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Reparative therapy & transformational ministries

Estimates of success rates

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Quotations:

bulletPRO:
bullet"...the Holy Spirit is available to transform all persons - including homosexual persons." Transforming Congregations.
bullet"A variety of studies have shown that between 25% and 50% of those seeking treatment experienced significant improvement." NARTH letter to the editor of the Wall Street Journal. 1
bullet"There is no scientific data that substantiates a genetic or biologic basis for same-sex attraction. Anybody can change." Richard Cohen, speaking at the year 2000 conference of Parents and Friends of Ex-Gays
bullet"People need to know this [homosexuality] is not a lifetime sentence. No one has been saying that. Change is possible." D. James Kennedy, Coral Ridge Ministries.
 
bulletOther statements by conservative Christian groups promoting reparative therapy.
 
bulletCON:
bullet"There is no published scientific evidence supporting the efficacy of 'reparative therapy' as a treatment to change ones sexual orientation." American Psychiatric Association fact sheet, 1994-SEP
bullet"...scientific evidence does not show that conversion therapy works." American Psychological Association, 1994.
bullet"...[reparative therapy] " can provoke guilt and anxiety while having little or no potential for achieving changes in orientation." American Academy of Pediatrics, 1993.
 
bulletOther statements by mental health professional organizations opposing reparative therapy.

Overview:

In this essay, we will use the term "conversion therapy" to refer to attempts to change homosexuals into heterosexuals. These attempts take two forms:

bulletReparative therapy, and 
bulletThe programs of transformational ministries to change clients' sexual orientation.

Both are extremely controversial. 

bulletIn North America, reparative therapy is mainly promoted by one small professional mental health organization, NARTH, and by many Evangelical and other conservative Christian ministries. Transformational ministries also promote their own programs of prayer, religious conversion and counseling to change their clients' orientation. These groups generally teach that homosexuality is an unnatural, abnormal, chosen and changeable sexual behavior. This is consistent with conservative Christian theological beliefs: They interpret the Bible as condemning homosexuality. They feel that God hates homosexual behavior, and that God is all powerful, all present, all knowing, and answers sincere prayers. With these beliefs, it is logical that God would help a sincere, gay believer who wants to become heterosexual.
 
bulletAll other major mental health professional organizations and many gay and lesbian groups have issued warnings against reparative therapy. They generally teach that homosexuality is natural, normal, unchosen and unchangeable sexual orientation for a minority of people. They believe that an adult cannot change their sexual orientation, that reparative therapy is potentially dangerous to some clients' self-esteem, and that some clients leave therapy seriously depressed -- occasionally with suicidal ideation.

It is extremely important that therapists, gays, lesbians, parents, and the rest of the public gain an understanding of the effectiveness of conversion therapies. Tens or hundreds of thousands of gays and lesbians have experienced these form of counseling. There is considerable anecdotal evidence that all or essentially all gays and lesbians fail to achieve their goals during reparative therapy. Many become very depressed; some of these attempt or commit suicide.

Unfortunately, reparative therapy still remains experimental; there appears to be no reliable data on either its effectiveness or its dangers. No long-term studies have never been done.

Defining "conversion rate" and other terms:

Unfortunately, both sides in this debate define basic terms very differently. In this essay, we will use the definitions that are recognized by most of the public, including religious liberals, mental health professionals, human sexuality researchers, gays, lesbians, etc. These include:

bulletHeterosexuality, homosexuality, and bisexuality are the three possible sexual orientations.
 
bulletA heterosexual is an individual who is sexually attracted only to members of the opposite gender. They may act on these feelings or decide to remain celibate.
 
bulletA homosexual is an individual who is sexually attracted only to members of the same gender, whether they act on these feelings or not.
 
bulletA bisexual is an individual who is sexually attracted to both men and women, although not necessarily to the same degree. Some are celibate; some have engaged in sexual behavior with both men and women; some restrict their sexual relationship(s) to one gender.
 
