In a recent post to On Line Opinion, David van Gend sang the praises of a paper by Spitzer entitled “Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation” published in the Archives of Sexual Behavior in October 2003. However, a cursory read of the article plus the 50 pages of published peer commentary demonstrates quite clearly that the findings are flawed on all relevant scientific, methodological and ethical grounds.
First, Spitzer recruited interviewees from groups with a vested interest in removing all semblance of homosexuality from the planet, including 86 people from ex-gay religious ministries and 46 from the National Association for Research and Therapy of Homosexuality. The remaining 50 participants were referred from therapists who specialise in what is called “reparative therapy”, a brain-washing of gay and lesbian people in order to impart a heterosexual lifestyle upon them.
So by all standards of scientific rigor this study used a very biased sample of participants who indeed had been coerced in one way or another by therapeutic or political means to change their sexual orientation. A typical participant was in their early forties, Caucasian, well-educated, married and all except a handful were protestant Christians. In fact 192 of the 200 participants reported that “religion was ‘extremely’ or ‘very’ important for their lives”, with 164 having “publicly spoken in favour of efforts to change homosexual orientation, often at their church! All participants had “sustained some change in homosexual orientation for at least 5 years”. That such a change in sexual orientation is no “short ride on the Titanic” is evidenced by 42 participants trying to change to heterosexual over an average period of 15 years and the remaining 158 participants having consumed almost five years on average trying to obtain heterosexual relief. I challenge any reader of this piece to remember precisely their sexual feelings 15 years ago, as was required of Spitzer’s interviewees. Surely such recall is affected by the passage of time and the need to reconcile old feelings with new ones.
Once Spitzer recruited his 200 carefully selected participants he proceeded to interview them himself, seeking answers to questions focusing on sexual attraction to same sex or opposite sex, feelings of yearning for romantic intimacy, lust, daydreaming of sex with a same-sexed person, feelings of being bothered about a homosexual orientation, as well as questions about the participant’s sexual relations with their opposite sex partner. For each of these questions, the interviewee was required to recall their sexual orientation prior to "reparative therapy” and during the last year. Since an authority figure such as Spitzer was the sole interviewer in such an important project, its objectivity is still questionable even with a research assistant re-transcribing the recorded interview answers for comparison.
Almost all the analyses reported in the paper involve comparisons of percentages of responses for men and women, these analyses being of course irrelevant to the research hypotheses under investigation. So the only evidence of change in sexual orientation is that presented via graphs and tables. Indeed it is possible that only 22 men and 74 of the women reported a complete change in sexual orientation from homosexual to heterosexual, the remainder still engaging in fantasy and masturbatory imagery regarding their former homosexual proclivities.
No participant was offered an opportunity to provide informed consent prior to partaking in the interview, as is required by international medical research ethics guidelines. This would mean that no participant would have been advised that they could withdraw from the interview at any time, once again in violation of ethics guidelines and principles of good scientific practice. This is substandard social research that would not be tolerated in any Australian institution of higher education. It is worth emphasising that the majority of peer-commentaries following Spitzer’s paper in the same issue of the Archives of Sexual Behavior determined that this is flawed research. However that is not to suggest that there might be some fluidity in people’s sexual orientation, especially if they are bisexual.
Only two generations or so ago, homosexual people were considered ill just because of their departure from the heterosexual norm. This situation led to considerable distress for such clients and perhaps for some of the treating professionals. Smith, Bartlett and King (2004) surveyed the experiences of 31 people who had been treated for homosexuality in Britain since the 1950s. Most of the participants received treatment during late adolescence and in their early 20s, the most common intervention being behavioural aversive therapy using electric shocks. Many thought that the simplicity of the treatment was inconsistent with the complexity of their sexual issues. Understandably, none of the participants indicated that the treatment had been successful. For some it caused even more emotional strife than they had experienced previously.
In a complementary study, King, Smith and Bartlett (2004) surveyed the experience of professionals in Britain who had treated homosexual clients during the 1950s by interviewing 12 psychiatrists, 16 clinical psychologists, a nurse specialist and a technician. The efficacy, and most disturbingly, the ethics of the behavioural treatments, including aversion therapy and covert sensitisation, were rarely questioned by the practitioners. Almost all treatment of gay men included both psychoanalysis and hypnotherapy, without any ethical or protocol guidelines. In hindsight, many of these professionals admitted to a lack of training and knowledge of sexual behaviour within its social context. King, Smith and Bartlett concluded that “assumptions about public morality and professional authority can lead to the medicalisation of human differences and the infringement of human rights.”
So Spitzer’s paper provides a turning of the clock back to a darker era where fanatical members of a minority group would want to impose their fears onto other people with neither an ethical nor scientific basis for their recommendations. In returning to van Gend’s nautical imagery, anyone with but an elementary knowledge of scientific research principles would have never boarded the doomed Titanic in the first place (clever people that they are!). However, those fools on board would have merrily partied throughout the night in the smug contentedness that all the incurable homosexuals were well out of the way. Just as the party on board was reaching the height of its heterosexual frenzy, it came to an icy conclusion with those on board realising that fact, ethics and just plain commonsense were left back home as well.
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