Box Turtle Bulletin

Ex-Gay Project Fails

The National Organization “for” Marriage is trumpeting a new survey about changing your sexual orientation, based on “religiously-mediated” involvement in Christian conversion ministries:

Many professional voices proclaim that it is impossible to change homosexual orientation, and that the attempt to change is commonly and inherently harmful…

The results show change to be possible for some, and the attempt not harmful on average.

I don’t have access to the full survey, but the researchers have summarized the results.  Here’s how it turned out after 6 to 7 years of tracking participants:

That’s a meager 14% success rate.

Or is it? Let’s learn more about those 14 people.

First, it’s probably not 14.  The study cautions us that the 14 conversions and 18 celibates represent “likely overly optimistic projections of anticipated success.”

In other words — less than 14 actual conversions.

But wait.  Check out what “conversion” means:

Most of the individuals who reported that they were heterosexual at Time 3 did not report themselves to be without experience of homosexual arousal, and did not report heterosexual orientation to be unequivocal and uncomplicated.

You know what they call straight people who experience homosexual arousal, and whose orientation is at most equivocal?  Bisexual. Most of the 14 heterosexual “conversions” seem to be bisexuals.

This leaves us with at most — at most — 6 individuals who went from gay to straight (as of now, at least; who knows where they’ll be in another 7 years).

6.

And the authors aren’t willing to go even that far.  Their single-sentence summary:

In short, the results do not prove that categorical change in sexual orientation is possible for everyone or anyone, but rather that meaningful shifts along a continuum that constitute real changes appear possible for some.

Wow.  Out of 98 highly-motivated subjects, the authors found that a small, unspecified number can use prayer and counseling to shut down their sexual feelings or become a bit more bi.  And possibly none who turned straight.

Frankly, I’m surprised they couldn’t find more.  The authors claim their results:

…challenge the commonly expressed views of the mental health establishment that change of sexual orientation is impossible or very uncommon…

Actually, it looks more like the results confirm those views.  If the antigay camp sees this as vindication and victory, they must be even more desperate than I thought.

UPDATE: I’m abashed to say that Timothy Kincaid has already covered this here at Box Turtle Bulletin, and in far more depth. You can check out his series of articles here.

Mark Yarhouse needs to decide between honesty and anti-gay activism

Mark Yarhouse, professor of psychology at Regent University, frustrates me.

On the one hand, he has been willing to conduct research and produce results that have called into question long held presumptions about orientation change efforts. In much of his current writing, Yarhouse has distinguished between experiencing attraction, identity, and behavior and seeks to move away from the affirmation vs. reorientation dichotomy and to focus on reconciling values with a structure of behavior.

But on the other, he has utilized selective language that encourages confusion and has allowed others to mischaracterize his work in ways that he knows to be dishonest. He has allowed, if not encouraged, political positioning that well serves anti-gay activists but which is in direct contradiction with his own endeavors.

And today we have an example of each.

As noted at Dr. Warren Throckmorton’s site, Yarhouse released a study in Edification (aChristian psychology journal published by the American Association of Christian Counselors) that found that same-sex attracted men in heterosexual marriages experienced an increase rather than * do not experience a decrease of such attractions over time. (Actually, the entire journal is fascinating in how it illustrates the way in which some within the most conservative end of Christianity are struggling to make sense of conflicts between doctrine and observation.)

But also today we have Yarhouse speaking to the Christian Broadcasting Network in defense of the Bachmann clinic’s prayer and promise about complete reorientation:

If you’ve watched the mainstream media’s reporting in the last day or so, you’ve seen these tapes which suggest that changing sexual orientation is not possible. In fact, at least one major study shows change is possible.

Psychologist Mark Yarhouse explored the question in a six year work that he presented at the American Psychological Association’s annual conference.

Yarhouse: I think our study raises that question again, says wait a minute, here’s a change effort sustained over time and there’s a pretty significant percentage of people for whom this is helpful.

Let’s stop there. Or, as Mark would say, “Wait a minute!”

There is a world of difference between “this is helpful” and “change is possible.” I don’t doubt for a moment that many people who stay year after year after year in Exodus ministries find the efforts to be “helpful”. If they didn’t, they probably would eventually quit, as more than a third of Yarhouse’s study did.

But did they change their orientation? That is a different question, one the CBN tries to answer through bulletin points.

Yarhouse and coauthor Stan Jones followed 63 people who tried to change with the help of Christian ministry.

Thirty percent were able to reduce their homosexual attraction enough to be celibate without distress. And (smugly) another twenty-three percent were able to convert to opposite-sex attraction. Total the change, fifty-three percent.

Is this a truthful representation of what Stan Jones and Mark Yarhouse discovered? No, not at all. Not even close.

First the numbers: Actually they followed 98 people, of which 37 dropped out of the program. While in testing drug efficacy it might be appropriate to ignore drop-outs, in testing whether one can change orientation, it’s pretty relevant whether they stick around.

After all, if Mark is going to say that “change effort sustained over time” is evidence of efficacy, then surely not sustaining it over time is evidence of inefficacy. Dr. Yarhouse simply cannot have it both ways.

Taking the 37 dropouts into consideration, we come up with a different calculation:

Success: Conversion – 14 (14%)
Success: Chastity – 18 (18%)
Non-Success – 29 (30%)
Drop-Outs – 37 (38%)

But this deception goes beyond numbers. It presents definitions of “success” that are laughable outside of hard-core anti-gay conservative Christian circles.

I don’t know of a secular person or a moderate to liberal Christian who would characterize achieving celibacy as a change in sexual orientation. We all know of a few gay people who have “achieved celibacy” who would much rather than they hadn’t and such an “acheivement” says nothing about their orientation.

But where the CNB report is most dishonest is in their smug announcement that twenty-three percent were able to convert to opposite-sex attraction.

Really? Opposite sex attraction without any caveat, asterisk, or explanation?

Then explain why Jones and Yarhouse’s report said this:

[W]hile we found that part of our research population experienced success to the degree that it might be called (as we have here) “conversion,” our evidence does not indicate that these changes are categorical, resulting in uncomplicated, dichotomous and unequivocal reversal of sexual orientation from utterly homosexual to utterly heterosexual. Most of the individuals who reported that they were heterosexual at T6 did not report themselves to be without experience of homosexual arousal, and they did not report their heterosexual orientation to be unequivocal and uncomplicated.

Or why Jones clarified:

A typical hetero male finds himself attracted to a wide range of females. But among the successful people who reported conversion the typical response was I’m very happy with my sexual responses to my wife, but I don’t experience much hetero attraction to other women. Also, when asked and pressed about whether they still find attraction to men, they will say: ‘Yes, if I let my mind go in that direction.’

Sorry, but that isn’t a heterosexual. It’s just not. And that isn’t the kind of change that is being promised by Bachmann’s clinic.

A dishonest researcher is not just one who misrepresents their own research. A dishonest researcher is one who sees others misuse or misstate his work and does nothing to correct them.

It’s time for Mark Yarhouse to decide which is more important to him, his honesty or anti-gay activism.

UPDATE

* More accurately, the participants expressed increased heterosexual behavior but measures that included both behavior and attractions, fantasies, and emotional attachments illustrated no material change (though a small change in the direction of homosexuality). It is reasonable to conclude that removing the behavior component would likely reveal a moderate shift towards homosexual attractions, but this is not clearly reported by Dr. Yarhouse.

Longitudinal Ex-Gay Study Update – Can Sexual Orientation be Changed?

This week the American Psychological Association released a report that said that while religion and its value in a patient’s life should be considered and respected, therapists should not encourage clients to seek a change in sexual orientation and that there was no evidence to suggest that such efforts are successful.

This did not sit well with those organizations who build their existence on convincing their public that gay persons can “change” and that because such change is possible then public policy can be punitive to gay persons that do not submit themselves to such a change.

In response to the APA\’s Resolution on Appropriate Affirmative Responses To Sexual Orientation Distress and Change Efforts, NARTH (the National Association for Research and Therapy of Homosexuality) declared

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.

And Alan Chambers, president of Exodus International spoke to USA Today.

Its president, Alan Chambers, describes himself as someone who “overcame unwanted same-sex attraction.” He and other evangelicals met with APA representatives after the task force formed in 2007, and he expressed satisfaction with parts of the report that emerged.

“It’s a positive step — simply respecting someone’s faith is a huge leap in the right direction,” Chambers said. “But I’d go further. Don’t deny the possibility that someone’s feelings might change.”

