Box Turtle Bulletin

Box Turtle BulletinNews, analysis and fact-checking of anti-gay rhetoric
“Now you must raise your children up in a world where that union of man and box turtle is on the same legal footing as man and wife…”
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Posts for April, 2010

Ontario District Branch of the APA Cancels NARTH “Training”

Jim Burroway

April 13th, 2010

Last week, Timothy Kincaid reported that the Ontario District Branch of the American Psychiatric Association had scheduled a seminar to be conducted by NARTH member Joseph Berger to discuss whether gay people should be subjected to psychotherapy. That salon was also advertised as an “accredited group learning activity.” BTB has now learned that the scheduled salon has been canceled.

In an email sent to members by Executive Secretary Colleen Gambier:

Please note that due to unfortunate circumstances, Salon #14 scheduled for May 13, 2010, will not take place. We regret any inconvenience and look forward to seeing you at our next Salon on Oct 14, 2010 with Dr. Ash Bender on Workplace Trauma.

In 2006, Berger ignited controversy over suggestions that gender non-conforming children should be exposed to taunting and bullying in schools in order to “re-establish that necessary boundary” of conforming to gender roles. That post on NARTH’s blog was removed after considerable outcry, and the blog was eventually shut down.

Has the Ontario District Branch of the APA completely lost its mind?

Timothy Kincaid

April 6th, 2010

Psychiatrists in Canada received the following invitation:

Dear Colleague:
As you may know sexuality is a ‘hot’ issue in the DSM V revision process. At one time, so was homosexuality. Do our attitudes change with science? Do come, and participate in a stimulating evening.

Topic: Should Homosexuals Be Treated with Psychotherapy?
Speaker: Dr. Joseph Berger, FRCPC, DLFAPA
Date/Time: Thursday, May 13, 2010, 7 – 9:30 p.m.
Location: TARTU College Main Floor/Masters Buffeteria
310 Bloor Street West
(1 block east of Spadina) at corner of Madison & Bloor
416-924-7651
There is street and lot parking on Bloor St and also Spadina Rd and side streets North of Bloor; subway 1 block from venue
Learning Objectives: At the end of this session, participants will:

1. be better able to distinguish between scientific evidence and media propaganda, personal beliefs, and organization – however prestigious – position statements.
2. understand the difference between voluntarily undertaken insight-oriented psychodynamic psychotherapy and past attempts at aversion or conversion so-called ‘therapies’.
3. be able to acknowledge that homosexual people can have emotional problems and conflicts and psychosomatic symptoms as can any other human being and be similarly fully deserving of psychotherapeutic treatment.

“This event is an accredited group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada, approved by the Canadian Psychiatric Association.”

Wait! What?

You mean that the Ontario Branch of the APA is hosting NARTH member Joseph Berger to discuss whether gay people should be subjected to psychotherapy? What kind of crazy is that?

Here is the letter I sent to the local head of the APA:

Mr. Sommers,

I am a bit perplexed at the decision of the Ontario District Branch of the APA to sponsor a presentation by Dr. Joseph Berger. And I am even more startled at the seminar’s Learning Objectives.

Perhaps you are unaware of Dr. Berger’s reputation and affiliation. Although Berger has served as ODBAPA’s president in the past, he is better known as an anti-gay activist and participant with NARTH, an organization that is hostile to the APA and it’s official positions on sexual orientation.

I am greatly concerned that Dr. Berger will be presented as an authority on distinguishing between scientific evidence and propaganda. As part of his association with NARTH, Berger has for many years been engaging in anti-gay propaganda that is in direct opposition to scientific evidence.

NARTH has repeatedly been criticized by study authors and researchers for misstating, twisting, and in some cases fraudulently claiming the opposite of their conclusions. Most of the mental heath profession recognizes NARTH to be primarily an anti-gay political advocacy organization invested heavily in propaganda.

Their latest endeavor was to send out propaganda to school principals (under the alter-ego American College of Pediatricians) in which they distort legitimate research in order to make outrageous claims about gay people (e.g. “more likely to suffer from a host of negative outcomes including psychiatric disorders, domestic violence and sexual assault, and increased risk for chronic diseases, AIDS and shortened life spans”), claim that reparative therapy is effective (“individuals with unwanted same sex attraction often can be successfully treated”), and advocate for principals to deny same-sex attracted youth from access to support systems. These are all in direct opposition to stated positions of the APA.

And Dr. Berger is still closely alligned with this organization. He sits on their Scientific Advisory Committee and as recently as November he contributed an article to their site. His premise was 1) removing homosexuality from the DSM was a political decision rather than based on science, 2) the APA is persecuting those who wish to perform ex-gay therapy, and 3) that the decision by the APA to endorse the legalization of same-sex marriage was not handled to his satisfaction.

Further, Berger is not a moderate member of the anti-gay community. His differences with the APA are not mild or limited to perspective or opinion. He advocates for treatment that is far beyond the norm and which may well be in violation of professional ethics. In 2006, Berger wrote an article on the NARTH website in which he addressed the appropriate way to treat gender non-conforming children:

I suggest, indeed, letting children who wish go to school in clothes of the opposite sex – but not counseling other children to not tease them or hurt their feelings.

On the contrary, don’t interfere, and let the other children ridicule the child who has lost that clear boundary between play-acting at home and the reality needs of the outside world.

Maybe, in this way, the child will re-establish that necessary boundary.

This was of sufficient concern to merit an article in the Los Angeles Times.

But it is not just the specific selection of Dr. Berger or his extremely unorthodox proposals. It is the very premise of the presentation, “Should Homosexuals Be Treated with Psychotherapy?”

This is extremely offensive. It is akin to pondering such things as “Should races be kept segregated?” or “Should cancer be treated with leaches?” Such questions are not only outdated, but contrary to decency and they should not be awarded credibility by professional organizations.

I look forward to hearing your response explaining your decision to lend the name of the ODBAPA to Dr. Berger’s views on curing homosexuals. I’ll be sharing them with the readership of Box Turtle Bulletin.

Should he choose to respond, I’ll be sure to let you know exactly what Sommers intended by this presentation.

Dr. Throckmorton Pleased with APA Report

Timothy Kincaid

August 5th, 2009

Dr. Warren Throckmorton was, at one time, a supporter of efforts to revise one’s sexual orientation. He even produced a video, I Do Exist, which presented the testimonies of some people who claimed to have changed their sexual orientation.

Since that time at least one testimonial came to understand his sexuality in a light different than was presented on the video. And, as time passed, so did Dr. Throckmorton.

I have witnessed an evolution in his thinking to where I now think it is now accurate to say that Dr. Throckmorton, though still religiously conservative and not inclined to find same-sex behavior to be pleasing to God, no longer believes that efforts to change the sexual attractions of same-sex attracted men are likely to be effective. He is particularly critical of “reparative therapy” – efforts to become heterosexual by “repairing” the damage done by a distant father and smothing mother – the pet theory of NARTH and others in the ex-gay movement.

