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Reparative Therapy: Idealized Heterosexuality

Reparative therapy has deep roots in the history of psychology. Prior to the American Psychological Association's 1973 decision to remove homosexuality from its roster of mental disorders, homosexuality was regarded as a mental illness and therapy for homosexuals included not only psychotherapy but also aversion therapy and shock therapy, both of which were practiced with regularity.17

Over the past four decades, several psychologists and psychiatrists have contributed to the notion that homosexuality is caused by childhood circumstances and can be unlearned. In 1962, Irving Bieber's book, Homosexuality: A Psychoanalytical Study of Male Homosexuals-a work that was instantly hailed within the psychiatric profession and is still cited today by ex-gay leaders-begins with the assumption that homosexuality is pathological. Bieber, like his colleagues Joseph Nicolosi, Charles Socarides (whose son is gay) and Jeffrey Satinover, insists that homosexuality in men is a result of a particular family configuration-dominant mothers and distant fathers.

The lead organization advocating secular reparative therapy is the National Association for the Research and Therapy of Homosexuality (NARTH). NARTH was founded in 1992 by Charles Socarides, Benjamin Kaufman, and Joseph Nicolosi in preparation for the 20th anniversary of the 1973 decision by the American Psychological Association to remove homosexuality from its Diagnostic Manual, the official APA manual that lists all mental and emotional disorders.18 NARTH's statement of policy idealizes heterosexuality as the norm and the organization clearly values social conformity above the needs of the individual:

"Homosexuality distorts the natural bond of friendship that would naturally unite persons of the same sex. It works against society's essential male/female design and family unit. Yet today children from kindergarten through college are being taught in school that homosexuality is nothing but a normal, healthy option. It is our policy as psychoanalytically-informed individuals to dispel the misinformation that surrounds the subject of homosexuality. Our task is to discuss issues misrepresented by social-activist groups who have portrayed sexual deviancy as a normal way of life. We seek to further the research and treatment of this disorder, while protecting the patient's right to treatment."19

NARTH's presence in the psychotherapy profession is small but significant. NARTH members are licensed psychotherapists, psychiatrists, and medical professionals who, by virtue of their credentials, have some influence within certain psychotherapy and medical institutions. In addition, these credentials give their ideas the appearance of legitimacy when marketed to the public. Last year, Charles Socarides, Benjamin Kaufman, Joseph Nicolosi, Jeffrey Satinover, and Richard Fitzgibbons co-authored an op-ed in The Wall Street Journal advocating reparative therapy for gay men:

"Suppose that a young man, seeking help for a psychological condition that was associated with serious health risks and made him desperately unhappy were to be told by the professional he consulted that no treatment is available, that his condition is permanent and genetically based, and that he must learn to live with it? How would this man and his family feel when they discovered years later that numerous therapeutic approaches have been available for his specific problem for more than 60 years? What would be his reaction when informed that, although none of these approaches guaranteed results and most required a long period of treatment, a patient who was willing to follow a proven treatment regime had a good chance of being free from the condition?"20

In response to the aggressive marketing of reparative and conversion therapy to both the public and the psychotherapy profession, the American Psychological Association, in August 1997, reiterated its long-standing official position that homosexuality and bisexuality are not mental disorders and therefore do not require treatment:

"Lesbians and gay people are the targets of considerable prejudice, discrimination, and even violence in our society. This is true in families, schools, churches, friendship networks, workplaces-all institutions in our society. All people, particularly young people, legitimately fear this prejudice, discrimination, and violence. For some the fear appears to be so powerfully internalized as shame and guilt that they wish to alter themselves to avoid it. Furthermore, there are powerful coercive forces operating in some institutions. While we respect the choice of some individuals to remain celibate due to their religious beliefs, it is important to recognize that celibacy is a behavior choice not a reformation of a person's sexual orientation. For example, in certain religious organizations homosexual people who are members of those organizations feel it necessary to change sexual behavior in order to retain their membership."21

The assessment of the American Psychological Association is echoed by other major medical and psychiatric institutions including the American Psychiatric Association, the American Academy of Pediatrics, and the American Medical Association.22 However, leaders within NARTH continue to promote reparative therapy despite its repudiation by virtually the entire mental health establishment. In his book, Homosexuality and the Politics of Truth, Jeffrey Satinover advocates medication for homosexuals. "Although research on the use of medications to change homosexuality would be quite difficult to accomplish in the current environment, there are nonetheless some indications that such an approach might help."23

Although NARTH has conducted a study analyzing its success rate with reparative therapy, it is difficult to give an accurate rate of success since it is unethical to contact clients once they have terminated therapy.24 However, as Dr. Joseph Nicolosi notes, reparative therapists cite a 33% success rate. Nicolosi states that one third of patients experience no change, one third experience some change, and one third are cured.

But by "cure" he doesn't mean that people don't experience homosexual feelings, but rather "the intensity of the attractions and the frequency of the attractions diminish to the point of being insignificant. The treatment goal is to teach these people how to identify the things that are going on in their lives that set them up for homosexual attractions."25 In other words, reparative therapists attempt to teach gay men and lesbians to repress their sexual identity, yet have a dismal failure rate of 67% in trying to reach this goal, even by their own questionable standards.

Advocates of secular reparative therapy for gay men and lesbians play an important role within the ex-gay movement and the homophobic agenda of the Christian Right, blurring the lines between clinical and political issues. In his Journal of Homosexuality article "I'm Your Handyman: A History of Reparative Therapies," Jack Drescher, MD notes, "The evolution of one branch of psychoanalytic theory into an antihomosexual political movement illustrates the permeability of boundaries between clinical issues and political ones. In their open support of antigay legislation, reparative therapists have moved from the traditional psychoanalytic center and have been embraced by conservative religious and political forces opposed to homosexuality."26

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