Guest Post - Andrew Lilico on the Gay Change Bill

A guest post by Andrew Lilico.


Andrew LilicoPeter has noted that the Counsellors and Psychotherapists (Regulation) Bill contains two specific prohibitions on “gay to straight conversion therapies”.  First, the Bill mandates that a new code of ethics for registered counsellors, therapists and psychotherapists include a “prohibition on gay to straight conversion therapy”.  Second, whereas other violations of the code might include temporary or permanent removal from the register or other lesser disciplinary actions, a “breach of that section of the code relating to prohibition of gay to straight conversion therapy shall result in permanent removal from the register.

Such a bill raises a number of issues.  I wish to highlight just two.

First, the bill in its current form prohibits any and every “gay to straight conversion therapy”, including any such “therapy” that might be developed in the future.  Peter takes an interest in the question of whether the best scientific research suggests that current therapies are or are not effective in changing sexual orientation and whether they have any undesirable side-effects.  I shall leave that to him.  Another related issue is what would count as “conversion” here — would training someone in the control and directing of sexual impulses so as to facilitate heterosexual rather than homosexual sexual activity, but without purporting to take homosexual sexual impulses away, constitute a “conversion therapy” or not?  Again, although that is a very interesting and important question, I shall leave discussion of it for another time.

Instead, I shall assume, for the purposes of our discussion here, that we know what a “gay to straight conversion therapy” would entail and that no such therapy works at present.  Does that mean all such “therapies” should be banned?

If a form of therapy has been demonstrated scientifically not to work, could we not ban the non-working variants of the therapy on the straightforward grounds that those particular therapies don’t work without ruling out the possibility that some future therapy might work?  For example, through much of history there have been all kinds of treatments for the common cold.  For much of history, almost all of them have been quack medicines.  So suppose someone passed a bill saying “‘Cold cure therapies’ are banned.”  Wouldn’t that seem rather odd?  The fact that no such “therapy” had worked up to now wouldn’t mean no such therapy could be imagined, does it?

“But could any ‘gay to straight conversion therapy’ ever work, even in principle?” I hear someone ask.  I don’t see why not.  We know that people can be brainwashed in all kinds of ways.  For example, my grandfather was one of many New Zealanders captured by the Germans during the Second World War, but liberated by the Soviets.  He was not immediately released but, instead, taken to Soviet territory to be “re-educated”, whereafter (like many other returning soliders in similar circumstances) he was a communist for many years.  Zen Buddhist monks train themselves to eschew all kinds of appetites.  I would expect it to be possible to brainwash someone into believing he was a poached egg, if you really tried hard enough.

Just because we don’t believe that a “poached egg therapy” would be a good idea, doesn’t mean we should believe it couldn’t work.  Similarly, whether or not we thought it desirable for those of a homosexual sexual orientation to be “converted” to a heterosexual sexual orientation (whatever that might mean — and I repeat that that is not straightforward as a concept) is largely irrelevant to the question of whether we think such a “conversion” could be possible or whether any “therapy” to achieve such a conversion might work.  Like “poached egg therapy”, just because we believed a “gay to straight conversion therapy” worked it wouldn’t follow that we thought it a good idea.

That would seem to be the nub of the issue — not whether “gay to straight conversion” is possible, but whether it is sufficiently undesirable that we ban it.

But once we see that, such a ban can be seen as rather odd and authoritarian, bringing us to my second point.  Presumably we would ban even a working “poached egg believing therapy” because we thought it undesirable for folk to believe themselves poached eggs.  But why would we ban a working “gay to straight conversion therapy”?  Presumably not because we thought it undesirable for folk to be straight?  Why, then?  Is it because we thought it undesirable for folk to change their sexuality?

Let’s assume that sexuality were genetic and morally neutral, like eye colour.  Would we ban an operation that worked that allowed people to change their eye colour from blue to brown?  I assume not — if it’s just as good for eyes to be blue as brown then it’s surely ethically harmless if folk change their eye colour.  Maybe out there there would be some deluded individual that thought blue eyes wicked, and so changed them to brown for that reason.  Would the fact we thought such an individual deluded really be a good enough reason to ban the operation?  Similarly, just because some individuals that would seek out a working gay-to-straight conversion therapy would do so because they thoughts being gay wicked, would that really be a good enough reason to ban what one assumes is thought otherwise an ethically harmless conversion – like an eye colour change?

Suppose there were a working “straight to gay conversion therapy”.  As this bill stands, it would be banned to have a working gay-to-straight conversion therapy, but not to have a working straight-to-gay conversion therapy.  Suppose some man had a very close gay male friend, and decided he wanted to express his affection for his friend sexually but lacked the relevant appetites to make the most of that experience.  Should such a man be banned from taking up a working “straight to gay conversion therapy”?  I presume not.  Why, then, should a man that had a close female friend, whom he decided he wanted to marry and have children with, not be able to take advantage of a “gay to straight conversion therapy” if a working version of such a therapy were available?

Whether we like it or not and whether we think they ought to or not, some people would like to change their sexual orientation.  Perhaps it is the case at present that we have no technology to permit anyone to change their sexual orientation.  In which case, we could ban any purported such therapies on the grounds that they didn’t work.  But why should we outlaw any and every “gay to straight conversion therapy” that might be developed in the future, even if it worked?


Thoughts? Andrew is going to be reading this thread so will happily engage with comments.

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  • Alastair J Roberts

    It is interesting contrasting prevailing resistance to therapies designed to change sexual orientation with attitudes relating to sex changes. It would be fascinating to explore the implicit understanding of human identity and the political factors that account for the privileging of one but the proscription of the other.

    • http://www.anthonysmith.me.uk/ Anthony Smith

      I’ve been thinking exactly the same. Somewhere deep down, there’s a “real me” (my true gender, my sexual orientation), and my body and my will are basically obliged to fall into line with who I “really” am.

      • ed77

        You dangerous revolutionary you! ;)

  • James Byron

    This kind of detailed professional regulation isn’t a job for legislatures: law is too blunt and inflexible for the task. The bill interferes in what ought to be an internal matter. It looks more like moral grandstanding than anything else. Hopefully it’ll go the way of most private bills.