Instead, Dr. Throckmorton is a proponant of Sexual Identity Therapy, a therapy that “seeks to aid people in conflict over sexual identity to integrate and live out a valued sexual identity.” Throckmorton seeks to support those whose religious beliefs and values are not consistent with accepting the identity, or sexual expression of a gay person – yet without trying to change them into an opposite-sex attracted person.

Throckmorton finds much within the APA Report to applaud. He praises the rigor, honesty, and nuance of the report along with the APA’s recognition that a client’s own religious can impact psychotherapy. Check out his response here.

Lying About The Hate Crime Bill, #1: “The Thirty Sexual Orientations”

Jim Burroway

May 11th, 2009

You can always tell when our opponents are really scared. Their lies become more ridiculous. Such is the case with the Local Law Enforcement Hate Crimes Prevention Act of 2009 (also known as the Matthew Shepard Hate Crimes Prevention Act). The proposed legislation expands the already existing federal hate crime law to include violent crimes based on the victim’s actual or perceived sexual orientation, gender, gender identity, and/or disability. The current law already covers actual or perceived race, ethnicity, color and religion.

One of the most egregious lies is this one, as told by the American Family Association:

The Hate Crime law, S.909 (and HR1913), will make 30 sexual orientations federally-protected. The American Psychiatric Association (APA) has published 30 such sexual orientations that, because of Congress’s refusal to define “sexual orientation,” will be protected under this legislation.

Focus On the Family’s James Dobson also jumped on the bandwagon as well:

As I’m recording this video greeting, there’s a so-called hate crimes bill that’s working its way through the congress that contains no adequate safeguards to protect the preaching of God’s word. Because the liberals in Congress would not define sexual orientation, we have to assume that protection under the law will be extended to the 30 sexual disorders identified as such by the American Psychiatric Association. Let me read just a few of them: bisexuality, exhibitionism, fetishism, incest, necrophilia, pedophilia, prostitution, sexual masochism, urophilia, voyeurism, and bestiality. Those are just a few. And I have to ask, have we gone completely mad?

Well, it appears that Dobson has. He, the AFA, the Traditional Values Coalition, Liberty Counsel, and many, many others, are pushing this obnoxious notion. Let’s break it all down, shall we?

“Congress would not define sexual orientation”
This line was brought up when the Hate Crimes Act was working its way though the House Judiciary Committee. During the hearing, Congressman Steve King (R-Iowa) sought to add an amendment to the bill indicating that the term sexual orientation does not include pedophilia.

This attempted amendment was, of course, a deliberate attempt to play on the slander that homosexuality is equivalent to child molestation — a slander that has no basis in the professional literature. But Rep. King pressed on in his attempt to write that slander into U.S. law, claiming that the law doesn’t define sexual orientation.

The problem, of course, is that the federal law which directs the FBI to collect hate crime statistics already includes a very specific definition of sexual orientation. The law’s definition goes like this:

As used in this section, the term “sexual orientation” means consensual homosexuality or heterosexuality.

It couldn’t be much clearer than that. Sexual orientation is exactly what everyone knows it to be: an orientation based on one’s own gender and the gender to which that individual is sexually attracted.

“The APA Defines Thirty Sexual Orientations”
But what if Federal law hadn’t already defined sexual orientation and we had to fall back on the American Psychiatric Association’s definition? Well, it turns out that the APA’s official definition is not much different from the federal government’s. The APA’s official handbook, the Diagnostic and Statistical Manual (DSM-IV-TR, 2000) offers a very precise definition of how clinicians should describe a client’s sexual orientation:

Specifiers
For sexually mature individuals, the following specifiers may be noted based on the individual’s sexual orientation: Sexually Attracted to Males, Sexually Attracted to Females, Sexually Attracted to Both, and Sexually Attracted to Neither. [Emphasis in the original]

In other words, the APA defines only four sexual orientations. And they do so in order to provide a consistent description of an individual’s sexual orientation. It is not a diagnosis itself, since homosexuality is not listed as a mental disorder.  And just so everyone’s clear on exactly what the APA means by their very short description of sexual orientation, they provided an expanded discussion on their web site:

Sexual orientation is an enduring emotional, romantic, sexual, or affectional attraction toward others. It is easily distinguished from other components of sexuality including biological sex, gender identity (the psychological sense of being male or female), and the social gender role (adherence to cultural norms for feminine and masculine behavior).

Sexual orientation exists along a continuum that ranges from exclusive heterosexuality to exclusive homosexuality and includes various forms of bisexuality. Bisexual persons can experience sexual, emotional, and affectional attraction to both their own sex and the opposite sex. Persons with a homosexual orientation are sometimes referred to as gay (both men and women) or as lesbian (women only).

So where did the list of thirty “sexual orientations” come from? Let’s turn again to the APA’s DSM-IV-TR under the heading of “Sexual and Gender Identity Disorders,” namely the APA’s examples of sexual paraphilias:

The Paraphilias are characterized by recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The Paraphilias include Exhibitionism, Fetishism, Frotteurism, Pedophilia, Sexual Masochism, Sexual Sadism, Transvestic Fetishism, Voyeurism, and Paraphilia Not Otherwise Specified.

The DSM goes further, identifying specific criteria for diagnosing these various paraphilias, something that the DSM does not do for sexual orientation. And the reason is simple: sexual paraphilias are mental disorders according to the DSM, while homosexuality is not. Which is why the DSM devotes several pages to sexual paraphilias — and describes them as an impairment to normal functioning — but just a few words to consensual adult homosexuality, heterosexuality or bisexuality, which the APA reminds us “is not an illness, a mental disorder, or an emotional problem.”

So just to be clear:

  • Sexual orientation is strictly limited to the realms of homosexuality, heterosexuality, bisexuality and asexuality.
  • All the other stuff — pedophilia, exhibitionism, masochism, and the other twenty-seven paraphilias are not sexual orientations. Homosexuality, heterosexuality, bisexuality and asexuality are not paraphilias.
  • The proposed hate crime laws covers only sexual orientation, and not paraphilias.

In other words, you can still punch a pedophile and not risk running afoul of the proposed hate crime law. I wouldn’t recommend it — you’d still be liable for assault charges, but there would be no federal hate crime enhancements involved.

If you won’t believe me, then how about Dr. Jack Drescher? He’s a member of the APA’s DSM-V Workgroup on Sexual and Gender Identity Disorders, one of the groups working on the next revision of the APA’s manual. He confirmed everything I said, and went further:

Pedophilia is not a sexual orientation, nor would pedophiles be covered by a law protecting people for their sexual orientation. Religious social conservatives who oppose gay rights are using terms that sound like science, as opposed to actual science, to make unwarranted and malicious comparisons between homosexuality and pedophilia. Not only is this scare tactic untruthful, it reveals how little respect some religious conservative leaders have for the intelligence of the people they are trying to persuade.