bulletA person with a homosexual orientation who emerges from conversion therapy with their sexual orientation unchanged is obviously not converted to a heterosexual orientation. If they decide to be celibate as a result of the therapy, then they have merely made a mental decision to become sexual inactive; their sexual orientation remains homosexual. 
 
bulletA person with a bisexual orientation who emerges from conversion therapy with their sexual orientation unchanged is obviously not converted to a heterosexual orientation. They may decide to confine their sexual relationship(s) to members of the opposite gender. However their sexual orientation remains bisexual.
 
bulletA person with a homosexual orientation who emerges from conversion therapy with their sexual orientation changed to either bisexual or heterosexual would be successfully converted from homosexuality.
 
bulletThe "conversion rate" of conversion therapy is defined as the percentage of persons with a homosexual orientation who have entered conversion therapy, have changed their orientation to either bisexual or heterosexual, and who have achieved "good heterosexual functioning.

Religious conservatives might refer to this as the "cure rate" However. "cure" implies that the person has been freed from a disease or disorder. A shrinking percentage of people regard a homosexual orientation to be a disease or disorder to be cured.

In a description of a conversion therapy study by Dr. Robert Spitzer, CNN.com defined such heterosexual functioning as:
bulletbeing "in a sustained, loving heterosexual relationship within the past year."
bullet"getting enough satisfaction from the emotional relationship with their partner to rate at least seven on a 10-point scale."
bullet"having satisfying heterosexual sex at least monthly," and 
bullet"never or rarely thinking of somebody of the same sex during heterosexual sex." 1,2

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Conversion rate estimates:

Unfortunately, as of 2001-MAY, no study of conversion therapy has been published in a peer-reviewed journal. Those studies that have been conducted have many deficiencies. Often complete data has been withheld. This makes the "conversion rate" impossible to estimate accurately. However, a few studies have uncovered sufficient information by which we may be able to make a very crude estimate of the conversion rate:

bulletExodus International (1978): The ministry selected 30 of their 800 members as having changed from exclusively homosexual to exclusively heterosexual in orientation. Two outside psychiatrists interviewed the 30 and found that only three were actually heterosexual.

Subsequent to the study, two of the male founders of Exodus fell in love and were united in a union ceremony. They claimed that the Exodus program was "ineffective...not one person was healed." The conversion rate, based on the study is 3 in 800, on the order of 0.4%
 
bulletMasters and Johnson (1979): This study claimed an impressive conversion rate of 50 to 60% which was maintained for 5 years after treatment. Unfortunately, only five of the 67 participants (7%) began the study with a homosexual orientation. From the available data is quite possible that none of these five converted to heterosexuality. No estimate of the conversion rate can be obtained from this study.
 
bulletNARTH (1997): They studied 860 clients whose data was sent by 200 therapists who were members of the organization. When the subjects entered therapy, 68% identified themselves as totally or almost exclusively homosexual. It is not clear whether this referred to sexual behavior or sexual orientation. The actual percentage of homosexuals was not reported; most of the subjects might have been bisexual. When they left therapy, 33% said they were exclusively or almost entirely heterosexual. Again, it is unclear whether this refers to behavior or orientation. Again, the percentage of heterosexuals is unknown. Unfortunately, 63% of the subjects were still undergoing therapy at the time of the survey. Of greater interest would be the percentage of subjects who entered with a homosexual orientation, converted to bisexuality or heterosexuality, and were able to sustain their sexual orientation for, say, two years following therapy. The NARTH report did not track the results of those clients after therapy. It is possible that none of the subjects who entered therapy with a homosexual orientation was able to change their orientation. No estimate of the conversion rate can be obtained from this study.
 
bulletSchroeder & Shidlo: This study is aiming at analyzing the experience of 202 people who have undergone conversion therapy. Eight of their subjects reported a change in sexual orientation. Unfortunately, seven of the eight were ex-gay counselors or leaders who statements may have been false. They are fairly certain that one of the 202 was able to change his/her sexual orientation They reported a conversion rate of 0.5%.
 
