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Cuius Culpa?

When George Rekers began treating four-year-old Kirk Murphy, Rekers was only 22 years old and had only earned his bachelor's degree a few months earlier. How was this allowed to happen?

Jim Burroway

June 7th, 2011

One of the more surprising aspects of this investigation has been the question of who was ultimately responsible for Kirk’s treatment at the UCLA Gender Identity Clinic’s experimental treatment program for children. Before the Murphy family decided to come forward, the answer seemed so obvious that few thought to question it. All of the published literature about “Kraig,” Kirk’s pseudonym in much of the professional press, pointed to George Rekers, who by 1975 was identified as the program’s director and main point man.1 Rekers eagerly claimed credit for Kirk’s therapy in at least 20 different articles, chapters and publications during the course of his career. He described Kirk as  “the first experimentally demonstrated reversal of a cross-gender identity with psychological treatment,”2 almost as if that were his pet nickname for his young patient. “No other therapeutic intervention approach in childhood has been experimentally demonstrated to have this same effectiveness,” he bragged.3 Rekers even proclaimed that his signature success “appears to hold potential for preventing homosexual orientation in males, if applied extensively in the population.”4 When it came to talking about Kirk, modesty was not Rekers’s strong suit.

So imagine my surprise when the first time I mentioned Dr. Rekers to Kirk’s mother, Kaytee, she didn’t know who I was talking about. Dr. Richard Green, the gender expert she had seen on television — that’s who she called, and she remembered him as her main point of contact at UCLA. During our first conversation we had this strange disconnect: I kept asking about Rekers, and she kept talking about Green. It wasn’t until more than twenty minutes had passed when I asked her to describe her first visit to UCLA that she finally mentioned two college students as a passing detail.

“Dr. Green had two college boys that were working with him,” she said. “Assistants, aides, whatever you want to call them. The only one I can remember, his name was George. The other one I don’t remember his name at all. But I do remember George because he was very, very kind to Kirk and Kirk liked him, and Kirk communicated really well with him. And when Dr. Green and George and the other one came to Kirk’s birthday party at our house in Saugas, I had bought water guns and they were all shooting water guns at each other. Kirk just thought that was just the cat’s meow, you know. So if George turned out to be a psychiatrist, he was probably a pretty good one.”

Well, that was George Rekers, I explained. She said that she couldn’t remember his last name. But as time went on, it became clear, both to her and to me, that this young college student that Kaytee gave so little importance to was the famous behavioral therapist who claimed so much credit for supposedly arresting Kirk’s developing homosexuality.

Kaytee may have first thought that George would have made a good psychologist, but her opinion changed as she learned more. But even after all she learned about Rekers’s role over the months to come, that still wasn’t the central issue for her. She had entrusted Kirk to Dr. Green’s care, not George’s. Not to some young college kid she had never met before and could barely remember afterwards.

Kirk’s older brother Mark also didn’t remember Rekers. Green’s name was the only one he remembered in connection with Kirk’s therapy, as well as his own abuse he suffered under the tyranny of the chips. “I told my mother a few years ago that if I ever came face to face with Dr. Green I’d rip his throat out. I blamed him for all of this.” Even Maris, who has almost no firsthand memory of Kirk’s therapy, remembered that it was Green’s name that could cast such an ominous shadow in the Murphy household. “From my perspective I thought Dr. Green was the only one involved,” she said. “I had no idea there was someone else actually involved in it.”

But that’s not how Rekers portrayed his involvement in Kirk’s case. Beginning with his 1972 dissertation, Rekers took full ownership of the project. When Rolling Stone magazine published its investigation of UCLA’s experimental program in 1975, it was Rekers, identified as the “young project director,” who came forward to defend the project with “Kraig” as his stellar success story.5 In 1982, Rekers described his project’s ownership in the first person singular: that Kirk was the first child in his ten year treatment project that “I launched,” and it was that “my purpose” to treat children who might become gay.6 In 1986, he reiterated his ownership: “Over the past 12 years, over 100 boys have been referred to my N.I.M.H. supported Gender Research Project for evaluation and potential treatment for a gender disturbance. My research team completed comprehensive psychological evaluations of approximately 70 of these children…”7

So based on Rekers’s own words, it seemed a no-brainer to me that he was fully in charge. That’s what virtually everyone familiar with this famous case believed. But when I shared this with Kaytee, she pushed back. Hard. “It just blew my mind when you said Rekers was in charge of this because I thought he was just a kid in college doing the work to help Green. That’s what I thought.”