    • DavidRevd

      Exactly, We are all equal simply because we are all human – end of.

  • http://www.peter-ould.net Peter Ould

    Perhaps the Bill will be amended to ban “sexual orientation change” therapies. What then the hope for someone who is a paedophile who wants to diminish his sexual attraction to children? The law says no therapist can help him.

    • Guglielmo Marinaro

      I’m glad you have mentioned that, Peter, because it is a point that certainly needs to be ironed out, and I suggest that you bring it to the attention of your MP. It does NOT, however, affect the question of whether gay-to-straight (or straight-to-gay) therapy is legitimate – whatever one’s opinion on that may be.

      • ed77

        Which presumably you do accept as legitimate given that you agree Peter’s personal testimony isn’t a lie! ;)

        • Guglielmo Marinaro

          I accept that it is legitimate for consenting adults – entirely of their own free will, at their own discretion and at their own risk – to dabble in gay-to-straight therapy, straight-to-gay therapy, reincarnation therapy, pyramid therapy, crystal healing, the Bates System (“better sight without glasses”), bee-sting therapy, astrotherapy, or any other fringe activity that takes their fancy. I do not accept it as legitimate that any of those things should be practised under the cloak of accredited medical treatment, psychotherapy etc.

          • http://www.peter-ould.net Peter Ould

            What for you would be the standards for something to not be a “fringe activity”? What kind of research / evidence standards do you demand?

            • Guglielmo Marinaro

              I would look at it the other way round and say that it IS a fringe activity if the evidence that it does “what it says on the tin” – if you will excuse that appalling cliché – is either non-existent or poor, or if the claims made for it are simply untestable.

              • http://www.peter-ould.net Peter Ould

                So you would call most therapies “fringe activities”? CBT? Gestalt? Or can you point me to some research that shows that they work?

                • Guglielmo Marinaro

                  No, I know absolutely zilch about Gestalt therapy. I know only that Gestalt is the German for “figure” or “shape” – it comes up in some of the Schubert lieder that I used to sing, e.g. “Der Doppelgänger”. As for CBT, I haven’t a clue what that even stands for. As I said, if people want to try these things, whatever they are, it’s up to them. One ultra-sceptical lady whom I knew when I was a student claimed that she had once had a maid who suffered from a non-life-threatening but very troublesome and persistent complaint which no doctor had managed to cure – no, I don’t think it was housemaid’s knee, but I can’t now remember what it was – and that it vanished completely after she visited a spirit healer. That didn’t mean that she would advise anyone who was ill to have recourse to a spirit healer, and nor would I. But there is even less reason to recommend conversion therapy for something that isn’t a disease or a disorder.

                  • http://www.peter-ould.net Peter Ould

                    Do you think GPs should refer patients to therapists using CBT? On what clinical basis?

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                    • Guglielmo Marinaro

                      I don’t know. I have discovered that CBT stands for Cognitive Behavioural Therapy, but I know nothing about its efficacy. So I can’t give an opinion on that matter.

                    • http://www.peter-ould.net Peter Ould

                      But you’re willing to give commentary on the efficacy of SOCE? On what basis? Anecdote or something more?

                    • Guglielmo Marinaro

                      Well, Peter, I think that these two statements from Dr Joseph Nicolosi to Alan Chambers, then president of the now defunct Exodus International, say plenty. In April 2011 he spun the following yarn to Chambers:

                      “The point Alan is that you can get to a place where THERE IS NO MORE HOMOSEXUALITY. REALLY. [Emphasis in original expressed by underlining]

                      “You can actually get to a place where you can willfully [sic] think of an SSA image and have no bodily sensation.

                      “Why stop half way? Why not do further work and finish the task and have it completely behind you. consider [sic] this invitation, not only for your sake but also as a testimony of complete healing to truly motivate others.

                      “We have the therapeutic tools to get you over what ever [sic] SSA is remaining.”

                      In July 2012 he wrote to Chambers with a different story:

                      “Alan, what you are saying is untrue. I have never said I could cure someone completely from homosexuality. All my books make it quite clear that homosexual attractions will persist to some degree throughout a person’s lifetime.”

                      I would disbelieve in any other therapy whose foremost advocate and exponent issued contradictory statements like that, and so, I suspect, would most other people who had not renounced their critical faculty. I see no reason to make an exception for SOCE.

                    • http://www.peter-ould.net Peter Ould

                      Right, and the research to validate or invalidate Nicolosi’s position is what?
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                    • Guglielmo Marinaro

                      Well, you tell me. But it is up to those who make the claims to validate them. There is no burden of invalidation resting on the sceptic.

                    • http://www.peter-ould.net Peter Ould

                      Well let’s make a basic premise. No therapy should be supported by professional bodies unless it has what standard of evidence for it?

                    • Guglielmo Marinaro

                      That’s for professional bodies themselves to decide. Both the BACP and the UKCP have judged that the evidence for the effectiveness of therapy that attempts to change sexual orientation is not good enough for it to deserve their support.

                    • http://www.peter-ould.net Peter Ould

                      And what evidence would this be? Or do you not know? And if you don’t know why are you commenting on the issue of evidence as to whether SOCE work?
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                    • Guglielmo Marinaro

                      The only direct research that I know of which has been done is that of Robert Spitzer and that of Jones and Yarhouse.

                      Leaving aside criticisms of Spitzer’s methodology and his retractation of his original conclusion, the facts that it took him nearly two years to find 200 subjects in a country the size of America whose claims of orientation change were even prima facie convincing enough to merit further investigation, and that 40% even of those fell through on closer examination, indicate that deliberately engineered change of sexual orientation, if it ever occurs, is a very rare occurrence – and he said as much at the time. His admission a few years later, that he had come to suspect that some of the subjects in his study had been deceiving themselves and him, and his more recent admission that he now believes the methodology of his study to have been too seriously flawed to support even his original modest conclusion, weaken the evidential force of his study still further.

