by Joseph Nicolosi, Ph.D.

The American Psychological Association (APA) has just released its “Task Force Report on Appropriate Therapeutic Responses to Sexual Orientation” (August 2009), a report issued by five psychologists and one psychiatrist who are all activists in gay causes.

Remarkably, the APA rejected, for membership on this committee, every practitioner of sexual-reorientation therapy who applied for inclusion.

The rejected applicants included–

• NARTH Past-President A. Dean Byrd, Ph.D., M.P.H., M.B.A., a distinguished professor at the University of Utah School of Medicine, longtime practitioner of reorientation therapy, and co-author of several peer-reviewed journal articles studying change of sexual orientation. Dr. Byrd is considered one of the foremost experts on same-sex attraction and reorientation therapy. He has published numerous articles on sexual reorientation, as well as gender and parenting issues.

• George Rekers, Ph.D., Professor of Neuropsychiatry and Behavioral Science at the University of South Carolina, editor of the Handbook of Child and Adolescent Sexual Problems, a National Institute of Mental Health grant recipient, author of the book Growing Up Straight, as well as numerous peer-reviewed articles on gender-identity issues.

• Stanton Jones, Ph.D., Provost and Dean of the Graduate School and Professor of Psychology at Wheaton College, Illinois, the co-author of Homosexuality: The Use Of Scientific Research In The Church’s Moral Debate..

• Joseph Nicolosi, Ph.D. (author of this article), a founder of NARTH, practitioner of Reparative Therapy® for 25 years, and author of Reparative Therapy of Male Homosexuality and the 2009 book, Shame and Attachment Loss.

• Mark A. Yarhouse, Ph.D., is Professor of Psychology, Doctoral Program in Clinical Psychology at Regent University in Virginia Beach, Virginia. Dr. Yarhouse is co-author of Homosexuality: The Use Of Scientific Research In The Church’s Moral Debate and has published many peer-reviewed articles on homosexuality.

All of these highly-qualified candidates were rejected by APA President Brehm. Instead, Dr. Brehm appointed the following individuals:

Chair: Judith M. Glassgold, Psy.D. She sits on the board of the Journal of Gay and Lesbian Psychotherapy and is past president of APA’s Gay and Lesbian Division 44.

Jack Drescher, M.D., well-known as a gay-activist psychiatrist, serves on the Journal of Gay and Lesbian Psychotherapy and is one of the most vocal opponents of Reparative Therapy®.

A. Lee Beckstead, Ph.D., is a counseling psychologist who counsels LBBT-oriented clients from traditional religious backgrounds. He is a staff associate at the University of Utah’s Counseling Center and although he believes reorientation therapy can sometimes be helpful, he has expressed strong skepticism, and has urged the Mormon Church to revise its policy on homosexuality and instead, affirm church members who believe homosexuality reflects their true identity.

Beverly Greene, Ph.D., ABPP, was the founding co-editor of the APA Division 44 (gay and lesbian division) series, Psychological Perspectives on Lesbian, Gay, and Bisexual Issues.

Robin Lin Miller, Ph.D., is a community psychologist and associate professor at Michigan State University. From 1990-1995, she worked for the Gay Men’s Health Crisis in New York City and has written for gay publications.

Roger L. Worthington, Ph.D., is the interim Chief Diversity Officer at the University of Missouri-Columbia. In 2001 he was awarded the “2001 Catalyst Award,” from the LGBT Resource Center, University of Missouri, Columbia, for “speaking up and out and often regarding LGBT issues.” He co-authored “Becoming an LGBT-Affirmative Career Advisor: Guidelines for Faculty, Staff, and Administrators” for the National Consortium of Directors of Lesbian Gay Bisexual and Transgender Resources in Higher Education.

Why a Gay Identity
Obstructs Objectivity

The fact that the Task Force was composed entirely of activists in gay causes, most of whom are also personally gay, goes a long way toward explaining their failure to be scientifically objective.

To be “gay-identified” means to have undergone a counter-cultural rite of passage. According to the coming-out literature, when a person accepts and integrates a gay identity, he must give up the hope of ever changing his feelings and fantasies. The process is as follows: the adolescent discovers his same-sex attraction; this causes him confusion, shame and guilt. He desperately hopes that he will somehow become straight so that he will fit in with his friends and family. However, he eventually comes to believe that he is gay, and in fact can never be otherwise. Therefore, he must accept his homosexuality in the face of social rejection, and find pride in his homoerotic desires as something good, desirable, natural, and (if he is a person of faith) a gift from his creator.

The majority of the Task Force members clearly underwent this same process of abandoning the hope that they could diminish their homosexuality and develop their heterosexual potential. Coming to the Task Force from this perspective, they would be strongly invested in discouraging others from having the opportunity to change — i.e., “If it did not work for me, then it cannot work for you.”

Conducting the Task Force Study

As the basis of their report, the Task Force members say they reviewed several hundred studies which, over the past century, have found subjects who changed their sexual orientation from homosexual to heterosexual.

The published and peer-reviewed studies they considered are all in some way flawed, the committee concluded, and therefore constitute “insufficient evidence” of the possibility of change. As a result, psychologists are advised to avoid telling their clients they can change their feelings. (The committee does grant, however, that some people can and do change their sexual identity–their sense of “who they are”–and go on to live heterosexually functional lives.)

How could the committee have reached a conclusion that would so sweepingly dismiss decades of research evidence? Some of it was conducted by well-known and highly prestigious professsionals, such as Irving Bieber, Charles Socarides, Houston MacIntosh, and Robert Spitzer–the same psychiatrist who oversaw the removal of homosexuality in 1973 from the diagnostic manual.

It was Dr. Spitzer who concluded in his recent report (published thirty years later by a prestigious journal — the Archives of Sexual Behavior, Vol. 32, No. 5, October 2003, pp. 403-417):

“Many patients, provided with informed consent about the possibility that they will be disappointed if the therapy does not succeed, can make a rational choice to work toward developing their heterosexual potential and minimizing their unwanted homosexual attractions.”

He adds, “[T]he ability to make such a choice should be considered fundamental to client autonomy and self-determination.”

Lack of Diversity Among Task Force Members

If the APA truly wished to study sexual orientation, they would have followed established scientific practice by choosing a balanced committee that included individuals with differing values and worldviews. Particularly, they would have selected clinicians who see the value of sexual-reorientation — not just such therapy’s philosophical opponents.

Instead, they “turned the henhouse over to the foxes” by selecting gay-activists members who are well-known for their disapproval of efforts on the part of other homosexual individuals to seek change. The committee prefaces their report by stating as “scientific fact” their view — which has not been scientifically demonstrated (and, which is as much a question of philosophy as of science) that homosexual attractions and behavior are no different from heterosexuality.

Why did the APA select only such individuals? Perhaps, in well-meaning ignorance, they thought only gay activists could be experts on homosexuality. Perhaps they were intimidated by the threat of “homophobia” if they invited reorientation therapists to participate.

The scientific bias of the Task Force is further evidenced by four facts:

• The Task Force failed to reveal the well-documented, far-higher level of pathology associated with a homosexual lifestyle. If they had truly been interested in science, they would have believed it their duty to warn the public about the psychological and medical health risks associated with homosexual and bisexual behavior. Their failure to advise the public about the risks not only betrays their lack of commitment to science, but prevents sexually confused young people from accurately assessing the choices available to them.

• Why do some people become homosexual? The reader of the Report might justifiably expect some discussion of the factors associated with the development of same-sex attractions. Instead, the Task Force failed to study the risk factors—instead, saying that it is a “scientific fact” that homosexuality is “as developmentally normal as heterosexuality.”

• The Task Force did not study individuals who reported treatment success. Even if (for the sake of argument) therapeutic change had been reported to be successful in only one case, then the committee should have asked, “What therapeutic methods brought about this change?” But since the Task Force considered change unnecessary and undesirable, they showed no interest in pursuing this avenue of investigation.

• The Task Force’s standard for successful treatment for unwanted homosexuality was far higher than that for any other psychological condition. What if they had studied treatment success for narcissism, borderline personality disorder, or alcohol/food/drug abuse? All of these conditions, like unwanted homosexuality, cannot be expected to resolve totally, and necessitate some degree of lifelong struggle. Many of these conditions are, in fact, notoriously resistant to treatment. Yet there is no debate about the usefulness of treatment for these conditions: psychologists continue to treat them, despite their uncertain outcomes.

Different Concepts of Wholeness

The Task Force moved on to address religious beliefs that conflict with the affirmation of homosexuality. They attempt to resolve this conflict through creating a false distinction.

Organismic Congruence. Their report says, “Affirmative and multicultural models of LGB psychology give priority to organismic congruence (i.e., living with a sense of wholeness in one’s experiential self)” (p. 18).

Telic Congruence. This applies to people of faith who do not wish to integrate their homosexuality; they are instead “living consistently within one’s valuative goals.”

This is a half-truth, and a deceptive distinction. It implies that persons striving to live a life consistent with their religious values must deny their true sexual selves. They will not experience organismic wholeness, self-awareness and mature development of their identity. These attributes are only possible, by their definition, for individuals who embrace, rather than reject, their same-sex attractions. Religious individuals seeking “valuative congruence” are assumed to experience instead a constriction of their true selves through a religiously imposed behavioral control.

