Monday, August 10, 2009

The Continuum Just Shrank

Internationally renowned sexologist Simon Rosser
contends that the real story of the American Psychological
recent repudiation of “reparative therapy”
is that there is now a new
continuum of acceptable care
for gay people seeking psychological help

In the wake of last Wednesday’s announcement from the American Psychological Association that mental health professionals should not tell gay clients they can become straight through therapy or other treatments, members of the Twin Cities-based Catholic Pastoral Committee on Sexual Minorities (CPCSM) have been in dialogue with a number of local psychological and sexual health care professionals so as to educate ourselves further on this important development.

One of the professionals we’ve been conferring with is B. R. Simon Rosser, Ph.D, MPH, LP, Professor and Director of HIV/STI Intervention and Prevention Studies (HIPS) program of the Division of Epidemiology and Community Health at the University of Minnesota School of Public Health.

Following, with his permission, is the text of an e-mail Dr. Rosser wrote to us about the APA’s recent repudiation of reparative therapy.


In all, I read this as minor good news, not a major break-through policy wise. The APA has been doing a political dance since 1973 when it affirmed that homosexuality is not pathological, but left open the whole range of therapies for those who seek counseling troubled by homosexual impulses. Particularly troubling were therapies to cure something the APA had declared was not inherently problematic, since logically some would ask, “why fix something if it’s not broke.”

At the two extremes were psychologists who swore that helping men and women accept their sexual orientation (gay-affirming therapies) was helpful while at the other end of the continuum, there were ex-gay therapists swearing they could help the client change and overcome their attractions. Now, it appears that continuum just shrank, and that ex-gay is officially de-bunked. That’s the real story here.

The new continuum of acceptable care ranges from gay-affirming therapy to strategies helping persons to be celibate. It may seem a small change but requiring all therapists to counsel that there is nothing wrong with sexual orientation, that gay people can lead happy lives, and that there is no evidence therapy can change orientation, cuts out, I am sure you would agree, a lot of crappy bad psychology that has done a disservice.

Dr. Warren Throckmorton was one of the leading researchers in ex-gay therapies. I have met him (and debated him) and found him to be a very nice, engaging, intelligent colleague passionate about this area, even if we are at opposite ends of the continuum on this issue. He has focused his career on proving ex-gay therapy works. The fact that he is in print now giving up ex-gay therapy is also very significant.

The APA decision appears a political compromise between two groups: one that is tired of psychologists “enabling” dysphoric gay persons’ sexual orientation distress. This group would advocate that the results of gay affirmative therapy are so clear that all persons with sexual orientation dysphoria should be encouraged to come out, improve their mental health and get on with the business of living. Clinicians who promote anything else are ultimately dis-serving the client (i.e., providing crappy therapy). This argument has much merit and empirical support.

On the other side are psychologists and clinicians who may argue that it is more effective and ethical to adopt a patient-centered approach, allow the patient to set their own goals (from embracing their sexual orientation to trying to sublimate it), and to help the person achieve these goals, provided they are feasible, realistic and achievable. I would have to say this argument also has significant merit, and because it keeps the diverse family of psychologists – who run the full range from highly conservative to highly liberal – together, appears to be the one adopted by the APA.

Take the case of a Catholic priest who comes to therapy depressed, lonely and frustrated. The presenting problem is “gay attractions.” The priest states he is content with his vocation, wants to remain a priest, but finds himself so preoccupied with his attractions that he is stressed and finding it hard to function. APA’s decision allows psychologists to explore the full range of therapeutic goals from affirming celibacy to embracing some form of gay life. And specifically, the policy clarifies that no psychologist has to tell the priest he must explore his sexual attractions.

Clearly, this is not the end of this. Indeed, it may open a new focus on sexual therapy: whether encouraging/affirming celibacy is an effective intervention. It would be interesting to see if this body of work mirrors the findings on ex-gay therapy (e.g., increased depression and suicidality) or whether it can work. Given that there are a number of groups for whom society has interest in refraining from sex with their preferred partners (e.g, pedophiles, ephebophiles, rapists, incestors) and others who choose for personal or religious reasons to become celibate, that would be a fascinating area to study.

Recommended Off-site Links:
Celibacy as a Therapy Goal - Wayne Besen (, August 6, 2009).
Fall Out from APA Repudiation of Reparative Therapy - Michael B. Hamer (Michael-in-Norfolk, August 8, 2009).

For more of Dr. Simon Rosser at The Wild Reed, see:
It’s a Great Time to Be Catholic . . . and Hopefully Part of the Change That Must Come: A Conversation with Simon Rosser

See also the previous Wild Reed posts:
It’s Official: APA Opposes “Reparative Therapy”
“Curing” Homosexuality
Debunking NARTH (Part I)
Debunking NARTH (Part II)
What Scientists in the UK are Saying About Homosexuality


Donna said...

Good for CPCSM for doing what the Archbishop and other church leaders should be doing - educating themselves about this latest news from the APA and its implications for the mental health care profession and those LGBT folks seeking help from it.

As you mentioned in an earlier post, Michael, the Church through Courage promotes reparative therapy. Let Courage push celibacy if it wants, but to fail to steer people away from reparative therapy, to actually point them in that direction (as you note they do on the Courage website) is simply disgraceful.

Obie Holmen said...

As Donna notes, the church is way behind the science on this issue. In many ways, the 21st century LGBT debate mirrors the Copernician Revolution of the 16th century ... hopefully, the church will get on board more quickly this time.

Hope to see you at the Goodsoil Service next week.