                      I have not read the Jones and Yarhouse study, only summaries of it and comments on it, including some of their own. It should be noted, however, that they themselves have said of it:

                      “These results do not prove that categorical change in sexual orientation is possible for everyone or anyone, but rather that meaningful shifts along a continuum that constitute real changes appear possible for some. The results do not prove that no one is harmed by the attempt to change, but rather that the attempt does not appear to be harmful on average or inherently harmful. The authors urge caution in projecting success rates from these findings, as they are likely overly optimistic estimates of anticipated success.”

                    • http://www.peter-ould.net Peter Ould

                      So you agree that the best evidence (a longitudinal study) shows that it works to some degree for some people and that on average it doesn’t cause any harm. And your reason therefore for opposing SOCE is what?

                    • Guglielmo Marinaro

                      Firstly, let us note that, as Dr Warren Throckmorton pointed out, the Jones & Yarhouse study was NOT an assessment of “reparative therapy” or of any other forms of psychological “conversion therapy”, and therefore, as Throckmorton rightly says, “cannot legitimately be used to say such therapies work.” Rather it was a study of the effects of “attempted religiously mediated sexual orientation change”.

                      How far the Jones & Yarhouse study showed religiously mediated change programs to be successful is debatable. Works “for some people” means for fewer than 20% (not of people who go through such programs, but) of the 98 whom they could persuade to participate in their study. (Although they originally wanted 300 participants, they had to settle for 98. Dropouts eventually reduced that number to 61.) One of their “successful” subjects later admitted that he had lied. Obviously, we have no means of knowing how many others may have done.

                      What does “to SOME degree” mean? According to Jones & Yarhouse’s press release, MOST of their “successful” minority – although I don’t know exactly what percentage – “did not report heterosexual orientation to be unequivocal and uncomplicated”. J & Y counted those who, in their words, “presented themselves as heterosexual success stories” as being “heterosexual in some meaningful but complicated sense of the term.” If some people are satisfied with that, then well and good, but the matter should not be misrepresented, and those considering pursuing programs of this kind should be told at the outset that this equivocal kind of “success” is the most that can be realistically hoped for, and that at least 80% of participants don’t achieve even that.

                      Adults must, of course, have the freedom to follow any religious programs that they choose, but there can be no question of using the mainstream health care system to practise or promote them. A spirit healer, for example, may be accredited by the Spiritualists National Union or by the Greater World Christian Spiritualist Association; he or she cannot be accredited by the General Medical Council.

                      Jones & Yarhouse do indeed claim that programs of this kind don’t on average do any harm, although I think I am right in saying – correct me if I’m wrong – that this was their general impression rather than a conclusion arrived at by actually investigating the question. However that may be, one kind of harm that is very seldom addressed is one to which I have recently drawn attention, and that is the time squandered from people’s lives to no useful purpose. Life is short. As Wayne Besen aptly expressed it, “Every day you waste on the ex-gay myth you will never get back.”

                    • http://www.peter-ould.net Peter Ould

                      So basically that’s a yes. Glad we got their in the end.

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                    • Guglielmo Marinaro

                      Peter, the Jones & Yarhouse study is of participants in ex-gay ministries affiliated with Exodus International. Others, who have read and analysed their study in depth, e.g. Dr Patrick M. Chapman, have made serious criticisms both of their methodology and of the conclusions that they have drawn from their data. As I have already made clear, I have not myself read the study, but my view even of the claimed success rate of under 20% cannot but be negatively coloured by three very important considerations:

                      (1) In April 2004 Alan Chambers, President of Exodus International, speaking at U.C. Berkeley, testified that he was “one of tens of thousands of people whom [sic] have successfully changed their sexual orientation.” He has recently admitted, however, that although he has been living a heterosexual lifestyle for years, his homosexual orientation has in fact never changed, and that change of sexual orientation, in men at any rate, is vanishingly rare, and he has given a ball-park estimate of the failure rate of attempts to change as “99.9%”. He has publicly apologized for all the misleading claims made by Exodus over the years, and Exodus has now closed down.

                      (2) John Smid was on the board of Exodus International for 11 years and directed Love In Action, Exodus’s largest and oldest-established “ex-gay” ministry, for NEARLY 22 YEARS. Many years ago, as an advert for the ministry, he put up a billboard in Memphis with his picture on it and the caption “I used to be a homosexual”. In 2010 he admitted that the implication of the billboard was a lie and that, although he, like Chambers, has long been living a heterosexual lifestyle, he has always remained homosexual. He said that during all his time in the “ex-gay” movement he never found a single homosexual man who became heterosexual through an Exodus ministry.

                      (3) The above are but two of the latest in a long line of people spanning nearly 4 decades who publicly proclaimed themselves “ex-gay”, and who founded and/or directed ministries to help others to “change” just as they allegedly had, but who finally told the truth and shamed the devil, confessing that their alleged change of sexual orientation was simply self-deception, and that none of the clients of their ministries changed either.

                      With regard to the matter of people wasting precious years of their lives on futile attempts to change their sexual orientation, it is of interest to note that 54 (over 50%) of the subjects in the Jones and Yarhouse study had, prior to their involvement with Exodus ministries, spent time going through other religious ministries aimed at changing their sexual orientation: 21 for between 3 and 5 years, 18 for between 5.5 and 12 years, and 15 for 13 years or more!

                      Comprehensive denials are always unwise, so I will not be foolhardy enough to make a dogmatic assertion that deliberate attempts to change sexual orientation NEVER succeed. But I will say that if one wants a judicious but generous estimate of the frequency of success, it would be “once in a blue moon”.

                    • James Byron

                      Well said.

                      Given the track record you describe, self-reporting of a shift in orientation by religiously-motivated people should be treated with skepticism.

                      I hasten to add that a general isn’t a particular. I’ve no reason to doubt Peter Ould’s testimony. That doesn’t hold for everyone.