So it was with great joy that those opposed to equality received news of evidence of change. The Baptist Press is crowing. Just “four days after an American Psychological Association task force released a 130-page report that said “gay-to-straight” therapies are unlikely to work”, they are trumpeting some amazing results of a study on Exodus International and their ex-gay ministries.

In findings that directly contradict mainstream academic thought, 53 percent of subjects in a new seven-year study reported successfully leaving homosexuality and living happily as heterosexual or celibate persons.

These “latest findings” are actually an update of the multi-year study of participants in Exodus ministries presented by Stanton Jones and Mark Yarhouse in their 2007 book, Ex-Gays? A Longitudinal Study of Religiously Mediated Change in Sexual Orientation.

The authors were not pleased that the study which they proclaimed throughout Christian media as an evidence of change in sexual orientation did not convince the APA.

“They selectively apply rigorous scientific standards,” he said. “So when it comes to examining the evidence that sexual orientation change can occur, they apply extraordinarily rigorous standards, and those standards allow them to disregard significant evidence that sexual orientation change can occur. That’s what happens with our study. They, I think, invalidly applied several methodological concerns to dismiss our study.

Indeed, the APA did apply concerns and dismiss the study.

Dr. Judith Glassgold, a clinical psychologist who led the APA task force, said the paper was not written in response to Dr. Jones’ work, though it did dismiss his findings.

“We don’t believe the claims were proven, to be honest,” said Dr. Glassgold in an interview. “In our looking at all the research we find that people don’t change their underlying sexual attraction. What they do is figure out a way to control their attractions. And some learn to live a heterosexual life but mostly for religious motivation.”

Presented as a counter-point to the APA’s declaration that there is inadequate evidence that therapies designed to change sexual orientation are effective, Jones and Yarhouse argue that:

the findings of this study would appear to contradict that commonly expressed view of the mental health establishment that sexual orientation is not changeable and that the attempt to change is highly likely to produce harm for those who make such an attempt.

I won’t speak to the likelihood of harm, but when it comes to change in orientation, their study convinced me of exactly the opposite.

When the Jones and Yarhouse book, was released in 2007, we hosted an exchange between Jim Burroway, BTB’s editor, and Stanton Jones.

My synopsis of the results, as published in the book, was

the Jones and Yarhouse study revealed little to no statistically measurable change in orientation in the prospective sample. The much touted “successes” were either in recollection (which again were quite small) or were those who had decided to no longer call themselves “gay”. However, they still identified their orientation as homosexual (“I\’m not gay but my attractions are”).

In short, the Jones and Yarhouse study was funded and fully supported by Exodus and conducted by two researchers who were avid supporters of ex-gay ministries. They wanted to study 300 participants, but after more than a year, they could only find 57 willing to participate. They then changed the rules for acceptance in order to increase the total to 98. After following this sample for 4 years, 25 dropped out. Of the remainder, only 11 reported “satisfactory, if not uncomplicated, heterosexual adjustment.” Another 17 decided that a lifetime of celibacy was good enough.

What the 2007 Jones and Yarhouse book revealed, and what this update further confirms, is that the “change” which NARTH and Exodus loudly proclaim is not a change in sexual orientation at all and, in fact, may be nothing more that a change in identity or recollection.

Prospective v. Retrospective
In order to understand the J&Y study, you have to understand the distinction between retrospective and prospective sampling. Prospective uses currently measured data, and retrospective uses recollections about the past.

For example, if one were wanting to compare changes in the length that a student has to walk in their morning commute to school, a prospective study would select a random sample (say a selection of schools), measure the distance the students walked, and repeat the process over a long enough period of time to determine if there is change. A retrospective study would go ask Grandpa and compare today’s walking distance to “ten miles through the snow, barefoot, uphill both ways!”

Obviously, measured differences are far more accurate than recollected differences. Time has a way of providing support for what we want to believe and recollections tend to be very selective. Things were simpler then, or tougher; summers were hotter, or milder; politicians were more honest, or scoundrels.

So the best studies are prospective rather than retrospective. Oddly, the J&Y study is both.

Of the 98 participants, 57 were more-or-less prospective. These were persons who had been involved with an Exodus (ex-gay) ministry for less than a year. So while there may have been some recollection error, it was at least a discussion of reasonably recent events. These participants are called Phase 1.

Unable to get a sample size that the authors felt was sufficient, they then recruited Exodus participants that had been in the programs for one to three years. These participants are called Phase 2 and to the extent that there is a measurement from a recollected starting point, their participation is retrospective.

Fortunately, it is possible to distinguish between the results for these two groups.

The Update
The paper presented by Jones and Yarhouse to the APA is significantly less detailed than was their book, as could be expected. Specifically, the several scales of measurement were reduced to two, Kinsey and Shively & DeCecco, and while the book provided information on interim points, the paper uses only the starting point (T1) and the final point (T6).

The results in the book are based on 75 of the original 98 participants. Since J&Y presented their results in their book, an additional 14 participants have dropped out of the study, bringing the sample size down to 61. The remaining participants have now been part of the study for six to seven years.

The Results
Because the total sample is a hodge-podge of two very different subpopulations, it is informative only to the extent that it reveals information about the difference between those subpopulations.

The group that is most accurately studied, and that whose results are most revealing about the extent to which Exodus is successful is Phase 1, the prospective study. And this is what Jones and Yarhouse report about that subpopulation:

• There was, on average, virtually no change in sexual orientation on the Kinsey scale using measures of behavior, sexual attraction, emotional/romantic attraction, and fantasy.
• There was, on average, a small but not significant increase in homosexual behavior.
• There was, on average, a slight but not significant reduction in homosexual attraction.
• There was, on average, virtually no increase in heterosexual attraction.

In other words, on average, after six to seven years of participation, those who went through Exodus ministries reported over the period of their involvement no change in sexual orientation at all.

Averages v. Individuals
Averages, while meaningful to statisticians and to those who are evaluating the effectiveness of Exodus International, do not tell the full story. We must also look at individual results.

For their book, Jones and Yarhouse classified their participants into categories based on their individual reports. They came from a religious evaluation model and defined two groups as successful (conversions and chaste), two as failure (identifying as gay and considering identifying as gay), and two in the middle that were still trying but seeing little to no results. For the final report, the authors changed their procedure and allowed participants to select their own category.

As I am less interested in adherence to religious identities and more interested in sexual orientation change, I’ll group the failure and the middle two together. After time T6, J&Y report:

Success: Conversion – 14 (23%)
Success: Chastity – 18 (30%)
Non-Success – 29 (48%)

This does not, however, present an accurate story of the study participants. It does not account for those who dropped out of participation and thus overstates the success rates. One could extrapolate from this reporting method that eventually only those who are successes of some sort will remain and the authors could declare with great fanfare that 100% of all Exodus participants eventually succeed.

But that would not be truthful.

When I made the observation that drop-outs should be considered a likely failure, those who defended the skewing upward of success rates argued that because we don’t know the reasons for discontinued participation, it was just as easy to believe that these individuals were now happily heterosexually married and not wanting to be reminded of their old life as that they had embraced a gay identity. But additional information in this report reveals otherwise.

Of the 14 persons who left the study between T3 and T6, two were Conversion, one was Chastity, and the remaining were Non-success. We know from the book that one of the Conversion drop-outs reported that he had never been heterosexual and was simply reporting what he thought the authors wanted to hear. So it is rather unlikely that these drop-outs went off to live heterosexual lives. Nor is it (or ever was it) likely that any sizable chunk of those who dropped out before T3 left because they are now happily hetero.

Considering drop-outs as their own category, a more accurate reporting of the self-identified placement into categories would look like this:

Success: Conversion – 14 (14%)
Success: Chastity – 18 (18%)
Non-Success – 29 (30%)
Drop-Outs – 37 (38%)

And considering just the Phase 1 participants, the results are

Success: Conversion – 5 (9%)
Success: Chastity – 6 (11%)
Non-Success – 18 (32%)
Drop-Outs – 28 (49%)

When looking at these numbers, we should consider two things about the “conversion” category shown above.

First, much of Exodus’ efforts go into changing identity. They view a “gay identity” as sinful and contrary to a “Christian identity”.

So this change in identity may not be related to an actual change in orientation. As I noted above, the first measurement of “change” reported in the book – the one trumpeted in anti-gay press upon the book’s press release – was a change in self identification. Yet is was accompanied by a measurement that spoke of one’s orientation as separate from one’s identity and found that those who claimed that they were not homosexual were willing to admit that their orientation is homosexual. It was literally a declaration that, “I’m not gay but my orientation is.”