It is indeed a scare tactic, and anti-gay activists know full well that it is a blatant distortion of the APA’s position on sexual orientation and paraphilias. Remember, Dobson holds a Ph.D. in psychology. He clearly knows that he’s lying, and he has chosen to do so as a deliberate tactic. There’s simply no other plausable explanation. And as the bill comes closer to passing and being signed into law, their rhetoric is likely to get worse, not better. Stay tuned.

See also:
Lying About The Hate Crime Bill, #2: “A Danger To Religious Freedom”
Lying About The Hate Crime Bill, #1: “The Thirty Sexual Orientations”

Today In History: APA Removes Homosexuality from List of Mental Disorders

Jim Burroway

December 15th, 2008

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-I) classified homosexuality as a mental illness beginning in 1952. Before then, psychiatrists and psychologists looked at homosexuality as a perversion and as a deviant behavior, but the idea that it was a mental illness was considerably more controversial. Sigmund Freud, the father of psychoanalysis, famously wrote to one American mother in 1935, “Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation, it cannot be classified as an illness.”

But by the early 1950’s American society’s view of homosexuality took a very sharp turn toward the dark side. This turn was partly sparked by the loud controversy stirred by Alfred Kinsey’s Sexual Behavior in the Human Male in 1948. Where before, homosexuality was little talked about; now it seemed suddenly to be everywhere. In the minds of Americans across the country, homosexuality now joined the other emerging threat, communism, as two great menaces to American order. By 1952, there had already been several purges of gays from federal employment. With the APA’s addition of homosexuality to its list of mental disorders, the fates of gays and lesbians would be sealed for the next two decades.

And as is always true in the medical and psychiatric fields, where there is an illness, there’s a quest for a cure. This was true for homosexuality long before 1952, and unfortunately it is still true today in some unenlightened circles. For the most part, the cure consisted of ordinary forms of talk therapy. But other, more abusive forms of therapy — namely electric shock therapy or therapies involving severe nausea-inducing drugs — weren’t exactly rare. And, of course, as long as gays and lesbians were labeled “mentally ill,” all manner of discrimination was made possible against those who officially declared to be operating under a mental impairment.

Thirty-five years ago today, on December 15, 1973, all of that began to change when the American Psychiatric Association’s Board of Trustees “cured” millions of gays and lesbians across America when they voted to pass this resolution (PDF: 464KB/5 pages):

For a mental or psychiatric condition to be considered a psychiatric disorder, it must either regularly cause subjective distress, or regularly be associated with some generalized impairment in social effectiveness or functioning. With the exception of homosexuality (and perhaps some of the other sexual deviations when in mild form, such as voyeurism), all of the other mental disorders in DSM-1 fulfill either of these two criteria. (While one may argue that the personality disorders are an exception, on reflection it is clear that it is inappropriate to make a diagnosis of a personality disorder merely because of the presence of certain typical personality traits which cause no subjective distress or impairment in social functioning. Clearly homosexuality, per se, does not meet the requirements for a psychiatric disorder since, as noted above, many homosexuals are quite satisfied with their sexual orientation and demonstrate no generalized impairment in social effectiveness or functioning.

The only way that homosexuality could therefore be considered a psychiatric disorder would be the criteria of failure to function heterosexually, which is considered optimal in our society and by many members of our profession. However, if failure to function optimally in some important area of life as judged by either society or the profession is sufficient to indicate the presence of a psychiatric disorder, then we will have to add to our nomenclature the following conditions: celibacy (failure to function optimally sexually), revolutionary behavior (irrational defiance of social norms), religious fanaticism (dogmatic and rigid adherence to religious doctrine), racism (irrational hatred of certain groups), vegetarianism (unnatural avoidance of carnivorous behavior), and male chauvinism (irrational belief in the inferiority of women).

The New York Times alerted the world with this Page One announcement:

The American Psychiatric Association, altering a position it has held for nearly a century, decided today that homosexuality is not a mental disorder. The board of trustees of the 20,000 member organization approved a resolution that said in part, “by itself, homosexuality does not meet the criteria for being a psychiatric disorder.” Persons who are troubled by their homosexuality, the trustees said, will be classified as having a “sexual orientation disturbance” should they come to a psychiatrist for help.

The full APA would go on to ratify the policy statement on April 9, 1974. But attempts to cure homosexuality would continue under a new illness inserted into the DSM as a compromise in 1974. Sexual Orientation Disturbance (SOD) defined homosexuality as an illness if an individual with same sex attractions found those attractions distressing and wanted to change. The new diagnosis served the purpose of legitimizing the practice of sexual conversion therapies, even if homosexuality per se was no longer considered an illness. The SOD diagnosis also allowed for the unlikely possibility that a person unhappy about a heterosexual orientation could seek treatment to become gay. Reflecting the realities of clinical practice, 1980’s DSM-III changed SOD to “Ego Dystonic Homosexuality” (EDH). That diagnosis was finally removed in 1987, but resurfaced as a brief mention under “Sexual Disorders Not Otherwise Specified”, which describes persistent and marked distress about one’s sexual orientation.

Update: The last paragraph describing subsequent diagnoses was revised and clarified, with thanks to Dr. Jack Drescher.

Frank Kameny’s Papers Available To The Public

Jim Burroway

September 19th, 2008

It’s been about two years since Frank Kameny, longtime Washington, D.C. LGBT activist, donated his papers to the Library of Congress. Now that those papers have been cataloged, they are available to the public:

Charles Francis, organizer of the Kameny Papers Project, said the 50,000 items were “organized to perfection” by library staff and would be an invaluable resource to people reviewing the earliest days of the gay civil rights movement.

“The Kameny Papers, documenting the evolution of the gay rights movement in the United States, are now available to study for many years to come,” he said.

Frank played a pivotal role in the gay rights movement since the 1960’s. He became involved when he was fired from his civilian job with the U.S. Army’s map service in 1957. Federal civil service rules at the time prohibited gays from federal employment, and security clearances were routinely denied to anyone who was found to be gay. He became the first to appeal a firing on the basis of homosexuality.

He lost those appeals, but went on to found the Washington, D.C. Mattachine Society. He also played a key role in getting the American Psychiatric Association to remove homosexuality from its list of mental disorders in 1973.

In 1968 Frank coined the phrase “Gay is Good,” inspired by the popular “Black is Beautiful” slogan. “Gay is Good” may appear rather simple today, but it was a particularly significant slogan for 1968 when homosexuality was still considered both a mental illness and a criminal act. Last year when some of Frank’s memorabilia was featured in a temporary display at the Smithsonian, he shared with me what the slogan meant to him:

I’ve said, for a long time, that if I’m remembered for only one thing, I would like it to be for having coined “Gay is Good.” But never did I expect that that would make its way to the Smithsonian. I feel deeply contented.

