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Posts for August, 2009

NARTH Responds To APA Resolution On Change Therapy

Jim Burroway

August 7th, 2009

The National Association for the Research and Therapy of Homosexuality (NARTH) has issued a press release in response to the American Psychological Association’s Resolution on Appropriate Affirmative Responses To Sexual Orientation Distress and Change Efforts. That APA resolution concludes that there is “no evidence” that therapy to change sexual orientation actually works, and calls on therapists to refrain from promising otherwise. NARTH didn’t like that one bit:

NARTH appreciates that the APA stressed the importance of faith and religious diversity. Unfortunately, however, the report reflects a very strong confirmation bias; that is, the task force reflected virtually no ideological diversity. No APA member who offers reorientation therapy was allowed to join the task force. In fact, one can make the case that every member of the task force can be classified as an activist. They selected and interpreted studies that fit within their innate and immutable view. For example, they omitted the Jones and Yarhouse study, the Karten study, and only gave cursory attention to the Spitzer study. Had the task force been more neutral in their approach, they could have arrived at only one conclusion: homosexuality is not invariable fixed in all people, and some people can and do change, not just in terms of behavior and identity but in core features of sexual orientation such as fantasy and attractions.

This is pretty rich. First, NARTH complains that the APA Task Force engaged in “a very strong confirmation bias” and gives a definition for conformation bias that is completely wrong. This is what confirmation bias really is:

In psychology and cognitive science, confirmation bias (or confirmatory bias) is a tendency to search for or interpret information in a way that confirms one’s preconceptions, leading to statistical errors.

Confirmation bias is a type of cognitive bias and represents an error of inductive inference toward confirmation of the hypothesis under study.

Confirmation bias is a phenomenon wherein decision makers have been shown to actively seek out and assign more weight to evidence that confirms their hypothesis, and ignore or underweigh evidence that could disconfirm their hypothesis.

NARTH instead offered a definition for confirmation bias that has nothing to do with confirmation bias, and everything to do with launching an ad hominem attack against the APA’s Task Force members.

But the charge that the APA Task Force engaged in confirmation bias is even more laughable considering the wholesale confirmation biases evident in NARTH’s own pre-emptive report on conversion therapy. We have already provided evidence that NARTH carefully selected studies for  their report based on purported successful outcomes, while omitting studies which ran counter to their pre-determined hypothesis. That, of course, is the very definition of confirmation bias. And in trying to find as much evidence to support their position as possible, they hoovered virtually every confirming “study” they could find regardless of scientific merit, including unpublished dissertations, non-peer reviewed books, (specifically, the Jones and Yarhouse book and the Karten dissertation they pointed to in their press release), pop-psychology paperbacks — you name it.

They even referenced the 1979 Masters and Johnson book Homosexuality in Perspective.  This is how NARTH’s report described that book:

In Masters and Johnson’s (1979) treatment of 90 homosexuals, a 28.4 percent failure rate was reported six years after treatment. Masters and Johnson chose to report failure rather than success rates to avoid vague, inaccurate concepts of success; however, by implication, more than 70 percent of their patients achieved some degree of success toward their self-identified goal of diminishing unwanted homosexuality and developing their heterosexual potential.

Of course, the most important thing that we now know about the Masters and Johnson book is that it was faked. There were no records for any of those reported patients and their supposed success stories. Co-author Virginia Johnson was later so embarrassed by it, she referred to it as a “bad book.”

The APA Task Force, in sharp contrast to the NARTH report authors, established a very rigorous criteria to determine what studies they would review before reviewing them. That criteria was this (PDF: 1,092KB/136 pages, see page 9):

Initially, we reviewed our charge and defined necessary bodies of scientific and professional literature to review to meet that charge. In light of our charge to review the 1997 resolution, we concluded that the most important task was to review the existing scientific literature on treatment outcomes of sexual orientation change efforts.

We also concluded that a review of research before 1997 as well as since 1997 was necessary to provide a complete and thorough evaluation of the scientific literature. Thus, we conducted a review of the available empirical research on treatment efficacy and results published in English from 1960 on and also used common databases such as PsycINFO and Medline, as well as other databases such as ATLA Religion Database, LexisNexis, Social Work Abstracts, and Sociological Abstracts, to review evidence regarding harm and benefit from sexual orientation change efforts (SOCE). The literature review for other areas of the report was also drawn from these databases and included lay sources such as GoogleScholar and material found through Internet searches.

…The task force received comments from the public, professionals, and other organizations and read all comments received. We also welcomed submission of material from the interested public, mental health professionals, organizations, and scholarly communities. All nominated individuals who were not selected for the task force were invited to submit suggestions for articles and other material for the task force to review. We reviewed all material received. Finally, APA staff met with interested parties to understand their concerns.

In other words, the APA Task Force defined the criteria before hand and reviewed every study that met that criteria, studies that purported to show change in sexual orientation, and studies which showed failures to change — including many studies that NARTH pretended never existed.

Conversely, there’s no evidence that NARTH’s review was in any way systematic. Given the studies that we know NARTH omitted, we know there was nothing systematic about their approach other than to confirm their predetermined outcome. And given the fraudulent material they did include – as well as the abundance of material that never met the scientific gold standard of having been peer-reviewed — it is clear that NARTH’s report is the very definition of confirmation bias. And their press release is the very definition of irony.

Exodus International Responds to the APA Resolution on Change Therapy

Jim Burroway

August 6th, 2009

Exodus International has issued a a strange press release in reaction to the APA’s resolution against sexual orientation change efforts (SOCE). In it, Exodus actually claims a bit of vindication:

While Exodus does not fully agree with the APA’s criticisms of clinical techniques such as reparative therapy and its view of sexual orientation change, the report does recognize that some choose to live their lives in congruence with religious values. The report also encourages therapists to avoid imposing a specific outcome on clients.

As I noted earlier, the APA resolution cautions Exodus, NARTH and other proponents of change therapy against “distortion and selective use of scientific data about homosexuality.” So where does the phrase about “imposing a specific outcome on clients” come up in the APA report? (PDF: 1,092KB/136 pages) You don’t have to go far; it’s on page v in the report’s abstract:

Even though the research and clinical literature demonstrate that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality, regardless of sexual orientation identity, the task force concluded that the population that undergoes SOCE tends to have strongly conservative religious views that lead them to seek to change their sexual orientation. Thus, the appropriate application of affirmative therapeutic interventions for those who seek SOCE involves therapist acceptance, support, and understanding of clients and the facilitation of clients’ active coping, social support, and identity exploration and development, without imposing a specific sexual orientation identity outcome.

The APA report goes into more detail on page 88:

Self-determination is the process by which a person controls or determines the course of her or his own life (Oxford American Dictionary, n.d.). LMHP [Licensed Mental Health Professionals -- ed.] maximize self-determination by (a) providing effective psychotherapy that explores the client’s assumptions and goals, without preconditions on the outcome; (b) providing resources to manage and reduce distress; and (c) permitting the client herself or himself to decide the ultimate goal of how to self-identify and live out her or his sexual orientation. We were not persuaded by some accounts that suggest that providing SOCE increases self-determination, because these suggestions encourage LMHP to offer treatment that (a) has not provided evidence of efficacy; (b) has the potential to be harmful; and (c) delegates important professional decisions that should be based on qualified expertise and training—such as diagnosis and the type of intervention. Rather, therapy that increases the client’s ability to cope, understand, acknowledge, and integrate sexual orientation concerns into a self-chosen life is the measured approach. [Emphasis mine]

In other words, the report was very clear that by encouraging therapists to avoid imposing a specific outcome on clients, the APA was not giving a license to Exodus and others to promote therapies that are unproven or potentially harmful. In fact, throughout the report, the APA emphasises the importance of allowing the client chose the path, and for the therapist to provide affirming and positive support.

As long as the client wants to try to suppress his sexuality, then what Exodus offers is in line with the APA’s recommendations — as long as Exodus doesn’t promise a change in sexual attractions as a likely outcome. But somehow I doubt that Exodus-affiliated therapists will be willing to follow this advice if the client decides to fully embrace rather than suppress his sexuality.

So unless Exodus is signalling that they are ready to step in a new direction, their press release is disingenuous at best and a “distortion and selective use of scientific data” at worst. Either way, it looks like more of the same ol’ same ol’.

How I Convinced Myself That I Was Changing My Sexual Orientation

Daniel Gonzales a former patient of Joe Nicolosi, explains.

Daniel Gonzales

May 4th, 2008

Oftentimes when I meet someone who’s been through ex-gay therapy I ask them if they ever reached the point where they believed they were beginning to change — It’s how I gauge just how deeply they got into the whole “ex-gay thing.” Ex-gay leaders often assert, “change is possible and I’m proof because I changed.” In my opinion the strongest response is “I too once believed I had changed.” Here’s my own explanation of how I believed I had changed:

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