from What do clinical studies say?
The APA has now begun to acknowledge what most scientists have long known:
that a bio-psycho-social model of causation best fits the data.
A. Dean Byrd, Ph.D., MBA, MPH
March 6, 2008 - In 1998, the American Psychological Association (APA) published a brochure titled "Answers to Your Questions about Sexual Orientation and Homosexuality."
This particular document was ostensibly published to provide definitive answers about homosexuality. However, few of the assertions made in the brochure could find any basis in psychological science. Clearly a document anchored more in activism than in empiricism, the brochure was simply a demonstration of how far APA had strayed from science, and how much it had capitulated to activism.
The newest APA brochure, which appears to be an update of the older one, is titled, "Answers to Your Questions for a Better Understanding of Sexual Orientation & Homosexuality."
Though both brochures have strong activist overtones (both were created with "editorial assistance from the APA Committee on Lesbian, Gay and Bisexual Concerns"), the newer document is more reflective of science and more consistent with the ethicality of psychological care.
Consider the following statement from the first document:
"There is considerable recent evidence to suggest that biology, including genetic or inborn hormonal factors, play a significant role in a person's sexuality."
That statement was omitted from the current document and replaced with the following:
"There is no consensus among scientists about the exact reasons that an individual develops a heterosexual, bisexual, gay or lesbian orientation. Although much research has examined the possible genetic, hormonal, developmental, social, and cultural influences on sexual orientation, no findings have emerged that permit scientists to conclude that sexual orientation is determined by any particular factor or factors. Many think that nature and nurture both play complex roles..."
Although there is no mention of the research that influenced this new position statement, it is clear that efforts to "prove" that homosexuality is simply a biological fait accompli have failed. The activist researchers themselves have reluctantly reached that conclusion. There is no gay gene. There is no simple biological pathway to homosexuality. Byne and Parsons, and Friedman and Downey, were correct: a bio-psycho-social model best fits the data.
On the question of whether or not therapy can change sexual orientation, the former document offered a resounding "no." However, the current document is much more nuanced and contains the following statement: "To date, there has been no scientifically adequate research to show that therapy (sometimes called reparative or conversion therapy) is safe or effective."
Of course, no mention is made of the Spitzer research, the Karten research, or the recent longitudinal research conducted by Jones and Yarhouse -- all of which support the conclusion that some people can and do change.
Of the Spitzer research, psychologist Dr. Scott Hershberger (who is a philosophical essentialist on questions of sexual orientation) conducted a Guttman analysis of the study sample, and declared:
"The orderly, law-like pattern of changes in homosexual behavior, homosexual self-identification, and homosexual attraction and fantasy observed in Spitzer's study is strong evidence that reparative therapy can assist individuals in changing their homosexual orientation to a heterosexual one."
The Spitzer study found no evidence of harm. Neither did the Karten study, nor the Jones and Yarhouse study.
Furthermore, one might ask, does the APA plan to conduct studies on the effectiveness of other therapies in use? Many are entirely without validation, yet practitioners regularly receive Continuing Education credits for teaching these same therapies through APA-approved courses. Perhaps it is time for APA to hold all therapies and all therapists to the standard which they advocate for reorientation therapy.
The Right to Self-Determination is Finally Recognized
In APA's new document, there is a greater emphasis on ethicality. The pamphlet includes this key statement:
"Mental health organizations call on their members to respect a person's [client's] right to self-determination."
Certainly, client self-determination is one of the cornerstones of any form of psychological care. And any attempt to ban psychological care for those unhappy with their homosexual attractions would be a direct violation of enormous magnitude of APA's own Code of Ethics -- one which neither the federal/state governments nor the American public would respond to favorably.
Imagine a media headline, "APA Declares That Homosexuals Are Not Competent To Determine Whether Or Not They Can Seek Psychological Care to Change" or "APA Bans Choice of Psychological Care for Homosexuals."
Additions to the new APA brochure also include sections on adolescents, homosexual marriage and adoption by homosexual couples.
