The APA's tast force statement on orientation change efforts

I read a few posts on Warren Throckmorton's blog recently, and I really enjoyed them. The commenters there seem very reasonable, and civil by conventional internet standards. I ended up reading bits of the Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation based on Dr. Throckmorton's suggestion (although he calls himself Warren, so I'm probably going to call him by his first name).

My take?

The overall position is conservative in the sense that it avoids any definitive statement of efficacy or harm, admitting the paucity of evidence. What disturbs is the pervasive bias in the way the data is discussed, regardless of the final, almost reluctant, conclusions. This bias bleeds out as imprecision and equivocation most frequently, but occasionally as blatant inconsistency in the standards to which the evidence is being measured (or even examined at all).

I don't have the time to trot out a lot of examples (or even read every word of the document), but here are a few passages with comments.

We see this multiculturally competent and affirmative approach as grounded in an acceptance of the following scientific facts:

• Same-sex sexual attractions, behavior, and orientations per se are normal and positive variants of human sexuality—in other words, they do not indicate either mental or developmental disorders.

What the task force here calls "scientific fact" is actually consensus opinion, and there's a big difference. Many studies have defeated the long-prevailing belief that homosexuality is or is associated with mental illness. That much I can swallow (but only on a provisional basis). But, as I've mentioned on this blog before, it's odd to me that a discussion of "human sexuality" can so thoroughly and emphatically ignore reproduction as a significant part of the equation. If one assumes, as the task force apparently does, that ejaculating and having viable sperm is all that is necessary to give the thumbs up on normal reproductive capability, then perhaps their consensus statement (which is not a fact) is defensible. However, I beg to differ.

Gay men, lesbians, and bisexual individuals form stable, committed relationships and families that are equivalent to heterosexual relationships and families in essential respects.

This is presented as another "scientific fact". What I think they meant to say was that these folks form said relationships at rates that are not statistically significantly different from heterosexual families in the essential respects that have been examined. This is not even close to the same thing. Maybe the studies satisfy non-inferiority criteria (that are subjectively assigned). Maybe there is statistical significance for the subjective answers to survey questions, but many "essential respects" are not so easily measured, and failing to show a difference is not the same as showing equivalence. They don't bother footnoting this statement, so there's probably some great quality data... but moving from great quality data to proclamations of unequivocal "fact" is a move I highly doubt I would support after reviewing the relevant literature.

...few studies on SOCE produced over the past 50 years of research rise to current scientific standards for demonstrating the efficacy of psychological interventions...

Few studies of anything produced more than a few years ago rise to current scientific standards. They still can inform, even if they can't prove. Because these studies weren't conducted as randomized controlled clinical trials, they can't show us what we'd like to know, but I don't think the task force is correct with: "there is little in the way of credible evidence that could clarify whether SOCE does or does not work in changing same-sex sexual attractions." The evidence that is presented is what it is. Just because it's not the kind of rigorous science that would demonstrate causality doesn't mean that it's not "credible"! If the researchers were found to have manipulated data there would be a credibility problem, but as the data is, it just gives us very limited evidence, albeit legitimate.

Interestingly, a footnote briefly mentions a Nicolosi study that was not included in the task force's consideration because it was published after the review period and "appeared" to be a reworking of an earlier study. I haven't read Nicolosi's 2008 study, but if it provided any new information that met "current standards" in a way that nothing else does, perhaps they could have gone ahead and extended the review period since the limited data is the whole point. And if it was a reworking of an earlier study, that's even more reason to suspect that it was specifically reworked to assuage criticisms of methodology or presentation. In other words, the task force laments having no "credible" data but can't be bothered to look at the most recent data, even when it was published a year in advance of this report.

White men continue to dominate recent study samples. Thus, the research findings from early and recent studies may have limited applicability to non-Whites, youth, or women.

This is certainly true. So is this: old people continue to dominate the cancer literature, so research findings may have limited applicability to young people. The trick is most people with cancer are old. Just like most people who seek out SOCE are white males. So it's okay to go ahead and accept that there's value in the data even if it's not completely generalizable. The population that has been studied happens to be the vast majority of those for whom this research will make any difference.

In general, the results from studies indicate that while some people who undergo SOCE do engage in other-sex sexual behavior afterward, the balance of the evidence suggests that SOCE is unlikely to increase other-sex sexual behavior.

Again, this is true. So is this: chemotherapy for breast cancer patients will not give any benefit to a majority of patients but will give toxicity to all of them. The trick is, I don't care what happens to the "majority," I want to know quantitatively whether there was a difference in the rate of other-sex behavior from the therapy (if not causally demonstrated, at least temporally). And it sounds like there was a quantitative difference, even a significant one. But I wouldn't know from this report as they just go ahead and stick with vague dismissals like the quote above.

Two participants reported experiencing severe depression, and 4 others experienced milder depression during treatment. No other experimental studies reported on iatrogenic effects.

Woah. Suddenly the fact that participants are experiencing things in association with treatment can be automatically causally linked. Well, hey, we moved on to harms, so the rules of scientific rigor have all changed. These cases of depression are "iatrogenic". Umm... how do you know? Although the task force does go on to admit that there is no causal attribution for harms or benefits, they go ahead and refer to "some evidence" of harm repeatedly through the report while adamantly holding that there is "no credible evidence" of benefit.

We recommend that APA take a leadership role in opposing the distortion and selective use of scientific data about homosexuality by individuals and organizations and in supporting the dissemination of accurate scientific and professional information about sexual orientation in order to counteract bias.

Ah. Here's something I totally agree with. I just wish they'd followed their own advice. I couldn't find it just now rescanning through, but there's a great gem in there where the task force refers to itself as an example of authoritative and reliable source of scientific information. Ha. Or... maybe individuals can actually go ahead and critically examine things for themselves since science isn't a religion and appeals to authority are both unnecessary and fallacious. A scientist ought to know that.

Opening a dialog

Since I'm excited to have some measure of Dr. Schow's attention, and to shift focus away from the size of my penis, I would like to open a dialog about the Dialogue articles written by none other than our own Master Fob and Dr. Schow. But, mainly Schow's. We'll always have Fob to talk about.

Dr. Schow's article highlights some of the limited information we have about "mixed orientation marriages" (MOMs), and offers some guidelines to help predict which marriages are likely not to end in divorce. Overall I really enjoyed the article and found a lot to agree with. But there were little nuanced things that bothered me, so I'm bringing them up here for discussion.

Why do so many marital relationships of this kind fail? Primarily because the homosexual attraction of one spouse creates a major difficulty, despite hopes that such attraction will diminish over time. In reality, the great majority of those who are homosexually oriented cannot fundamentally alter their feelings by desire, therapy, or religious practice.
...
The reality is that homosexuality is not a choice and, except in rare cases, is not subject to change.