We should be careful to recognize that those claiming conversion at T6 may be doing so for themselves and not for their orientations. The authors do acknowledge that such success may be seen as relating more to identity than to orientation:

Some may see these results as reflecting not a change in sexual orientation for most participants who reported such change, but rather a change in sexual identity. Such a change might result from how one thinks of oneself and labels one\’s sexual preferences (that is, attributions and meaning-making).

But with Exodus placing heavy emphasis on identity, by allowing unanalyzed self-assignment the authors may have created a scenario in which there is an inflated increase in the “success” categories.

And second, this report differs from the book in that the qualifiers are removed. The book provided discussion of the non-traditional definitions of “heterosexual” used in the study and how those who were so identified also experienced wandering eyes, erotic dreams, and other situations that are most often associated with a homosexual orientation. In the paper, it is limited to

[W]hile we found that part of our research population experienced success to the degree that it might be called (as we have here) “conversion,” our evidence does not indicate that these changes are categorical, resulting in uncomplicated, dichotomous and unequivocal reversal of sexual orientation from utterly homosexual to utterly heterosexual. Most of the individuals who reported that they were heterosexual at T6 did not report themselves to be without experience of homosexual arousal, and they did not report their heterosexual orientation to be unequivocal and uncomplicated.

I don’t think that I’m alone in noting that few of the heterosexuals that I know experience much homosexual arousal. Perhaps Stanton Jones himself said it best in an interview.

“A typical hetero male finds himself attracted to a wide range of females. But among the successful people who reported conversion the typical response was I’m very happy with my sexual responses to my wife, but I don’t experience much hetero attraction to other women. Also, when asked and pressed about whether they still find attraction to men, they will say: ‘Yes, if I let my mind go in that direction.’ “

And finally, when comparing the individual with the average, it must be noted that without an average change, any individual change experienced is offset by an equal and opposite experience.

In other words, for every person who came to Exodus and found that they became one Kinsey point more heterosexual, there was a person who found that Exodus made them one Kinsey point gayer. If Exodus sees their mission as rescuing those sinking in a sea of sin, for each person they pull into the lifeboat, they hit another over the head with an oar.

Failure to report Phase 2 Results
Jones and Yarhouse report the “whole population”, a commingled combination of Phase 1 and Phase 2 as though it is informative. While they do break out Phase 1 results, they do not disclose Phase 2 results.

I believe that were Phase 1 to be visually compared to Phase 2, the variances between the two would be startling. The question jumping out from the report might shift from whether there is a significant effect size in responses to why these two subpopulations are reporting opposite conclusions.

And, indeed, the results from Phase 2 can be deduced to be significantly different from Phase 1. If we know the average response of the 29 remaining participants in Phase 1 and the total average responses of all 61 remaining participants, we can back into the Phase 2 reported change.

A comparison of the two would show:

Kinsey – behavior only
P1, -0.21
P2, 1.79

Kinsey Expanded
P1, 0.55
P2, 1.01

Shively & DeCecco homo
P1, 0.40
P2, 0.99

Shively & DeCecco hetero
P1, 0.05
P2, 0.62

As we can see, there are sharp differences in the results of these two subpopulations. And although no information on Phase 2 is directly reported, the authors somewhat acknowledge that the two subpopulations vary in results

We expected that the results of change would be somewhat less positive in [Phase 1], as individuals experiencing difficulty with change would be likely to get frustrated or discouraged early on and drop out.

That is a round-about way of admitting that the Phase 2 subpopulation does not include those who got frustrated early and dropped out in the first one to three years. It avoids pointing out that results for the Phase 2 subpopulation are already skewed towards those who either believe they are experiencing “change” or have a stronger more deeply dedicated commitment to Exodus ministries.

But even so, with such astounding results in this subpopulation, why wouldn’t the authors include this separate information. It may be that isolation of Phase 2 raises questions about the validity of including them at all and, more importantly, what it says about the claims made by Exodus members both included and not included in the study.

The real difference between Phase 1 and Phase 2 is more than just that P2 has been in the program for a few more years. It is more than that they have fewer drop outs. The real difference is that P2 is based on recollection to a much greater extent than P1.

And Phase 2 participants recalled being more gay than Phase 1 reported. Significantly, especially in the area of behavior. The Kinsey 1 report was 4.52 for Phase 1 and 5.49 for Phase 2.

There is no reason to believe that those in Phase 2, having eliminated the drop outs, actually were any more homosexually oriented than those in Phase 1. Rather, it seems likely that they simply recalled being more homosexually oriented when they established their base point some one to three years later.

So all reported change in Phase 2 – and indeed all reported change – may be attributable to this variance in starting point due to reliance on recollection. Ultimately, all of Jones’ and Yarhouse’s announced success may be nothing more than, “I remember being much more gay three years ago than I am today.”

Truly Gay
The one subpopulation that Jones and Yarhouse are excited about is what they call the “truly gay subpopulation.” These are defined as those who “scored above the scale midpoint at T1 for homosexual attraction, and for homosexual behavior in the past, and for having previously embraced full homosexual or gay identity.” This subgroup reported the most change.

It is difficult to know whether these persons are mostly Phase 1 or Phase 2, but it would appear that they are a combination of both. We know from the break out of results in the book that a number of the non-successes in the truly gay subpopulation were also Phase 1. This lends itself to assumptions that those in the truly gay subpopulation that reported progress were likely in Phase 2 and that much, if not all, of their progress consisted solely of exaggerated recollection.

This is further supported by noting that most of the change reported over the seven year life of the study was between the first measurement (often as recollected) and the second. In discussing the possibility that reported change is largely identity, the authors noted:

This might also explain to some why the Truly Gay subpopulation showed more dramatic change, as their shift was away from a more pronounced gay identity. Such a departure may have been measured as a greater movement away from something that had previously been more salient to them.

Or, more likely, a greater movement away from the recollection of being very gay three years ago.

Conclusions
Based on the Jones and Yarhouse book, Ex-Gays? A Longitudinal Study of Religiously Mediated Change in Sexual Orientation, and on their follow up report, Ex-Gays? An Extended Longitudinal Study of Religiously Mediated Change in Sexual Orientation, we can observe the following:

• The prospective sample reported, on average, virtually no change in attractions and a small increase in homosexual behavior.
• A retrospective look at ones perceptions of prior orientation from the perspective of one to three years yields a sharply different result from that seen by a prospective sample. This change in perspective may account for all reported change in Exodus ministries.
• Most change reported away from homosexuality and towards heterosexuality was in the interval between the starting point (T1) and the second measurement point (T2). This change occurred most strongly in the retrospective sample and may be due to variances in recollection.
• A combined prospective and retrospective sample experienced, on average, no significant increase in opposite sex attraction.
• A small percentage (perhaps 9%) of those who start Exodus programs may eventually self-categorize themselves as “experiencing substantial reductions in homosexual attraction and substantial conversion to heterosexual attraction and functioning. These persons will be unlike other heterosexuals in that they will continue to experience homosexual arousal and not experience much attraction to the opposite sex.
• Another small percentage (perhaps 11%) of those who start Exodus programs may eventually achieve a life of manageable homosexual attraction and chastity.
• Others may continue perpetually in Exodus programs without ever achieving any significantly reduced homosexual attractions.
• Eventually, most of those who start Exodus programs will drop out.
• On average, for each person who enters and Exodus program and finds any movement away from homosexual attraction, another will find movement towards homosexual attraction.

But these observations are not readily obvious from the media reports of either the 2007 Jones and Yarhouse book nor this follow-up report. And those seeking “proof” that homosexuals can “change” have used both to advance a false image of the results of this study. Exodus, NARTH, and many others will spin this study to come to conclusions that are far from of those I’ve stated above.

The authors have a moral responsibility to discourage those who will make false statements or who will falsely claim that this study justifies their ex-gay or anti-gay endeavors. And they have a moral obligation not to allow their wishes about the mutability of sexual orientation cloud the results of their study and give false hope to those who believe Exodus’ slogan that “change is possible”.

Father of Ex-Gay Rants NARTHisms in Utah

A while back, Belinda Jensen, the president of the American Fork High School PTSA in Utah became impressed with Standard of Liberty, an LDS-oriented anti-gay organization. So she invited the group to make a presentation.

Standard of Liberty, and it’s co-founder Stephen Graham, are passionate, but not particularly accurate or logical.

Q: You say homosexuality is physically harmful. How?

A: Homosexual sex (sodomy), causes chronic illnesses and life-threatening disease (HIV/AIDS), shortening life by an average of 20 years. The human body is simply not made for this behavior. In addition, adopting the “gay” identity often masks dangerous psychological problems that need attention.

Q: Doesn’t heterosexual sex carry the same physical risks as homosexual sex?