According to the Washington Blade, highlights of the Kameny Papers include papers related to the American Psychiatric Association’s 1973 decision and the landmark 1974 federal decision to grant an openly gay man a Pentagon security clearance.

And by the way, in case you were wondering, Frank Kameny is still very much alive.

Our Godmothers Exchange Vows

Jim Burroway

June 16th, 2008

The first same-sex marriages took place in California, beginning at just one minute after 5:00 p.m. local time.

Phyllis and Del

This is Phyllis Lyon (right, 83) and Del Martin (left, 87) of San Francisco. They have been together for fifty-five years. They, along with six other women, founded the Daughters of Bilitis in 1955. The Daughters were the first major lesbian organization in the United States. Phyllis edited the DOB’s newsletter The Ladder beginning in 1956. Del edited The Ladder from 1960 to 1962. The Daughters eventually disbanded in 1970 after having established chapters all across the United States

In 1964, they helped found the Council on Religion and the Homosexual, bringing together national religious leaders and gay and lesbian activists for a national discussion of gay rights. Phyllis was also the first open lesbian to serve on the board of the National Organization for Women in 1973. Meanwhile, Del was heavily involved in getting the American Psychiatric Association to remove homosexuality from its list of mental disorders.

When Del and Phyllis met in 1950, the very idea that their relationship would someday be recognized by the state must have seemed utterly outlandish. But these pioneers have made a real difference for millions of gays and lesbians the world over, not just here in the United States. You might say that they are godmothers to all of us and our movement. After all these years of their hard work and dedication to the cause of lesbian rights, it’s hard to imagine a more appropriate couple to be the first to marry in San Francisco.

We not only offer our congratulations, but also our deepest thanks for all that Phyllis and Del have done, and all that they represent.

APA Statements on DSM Workgroups

Jim Burroway

June 3rd, 2008

Last week, we posted a statement from four transgender advocacy organizations on the American Psychiatric Association’s ongoing efforts to update the Diagnostics and Statistical Manual for its fifth edition (DSM-V). This week, we have two statements from the APA. The first one is about the DSM revision process, and the second one is about Kenneth Zucker’s participation on the DSM workgroup.


APA STATEMENT ON GID AND THE DSM-V
May 23, 2008

The American Psychiatric Association has received inquiries about the DSM-V process, particularly concerns about the Sexual and Gender Identity Disorders Work Group. The APA recognizes that this work group and others will address difficult and sometimes controversial issues. The APA’s goal is to develop a diagnostic manual that is based on sound scientific data, but also sensitive to the needs of clinicians and their patients. To this end, the APA has created a process that involves opportunities for review and input from persons with varied backgrounds and opinions.

Thirteen DSM-V work groups have been established to review all existing diagnostic categories in the current DSM. Individual work groups may propose revisions to existing disorder criteria, inclusion of new disorders, removal of existing disorders, or no changes to a disorder or its criteria. They may also propose revisions to the text that accompanies the criteria for each disorder. The Sexual and Gender Identity Disorders Work Group, chaired by Kenneth J. Zucker, Ph.D., has three subworkgroups:

  • Gender Identity Disorders, chaired by Peggy T. Cohen-Kettenis, Ph.D.
  • Paraphilias, chaired by Ray Blanchard, Ph.D.
  • Sexual Dysfunctions, chaired by R. Taylor Segraves, M.D., Ph.D.

Each subworkgroup meets regularly, in person or on conference calls. They begin by reviewing DSM-IV’s strengths and problems, from which research questions and hypotheses are developed and then investigated through literature reviews and analyses of existing data. They also may further test research questions in field trials involving direct data collection. Because the work groups are limited in size, they may request outside advisors to assist them in these tasks, and to provide reviews and comments from other perspectives. Finally, in order to invite comments from even wider communities of researchers, clinicians, and consumers, the APA launched a web site in 2004, on which these groups can submit questions, comments and research findings, which are then distributed to the relevant work groups.

Based on this comprehensive review of scientific advancements, targeted research analyses and clinical expertise, the subworkgroups will develop draft DSM-V diagnostic criteria. After a period of comment, the subworkgroups will review submitted questions, comments and concerns. The final draft of DSM-V will be submitted to APA’s Council on Research, Assembly, and Board of Trustees for their review and approval. The final, approved DSM-V is expected to be released in May, 2012.

In summary, the DSM-V development process was constructed to achieve a thorough, balanced review of scientific data, with multiple levels of approval required, and opportunities for input from stakeholders. It is important to recognize that the DSM is a diagnostic manual and does not provide treatment recommendations or guidelines. The APA is aware of a need for more scientific and clinical knowledge about the best medical and psychiatric care for individuals with Gender Identity Disorder. To address this need, the APA Board of Trustees voted to create a Task Force to review the scientific and clinical literature on GID treatment. The members of this Task Force will be appointed shortly.


Statement on Dr. Kenneth Zucker and Gender Identity Disorder (5/23/2008)

Kenneth J. Zucker, Ph.D., C.Psych., the Chair of the DSM-V Sexual and Gender Identity Disorders work group, is a widely respected and pre-eminent scholar in the world of academic sexology research. As Chair of the work group for Sexual and Gender Identity Disorders, Dr. Zucker’s role is to coordinate and facilitate the work of the three sub-work groups addressing Sexual Dysfunctions, Paraphilias, and Gender Identity Disorders. Further information on the DSM-V development process can be found at [this web site].

Dr. Zucker has published 97 peer-reviewed journal articles, 48 book chapters, and a landmark textbook. His published work addresses psychosexual differentiation and its disorders, based on a wide range of empirical research studies on children and adolescents with gender identity disorder, with a focus on diagnosis and assessment, and their associated behavioral and psychological distress. As the current Editor of Archives of Sexual Behavior, the premier human sexuality research journal, he also has a wide familiarity with the disparate areas of sexual dysfunctions and paraphilias. Since 2001, he has been the Psychologist-in-Chief at the Centre for Addiction and Mental Health (CAMH), is a Professor in the Departments of Psychiatry and Psychology at the University of Toronto, and is on the Scientific Staff (Division of Child Psychiatry) at the Hospital for Sick Children. He was the President of the International Academy of Sex Research in 2005-2006.

Dr. Zucker and his service team at CAMH in Toronto have the longest standing research-clinical service for children and youth with gender identity problems in North America. Since the mid-1970s, Dr. Zucker and his team have evaluated over 900 children and youth with gender identity issues. Dr. Zucker is one of the few researchers who is doing long-term follow-up of the patients he has treated.