This erroneous distinction (one that can only be made by persons who have never known the harmonious integration of religious teachings) misunderstands and offends persons belonging to traditional faiths.

Rather, the members of the Task Force need to understand that the person of traditional faith finds his biblically based values to be guides, signposts, and sources of inspiration that will guide him on his journey toward wholeness. He intuitively senses that they lead him toward a rightly-gendered wholeness which allows him to live his life in a manner congruent with his creator’s design.

This wholeness is satisfying, experiential, and deeply integrated into the person’s being. It is achieved not by suppression, repression or denial–but by understanding homosexuality within the greater context of a mature religious wisdom that is integrated into a scientifically accurate psychology.

•  The Task Force showed no interest in investigating the causes of homosexuality, stating erroneously that it is a “scientific fact” that homosexuality is as normal as heterosexuality. Nothing in the Task Force report substantiates their assertion that same-sex behaviors are “positive.” In fact, research shows indisputably that homosexuals and bisexuals have a significantly higher rate of mental-health problems than do heterosexuals.

•  They failed to acknowledge the life-threatening health risks associated with gay male sexual behavior, and the fact that a significant percentage of gay men prefer risking death to using a condom.

•  The Task Force demands an impossibly high standard of proof for reorientation therapy which it does not demand of any other therapy.  APA must address the fact that gay-affirmative therapies are, by the same standard they have set, “unproven.”

•  The Task Force stated that family factors, gender identity and trauma are not implicated in the development of homosexuality. They cited various studies as evidence for their claim. However, when only two of these studies were methodologically investigated by NARTH Board member Christopher Rosik, Ph.D., Rosik found that the McCord, McCord and Thurber study  (1962), for example, failed to meet at least 10 of the 16 standards of proof by which APA rejected the sexual-reorientation research  as “insufficient.”  Another study cited by the Task Force  (Kurdek, 2004) violated at least 8 of the 16 same standards of proof set by APA. Therefore, serious concerns must be raised about APA’s politically selective use of scientific standards.

•  The Task Force deems studies of successful sexual-orientation change to be of lesser scientific worth than other studies because they appear in less prestigious peer-reviewed publications. Top-tier journals, however, have a strong reluctance to accept such studies because their editors will pay a career price for doing so.

•  Gay-activist members opposed to reorientation therapy were the sole members of the Task Force.  Some of them, such as Jack Drescher, M.D. (the author of “The Joy of Gay Sex”) are well-known as highly vocal opponents of reorientation therapy. All members were on record as in opposition to reorientation therapy prior to their selection for the Task Force.

•  As homosexually oriented individuals themselves, the Task Force members would inevitably be invested in demonstrating that “If change did not work for me, then it cannot work for you.”

•  Every reorientation therapist who applied to join the task force was rejected by the APA for inclusion, including George Rekers, Ph.D.,  A. Dean Byrd, Ph.D., Joseph Nicolosi, Ph.D., Mark Yarhouse, Ph.D., and Stanton Jones, Ph.D.. all of whom are well-known and much-published professionals who have been active in studying sexual reorientation therapy throughout their careers.

•  Two very important recent studies (Spitzer 2003, see paragraph below) and Jones and Yarhouse 2007) which showed successful reorientation for at least some clients, were treated in a very cursory manner in APA’s report.

•  The Task Force ignored the advice of the psychiatrist who was instrumental in removing homosexuality from the diagnostic manual—Robert Spitzer, M.D.  Spitzer said, in his study published by the Archives of Sexual Behavior (vol. 32, no. 5, October 2003, pp. 403-417)   “Many patients, provided with informed consent about the possibility that they will be disappointed if the therapy does not succeed, can make a rational choice to work toward developing their heterosexual potential and minimizing their homosexual attractions….to make such a choice should be considered fundamental to client autonomy and self-determination.” 

•  The Task Force showed no interest in studying those individuals who reported treatment success and in investigating the reasons for success in their cases. Nor did they report on the spontaneous changes of sexual attraction that have occurred in homosexually oriented individuals without any therapy at all.

•  The Task Force failed to exhibit an appreciation for the long-established worldview that sees gender complementarity as representative of rightly ordered human wholeness.  The APA must recognize this worldview, too, as a legitimate expression of socio-political diversity.

References:

Jones, S. L., & Yarhouse, M. A. (2007).  Ex-gays?: A longitudinal study or religiously mediated change in sexual orientation.  Downers Grove, IL: InterVarsity Press Academic.

McCord, J., McCord, W., & Thurber, E. (1062). Some effects of paternal absence on male children.  Journal of Abnormal and Social Psychology, 64, 361-369.