                    • http://www.peter-ould.net Peter Ould

                      “Self-reporting … should be treated with skepticism” – No problems with that. So on that basis you agree with me that:

                      i) Shidlo and Schroeder is worthless
                      ii) The Jones and Yarhouse research on harm is very important (since it wasn’t just self-reporting, it was using standard harm indexing)

                    • James Byron

                      “Skepticism” isn’t the same as worthless. I just means findings should be evaluated with care. Reports become stronger when they’re against interest, for example.

                      Jones and Yarhouse isn’t worthless. It’s a valuable piece of research, which shows that, even when people are highly-motivated to change their orientation, only a minority report success.

                      More important than asking “Is change possible?” is asking “Why is it being sought?” Why seek to change something that isn’t, in itself, a disorder?

                    • http://www.peter-ould.net Peter Ould

                      So one shouldn’t help a client to stop being adulterous then according to your criteria, even if the client comes to you and seeks your help.

                    • James Byron

                      Apples and oranges — adultery isn’t a sexual orientation, it’s an action.

                      A better comparison would be, “Should a therapist help a lesbian or gay man deal with being celibate?” If, in the therapist’s clinical judgment, that would be best for their patient, OK.

                    • http://www.peter-ould.net Peter Ould

                      Au contraire James. It is the compulsion to the sinful activity (adultery, same-sex behaviour) that is the issue.

                    • James Byron

                      Not when the issue is changing a person’s sexual orientation. You’re not talking about controlling a “compulsion,” rather, altering who we’re attracted to. The first is behavioral, the second isn’t.

                      A better analogy would be dealing with adultery by making the adulterer gay or asexual.

                    • http://www.peter-ould.net Peter Ould

                      Are you suggesting that adulterers choose to commit adultery, that there is no sexual attraction involved?

                    • James Byron

                      No, of course not, but are you suggesting that it would be appropriate for a therapist to respond to adultery not by helping the adulterer to control themselves, but by attempting to shift their sexual orientation?

                      Because that’s equivalent to what reparative therapy attempts.

                    • http://www.peter-ould.net Peter Ould

                      Well, perhaps you need to be comparing it to things like the Sexual Identity Therapy Framework (http://sitframework.com/) school of therapy which helps individuals look at their sexual desires and decide what to do with them. In that sense it would approach homosexuality and adultery in exactly the same manner.

                    • James Byron

                      SIT isn’t about change, but acceptance within the parameters of a belief. As the controversy focuses on whether talk-theraphy, or other methods, can alter sexual orientation, that’s getting away from the point.

                      Since sexual orientation isn’t a disorder, mental health professionals aren’t looking for ways to change it, anymore than they’re researching ways to change handedness. Like handedness, as we don’t know how sexual orientation is formed, we don’t know if talk-theraphy can do anything to alter it.

                      This is a conflict between psychology and theology. As psychology doesn’t work within theological parameters, its priorities will be different.

                    • http://www.peter-ould.net Peter Ould

                      But for some they do want their sexuality to change enough to be able to function heterosexually, and they look at research like J&Y and see it might be possible. What do they do?

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                    • James Byron

                      If by “function heterosexually” you mean have a sexual relationship with a person they’re not sexually attracted to, I suppose that talk-theraphy might (just about) be able to help them and their partner to deal, although to call the situation unadvised would be an understatement of epic proportions. I wouldn’t blame any therapist who refused to get involved.

                      If instead you mean change sexual orientation to some degree, if they refuse to even consider the possibility that X source of religious authority might be wrong, and can’t live a life of celibacy or heterosexuality, they’re going to look for ways to change. Given what’s currently known, it’s not something that mental health professionals ought to be involved in (at least in a professional capacity), and the APA agreed as much in 2009. I suppose various religious groups are their best option.

                    • http://www.peter-ould.net Peter Ould

                      I don’t disagree with a lot of what you say. But the problem is that you present “gay to straight” as a straw man to beat ministries with. The reality of change is that it is often just a point or two on the Kinsey scale, but that is enough to help men and women function successfully heterosexually.

                      People offering SOCE aren’t expecting clients to walk out a Kinsey 0 (or at least most of them aren’t and if they are they should be avoided). What they are expecting is to see *some* kind of change in sexual identity and ability to sexually function in the desired way.

                    • jillfromharrow

                      Life is short. Well, yes, and can be up to 20 years shorter for practising homosexuals.
                      Tell that to Wayne Besen.

                    • Guglielmo Marinaro

                      Well, yes, Jill, and it can be up to 20 years shorter for anyone, EVEN including practising heterosexuals, if they behave irresponsibly and dangerously. Changing people’s sexual orientation isn’t the answer because, by and large, it doesn’t work – not in this actual, real world that most of us are living in, anyway.

                    • http://www.peter-ould.net Peter Ould

                      I’m also not that sure Paul Cameron’s research is that robust. Much better similar research puts the figure nearer five years.

  • David Hussell

    Is there any limit to The State trying to dictate to us how we should live our lives ? This control freak Government is getting an appetite for ordering our lives. It is most illiberal and bossy. The proposed banning of a whole class of techniques, not just ones proven to be dangerous in a non- judgmental way, is exceedingly authoritarian, and part of the determination to invert the moral order, a step towards an extremely controlling society. True choice is being attacked constantly, but it’s being done under the deceitful banner of “diversity”, and similar such mantras, where words have had all their true meaning sucked out of them. The democracy we had needs restoring !

    • ed77

      Short answer to your question is no, forced abortions in China possibly the most extreme example I’m aware of at the moment.

  • David Hussell

    Politicians are blundering about in exceedingly delicate areas of human behaviour, a persons identity. They have a very poor understanding about what they are doing, and the techniques they use, law, is far too blunt. They need to butt out ……

  • http://www.anthonysmith.me.uk/ Anthony Smith

    Peter/Andrew – I’ve not seen much in the news about this. Is it a private member’s bill? If so, does it have any hope of getting anywhere? (What’s the typical success rate of a private member’s bill?)

    • http://www.peter-ould.net Peter Ould

      It is a PMB so it may not go very far, but if it builds up steam it might.

      • ed77

        Something I can turn my prayers on when I can pause in praying for your health!