Interestingly enough, the section on adolescents contains fairly good information regarding the differences between homosexual attractions, homosexual orientation and homosexual identity (though the terms are not used). There is an admission of the sexual fluidity of adolescence, with different ultimate outcomes for different sexually confused adolescents.
The section on marriage is simply an advocacy statement suggesting that marriage might enhance the stability of homosexual couples.
The discussion on parenting by homosexual couples was noteworthy for its internal contradictions. There is an admission that there is a dearth of scientific data on children raised by same-sex couples, but the authors conclude that there are "few differences." How can the dearth of scientific studies allow anyone to offer such a conclusion?
Finally and most intriguing are the recommended resources for further reading. The former brochure referred readers to the National Gay and Lesbian Task Force; to Parents, Families and Friends of Lesbians and Gays, and to Sexuality Information and Education Council of the United States (SIECUS), all activist groups.
The current brochure refers readers to the American Psychological Association, Mental Health America, and the American Academy of Pediatrics.
A significant portion of the new brochure was devoted to the role that prejudice and discrimination plays in the lives of lesbian, gay and bisexual people. This theme seemed pervasive throughout the document. Homosexual relationships are viewed as no different from heterosexual relationships. There is no acknowledgement of the substantial research that clearly demonstrates that homosexuals are at greater risks for some forms of mental illness (Herrell, Ferguson, Sandfort).
It's unfortunate that APA does not move beyond its single-minded focus on "discrimination and prejudice" to allow honest and open study of GLBT issues. In areas such as homosexuality, political correctness seems to have gone amok. On this front in particular, APA seems to have surrendered its professionalism and its science to political correctness.
Some Say That Truth Doesn't Matter
Consider the following statement made by a prominent member of the American Psychological Association and published by the Harvard University Press: "...it may be that for now, the safest way to advocate for lesbian/gay/bisexual rights is to keep propagating a deterministic model: sexual minorities are born that way and can never be otherwise. If this is an easier route to acceptance (which may in fact be the case), is it really so bad that it is inaccurate?"
Where are the guardians of our professional ethics? Will they really allow such Machiavellian statements to go uncritically examined? Is there an ethical violation when a self-identified psychologist and a member of APA supports activism masqueraded as science, and states that it is not so bad?
Political correctness would suggest that there will be no response from the APA.
In his book, Destructive Trends in Mental Health, former APA president Nicholas Cummings notes that he and his co-author lived through the abominable McCarthy era and the Hollywood witch hunts; still he notes, there was "not the insidious sense of intellectual intimidation that currently exists under political correctness." He says, "Now, misguided political correctness tethers our intellects."
Perhaps the British playwright, self-identified secularist atheist Pat Condell, is indeed correct: "Political correctness is like a drug that we just can't stop injecting, even though we know it's going to kill us."
In summary, if one reduces the recent APA document to one based on scientific merit and ethicality, it might translate into something like the following:
"We at APA acknowledge that there are probably many factors that lead to one to claim a gay identity, likely different for different folks. However, what is clear is that homosexuality is not simply a biological phenomenon. We are not sure about the effectiveness of reorientation therapy (or any other therapies for that matter!) but political correctness demands that APA take a position of extreme caution, even though there is no evidence to support such a position. And APA believes that though homosexuality may be fluid for some people, it is certainly not a matter of choice for anyone. However, having expressed these reservations (and fears), it is important that all mental health professionals respect client self-determination (including those who seek reorientation therapy)."
The APA should be commended for its greater reliance on science and ethicality in this document. Perhaps now is the time for the association to abide by its commitment that accompanied then-APA President Nicholas Cummings' proposal to remove homosexuality as a mental disorder in 1974: "a proscription that appropriate and needed research would be conducted to substantiate these decisions." None, however, was ever conducted.
Such research should include a study of the efficacy of psychological care for those unhappy with unwanted homosexual attractions, as well as for its counterpart--gay-affirmative therapy for those who wish to claim a gay identity.