A: No, none, if there is abstinence before marriage, and fidelity and healthy, normal sexual intercourse in marriage.

Because, of course, he thinks fidelity is by definition missing from gay relationships.

And my favorites:

Q: Should even those privately struggling with SSA, who have not “acted out,” be chastened, offered help and correction, and held accountable by the church?

A: Yes. The church should be concerned with the person’s soul. People with this problem have become involved in perverse and sinful lust to the detriment of their eternal salvation.

and

Q: How many really change from unwanted homosexuality?

A: A new study reports a 38% success rate. An additional 29% had made progress and were committed to continuing their efforts. That’s a combined total of 77% experiencing success. (Jones and Yarhouse, 2007) In the mental heath profession, this rate of success is considered very high.

You may recall that the Jones and Yarhouse study revealed little to no statistically measurable change in orientation in the prospective sample. The much touted “successes” were either in recollection (which again were quite small) or were those who had decided to no longer call themselves “gay”. However, they still identified their orientation as homosexual (“I’m not gay but my attractions are”).

In short, the Jones and Yarhouse study was funded and fully supported by Exodus and conducted by two researchers who were avid supporters of ex-gay ministries. They wanted to study 300 participants, but after more than a year, they could only find 57 willing to participate. They then changed the rules for acceptance in order to increase the total to 98. After following this sample for 4 years, 25 dropped out. Of the remainder, only 11 reported “satisfactory, if not uncomplicated, heterosexual adjustment.” Another 17 decided that a lifetime of celibacy was good enough.

But for some reason Jensen thought that Stephen Graham had just the presentation that she wanted for the Parents, Teachers and Students Association. The principle of the High School was not so convinced and canceled Graham’s presentation.

Undeterred, Graham shifted the forum to a local library. In his speech his anti-gay activist motivations became clear.

Standard of Liberty co-founder Stephen Graham began with an account of how his son overcame gay tendencies after counseling, then screened individual film segments detailing the “gay agenda,” “gay demands” and “gay agenda in schools.”

Graham relied heavily on NARTH materials:

Graham presented statistics from www.narth.com, the National Association for Research and Therapy of Homosexuality. Some of the most common concerns for gay men, he said, include HIV/AIDS, marijuana, Ecstasy, amphetamines, sexually transmitted diseases, suicide, heart disease, anorexia, anal warts and anal cancers.

“These things do occur in normal population, but not nearly at the rate as in people troubled with homosexuality,” he said.

Along with some unidentified 1993 video, Julie Harren-Hamilton’s 2006 DVD, Homosexuality 101, starring Alan Chambers, Julie Harren, Mike Ensley, Christine Sneeringer, and Jack Harren, was featured both on his site and in his speech.

Various representatives from the Utah Pride Center were at the presentation to counter Graham’s propaganda.

The Utah Pride Center will hold another meeting to offer information on resources for parents and youths at the library at 5:30 p.m. on Wednesday, April 9.

Peterson Toscano Debates Memphis Pastor on Christian Radio

Peterson Toscano went on the Info Radio Network to debate pastor Bill Bellican from Memphis’ Central Church, which hosted the Love Won Out ex-gay conference this weekend. It’s a very long program and difficult to listen to at times. It is definitely not for the faint of heart.

But I love how host Larry Bates suddenly rushed to commercial when Peterson vigorously challenged him on the story of Sodom and Ghomorrah (that’s at about the 20 minute mark). Also, at the 34 minute mark the host went straight to the usual Paul Cameron statistics. At the one hour mark, he very adroitly and compassionately handled the alcoholism analogy. And at the 1:32 mark, Peterson was able to reveal to that audience what the Jones and Yarhouse ex-gay study really found — something that very few ex-gay proponents are willing to acknowledge.

But the worst is at the 1:36 minute mark when the host said, “The reason that a lot of homosexuals are upset with programs like Love Won Out, the ex-gays getting out of the gay lifestyle is, quite frankly, is they’re raiding the meat market, in other words you’re just simply are losing propects, because the average gay man and gay woman has multiple partners and you’re running out of prospects.”

At times, the program appeared to be two-against one, with the host and pastor on one side against Peterson. And yet Peterson seemed to retain the upper hand through it all. I’m amazed at how well he was able to keep his cool throughout the two hour program. I really don’t think I could have done it.

Ex-Gay Watch Analyzes the Jones & Yarhouse Study

Last September, Stanton Jones and Mark Yarhouse released the results of their ex-gay study at the meeting of the American Association of Christian Counselors. That study later appeared in the book, Ex-Gays? A Longitudinal Study of Religiously Mediated Change in Sexual Orientation, published by InterVarsity Press. At the time, I published a preliminary review of that study, followed by a rejoinder by Stanton Jones.

Ex-Gay Watch asked Patrick M. Chapman to review Ex-Gays? Dr. Chapman is the author of the forthcoming book, Thou Shalt Not Love: What Evangelicals Really Say to Gays. Ex-Gay Watch published his review in three parts (Read parts one, two and three). XGW expects to publish a reply by Stanton Jones in the next few days. All of this makes excellent reading.

Meanwhile, Exodus, which has been mostly silent about the study since the initial clamor over its release, has added Ex-Gays? to their online bookstore.

Dr. Throckmorton Reports on Crosswalk Blog about Jones and Yarhouse Study

In perhaps the most careful and least exaggerated coverage of the study in the Christian Press that I have seen, Dr. Warren Throckmorton talks on his blog on Crosswalk.com about the results of the Jones and Yarhouse Study. He concludes:

In a way, this book has something for everyone. Critics who say change is rare will note that a relatively small percentage made complete shifts. And the authors disclosed that same-sex attractions lingered for many participants. Social conservatives will point out that, for many people, living in accord with traditional religious teachings regarding sexuality does not appear to increase emotional distress. From my perspective, the study highlights the beneficial role that faith and religious community can have in supporting valued identity and behavior.

I would suggest that this report did not seem to identify anyone who made a “complete shift” (I’m still waiting for my copy of the book so this is a tentative claim). Otherwise this conclusion seems true.

Associated Baptist Press Reports Criticism of Ex-Gay Study

In an article today, Robert Marus reported in ABPnews.com both the claims and the criticisms of the Jones and Yarhouse study. It is encouraging that this Christian press was willing to put accuracy ahead of theology in reporting the story.

A new study suggesting that religiously motivated conversion from homosexual orientation is possible and not harmful has been hailed by some social conservatives, while others are questioning the study’s motive and methodology.

It’s also cool that they quoted us.

Jones and Yarhouse’s effort did not provide much better evidence, Burroway said. “This study held great promise based on its initial design, but its conduct left much to be desired,” he wrote. “Its rigorous design was not matched by similar rigor in execution. And so we’re still left waiting for that definitive breakthrough ex-gay study. I don’t think this one is it.”

Fun with Numbers

It’s a Friday. It’s time for Fun With Numbers.

Today’s exercise looks at Exodus’ retention rates. Let’s assume, for the sake of this exercise, that the sample used by Yarhouse and Jones is representative of all new Exodus participants and see what it tells us.

To start we know that 98 participants started in the study (point A) and that at some point 30 to 48 months later (point C) there were only 73. We’ll take three years as our point C for the simplicity of math. Further, we know that at the midpoint (point B) there were 85.

This tells us that between point A and point B there was a retention rate of 86% (85/98) and that between point B and point C there was also a retention rate of 86% (73/85).

But wait. We also know that of the 98 participants, 57 were new and 41 were one to three years into the program. Just for fun, let’s apply our retention rates backwards to see if we see anything about these participants.

If we assume the same retention rates, the 41 would have been 48.2 a year and a half before and 56.7 at three years back.

Wow, that’s the same as the current size sample. Perhaps a coincidence? Or perhaps this suggests that there is a consistent drop off rate of 15% every year and a half that continues for at least four years. This translates into roughly a 91% retention rate per year.

Now let’s make some guesses about how many new participants there are each year in Exodus programs.

The researchers claim that not all Exodus ministries were willing to cooperate. Even after pressure from Yarhouse and Jones and, presumably, Exodus national. So let’s suppose that only a third of new Exodians participated in the study.

Well then, in any given year there would be about 171 new Exodians. With a 91% retention rate, the following six years would show retention of these Exodians of 156, 142, 129, 117, 106, and 96. Let’s charitably assume that after six years there is no longer any drop off at all.

Obviously each new year brings more Exodians to count up. There would be 171 new participants and 156 hold overs from the previous year along with 142 from the year before that. And so on.

