200001a

Therapies Focused on Attempts to Change Sexual Orientation (Reparative or Conversion Therapies)
SUPPLEMENT

Background to the POSITION STATEMENT

Recommendations:

1.     APA affirms its 1973 position that homosexuality per se is not a diagnosable mental disorder.  Recent publicized efforts to repathologize homosexuality by claiming that it can be cured are often guided not by rigorous scientific or psychiatric research, but sometimes by religious and political forces opposed to full civil rights for gay men and lesbians.  APA recommends that the APA respond quickly and appropriately as a scientific organization when claims that homosexuality is a curable illness are made by political or religious groups.

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 whose scientific validity is questionable.  Furthermore, anecdotal reports of "cures" are counterbalanced by anecdotal claims of psychological harm.  In the last four decades, "reparative" therapists have not produced any rigorous scientific research to substantiate their claims of cure.  Until there is such research available, APA recommends that ethical practitioners refrain from attempts to change individuals' sexual orientation, keeping in mind the medical dictum to First, do no harm.

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 stigmatizes homosexuality as well.  "Reparative" therapy literature also tends to overstate the treatment's accomplishments while neglecting any potential risks to patients. APA encourages and supports research in the NIMH and the academic research community to further determine "reparative" therapy's risks versus its benefits.
 
References
1.     National Association for Research and Treatment of  Homosexuality, (1999), American Counseling Association Passes Resolution to Oppose Reparative Therapy. NARTH Web site:  (www.narth.com/docs/acaresolution.html).
2.     Bayer, R. (1981), Homosexuality and American Psychiatry; The Politics of Diagnosis.  New York:  Basic Books.
3.     Haldeman, D. (1991), Sexual orientation conversion therapy for gay men and lesbians:  A scientific examination.  In Homosexuality: Research Implications for Public Policy, ed. J. C. Gonsiorek & J. D. Weinrich.  Newbury Park, CA:  Sage Publications, pp. 149-161.
4.     Haldeman, D. (1994), The practice and ethics of sexual orientation conversion therapy.  J. of Consulting and Clin. Psychol., 62(2):221-227.
5.     Brown, L. S. (1996), Ethical concerns with sexual minority patients.  In:  Textbook of Homosexuality and Mental Health.  ed. R. Cabaj & T. Stein.  Washington, D.C.:  American Psychiatric Press, pp. 897-916.
6.     Drescher, J. (1997), What needs changing?  Some questions raised by reparative therapy practices.  New York State Psychiatric Society Bulletin, 40(1):8-10.
7.     Duberman, M. (1991), Cures:  A Gay Man's Odyssey.  New York: Dutton.
8.     White, M. (1994), Stranger at the Gate:  To be Gay and Christian in America.  New York:  Simon & Schuster.
9.     Isay, R. (1996), Becoming Gay:  The Journey to Self-Acceptance. New York:  Pantheon.
10.   Freud, S. (1905), Three essays on the theory of sexuality. Standard Edition, 7:123-246.  London:  Hogarth Press, 1953.
11.   Rado, S. (1940), A critical examination of the concept of bisexuality.  Psychosomatic Medicine, 2:459-467.  Reprinted in Sexual Inversion:  The Multiple Roots of Homosexuality, ed. J. Marmor.  New York:  Basic Books, 1965, pp. 175-189.
12.   Bieber, I., Dain, H., Dince, P., Drellich, M., Grand, H., Gundlach, R., Kremer, M., Rifkin, A., Wilbur, C., & Bieber T. (1962), Homosexuality:  A Psychoanalytic Study.  New York:  Basic Books.
13.   Socarides, C. (1968), The Overt Homosexual.  New York:  Grune & Stratton.
14.   Ovesey, L. (1969), Homosexuality and Pseudohomosexuality.  New York:  Science House.
15.   Hatterer, L. (1970), Changing Homosexuality in the Male.  New York:  McGraw Hill.