It's no news that the idea that change is impossible is disputed by NARTH. I'm still considering the idea of reading Schow's and Byrd's books as a set to compare the disparate data they present. Regardless, I agree with the statement here except that I would modify it to say, "...In reality, the great majority of those who are homosexually oriented have not been able to fundamentally...". Per the APA's consensus statement there have been no scientifically rigorous data to prove or disprove the possibility of even Reparative Therapy as a viable therapeutic option, let alone other therapies that could be conceived and have never been tried at all. To say "can't" is what nearly everyone does, and is to overstate our collective knowledge on the matter. Resist, people, and keep a good balance between skepticism and an open mind.

Thus, marriage seems risky for homosexuals and even bisexuals since we presume that some will end their marriages without trying therapy and that those receiving skilled professional assistance still achieve only this level of success.

I'm in total agreement that marriage is risky (for heteros too), but perhaps there ought to be inquiry into the manner and quality of "skilled professional assistance" those in the different outcome groups received. I've widely publicized my initial biases on this matter throughout this blog. The fact that people so pig-headedly refuse to find a workable therapist (and it may involve trying more than one) irks me. Well, I said it. Now you all know what I'm thinking. :-)

One of the reasons so many homosexuals enter into such high-risk marriages is that they are encouraged to do so by many LDS counselors, therapists, and ecclesiastical leaders who are ill informed about the nature of homosexuality and the dangers of homosexual-heterosexual bonding.

The idea that leaders are ill informed on this topic is one I agree with. But I'm curious about the "dangers of homosexual-heterosexual bonding"... or is this in reference to the dangers of not bonding?

The vast majority of homosexual-heterosexual marriages fail. However, as Ben attests, some, with strong determination, choose to try and beat the odds. Such hopes of success are, in part, based on claims that some homosexuals have achieved successful marriages characterized by adequate sexual compatibility. Such claims, however, must be examined in the light of (1) the complexity of homosexual feeling as it manifests itself in individuals (the HH Scale); (2) the relative importance that individuals attach to sexual intimacy as an element in the marital relationship (strength of libido and capacity for sublimation of sexual desire); and (3) other important factors such as whether individuals have personal compatibility and maturity adequate to withstand challenges to the marriage which are far greater than average.

Here's where I'm lost. First of all, as Dr. Schow mentioned in a previous comment, we don't know how many MOMs fail, because the sampling is always biased. It's a privacy issue, a fear issue, a homophobia issue... whatever kind of issue it is, to say the vast majority fail is unfounded. To say the vast majority fail for those couples willing to come forward may be okay. To say the vast majority have failed for those who have written books, opined on blogs, or otherwise inserted themselves into dialog on the topic also might fly. But I'm not aware that anyone has managed to measure how many MOMs are out there plugging away unassailably. Do I think it likely that there are droves? No. But let's be precise so as to give people the best information possible with which to make life-altering decisions.

Also, in regard to this passage, I have some questions for Dr. Schow. Are these three characteristics "common sense" or have they actually been measured as contributing to the success or failure of MOMs? They sound plausible enough, but that alone is not enough to suggest they be used as a yardstick for making this decision. And here's why: you also say, "Much pain—directly and indirectly—results when these marriages fail," but you don't even mention the joy that those who were able to make it work may have achieved. Had I (a highly libidinous, Kinsey 6, man of average maturity) not married, I wouldn't be in the enviable position I am right now of being the happiest I have ever been in my life. I don't offer this to suggest that others can or will achieve the same thing by following the same path, but as an example of the perils of presenting only one side of the data (or patchy data or no data at all).

Using language like, "the odds are against him" bothers me a little bit too. Speaking of "odds" in scientific literature ought to be in reference to odds ratios or statistical measurements where the word has legitimate meaning. To use it as it is used here gives the impression that whether a marriage succeeds or fails is a matter of luck--where you land in that distribution curve is just a matter of odds. I couldn't disagree more.

Overall, the article shares some great information and an important caution about the dangers of hastily entering a MOM without a clear understanding of the risks. Many thanks to Dr. Schow for his tireless efforts to research these issues and help engender compassion and understanding within the church and society. Unfortunately, the repeated statements that adapting to heterosexual intimacy is impossible (sometimes with caveats, sometimes caveats omitted) and statements expressing opinions as facts (who "probably" should or should not marry) leave me disappointed that people will be misinformed on these points.

Concession

August 21, 2006 - At the APA Conference in New Orleans — where APA President Koocher commented about the ethicality of sexual reorientation therapy — Clinton Anderson, director of the APA Office of Lesbian, Gay and Bisexual Concerns, offered further commentary.*

Mr. Anderson said he does not dispute that some people leave homosexuality. "I don't think that anyone disagrees with the idea that people can change, because we know that straight people become gay and lesbian — so it seems totally reasonable that some gay and lesbian people would become straight. The issue is not whether sexual orientation changes...the issue is whether therapy changes sexual orientation."

NARTH

That shifting moment when everyone suddenly agreed that change is possible somehow escaped me. Was someone else there? Can you describe it for me? Regardless, I hope the legions of folks who constantly reference the APA as a scientifically credible organization which has debunked reparative therapy will now fall in line with this statement that nobody "disagrees with the idea that people can change" sexual orientation! Hee.

Repairing things

My therapist told me once that the therapy we had undertaken was not appropriately called "conversion" therapy. That, he explained, suggests conversion from one sexual orientation to another and obscures the actual internal processes taking place. The term he prefers is "reparative" therapy, not because your sexuality is broken and needs to be repaired, but because your development is incomplete and in need of repair. The repair takes place in inter-personal relationships that may seem to have no bearing on sexuality whatsoever. Relationships with parents, with others of the same gender, with friends who love and support you....

The oft publicized problem with reparative therapy is 1) that it hasn't been rigorously proven or disproven (and yes, I know there are those who disagree and I can forward you to the current body of evidence to decide for yourself if you want), and 2) the success rate is quite low even in the best case scenarios.

Any particular therapy should have a good therapeutic ratio to be useful to anyone--the chance of benefit must be high enough to justify the risks of harm. The risks of reparative therapy get a lot of press, but they are just as unverified as the supposed successes.

So, despite that I have a number of friends who have undergone reparative therapy and are still as gay as a pink tie, I wonder to myself whether there is still some benefit. What if the social relationships "repaired" during the therapy really needed to be repaired apart from any sexual consequences?

That's pretty much where I am these days. Still undergoing reparative therapy (although not intensively right now) because I see lots of ancillary benefits that have nothing to do with my sexual orientation. I've really looked at the way I view myself. I've looked at the way I view my family members. I've carefully considered what intimidates and attracts me and why. And that sort of insight is really valuable no matter how you look at it. I'm completely okay with the prospect that my sexual orientation may not budge from this exercise. And I think that sort of attitude is a far better way to mitigate the risks and increase the therapeutic ratio than to avoid the therapy altogether.