Also, we have to assume that these participants will some day die. Since the average age of participants was listed at 37.5 years, let’s assume they’ll live for another 40 years to the ripe old age of 77.

So let’s see how many years it would take to reach Alan Chambers’ favorite number of “hundreds of thousands”.

OH NO!!! We can’t get there!! It turns out that with the above assumptions, the number of Exodians participating in Exodus ministries plateaus in its 39th year at 3,989. (Thank God we stopped dropping off in the sixth year or it would plateau at 1,854).

Oh gosh!! Well, maybe Yarhouse and Jones got less than 1/3 participation. Maybe only one out of ten Exodians joined the study and maybe really each year there are 570 new recruits. Ah, that’s much better. The peak participation rises to 13,430.

But that’s still a far cry from “hundreds of thousands”. In order for there to be 100,000 participants ever at Exodus, with a 91% annual retention rate for six years after which there is NO drop off, and a 40 additional year life expectancy (and participation), Exodus would have to have 4,249 new participants each year, or an average of 28 new participants each year in each of Exodus’ 150 affiliates (news reports suggest that the total membership in any given group is in the single digits).

Which would mean that Yarhouse and Jones’ study used a 1.3% population sample of 57 and called it representative. Or, alternately, that Chambers’ claims of “hundreds of thousands” is nothing more than a figment of his imagination. You do the math.

Dr. Stanton Jones Replies

Dr. Stanton Jones, co-author of Ex-Gays? A Longitudinal Study of Religiously Mediated Change in Sexual Orientation, responded to my preliminary review in the comments. I wanted to elevate his comments to another post for visibility and to start a new comment thread. I’d like to thank Dr. Jones for sharing his thoughts. I ask that all commenters treat the subject matter with similar civility. Thank you.

Dear Mr. Burroway and the readers of the Box Turtle Bulletin:

Some brief reflections on your review (with a quick added note that we will not be responding much in this type of format; the demands are simply too great):

1. Above all else, thank you for a substantive and thoughtful preliminary review that actually engages the factual, scientific and intellectual issues of the study instead of engaging in the types of character assassination and other negative tactics of some commentators. While I obviously disagree with your conclusion that “we’re still left waiting for that definitive breakthrough ex-gay study. I don’t think this one is it,” you have nevertheless made clear the grounds on which you have made this judgment, have discussed those grounds rationally, and those grounds are areas of legitimate debate.

2. There seems to be considerable confusion about the book not being available until October. The book is in fact available now; it was released the same day as the paper presentation in Nashville. Quite a number of your questions are answered in the full book presentation; the paper is a sampling of the findings, with an emphasis in the paper (admittedly) on the clearer findings that led us to our conclusions. Now to four substantive issues you raise:

3. Psychophysiological measurement: You ask about our failure to use MRI technology. First, we report in this paper and book on the data gathered up to two years ago, and the MRI technology was unavailable then. Second, even today I would not use it. The “No Lie MRI” appears to be just the latest hyped and unproven version of the hope for a foolproof lie detector. A recent New Yorker article by Margaret Talbot (“Duped: Can Brain Scans Uncover Lies?,” July 2, 2007) presents a readable and thorough discussion of just how overly-hyped and poorly validated this new technology is. There is inadequate scientific basis to believe the “No Lie MRI” would be a suitable measure for our subjects.

4. Retention: You put quite a bit of emphasis on our drop-outs and chided our efforts to contact and assess drop-outs without benefit of reading our account of this in the book. You particularly compare us unfavorably to the Add Health Study. Remember that the Add Health Study was a study of adolescents with parental approval, so those researchers were remarkably advantaged in terms of being able to track down missing participants through their families. We had no such advantage with an adult population. We went to extreme lengths to keep people in the study, involving multiple pleas and contacts including those through families and friends, and, when we had contact information at all, with personal calls and pleas from me. At some point, you must respect people’s wishes not to be contacted. We remain proud of our retention rate in the study.

5. Representativeness of sample: You say “I think at least one demographic variable they provided [i.e., age] is ample evidence that their sample is not representative.” To the best of my knowledge, there is only one study that can come close to the claim of getting a representative sample in this area, and that is the Bailey, Dunne, & Martin Australian twin study (Journal of Personality and Social Psychology, 2000) that concluded that genetic factors were not a statistically significant contributor to causation; this is a great sample because it was an exhaustive sample of every twin born in Australia! (Update: Dr. Jones has more on the Australian twin study here.) At some level, the ultimate representativeness of all other samples is debatable. The evidence you cite in your dismissal is a good example of our difficulty: You state your impression that Exodus conferences draw a younger crowd while our sample age is older, and that therefore that we have a bad sample. But you have provided no justification that your impressions of Exodus conference ages are valid, nor stated the bases for your inference that conference attenders are in turn representative of those who seek help in local Exodus ministries. We do acknowledge that we cannot prove the representativeness of our sample, but have numerous reasons, cited in the book, for why we think we got something like a representative sample. And one final note: samples have to be adequate to the task of the study, and we discuss in the book the reasons why the sample is adequate to test an absolute hypothesis (that change is impossible) and a strong hypothesis (that the change attempt is often and decisively harmful).

6. Truly prospective: We explicitly discuss in the book the implications of including the Phase 2 group. I would soften your criticism of the retrospective implications of this group, because in contrast to the Spitzer study where subjects could be looking back over many years or decades to remember their prior experience, our Phase 2 group were looking back into their immediate past. More importantly, however, it is vital to note that while the average changes noted were less strong for the Phase 1 group, Phase 1 subjects were proportionally represented in all of our success categories, so an easy dismissal of significant changes in this group is simply not possible.

Again, it was a delight to read a thoughtful review of our study. No study is perfect. To argue that ours is the strongest study yet done in this area is not the same as to argue that it is exemplary or perfect. It is a stronger study than any available, one particularly suited to the hypotheses investigated.

Stanton L. Jones

A Preliminary Review of Jones and Yarhouse’s “Ex-Gay? A Longitudinal Study”

Last Thursday, Stanton Jones and Mark Yarhouse announced the results of their new ex-gay study at a press conference in Nashville, where the American Association of Christian Counselors was holding its annual conference. The study, Ex-Gays? A Longitudinal Study of Religiously Mediated Change in Sexual Orientation will be published by InterVarsity Press October 10. This review is based on a thirteen-page synopsis that was provided for the AACC.

This study was funded by Exodus, with Jones and Yarhouse promising that “we would be reporting publicly the results of our outcome study regardless of how encouraging or embarrassing Exodus might find those results.” Based on Exodus’ press release and Alan Chambers’ presence at the press conference, it appears that Exodus is quite pleased with the study. Exodus, by the way, chose that same weekend to host their regional conference in Nashville, making for a very well coordinated event.

The Study’s Design

According to Jones and Yarhouse, their study was intended to answer two questions: Is change in sexual orientation possible, and are attempts to change harmful? And to answer those questions, they set out to do something that hadn’t been done before. They constructed what’s called a longitudinal or prospective (i.e. forward-looking) study, where they followed a population of study participants as they were beginning their experience with ex-gay ministries and continued to follow them over a period of four years.

This is an important feature of the study. One of the many criticisms for Robert Spitzer’s 2003 ex-gay study was that it was a retrospective (i.e., backwards-looking) study. In other words, study participants were asked to remember back to before they began their attempts to change and report from memory their sexual orientation and attractions. Jones and Yarhouse chose to conduct a prospective study instead:

In contrast to retrospective methods that ask participants to remember change experiences that happened in their pasts, a prospective methodology begins assessment when individuals are starting the change process and assesses them as the results unfold.

Because it’s longitudinal, beginning as the ex-gay participants begin their own journey, there’s no reliance on possibly faulty memories when asked, “What were your attractions several years ago when you started?”

When the study began, participants undertook a number of interviews face-to-face. This was at Time 1. There were two more interviews, Time 2 and Time 3, with the span between Time 1 and Time 3 being between thirty months to four years. Most of the Time 2 interviews were conducted face to face (15% were over the phone) and all of the Time 3 interviews were done over the phone. For all three, Jones and Yarhouse used a number of recognized, standardized measures for sexuality and mental health, with the crucial self-reports of sexuality being conducted via mail-in questionnaires.

Another weakness with Robert Spitzer’s study was that he didn’t use any standard measures for sexual orientation. He didn’t use the Kinsey scale (where 0= completely heterosexual and 6 = completely homosexual), nor did he use the Shively-DeCecco scales (which separates the intensity of homosexual and heterosexual attractions on two separate scales for independent measurement, with the zero axis representing perfect asexuality). Jones and Yarhouse used both sets of scales for their analysis, using commonly recognized standardized questionnaires to determine ratings at Time 1, Time 2 and Time 3.