  • Martin Reynolds

    I have some sympathy with the views expressed here.
    Though I would like to point out that my experience of those who have been through these healings and therapies has been that folk are left more damaged at the end than when they began, sometimes catastrophically so.
    So, I understand the need to see something done.
    In conversations with the Royal College of Psychiatrists and others I have been pushing for the pressure to come from the Insurance Companies. If there were a class action against some group, say that advocated and practiced such therapies this would see things move along.
    From what I had understood, the medical insurance companies were moving to refuse cover. This was far more satisfactory than legislation, though I notice New Jersey has gone that way and it looks as if what they have done is just the tip of the iceberg.

    • ed77

      Either way Martin you have to decide on the questions posed that you have ‘some sympathy with’.

      I seriously question that these ‘folk [that] are left more damaged at the end than when they began’ are giving the whole truth in their account. I generally find that these guys are congenital liars when it comes to describing the therapies of extremely professional therapists. When they’re being honest they say ‘I was lying to myself’ to which my response is ‘well then no wonder, nothing changed for you, and no wonder you were damaged if you were lying to yourself and presumably your therapist as well!’

      In fact I consider the lies gay identified people tell about ‘reparative therapy’ etc as far more troubling a sin than any lust they might indulge.

      • http://www.peter-ould.net Peter Ould

        I’m not sure I would want to label people as “congenital liars” What I am clear about though is that we cannot validate or invalidate such therapy (and any harm it does or does not cause) on the basis of anecdote. That’s why I keep bringing us back to the research, and when it comes to a proper longitudinal study of these courses and their impact on people, there is only one game in town and that is Jones and Yarhouse.

        • ed77

          I just think it a bit rich when they argue that a therapy that seeks to bring people out of shame is labelled as ‘shaming’, and that a therapy which categorically states that suppression/repression will not work is labelled as encouraging repression/suppression, not sure what else you can call that apart from bare faced lies!

        • wondering_soul

          I might add, from the perspective of someone with no knowledge whatsoever of the scientific pros and cons of the issue, that this Government has emphasised on a number of occasions the importance it attaches to evidence-based policy. In which context, as a layman in this area, the very limited scale of high-quality peer-reviewed research there appears to be one way or the other on a matter of fundamental personal identities would make me very leery indeed of concluding that there was sufficient evidence to justify binding legislation. And for Private Members Bills to become law, the Government needs to cooperate in finding the necessary Parliamentary time.
          Leaving that point aside, even if the evidence were clear, I find it the idea that Parliament should seek to define professional standards in this way worrying. MPs are hardly the right people to decide what surgical interventions are or are not professionally valid. What is the fundamental difference about psychological interventions?

      • Guglielmo Marinaro

        What exactly did they say that they were lying to themselves about?

  • James Byron

    Instead of therapy to alter sexual orientation, why not therapy to alter the belief that gay sex is sinful? Challenge the framework that creates the problem.

    If a belief impairs function and self-worth, “disorder” is a fair description. People can change their beliefs without ill-effect. Therapist and client could work through how beliefs are formed, their basis, and how they should be tested and evaluated.

    A belief that gay sex is sinful is rooted in a source of authority, whether scripture, tradition, or both. “The Bible condemns same-gender sex” presupposes that the Bible is authoritative. How did this belief form, what role did social pressure and nurture play in its formation, and is it a reasonable belief to hold?

    Instead of, “How do I change my orientation?” therapist and client explore, “How do I change my mind?”

    • Fiddlesticks

      ‘Instead of therapy to alter sexual orientation, why not therapy to alter the belief that gay sex is sinful?’

      Don’t we already have that?

      • James Byron

        Yup, which is why it should be addressed when reparative therapy is raised.

        Unpicking beliefs is, as you say, a therapeutic norm. If a person goes to a therapist with body dysmorphic disorder, no reputable clinician will pack them off to a cosmetic surgeon. Instead their negative belief will be examined and worked through.

        If a belief so conflicts us that it impairs our function, the conflict needs to be removed, something done by removing or modifying the underlying belief.

        • Fiddlesticks

          Client: ‘I had an abortion when I was 17. At the time it seemed like I had no choice, but now I think what I did was very wrong.’
          Psychiatrist: ‘So you have this belief that abortion is wrong and it’s making you very unhappy. Let’s unpick this belief ….’

          Client: ‘My wife and I have been having problems in our marriage for quite a few years now. I feel like she’s a stranger. I have a work colleague that I get on with really well. I can’t get it out of my head that I made a mistake – maybe married too young – that this other woman is the person I would have married if I’d been free. But I made a promise to stay with my wife.’
          Psychiatrist: ‘So you have this problem that you think that adultery is wrong …’

          Client: ‘I’ve been happily married for 10 years and have 3 children, but I have really strong feelings for other women. I’ve felt this way since I was a teenager. Sometimes I wonder if I made a mistake getting married, but I love my husband. Am I not being true to myself?’
          Psychiatrist: ‘So you have this belief that homosexuality is wrong and it’s preventing you from being the person you really feel that you are …’

          You see, to my mind, this type of ‘therapy’ is just as manipulative as conversion therapies.

          • James Byron

            Examining a belief with a client isn’t the same as giving moral instruciton. Therapists aren’t priests. Rather, therapy gives clients the tools to understand themselves better and make informed decisions.

            I haven’t suggested that a therapist tell a client, “Biblical authority is baloney, it’s great to be gay, get ye to a pride parade!” Rather, I suggested that they help the client to examine *why* they hold the beliefs they do, just as a therapist treating BDD works through body image with a patient.

            People can and do assume beliefs like biblical authority for social and cultural reasons. Could be that a therapeutic examination reinforces a belief. That’s down to the client. All therapy does is give them the tools.

            How is that “manipulative”?

            • Fiddlesticks

              It rather depends on how the question is asked. When you turn up in therapy you’re feeling rather down and vulnerable. Having your whole belief system shaken might not be the thing you need from your therapist – especially if done in a very leading way designed to make you feel like there’s something very wrong with you for having these values – might be the last thing you need. About as unhelpful as having someone plant the idea in your head that you must have been abused as a child, or some other phantom problem that you don’t actually have (which is my main reason from being sceptical about ‘conversion therapy’).

