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Gay ‘conversion therapy’: The danger of letting bias rather than evidence guide medical practice

REUTERS/Jason Reed
Marcus Bachmann, husband of Minnesota Rep. Michele Bachmann, has admitted that his clinics do conversion therapy, but only, he says, if the patient requests it.

Last week, the California state legislature became the first in the country to ban so-called gay conversion therapy for minors. Gov. Jerry Brown has until Sept. 30 to either sign or veto the bill. Or he can do nothing and let the bill’s provisions take effect Jan. 1, 2013, without his signature.

Also called reparative therapy, gay conversion therapy’s primary purpose is to change (“convert”) the sexual orientation of individuals. The practice has been thoroughly debunked as being not only ineffective, but also potentially cruel and dangerous. Anecdotal evidence suggests that conversion therapy can lead to anxiety, depression and even suicide.

Earlier this year, Dr. Robert Spitzer, a professor of psychology at Columbia University, made a very public apology for a 2003 paper he published in a prestigious medical journal in which he had claimed that conversion therapy could work on “highly motivated” individuals. He acknowledged that the paper’s methodology had serious flaws and retracted its findings.

Also earlier this year, the Orlando-based Christian group Exodus International, which had spent decades trying to “cure” gay people’s sexual orientation, announced that it would no longer engage in such efforts.

It’s unclear how many other religious groups are abandoning the discredited “therapy.” Here in Minnesota, undercover gay-rights activists claimed last year that  treatment clinics co-owned by Rep. Michele Bachmann and her husband, Marcus, engage in conversion therapy. Marcus Bachmann has admitted that his clinics do such therapy, but only, he says, if the patient requests it. 

The California ban, by the way, would apply only to licensed therapists. Religious and other groups would be free to continue “counseling” minors with reparative therapy.

Long and ugly history

Last Friday, in the wake of the passage of the landmark California legislation, Lindsay Abrams, an editorial fellow at the Atlantic Health channel, wrote a brief but fascinating article on the long and ugly history of conversion therapy. Her summary of that history, which draws heavily on a longer 2008 article by Timothy Murphy in the journal Gay and Lesbian Review, is a reminder of how much unnecessary suffering can result from medical “therapies” that are supported by biases rather than evidence.

Here’s an excerpt:

[Such efforts began] in the late nineteenth century, with a neurologist prescribing vigorous bicycling to “restore health and heterosexuality.” From there, methods for “curing” homosexuality get progressively stranger.

Multiple psychologists once recommended heterosexual intercourse — aided, in one case, by hypnosis and copious amounts of alcohol — as the most straightforward solution to conversion. Unfortunately, the other thing that wasn’t curable in those days was STDs. In the 1980s, William Masters and Virginia Johnson updated the practice through the use of “sexual surrogates.”

Meanwhile in Germany, replacing a patient’s testicles like faulty light bulbs caught hold. It sounds like a sick Nazi experiment, because it was. Dr. Eugen Steinach, whose practice of removing one testicle from a homosexual male and replacing it with one from a heterosexual donor was, insists one writer, “a logical culmination of his experiments on the sex glands.” Again, in the 1980s, this line of thinking was adapted to the idea that homosexuality begins in the womb, and a German researcher theorized that it could be prevented through the manipulation of sex hormones during pregnancy.

The same doctor who, in the 1950s, recommended brothels, also reported treating homosexuality by threatening patients with beatings. In 1963, aversion therapy went DIY, with the innovation of “a small electroshock device that would be suitable for home use.” But the award for most creative attempt at convincing gays that their sexual preference is gross goes to British psychologist I. Oswald, who in 1962 “inject[ed] a man with nausea-inducing drugs, repeatedly playing audiotapes of men engaging in sex and surrounding the man with glasses of urine.”

You can read Abrams’ article on the Atlantic website. You can read Murphy’s longer article in the Gay and Lesbian Review online.