And why wouldn’t she? When Kaytee first took her son to UCLA, Rekers was only twenty-two years old and had just gotten his bachelor’s degree only a few months earlier.8 While it wouldn’t be unusual for a grad student to treat clients under the supervision of a licensed professional, it is hard to believe that Rekers, who would have been unlicensed himself, could have been given full autonomy over Kirk’s treatment.

To be sure, whoever did oversee Kirk’s treatment in 1970 would likely have been justified in seeing the work as important, perhaps even heroic. Homosexuality in 1970 was still considered a mental disorder by the American Psychiatric Association, and therapeutic attempts to prevent the formation of any mental disorder are ethically justifiable even today – as long as the dictum of “first, do no harm” is front and center. Obviously, with aversive, negative-reinforcement therapy, that dictum in itself poses a challenge. But aside from that, it’s problematic to impose today’s knowledge and professional standards onto past practices, particularly if those past practices were proffered in good faith. We may fault 18th century bloodletters for bleeding harmful “humors” from George Washington on his death bed, but we can’t exactly find them morally culpable. We would however hold them accountable if they tried to offer those treatments today. Given where psychology was in 1970, those many therapists who were trying to prevent or cure homosexuality, it could be argued, may well have been working in good faith, if not in good works, good science, or, in the case of those providing punitive behavioral therapies, good conscience on reflection.

But it’s that reflection, one hopes, which provides at least one darn good reason why this question of accountability is important: the Murphys have lost their son and brother, and they could really use some answers. And in the best outcome, those answers might lead to a healthy discussion of why things played out the way they did, and why it would be – or should be — different today based on the body of knowledge we have available to us. Kaytee is still carrying around a lot of guilt for 1) taking Kirk to the wrong babysitter and 2) taking Kirk to the wrong doctor to cure his girly ways. On those two points alone, there’s a mountain of new information derived from forty years of research which she could derive enormous benefits from.

And besides that, we have the moral equivalent of bloodletters out there in the ex-gay movement today who are still trying to cure something that is not an illness And many of them are still mightily impressed with Green’s 1987 book Sissy Boy Syndrome, even if they do resolutely ignore the foreshadowing provided by Kirk’s suicide attempt at age seventeen.

And so the question remains: who oversaw this grad student’s experiments on Kirk?

Well, to add more confusion into the puzzle, the first person we might consider would actually be Dr. Ivar Lovaas rather than Green. Rekers acknowledged Lovaas as his mentor,9 and Lovaas’s signature appears on Rekers’s doctoral thesis as chairman of his dissertation committee. (Green’s doesn’t.) Lovaas was the head of UCLA’s Neuropsychiatric Clinic which sponsored the Gender Identity Clinic, and in that capacity, he would have been ultimately responsible for everything that went on there. What’s more, Dr. Lovaas is named as principal investigator for the research grant that paid for Kirk’s treatment.10 Lovaas’s name also appears alongside Rekers’s in the seminal 1974 paper that introduced “Kraig” to the therapeutic world. He was also the first person Kaytee remembers speaking to on her first visit at UCLA.

While Lovaas had been trained as a psychoanalyst, he had become one of the top experts in Applied Behavioral Analysis (ABA), the field of psychology that was perhaps the least psychological in its approach. Behavioral analysts don’t dig around much into people’s feelings, fears, dreams, family relationships or childhood memories. Indeed, in cases like autism, Lovaas’s specialty, those avenues of exploration would be irrelevant. Instead, behaviorists mainly confine themselves to the Pavlovian science of “training” their patients for a desired set of behaviors, with the idea being that those behaviors would provide their patients with new skills (or, perhaps more accurately, reflexes) so they can better cope with whatever condition they may have.