              I may be incorrect, but I believe that the directions to those working in the health professions is to tread carefully around people’s religious beliefs, as these are often a source of comfort and security, rather than heading straight for the jugular ‘your belief system is making you sick and is the cause of all your problems’. You’re meant to be helping people work through their feelings about themselves and their relationships, not running a philosophy class.

              • James Byron

                Thing is, in these circumstances, beliefs aren’t “a source of comfort and security,” they’re the cause of the problem.

                If a gay person was comforted and secured by a belief that expressing their orientation is a sin, they wouldn’t be in therapy. For those who do seek help, if they can’t “change” their orientation, the options are either to help them to change their beliefs, or to send them away.

                Ultimately the client makes the decision. If they want to walk, they can walk. A therapist can only lay out their options, explain the process, and give a realistic assessment of what they can expect.

                You’re right to say that patients are vulnerable. Therapy is often a painful, frightening process, gone through because the alternative is worse. What alternative would you suggest?

                • Fiddlesticks

                  There are a *heck* of a lot of assumptions in there. For one thing, I didn’t say the client was conflicted because they thought homosexual relationships were sinful. The scenario was someone who wanted to stay with her husband, but was confused about the strong feelings she had for other women. However, perhaps I’ll let someone closer to the situation pick this up, as I don’t know very much about conversion therapy and there’s only so far you can go with hypotheticals.

                  Like I said, I’m not really that fussed on the type of therapy that aims from the outset to do something as specific as change someone’s sexuality. I just know a lot of cases where someone’s psychiatrist has tried to persuade them to have sex at a time in their life when they were feeling vulnerable and alone and, really, having sex would have been a bad idea. I know that’s a slightly different topic, but it’s made me wary of the whole claim of the psychiatric profession to be scientific and unbiased, although in some areas (like CBT) they can be very good.

                  • James Byron

                    OK, to address the hypothetical of a happily married lesbian who develops feelings for another woman: a therapist could work through the feelings, explore consequences with the client, and so on. Ultimately it’s for her to decide whether she wants to initiate divorce proceedings. Therapists aren’t there to make decisions for you.

                    The clinical recommendation from the American Psychological Association’s report on reparative therapy* can be summed up as “help client to change their beliefs,” even if the change is as modest as coming to terms with their sexual orientation. It’s chapter six, on page 54 of the link, and has specific info on religion.

                    * http://www.apa.org/pi/lgbt/resources/therapeutic-response.pdf

                    • Fiddlesticks

                      That’s my point. There’s a big difference between helping a client come to a realistic view on the likelihood of whether or not they’re going to morph into this completely other person with a whole different personality and attractions, and telling them ‘you’ll be happy when you find a nice girl to settle down and marry and have five kids’ or ‘all you need to do is find a nice same sex partner and be proud of who you are’. I don’t think it’s a psychologists job to be so directional about somebody’s life.

                    • James Byron

                      A therapist’s job is to seek the best possible outcome for their client. That’s the direction in which they ought to be traveling. Goals should be discussed and negotiated.

                      If a therapist says, “You’re gay, that’s not changing, that’ll be $200,” the most charitable description would be unhelpful. Anything beyond that assertion will look into beliefs.

                      It may be, at the end of it, that the client decides that biblical authority is non-negotiable, and they’re a lesbian/gay man called to a life of celibacy. If that works for them, well, that’s their choice, but it should be a genuine choice, not something imposed by upbringing, circumstance and socialization.

                    • Fiddlesticks

                      ‘It may be, at the end of it, that the client decides that biblical authority is non-negotiable, and they’re a lesbian/gay man called to a life of celibacy. If that works for them, well, that’s their choice, but it should be a genuine choice, not something imposed by upbringing, circumstance and socialization.’

                      I couldn’t agree more. But that’s not what you said at the beginning. You said ‘why not therapy to alter the belief that gay sex is sinful?’.

                    • James Byron

                      I also said, “Therapist and client could work through how beliefs are formed, their basis, and how they should be tested and evaluated.”

                      My comment applied to people who want to change their orientation, which excludes those content to be gay and celibate. If someone can’t bear the conflict of being gay and holding conservative religious beliefs, changing beliefs is a better option than seeking to change orientation.

                      In Jones and Yarhouse, a study of self-selecting people motivated to change, conducted by sympathetic researchers, only a small minority of participants (11 from 98) completed and reported “heterosexual adjustment.” In the best-case scenario, 11% can expect orientation-change. Even if those reports are accurate, the prognosis is bleak. If they’re inaccurate, it’s bleaker still.

                    • Fiddlesticks

                      Personally, I would not feel at all comfortable discussing with a secular therapist how ‘beliefs are formed, their basis, and how they should be tested and evaluated’. So this approach would be a big problem for me. Can’t speak for anybody else.

                    • James Byron

                      By “secular therapist” d’you mean “non-Christian therapist”? ‘Cause if so, there’s plenty of Christian psychologists and psychiatrists.

                    • Fiddlesticks

                      By ‘secular’ I meant someone who doesn’t have much understanding of faith or religion. I think a lot of well-meaning people in the secular world imagine that faith is either an abstract set of philosophical principles that can be challenged, or a kind of personal identity with which you can be flexible and creative. They really have no idea what they’re blundering into when they say things like ‘but surely you can find ways around that and still keep your faith – lots of people do.’

                      I would be much more likely to discuss romantic relationships/ feelings with a Christian psychologist/psychiatrist, but I’d hope they wouldn’t have an agenda to ‘alter the belief that gay sex is sinful’ while it’s still the official position of both the mainstream Protestant churches and the RC Church that it is sinful (although no more sinful than masturbation).

                    • James Byron

                      Depends which mainstream protestant churches you’re referring to: the Evangelical Lutheran Church in America, the Episcopal Church (Scotland and America), and various Lutheran churches in Europe don’t consider it a sin.

                      A therapist could work through questions of authority and obedience with a client. The desired result isn’t “covert patient to X theology,” but to make them more comfortable with themselves, however that’s achieved.