The philosophy of Dr. Zucker’s team is to provide client-centered care that maximizes benefit and minimizes harm to each child or youth. The goal of treatment is a well-adjusted youth, regardless of ultimate gender identity or sexual orientation, who feels she or he has been genuinely helped by her or his healthcare providers. Dr. Zucker has offered a variety of treatment options, understanding that options may vary greatly with the age of the client. For younger clients, therapy options include helping the child to overcome discomfort with his or her body, i.e., helping clients learn to live comfortably in their natal sex. Diagnosis and treatment of other problems that may be present, such as anxiety, depression, or substance abuse are also available, as are services for family members.

For adolescent patients (including those who first came to the clinic as young children), Dr. Zucker follows the Standards of Care Guidelines of the World Professional Association for Transgender Health. The treatment options include helping patients make a satisfactory transition to the opposite sex, including the institution of hormonal treatment to facilitate transition. In some cases, treatment may include helping an interested adolescent obtain sex-reassignment surgery.

For all patients, regardless of age, the focus of therapy is the patient’s gender identity, not the patient’s sexual orientation. Dr. Zucker’s therapeutic approach has no relationship to so-called reparative or sexual conversion therapies that attempt to change homosexual orientations to heterosexual ones. The goal of his therapy is the opposite of conversion therapy in that he considers well-adjusted transsexual, gay, lesbian or bisexual youth to be therapy successes, not failures.

Transgender Advocates’ Statements on APA DSM Workgroups

Jim Burroway

May 30th, 2008

The American Psychiatric Association has convened several panels to discuss revisions to the Diagnostics and Statistical Manual (DSM), which is currently in its fourth edition (DSM-IV). It’s a standard practice for the APA to revise the manual every decade or so in order to incorporate knowledge generated by more current research.

The APA has begun the work of compiling the data for DSM-V, and that process has sparked several strange rumors around the Internet that really didn’t ring true with me. According to a few of these rumors, the American Psychiatric Association (APA) is poised to either reinstate homosexuality in the Diagnostics and Statistical Manual (DSM), or that the APA was going to decide to approve of sexual reorientation therapy. There is nothing however to suggest that anything like that will be happening.

But most of these rumors surround the diagnosis of Gender Identity Disorder (GID), which is of particular interest to the transgender community. These rumors are centered around two researchers who have been appointed to some of the working groups: Kenneth Zucker, who chairs the Sexual and Gender Identity Disorders work group, and Ray Blanchard, who chairs the Paraphilias subworkgroup under Zucker.

To understand transgender people’s concern about these two appointments, some background is in order. Kenneth Zucker and Ray Blanchard are associated with the Centre for Addiction and Mental Health in Toronto, Canada. This center resulted from the merger of four mental health centers, one of which was the Clarke Institute of Psychiatry. The Clarke Institute was the referral agency for transgender clients who wanted to surgically transition.

Many transgender clients found their treatment in the hands of the Clarke Institute degrading and offensive, feelings which were greatly magnified by the Institute’s main mission of treating sex offenders. Transgender clients often describe inappropriate and degrading tests and experiences at the institute. In fact, feelings run so deeply about the Clarke Institute that some transgender advocates have dubbed it “Jurassic Clarke.”, while others append the adjective “notorious” in front of the Institute’s name so routinely that one might be tempted to think that its official name was “The Notorious Clarke Institute.”

Because of the Clarke Institute’s history, virtually anything emanating from the Centre for Addiction and Mental Health is suspect among the transgender community, and those suspicions often radiate to the rest of the LGBT community.

Associations with the Clarke Institute however isn’t the only source of transgender advocates’ concerns. Also controversial are some of Blanchard’s theories on MtF transgender etiology that he calls “autogynephilia,”which many people find deeply offensive and off the mark. (Blanchard, on the other hand, is a leading researcher into what he believes to be the biological causes of male homosexuality.) Also controversial is Zucker’s approach to treating transgender clients, which involves counseling the client to take on behaviors and attitudes which are considered to be more socially appropriate to that person’s biological sex. This is an approach which raises alarm bells among gays and lesbians who recognize the parallels to sexual reorientation therapies, which may be the source of the rumors concerning homosexuality and sexual reorientation therapy that I mentioned earlier.

Today, we have a statement from four Transgender advocacy groups, which will hopefully provide some clarification on Zucker’s and Blanchard’s role in the DSM-V revision.


Statement from:

National Center for Transgender Equality (NCTE)
Transgender Law and Policy Institute (TLPI)
Transgender Law Center (TLC)
Transgender Youth Family Allies (TYFA)

On May 1, 2008, the American Psychiatric Association (APA) announced the composition of work groups to review scientific advances and research-based information to develop the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The composition and scope of the work group on Sexual and Gender Identity Disorders and two subgroups are of great interest to transgender people and therefore to our organizations.

Though no consensus exists among transgender people about whether and how a GID diagnosis should be in the DSM-V, there is certainly agreement that decisions made by the APA about transgender and gender non-conforming people will deeply affect the lives of millions of transgender adults, adolescents and children.

We have met with and strongly encouraged the APA to closely adhere to its stated commitment to scientific process regarding diagnosis of transgender people. We are confident that a fair, unbiased review of current knowledge can result in a DSM-V that can move society toward a more rational and humane understanding of transgender people.

We encourage our transgender brothers and sisters to approach this issue with thoughtful consideration of all available information. To that end, we encourage transgender people and allies to remember that:

The naming of this working group on May 1 was not the commencement of advocacy around rethinking or revision of the GID diagnosis. Thoughtful advocates, within and without the APA, have been working on this issue for several years and they will continue to do so for several more, through at least 2012 when the DSM-V is finalized. We look forward to strengthening our relationships and positive communication channels with the many APA-affiliated professionals who are knowledgeable and understanding of transgender issues.

It is inconceivable that in the 21st century any credible scientist or medical professional would recommend any discredited treatment that would attempt to change a person’s core gender identity or sexual orientation. Such treatments have no empirical basis and are harmful. Importantly though, the DSM consists of diagnoses and not treatments. As such, the DSM-V will not offer any treatment recommendations for transgender people of any age.

The APA has created several mechanisms for thoughtful input into the DSM revision process from mental health professionals as well as laypeople affected by the DSM. We encourage transgender people and allies, especially mental health professionals, to utilize these systems to appropriately impact the process. In particular the APA has created a website through which written comments can be submitted. Additionally, as the DSM-V development process advances, working groups are charged with seeking the counsel and input of various advisers who will be selected from various clinicians, academics and other stakeholders. We will advocate for the inclusion of fair-minded advisors who are committed to providing only scientific, fair, reasonable and humane input. We are hopeful that these systems will help provide sufficient information to assure a fair and scientific process for the creation of the DSM-V.