Kurdek, L. A. (November, 2004). Are gay and lesbian cohabiting couples really different from heterosexual married couples? Journal of Marriage and Family, 66, 880-900.

by Joseph Nicolosi, Ph.D.

On January 13th, 2015, I was a guest on the “Dr. Phil Show” when a segment was aired on children who want to be the opposite sex.

Also appearing on the show was the mother of a transgendered boy who is living life as a girl, and several psychotherapists who believe that transgenderism is normal, natural and healthy for some people.

I took the position that children should not, however, be encouraged to think of themselves–and live as–as the opposite sex. All of the other psychotherapists disagreed with me.

“Imitative Attachment” in the Gender-Disturbed Boy

“Gender-identity disorder is primarily an attachment problem.” These words, spoken by me during the TV interview, were edited out, but they are critical to the understanding of gender-disturbed children. No one on the show discussed this issue.

GID children do not necessarily suffer from a lack of parental love. But to begin to understand the GID child, we must understand that in early infancy, the child’s sense of self is very fragile, and is formed in relationship to the mother. The mother is the source and symbol of the child’s very existence. It is a simple, biological reality that infants cannot survive without a nurturing caregiver.

Experts in the area of childhood gender-identity disorder (GID) have found certain patterns in the backgrounds of GID children. A common scenario is an over-involved mother with an intense, yet insecure attachment between mother and child. Mothers of GID children usually report high levels of stress during the child’s earliest years.

We often see severe maternal clinical depression during the critical attachment period (birth to age 3) when the child is individuating as a separate person, and when his gender identity is being formed. The mother’s behavior was often highly volatile during this time, which could have been due to a life crisis (such as a marital disruption), or from a deeper psychological problem in the mother herself -i.e., borderline personality disorder, narcissism, or a hysterical personality type.

When the mother is alternately deeply involved in the boy’s life, and then unexpectedly disengaged, the infant child experiences an attachment loss–what we call “abandonment-annihilation trauma.” Some children’s response is an “imitative identification”– the unconscious idea that “If I become Mommy (i.e., become female), then I take Mommy into me and I will never lose her.”

This is the same dynamic that we see in the fetish, where the boy is “taking in a piece of Mommy” (her shoes, her scarf) and developing an intense (and later sexualized) attachment to an object associated with her.

The infantile dynamic of “imitative attachment” is such that “keeping Mommy inside” becomes truly a life-or-death issue – “Either I become Mommy, or I cease to exist.” This explains why gender-disturbed boys are willing to tolerate social rejection for their opposite-sex role-playing–it feels like death to abandon this perception of themselves as a female.

The phenomenon of “imitative attachment” explains why gender-disturbed boys do not display femininity in a natural, biologically based way, as do girls; but rather, demonstrate a one-dimensional caricature of femininity–exaggerated interest in girls’ clothes, makeup, purse-collecting, etc. and a mimicry of a feminine manner of speaking.

As one mother explained to me, “My GID boy is more ‘feminine’ than his sisters.”

“Born that Way?”

Although I believe gender disturbances always involve some kind of attachment problem, there may also be biological influences that lead some children in that direction.

One psychiatrist on the show discussed a recent, credible biological theory. For at least some boys who want to be girls, there may have been an unusual biological developmental problem, during the time when the then-unborn child was being formed in the uterus. This resulted in the incomplete masculinization of the boy’s brains. These boys’ brains are more feminine than other boys’; in extreme cases, they may grow up feeling like girls trapped in a male body.

This biological theory has some credible support–in fact, it may well explain some cases of gender disturbance. But science has, as yet, no biological test that can confirm that this brain event has actually occurred. Furthermore, we know that human emotional attachment changes the structure of the infant’s brain after birth. So if we encourage the gender-disturbed boy to act like a girl, we will never know to what extent he could have become more comfortable with his biological sex if his parents were committed to actively reinforcing his normal, biologically appropriate gender identity and working to address the psychological problem of imitative attachment with the mother.

In our clinical work with GID boys, we see genuine, positive changes occur. We never shame the child for acting like a girl; we reinforce him for biologically appropriate behaviors and encourage him to grow more comfortable as a boy, thus helping him to sense that being a boy (and internalizing a masculine identity) is safe, and that being a boy is good.

No one on the Dr. Phil Show mentioned the implications of taking the opposite approach–actively preparing a boy for future sex-change surgery. Surgery can never truly change a person’s sex. Doctors can remove the male genitals and form an imitation of the sex female sex organs, but they cannot make the simulated organs reproductively functional. The DNA in a boy’s body cells cannot be changed with surgery. Thus, after sex reassignment surgery, there will still be a typically male genotype present.

We believe that every effort should be made to help a gender-disturbed boy accept his biological maleness, and be comfortable in life with the intact (not surgically mutilated) body with which he was born.