                      It’ll of course depend on the individual, but many could welcome an outside perspective. Not “find ways around that,” but exploring why the client thinks the way they do.

                    • http://www.peter-ould.net Peter Ould

                      Oh I think you’ll find that the official position of the Scottish Episcopal Church is that *all* sex outside of marriage is sinful.

                    • James Byron

                      Is it? The most recent statement I can find from them, issued in 2005, was that they “had never regarded the fact that someone was in a close relationship with a member of the same sex as in itself constituting a bar to the exercise of an ordained ministry.”

                    • http://www.peter-ould.net Peter Ould

                      Get them to define “close relationship”.

                    • James Byron

                      They’re not likely to, given the firestorm that’d follow, but they clearly don’t have an equivalent to the Church of England’s Higton motion, or ‘Issues in Human Sexuality.’

                      Beyond inference, is there a clear policy statement from the Piskies that says *all* sex outside marriage is sinful?

                    • http://www.peter-ould.net Peter Ould

                      Their website is suitably unhelpful (at least the CofE makes all its publications available online as free pdfs) but to the best of my knowledge they have never moved from the formal position of the traditional BIblical sexual morality.

                    • James Byron

                      I don’t think the Piskies take a legalistic approach to sexual morality, running through various acts to define what’s OK, and what’s forbidden. There is a sexual morality implicit in their liturgy, but SFAIK, that’s as far as it goes, and it leaves much potential to argue that monogamous same-sex relationships are acceptable in the sight of God.

                    • http://www.peter-ould.net Peter Ould

                      I think you’d be hard pressed to find any official position that varies from the traditional Biblical morality, but by all means correct me.

                    • James Byron

                      SFAIK, the Piskies don’t work in that way, issuing “official positions” on sex, like an Anglican magisterium. You and they appear to think in different terms.

                      The Pisky response to the Scottish Government’s marriage consultation merely said that same-sex marriage was outside their canons, but also raised the possibility that those canons might be changed in future.

                    • Fiddlesticks

                      If I thought my therapist had an agenda to alter my religious beliefs I would not feel at all comfortable about discussing questions of authority or obedience. I would feel like they were leading the discussion, not respecting me or my feelings, and taking advantage of the fact that I was feeling down and depressed. I would much rather discuss these issues with a close Christian friend that I trust. I think we possibly have quite a different idea about what good therapeutic practice should look like and that’s why this discussion is going round in circles.

                      BTW, I’d put money on it that when the Scottish Episcopal Church says that they have ‘never regarded the fact that someone was in a close relationship with a member of the same sex as in itself constituting a bar to the exercise of ordained ministry’ that they mean that they don’t assume that just because two unmarried priests have a very close relationship or are living together that the relationship is sexual.

                    • James Byron

                      In therapy, the client is sovereign. They can make it clear at the outset that X source of religious authority is a no-go area, and if the therapist refuses to work within those parameters, the client can go elsewhere.

                      Are you saying that sources of religious authority ought to be no-go areas regardless of the patient’s wishes? If not, provided the patient consents, I don’t see why they shouldn’t be discussed. There is the potential for coercion, whether intentional or not, but that goes for most anything in therapy, or for that matter, any interaction with a medical professional.

                      Regarding the Piskies — they’ve clearly avoided a legalistic definition of relationship. As their Primus said in the link, “We do not have a synodical decision like the Church of England has.” Given the mess the Anglican church is England has got itself into with legalism — absurd debates about what constitutes sex, pretending that gay relationships are “friendships,” and so on — the Scots are showing much good sense in refusing to go there.

                    • Fiddlesticks

                      What I’m saying is that therapy aimed at ‘altering the belief that gay sex is sinful’ is not going to be at all helpful for people who have already asked these questions (about authority etc.) and made up their minds to follow biblical/church teaching. So where are these people supposed to go if this is the only type of counselling on offer?

                    • James Byron

                      For people who have thought it through, something like SIT might be the way to go, although I don’t know how much research has been done into its efficacy.

                      There are plenty folks who haven’t thought it through, or at least, haven’t considered every possibility. Received beliefs, rooted in social acceptance, are potent things. Many people haven’t considered being a Christian who rejects biblical inerrancy, and the idea that it’s not as simple as “God condemns me” could be a liberation. As could the idea that they can exist in an affirming social environment.

                      The only reason not to at least raise these possibilities with a patient are theological, and as I’ve said, psychology isn’t bound by theological parameters.

                    • Fiddlesticks

                      Are you seriously saying that in the society we’re living in in the UK there are really people who haven’t thought to themselves ‘oh, maybe this tiny minority religion I’ve been brought up in that hardly any of my classmates/workmates practice is just wrong. Maybe I can just go with my inclinations and be in a same-sex relationship’?

                      As I said at the beginning, we already have plenty of gay-affirming therapy, not to mention gay-affirming groups, gay-affirming TV and films, gay-affirming literature, gay-affirming churches. So what is your point?

                      There are also so many false assumptions in your last comment that I don’t think you can possibly know any conservative gay Christians or much about what they believe. That’s the problem for many conservative Christians (gay or otherwise), they find that the medical profession has a lot of unhelpful perceptions about them and their beliefs so that visiting a psychologist can be a very alienating experience at times.

                    • James Byron

                      Of course people have thought about it in the general way you describe. Examining beliefs step-by-step, in a structured environment, is a clean different thing. That’s why so many fervent believers find their faith challenged, deconstructed, and perhaps reconstructed at seminaries.

                      We’re talking of people who *can’t* reconcile their beliefs and sexual orientation. If they could, they wouldn’t be seeking therapy, and it would be no one’s business but their own. This isn’t inducing a crisis to push a theological agenda. When they seek help they’re *already* at crisis point.

                      So what then? Offer them a false hope of change, try to acclimatize them to a conflict that they already find unbearable, or help them to reconcile the expression of their sexual orientation with their faith? Clinically, the last would be the strongest option, in that it removes the cause of distress, which is why the AMA recommended it.

