a person's sexual orientation in a non-neutral environment
can be compared to two other possible "reparative" acts:
for a black person to try to change the color of his skin to white
and for a left-handed person to try to change into becoming right-handed.
I rightly think that such attempts are considered induced by social
attitudes and, hence, that one should be very reluctant to encourage
them.
But, it may be argued, homosexuality
is a mental disorder and, as such, is not natural, like being
black or left-handed. This argument is considered incorrect by
the Western psychological, psychiatric, and medical associations
(see fact sheets from The American Psychological Association
and The American Psychiatric Association
for representative statements), and it is also rejected by biologists
(see the essay "Naturligt är mångfalden"
by two Swedish professors of ethology at the University of Stockholm,
and the essay "Homosexuality and the 'Unnaturalness Argument'"
by Burton M. Leiser). That is to say, the exclusive reliance of
reparative therapists on one particular set of psychodynamic theories,
and the diagnoses stemming from these theories, are not
in accordance with the overall scientific understanding of the
cause of homosexuality.
These psychodynamic theories usually
have one thing in common: they view homosexuality as the direct
result of some type of emotional experience during early childhood,
most often the presence of a dominant mother and a weak or absent
father, or some other problem in relating to the same sex. I will
not discuss them in detail; for such a discussion, I recommend
the book Homosexuality: A Philosophical Inquiry by philosopher
of science Michael Ruse (Oxford: Blackwell, 1988), the book Man och man emellan: en bok om manlig homosexualitet
by psychiatrist Lars Bohman (Stockholm: Natur och kultur, 1995),
and the major scientific study Sexual Preference (Bloomington:
Indiana University Press, 1981) by A. Bell, M. Weinberg, and S.
Hammersmith, which finds no empirical support for the psychoanalytic
theories of homosexuality. Suffice it here to note that there
are severe problems with these theories in their own right (for
instance, they cannot explain many cases of homosexuals without
dominant mothers and absent fathers, they cannot explain why many
children of dominant mothers and absent fathers are heterosexual,
and they ignore the logical problem of causality, which states
that a real possibility, for the cases where dominant mothers
and absent father are a reality, that homosexuality - or some
characteristic correlated with homosexuality, such as, possibly,
effeminacy - precedes that situation and actually causes it).
But in addition, they do not incorporate the recent scientific
findings that imply that there is a genetic element to homosexuality
(see The Gay Gene
and the book Queer Science: The Use and Abuse of Research into Homosexuality
by Dr. Simon LeVay (Boston: The MIT Press, 1996)). What determines
someone's sexual orientation is thus a very complex issue, and
only to base one's analysis of this phenomenon on a subset of
the theories must be considered highly irresponsible and unscientific.
There is a further problem here,
namely, that people that have been exposed to the rhetoric of
reparative therapists, who describe homosexuality in terms which
themselves convey negative attitudes (think about the words "disorder",
"disease", "pathology","cure", etc.),
may indeed have come to view their homosexuality as undesirable
simply on the basis of the terminology of the therapists.
Hence, reparative therapy may entail an element of self-fulfilling
prophecy, which should further make us question the accuracy of
their analysis.
As for the lives of homosexuals,
are they of lower quality than if they had been heterosexuals?
I personally do not see how anyone can make such a general statement.
First, the statement seems to follow from questionable psychodynamic
theories, which define homosexuality as inferior, in some
manner. Of course, since the statement is empirical, it should
also be supported by empirical studies and not merely by (often
non-falsifiable) theories. Second, how does one measure this type
of "quality"? Is it possible to conduct an empirical
study of this issue? Just consider a person who receives an enquiry
which asks him to report how happy he is in life. Is it not highly
probable that he would tend to answer such a question on the basis
of his present feelings, which randomly may vary from day to day,
rather than on some overall evaluation of his entire life? And
how can happiness be quantified and, more importantly, be compared
between persons? Fourth, how can one credibly identify correct
groups of heterosexuals and homosexuals, considering such things
as bisexuality and many people's wish not to identify publicly
as homosexuals. Conceivably, the conservative, stable homosexual
person is someone who, unlike more visible activists, are not
easily identified. Fifth, even if it was possible to conduct an
empirical study along these lines, which it most probably is not,
and even if it showed that the homosexuals responding were less
content with their lives than heterosexuals, then one still has
to question the relevance of such a finding. Might not such figures
reveal that social disapprobation is severely felt, and that reparative
therapy itself has contributed to a low self-esteem by categorizing
homosexuals in negative terms? Might not a responsible therapist
assist unhappy persons to feel better about themselves instead
of spending much longer periods of time trying to alter someone's
sexual orientation? (Perhaps that is not as pecuniarily lucrative…)
Someone might object that it is homosexuality
as such, not social attitudes, which forms the basis for unhappiness.
Again, such a claim must, to be credible, be supported by empirical
evidence. If this (homosexuality and unhappiness) is thought to
be a logically necessary relationship, it is most certainly incorrect.
To disprove claims of logical necessity, it suffices to present
one counter-example, and I wish to present myself as such. A person
who reads my personal story
realizes that I am at base a very happy person, and I am a homosexual.
(I was unhappy for a long period, but that was because of a detrimental
religious conviction that homosexuality was sinful and certainly
not because of homosexuality as such.) In fact, there is a disturbing
tendency for reparative therapists to ridicule those homosexuals
who claim to lead very rewarding lives (see, for instance the
review of Bruce
Bawer's excellent book A Place at the Table: The Gay Individual in American Society
(New York: Poseidon Press, 1993), which must be considered
a reflection of anti-gay ideology).
