Going straight
Revered by the religious right and bolstered by a supposedly scientific theory, a new wave of therapist-gurus claim they can 'cure' homosexuality. Their success rate is hotly contested. Decca Aitkenhead joins a rally of would-be converts in Nashville.
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"There is no such thing as a homosexual," the chief speaker, a clinical psychologist called Dr Joseph Nicolosi, assures his audience. "Everyone is heterosexual. Some of you may have a homosexual problem. But you are still a heterosexual. 'Homosexual' is simply a description of a psychological disorder, prompted by an inner sense of emptiness. This," he reminds them, "by the way, is non-religious, non-political information. This is scientific information."
Homosexuality has not been classified as a mental illness in America for more than 30 years. It was removed from the national register of mental illnesses, the Diagnostic and Statistical Manual of Mental Disorders (DSM), in 1973, following pressure from gay activists. Nearly 20 years later, Nicolosi founded an organisation for psychiatrists and psychologists who still rejected that 1973 decision, and believed homosexuals could and should be cured. As president of the National Association for Research and Therapy of Homosexuality (Narth), Nicolosi devised a programme of reparative therapy - sometimes known as conversion or reorientation therapy - and built up an international network of therapists who provide this treatment.
It is not an insignificant network. Narth's membership includes a former president of the American Mental Health Counsellors' Association and university clinical professors of psychiatry Charles Socarides, Dean Byrd and Benjamin Kaufman. Along with Drs Jeffrey Satinover, Richard Fitzgibbons and Irving Bieber, all have published or contributed to books about reparative therapy, and claim that at least a third of all clients can be completely cured of their homosexuality.
Their views didn't enjoy a great deal of credibility in the 1990s. Sexual reorientation had traditionally been an evangelical idea found in ex-gay ministries, who preached that homosexuality could be prayed away. Most mental health organisations took the view that reparative therapy was no more clinically effective, still less appropriate, than a prayer.
Then something happened that Nicolosi and his associates could not in their wildest dreams have hoped for. To the gay activists involved in the 1973 campaign it was unimaginable, but to the families of boys such as Drew Sermon, it is news to be clung to like a life raft. The very psychiatrist who led the removal of homosexuality from the DSM in 1973 announced, in 2000, that he was going to investigate the success rate of reparative therapy. Dr Robert Spitzer, by then a senior professor of psychiatry at Columbia University, wanted to know whether it was possible for homosexuals to change. Could therapy turn gays straight? Late last year, Spitzer's study was published. And his answer was: yes.
Spitzer found 274 men and women who claimed to have changed their orientation from gay to straight, thanks to therapy, and he interviewed them. In 74 of these subjects, the only change Spitzer could identify was their decision to call themselves straight, or to stop having sex, and these he rejected from the study. He found that all of the remainder - 143 men and 57 women - had changed to some degree.
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Another spoke to me from Washington DC. When Richard Cohen first sought help in the 1970s, therapists told him to accept the fact that he was born gay. "I knew that wasn't true. I just knew it in my gut." Then a religious group told him to get married. "I was told, find the right woman and she'll straighten you out. Well, I did, and she didn't. We were both looking for the same thing - a good man." But, after therapy, Cohen "came out straight". His marriage prospered, he had three children, and "my wife certainly isn't the only woman I'm attracted to!"
How had it happened? Reparative therapy is based on a theory of a child's early rejection by the same-sex parent. It applies equally to lesbians, but the literature tends to focus on men and states that homosexuality begins when a young boy experiences his father as cold or hostile. To protect himself from the pain of rejection, he develops "defensive detachment" - he rejects his father in retaliation. But, in doing so, the boy rejects masculinity, and this leads to a gender identity disorder. The little boy, having spurned masculinity, finds he cannot be a real boy.
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Two New York psychologists carried out another study of reparative therapy at the same time as Spitzer, and reached the opposite conclusion. "We interviewed 182 people who tried very hard to change," Dr Ariel Shidlo told Newsweek. "The stakes were really high for them. Some really thought that if they didn't change, they would literally find themselves in hell... And they still failed."
"Spitzer?" Besen says. "I just don't understand the man. I told him, if there is one thing we know about these people, it is that when they say they've changed, they haven't." He shrugs, as though worn out with disbelief. "C'mon. He had John Paulk in his study, for chrissakes."
Spitzer sounds fairly worn out as well. "If I were in my 30s," he says drily, "this is not something I would advise somebody to do. It would not advance their career." He has been condemned as a bigot, and claimed as a cheerleader by the religious right. Wary of misrepresentation, he tries to clarify once again the purpose of his study, and what he believes it proved. It was very straightforward, he sighs. The received scientific wisdom was that sexual orientation never changed. He found people who said theirs had. He asked them questions designed to test their credibility, and found that for a significant number it had changed to a significant degree.
"Yes, I think change is probably extremely rare, otherwise it would not have taken so long to find the participants. And, yes, the change I found was seldom from one extreme to the other. But nevertheless, there was change. And that seems to me to be a worthwhile discovery, isn't it?"
No one has ever tested the efficacy of gay affirmative therapy, Spitzer points out. If clients told a researcher that it had worked for them, would we disbelieve them? No. When a homosexual says he was emotionally damaged by reparative therapy, gay activists do not doubt his word.
"So," Spitzer asks, patiently and deliberately, "why assume he is lying when he says it helped?"
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Is it OK? "Ex-gay" is a wholly unambiguous expression. The message at Love Won Out is unequivocal: you can be cured. The discrepancy between these promises and what reparative therapy's own chief architect has just conceded seems startling - and for the APA it is not OK at all. The APA warns that reparative therapy can be deeply harmful, because a client who is fed false promises may experience his own failure to change as a shameful personal indictment. Guilt, depression and suicide can be the disastrous consequences of unsuccessful therapy. "Those who have integrated their sexual orientation into a positive sense of themselves," it maintains, "function at a healthier psychological level than those who have not."
In a peculiar way, the debate has muddled liberal and conservative vocabulary, until everyone's role is reversed. Besen was far and away the most straight-acting man I met in Nashville, though some of the ex-lesbians at Love Won Out would give him a run for his money in the butch department. Gay activist groups such as the Human Rights Campaign want to see reparative therapy banned, but the ex-gay movement appeals to homosexuals' right to freedom of choice.
"People have a right to choose to live as a homosexual, or to come out straight," argues Cohen. "It's a matter of choice; they should have the chance. I'm not anti-anything. I'm pro-possibility, pro-choice." And ex-gays have appropriated the old gay activists' perennial plea on behalf of young homosexuals everywhere, for "the truth".