And it’s the particular kind of therapy that Kirk went through, classic ABA conditioning, which suggests Lovaas’s influence. Rekers employed what’s called an “operant conditioning” method for treating Kirk that came straight from Lovaas’s behavioral therapy playbook. Act girly, and Kirk is punished; act manly and he gets a reward. Rekers’s approach was limited to changing Kirk’s behavior, and except for suggesting that Kirk’s father play ball with him more often, Rekers did little to investigate or influence Kirk’s family dynamics — which is odd, given that family dynamics were at the heart of what many psychologists thought made children gay to begin with. Yet Rekers’s approach to treating Kirk while eschewing any attempts to influence underlying family dynamics is practically a walking definition of behaviorism in its most radical form.

Rekers was clearly following Lovaas’s behaviorist lead in Kirk’s treatment, and it’s no accident that Rekers and Lovas’s 1974 paper appeared in the Journal of Applied Behavioral Analysis, one of the most influential journals in the behaviorist school of psychology. When Rolling Stone came calling in 1975, Lovaas described the project’s methods in purely behavioral terms. He denied the goal was to extinguish feminine behaviors in favor of masculine ones, saying instead that “the end result is a larger behavioral repertoire, such that the child is only then able to truly ‘choose’ between performing masculine or feminine behaviors.”11

As the years wore on and controversy grew, Lovaas would distance himself from the Clinic’s experimental children’s program and, in particular, Kirk’s therapy. When author Phyllis Burke interviewed Lovaas for her 1996 book Gender Shock, she pointed out that Green reported that Kirk tried to commit suicide at the age of seventeen. Lovaas responded, “I am not responsible for that. I don’t know what happened to these kids in follow-up. My responsibility was to help George Rekers set up a scientific study.” He also discounted Green’s book. “It didn’t provide any information to me which I thought was all that helpful.”12

But aside from co-authoring four papers with Rekers,13 Lovaas wasn’t much of a figure in the fields of gender identity or sexual orientation. Lovaas’s specialty was in autism with an occasional dabbling, early on, with childhood schizophrenia. Robert Stoller and Green were the Institute’s acknowledged experts on gender variance. Stoller’s name doesn’t appear in connection with the Clinic’s children’s program, but Green’s name does, as does Lovaas’s. Green is also deeply connected in the Murphy family’s collective memory.

So what about Green? In Rekers and Lovaas’s 1974 paper, the authors expressed their appreciation to Green “for referring the first treatment cases to us.”14 Those first cases, of course, included Kirk. But beyond that, I haven’t been able to find anything in which Rekers acknowledged working with Green, and Green appears perfectly delighted to return the favor. Green was many things, but one thing he most certainly was not was a behavioral therapist. He dabbled halfheartedly in behaviorism with three families, but abandoned it after finding the experience “an exercise in ambivalence.”15 He found that his use of behavioral therapy “revealed more about parental attitudes toward atypical sex-role development than whether such behavior is amenable to change.” Meanwhile, Green also noticed that very young effeminate boys would often spontaneously lose many of their girlish behaviors as they got older even without any therapeutic intervention. Those experiences, he believed, “point up the need for control groups for comparing the efficacy of ‘treatment’ intervention.”

But Rekers categorically rejected the idea. “For ethical reasons,” he wrote, “I have specifically chosen not to conduct a group-designed study in which some children are offered treatment and treatment is withheld from a ‘control’ group of gender-disturbed boys.”16 Rekers also criticized Green’s failed attempt at behavioral therapy by saying, in essence, that Green did it wrong. “He did not pretrain the parents with clinic shaping procedures and he did not obtain reliable observational data on the child’s behavior, which might have served to evaluate the intervention outcome,” he wrote.17 Given what is known about Kirk’s case today, one can only marvel at that criticism.