Comments (20)

  1. Submitted by Thomas Swift on 09/05/2012 - 10:16 am.

    It’s true…

    Not every mental disorder can be cured. But most, if not all can be controlled successfully enough for the sufferer to lead a largely normal, productive life.

    But I find it highly offensive to suggest that sincere attempts by caring people to extend a helping hand to people suffering from disorders constitutes a “Long and ugly history”. That description would be far better suited to the thuggish tactics the small, but loud group of homosexual special interest groups, and their leftist supporters have engaged in so successfully the past two decades.

    • Submitted by Pat Berg on 09/05/2012 - 10:36 am.

      Homosexuality . . . .

      is not a mental disorder.

      • Submitted by Thomas Swift on 09/05/2012 - 10:46 am.

        You might benefit from some background research, Pat.

        http://behaviorismandmentalhealth.com/2011/10/08/homosexuality-the-mental-illness-that-went-away/#.UEdzF4LgEVI

        Helping educate confused people is one of my favorite things to do.

        • Submitted by Pat Berg on 09/05/2012 - 11:29 am.

          I’m not confused . . .

          but Dr. Hickey appears to be.

          He’s got some nice, circular logic going on there when he says “homosexuality actually does meet the APA’s present criterion for a mental illness! The criterion is: ‘… a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress…or disability…or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom.’” and then goes on to say “Although conditions for gay people have improved considerably since 1974, they are still subject to ridicule, discrimination, and violence.”

          So let’s see. Because people who consider homosexuality to be an aberration cause gays to be “subject to ridicule, discrimination, and violence” that then qualifies it to be classified as a mental illness when in fact it is those who view it as an aberration that are instigating the abuse that Dr. Hickey says then qualifies being gay as an aberration.

          My head hurts.

          But not over any confusion as to the status of homosexuals as perfectly normal people who simply happen to have a sexual orientation that doesn’t happen to be in the majority.

          • Submitted by Terry McDanel on 09/05/2012 - 05:19 pm.

            In response to Mr. Swift regarding Dr. Hickey’s logic

            In Mr. Swifts comment suggesting another link as “evidence” Dr. Hickey wrote:

            “An interesting aspect of this is that homosexuality actually does meet the APA’s present criterion for a mental illness! The criterion is: “… a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress…or disability…or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom.” (DSM-IV-TR, p xxxi) Although conditions for gay people have improved considerably since 1974, they are still subject to ridicule, discrimination, and violence.”

            An interesting comment at the bottom of the article spawned this idea. Being black and aware of your own race could also be defined as mental illness by this definition. Substitute “black” for “gay” above. I am certain in the history of the APA, this has been discussed. Perhaps it would be justifiable for the extraordinary percentage of black men in prison to claim SSI? Cynical but by it’s own circular logic, not unreasonable.

        • Submitted by Bill Gleason on 09/05/2012 - 12:08 pm.

          Mr. Swift apparently thinks that going on the web

          and finding a cite in favor of his position equals background research.

          Unfortunately, as we have discussed before Mr. Swift, it is possible to find on the web articles confirming the hypothesis that the moon is made of green cheese.

          Rather than quoting some “outliers” who support your by now minority opinions about homosexuality, why don’t we look at the position of some of the larger professional groups with an interest in the question?

          American Psychological Association
          link:http://bit.ly/a2CPqh

          Is homosexuality a mental disorder?

          No, lesbian, gay, and bisexual orientations are not disorders. Research has found no inherent association between any of these sexual orientations and psychopathology. Both heterosexual behavior and homosexual behavior are normal aspects of human sexuality. Both have been documented in many different cultures and historical eras.

          and

          The American Psychiatric Association removed homosexuality from its list of mental illnesses in 1973.

          link: http://bit.ly/PIQ9HT

          I don’t pretend to educate confused people, Mr. Swift. But I try to give them a fair chance to make some rational decisions by providing authoritative references.

        • Submitted by Bill Schletzer on 09/05/2012 - 01:06 pm.