Public acceptance of transgender people and anti-discrimination protections have been advancing swiftly. This is in large part due to scientific and medical advances, but also to the assertive, vigilant and intelligent activism of thousands of transgender people and our allies. While transgender people’s history with the psychiatric and medical professions has been, at times, fraught with misunderstanding and tainted by bigotry, we are optimistic that current and developing scientific research and clinical data will further the understanding of transgender issues among health care professionals and the public.

National Center for Transgender Equality (NCTE)
www.nctequality.org

Transgender Law and Policy Institute (TLPI)
www.transgenderlaw.org

Transgender Law Center (TLC)
www.transgenderlawcenter.org

Transgender Youth Family Allies (TYFA)
www.imatyfa.org

Give Us Your Opinions: What Should The APA Symposium Have Looked Like?

Jim Burroway

May 14th, 2008

Yesterday, I wrote about the deficiencies I saw in the make-up of the canceled APA Symposium, “Homosexuality and Therapy: The Religious Dimension.” Dr. David Scasta, the organizer of the symposium, saw my piece and left a thoughtful comment. I want to raise that comment in this post and ask you to share your thoughts on what a useful symposium might look like.

One important thing to remember is this: The symposium was not structured as a “debate.” I didn’t call it that in my post, but I didn’t clarify what it was exactly. It wasn’t a debate. Each participant had a topic on which they would talk on for a few minutes, and then questions would be entertained from the audience — at least that’s how I understand it.

Here is Dr. Scasta’s comment:

Dear Mr. Burroway,

I have read your observations regarding the symposium which I organized. Let me first complement your organization for its stated goal because it could easily be used as a mantra for the symposium. I have taken the liberty of repeating such verbatim because I think it is so well put:

“In the heat of the debate, several things have been lost. We’ve lost the ability to look at the situation calmly, rationally and with civility. We’ve lost the ability to oppose other viewpoints without demonizing those who hold them. We’ve lost the ability to know who is telling the truth and who is practicing deception or spreading falsehoods. We’ve lost the ability to treat each other with respect and dignity. We’ve lost a lot. Box Turtle Bulletin exists to help address this problem. I hope to shed some light, with honesty and integrity, and without rancor. I hope to earn your trust in what we report, and your respect in how we report it.”

I have been distressed that the media hype has so grossly mischaracterized the symposium. The symposium was portrayed unfortunately as a “debate.” All of the panel members on the symposium agreed that it was not to be a debate and that our goal was to be able to present our views in a collegial way that opened discussion instead of angry debate — exactly what the Box Turtle stands for.

All on the panel have also shown a willingness to make some concessions in their belief system when they are presented with new information and perspectives. Dr. Throckmorton, for instance, has distanced himself from his film, “I Do Exist.” A few copies are still available for historical purposes but he has clearly changed some of his views about the appropriateness or likelihood of change. By the same token, I have called into question some of the “scientific facts”” in the film that I helped to fund and create: “Abomination: Homosexuality and the Ex-Gay Movement.” It is not that I do not support the message of the film (that gay people of faith who go through reparative therapies become free when they shake off the chains of dogma and discover an accepting God). It is just that one of the studies seems to imply more “science” than is justified — a point that was effectively pointed out by Dr. Throckmorton. Dr. Mohler has taken extensive heat among his Southern Baptist constituency for suggesting that homosexuality might not be a choice. His concept that a cure for homosexuality should be sought, in the same way that a cure is being sought for Huntington’s chorea, is a concept which deserves fuller discussion. Perhaps as a physician I can give him a different perspective. Whether or not my arguments are persuasive, I can tell you that I have no doubt that Albert Mohler will give me a full and fair hearing and will respond with both insight and incisive thinking. And, he will put me to my proofs. I also believe that, if he is persuaded otherwise, he is the type of person who has the strength and moral fortitude to stand up for what he believes, even when it contradicts what he is “suppose” to believe.

The goal of the symposium was not to settle questions about reparative or change therapies. I do not know where you got the information that the panel was a “response to the APA’s decision to form a working group to review its stance on ex-gay therapy.” This statement is false — completely false. The Assembly of the APA (the legislative body of which I am a member) has asked that ALL position statements be reviewed and updated every five years. We are going through that process now. I sit on the Committee on Gay, Lesbian, and Bisexual Issues of the APA which is reviewing all of the statements related gay and lesbian issues. I can assure you with absolute certainty that the APA does not have a working group to reassess its view on ex-gay therapy and there is absolutely no desire in my committee to change the current stance. My symposium would have addressed how religion colors therapy with gays and lesbians as a separate dimension from therapy; it would not have posited any substantive change in APA position papers on the subject. I have the advantage of knowing the positions that the panel speakers would have taken. It is unfortunate that I was compelled to withdraw the symposium because I believe that rational people would realize that the ultimate outcome of the symposium would have been less change therapy, not more, if it had been allowed to proceed.

The issue is not over. There are still legions of lesbian and gay people of faith who say to mental health professionals, “I understand that mental health professionals believe I should accept myself as I am; but, if I do that, I am damned.” It is my goal to find a path out of that conundrum. To do so, we have to begin talking respectfully and rationally with people of faith — including some former enemies. It is time to stop preaching to the choir; but rather to enter into the lions’ den — and tame lions. If your are truly committed to Box Turtle’s goals of talking reasonably to our opponents without demonizing them, we are uncannily on the same page and I ask you for your help and guidance with this project.

David Scasta, M.D., DFAPA

Scasta, D. (2007). “John E. Freyer, M.D., and the Dr. H Anonymous Episode.” Ch. 1, in Homosexuality and American Psychiatry: An Oral History. (J. Marino and J. Drescher, Eds.). Haworth Press; New York

Scasta, D. (1998). “Historical perspectives on homosexuality.” Journal of Gay and Lesbian Psychiatry. 2(4):3-17.

Scasta, D. (1998) “Issues in helping people come out.” Journal of Gay and Lesbian Psychiatry. 2(4):87-98.

Scasta, D. (1998) “Moving from coming out to intimacy.” Journal of Gay and Lesbian Psychiatry. 2(4):99-111.

So readers, here’s the question: If you think a symposium with participation from both sides is a good thing (and I think it is), what do you think should be the makeup of such a symposium? I’ll offer my thoughts later today in the comments to this post.

Discuss! I am especially interested in input from those who support the goals of sexual reorientation therapy as well as those who are opposed. But as a corollary, and to ensure people feel safe in providing their thoughts on the subject, I will ask that everyone be respectful per our Comments Policy.

APA Symposium’s Critical Flaw: What About The Ex-Gay Survivors?

This commentary is the opinion of the author and is not necessarily the opinion of other authors at Box Turtle Bulletin.

Jim Burroway

May 13th, 2008

Don’t you hate it when you know that people are talking about you and you’re not there? And don’t you hate it even more when they’re talking about something that’s directly relevant to your experience, and that the whole point of their conversation is to arrive at conclusions about how to deal with you in the future? And you’re not invited to be a part of the conversation?