Green’s doubts about behavioral therapy grew, and in 1987 he attacked Rekers’s exclusively behavioral approach directly in Sissy Boy Syndrome. “To me,” he wrote, “the basic strategy of Rekers’s treatment model, which is based on operant-conditioning, can be faulted in that it ignores the motivation behind the child’s behaviors. … Simply conditioning the boy so that he obtains rewards for alternate behaviors and is punished for earlier preferences may make the child look different. But to what extent is self-concept changed?”18 Green also blasted Rekers for abandoning science in favor of “the moralistic basis that has recently been revealed behind much of Rekers’s attempts to ‘treat’ these children.”19 And after revealing that Kirk was still attracted to men despite Rekers’s treatment, Green concluded that Kirk’s case, along with several others, showed “[t]he apparent powerlessness of treatment to interrupt the progression from ‘feminine’ boy to homosexual or bisexual man.”20 In fact, it must be said that if it hadn’t been for Green’s book, no one would have had any inkling of “Kraig’s” problems after completing therapy. Rekers certainly never hinted at them, not even after Sissy Boy Syndrome appeared in 1987.

When Maris emailed Green last October asking about Kirk, Green again took the opportunity to put as much distance as he could between Rekers and himself. He pointedly noted the differences in their therapeutic frameworks, saying that that Rekers was Kirk’s therapist in UCLA’s Psychology Department while Green was in the Psychiatry Department. He also repeated that he would later learn that Rekers’s motivation was actually religious, and got her caught up to date with the whole rent-boy scandal. It would appear that today Green still wants nothing to do with Rekers or with Kirk’s treatment, even though he recruited Kirk into the project, referred him to Rekers and Lovaas for treatment, and evaluated Kirk at least twice following treatment.

Yet Green’s prominence, at least in Kaytee’s mind, leads her to insist that Green was in charge. “That’s the way I see it. I see it as Green in charge, and Rekers was his assistant. It was Green’s baby, or he wouldn’t have been the one on TV. And I don’t think I’m wrong about this. And I trusted him because I liked what he presented on TV. That’s why I called him in the first place. He’s the one that got me to come in there. And so I’m putting the responsibility on his shoulders.”

Lovaas died last August. Dr. Alexander Rosen, another UCLA psychologist who was involved with the experimental children’s program and co-wrote thirteen papers with Rekers, died in 2007 of complications from Alzheimer’s. I was able to reach Dr. Peter Bentler who is still at UCLA. He was involved with the project and co-wrote five papers with Rekers and Rosen (including some containing discussions of Kirk’s case). He was also a member of the Rekers’s doctoral dissertation committee. He said he couldn’t remember who oversaw Rekers’s work when Rekers was a grad student. Bentler also distanced himself from the program, saying that Green, Rekers and Rosen handled the project’s clinical work; his specially was “psychometrics,” which involved running statistical calculations and interpretation of the project’s data. Green declined to respond to my email requests for comment about the project and efforts to contact Rekers were unsuccessful. Until one of them speaks up, the Murphys may never see their questions answered.

Notes:

1. Rorvik, David Michael. “The gender enforcers: Seeing to it the boys will be boys.” Rolling Stone (October 9, 1975): 53ff. [BACK]

2. Rekers, George A; Oram, Kimberly Barnett. “Child and adolescent therapy for precursors to adulthood homosexual attractions.” In Julie Harren Hamilton & Philip J. Henry (eds.) Handbook of Therapy for Unwanted Homosexual Attractions: A Guide to Treatment (Self-published via Xulon Press, 2009): 302. Available online at the NARTH bookstore at http://www.shop.pilgrimageresources.com/product.sc?productId=41&categoryId=2. [BACK]

3. Rekers, George A. “Gender identity problems.” Chapter 16 in Philip H. Bornstein & Alan E. Kazdin (eds.) Handbook of Clinical Behavior Therapy with Children (Homewood, IL: Dorsey Press): 658-699. [BACK]

4. Rekers, George A. “The development of a homosexual orientation.” Chapter 2 in Christopher Wolfe (ed.) Homosexuality and American Public Life (Dallas: Spence Publishing Co., 1999): 62-84. [BACK]

