In part 9 of our series on the trial of the Southern Poverty Law Center against the small non-profit organization JONAH, Laura Haynes, PhD, looks into the question whether the psychodynamic approach has been debunked as the SPLC claims in its report of May 2016; she will also demonstrate the scientific evidence that psychotherapy works, and she analyzes the heavily marketed ‘harm’ issue, proving that there is no sound scientific basis for the dissemination of the extremists’ hysterical rumors.
1. Childhood abuse can contribute to same-sex attractions
Have theories of sexual abuse and psychodynamics as factors in the origins of same-sex attractions origins been debunked?
The matter of whether sexuality can be an outcome of childhood trauma is not as settled as the SPLC and some organizations would like everyone to believe. The APA Handbook on Sexuality and Psychology confirms “associative or potentially causal links” between childhood sexual abuse and the possibility of having same-sex partners (Mustanski, Kuper, and Greene, 2014, pp. 609-610).
Remarkably, a position has too often been presented that trauma and painful experiences can affect most every aspect of human experience except sexual orientation. Astonishingly, sexual orientation is uniquely and miraculously spared.
But the APA Handbook confirms
“One of the most methodologically rigorous studies in this area used a prospective, [30 year] longitudinal case-control design. It found that men with documented histories of childhood sexual abuse had 6.75 times greater odds than controls of reporting ever having same-sex sexual partners….The effect in women was smaller and a statistical trend (p = .09).” (Wilson & Widom 201 reported in Mustanski, Kuper, and Greene, 2014, vol. 1, pp. 609-610).
Many individuals have reported that they experienced sexual abuse and subsequently experienced same-sex attraction and behavior that they felt did not represent their authentic self, and through therapy that treated the trauma and their unwanted SSA, they experienced a significant and meaningful shift in their SSA. Should such individuals be able to have the therapy they desire? Yes, they should. To deny them would be harmful and ineffective.
But that denial of therapy is exactly what the SPLC is willing to perpetrate for political purposes. What kind of an organization tries to deny therapy to victims of sexual abuse, some of whom are suicidal?
The SPLC claims theories that relate psychodynamic theories or psychopathology to SSA for some individuals have been debunked.
The APA Task Force Report (2009) listed about ten references it considered to support the idea that psychodynamic theories or psychopathology cannot be connected to SSA. About three of those references were old and could not be found on EBSCO. One was a review of the Hooker publications, and the remaining six were original research.
The Hooker publications (Schumm 2012; Cameron & Cameron 2012) and the other six studies (Rosik 2012) all had the same flaws as the studies on SOCE that the Task Force had already so meticulously reviewed for flaws. In the case of the studies that were said to debunk that psychodynamic theories or pathology apply to same-sex attraction, the task force accepted the studies wholesale. Yet in the case of the studies supporting the safety and/or effectiveness of sexual orientation change efforts, the Task Force concluded that no conclusions could be made. The Task Force applied its standards inconsistently, and this is but one of the indications that the Task Force Report was biased. Whitehead and Whitehead found studies on psychodynamic factors did show effects (2013, Chapter 11).
Some individuals would like to decide for themselves whether their sexual orientation or gender identity (SOGI) represents an authentic or positive variation of sexuality for themselves.
No activist, professional organization, or legislature should decide that for others. All have a right to know that non-heterosexual sexual orientation and transgender identity shift spontaneously in most cases. Also, all have a right to know that therapy that is open to a goal of change is an option by which some, though not all, make a significant and meaningful shift in their sexual orientation or gender identity.
2. THERE IS PLENTY OF EVIDENCE FOR SIGNIFICANT AND MEANINGFUL CHANGE IN SEXUAL ATTRACTION/BEHAVIOR THROUGH THERAPY
In reality, there is a century of research and published reports of successful sexual attraction/behavior change through therapy (Phelen 2014, Phelen, Whitehead, & Sutton 2009) that the APA Task Force (2009) meticulously scrutinized for flaws. Although we do not use some of the older methods today, the studies do show that sexual attraction/behavior has changed through active interventions, countering claims that that never happens.