bulletOCRT pilot study (2000): The sponsors of this web site surveyed each of the 36 websites of the GayChange WebRing. 3 These are mainly Internet sites created by individuals or small Christian ministries. From the sites' content, all appear to be Evangelical Christian in outlook. Of the 28 accessible web sites, only one reported what they felt were conversion success. They had two clients who entered therapy with a homosexual orientation, and decided during therapy to remain celibate. One entered therapy as a bisexual and has developed a relationship with a person of the opposite sex. Neither actually changed their sexual orientation. The conversion rate of the Christian ministries sampled was 0%.
 
bulletExodus International (2000): On 2000-JAN-21, the board of directors of the National Association of Social Workers issued a statement which condemned all therapies which attempt to change a person's sexual orientation. Exodus International (EI) offered a rebuttal to that statement. In his rebuttal, Bob Davies, North American director of EI wrote that:
 
bulletOver 250,000 individuals have contacted various EI offices inquiring about a sexual orientation change. This includes "gays, lesbians, family members, friends, counselors and pastors."
 
bulletThousands of men and women have stopped homosexual behavior. That is, they have decided to become celibate. These are now "in the process of seeking deeper change in their sexual feelings and attractions."

Unfortunately, he does not estimate how many of these thousands of clients have actually changed their sexual orientation. On 2001-MAY-14, we Emailed EI asking for additional information. As expected, no response was received.

Davies does mention that some "are now happily married and raising children." However he does not give estimates of their number, nor does he indicate how many were entered EI as bisexuals and have remained with that sexual orientation. No estimate of the conversion rate can be obtained from this study.
 

bulletSpitzer (2000): Dr. Robert Spitzer conducted a study of 143 "ex-gays" and 57 "ex-lesbians" who had reported that they had become "straight." In fact, the data shows that few are now heterosexual. He reported that 89% of the men and 63% of the subjects emerged from therapy still having feelings of attraction to persons of the same-sex. 16 (11%) of the men and 21 (37%) of the women report that they now have a heterosexual orientation. Again, it is not known how many entered therapy as bisexuals or as homosexuals.

A total of 86 of the 200 subjects were referred to Dr. Spitzer by conservative Christian groups specializing in homosexual ministry; NARTH referred 46 subjects; other sources provided 68. It is apparent that the individuals that Dr. Spitzer interviewed were hand-selected from a very large group of persons who had either a homosexuals or a bisexual orientation. The 46 subjects from NARTH might have been chosen as the most successful patients from as many as 250,000 individuals who entered therapy. Unfortunately, no data has been reported about the total number of persons from whom the 200 carefully selected patients were provided. Assuming that only 100,000 subjects were involved -- a VERY conservative figure, then 37 "success stories" represents a conversion rate of 0.04%

More details on this study.

bulletNicolosi (2005): Dr. Nicolosi, the founder of NARTH who coined the term "reparative therapy" said in an interview with the Washington Post that of the patients at the Thomas Aquinas Psychological Clinic, of which he is founding director:
 
bulletOne third experience "significant improvement -- they understand their homosexuality and have some sense of control." However, they may engage in same-sex sexual behavior.
 
bulletAnother third are "cured;" they refrain from same-sex behavior and the strength and frequency of their same-sex desires is diminished, but not necessarily gone.
 
bulletThe other third fail to change.