          I looked at that weird web site Swift cites…

          …but had to get away from it for fear of being infected by the hate virus. The site seems to be dedicated to people who hate gays but can’t stop obsessing about them. Talk about protesting too much! Creepy.

        • Submitted by Robert Gauthier on 09/05/2012 - 05:17 pm.

          Wrong

          Homosexul orientation was removed from ICD codes as a disease more than a decade ago. And the earth is not flat because you can find someone that says it on a web site. You are entitled to your hateful opinions but do not confuse them with facts. Marcus Bachmann is just another nut job Republican willing to mine federal dollars for a living while claiming loudly that government is he problem. All to distract their loud slurping at the trough.

        • Submitted by Paul Scott on 09/05/2012 - 05:43 pm.

          you have got to be kidding.

    • Submitted by Lance Groth on 09/05/2012 - 05:07 pm.

      The Long & Ugly History of Denialism

      Here we see, once again, the misguided and downright dangerous ideation produced by science-denialism. Never mind that sexual orientation is genetically predetermined, those with genetic configurations differing from Mr. Swift’s are not “normal”, are “unproductive”, and are clearly “suffering” and in need of a “cure”. Those who argue otherwise are “thugs”.

      I personally couldn’t care less about Mr. Swift’s confusion, or how disconnected his cognition may be from objective reality, but when he and others seek to impose their fantasies on others through social policy, even to torture others with bizarre “therapies” in hope of turning them against their biological nature, regardless of the psychological cost, it rises to the level of becoming dangerous.

  2. Submitted by Bill Schletzer on 09/05/2012 - 10:51 am.

    Bigotry and hatred….

    ….are mental disorders but unfortunately not treatable without the subject’s cooperation.

  3. Submitted by James Hamilton on 09/05/2012 - 12:11 pm.

    You seem to have missed Dr. Hickey’s point, Mr. Swift.

    “The overall point being that the APA’s taxonomy is nothing more than self-serving nonsense. Real illnesses are not banished by voting or by fiat, but by valid science and hard work. There are no mental illnesses. Rather, there are people. We have problems; we have orientations; we have habits; we have perspectives. Sometimes we do well, other times we make a mess of things. We are complicated. Our feelings fluctuate with our circumstances, from the depths of despondency to the pinnacles of bliss. And perhaps, most of all, we are individuals. DSM’s facile and self-serving attempt to medicalize human problems is an institutionalized insult to human dignity.”

    While I may not agree with Dr. Hickey’s overarching conclusion, it’s a bit foolish to cite him as an authority supporting your claim that homosexuality is a psychological disorder. Of course, to know that you’d have had to read the entire piece.

    • Submitted by Pat Berg on 09/05/2012 - 12:36 pm.

      Good catch!

      I confess to having missed that!

    • Submitted by Thomas Swift on 09/05/2012 - 02:43 pm.

      I saw that James.

      Those are Dr. Hickey’s opinions, which I must say are probably the most well considered I’ve seen yet. He looks like someone who might pose an interesting challenge in a debate.

      But my thrust was to educate Pat against a foolish reliance on a thoroughly co-opted and discredited source like the APA. To that, Dr. Hickey provides well documented historical facts to support an argument, as opposed to an opinion.

      • Submitted by Dan Hintz on 09/05/2012 - 10:16 pm.

        Background research needed

        Hickey’s main idea is that homosexuality was removed from the list of mental disorders because of political pressure from the gay community. In making that argument in the article you link to, Hickey says that prior to the change “[t]here was little or no suggestion within the psychiatric community that homosexuality might be conceptualized as anything other than a mental illness that needed to be treated.”

        That is complete nonsense. The psychiatric community had been debating the issue since the beginning of the 20th century, and there were numerous published studies that found homosexuality is not a disorder. Hickey does not provide “well documented historical facts” to support his argument. Rather, he ignores well documented historical facts and just makes things up. If Hickey’s fiction is the most well considered thing you have ever seen, then you have failed your own background research requirement on an epic scale.