Dr. Alfred Kinsey himself, arguably the father of scientific study into homosexuality, helped more than 80 homosexual men make a “satisfactory heterosexual adjustment which either accompanied or largely replaced earlier homosexual experience,” and he specifically helped “a boy” (Pomeroy 1972).
Former APA president Nicholas Cummings initiated the 1975 APA resolution that homosexuality is not a mental illness (2011a). He saw “hundreds” of homosexuals “change and live very happy heterosexual lives” (2011b).
Dr. Robert Spitzer (2003), famous for his parallel resolution to remove homosexuality from the list of mental disorders in the American Psychiatric Association, published research showing almost 200 individuals made a substantial shift in their sexual attraction and did so safely.
Rebutting controversy such as claims of the SPLC, the editor of the prestigious journal that published the study confirmed the research was sound (Dreger, April 11, 2012).
Individuals should have the right to know that many, though not all, make a significant and meaningful shift in their SSA or TGNC, some of them assisted by therapy that is open to their goal of change. For those who do not change in therapy, not all regret that they tried; therapy has many benefits.
3. No harm has been found
The APA Task Force Report (2009) indicated there is no research on sexual-orientation change efforts for minors, so no research demonstrates harm. Therefore all legislation efforts aimed at ‘protecting’ minors from therapists, are not founded on any verifiable research. Therapists who are accused of all sorts of things, cannot defend themselves because there are no peer-reviewed documents to go on. There is just political spin, which gets exaggerated by every new speaker on the subject, using his or her imagination under great applause in front of an activist audience. NCLR activist Samantha Ames states on her website as she gloats about her Bornperfect campaign:
“Since then, our #BornPerfect campaign has helped protect thousands of kids across the country from practices linked to severe depression, substance abuse, and even suicide.”
These conclusions cannot be backed up by any research. The extremists (NCLR) even approached the UN in 2014 for the cause of ‘torture‘, spreading alarmist tales and prejudices, where no scientific evidence can back this up.
The Americans were given the benefit of the doubt by the UN, purely on the testimonies unfolded by the NCLR gay activists who flew to Geneva for their cause. The other side was of course not invited. We only heard about it after the UN had already made up its mind and merely a day later added licensed therapy to the Geneva Convention without further ado:
“This historic development comes a day after leaders from the National Center for Lesbian Rights’ (NCLR) #BornPerfect campaign, Samantha Ames and Samuel Brinton, testified before the Committee.”
4. Suicide not related to orientation therapy
Research about suicide among same-sex attracted adolescents is unrelated to therapy that is open to SOGI change (Ryan 2009). Therapy that is open to change seeks to help parents love their same-sex attracted (SSA) or transgendered or gender non-conforming (TGNC) minor and respect their child’s wish to have or not have therapy that is open to change.
5. All psychotherapy has an average rate of side-effects
Psychotherapy in general results in harm for 5-10% of adults and 15-24% of minors (Lambert, 2013; Lambert & Ogles, 2004). For anti-change therapy activists to justify their claims, they would need research that meets scientific standards and demonstrates that harm from therapy that is open to change significantly exceeds the general rate of harm and is prevalent. No such data exists.
The American Psychological Association Task Force Report (2009) found research for the safety and effectiveness of both gay-affirmative therapy (p. 91) and therapy that is open to change (pp. 3, 42, 83) to be inconclusive. Therefore, gay-lib is not at liberty to present it as a truth.
6. How harmful is Gay Affirmative Therapy?
The Task Force reported that no data for the safety of gay-affirmative therapy existed. Wild anecdotes claiming harm from therapy that is open to change that some opponents repeat should be carefully checked for validity.
The American Psychiatric Association (2009) could not conclude whether various therapeutic approaches for children—to change gender dysphoria, to affirm TGNC identity, or to “wait and see”—affected whether gender dysphoria persisted or changed, because no systematic longitudinal studies of gender dysphoric children exist (DSM-5, p. 455), nor can conclusions be made on the safety or harm of any of these psychotherapeutic approaches.
We do know the protocols for chemical transitioning of transgender adolescents and adults are based on research that is rated to be of poor and very poor quality. It is also known that puberty blocking hormones and cross-sex hormones (testosterone and estrogen) are associated with dangerous health risks (Olson-Kennedy & Forcier 2015, Hembree 2009, Moore, Wisniewski & Dobs 2003, FDA, WHO).