It would seem that he is admitting that reparative therapy has a nearly 100% failure rate in terms of converting persons with a homosexual orientation to heterosexual. He does imply that some of his second group may become either asexual -- suffer a complete loss of sexual desire -- or successfully decide to remain celibate. All or almost all of his clinic's patients retain same-sex desires; they remain either with a homosexual or bisexual orientation. 6

Conclusion:

From the available data, four studies reported a "success" rate during conversion therapy of 0.4%, 0.0%, 0.5 and  0.04%. That is, conversion therapy has a failure rate in excess of 99.5% during each study. Considering the anecdotal data which indicates a large percentage of extremely depressed and suicidal clients emerging from conversion therapy, it would appear that this form of therapy is worthless. It my well result in the death by suicide of more gays and lesbians than it "converts" to a heterosexual orientation.  Unfortunately, we cannot be certain of this. The quality of the studies is extremely poor.

Jack Drescher is a New York psychiatrist and chairperson of the American Psychiatric Association's committee on gay, lesbian and bisexual issues told a Washington Post reporter in 2005: "There are probably a small number of people with some flexibility in their sexual identity who can change. Out of the hundreds of gay men I've treated, I've had one." If we assume that his term "sexual identity" is a synonym for "sexual orientation," and that Dr. Drescher has treated 200 gay men, then he would seem to estimate that about 99.5% of gay men have a fixed sexual orientation, and that only about 0.5% can change their orientation. 6

Personal note by the author:

Bias alert.

I am enraged by the state of therapy in North America. During recent decades, minorities of Psychiatrists, Psychologists, church counselors, social workers, etc. have wholeheartedly embraced worthless experimental therapies, like recovered memory therapy, facilitated communication, multiple personality disorder/dissociative identity disorder. In each case, an experimental therapy du jour has been accepted by a minority of therapists. Typically, over a 15 year interval, the popularity of each therapy increases, levels out, and then sinks into oblivion, sometimes leaving a trail of dead bodies and accused parents falsely accused of child abuse. The complete lack of any hard data supporting these therapies, and anecdotal evidence of the great harm that they cause, results in their eventual demise. I have a hunch that conversion therapy is another one of these worthless therapies. However, we just do not know for certain.

My personal opinion is that the North American public needs to be protected from experimental therapies until their effectiveness and safety can be evaluated with properly designed studies. The American Psychiatric Association, American Psychological Association, and other similar groups have warned about the dangers and lack of effectiveness of various experimental therapies, but have taken no action to prevent their members from using them in their practices. The Federal Governments have taken no action to evaluate and approve therapeutic practices in the same way as they handle pharmaceuticals. Yet dangerous drugs and dangerous therapies have both caused deaths.

If even 1% of the money involved in conversion therapy were diverted into a study of its efficacy and safety, then a meaningful evaluation could have been completed years ago, and conversion therapy would either be encouraged or discouraged. NARTH asked the American Psychological Association to join with them in conducting such a study. But the APA has refused to participate. 

Associated essays on this web site:

bulletOverview of studies about conversion therapy 
bulletDetails of these studies
bulletConversion therapy menu

References

  1. "Study suggests some gays can go straight," CNN.com news, 2001-MAY-9, at: http://www.cnn.com/2001/US/05/09/sexual
  2. Malcolm Ritter, "Some gays can turn straight, controversial study suggests," Associated Press, 2001-MAY-8.
  3. A list of web sites in the GayChange Webring is at: http://www.webring.org/cgi-bin/webring?ring=gaychange;list 
  4. Charles Socarides, et al., "Don't forsake homosexuals who want help," Letter to the Editor, The Wall Street Journal, 1997-JAN-9. See: http://www.narth.com/docs/wsjletter01.html 
  5. A statement by the National Association of Social Workers which condemns reparative therapy, along with a rebuttal by Exodus International, is available at: http://www.exodusnorthamerica.org/
  6. Sandra G. Boodman, "Vowing to Set the World Straight: Proponents of Reparative Therapy Say They Can Help Gay Patients Become Heterosexual. Experts Call That a Prescription for Harm," Washington Post, 2005-AUG-16, at: http://www.washingtonpost.com/

Copyright © 2001 to 2009 by Ontario Consultants on Religious Tolerance
Originally written: 2001-MAY-10
Latest update: 2009-OCT-22
Author: B.A. Robinson

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