Probably the weakest link in the design was in relying on self-reports for assessing sexual orientation instead of physiological measures of arousal. They addressed those criticisms this way:

Psychophysiological measures assess sexual arousal and orientation by attaching sensors to the genitals of subjects and measuring sexual arousal while the subjects watch pornography. We judged these methods as pragmatically impossible given the dispersed nature of our sample and the limitations of our funding, as morally unacceptable to the bulk of our research participants, and as not justified in light of current research challenging the reliability and validity of the methods themselves.

These are all legitimate objections as far as penile and vaginal plethysmography are concerned. There are however new emerging technologies involving MRI’s which may be useful for future studies.

Difficulty In Recruiting Participants

While Jones and Yarhouse’s study appears to be very well designed, it quickly falls apart on execution. The sample size was disappointingly small, too small for an effective retrospective study. They told a reporter from Christianity Today that they had hoped to recruit some three hundred participants, but they found “many Exodus ministries mysteriously uncooperative.” They only wound up with 98 at the beginning of the study (72 men and 26 women), a population they describe as “respectably large.” Yet it is half the size of Spitzer’s 2003 study.

Jones and Yarhouse wanted to limit their study’s participants to those who were in their first year of ex-gay ministry. But when they found that they were having trouble getting enough people to participate (they only found 57 subject who met this criteria), they expanded their study to include 41 subjects who had been involved in ex-gay ministries for between one to three years. The participants who had been in ex-gay ministries for less than a year are referred to as “Phase 1” subpopulation, and the 41 who were added to increase the sample size were labeled the “Phase 2” subpopulation.

This poses two critically important problems. First, we just saw Jones and Yarhouse explain that the whole reason they did a prospective study was to reduce the faulty memories of “change experiences that happened in their pasts” — errors which can occur when asking people to go back as far as three years to assess their beginning points on the Kinsey and Shively-DeCecco scales. This was the very problem that Jones and Yarhouse hoped to avoid in designing a prospective longitudinal study, but in the end nearly half of their results ended up being based on retrospective responses.

This diluted the very purpose of doing a longitudinal study, and as Jones and Yarhouse describe it, this also clearly affected the results:

We expected that the results of change would be somewhat less positive in this group (phase 1), as individuals experiencing difficulty with change would likely be somewhat less positive in this group, as individuals experiencing difficulty with change would be likely to get frustrated or discouraged early on and drop out of the change process. We were able to retain these Phase 1 subjects in our study at the same rate as the whole population, and indeed found that change results from them were a bit less positive.

Left unsaid but clearly implied is the second problem with adding Phase 2 participants. Since they had already hung in there for between one and three years, that subpopulation would not have included those who entered ex-gay ministries at the same time they did but who were discouraged early on and dropped out. It’s no wonder the change results for Phase 1 were less positive than Phase 2. There’s no indication how “less positive” those results were, not in this synopsis anyway. Hopefully the book will break these numbers out.

But in the synopsis at least, the study’s results appear to combine Phase 2 and Phase 1 participants, which represents an unacceptable mixing of prospective (Phase 1) and retrospective (Phase 2) participants. And since the Phase 2 participants make up nearly half the total sample, this ruins any chance of this being a truly prospective study.

Study Dropouts

Whenever a longitudinal study is being conducted over a period of several years, there are always dropouts along the way. This is common and to be expected. That makes it all the more important to begin the study with a large population. Unfortunately, this one wasn’t terribly large to begin with; it started out at less than half the size of Spitzer’s 2003 study. Jones and Yarhouse report that:

Over time, our sample eroded from 98 subjects at our initial Time 1 assessment to 85 at Time 2 and 73 at Time 3, which is a Time 1 to Time 3 retention rate of 74.5%. This retention rate compares favorable to that of the best “gold standard” longitudinal studies. For example, the widely respected and amply funded National Longitudinal Study of Adolescent Health (or Add Health study reported a retention rate from Time 1 to Time 3 of 73% for their enormous sample.

The Add Health Study Jones and Yarhouse cite began with 20,745 in 1996, ending with 15,170 during Wave 3 in 2001-2002. But this retention rate of 73% was spread over some 5-6 years, not the three to four years of Jones and Yarhouse’s study.

What’s more, the Add Health study undertook a rigorous investigation of their dropouts (PDF: 228KB/17 pages) and concluded that the dropouts affected their results by less than 1 percent. Jones and Yarhouse didn’t assess the impact of their dropouts, but they did say this:

We know from direct conversation that a few subjects decided to accept gay identity and did not believe that we would honestly report data on their experience. On the other hand, we know from direct conversations that we lost other subjects who believed themselves healed of all homosexual inclinations and who withdrew from the study because continued participation reminded them of the very negative experiences they had had as homosexuals. Generally speaking, as is typical, we lost subjects for unknown reasons.

Remember, Jones and Yarhouse described those “experiencing difficulty with change would be likely to get frustrated or discouraged early on and drop out of the change process.” And so assessing the dropouts becomes critically important, because unlike the Add Health study, the very reason for dropping out of this study may have direct bearing on both questions the study was designed to address: Do people change, and are they harmed by the process? With as much as a quarter of the initial population dropping out potentially for reasons directly related to the study’s questions, this missing analysis represents a likely critical failure, one which could potentially invalidate the study’s conclusions.

Representativeness of Study Participants

Jones and Yarhouse describe their sample’s representativeness in contradictory and confusing terms:

Our study examines a representative sample of the population of those in Exodus seeking sexual orientation change. We cannot be absolutely certain of perfect representativeness, since no scientific evidence exists for describing the parameters of such representativeness. Still, we are confident that our participant pool is a good snapshot of those seeking help from Exodus.

Did you get that? It’s representative, but they can’t prove it. But they’re confident anyway.

When researchers make a sweeping statement, especially one as important as representativeness, they bear the burden of providing evidence to support their claim. If they can’t do that, then they must instead caution that their sample may not be representative and list the reasons why. I don’t think a respected peer-reviewed journal would let Jones and Yarhouse get by with claiming representativeness with nothing to substantiate that claim.

Their synopsis doesn’t describe how members were recruited into the study, so we can’t judge what selection biases may occur during recruitment. (I’m sure the book addresses some of this — I’d be shocked if it didn’t.) Nor do they discuss how their demographics might compare with other measures for ex-gay ministry participant populations. There are conferences, rosters, or simple surveys of ex-gay ministry leaders that they could have culled and compared their demographic data with.

But they didn’t appear to have done this, not according to the synopsis anyway.

But I think at least one demographic variable they provided is ample evidence that their sample is not representative. For example, they said that the average age of their sample was 37.50 years. Having asserted that their sample was “fairly representative,” they extrapolated that to the entire Exodus population this way:

The average age was older than we had expected, and its significance should be underscored. There is an unflattering caricature that Exodus groups appeal primarily to young, naïve, confused and sexually inexperienced individuals.

In this statement, Jones and Yarhouse appear to be more interested in defending Exodus’ reputation than in defending their own sample. But when I attended the Exodus Freedom Conference in Irvine California in June 2007, I got the distinct impression that the average age of the 800 participants was well under 37 years — perhaps even under thirty. The median age of “strugglers” was certainly close to thirty. The conference audience definitely skewed quite young.

We should keep in mind that Jones and Yarhouse limited their study sample to those over eighteen; their youngest participant ended up being twenty-one. Exodus, on the other hand, allowed registrants for their annual conference to be as young as thirteen, although I don’t think I saw anybody that young there. I did see a large number of teenagers, and an extraordinary number of young people, largely under thirty. Exodus had special programs set aside at that conference for younger people which old fogies like me weren’t allowed to attend. Exodus even operates an entire ministry called Exodus Youth, headed by Scott Davis, which specifically targets young people of high school and junior high ages. The Love Won Out ex-gay conferences also conduct several workshops for youth. And again, some of these workshops are closed to older adults.

Jones and Yarhouse may have had good ethical and methodological reasons for limiting their study to those above the age of eighteen. There are issues of informed consent, and questions would undoubtedly arise as to whether youth who are still under their parents direction would feel free to answer questions truthfully. But by limiting the study to those above the age of eighteen, Jones and Yarhouse guaranteed that their study would not be representative of Exodus participants overall.

Results – Is Change Possible?