7. Equal ban on Gay Affirmative Therapy?
If lack of conclusive research evidence is grounds for labeling a goal of therapy like orientation therapy “harmful, quackery, snake oil, bogus, consumer fraud” and something that “should be banned,” then gay-affirmative therapy, transgender-affirmative therapy, “wait-and-see” therapy, and many other approaches to therapy should be given those same labels and be “banned.”
(to be continued)
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Association, pp. 451-459. See especially pp. 455-456.
American Psychological Association Task Force. (2009). Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation. Washington, DC: American Psychological Association.
American Psychological Association (2011). Definition of Terms: Sex, Gender, Gender Identity, Sexual Orientation. In The Guidelines for Psychological Practice with Lesbian, Gay, and Bisexual Clients, adapted by the APA Council of Representatives, February 18-20, 2011. http://www.apa.org/pi/lgbt/resources/guideli
Cameron, P. and Cameron, K. (2012). Re-examining Evelyn Hooker: Setting the record straight with comments on Schumm’s (2012) reanalysis. Marriage and Family Review, 48: 491-523.
Cummings, N. (2011a) When did sexual reorientation therapy begin to change in the APA? Interview. Convention, National Association of Research and Therapy for Homosexuality (NARTH), Phoenix, AZ. (Dr. Cummings criticizes the APA for ultra liberal bias leading to significant loss of membership.) See 0:44 min. through 1:44 min.; 6:44 min through 11:44 min. https://www.youtube.com/watch?v=S4O33IbTWQ8
Cummings, N. (2011b; published March13, 2013). NARTH Convention Dr. Cummings. Convention, National Association of Research and Therapy for Homosexuality (NARTH), Phoenix, AZ. See 29:20 min to 33:10 min. https://www.youtube.com/watch?v=BKxYBch2LVM. Cummings also submitted an affidavit in the case.
Diamond, L. (Published Dec. 6, 2013). Lisa Diamond on sexual fluidity of men and women, Cornell University. From Diamond, L. (Oct. 17, 2013). Just how different are female and male sexual orientation? Human Development Outreach and Extension Program. https://www.youtube.com/watch?v=m2rTHDOuUBw. Dr. Diamond is professor of psychology and gender studies at the University of Utah and the co-editor-in-chief of the APA Handbook on Sexuality and Psychology (published by the American Psychological Association).
Diamond, L. (2014) Chapter 20: Gender and same-sex sexuality. In Tolman, D., & Diamond, L. (2014) APA Handbook of Sexuality and Psychology, Volume 1. Person Based Approaches. Washington D.C.: American Psychological Association. Vol. 1, pp. 629-652.
Dreger, A. (April 11, 2012). How to ex an “ex-gay” study. Psychology Today Blog. http://www.psychologytoday.com/blog/fetishes-i-dont-get/201204/
Federal Drug Administration (FDA) (March 5, 2015). Drug Safety Communication issued for Testosterone products. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm161874.htm
Hembree, W. C., et al. (2009) Endocrine treatment of transsexual persons: An Endocrine Society clinical practice guideline. J Clinical Endocrinology and Metabolism.; 94: 3132-3154. http://press.endocrine.org/ doi/pdf/10.1210/jc.2009-0345.
Jones, S. L., & Yarhouse, M. A. (2007). Ex-gays? A longitudinal study of religiously mediated change in sexual orientation. Downer’s Grove, IL: InterVarsity Press.
Jones, S. L. & Yarhouse, M.A. (2011). A Longitudinal Study of Attempted Mediated Sexual Orientation Change. Journal of Sex & Marital Therapy, 37:5, 404-427.
Katz-Wise & Hyde (2014). Sexual fluidity and related attitudes and beliefs among adults with a same- gender orientation. Archives of Sexual Behavior. DOI 10.1007/s10508-014-0420-1.
Kleinplatz, P. & Diamond, L. (2014) Chapter 9: Sexual diversity. In Tolman, D., & Diamond, L. (2014) APA Handbook of Sexuality and Psychology, Volume 1. Person Based Approaches. Washington D.C.: American Psychological Association. Vol. 1, pp. 245-267.