                      If instead they find peace by accepting a life of celibacy, no one’s going to deny it to them.

                    • Fiddlesticks

                      Because a psychologist *isn’t qualified* to discuss these kinds of questions. I’m sure you and the APA mean well, but I’ve been through this type of ‘therapy’ where, instead of listening to you, your therapist tries to persuade you to change all your beliefs to fit in with what everybody else is doing and is very dismissive of your explanation that you can’t because of your faith because ‘lots of other people manage to reconcile their faith with sexual activity outside marriage’. It was one of the most alienating and unhelpful experiences of my life.

                    • http://www.peter-ould.net Peter Ould

                      I think that’s a terribly useful personal experience to share.

                    • James Byron

                      Absolutely, a light should be shone on bad practice, however good the intentions behind it may be.

                    • Fiddlesticks

                      We aim to be helpful. Though I’m beginning to despair of getting my point across with this one …

                    • James Byron

                      Therapy shouldn’t be about persuasion. If that happened to you, it was wrong. Attempts to persuade get our defenses up, make us feel attacked.

                      In my BDD analogy: a sufferer has of course been told, “You’re not ugly,” which bounces off. A good therapist wouldn’t persuade, they’d explore, in partnership with their client.

                      Qualification to discuss theological issues is a fair point: if a therapist is also trained in theology or philosophy, would that objection be satisfied?

                    • Fiddlesticks

                      It would rather depend on the background in theology or philosophy. Arguing philosophy or theology with someone coming from a very different perspective than you might be even more annoying than a well-meaning psychologist who just doesn’t understand what they’ve blundered into.

                      I agree with you that one of the big problems with ‘conversion therapy’ seems to be that often the therapist hears what they want to hear (i.e. ‘I want to stay true to my faith’, or, even worse, ‘I want to be straight’ or ‘I want to get married’) and just jumps right in with the conversion therapy without exploring the issue of motivation any further. It’s only later that the client realises that this wasn’t what they really wanted (which I wouldn’t say was the same thing as lying).

                      However, I would still say that exploring issues of motivation, expectation of change etc., is quite different from ‘therapy to alter the belief that gay sex is sinful’. Sorry to keep harping on about it, but those were the words that you used.

                    • James Byron

                      I did, and I stand by it, as it’s the optimum resolution, just as removing a negative body image is the optimum resolution of BDD.

                      Important thing is how therapy alters beliefs. It’s not by argument. Change has to come from the patient; a therapist can only facilitate that process. As you rightly say, reparative therapists are often agenda-driven, and the mistake shouldn’t be repeated.

                      Running with the BDD comparison, a sufferer’s beliefs about their body can be just as powerful as beliefs rooted in religion. If a therapist can try to change one belief, they can try to change another.

                    • Fiddlesticks

                      So you know what the optimum resolution is for somebody else’s life? You don’t really want to explore it with them, you want to pretend to explore it with them in order to lead them in the direction that you think is going to make them happy and try to convince them that this is entirely in keeping with their religion (a religion that you don’t believe in and don’t share)? And you don’t think that’s just a tadd paternalistic?

                      In my own case I realised that I had to stop obsessing over it and be grateful that I was free and single and had time to spend with friends – friends that i still have and that, in some ways, I need more than ever now I’m married. If I’d done what the psychologist said I think it very likely that it would have ended in heart-ache and gaining the reputation for being a tease and a hypocrite.

                      I’ve heard people say it before, and I agree, that psyhiatric therapy ‘works’ because it makes you realise that these people can’t tell you how to live your life and you’re better off finding your own way through and making your own bad decisions. Unfortunately, you have to go through the process of getting quite battered by their bad advice before you realise that.

                    • James Byron

                      The optimum resolution should be dictated by symptoms. Any healthcare professional could be accused of paternalism, in that they apply their training to diagnose a patient, and recommend a course of action. They aren’t neutral.

                      A person with BDD may be convinced that they need radical cosmetic surgery. Is it paternalistic for a therapist to examine and challenge that belief? Should they instead say, “OK, it’s your body,” and sign-off on surgery? If not, why is a belief in the sinfulness of homosexual expression different?

                      Any clinician should be wise to the dangers of abusing their power, especially inadvertent abuse, but that’s not grounds to make a patient’s beliefs untouchable.

                    • Fiddlesticks

                      But why assume that the distress is being caused by the person’s beliefs? Could it not be caused by the messages about sexual fulfillment and happiness that come from our society? Could it not be caused by loneliness in an urban living situation? Could it not be caused by receiving hate mail telling you that your marriage is a sham and that your children are the result of an unnatural union? Could it not be caused by being told that you’re sick and repressed and brain-washed? Could it not be caused by feeling that you don’t live up to some ideal of manhood or womanhood coming from your church or society.

                      The difference is that believing you’re ugly is a belief/feeling about yourself. Entering into a sexual relationship – heterosexual or homosexual – is an action – a decision that’s going to change the whole course of your life. Just like abortion is an action, or divorcing your husband/wife is an action. It’s not like skin colour or the colour of your eyes that you have no control over.

                    • James Byron

                      It’s not based on assumption, it’s based on the available evidence.

                      The 2009 APA report recommends affirmation, the success of which is illustrated by the peace brought to the gay and lesbian teens in this Rolling Stone piece.

                      Once the principle’s accepted that changing beliefs is a legitimate therapeutic goal, the option can’t be easily dismissed as a response to a conflict between faith and homosexual attraction. The fact that it’s a moral question doesn’t, by itself, invalidate its clinical effectiveness.

                    • Fiddlesticks

                      Statistics not really my area, so wouldn’t want to argue with the APA report. All I know is that I’d rather my psychologist was interested in me, rather than trying to make me fit into a case study or a statistical model. Sometimes these things can be helpful, but quite often you come away feeling that something’s not quite right because you just don’t quite fit the model.

                    • James Byron

                      Of course. Talk-therapy is personal above all else. If the relationship doesn’t work, no progress will come, let alone a cure.

                      Evidence and best practice informs the therapist’s work, but shouldn’t be used to objectify their client.

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