I know I do. But the now-canceled American Psychiatric Association Symposium “Homosexuality and Therapy: The Religious Dimension” was about to do just that.

The symposium, as the title suggests, was intended to discuss the intersection of faith and therapy, with special consideration to issues surrounding homosexuality. One particular topic was likely to dominate the discussion: efforts to change sexual orientation through therapeutic means. After all, this panel’s formation came as a response to the APA’s decision to form a working group to review its stance on ex-gay therapy.

The panel was organized by Dr. David Scasta, past president of the APA’s Association of Gay and Lesbian Psychiatrists. Also participating would have been Dr. Warren Throckmorton, who defends sexual reorientation therapy for those who want it, while recognizing that some forms can be harmful. Together they were to have covered the “therapy” aspects of what might have been a interesting exchange (although it would have been grossly incomplete for reasons I’ll get into in a moment).

But the panel was doomed from the start with the participating of two starkly polarizing figures representing the “religious dimension” of the panel. Southern Baptist Theological Seminary president Rev. Albert Mohler was to be one participant. He has been a stridently vocal advocate for sexual reorientation therapy, so much so that he even approved of prenatal therapy if such a thing were to exist — which, of course, it doesn’t. What contribution he might have had to a symposium which was supposed to bring “scientists and clinicians” together is very unclear.

Providing “balance” for the other side would have been Bishop Gene Robinson, the first openly gay bishop in the Anglican community. He too is a very odd choice. Bishop Robinson may be famous for his groundbreaking position in the church, but there’s no indication that he has any background for speaking about sexual reorientation therapy. Against Dr. Throckmorton and Rev. Mohler (who often speaks in support of reorientation therapy), Rev. Robinson would have been very much out of his element. No wonder Focus On the Family was so excited to mischaracterize the event as a “debate” between Robinson and Mohler to validate their position on sexual reorientation therapy.

That would have left Dr. Scasta as the only one who would have had even a remote possibility of speaking knowledgeably about reorientation therapy as an LGBT-affirming advocate. But unlike Throckmorton, Scasta has not published anything himself concerning sexual reorientation therapy that I’m aware of. With his background as editor of the Journal of Gay and Lesbian Psychotherapy, he may have been able to hold his own just fine, but I’ve not been able to find anything which speaks to his knowledge on this particular subject.

We were about to hear a lot of people talking about people who tried to change their sexual orientation, but it wasn’t clear that we were going to hear a lot of informed people talking about them. And worse, in setting up the symposium they left out the most important perspective: ex-gay survivors. This seems to happen all too often. Christine Bakke, ex-gay survivor and a Beyond Ex-Gay organizer, put the problem this way:

What got lost was the actual people who were doing [the ex-gay ministries]. It’s like a kid in a custody battle.

Well they’re definitely not kids anymore. Over the past year, we’ve seen hundreds of former ex-gays come forward in something that is beginning to resemble a movement. Before now, we all knew they existed — we certainly talked about them a lot — but we are just now starting to hear from them directly in pretty significant numbers — as well as from former ex-gay leaders and spokespersons. The days when they were seen but not heard are clearly over. Their experiences in ex-gay therapy are far too compelling to ignore, and their rapidly growing numbers in just a few short years suggests that many more will follow.

But so far, their existence was been largely overlooked or, worse, dismissed as a stunt. When survivors organized their very first conference in Irvine, California, more than two hundred people showed up. But Exodus International president Alan Chambers responded with snide comments while Focus On the Family spread bold-faced lies about the gathering. Even Dr. Throckmorton cast doubts on the ex-gay survivors motives during their historic, first-ever meeting.

Clearly this new movement has touched a nerve. Before now, the ex-gay movement and their defenders have had a free hand in defining the parameters of debate with very little effective opposition. Beginning in the 1990’s they embarked on a massive television and billboard campaign to convince the world that “ex-gays do exist” and “change is possible.” Exodus International took out full-page ads in national newspapers, and ex-gay ministry leader Michael Johnston appeared in television commercials. This, of course, was before his downfall in 2003 when it was learned that he had been hosting orgies, taking drugs and practicing unsafe sex without disclosing his HIV status.

Dr. Throckmorton himself has contributed to this publicity effort. In 2004, he produced the video “I Do Exist,” which he encouraged churches and schools to show as a counter to National Coming Out Day. In it, he described studies which he claimed documented cases “of people who had changed from completely homosexual to completely heterosexual.” The video featured several ex-gays including Noé Gutierrez, Sarah Lipp, Joanne Highley, and Cheryl and Greg Quinlan. All of these were presented as though they were ordinary, run-of-the-mill ex-gays who had an interesting story to tell.

But Sarah Lipp certainly isn’t an ordinary humble ex-gay picked at random. Her segments were filmed in Chattanooga, where she happens to be the women’s ministry coordinator for the Harvest USA ex-gay ministry, having founded several ex-gay support groups throughout the mid-South. Joanne Highley also leads an ex-gay ministry in New York. She’s an especially interesting character. She describes her lesbian past as having been “under demonic oppression.” She has also said that she heard a voice telling her that she would be “ministering to homosexuals and Jews.” That, of course, is not on the video, where she instead appears as a nice, kindly, and perhaps even a timid older lady.

Also not on the video is Greg Quinlan’s exuberance for manufacturing public confrontations while representing PFOX. He does that when he’s not acting on behalf of his own Dayton-based Pro Family Network. He and his wife Cheryl were very active in promoting Ohio’s anti-marriage constitutional amendment, which is just one example of how ex-gay leaders routinely leverage their own marriages for political causes against LGBT citizens.

In fact, of the five ex-gays appearing in that video, four of them had a personal vocational stake in promoting ex-gay ministries. Not surprisingly, this fits a well-known pattern. In Spitzer’s famous 2003 ex-gay study of people who claimed to have changed, he reported that “the majority of participants (78 percent) had publicly spoken in favor of efforts to change homosexual orientation, often at their church,” and that “nineteen percent of the participants were mental health professionals or directors of ex-gay ministries.” Exodus president Alan Chambers and vice-president Randy Thomas were just two of those participants.

The only person featured in “I Do Exist” who was not an anti-gay activist was Noé Gutierrez. He proclaimed himself to be “entirely heterosexual” in the video, but after the video’s release he announced that he regretted that his story became a part of “the divisive message of the ex-gay movement.” In a later update to his web site, he described how quickly Exodus International banned him from their annual conferences after he expressed doubts about ex-gay ministries, and some of the harms that he experienced as a fallout from his participation in ex-gay ministries — harms that are remarkably familiar to many ex-gay survivors I’ve talked to over the past year.

Nevertheless, “I Do Exist” is still available for sale on Dr. Throckmorton’s web site.