Lambert, M. (2013). The efficacy and effectiveness of psychotherapy. In Michael J. Lambert (Ed.), Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change (6th Edition), pp. 169-218. Hoboken, NJ: Wiley.
Lambert, M., & Ogles, B. (2004). The efficacy and effectiveness of psychotherapy. New York, NY: Wiley.
Laumann, E., Gagnon, J., Michael, R. & Michaels, S. (1994). The Social Organization of Sexuality: Sexual Practices in the United States. The University of Chicago Press..
Moore, E. Wisniewski, A. & Dobs, A. (2003). Endocrine treatment of transsexual people: A review of treatment regimens, outcomes, and adverse effects. The Journal of Clinical Endocrinology & Metabolism 88(9):3467-3473. doi: 10.1210/jc.2002-021967. http://press.endocrine.org/doi/pdf/10.1210/jc.2002-021967.
Mustaky, B., Kuper, L., and Geene, G. (2014) Chapter 19: Development of sexual orientation and identity. In Tolman, D., & Diamond, L. (2014) APA Handbook of Sexuality and Psychology, Volume 1. Person Based Approaches. Washington D.C.: American Psychological Association.
Olson-Kennedy, J and Forcier, M. (November 4, 2015). “Overview of the management of gender nonconformity in children and adolescents.” UpToDate. http://www.uptodate.com/contents/overview-of-the-management-of-gender-nonconformity-in-children-and-adolescents?source=search_result&search=overview+of+the+management+of+gender+nonconformity+in+children+and&selectedTitle=1%7E150.
Phelan, J. (2014). Successful outcomes of sexual orientation change efforts (SOCE). Charleston, SC: Practical Application Publications. https://www.createspace.com/4575034; Kindle: https://www.amazon.com/dp/B00HMQAATG; NARTH Book store: https://www.narth.com/#!books-and-publications/clc
Phelan, J., Whitehead, N., & Sutton, P.M. (2009). What research shows: NARTH’s response to the APA claims on homosexuality: A report of the scientific advisory committee of the National Association for Research and Therapy of Homosexuality. Journal of Human Sexuality, 1: 1-121. Available at http://www.narth.com at the online bookstore.
Pomeroy, W. (1972). Dr. Kinsey and the Institute for Sex Research. N.Y. Harper and Row. Pp. 75-77.
Rosik, C. (2012). Did the American Psychological Association’s Report on Appropriate Therapeutic Responses to Sexual Orientation apply its research standards consistently? A Preliminary examination. Journal of Human Sexuality, 4:70-85. http://media.wix.com/ugd/ec16e9_14baa93db92c4778b24234626c680e7a.pdf
Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123, 346-352. doi: 10.1542/peds. 2007-3524.
Savin-Williams, Joyner, and Rieger (2012). Prevalence and stability of self-reported sexual orientation identity during young adulthood. Archives of Sexual Behavior 41:103-110.
Savin-Williams & Ream (2007). Prevalence and stability of sexual orientation components during adolescence and young adulthood. Archives of Sexual Behavior 36: 385-394.
Schumm, W. (2010). Re-examining a landmark research study: A teaching editorial. Marriage and Family Review, 48 (5); 465-489.
Spitzer, R. L. (2003). Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation. Archives of Sexual Behavior, 32(5), 403-417. doi: 10.1037/t02175-000.
Tolman, D., & Diamond, L. (2014) APA Handbook of Sexuality and Psychology (2 volumes). Washington D.C.: American Psychological Association.
Whitehead, B. & Whitehead, N.E. (2013). In, My Genes Made Me Do It! Homosexuality and the Scientific Evidence. Especially Chapter 12: Can sexual orientation change? pp. 231 to 235. Also, Chapter 11: Path analysis environment. Book available in online format. http://mygenes.co.nz/PDFs/Ch12.pdf
Wilson, H. & widom, C. (2010). Does physical abuse, sexual abuse, or neglect in childhood increase the likelihood of same-sex relationships and cohabitation? A prospective 30-year follow-up. Archives of Sexual Behavior, 37: 794-809.
World Health Organization (WHO) Classification of Estrogen as a Class I Carcinogen: http://www.who.int/reproductivehealth/topics/ageing/cocs_hrt_statement.pdf