But let us consider a hypthetical
scenario, where social attitudes are perfectly neutral between
homosexuality and heterosexuality. How about the ethics of reparative
therapy then? In such a case, someone who wishes to change his
sexual orientation (perhaps from straight to gay!) would presumably
wish to do that on a strictly personal evaluation, that he thinks
he would be happier as a heterosexual. Since social and cultural
influences are ruled out, this wish would correspond to an honest
evaluation of homosexuality as undesirable. I do not consider
reparative therapy unethical in such a context - but it needs
to be stressed that the world will never be neutral in this manner,
and hence my conclusion from above stands: reparative therapy
is unethical. (However, as a libertarian, I do not wish to prohibit
it, legally, but I wish to warn people against it, such as in
this essay.)
III.
Thus far, we have considered the
issue "Is it desirable to change from gay to straight?"
and have found that the answer is "No". In this section,
the following issue will be addressed: "Is it possible
to change from gay to straight?" and the answer will be,
"No".
The promoters of reparative therapy
usually furnish two (related) arguments on this issue: (i) since
the psychodynamic theories state that homosexuality is the sole
result of certain childhood experiences and phenomena, and that
it, as such, is a disorder, it can be cured by means of regular
therapy; and (ii) there are empirical results which show that
people have, indeed, been able to change from gay to straight.
The first argument has been addressed
above, and the theories which are used are suspicious, to say
the least, both internally and in their neglect of research results
from the natural sciences (such as brain research, hormonal research,
genetic research, and twin studies). But what about the second
argument, that there are real-life cases of people who have gone
from gay to straight?
As stressed by the American Psychiatric
Association: " There is no published scientific evidence
supporting the efficacy of 'reparative therapy' as a treatment
to change ones sexual orientation. It is not described in the
scientific literature, nor is it mentioned in the APA's latest
comprehensive Task Force Report, Treatments of Psychiatric Disorders
(1989). There are a few reports in the literature of efforts to
use psychotherapeutic and counseling techniques to treat persons
troubled by their homosexuality who desire to become heterosexual;
however, results have not been conclusive, nor have they been
replicated. There is no evidence that any treatment can change
a homosexual person's deep seated sexual feelings for others of
the same sex. Clinical experience suggests that any person who
seeks conversion therapy may be doing so because of social bias
that has resulted in internalized homophobia, and that gay men
and lesbians who have accepted their sexual orientation positively
are better adjusted than those who have not done so."
So the scientific judgement is that
there is no basis for this claim of reparative therapists. But
still, reparative therapists claim that they have such a basis.
However, I can see at least two possible explanations for such
claims. First, it bears noting that sexual orientation is not
dichotomous; rather it is a continuous variable, which incorporates
various degrees of bisexuality. Hence, a quite plausible explanation
for many cases of "change" is that bisexuals with a
fairly strong attraction to the same sex, but with a possibility
for opposite-sex attraction, have led a life with primarily same-sex
relationships, but with some help, they have been able to "reorient"
themselves toward functioning sexually and emotionally with people
of the opposite sex. It may be that this bisexual element has
been latent and discovered by means of therapy. But this does
not imply that someone's sexual orientation has changed; in fact,
one would assume it impossible for someone exclusively homosexual
(with no latent bisexuality) to undergo a "change" of
the kind reported. Second, people are complex psychological beings,
and it is plausible to think that many people repress elements
of reality which they find unpleasant. (For instance, I have encountered
Christians who have thought that they had been healed from a disease,
which they eventually had to admit they had not.) People tell
themselves things, and a reparative therapist may very well "assist"
in such delusions.
If these two explanations are correct,
then reparative therapy is largely an illusion and, I would suspect,
damaging to the mental well-being of its patients, in the long
run.
IV.
But isn't this only about politics
and ideology? Don't the scientific mainstream in the Western world
say these pro-homosexuality things because they have been forced
to do so, or lured to do so, by a powerful gay lobby? Aren't the
biological research results suspicious, as they have often been
produced by gay researchers? To this I would like to say that
the scientific method is the only proven safeguard available against
false beliefs, and it entails a constant evolution of scientific
judgement, as more and more things get known. Old myths are displaced
by new findings, never absolutely certain, but more certain than
earlier hypotheses. And unlike reparative therapists, mainstream
researchers on homosexuality have had their results published
in scientific journals (again, note the preceding quote from the
APA, asserting that the scientific literature does not lend credence
to the ideas of reparative therapy) and accepted by the scientific
associations throughout the Western world. Of course, this development
is in line with those of us who happen to be gay and who think
that this in no way entails unhappiness or anything else of a
negative nature. But it is absurd to think that a "gay lobby"
could direct mainstream science in dozens of countries.
Let me turn this around and ask:
What is the ideological motivation of reparative therapists? Are
they inclined to work scientifically and without bias? Clearly
not, as is obvious from, say, the works of Charles Socarides.
(As an aside, one may further doubt the efficacy of reparative
therapy when one of its leading figures, the just-mentioned Socarides,
did not manage to make his own son heterosexual.) Not seldom,
conservative political tendencies emerge, along with Christian
influences. So if someone should be disregarded in this on-going
discussion on the basis of ideology, it is, in my view, clearly
the reparative therapists.
To me, it stands clear that reparative
therapy is not able to change anyone's sexual orientation; rather,
it may "help" in making people focus on a possible bisexual
element and in making people deceive themselves. In the long run,
this is not conducive to the well-being of a person.
V.
Let me conclude this discussion by
restating the important insights from above: that homosexuality
is as desirable or undesirable as heterosexuality and that it
is not possible to change one's sexual orientation. My recommendation,
to someone who is thinking about getting involved in reparative
therapy, is to save the time and the money and, instead, to get
in touch with decent homosexuals (like myself), who can illustrate
that life can really be good if you happen to be gay. And isn't
that what counts in the end?
Finally, I recommend the following
links: