2Homosexuality Myths and Truths Do you think that some people are born homosexual and cannot change?Is homosexuality - like race, sex and ethnicity- an innate and immutable characteristic, and any attempt to change it is futile?
3Homosexuality Myths and Truths Can people escape from the bondage of homosexuality?Is it preventable and treatable?
4Homosexuality Myths and Truths Topics & SegmentsThe Roots & Causes of HomosexualityCaring for the Homosexual - a Clinical and Pastoral ApproachQuestions and Answers Session
5Homosexuality Myths and Truths The Roots & Causes of HomosexualityGender Identity Disorder& Video Case Studies
6Root Causes of Homosexuality The Hidden Secret of Psychiatry & Psychology in understanding the formation of Homosexuality…It is about Gender Identity Disorder
10DSM-IV Sexual and Gender Identity Disorders, Quote (page 536) By late adolescence or adulthood,about three-quarters of boys who had a childhood history of Gender Identity Disorder report a homosexual or bisexual orientation,
11Gender Identity Formation Stages Stage 1 (Birth to Four years old)Parental Same-Gender AttachmentStage 2 (Kindergarten to Stage 1 School)Social Same-Gender AttachmentStage 3 (Elementary to Middle School)Social Opposite-Gender AttachmentStage 4 (Middle to High School)Stage 5 (High School to College)Stage 6 (Beyond First Stage College & Marriage)
12Family Tree DiagramMotherFatherSon-1Son-2Daughter
13Son separates from mom for psychological individuation successfully Healthy RelationshipMotherFatherSon-1Son-2DaughterSon separates from mom for psychological individuation successfully
14Son attaches with dad for Gender-Identity formation sucessfully Healthy RelationshipMotherFatherSon-1Son-2DaughterSon attaches with dad for Gender-Identity formation sucessfully
15Son separates from mom for psychological individuation successfully Healthy RelationshipMotherFatherSon-1Son-2DaughterSon separates from mom for psychological individuation successfully
16Son attempts to attach to father for Gender-Identity formation Healthy RelationshipMotherFatherSon-1Son-2DaughterSon attempts to attach to father for Gender-Identity formation
17Unhealthy Relationship Begins MotherFatherSon-1Son-2DaughterSon’s attempts to attach to father was rebuffed and he experiences rejection and hurt
18Unhealthy Relationship Defensive Detachment Begins MotherFatherSon-1Son-2DaughterSon’s attempts to defend against more pain from rejection by defensively detaching from father’s relationship emotionally
19Unhealthy Relationship Defensive Attachment Begins MotherFatherSon-1Son-2DaughterSon has no choice but to re-attach with mom for emotional security
20Unhealthy Relationship Defensive Attachment Continues MotherFatherSon-1Son-2DaughterSon has no choice but to re-attach with mom for emotional security Forming Defensive Attachment
21Unhealthy Relationship Defensive Attachment Intensifies MotherFatherSon-1Son-2DaughterSon generalizes defensive detachment to defensively attach to girls and women: Non- aggressive & softer
22Unhealthy Relationship Defensive Attachment Intensifies MotherFatherSon-1Son-2DaughterGeneralization intensifies. Father becomes a stangerGirl 1Girl 2
23Unhealthy Relationship Defensive Attachment Intensifies MotherFatherSon-1Son-2DaughterGeneralization intensifies. Men are unfamiliarGirl 1Girl 2Girlfriend
24Unhealthy Relationship Defensive Attachment Solidifies GrandmaMotherFatherSon-1Son-2DaughterMen are objectified-curious-sexualizedGirl 1Girl 2Girlfriend
31DSM-IV “Homosexuality is not a disease” 1973 APA Committee ActionPolitical actionNot a Clinical DecisionMany Psychiatrists and Psychologists are in disagreementNARTH.com: National Association of Research and Therapy for Homosexuality
37"It occurred to me that maybe the general consensus, Dr. Robert Spitzer’s Research APA: New Orleans, May 9, 2001 New York TimesDr. Spitzer said."It occurred to me that maybe the general consensus,which was that the behavior can be resisted but sexual orientation couldn't be changed, was wrong,"
38200 Subjects Who Claim to Have Changed Their Sexual Orientation from Homosexual to Heterosexual Robert L. Spitzer, M.D.Chief, Biometrics Research andProfessor of Psychiatry, Columbia University1051 Riverside Drive, Unit 60, NYS Psychiatric InstituteNew York, NY 10032(Presented at the APA: American Psychiatric Association Meeting: May 9, 2001, New Orleans, U.S.A.)This is a more accurate title for my talk.
39Excluded 74: 200 Study Subjects 143 Men, 57 Women 274 Subjects interviewedExcluded 74:No change in attraction,Change less than 5 years,Not predominantly homosexual before change effortIn order to obtain 200 study subjects, which turned out to be 143 men and 57 women, we interviewed 274 potential subjects that we found, with great difficulty over a period of 16 months.74 subjects were excluded, most commonly because there was a change in behavior and self-identity, but no change in sexual attraction, or the individual was not predominantly homosexual, or the change was less than 5 years duration.200 Study Subjects143 Men, 57 Women
40Dr. Robert Spitzer’s Research Findings APA: New Orleans, May 9, 2001 New York Times Referral SourceEx-Gay Ministries*43%NARTH23%Former therapist9%Other25%Our 200 subjects were primarily recruited from ExGay religious ministries that offer a variety of programs to help homosexuals who want to overcome their homosexual feelings.And from NARTH, the National Association for Research and Therapy of Homosexuality, a group of mental health clinicians and lay people who by and large regard homosexuality as a treatable developmental disorder.The “Other” was largely other subjects, therapists who do sexual reorientation Rx , as well as responses to notices of the study on the radio and in newspaper advertisements.The referral source, by various means, got in contact with potential subjects who then called my office to arrange for an interview.* Exodus International, religious ministries programs
41“Most Helpful or Only Type of Help” Dr. Robert Spitzer’s Research Findings APA: New Orleans, May 9, 2001 New York Times“Most Helpful or Only Type of Help”Mental health professional47%Ex-Gay/ religious support group34%Other (mentoring, books, spiritual work)19%About 90% of subjects reported using more than one kind of change effort. The slide presents the answer to the question, “Which was most helpful?”The mental health professional was most commonly a psychologist (23%),or pastoral counselor (12%). Rarely a psychiatrist (3%).“Other” included repeated meeting with a heterosexual role model, often referred to as “mentoring,” self help books or what some subjects called “spiritual work” – meaning changing one’s relationship with God.
42Dr. Robert Spitzer’s Research Findings APA: New Orleans, May 9, 2001 New York Times Sample DescriptionAge (mean)43Currently marriedM=76%F=47%Married before change20%Caucasian95%Completed college76%When results for males and females are very similar, the result for the total sample of 143 men and 57 women is shown.About three quarters of the men and half of the women were currently heterosexually married.About a fifth of the subjects were married before the change effort and often reported that homosexual behavior or attraction threatened their marriage.Most were Caucasian and had completed college.
43Dr. Robert Spitzer’s Research Findings APA: New Orleans, May 9, 2001 New York Times ReligionProtestant81%Catholic8%Mormon7%Jewish3%Religion “extremely” or “very important”93%Had publicly spoken in favor of efforts to change78%Most subjects were Protestant.The vast majority said religion is “extremely” or “very” important in their lives. Many nonreligious therapists that we sought referrals from were reluctant to get in touch with former patients. This may, in part, account for the unusually high proportion of our sample that was very religious.The great majority of subjects had publicly spoken in favor of efforts to change homosexual orientation. Indeed, the primary motivation for participating in the study for almost all subjects was their interest in providing evidence, from their own experience, that homosexuality can be changed and to offer hope to others.
44“Reasons for Wanting to Change” Dr. Robert Spitzer’s Research Findings APA: New Orleans, May 9, 2001 New York Times“Reasons for Wanting to Change”Gay life-style not emotionally satisfying81%Religious conflict79%Desire to get or stay marriedMale67%Female35%Why did the subjects want to change? These were the most commonly reported answers.Gay life-style not emotionally satisfying…Usually this referred to widespread promiscuity, stormy, painful relationships, often with extreme jealousy.Religious conflict…Desire to get or be able to stay married, particularly for the men.
45Dr. Robert Spitzer’s Research Findings APA: New Orleans, May 9, 2001 New York Times “Time Line”AgeOnset of same sex arousal12Begin change effort30Begin to feel different sexually32End of change effort (for 78% of Subjects)35Here is the average time line – almost identical for men and women. There was, of course, great individual variability. The onset of sexual arousal to same sex was about 12 years. About 18 years later is the beginning of the change effort that they found helpful (often preceded by one or more change efforts that were not helpful..including, often, therapists who told them they had no choice but to accept their homosexuality). After two years into the change effort, they begin to feel different sexually. The vast majority of subjects reported this change as being gradual, and often starting with diminution of homosexual feelings and gradual emerging or intensification of heterosexual feelings. Three years later, after about five years of the change effort, it ends for 78% of the subjects. The remaining 12% report that the change effort continues up to the present time, usually referring to continuing to attend an ExGay support group or having a life-long struggle with the underlying issues that they believe caused their homosexuality.
46“Markedly” or “Extremely” Bothered by Depression Dr. Robert Spitzer’s Research Findings APA: New Orleans, May 9, 2001 New York Times“Markedly” or “Extremely” Bothered by Depression47%43%Depression has been reported to be a common side effect of attempts to change sexual orientation. This certainly was not the case for our subjects, who were often “markedly” or “extremely” depressed BEFORE, and rarely so depressed AFTER.1% 4%
47Sexual Attraction Scale “Mean” (100 = same sex, 0 = opposite sex) Dr. Robert Spitzer’s Research Findings APA: New Orleans, May 9, 2001 New York TimesSexual Attraction Scale “Mean” (100 = same sex, 0 = opposite sex)The next group of slides, on various indicators, contrasts BEFORE, with AFTER.First, mean sexual attraction scores for males and females. Remember, 100 is exclusively same sex, and 0 is exclusively opposite sex, BEFORE and AFTER.Both males and females, on average, BEFORE, are in the very high homosexual range. AFTER, on average, they are in the high heterosexual range, even more so for the females.Here, as in most of the remaining slides, note that the females often BEFORE are similar or less extreme on homosexual indicators, and AFTER are always more heterosexual than the males.
48Change effort was “Very Helpful” in… Dr. Robert Spitzer’s Research Findings APA: New Orleans, May 9, 2001 New York TimesChange effort was “Very Helpful” in……feeling more [masculine, feminine]87%…developing nonsexual relations with same sex93%During the pilot study we noted the common ways that subjects reported they had been helped by the change effort.This shows how often subjects reported these ways of being helped when asked close ended questions during the study.…feeling more [masculine, feminine]…developing nonsexual relations with same sex
49Dr. Robert Spitzer’s Research APA: New Orleans, May 9, 2001 New York Times Still, he added that the number of homosexuals who could successfully become heterosexual was likely to be "pretty low." And he conceded that the subjects in the study were "unusually religious" and were not necessarily representative of most gays and lesbians in the United States.
50Dr. Robert Spitzer’s Research APA: New Orleans, May 9, 2001 New York Times For Dr. Spitzer's May 9, 2001 APA presentation "200 subjects who claimed to have changed their sexual orientation from homosexual to heterosexual“Full Research Presentation in its original formFull Research Presentation in Chinese二百個自稱已將他們的性取向從同性戀者改變成為異性戀者
51Caring for Homosexuals Basic PrinciplesDouble-Edged Sword: They need to be accepted in the process to get wellIndividual acceptance and group acceptanceWalking this thin line: Excuse v. limitsNon-sexual same-sex friendships: IntimacySecure with opposite-sex peers & friends
52The Ethics of Treatment Treatment for “Unwanted homosexuality”Cannot be forced or coercedMust be strongly motivated to changeIt takes a long time and is hard workRecovery model: Addiction model: CyclicalRecovery is not linear: Expect RelapseMinors needs parental consentParents can suggest child to change: Can’t force
53Factors affecting prognosis Treatment IssuesFactors affecting prognosisTherapist/Client matchTransference/Counter-transference issuesPsychodynamic: “Object Relations” worksBuild Nonsexual male relationshipsGroup therapyThe role of father and religious support groups
57What is Healing & Recovery? Presence or Absence of SSA “Orientation”?Realistic Expectations: Some Traces of SSAMemories Can’t be Completely Obliterated, But Emotions Can Reduce SignificantlyDegree or Intensity of SSA’s?Overwhelming vs. “In Passing” “Non-Dwelling”The Recovered vs. The StrugglersAddiction Cycles: Presence or Absence?Intrusive ThoughtsPreoccupation & ObsessionsSecret vs. HonestyLitmus Tests: Stressful Times, Unstructured Times
58Religious Support Groups Exodus International (North-America)ExodusNorthAmerica.orgChristianMentalHealth.comNational Association for Research & Therapy for Homosexualitynarth.comRegeneration Books (Exodus Member)Courage (Catholic)Parents and Friends of Ex-Gays Pfox.orgEvergreen International (Mormons)Evergreen-intl.org