Ambassadors & Bridge Builders International: What do mental health organisations say about ex-gay/reparative/conversion therapy?

There is no published scientific evidence supporting the efficacy of 'reparative therapy' as a treatment to change ones sexual orientation. It is not described in the scientific literature. There are a few reports in the literature of efforts to use psychotherapeutic and counselling techniques to treat persons troubled by their homosexuality who desire to become heterosexual; however, results have not been conclusive, nor have they been replicated. There is no evidence that any treatment can change a homosexual person's deep seated sexual feelings for others of the same sex.

1997: The American Psychological Association

President said……"In the past 10 years, Christian fundamentalists have enlisted a coalition of old-style psychologists, psychiatrists and social workers who have become very visible in this country and internationally, and who have as a mission to 'help' homosexuals get rid of their sexual orientation... Our aim is not to try to stop them per se or interfere with anyone's right to practice [therapy] but we want to expose the social context that creates this market."

1997 The American Psychological Association Resolution

APA officials are concerned that some who enter therapy are being coerced by their families, employers, church members etc. Therefore the APA resolution asks that the therapist obtains "informed consent" from the client. This includes:

1999 the American Psychiatric Association

"The potential risks of 'reparative therapy' are great, including depression, anxiety and self-destructive behaviour, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient. Many patients who have undergone 'reparative therapy' relate that they were inaccurately told that homosexuals are lonely, unhappy individuals who never achieve acceptance or satisfaction. The possibility that the person might achieve happiness and satisfying interpersonal relationships as a gay man or lesbian is not presented, nor are alternative approaches to dealing with the effects of societal stigmatization discussed."

"Therefore, the American Psychiatric Association opposes any psychiatric treatment, such as 'reparative' or 'conversion' therapy which is based upon the assumption that homosexuality per se is a mental disorder or based upon a prior assumption that the patient should change his/her homosexual orientation.”

1999 the American Psychiatric Association

Board of Trustees "endorsed a position statement at its December meeting that opposes therapeutic techniques some psychiatrists and mental health professionals claim can shift an individual's sexual orientation from homosexual to heterosexual. The Board also acknowledged that there is no evidence that these so-called 'reparative therapies' have any efficacy in converting someone from one sexual orientation to another." The statement points out that "potential risks of 'reparative therapy' are great, including depression, anxiety, and self-destructive behaviour, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by a patient.”

1999 The American Academy of Paediatrics, American Counselling Association, American Association of School Administrators, American Federation of Teachers, American Psychological Association, American School Health Association, Interfaith Alliance Foundation, National Association of School Psychologists, National Association of Social Workers, and National Education Association formed the "Just the Facts Coalition." They developed and endorsed "Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel" which stated:

The most important fact about 'reparative therapy,' also sometimes known as 'conversion' therapy, is that it is based on an understanding of homosexuality that has been rejected by all the major health and mental health professions. The American Academy of Paediatrics, the American Counselling Association, the American Psychiatric Association, the American Psychological Association, the National Association of School Psychologists, and the National Association of Social Workers, together representing more than 477,000 health and mental health professionals, have all taken the position that homosexuality is not a mental disorder and thus there is no need for a 'cure’. Health and mental health professional organizations do not support efforts to change young people's sexual orientation through 'reparative therapy' and have raised serious concerns about its potential to do harm."

2000 Australian Psychological Society Position Statement on the Use of Therapies that Attempt to Change Sexual Orientation

In the past, defining homosexuality as an illness buttressed society's dislike for same-sex relationships. In the current social climate, claiming homosexuality is a mental disorder stems from efforts to discredit the growing social acceptance of homosexuality as a normal variant of human sexuality. Consequently, the issue of changing sexual orientation has become highly politicised. The debates surrounding this issue have obscured the scientific data by calling into question the motives and the character of individuals on both sides of the issue.

The validity, efficacy and ethics of clinical attempts to change an individual’s sexual orientation have been challenged. To date, there are no scientifically rigorous outcome studies to determine either the actual efficacy or harm of therapies or treatments that attempt to change a person’s sexual orientation. There are sparse scientific data about selection criteria, risks versus benefits of the treatment, and long-term outcomes of such therapies. The literature consists of anecdotal reports of individuals who have claimed to change, people who claim that attempts to change were harmful to them, and others who claimed to have changed and then later recanted those claims.
With little data about patients, it is impossible to evaluate the theories, which rationalise the conduct of ‘reparative’ or conversion therapies. Firstly, they are at odds with the scientific position of the American Psychiatric Association, which has maintained, since 1973, that homosexuality per se is not a mental disorder. The theories of ‘reparative’ therapists define homosexuality as either a developmental arrest, a severe form of psychopathology, or some combination of both. In recent years, noted practitioners of ‘reparative therapy’ have openly integrated older psychoanalytic theories that pathologise homosexuality with traditional religious beliefs condemning homosexuality.
The earliest scientific criticisms of the early theories and religious beliefs informing ‘reparative’ or conversion therapies came primarily from sexology researchers. Later, criticisms emerged from psychoanalytic sources as well. There has also been an increasing body of religious thought arguing against traditional, biblical interpretations that condemn homosexuality and which underlie religious types of ‘reparative’ therapy.

Recommendations:
1. APS supports the APA 1973 position that homosexuality is not a diagnosable mental disorder.
2. As a general principle, a therapist should not determine the goal of treatment either coercively or through subtle influence. Psychotherapeutic modalities to convert or ‘repair’ homosexuality are based on developmental theories the scientific validity of which is questionable. Furthermore, anecdotal reports of ‘cures’ are counterbalanced by anecdotal claims of psychological harm. ‘Reparative’ therapists have not produced any rigorous scientific research to substantiate their claims of cure. Until there is such research available, APS recommends that ethical practitioners refrain from attempts to change individuals’ sexual orientation.
3. The ‘reparative’ therapy literature uses theories that make it difficult to formulate scientific selection criteria for their treatment modality. This literature not only ignores the impact of social stigma in motivating efforts to cure homosexuality, it is a literature that actively stigmatises homosexuality as well. ‘Reparative’ therapy literature also tends to overstate the treatment’s accomplishments while neglecting any potential risks to patients. APS encourages and supports research in the academic research community to determine further the efficacy or otherwise of therapies or treatments that attempt to change a person’s sexual orientation.

2010 Royal Australian & New Zealand College of Psychiatrists Position Statement

The American Psychological Association published a report of a study that reviewed the results of 83 studies carried out between 1960 and 2007 on the controversial concept of Sexual Orientation Change Efforts (SOCE). The report found that, contrary to the claims of SOCE practitioners and advocates, recent research demonstrates that there is no sound scientific evidence that sexual orientation can be changed. The harm such therapies can cause to individuals, the contribution they make to the misrepresentation of homosexuality as a mental disorder, and the prejudice and discrimination that can flourish through the use of such therapies has led all major medical organisations to oppose the use of sexual reorientation therapies.