As Timothy Kincaid already reported, the breakdown of the quantitative results went this way:

• 33 people reported change (moving from homosexual, bisexual or other at Time 1 to heterosexual at time 3; or homosexual at Time 1 to bisexual or other at Time 3)
• 29 reported no change
• 8 reported “negative change” (moving from heterosexual, bisexual or other at Time 1 to homosexual at Time 3; or from heterosexual at Time 1 to bisexual or other at Time 3).
• 3 reported uncertain change (moving from bisexual to other, or the reverse)

Keep in mind however that these results mix the truly prospective participants (Phase 1 participants who who began the study during their first year in Exodus ministries) and the retrospective participants (Phase 2 participants who had been in ministries for between one and three years). We don’t know what the mix of these two subpopulations are in the results. Since Jones and Yarhouse already stated that reported change from the prospective phase 1 group were “a bit less positive,” we know the results aren’t the same. But unless we understand how Phase 1 fared, we don’t know how mixing in people who were asked what their beginning orientation was retrospectively affected the results.

These results were derived using standardized measures using Kinsey and Shively-DeCecco scales. And the the Shively-DeCecco scales (remember, this separates homosexual attraction and heterosexual attractions on two separate axis), revealed something particularly interesting:

Changes on the Shively and DeCecco ratings for all three of our analysis followed a stable pattern… We see that change away from homosexual orientation are consistently about twice the magnitude of changes toward heterosexual orientation. It would appear, then, that while change away from homosexual orientation is related to change toward heterosexual orientation, the two are not identical processes. The subjects appear to more easily decrease homosexual attraction than they increase heterosexual attraction. [Emphasis in the original]

In many ways this confirms what many opponents of ex-gay therapy have noted, that attempting to change sexual orientation does not necessarily make someone straight. In fact, this particular finding makes it all the more unlikely, and puts into context Jones and Yarhouse’s characterization of success as “satisfactory, if not uncomplicated, heterosexual adjustment.”

This also, I think, goes a long way toward describing something else. It is often assumed that those who reported the most change were probably bisexual to some degree when starting the change process. To test that theory, Jones and Yarhouse created a subpopulation from their sample that, for want of a better term, they dubbed “The Truly Gay”:

… [T]o be classed as truly gay, subjects must have reported above average homosexual attraction and reported homosexual behavior and reported past embraced of a gay identity. We would emphasize that these were much more rigorous standards than are typically employed in empirical studies to classify research subjects as homosexual. Using this method, 45 out of our total 98 subjects were classed as “Truly Gay,” just less than half the population sample. We expected that the results of change for the Truly Gay subpopulation would be less positive, as they individuals would be those more set and stable in their sexual orientation. This is not what we found. Rather the change reported by the Truly Gay subpopulation was consistently stronger than that reported by others.

It’s unclear to me what they meant by “above average homosexual attraction” in their definition for the “Truly Gay.” Most researchers consider only Kinsey 5’s and 6’s to be “truly gay.” It’s not clear that this is what Jones and Yarhouse did here. By saying “above average homosexual attraction,” do they mean above average for this sample? If so, what was that cut-off? Maybe the book will clear things up. We’ll see.

But let’s assume for a moment that their criteria is valid, and let’s look at this in light of what they noticed about change to begin with: A change away from homosexual attractions at a rate that is about twice the rate of change toward heterosexual attraction. When looked at it this way, it is possible that the “stronger change” for the “Truly Gay” subpopulation was possible simply because there was a greater potential travel along the Kinsey or Sively-DeCecco scales to begin with; many bisexuals would have begun their attempts to change already partway down those paths. And since overall, the best functioning was “satisfactory, if not uncomplicated, heterosexuality,” it appears that for both groups, there was a finite limit short of Kinsey 0 or 1 that few in either group approached.

Qualitative Analysis of Change

So far, we’ve talked about statistical measures of change based on Kinsey and Sively-DeCecco scales. Jones and Yarhouse also described some qualitative analysis, based on open-ended questions about participants’ attractions, experiences and identity. Those results were:

• “Success: Conversion”: There were subjects who reported that they felt their change to be successful and reported substantial reduction in homosexual desire and addition of heterosexual attraction and functioning. 15% (11 of 72) at Time 3 met this standard.
• “Success: Chastity”: These were subjects who reported that their change was successful, and who reported homosexual attraction to be present only incidentally or in a way that does not seem to bring about distress, allowing them to live happily without overt sexual activity. 23% (17 of 72) at Time 3 met this standard.
• “Continuing”: These persons may have experienced modest decreases in homosexual attraction, but were not satisfied with their degree of change and remained committed to the change process. 29% (21 of 72) at Time 3 met this standard.
• “Non-response”: These people experienced no significant change. They had not given up on the change process, but may be confused or conflicted about which direction to turn next. 15% (11 of 72) at Time 3 were in this category.
• “Failure: Confused”: These persons had experienced no significant change and had given up on the change process but without yet embracing gay identity. No change reported and had given up but did not label themselves gay. 4% (3 of 72) at Time 3 were in this category
• “Failure: Gay identity”: These persons had clearly given up on the change process and embraced a gay identity. 8% (6 of 72) of the sample at Time 3 were in this category.

To further understand what all this means, it would be important to know how the dropouts might have affected these results. As we mentioned earlier, the Adolescent Health study (which Jones and Yarhouse upheld as a “gold standard”) made a concerted effort to understand how their dropouts might have affected the results. In doing so, they discovered that fewer than 5% dropped out because of refusal to continue. With that and other information at hand, they were able to determine that their dropouts affected the results by no more than a single percentage point.

Jones and Yarhouse appear to show no similar curiosity, and this represents a very significant failing of their study. In fact, the dropouts might have contributed very significantly towards higher “failure” numbers. But since Jones and Yarhouse appear to be incurious to find out more about this group, we are left in the dark.

Outcomes for Harm

Jones and Yarhouse administered the System Check List-90-Revised (SCL), which they describe as “a respected measure of psychological distress that is often used to measure the effects of psychotherapy.” They report no difference in the SCL scores from Time 1 to Time 3 when compared to others who are undergoing outpatient counseling.

But again, what about the dropouts? Did they report higher SCL scores at Time 1 or Time 2 before dropping out? We don’t know, not from the synopsis anyway. Again, maybe the full book will provide more details. But without this critical information to understand how the dropouts might have affected the results, Jones and Yarhouse cannot confidently conclude that attempting to change produced no harm. At best, they can only conclude that there was no greater degree of distress among those who continued ex-gay therapy when compared to mentally distressed persons undergoing psychological counseling for other issues — and by the way, is that really a legitimate comparison? I think it’s debatable. At any rate, where they chose to look, there was no problem. Where they chose not to look, who knows?

Conclusions

From Jones and Yarhouse’s synopsis of their study, I have a few more questions than answers. Hopefully I’ll get a copy of the full report in a few days. If so, I’ll post a more complete review as time permits. Until then, consider this review a preliminary one.

I’d have to say that I was very impressed with the study’s design, and very disappointed in its execution. Seventy-two participants out of Alan Chambers much-repeated “thousands” or “tens of thousands” doesn’t impress me much. I’m especially disappointed with these particular weaknesses:

• Jones and Yarhouse’s insistence that the study is representative of Exodus participants is completely without merit. If Jones and Yarhouse feel free to make such a sweeping claim with no data to support it, one wonders what other sweeping claims they may have made.
• Jones and Yarhouse’s apparent incuriosity towards those who dropped out borders on willful ignorance. Maybe the full book will provide better information in this area, but the synopsis leaves the impression that unlike the Add Health study that they admired, they didn’t try to learn what those dropouts might mean for their results.
• Jones and Yarhouse’s inclusion of those who had been in Exodus member ministries for between one and three years — and having that group making up nearly half of the study — makes a significant chunk of what was supposed to be a prospective study a retrospective one instead. And it misses those who “failed” out of that Phase 2 group before they had a chance to join the study. This is a particularly sloppy failing that most certainly biased the results in favor of more “successes” and fewer “failures.”

We’ve waited quite a long time for a better study than Robert Spitzer’s 2003 effort. This study held great promise based on its initial design, but its conduct left much to be desired. Its rigorous design was not matched by similar rigor in execution. And so we’re still left waiting for that definitive breakthrough ex-gay study. I don’t think this one is it.

Update: Stanton Jones Responds

Exodus Press Release Spins Study

Yesterday, I made the mistake of promising a detailed review of the synopsis from Stanton Jones and Mark Yarhouse of their new ex-gay study. Little did I know that unexpected company would be dropping in this weekend. So watch this space for my review sometime Monday.

Meanwhile, Exodus is pleased as punch about Jones’ and Yarhouse’s ex-gay study:

Alan Chambers, a former homosexual and President of Exodus International, responded to the study findings at today’s press conference, “Finally, there is now scientific evidence to prove what we as former homosexuals have known all along – that those who struggle with unwanted same-sex attraction can experience freedom from it.”

