Box Turtle Bulletin
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News and commentary about the anti-gay lobbyFebruary 25th, 2010
Earlier this year, Patrick Strudwick reported on an under-cover investigation into the UK’s ex-gay therapy movement. One of the therapists he exposed was Dr. Paul Miller, an ex-gay whom had previously receive notoriety when he was mentioned by Iris Robinson, wife of North Ireland’s First Minster (Pink News)
“I have a very lovely psychiatrist who works with me in my offices and his Christian background is that he tries to help homosexuals trying to turn away from what they are engaged in.
“And I have met people who have turned around to become heterosexual.”
Now Strudwick has now reported Dr. Miller to the General Medical Council and is seeking to have him “struck off” from being able to practice due to his reorientation efforts.
I hope his effort fails.
Or, to be more specific, I hope that if the GMC does strike off Dr. Miller, it will not do so for the reasons that Patrick Strudwick is stating. (BBC)
Patrick Strudwick wants the medical governing body, the GMC, to take action against Dr Miller.
“I’m actually the first person in British history to try and get a doctor struck off for treating homosexuality,” he said.
“If Dr Miller is struck off, which I hope he is, this is a test case and will serve as a warning to other psychiatrists and mental health professionals attempting to do this.”
I think that Dr. Miller’s behavior was highly unethical and based in ignorance and prejudice. He crossed borders and sexualized the therapy in ways that should never be allowed. He made wild assertions about the bases of Strudwick’s orientation and provided “information” that is not credible. He chose to believe the bizarre and baseless theories of fringe “counselors” and attempted to apply them to clients. I would not be at all sympathetic if he were seriously curbed in his ability to continue in these behaviors.
But I do not want Dr. Miller to “struck off for treating homosexuality.”
Let me be clear. I do not believe that therapy is effective in changing sexual orientation. If there is any change in attraction, it does not appear to be consistent, permanent, thorough, or traceable to specific therapy protocols. And it appears that the vast majority of persons who seek change in sexual orientation – a change from primarily or exclusively same-sex attracted to primarily or exclusively opposite-sex attracted – never achieve this goal.
But I don’t believe that an out-right ban on therapy for persons who wish to change their orientation is appropriate. While I find the evidence of “change” to be unsubstantial, we do know that some individuals do achieve a change in life patterns which they find to be meaningful and rewarding. Some find tools to manage their sexual impulses, others find coping skills for aligning their faith with their attractions, and some few find a spouse that adequately fulfills their desires.
I would not (and probably could not) find meaning in choosing social goals over internal cohesion, but I have no right to demand that others make the same priorities as me. And I would not want that their ability to seek supporting therapy to be eliminated.
And on a pragmatic level, I know that Mr. Strudwick’s efforts will be trumpeted across the anti-gay media network as an “attempt by militant homosexual activists to silence Christians.” The next attack on our freedoms will include a distorted telling of this tale which, of course, will highlight the reporting to the GMC and will conveniently forget Dr. Miller’s creepy and inappropriate sex talk. I don’t want their dire predictions about how “the UK has banned Christian therapists and we’re next” to have basis.
What I would like to see is a tightening of regulations for those who counsel unhappy same-sex attracted people. I would like for the medical community to disallow affirmative claims for cures that have not been studied, require that clients be provided with the official positions of mental health organizations, enforce prohibitions on inappropriate violations of boundaries, and hold ex-gay therapists to the same standards that other therapists must follow. In other words, if you want a professional license, you have to behave professionally.
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Dr. Matthew
February 25th, 2010
I get concerned about the latter points you mention, if only because that has long been the stance of the APA, more or less (i.e., inform a client about the science, respect appropriate boundaries, etc.), and there’s little evidence it has changed therapist behavior. On the other hand, there’s no reason that an outright ban on what are, essentially, cases of malpractice and unethical levels of dishonesty to clients, would impact the type of therapy that you, and most therapists, agree should happen – a more general therapy for those who want to integrate their lives in a congruent way. There’s nothing about a ban on conversion therapies that would preclude a therapist from discussing means of pursuing, say, celibacy, if that is the wish of the client. Such a ban would only require therapists be much more rigorous in clarifying the limits and likely outcomes of therapy, and providing accurate perspectives on the research about LGBT lives. I agree with your goal, I just differ in that I feel it’s compatible with a ban on ex-gay therapies.
That said, given the data, we hold all other allied health professions to a common standard that disseminating disproven and potentially harmful treatments, in flagrant ignorance of the current body of knowledge in the field, is typically grounds for loss of licensure, or at least strong sanctioning. I don’t think there’s anything in Dr. Miller’s case that should preclude him receiving the same consequence as any other doctor guilty of malpractice (I’m ignorant of typical consequences in the UK – I assume in some cases it would warrant revocation of a license, however).
Ray
February 25th, 2010
I anticipate a distorted message regardless of what the Brits do. Nothing prevents the Christian Right from distortion – no victory nor defeat nor plain facts nor television cameras rolling to record the actual truth. Nothing will prevent them from distorting. Nothing. IMHO.
John
February 25th, 2010
Medical Boards are like prosecutors. They usually take the surest, shortest route to their goal: in this case, stopping this guy from seeing other patients.
Given his inappropriate, overly sexual interations with a patient, that is enough right there to sanction him. Further investigation might show a pattern of behavior, making it that much easier to remove his license completely. All without even broaching the issue of reparative therapy.
Policy issues with regard to ex-gay therapy would probably require a different approach, starting with convening a group to evaluate the science and make recommendations. If a particular therapy was deemed ineffective, potentially dangerous, etc, the Board could send a letter to physicians and other practitioners, instructing them about the limits of what they can or should promise with regard to “change” of sexual orientation. Those who violate this clearly stated policy of the Board might be more vulnerable to sanctions, but most likely for activity they engage/ in after they have been warned.
The shorter road to going after ex-gay therapists is just to sue them in court. There, you just have to prove that they are committing fraud, selling snake oil, that there is no science to back their claims and that there practice does not meet the standard of care of their community, region, state or national levels of standard of care. Malpractice suits in the UK might be handled differently.
I guess there are mulitple reasons that there haven’t been a lot of these suits. Shame. Also, you have to demonstrate that you have been damaged, which aside from money wasted on therapy might be difficult to prove from some wanting to sue. For others the damage might be more obvious. The final damages would probably end up being the amount spent on the therapy (which could be a lot, I guess). Pain and suffering, as well as punitive damages, are limited in some states, like California.
RCM
February 25th, 2010
To complain about bad practice to the relevant professional body is actually the most typical route to take in the UK. Taking someone to court to sue is often prohibitively expensive, so people rarely do that unless they are very sure that they will win.
I think I understand Timothy’s moral reservations about getting all ex-gay therapy banned, if people want to get help keeping their desires within the bounds of their religion, that is their choice, and harms no one else. However, I believe Patrick Strudwick specifically asked the therapists that he was researching if they could cure him of homosexuality, and since the Royal College of Psychiatrists do not regard homosexuality as a disorder, they are not likely to find it acceptable that a member offered treatment or a cure for it as if it were a disease.
Mostly I think Patrick is doing a good job of getting these issues into the public eye, because a lot of people will have no idea that this stuff is even going on, that is going to change now that he has the Independent and the BBC talking about it.
Fred in the UK
February 25th, 2010
John,
GMC hearings are quite different to your description of Medical Boards. Although there is a prosecution and a defence, they are not trying to strike doctor’s off the Medical Register, that is considered a last resort.
The GMC hearing would certainly do none of that. The GMC regulates all doctors and does not divide itself up into boards that regulate different specialties. The job of evaluating evidence, producing guidelines, in this case, would fall to the Royal College of Psychiatrists. The GMC would certainly consider the actions of a doctor in the light of existing guidelines, but not ones produced subsequently.
As for suing doctors in court in the U.K., it is in theory possible to sue them for fraud/mis-selling but you would have to prove that what they promised you was false. However unless they gave you specific assurances you would be cured then that would be difficult. Doctors are much more commonly sued for negligence, essentially that they failed in their duty of care towards the patient. It’s relatively to prove that in a case of a doctor who failed to check symptom X wasn’t caused by cancer Y. However I imagine in the case of a patient who wanted to be ‘cured’ of being gay, and a psychiatrist engaged in a course of talking therapy, its more difficult. Telling a patient who is deeply distressed, that they is nothing wrong with them, they need to cope with it and to go away is not exactly great patient care.
Compensation would depend on showing loss/damage in financial, physical and/or emotional terms that was a result of the negligent treatment either directly or indirectly e.g. by delaying proper treatment. Punitive damages are almost unheard of in the UK, but they do technically exist, I cannot imagine a court using them in a case like this.
Fred in the UK
February 25th, 2010
RCM,
While that is strictly speaking true, I am not sure they would take the same hard-line with the claim that the disorder was the patient’s distress about their homosexuality and the aim of the treatment was to relieve that distress.
John
February 25th, 2010
Medical Boards in the US only take away licenses permanently as a last resort as well. However, an effective way to get your permanent license revocation on the fast track is repeated sexually inappropriate interactions with multiple patients.
Mark in Colorado
February 25th, 2010
“we do know that some individuals do achieve a change in life patterns which they find to be meaningful and rewarding. Some find tools to manage their sexual impulses, others find coping skills for aligning their faith with their attractions, and some few find a spouse that adequately fulfills their desires.”
Unsurprisingly, words that tell me Mr. Kincaid isn’t quite certain of his own orientation.
Words that give aid and comfort to anti-gay bigots and so called ex-gays.
Mr. Kincaid’s closet door appears to still be on its hinges.
“Chicken Littles” are becoming so tiresome.
Ben in Oakland
February 25th, 2010
I would disagree, Mark. They are going to believe what they believe regardless, including the belief that they are victims of the mean ol’ mo’s. I think timothy is hardly exhibiting closeted behavior or attitudes. I also think timothy is just describing reality. I never quarrel with reality, myself. I’ll leave that to the dancing-on-the-head-of-a-pin crowd.
I’m not sure how it works in UK, but if it were here, and soemone was really unhappy with his ex-gay experience, a regular malpractice lawsuit would be in order.
And then it would all ocme out in the wash.
TampaZeke
February 25th, 2010
Timothy, if it’s guidance and counseling toward living within their religious beliefs that these unhappy gay people seek then they need to go to their RELIGIOUS leaders, not to licensed, SCIENCE based psychologists and psychiatrists. Psychologists and psychiatrists should deal in SCIENCE and scientifically proven therapies ONLY. Psychiatric professionals won’t have to worry about losing their licenses if they stay out of the religious, spiritual, non-scientific counseling business.
It’s really very simple. If you want advice on how to live your life in concert with your CHOSEN faith then go to your pastor, priest, monk, rabbi, imam or what ever head holy honcho that is qualified to counsel you about your faith.
The ONLY reason religion based ex-gay therapy is moving into the psychiatric professional realm is to gain scientific/secular credibility for a therapy that has none. We do everyone a disservice when we try to find ways to excuse or support this dangerous crossover.
I fully support this man’s attempt to have the license of this snake oil salesman revoked. If he wants to do religious based counseling then he needs to go to seminary so that he can get the proper credentials. Then he can sell whatever hokus pocas hokam he wants and as long as he calls it religion and not science.
TampaZeke
February 25th, 2010
…he’ll be within his scope.
RCM
February 26th, 2010
Fred, I agree with you, but I am under the impression that Mr Strudwick actually has evidence of Dr Miller attempting to correct his sexual attraction to men, not just distress about the attraction.
John, they will certainly take action against Dr Miller if whatever he did constitutes sexual assault.
I agree wholeheartedly that religion should not be getting mixed up with mental health care, but I’m dubious as to how much real science there is behind a lot of mental health care. At least who is who should be clear for the sake of the service users.
AdrianT
February 26th, 2010
TampaZeke hits the nail on the head –
Mr Strudwick is not banning him from seeing gay people who are not happy with their sexuality. Patrick is just asking for his accreditation to be removed. The therapist in question must NOT be allowed to defraud people into thinking he is offering medical expertise. Spiritual, religious – yes.
But medical? A resounding ‘No’.
The public needs to know what they are letting themselves in for. Unless he is struck off, the NHS could refer patients to him, and vulnerable people seeking therapy for numerous other psychiatric problems could end up being encouraged to think their sexuality was the problem.
What next, shall doctors advise cancer patients to throw away their medicine and use homeopathy instead? Or why don’t we get astrologers to set the discount rates at the Fed?
(*oh silly me, magic water is actually available on the NHS and astrologers would probably do a better job than most economists….)
wister
February 26th, 2010
Also, let’s not forget that the psychiatrist was being paid by the NHS and not out of the patient’s pocket. Which means that the government’s health fund is paying for this nonsense.
I hope they can manage to stop the dangerous spread of fundamentalism to the UK which is what this case represents. I think that Mr. Strudwick underestimates the amount of money American groups like Exodus stand to make by exporting their nonsense.
RCM
February 26th, 2010
I know Mr Strudwick claims that some of the therapists he found were available on the NHS, but the article in the Independent says this:
“”It’s difficult to access money, but if we’re clever there are ways.” He talks about his conversion practice, and how it’s funded. “We use people’s private medical insurance,” he says””
Link to whole article:
http://www.independent.co.uk/life-style/health-and-families/features/the-exgay-files-the-bizarre-world-of-gaytostraight-conversion-1884947.html
I’m not so sure that Fundamentalism is going to take over the UK, they already don’t have the kind of political power or wealth behind them as in the USA, and our most powerful churches are not Bible literalist…http://www.pinknews.co.uk/2010/02/23/bishops-call-for-gay-civil-partnerships-in-church/
Priya Lynn
February 26th, 2010
If people are seeking out this “therapy” because their sexuality conflicts with their religious beliefs it is the religious beliefs that are the problem not their sexuality. People need therapy for their faulty religious beliefs, it is simply crazy to indulge faulty thinking by accepting it as valid and trying to modify core features of a person to be congruent with damaged thinking.
Richard W. Fitch
February 26th, 2010
@Priya: YES! A resounding YES! No religion, least of which is Christianity, is monolithic. This in itself should indicate that no one sect has THE TRUTH. It is not so much shopping around to find a church that conforms to your beliefs, but it is testing the interdependent aspects of doctrine and reason to assess where the closest thing to ‘truth’ can be found. [I do get miffed at times regarding your dissing of religion. This is one time I find you definitely on-point.]
Priya Lynn
February 26th, 2010
Richard, uhh, thanks, I think…
Richard W. Fitch
February 26th, 2010
Priya – it was meant sincerely. Those of us who comment here have a multiplicity of backgrounds and commitments. We’re not going to agree all the time, but it’s good to know that we have enough convictions in common to work together.
RCM
February 26th, 2010
Priya,
“it is simply crazy to indulge faulty thinking by accepting it as valid and trying to modify core features of a person to be congruent with damaged thinking.”
Good point, but either we are all going to have to put up with people we think are nuts, or we are going to have to give up on believing there is a human right to freedom of religion. Personally, I’m ok with having to share the planet with loons, as long as they aren’t harming others.
Priya Lynn
February 26th, 2010
I don’t disagree with you RCM.
R Holmes
February 26th, 2010
Strudwick has set up a Facebook page for his group “Stop Conversion Therapy Taskforce”. So far, in the discussions, he’s been pretty unpleasant to a couple of people who disagreed with him. His exchange with one person has been removed (I don’t know whether Strudwick removed both posts or only his own). The other person backed down in the face of Strudwick’s criticism.
I’m following this matter with interest, but so far I’m disheartened by the way Strudwick’s has dealt with disagreement.
Timothy Kincaid
February 26th, 2010
I’m all for sharing the planet with loons.
Of course, my definitions would be quite different than that of some. :)
RCM
February 26th, 2010
Perhaps Mr Strudwick is not so good as a leader of a pressure group, maybe he too stridently wants to get all anti-gay opinions banned, also he might just be a bit quick tempered. SCOTT is very new, but if it turns out he cannot lead the protest movement, I’m sure someone else will.
Dan
February 26th, 2010
I guess I’m of two minds about this:
“Let me be clear. I do not believe that therapy is effective in changing sexual orientation….But I don’t believe that an out-right ban on therapy for persons who wish to change their orientation is appropriate. While I find the evidence of “change†to be unsubstantial, we do know that some individuals do achieve a change in life patterns which they find to be meaningful and rewarding. Some find tools to manage their sexual impulses, others find coping skills for aligning their faith with their attractions, and some few find a spouse that adequately fulfills their desires.”
I definitely agree with you that therapy should be available for persons who wish to change their orientation. But the therapist must be honest: there is no good evidence that this sort of change is possible or that the attempt to change is safe. The APA, for example, is very clear about this.
Once this is established, I have no problem with exploring the client’s dissatisfaction and finding ways to alleviate it. The client may decide, as a friend of mine did, “There’s nothing wrong with being gay, but MY way of being gay has been self-defeating.” If so, a change in life patterns or better impulse control may be a worthwhile goal.
Finding a compatible, same-sex spouse would be a great outcome. And “aligning their faith with their attractions” makes perfect sense to me. After all, a faith that runs counter to our basic biology needs some realigning, at a minimum. In my opinion, an unreasonable, harmful faith is neither true nor good.
Before any of this can be achieved, though, the rubbish that it’s wrong to be gay has to be cleared away. It interferes with finding fulfillment as a gay person. Clients who are trying to turn straight need to see their sexual orientation in a new way, as something that is at least potentially beneficial. For ultimately, they need to derive benefit from it. As Priya said, faulty thinking must be modified, not indulged.
For conversion therapists to accomplish this, they’d have to have a conversion of their own. They can’t just refrain from making antigay remarks and expect to help a gay client. In most cases – perhaps not all – they should be told not to see clients who want to change their orientation. Someone whose prejudice won’t get in the way should take those cases.
Mark in Colorado
February 26th, 2010
Thank you. For my own research.
Mr. Kincaid has NOT refuted me.
Arrogance or NOT.
Thank you!
Timothy Kincaid
February 27th, 2010
Mark in Co.,
You are welcome to express your opinions here. But doing so does not in any way obligate me or anyone else to respond.
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