        In case you are actually interested in the background research you suggest others do, you can start with this link which covers some of the history Hickey omits. You will see why the average 10 year old with internet access would crush this guy in a debate.

        http://psychology.ucdavis.edu/rainbow/html/facts_mental_health.html

        • Submitted by Thomas Swift on 09/06/2012 - 09:37 am.

          Thank you Dan

          That was indeed an interesting link; did *you* read it? If so, I wonder if you really meant for me to do so because it is pretty thin gruel to support your position.

          For instance, here Freud defends the morality of homosexuality by describing it as an abnormal sexual development.

          “Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation, it cannot be classified as an illness; we consider it to be a variation of the sexual function produced by a certain arrest of sexual development.”

          And here, he suggests restorative therapy is a viable option!

          “”If [your son] is unhappy, neurotic, torn by conflicts, inhibited in his social life, analysis may bring him harmony, peace of mind, full efficiency WHETHER HE REMAINS A HOMOSEXUAL OR GETS CHANGED [emphasis ed.]….”

          Sandor Rado is quoted as stating that “homosexuality is a “reparative” attempt to achieve sexual pleasure when normal heterosexual outlet proves too threatening.”

          Finally, and most damning to your argument is this:

          “In 1973, the weight of empirical data, COUPLED WITH CHANGING SOCIAL NORMS AND THE DEVELOPMENT OF A POLITICALLY ACTIVE GAY COMMUNITY IN THE UNITED STATES [emphasis ed], led the Board of Directors of the American Psychiatric Association to remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM).”

          You have proven my point, Dan. And for that I thank you sincerely.

          • Submitted by Dan Hintz on 09/06/2012 - 10:21 am.

            I did read it

            And I am quite aware that it cites research and or opinions finding that homosexuality was a disorder and something that could be cured. And if you read it as well, you are aware that it also cites research and opinions finding that homosexuality is not a disorder. My point wasn’t that everyone agreed that homosexuality was not a disorder. Rather, it was to refute Hickey’s false statement that “[t]here was little or no suggestion within the psychiatric community that homosexuality might be conceptualized as anything other than a mental illness that needed to be treated.” That, contrary to Hickey’s statement, whether or not homosexuality was a disorder was something that had been actively debated in the pyschiatric community for decades. The difference between what you cited and what I sided is this: You cited a source that deliberately misrepresented the facts and the arguments on the other side of his position. I cited a source that included all the facts and arguments on both sides.

            As far as proving your point, I won’t claim that politics did not play a factor in changing the DSM at that time. But contrary to Hickey’s argument, the change was supported by “the weight of empirical data” – you know, the part of the quote from my link that you did not put in bold. Sometimes, evidence is not enough, but in this case, it certainly was there.

            • Submitted by Thomas Swift on 09/06/2012 - 10:47 am.

              Fascinating advances in science…

              Dan, I was completely unaware that science had proved that political pressure was a valid data point.

              Also, empirical research includes experimental and observational data. Since I’ve never seen a peer reviewed report citing the results of experiments into the causes of homosexuality, it suggests that the APA is relying on it’s observations, which as we both acknowledge, are influenced by political pressure.

              If that satisfies your definition of the path to a rigorous, logical conclusion so be it.

      • Submitted by James Hamilton on 09/06/2012 - 09:28 am.

        I’ve always wanted to learn

        to pedal backwards, Mr. Swift. Thanks for the lesson.

        By the way, it’s worth noting that nowhere does Dr. Hickey say that homosexuality is a psychological disorder, in his opinion or in anyone else’s.

  4. Submitted by Ray Schoch on 09/05/2012 - 06:43 pm.

    A “…foolish reliance”

    “…on a thoroughly co-opted and discredited source like the APA…” Do you mean the APA, the professional organization most likely to have a reasonably accurate view of the scientific rigor – or the lack thereof – of studies that focus on this issue, has been “co-opted” and “discredited?”

    Pray, tell us, Mr. Swift… Co-opted by whom? Discredited by whom? And equally important, what more scientifically-reliable sources should we be using for our own analyses of these issues?

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