16.   Moberly, E. (1983), Homosexuality:  A New Christian Ethic. Cambridge, UK:  James Clarke & Co.
17.   Harvey, J. (1987), The Homosexual Person:  New Thinking in Pastoral Care.  San Francisco, CA:  Ignatius.
18.   Nicolosi, J. (1991), Reparative Therapy of Male Homosexuality:  A New Clinical Approach.  Northvale, NJ:  Aronson.
19.   Kinsey, A., Pomeroy, W., & Martin, C. (1948), Sexual Behavior in the Human Male.  Philadelphia, PA:  Saunders.
20.   Kinsey, A., Pomeroy, W., & Martin, C. and Gebhard, P. (1953), Sexual Behavior in the Human Female.  Philadelphia, PA:  Saunders.
21.   Ford, C. & Beach, F. (1951), Patterns of Sexual Behavior.  New York:  Harper.
22.   Hooker, E. (1957), The adjustment of the male overt homosexual.  J Proj Tech, 21:18-31.
23.   Bell, A .& Weinberg, M. (1978), Homosexualities:  A Study of Diversity Among Men and Women.  New York:  Simon and Schuster.
24.   Bell, A., Weinberg, M. & Hammersmith S. (1981), Sexual Preference: Its Development in Men and Women.  Bloomington, IN:  Indiana University Press.
25.   LeVay, S. (1991), A difference in hypothalamic structure between heterosexual and homosexual men.  Science, 253:1034-1037.
26.   Hamer, D., Hu, S., Magnuson, V., Hu, N. & Pattatucci, A. (1993), A linkage between DNA markers on the X-chromosome and male sexual orientation.  Science, 261:321-327.
27.   Bem, D. (1996), Exotic becomes erotic:  A developmental theory of sexual orientation.  Psychol. Review, 103(2):320-335.
28.   Marmor, J., ed. (1965), Sexual Inversion:  The Multiple Roots of Homosexuality.  New York:  Basic Books.
29.   Mitchell, S. (1978), Psychodynamics, homosexuality, and the question of pathology.  Psychiatry, 41:254-263.
30.   Marmor, J., ed. (1980), Homosexual Behavior:  A Modern Reappraisal.  New York:  Basic Books.
31.   Mitchell, S. (1981), The psychoanalytic treatment of homosexuality:  Some technical considerations.  Int. Rev. Psycho-Anal., 8:63-80.
32.   Morgenthaler, F. (1984), Homosexuality Heterosexuality Perversion, trans. A. Aebi.  Hillsdale, NJ:  The Analytic Press, 1988.
33.   Lewes, K. (1988), The Psychoanalytic Theory of Male Homosexuality. New York:  Simon and Schuster.  Reissued as Psychoanalysis and Male Homosexuality (1995), Northvale, NJ:  Aronson.
34.   Friedman, R.C. (1988), Male Homosexuality:  A Contemporary Psychoanalytic Perspective.  New Haven, CT:  Yale University Press.
35.   Isay, R. (1989), Being Homosexual:  Gay Men and Their Development. New York:  Farrar, Straus and Giroux.
36.   O'Connor, N. & Ryan, J. (1993), Wild Desires and Mistaken Identities:  Lesbianism & Psychoanalysis.  New York:  Columbia University.
37.   Domenici, T. & Lesser, R., eds. (1995)  Disorienting Sexuality: Psychoanalytic Reappraisals of Sexual Identities.  New York: Routledge.
38.   Magee, M. & Miller, D. (1997), Lesbian Lives:  Psychoanalytic Narratives Old and New.  Hillsdale, NJ:  The Analytic Press.
39.   Drescher, J. (1998) Psychoanalytic Therapy and The Gay Man. Hillsdale, NJ:  The Analytic Press.
40.   Boswell, J. (1980), Christianity, Social Tolerance and Homosexuality.  Chicago, IL:  University of Chicago Press.
41.   McNeil, J. (1993), The Church and the Homosexual, Fourth Edition. Boston, MA:  Beacon.
42.   Pronk, P. (1993), Against Nature:  Types of Moral Argumentation Regarding Homosexuality. Grand Rapids, MI:  William B. Eerdmans.
43.   Boswell, J. (1994), Same-Sex Unions in Premodern Europe.  New York:  Villard Books.
44.   Helminiak, D. (1994), What the Bible Really Says About Homosexuality.  San Francisco, CA:  Alamo Press.
45.   Gomes, P. J. (1996). The Good Book:  Reading the Bible with Mind and Heart.  New York:  Avon.
46.   Carrol, W. (1997), On being gay and an American Baptist minister. The InSpiriter, Spring, pp. 6-7,11.











 



 

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