So yeah, we’ve all heard a lot from ex-gays. They’ve had free reign for nearly two decades to use their lives as examples to argue against advancing the civil rights of their fellow LGBT citizens. And until now, they’ve enjoyed something of a monopoly on the public square. Sure, there have always been activists who argued against sexual reorientation therapy, but many of them — as well-intentioned as they may have been — were often demonstrably uninformed about the movement, and that has diminished both their credibility and their effectiveness.

But now we have real live former ex-gays who, in concordance with their faith, tried to change their lives to fit the only mold their faiths allowed them — only to find themselves outside the false promise of “change” and, worse for some of them, feeling as though they were beyond reconciliation with God. These are people who really tried to bring their lives into congruence with their faiths, and yet this is where their ex-gay experiences left them. Ex-gays and their supporters have been speaking for decades now; it is way past time now for survivors to have a place at the table.

Talking is good, but this forum would not have included the very people who most needed to be heard. Ex-gay survivors really do exist, to borrow a phrase. And until these survivors are invited to speak to those who would presume to speak about them, a critical part of the conversation will remain unheard. And that won’t do anyone any good.

Controversial Ex-Gay Symposium Cancelled

Jim Burroway

May 2nd, 2008

Gay City News confirmed from Dr. Jack Drescher that the controversial symposium, “Homosexuality and Therapy: The Religious Dimension,” planned for May 5 has been canceled. That confirmation follows earlier reports that one of the panelists, Bishop Gene Robinson, had pulled out of the event.

The symposium was organized by Dr. David Scasta, former president of the Association of Gay and Lesbian Psychiatrists, and was planned to coincide with next week’s American Psychiatric Association conference in Washington, D.C. Controversy over the panel centered around the participation of Dr. Warren Throckmorton, who has been an active proponent of sexual reorientation therapies.

Also scheduled to be part of the panel was Dr. Albert Mohler, president of the Southern Baptist Theological Seminary in Louisville, Kentucky. He has previously supported the use of a prenatal test to undo an embryo’s homosexual orientation.

“Refried Freud” — Psychoanalysis and Ex-Gay Therapy

Jim Burroway

March 30th, 2008

Christine BakkeBeyond Ex-Gay co-founder Christine Bakke is truly a delightful woman. I got to spend a little bit of time with her again last February in Memphis during the Beyond Ex-gay Mid-South Regional Gathering. Not nearly enough time though — she was exceptionally busy putting together the art show for the weekend.

Last Friday, Christine posted a very thoughtful essay inspired by Peterson Toscano’s comments that ex-gay ministries are still depend on the developmental theories of Sigmund Freud — “Refried Freud” he called it. Which, when you think of it, means that the ex-gay movement is stuck in a very peculiar time warp. Most of their operating theories are founded on some rather ancient Freudian theories that the rest of psychology has largely abandoned.

Sigmund FreudSome of us are old enough to remember when Freudian psychoanalysis was all the rage back in the 1950’s and 1960’s. Everyone who was anyone, it seemed, was seeing an analyst. And everyone who was anyone was just as messed up after seeing their analyst as they were before. It’s no wonder that Freudian psychoanalysis has largely fallen by the wayside. As a discipline, they remained too wedded to a narrow set of untested and untestable theories, while the rest of psychology and psychiatry honed their methods and understanding over generations of research and observation, throwing out old theories when they were disproved and adopting new ones as they came along.

Meanwhile, Freudian analysts and their ex-gay therapy counterparts, undeterred by the march of time, continued to press forward with their oft-parodied opening gambit: “So now, tell me about your mother.”

Christine Bakke knows where that leads all too well:

The fishing expeditions (a friend started to believe he didn’t feel his father’s love after being badgered with, “did your father say he loved you? It doesn’t matter if you knew; did he say it? He didn’t say it? Then you didn’t really know it, did you? Of course you didn’t know it; didn’t feel it. How can a child know it if they’re not explicitly told it?” and so on) and leading questions and suggestions (one pastor’s wife suggested I make up abusive things that might have happened to me, so that I could break the curse of satan, just in case I didn’t remember specific things that might have happened to me in my life. I forcefully refused.) I was even told that sometimes women can be gay because they have not been able to grow out of the stage of penis envy.

I knew one women whose therapist gave her assignments to flirt with men. An ex-gay guy who went on several dates to try to learn how to be with a woman (without disclosing that he identified as ex-gay), on the recommendation of his therapist. A woman who was counseled by the leader of the ex-gay group that women should wear makeup (“need to put some paint on the side of the barn”). A man who changed his last name because his ex-gay therapy led him to believe that his parents were to blame for him being gay. A woman who insinuated that she had been abused because she felt like her story didn’t “fit” the ex-gay model without some kind of a root cause. A young man who said that after he got out of the ex-gay movement and was finished with reparative therapy, that’s when the real repairing began. He had to repair the relationships with his family after buying into the belief that they were distant from him and made him gay.

The American Psychological Psychiatric Association removed homosexuality from its list of mental disorders in 1973. In doing so, they relied on non-psychoanalyitic studies like those of Evelyn Hooker. But the American Psychoanalytical Association dismissed non-psychoanalyic studies as “superficial.” This created a strange closed-off echo chamber where evidence that ran counter to a theory was thrown out because it didn’t fit the theory. In fact, the APsyA remained hostile to homosexuality until 1991, when openly gay candidates were for the first time allowed to apply for acceptance by the APsyA.

Since then, the APsyA has begun to consider the implications of research in a whole host of mental disorders like schizophrenia and bipolar disorder, which today are regarded as being at least partly physiological disorders. This would have been anathema to psychoanalysts a mere generation ago. Last year, the APsyA issued a statement supporting same-sex marriage. That’s quite an improvement since 1991.

But ex-gay therapies continue to rely on the same outdated theories that once threatened to make psychoanalysis a historical footnote. While the APsyA are allowing nonpsychoanalytic research to inform their work, ex-gay ministries remain stuck firmly in the past. But the problem with relying on untested and untestable theories is that they are no more scientific than any other folk remedies or superstitions. And some of these remedies may be damaging. Christine Bakke contrasts her experience with therapists and misguided religious-based lay leaders, and concludes:

Of course, like in my case, even licensed therapists who have an ex-gay mindset and agenda can be just as damaging as the lay leaders. Sometimes I can’t decide which is worse. Counseling by a therapist we think should know the best because we think they’re the experts and we trust them more, or lay leaders who we think love us more because we are not paying them. No matter what, ex-gay counseling done by therapists or lay leaders, many poorly equipped through books, Exodus conferences, Living Waters training programs (one week long), Love Won Out day-long conferences, on-the-job training, or for some, nothing more than being ex-gay themselves, mixed with refried Freud, is a recipe for disaster.

I highly recommend you read her entire essay.