Alan Chambers’ sweeping generalization “that those who struggle.. can experience freedom” isn’t supported by the study. At best, a few (namely, eleven out of this sample of seventy-three) found freedom — that is, if freedom means “satisfactory, if not uncomplicated, heterosexual adjustment” as Jones and Yarhouse so carefully put it. Another seventeen decided that celibacy was good enough. Not what I’d call freedom, but hey — different strokes, right?

Update: Here’s the review I promised: A Preliminary Review of Jones and Yarhouse’s “Ex-Gay? A Longitudinal Study”

Limited Available Information on Study has Confusing Numbers

Dr. Warren Throckmorton is reporting some of the findings from the Yarhouse and Jones book. It appears that the study was over four years and included 98 people who were referred by various Exodus ministries.

• 33 people reported change in the desired manner (from gay at time 1 in the heterosexual direction at time 3)
• 29 reported no change
• 8 reported change in the undesired direction
• 3 were unsure how to describe their experience of change

and 25 people discontinued participation in the study during that time. The study also reports:

• Success: Conversion – There were subjects who reported that they felt their change to be successful and reported substantial reduction in homosexual desire and addition of heterosexual attraction and functioning at Time 3. 15% met these criteria.
• Success: Chastity – These people experienced satisfactory reductions in homosexual desire and were living chaste lives. 23% were in this category.
• Continuing – These persons experienced only modest change in the desired direction but expressed commitment to continue. 29% were in this category.
• No-response – These people experienced no change and were conflicted about the future even though they had not given up. 15% were here.
• Failure (from their perspective): Confused – No change reported and had given up but did not label themselves gay. 4% were in this group
• Failure: Gay identity – No change, no pursuit and had come as gay. 8% were in this category.

Assuming that these are percentages of the 73 participants who made it to the fourth year, this would break out as follows:

• Success: Conversion – 11
• Success: Chastity – 17
• Continuing – 21
• No-response – 11
• Failure: Confused – 3
• Failure: Gay identity – 6

With four people left unaccounted for.

Try as I might, I can’t get these two findings to reconcile. Did 33 people report a change in the positive direction, or did 28? Did 8 people identify as gay or did 6?

We will have to wait for Jim’s analysis of the book for better answers. At present, we can only conclude that, at best:

Perhaps eleven percent of an nonrepresentative sample of 98 highly motivated gay people who went through Exodus programs reported that after four years there was “substantial reduction in homosexual desire and addition of heterosexual attraction and functioning”.

Christianity Today provides further clarification on those eleven successes.

Most of the individuals who reported that they were heterosexual at Time 3 did not report themselves to be without experience of homosexual arousal, and did not report heterosexual orientation to be unequivocal and uncomplicated. … We believe the individuals who presented themselves as heterosexual success stories at Time 3 are heterosexual in some meaningful but complicated sense of the term.

These sound less like Mom and Dad heterosexuals and more like Larry Craig heterosexuals. In other words, the number of individuals who went from plain old gay to plain old straight: zero. Not an overwhelming success story, I’m inclined to think.

Jones’ and Yarhouse’s Ex-Gay Study Released

The results of Stanton Jones’ and Mark Yarhouse’s Exodus study were released yesterday. I have a synopsis of that study that I’m reviewing now. Short take: The methodology seems to be pretty good, (I’m especially happy to see them use standardized measures for sexuality, something that Spitzer didn’t do).

The greatest weakness is its small sample size, and I’m concerned about the cohorts that they added to the study to try to beef it up. They originally wanted to study Exodus participants who were in their first year of attending an Exodus member ministry, but when they couldn’t find enough subjects they added a cohort of strugglers who had been in the ministry for one to three years. I don’t think there’s anything nefarious going on there, but so far I can’t sort out how those cohorts affected the results. I think that for what’s supposed to be a longitudinal study, this is critically important. I also question their claims that their sample is representative of Exodus participants. So far as I can tell, they fail to justify that claim.

These are just first quick impressions from the synopsis. I’ll have more for tomorrow morning late tomorrow afternoon. The study itself is a 375-page book. I’m trying to obtain an advance copy, and when I do it will obviously take a great deal of time to go through it.

InterVarsity Press Announces Release of Exodus Ex-Gay Study

InterVarsity Press issued this press release, announcing the Sept 13 release of a study by Stanton L. Jones (Wheaton College) and Mark A. Yarhouse (Regent University). Titled “Ex-Gays? A Longitudinal Study of Religiously Mediated Change in Sexual Orientation,“ the study is intended to address two questions: can people change, and is trying to change harmful?

When Robert Spitzer’s ex-gay study, “Can some gay men and lesbians change their sexual orientation?” appeared in the October 2003 issue of the Archives of Sexual Behavior, the journal took the highly unusual step of publishing twenty-six peer review commentaries, both critical and laudatory. Among the commentaries was Mark Yarhouse’s “How Spitzer’s study gives a voice to the disenfranchised within a minority group.” He notes a few of the limitations of Spitzer’s study and muses on what a better constructed study might look like:

There is a need for studies with improved methodology. This would include a prospective longitudinal design in which participants provide information on sexual behavior, attractions, fantasy, and so on, prior to or in the early stages of therapy, and then tracked over tie, so that something as potentially unreliable as memory recall would not play so prominent a role in studies that touch on such a controversial topic.

I would also suggest another set of data: follow-up on those who drop out of ex-gay ministries, and their post-therapeutic experiences and perspectives. Yarhouse wrote another paper titled, “An Inclusive Response to LGB and Conservative Religious Persons: The Case of Same-Sex Attraction and Behavior”, which appeared in the June 2002 issue of Professional Psychology: Research and Practice. In that paper, he recognized the existence of “ex-ex-gays”:

A similar tension exists when we consider “ex-ex-gays.” They are individuals who once lived an LGB lifestyle, later attempted to change their behavior or attractions, and still later returned to living an LGB lifestyle. From a conservative religious perspective, ex-ex-gays may be the result of poor therapeutic technique, insufficient client commitment or motivation, moral or spiritual failure, or failure of ministries to offer realistic expectations of change. This last consideration is particularly important. It might be that conservative religious persons hold out expectations for change that are too high (i.e., that a person would be free from every vestige of same-sex desire and would be happy and fulfilled in marriage). From this perspective, ex-ex-gays are discouraged, sometimes angry, about their experiences within religion-based ministries.

Yarhouse continues:

Gay-affirmative theorists tend to see ex-ex-gays as casualties of professional interventions and religious ministries (Haldeman, 1994). Gay-affirmative theorists propose that ex-ex-gays are the result of the predictable failure of sexual reorientation therapy and religion-based ministries to accomplish what they purport to accomplish. According to Haldeman, some question whether these proponents of reorientation and reparative therapies are not disturbed themselves, preying on vulnerable persons who are hoping against hope to experience change.

Again, is there merit to both accounts? Is it possible that some people are misled about what reorientation and reparative therapy can offer? It is possible that some people do hold expectations for change that are too high. Whether the individual is freely seeking changes for personally felt reasons or is being taken to a program for change by a third party is also a factor in relation to this topic. All of this depends on several factors, including what sexual orientation is, whether it is immutable, and what evidence exists for the effectiveness of reorientation and reparative therapies.

Having talked to a number of ex-ex-gays myself, I think this discussion of their perspectives are highly over-simplistic. While some may have held a number of unrealistic expectations — expectations that are often promoted by ex-gay ministries themselves — most whom I talked to had more realistic expectations. They just found the prospect of living with those expectations unrealistic.

When discussing possible harms of attempting to change, it will be essential for this study to also follow the experiences of those who drop out of ex-gay ministries, and to talk to ex-gay survivors directly.

Jones and Yarhouse have collaborated before. They wrote “The Use, Misuse and Abuse of Science in the Ecclesiastical Homosexuality Debates,” which appeared in the 2000 anthology Homosexuality, Science, and the “Plain Sense” of Scripture” (edited by David L Balch and published by Eerdmans). This article, which largely limits its focus on the “misuse and abuse” by the gay-affirming side rather than the anti-gay side, clearly shows their biases in discussing whether homosexuality is a pathology and in dealing with the possible biological and environmental causes of homosexuality. I’ll have more on this later.

This latest study will be released during a press conference at the American Association of Christian Counselors World Conference on September 13 in Nashville, Tennessee. And what a coincidence. Exodus will be holding their regional conference in Nashville that same weekend. Gee, what are the odds?