Groups

The principle that Elder Wickman has talked about, in a nutshell, is that if you are trying to live with and maintain ascendancy over same-gender attractions, the best way to do that is to have groups that define their members in terms other than same-gender attractions.

Elder Dallin H. Oaks

Enter: the queerosphere. The catch 22 about same gender attraction is that if you believe some of the experts, fostering platonic friendships with other guys is a great exercise in healing. It's a way to belong to the community of men, to feel accepted as you, to have the intimacy you crave without sexualizing it.

Blogging has the added benefit of being remote (and therefore less likely to culminate in french kissing). It's the first chance I've ever had to really discuss this issue with anyone who had given it some thought. I enjoy discussing it with faithful saints in a similar situation, as well as nice folks who disagree with the church. The angry screamers I can do without, but they seem to avoid me for the most part. Knock on wood.

But I can't avoid the nagging feeling that Oaks is telling me to be in a group that doesn't define it's members in terms of this issue.

It makes sense, when I consider the small amount of info I have on how cyber-friendships have turned out for others. I know that gay LDS men who have joined online support groups have sometimes been propositioned repeatedly by other members... including nude photos. I know that people have hooked up in person after meeting online--sometimes for supportive fellowship, sometimes for sex, and sometimes for supportive fellowship that is at risk of becoming sex.

For example, what do you make of a virtual stranger who offers to fly to your hotel room when you are lonely and thinking of looking at porn? The ostensible reason is friendship and support. But the circumstances aren't appropriate. I declined the offer not because I didn't trust the person (who very well may read this), but because it didn't seem right. It's scary stuff, these waters we swim in online.

The in-person support groups seem to have just as much baggage, if not more. Would I want to attend even if I had the opportunity? I kind of don't think so. I know they're helpful for some, but at what risk? And when the activities involve camping and sports, what happens when it's time to take showers or bunk down in a tent together remote from civilization?

You know, I'm glad I'm anonymous. It gives me a good excuse not to socialize with other gay LDS guys in person.

But should I blog? Maybe as an island. An independent nation not affiliated with the Queerosphere at large. ;-) I don't see that flying. But, conceptually, it avoids identifying with a group. We'll see...

Goldilocks and the three queers

Some who misunderstand the nature of same-gender attraction would argue that one cannot experience an attraction that is so"unnatural" and still be in God's full favor. Others may claim that one should focus on "changing" and doing all within his or her power to "overcome" same-gender attraction. Although our faith in God may require us to reconcile things in our life that may influence the attraction, putting an unbalanced and unhealthy emphasis and focus on "change" as a prerequisite to happiness or divine love and favor can be counterproductive, discouraging, and emotionally exhausting.
...
People who experience same-gender attraction may often feel overwhelming pressure to "change" the nature of their attractions, or their sexuality-and they'll do anything to make it happen. There is a strong tendency to feel that no matter what our challenges may be, if we pray more, fast more, read scripture more, or attend church and the temple more, then we can and will "change." Yet, despite how often or how deeply and sincerely many have prayed, fasted, read scripture, or attended the temple, they have continued to experience feelings of same-gender attraction with little or no change in intensity.
...
We who have the challenge of same-gender attraction have a responsibility to do all we can to understand our feelings or attractions and work to alter anything that may have influenced the attraction, but it is also important to remember that those things in and of themselves cannot alter our natures in any saving way: only Christ can do that.

Ty Mansfield in In Quiet Desperation

My last post may have given the impression that I favor obsessing about changing to heterosexual orientation. I don't. I'm more like Goldilocks in that famous fable, Goldilocks and the Three Queers.

Once upon a time, Goldilocks found himself discussing same-gender attraction with three LDS friends who were same-gender attracted. The first friend, who called himself PapaQueer, took a pretty militant stance about same-gender attraction. He felt his feelings were ungodly and he vowed to do anything to change them, because that's the only way he could imagine being happy and pure. He had already been through reparative therapy, fasted til he was thin as a rail, and prayed til his knees were bloody. His eyes had a fire of determination that was both a little inspiring and scary.

MamaQueer, on the other hand, believed her feelings of same-gender attraction were completely acceptable, and indeed, a vital part of who she was. She felt that even given the chance to change her sexual orientation, she would not do it because to do so would be sacrificing an integral part of herself. Her apathy was both a little comforting and scary.

Goldilocks found himself bothered by both of these queers. PapaQueer really seemed to need some therapy. He had an unhealthy self-image and seemed to be in denial. MamaQueer was much happier, but seemed to be oblivious to the conflict between her image of herself and the eternal role Goldilocks understood she could someday fulfill.

Then the wee BabyQueer spoke up. BabyQueer's view seemed just right. He accepted his same-gender attraction as an incidental part of his identity, nothing to worry about necessarily, but also as something that needed some careful attention as sexuality is an important issue. He wanted his views to deepen and mature with healthy mental attitudes and spiritual insights, and so gave the matter quite a bit of thought. "Change" was never out of the question. In fact, change seemed like the best solution and worth some investigation. However, if change were not possible, that would be okay. He planned to spend time thinking and reading on the subject, but to avoid obsessing about it or making it the primary concern of his life. Deliberate and proactive, but not obsessive.

Goldilocks wanted to kiss BabyQueer, but realized that would be counter-productive. So, he left and went to sleep because it's going to be a long night in the hospital.

The end.

The missing option

When the second season of The Office ended with Jim finally telling Pam he loved her, I had to wonder what they would do with the third season. There was no way they were getting rid of either of two of the best characters and there was no way they were going to get together. Getting together equals living happily ever after (and no more advertising revenue) while staying apart with lots of torment and sexual tension brings the hearts and spending dollars of the masses back for more and more (but would be unbelievable). I couldn't imagine the show going forward with them together or apart. There had to be a third option. When I finally saw what that option was... it was brilliant. Yet obvious enough that I felt really stupid.

Subject change to ex-gay efforts. Criticisms of ex-gays often focus on the therapy that is supposed to have accomplished it for them. Reparative therapy is extremely inefficient, even by the most favorable data, succeeding in only a fraction of the folks who undergo the therapy. Those whose blogs I've read who have tried reparative therapy in one form or another haven't found much (if any) change in their sexual orientation. But some folks reportedly have changed, and I'm left to wonder if the therapy was incidental--a confounder in the real journey that only obscures the actual events that contributed to change.

Through Sam's blog I found a great blog that discusses ex-gay ministries. The author describes her objections to reparative therapy and the psychological theories behind it in a post that concludes with a description of an alternate approach that she found more effective. While I appreciate her approach and agree that it could be workable for lots of folks, I wonder if there's not something better... something brilliant that I haven't run across yet. Maybe it hasn't even been figured out yet. There may be an option for someone like me that I'm not even aware of. I'll try to put my finger on it, but if any of you find a missing option, let me know.

Always the guest

Over the weekend I had an experience that interrupted my peace... brought up a rush of familiar angst. As I talked to my wife about it, my mind wandered to high school and an experience that may be meaningful.

The experience itself doesn't really have a story to it, it's more of a snapshot. I'm lying on my back in a field watching the stars with three guys from school that I really admire. Two of them are the co-captains of the soccer team, two are on the school's competitive academic team with me, one is a leader in band with me, and one is my best friend. All three are way smart, good looking, self confident, and all around nice guys. In short, I find them to be oddly appealing and incomprehensible. I want to be like them. I want... them.

And how does one have another person?

I think the healthy way to dispatch such feelings is to become good friends with people I admire. To come to know them well enough that they are at once a real person with real faults, someone who affirms my own humanity and value, and someone who is worth knowing even when I see they aren't as perfect as I thought.

That didn't happen for me in high school. Well, not enough, anyway. As we chatted under the stars about friends from school, astronomy (yeah, we were geeky like that), and everything else, I felt great. There was acceptance and an intangible affirmation for me. But ultimately, after the campout was all over I felt like an outsider. These guys had known each other longer than me. I felt like they had a friendship with each other that was more genuine than my own. I was the last invited on the campout. I hadn't been invited to others at all, but that was probably because I lived further away and was a relative new-comer. I was a guest.

I don't want to be a guest. I want to have them for myself. How can I satisfy that hunger? How can I be home?

My impotence

My impression was that Drescher's opposition to reparative therapy centers around three main points

1. It doesn't work
2. It is unethical
3. It is harmful

However, when pressed, I think he would acknowledge that none of these are proven to be true.

It doesn't work
The efficacy of reparative therapy has never been shown in a scientifically rigorously way. Some have said (wrongly) that if change were really possible it would have been demonstrated long ago. I don't remember Drescher taking this stance, but he did criticize the theories and studies in support of reparative therapy. Perhaps the most widely known study is Spitzer's. Drescher edited an entire book of responses to Spitzer's work, all attempting to discredit the conclusions. Drescher's own opposition (again, based on my poor memory only) was centered around follow up and failure to document actual sexual orientation through objective testing. More specifically, these men who claimed to change orientation, did they stay changed or was it just temporary? Were they able to persist in their "new" orientation? Long term follow up was not measured, and that is a weakness in the conclusion that change is possible. However, to the extent that Spitzer acknowledged this limitation in his discussion, it doesn't make the study invalid, just limited. That's a big difference.

Drescher also asked Spitzer why he didn't verify orientation with plethysmography (what GayMormon calls a "boner-detector"), and he was unhappy with the candid answer Spitzer provided: he didn't have the funding. Drescher seemed to irrationally believe this was a personal failure on the part of Spitzer. I was quite confused. Again, plethysmography would have improved the study, but its omission does not make the study invalid.

It is unethical
You are probably familiar with the medical aphorism "do no harm." Doctors haven't done a very good job of following that advice without some regulation here and there. For example, regulation of research involving human subjects has greatly improved ethical practices. And "informed consent" is an important part of every medical or psychiatric therapy--research based or not.

Drescher had a list of 6 criteria that must be followed for a therapy to be ethical. I don't remember what they all were, but properly informing the patient about potential benefits and harms, respecting autonomy, etc., were central. Drescher went through the list point by point and made his case that reparative therapy did not meet the criteria. However, I was not convinced. I have actually been in reparative therapy sessions, and the way he described the dialog was simply not reflective of my personal experience. I was indeed given a thorough explanation of potential benefits and risks. My consent was documented carefully. Confidentiality and specific therapeutic goals were discussed. It was all quite professional. I wondered where Drescher was getting his information.

It is harmful
Drescher stated unequivocally that not a single reparative therapy book or practicing therapist was honest in disclosing the risks. Not one. My vast readership [hee] may remember a recent series of posts in which I reviewed a couple books on reparative therapy (Nicolosi and Parks). They were library books, so I can't go back to find pages, but I believe I recall a discussion of theoretical risks in both of them. Regardless, I know my therapist and I discussed the issue. Therefore, I had to restrain myself from standing up and calling Drescher a pig-faced liar. Actually, restraining myself wasn't hard, because the crowd had proven themselves to be completely tolerant of blatantly anti-religious hate-speech. I felt like a mole.

Despite the fact that his own handout specifically noted that the only data regarding risks in reparative therapy are anecdotal (i.e. not scientifically meaningful), he was standing there condemning anyone who would not discuss the harms as if they were real. His take became more and more clear: reparative therapy is an extension of conservative religious fanatics who speak of loving gays publicly, but call them an abomination privately. They have no interest in the individuals, only their own political agenda.

You can imagine how such generalized moral condemnation turned me off. But everyone else seemed to be eating it up. The picture was painted to show down-trodden gays hustled into therapy they didn't choose for themselves, psychologically abused by self-promoting "ex-gay for pay" quacks, and then condemned personally for any poor outcome. Such an exaggerated caricature was so far from my personal experience that I wondered if I would be able to tolerate the discussion. Had he cited examples as examples I would have had no objection, but vilifying an entire demographic whose views differs from your own? Generalizing motivations and unethical conscience?

If this is the national leader in opposing reparative therapy, I must admire the ingenuity of gay activists in getting medical professionals to swallow such swill. It was patently ridiculous. And I was impotent in commenting because of my concerns for personal privacy. It makes me rethink my desire for anonymity. But, not surprisingly, it did not make me rethink my decision to attempt reparative therapy.

And, no, I'm not worried about any other kind of impotence at the moment. :-)

Drescher

After reading a few books on reparative therapy by proponents, I asked my therapist whether he thought it would be a good idea to read books debunking the idea. I wondered if he would respond like a priesthood leader might if you asked about reading anti-Mormon literature after having just finished the scriptures, but he did not. He strongly encouraged me to read up on their arguments, to be as informed as I could about all sides of the issue, and to assess it all for myself. Who, I asked, would be a good author to start with? He promptly suggested Jack Drescher, the national leader in the psychiatric field in opposing reparative therapy.

As it turned out, I was able to not merely read something by Drescher, but to meet the man and hear him speak in person at a professional meeting not long afterward. Unfortunately, a few days later I moved across the country and have yet to find the handout and my notes from the presentation! So, regrettably, all I have to go by now is memory.

He introduced the science, the politics, and the history of reparative therapy. The interplay between homosexuality and medical and psychiatric scientists is pretty darn dramatic. Gay advocates got some traction from a gay psychiatrist who agreed to be part of a panel at a national psychiatric conference--as long as he could wear a rubber Nixon mask! Drescher discussed the remarkable way gay rights activists organized and started a cultural revolution of gay tolerance. They began framing homosexuality as an identity characteristic that requires non-discrimination protection under federal law. It was brilliant.

But alas, it wasn't long before Drescher began bashing. It always amazes me how people can become so committed to a worthy cause like opposing hate and bigotry that they then slip into allowing themselves to hate and be bigoted against those they see as enemies. Drescher sees nothing, nothing at all, redeeming about what reparative therapists do. He sees it as unethical. He sees it as harmful. And he sees it as something to spend a great deal of his time and effort to write and speak out against. I respect all of this. It's when he then falsely described the methods of reparative therapists, vilified the practitioners, and derisively described religious conservatives as hypocrites--not some, but all--that I started losing respect. He called NARTH (the National Association for Research and Therapy of Homosexuality) Narth Vadar. Clever. Especially if you're a propagandist. I expect something a little less sensational and perhaps respectful from a scientist.

Hefting hate

Protean posted and Mark commented on a book about ex-gay ministries called Straight to Jesus. I read the review article in question and it really pissed me off. I think the book sounds quite interesting, but the Solon article was a biased piece of trash. Here are a few favorite parts:

Erzen wasn't interested in collecting fodder for political battles, though, and that's what makes "Straight to Jesus" so enlightening. As an ethnographer, she made every effort to listen to and understand everyone at New Hope Ministry, whether or not she agreed with their beliefs (and it's fairly clear that most of the time she didn't). That's practically unheard of in most popular discussions of charged issues like homosexuality -- and rare in scholarly discussions, too. Nowadays, everyone's convinced that they already know everything the other side has to say and that actually having to listen to it would constitute an insupportable demand on their own patience. Everyone thinks their side of the argument never gets any exposure, yet rabid, ranting opinion of all varieties howls at us everywhere we turn.

Hey crazy lady, have you looked at yourself? You are a loon who I doubt would know a politically neutral position if it bit you on the ass. As evidence:

In fact, scandals involving the sex lives of ex-gay movement leaders are so common (even one of the straight leaders, Kent Philpott, got busted for fooling around with his adopted daughter), that it's hard for anyone outside the evangelical right to take them seriously. Add that to several prominent cases of parents forcing their gay teenage children into scary camps like Love in Action's Refuge, an "intensive discipleship program" -- and the fact that no reputable professional psychological organization endorses the idea that homosexuality is a mental "disorder" that can be "cured" -- and the image of a pack of dangerous cultists is cemented.

I have heard this same ridiculous song and dance over and over in the discussion. Attack carefully selected ex-gays' credibility, then generalize that character attack to all and conclude none can possibly be honest, have anything relevant or cogent to say, or be motivated by something good, and you should fit right in with the howling you describe. Or, better yet, go with nuance: "a pack of dangerous cultists."

Because they could never reconcile these deeply rooted beliefs with their homosexual behavior and relationships, those behaviors and relationships could never be truly joyful or satisfying, and because they had never had joyful or satisfying homosexual experiences, they assume that gay life is inherently empty and destructive.
...
Still, whatever the benefits these men get from evangelical Christianity, their religion is no more a rational choice than their sexuality is. Even when opting not to believe seems the only and obvious healthy, life-affirming alternative, these men -- some of them educated and sophisticated -- can't manage it.

Yes, conclusions about gay life are all about irrational religious beliefs by those with no positive gay experiences. It has nothing to do with statistics about suicide, drug abuse, promiscuity, life expectancy, etc. Clearly because they are religious they are irrational, and because they disagree with you, they are wrong.

I commented on Protean's post a bit about this, but I wanted to go into a little more detail. I don't mind the idea of the book--it sounds like a good read. I don't even mind the author's personal position on ex-gays and reparative therapy in general. What I do mind is the incessant character attacks on the religious, reparative therapy practitioners, and ex-gay ministry leaders. It's hateful, venomous, hypocritical, and I'm sick and tired of the unfettered hate hefted out there on the public like so much flying manure to fertilize the grassroots efforts of activists.

A Congregation of One, part 7

I wasn’t particularly surprised to find the Planned Parenthood presenter a bit off-putting. The last lecturer I remembered from Planned Parenthood staff had played a phone recording from an abortion hotline in which a young woman wailed about the physician who had turned her away. This was the type of thing that brought people to attempt abortions on themselves with coat hangers, we were told. Valid point, certainly, but perhaps she could have emphasized it more with bright lights shining in my face after a period of sleep deprivation.

There was no attempt to address the elephant in the room—what were physicians to do when their personal values held performing an abortion to be immoral? Ignore or change their values? It was an interesting question that was smoothly bypassed giving the impression there was only one answer—physicians were to put aside their personal issues in the best interests of the patient.

Now, this new Planned Parenthood lecturer had asserted with complete finality that reparative therapy had been shown to be “ineffective, unnecessary, and harmful.” In an e-mail I requested primary sources for this claim. He directed me to the American Psychiatric Association’s position statement on the topic. I responded by quoting their position statement: “To date, there are no scientifically rigorous outcome studies to determine either the actual efficacy or harm of ‘reparative’ treatments.” Changing tacks, he asked why I was so interested in the topic. I replied that I was concerned that science and not politics inform our medical education. Then, he wanted to know why I was bringing politics into the discussion at all.

Why indeed. There’s nothing political about homosexuality. Oh no, nothing at all.

He suggested if I had further questions to direct them to the course directors. I did, but I never heard back. I didn’t really expect to. I had spent hours and hours—collectively, probably days—filling out evaluation forms, but I had never received any indication that my feedback on sensitive issues was heard or appreciated. Sure, when I suggested they change the date of a test it was given some thought. But when I evaluated FCP’s sexuality course, I imagined they had done the opposite of my suggestion the following year just to spite me.

So, again, I was left to wonder about reparative therapy all on my own. Was it just “psychobabble”, as one of my psychiatry mentors had derisively dismissed it? Irresponsible and unethical therapists preying on desperate gay men with nowhere else to turn, now exploiting guilt and shame to promote their own political agenda while ignoring the diabolical risks of failure, despair, and suicide?

Please. I couldn’t believe the pervasive ignorance on the subject among the ivory tower that was my medical school. I had read some books, and they made sense to me. I had a friend who was undergoing reparative therapy and he seemed far happier than before. I had been referred to a reparative therapist for myself, and he claimed to be a man who had changed his sexual orientation many years before. He had written a book about his experience. I read it. I doubted. I hoped. I wondered.

Was this my coat hanger? Too bad the APA had encouraged therapists to turn me away, to attempt to abort my homosexuality in a closet at home with nobody to watch for side effects. Nobody to mitigate the risks.

Index for A Congregation of One
part 1
part 2
part 3
part 4
part 5
part 6
part 7
part 8

Thinking things

For the last couple years I've had a recurring nightmare. It isn't always the same, but the theme is consistent: I find myself in a high-stakes situation in which I am unprepared. It's often academic. For example, I'm waiting to start a final and I realize (somehow suddenly) that I never bothered to read the textbook. Or I never once showed up for class, forgetting that I had even enrolled. I scramble through my backpack trying to find the text to flip through for a few moments as the proctor says to put away your materials. Panic ensues. Terror.

Life foists that same uneasy feeling on me once in a while. But, being awake, I experience it differently. I feel defensive. I rationalize. I justify. Thankfully, I don't feel nearly as out of control. My mind starts going into overdrive to lay some cognitive path that will protect and defend my... I dunno... happiness?

Yes, I'm still on the happiness kick. Essentially, I'm trying to convey that our brains drive our behaviors, and our personal needs drive our brains in some significant ways without our ever necessarily even realizing it. There's some brand of happiness that our mind vigilantly attempts to get and defend. And when our world view is threatened... when things go wrong, our mind has as its primary task making things better. Unhappiness of this variety gets things going. It makes me move. It protects me as a creature. Can it be viewed as merely another means to a biological end? What about a psychological end? I think it certainly could explain why people (myself included, of course) have such a hard time having a civil conversation about sensitive topics. Happiness is at stake. Sacred personal psychological comfort.

I suppose this explains why I had dread in the pit of my stomach when I attended the scientific presentation about reparative therapy given by Jack Drescher. I suppose it also explains why Dr. Drescher during the lecture was willing to categorically condemn anyone involved with reparative therapy (offering or receiving) as guided by poor motives. Our respective world views seemed to be at stake during that lecture. Consequently, I would have been reluctant to change my opinions had he said something compelling but particularly at odds with my hopes (which he didn't, scientifically), and he offered no concessions of good faith to conservatives or religious folks I believe because to do so would have opened the door to middle ground (unacceptable in terms of his political goals). Anyway, I digress. The point is, people need happiness and they're willing to do mental gymnastics to get it. And it's all quite unnecessary. Truth doesn't give a damn about your mental gymnastics, or your happiness. Things just are what they are. And being aware of that and okay with it seems to be a step toward a more robust and genuine happiness.

Unfortunately, everyone thinks they're already rooted in truth. Their happiness is already genuine. And when the shadows are cast across the quaking soil... panic. Defend the happiness.

Science

Last night I attended a scientific presentation on GLBT psychology and biology. It was very interesting. I was quite nervous beforehand because I feel like there is such a huge fervor on anything gay related, I wondered if it would end up being a circus freak show of medicine. But it wasn't. It was real science, real medicine, presented by nice and caring people. And that made me glad.

However, ever the skeptic, I paid pretty close attention to what the experts were saying to see how much of it I believed. Turns out, even the experts have some real bias issues. I guess there's nothing surprising there. I just hope they realize it. I hope I'm not going to be the only one to challenge the information they've presented because it will appear to be a sensationalization of the topic--exactly what I feared would be imposed on me before attending!

For example, a brief history of early prejudicial paradigms on the subject showed that research results about gay populations were skewed because the only gays enrolled in the study were those in prison for violating anti-sodomy laws. Not exactly scientifically appropriate selection criteria for a study that seeks to say something externally valid (i.e., have generalizable results). Interesting stuff... scientifically appropriate... all good material presented so far.

And then they showed [fanfare music] the new improved methodology that compared non-clinical homosexuals and heterosexuals, controlled for confounding factors like age and religion and excluded individuals with a psychiatric history. The new results completely defied the old ones: rather than gays always having "global deficits" as was previously scientifically demonstrated, they were now shown to be potentially "as adjusted as heterosexuals". Yeah!

Except... doesn't excluding all the gays with psychiatric issues sort of beg the question? Psychiatric issues are much more prevalent among gays, and hand-picking the population of gays to demonstrate "adjustment" is just as inappropriate as using prison inmates! It's not generalizable. And yet, here was an expert in the field completely ignoring this fact.

Later in the presentation the question was posed: "What causes people to be gay?" The answers offered as representative views included:

• parents
• labeling
• poor peer relations
• biology
• choice
• lack of hetero experience
• same sex seduction

Through the magic of statistics and research, most of these possible causes were disproved in the subsequent discussion. Well... sort of, anyway. A statistically significant correlation to a cold father was discussed, but the magnitude of the relative risk was minimized by the lecturer (unbelievable--if you have a statistically significant result, it is by definition SIGNIFICANT). He asserted, "There is no ONE family situation that produces a gay sexual orientation." Ultimately, the lecturer declared that through "path analysis," an esoteric branch of statistics, tautology had been demonstrated to be the cause of sexual orientation. Tautology meaning that the relation between childhood same-sex feelings and adulthood same-sex feelings are that they are one and the same. People are gay because they're gay.

Thank you, science. For nothing.

There was one other particularly interesting point in this lecture. When "gender nonconformity" was measured, it was significantly related to orientation. So, if you don't do masculine stuff, you are more likely to be gay. Hmmm... now whose theories does that remind me of? A woman stood up during the Q&A and asked why that was the case. Lecturer: we don't know. But after the subsequent presentation when the Q&A was reopened for either presenter, he back-pedaled. Someone in the audience had apparently glared disapprovingly at his academically honest indication that the reason wasn't known. So, he wanted to clarify that his conjecture was that gay boys feel different as children because of society's straight projections, and gender nonconformity follows from that. The fact that reparative theory explains the situation much more plausibly was never even entertained.

The only part of the second lecture that I want to comment on right now was a question from the audience. After a presentation of a wide range of scientific data, the executive head of a special interest in San Francisco wanted to know which of all the studies presented was the most concise and compelling in demonstrating that orientation is immutable. The lecturer offered his opinion that a study of pheromones did the trick. The study showed that male scents stimulate the "smell" part of the brain in straight men and gay women, but stimulate the sexual part of the brain in gay men and straight women. There were analogous results for female scents. He concluded from this that sexuality is biologically based and is therefore immutable. I have no idea why showing that sexuality is physiological rather than merely psychological proves anything about mutability, but that's what he said.

And I suddenly feel more at peace with the science. I can appreciate the good science without being taken for a ride by some of the silliness. I'm a huge advocate of science informing public policy. Huge. But although science is good, I will keep looking for understanding in other places too.

Joseph Nicolosi, 2

Motivation to change has repeatedly been found to be a primary predictor of success in treatment. Motivation means the client is unambivalent in rejecting a homosexual identity and is striving toward heterosexuality. Other indicators of favorable prognosis are lack of indulgence in self-pity, a positive sense of self, and the ego-strength to tolerate stress and frustration. Heterosexual fantasies and dreams are also strongly favorable. Also the stronger family relationships the client has, the better his prognosis.

Joseph Nicolosi, Ph.D.
in Reparative Therapy of Male Homosexuality

Is change something I really want? Not always, to be honest, but it's something I want to want. Premish recently got me thinking about desire to change. I've thought about it before in a more broad sense: when I'm hungry, would I rather be fed or just have the hunger eliminated altogether. Logically, they result in the same thing, satiety. But when I'm hungry, I don't WANT to have the hunger simply removed, I want it to be gratified. I suppose there's something psychological about that, but I'm far from insightful enough to realize what it is and if someone were to try to tell me I would most likely laugh them off.

Well, maybe I'll give it a try. Maybe there's something deep down that recognizes that a hunger has its basis in a real need--that just removing the hunger doesn't fill the need for sustenance. And my sexual hunger is reflective of a real need that will never be satisfied by castrating myself emotionally or physically, figuratively or literally. Further, in the case of sexual desire, the physical itch can be gratified without ever touching the underlying need for companionship and intimacy. That, I believe, is why I believe sexual and emotional needs cry to be met and it's hard for me sometimes to even WANT to change.

And I suppose that's why I find Nicolosi's theories so compelling. I'm as prone as the next person to label a person or his work as categorically good or bad, right or wrong, treasure or trash, but that's a lazy generalization. When I give him a charitable read, I realize that despite a number of flaws, I have much to learn from this man and his research. The etiology he suggest fits with my concept of neither sufficient nor necessary causes for homosexual orientation, and matches surprisingly well with events and conditions in my own past. My sexual, emotional, and intimacy needs can be met without behaving in a way contrary to what I know God expects of me. How to manage it is the game currently afoot. A game I think I'm winning, I might add.

A line at the beginning of the treatment section of the book made me stop in my tracks. He said, "I do not believe that any man can ever be truly at peace in living out a homosexual orientation." I found it to be repulsive on the surface. After a moment I realized that he means merely to conclude from his psychological work that homosexuality is a symptom of other identity and developmental problems that prevent complete well-being. From a secular point of view, I don't think he has sufficient data to conclude that, nor does his theory seem to require it. But, do I really believe that is true? I surprise myself by resisting the idea pretty strongly. Why should I resist, when that is exactly the core reason for church doctrine on the subject? If I believe the Proclamation on the Family (and I do), then I can't avoid drawing the conclusion that homosexuality is an obstacle to true peace. I feel almost like I need to apologize to my gay friends for believing this, but I suppose that's my strong-willed personality traits coming through (stumbling all over myself trying not to offend, to get everyone on the same page... well you can see that I've managed to survive a number of failures on that front in the past!).

Other than my fantasies and dreams, I think I've got some pretty good prognostic indicators in my favor. I look forward to loving more, believing in myself more, and struggling for lofty goals.

Index of Joseph Nicolosi posts:
Joseph Nicolosi, 1
Sensitivity
Limitations of gay love
Causes
Affirmative therapy
Self-acceptance
Joseph Nicolosi, 2

Self-acceptance

According to popular gay rhetoric, if a man attempts to resolve his homosexuality, he must be unable to accept himself as he is. Even popular psychotherapies promote this false dichotomy.

Critics of reparative therapy suspect that it is primarily guilt that keeps clients coming to treatment. Although guilt may have been a strong motivator that originally propelled the client into therapy, it is never the foundation for successful treatment. In fact, after some months in therapy, the client typically reports a diminishment of guilt. What has diminished here is not actually valid guilt, but the excessive guilt he has felt so long that it feels natural.

Joseph Nicolosi, Ph.D.
in Reparative Therapy of Male Homosexuality

I can only speak for myself in terms of self-acceptance, guilt and my motivation for reparative therapy.

Guilt isn't much in play at this point. I still have some guilt when I look at porn, but never from being attracted to men. And whether for better or worse, I have less guilt from the porn too. I think it's just that I'm not as fatalistic about it. Sometimes I feel guilty for not feeling guilty, but porn seldom takes centerstage anymore--I just acknowledge it and move on. So, the point is, guilt isn't my motivation for wanting to change my orientation.

As for self-acceptance. It almost makes me smile at the suggestion that a desire to change shows a problem with self-acceptance. So, studying for school, getting a haircut, working on my tennis backhand (if I played tennis--haha), and lifting weights are all symptoms of my inability to accept myself the way I am. If we're talking about personal worth, I have all the self-acceptance that I need and I don't think changing my orientation will make me any more of a human being. If we're talking about self-improvement, I'm afraid I have to concede that I consider self-acceptance to be antithetical to my goals. Even having goals is antithetical to self-acceptance. :)

Ultimately, I wonder if the problem with the "self-acceptance" argument is that it ends up being an authoritative person telling some other person that they are living a lie--that the authoritative person allegedly knows more about their character and identity than they do themselves. Therapists and activists (and for that matter, church leaders) all assert with ostensible authority what parts of a person's character are necessary. Who's a person to believe? As I've said before, I don't buy that my sexual orientation is a necessary part of my character.

Affirmative therapy

While support of the gay man in adjustment to his life challenges is a worthy [Gay Affirmative Therapy (GAT)] goal, we take issue with GAT's assumptions.

At the foundation of those assumptions is the intractable conviction that homosexuality is a natural and healthy sexual variation. With this a priori assumption, GAT then proceeds to attribute every personal and inter-personal problem the gay person develops to social or internalized homophobia. GAT's theoretical model frames the life experiences of the client in the context of victimization, inevitably setting him against conventional society and disenfranchising him from family and even ethnic identity...
...
Ironically, GAT and reparative therapy agree on what the homosexual man needs and desires: to give himself permission to love other men. However, GAT works within the gay ideology of eroticization of these relationships. We believe this sabotages the mutuality that will lead to bonding.

Joseph Nicolosi, Ph.D.
in Reparative Therapy of Male Homosexuality

I particularly like this part (except the last sentence). Mainly, because I absolutely love the idea of giving myself permission to love men. It feels right. And yet, I think the common view of reparative therapy is that it attempts to instill an aversion to men. Hence the misguided sentiment I've seen on other blogs that reparative therapy isn't desirable because the writer doesn't want to lose the will to love.

And then, of course, there's the debate about whether homosexuality is normal. Insert political hot-button here. But, hey, I'll be honest (after all, I'm pseudo-anonymous here and I doubt any of you will come throw eggs at my house). I believe it is not normal. [gasp!] I've compared it in the past to obesity in that it is a physiological adaptation that carries risks but is itself normal, but even that is pandering a bit. Because when it comes down to it, I think it might fit better with my concept of disease--a condition of abnormal functioning. And of course, I think that deserves no more derision or discrimination than any other disease (so don't even go there that I'm phobic or prejudiced or something.) Sure, a gay person can live a normal and happy life (so can a person with 6 fingers, but that doesn't make it less an abnormal condition). It's not about prevalence or social function, or any other host of reasons why I've heard people declare with absolute disdain that no reasonable person could consider it a disease. It's about sexual function. And sexual function from a physiological perspective is much more than putting a smile on your face. It's primarily about babies, folks. Nicolosi thinks it's a disease because it is pathological. Others think it's a disease because it's abnormal. I think they're both reasonable conclusions, but so is the conclusion that it is an uncommon normal variant. Semantics.</digression>

Nicolosi goes into a lengthy discussion about how therapists are guilted into not offering reparative therapy (afraid of making themselves vulnerable to homophobic charges) even though there are folks like me who WANT the therapy and will make the attempt with or without a professional there to minimize the risks. Like the woman who will perform an abortion on herself with a coat hanger if she doesn't get one from her medical provider, a gay man hungering for reparative therapy should not be turned away by any decent therapist. I believe the ethical position of the APA is lamentably wrong. But, I'm not going to stand up in their House of Delegates to testify on the subject either. So it's no wonder gay advocates carry the day in organized medicine.

All in all, this was an interesting chapter.

Causes

Scientific evidence has confirmed that genetic and hormonal factors do not seem to play a determining role in homosexuality (Birke 1981, Perloff 1965, West 1977). However there continue to be attempts to prove that genetics rather than family factors determines homosexuality. These continuing efforts reflect the persistence of gay advocates to formulate a means by which homosexual behavior may be viewed as normal.

Joseph Nicolosi, Ph.D.
in Reparative Therapy of Male Homosexuality

I don't think it's entirely fair to criticize a 10 year old book in terms of today's scientific knowledge, but it certainly underlines why one should cautiously if ever claim that scientific evidence has "confirmed" anything. That's not really how science works. Depending on the skill of the scientist, the structure of the experiment, and the power of the data one can get a very good idea about whether or not some observation is random or not. How you interpret it will weigh in just as heavily (probably more) in how the "scientific" results are reported. In this case, new methods like new genetic technologies have completely changed the playing field.

Regardless, I disagree with the logical progression he reports for gay advocates. Genetic causality alone doesn't make something normal. Huntington's disease is genetically determined, but it's far from normal. In my view, it's usually an ill-conceived effort to try to ascertain whether homosexuality is genetic or developmental in cause. Nicolosi has based his therapy on the developmental hypothesis. Some gay advocates decry anything but an acknowledgment that orientation is innate and immutable. I think these people are grossly oversimplifying. I doubt there is a universally necessary cause for something as complex as sexual orientation (unlike chicken pox, for example, where the pathogen is always the same... and no, I'm not comparing homosexuality to a disease... right now). It's certainly not a matter of choice. At least, not in any definitive sense. Reparative therapy may be one choice that can influence orientation, and I suppose that's one reason many people hate it so vehemently.

When I first began this book, I thought Nicolosi's main flaw was that he believes one-size-fits-all despite his somewhat frequent (but seemingly contradictory) admissions that there are exceptions. Toward the end, though, he finally explicitly acknowledged limitations of his therapy:

Another type of client who does poorly is the one who does not fit the syndrome decribed in this book.... This type of client usually has no particular difficulties with male friendships or self-assertion, shows no evidence of male gender-identity deficit, and has a family history that does not fit our pattern. The treatment issues we address are not relevant to his issues.

Limitations of gay love

Each one of us, man and woman alike, is driven by the power of romantic love. These infatuations gain their power from the unconscious drive to become a complete human being. In heterosexuals, it is the drive to bring together the male-female polarity through the longing for the other-than-me. But in homosexuals, it is the attempt to fulfill a deficit in wholeness of one's original gender.
...
The inherent unsuitability of same-sex relationships is seen in the form of fault-finding, irritability, feeling smothered; power struggles, possessiveness, and dominance; boredom, disillusionment, emotional withdrawal, and unfaithfulness. As a result of this binding ambivalence, his same-sex relationships lack authentic intimacy.
...
Gay couplings are characteristically brief and very volatile, with much fighting, arguing, making-up again, and continual disappointments.... Research, however, reveals that they almost never possess the mature elements of quiet consistency, trust, mutual dependency, and sexual fidelity characteristic of highly functioning heterosexual marriages.
...
The results show that of those 156 couples, only seven had been able to maintain sexual fidelity. Furthermore, of those seven couples, none had been together more than five years. In other words, the researchers were unable to find a single male couple that was able to maintain sexual fidelity for more than five years.

Joseph Nicolosi, Ph.D.
in Reparative Therapy of Male Homosexuality

It makes me chuckle when I see words like "authentic" used like swords--first the one side swings, then the opponent. Who gets to be acknowledged as really "authentic"?

And why exactly should I buy matter-of-fact statements about the unconscious basis for sexual drives? So, everyone everywhere is subconsciously trying to become a complete human being by filling up personal deficits or consuming "other-than-me" by having sex? I don't like unsupported assertions like that, but I suppose I find it plausible because it is consistent with my own experience--I want to have in a visceral way the object of my attraction. Even with that concession, it seems hokey.

Lastly, I don't buy the qualitative difference he suggests between gay and straight sex because two gay men have the same "deficits" and a man and a woman don't. This just all seems like what one of my psychiatry mentors calls "psychobabble". I try, I really try, not to think psychology is crap-science. But it's hard. :)

What I DO buy is the data about long term relationships. These couples had made a commitment of fidelity and the outcomes were measured by gay researchers. Lacking some other explanation for it, I suppose his theory takes on some credibility.

Sensitivity

Contributing to my retreat into homosexuality was that I was one of those sensitive, "artistic" children with neither the talent nor interest in any of the usual "masculine" pursuits. I hated physical activity--sports and games most of all--and when I would make an effort to be a part of the gang I would fail so miserably to perform well that for a long time afterward I would suffer from the shame of ineptitude.... I was a classic case in that I (later) felt out of place in a man's world, and comfortable and capable in a more esoteric environment.

Willam Aaron in his biography as quoted by
Joseph Nicolosi, Ph.D.
in Reparative Therapy of Male Homosexuality

I got straight A's through elementary school except one C in gym. I embarrassed myself with regularity in P.E. during middle school and by the time I got to high school I was all sorts of enthusiastic to avoid P.E. altogether by being in the marching band. I hated church basketball and softball because I couldn't handle being the charity case. My mom always told me I had "thin skin" and I shouldn't worry so much about what other people think. I was too sensitive, she said. As an adult, I've been told I "throw like a girl". I hate it when conversations turn to sports or cars during social events--topics I know virtually NOTHING about.

Compare that with my less masculine abilities. I love performing in theater, singing, playing the piano, I'm quite a good artist, I have a great eye for design and photography, and I like cooking and gardening. I'm damn good at all that stuff and I know it. People respect me when I, for example, have my art in a professional show, and I'm proud of myself. So proud, I occasionally feel smarter and more sophisticated than the guys who woop at Monday night football and talk up Harley Davidsons. I find myself alternately disdainful and envious of them at odd times.

I just can't get myself to believe there is nothing to what Nicolosi is getting at. Sure, he presents his info in a way that bothers me (pretty much all social sciences do), but if I get past that, it compels me.