5. Rorvik, David Michael. “The gender enforcers: Seeing to it the boys will be boys.” Rolling Stone (October 9, 1975): 53ff. [BACK]

6. Rekers, George A. Shaping Your Child’s Sexual Identity (Grand Rapids, MI: Baker Book House, 1982): 138. [BACK]

7. Rekers, George A. “Inadequate sex role differentiation in childhood: The family and gender identity disorders.” Journal of Family and Culture 2, no. 3 (1986): 8-37. [BACK]

8. Rekers, George A. “Pathological sex-role development in boys: Behavioral Treatment and Assessment.” Unpublished doctoral dissertation, University of California at Los Angeles. (1972). His Vita is provided on page x. [BACK]

9. Rekers, George A. “Pathological sex-role development in boys: Behavioral Treatment and Assessment.” Unpublished doctoral dissertation, University of California at Los Angeles. (1972): ix.

Rekers, George A. Growing Up Straight: What Every Family Should Know About Homosexuality (Chicago: Moody Press, 1982): 9. [BACK]

10. United States Public Health Service Research Grant 21803 OlAl from the National Institute of Mental Health, according to the Alcohol, Drug Abuse, Mental Health Research Grant Awards Index for fiscal year 1974. [BACK]

11. Rorvik, David Michael. “The gender enforcers: Seeing to it the boys will be boys.” Rolling Stone (October 9, 1975): 53ff. [BACK]

12. Burke, Phyllis. Gender Shock: Exploding the Myths of Male and Female (New York: Anchor Books, 1996): 50. [BACK]

13. Rekers, George A.; Lovaas, O. Ivar. “Behavioral treatment of deviant sex-role behaviors in a male child.” Journal of Applied Behavior Analysis 7, no. 2 (Summer 1974): 173-190.

Rekers, George A.; Lovaas, O. Ivar; Low, Benson. “The behavioral treatment of a ‘transsexual’ preadolescent boy.” Journal of Abnormal Child Psychology 2, no. 2 (June 1974): 99-116.

Rekers, George A.; Bentler, Peter M.; Rosen, Alexander C.; Lovaas, O. Ivar. “Child gender disturbances: A clinical rationale for intervention.” Psychotherapy: Theory, Research and Practice 14, no. 1 (Spring 1977): 2-11.

“Rekers, George A.; Rosen, Alexander C.; Lovaas, O. Ivar; Bentler, Peter M. “Sex-role stereotypy and professional intervention for childhood gender disturbances.” Professional Psychology 9, no. 1 (February 1978): 127-136. [BACK]

14. Rekers, George A.; Lovaas, O. Ivar. “Behavioral treatment of deviant sex-role behaviors in a male child.” Journal of Applied Behavior Analysis 7, no. 2 (Summer 1974): 173-190. [BACK]

15. Green, Richard. Sexual Identity Conflict in Children and Adults (New York: Basic Books, 1974): 277. [BACK]

16. Rekers, George A. “Therapies dealing with the child’s sexual difficulties (Behavioral approach).” In Jean-Marc Samson (ed.) Enfance et Sexualité / Childhood and Sexuality. Proceedings of the International Symposium held at the Université du Québec à Montréal, September 7-9. 1979 (Montréal: Éditions Études Vivantes, 1980): 525:538. [BACK]

17. Rekers, George A. “Assessment and treatment of childhood gender problems.” Chapter 7 in Benjamin B. Lahey & Alan E. Kazdon (eds.) Advances in Clinical Child Psychology, Vol. 1 (New York: Plenum Press, 1977): 267-306. [BACK]

18. Green, Richard. The “Sissy Boy Syndrome” and the Development of Homosexuality (New Haven, CT: Yale University Press, 1987): 261-262. [BACK]

19. Green, Richard. The “Sissy Boy Syndrome” and the Development of Homosexuality (New Haven, CT: Yale University Press, 1987): 261-262. [BACK]

20. Green, Richard. The “Sissy Boy Syndrome” and the Development of Homosexuality (New Haven, CT: Yale University Press, 1987): 318. [BACK]