What is Conversion Therapy?

The “Conversion” of the APA

The drama around so-called “conversion therapy” is not new. In fact, Americans have seen all this before… in the 1970s as LGBT activists first began attacking therapeutic approaches to homosexuality. Political pressure by early activists resulted in the removal of homosexuality from among the American Psychiatric Association’s listing of diagnoses. In the same way today, Christianity is in the crosshairs. Will prohibitions against homosexuality be removed from the Bible? Or worse, will Christianity, with its historic teaching about male-female marriage, be banned? That certainly is the direction LGBT activists are headed. Conversations focusing on the efficacy of so-called “conversion therapy” reveal a legacy of moral questioning that modern psychology and Christian faith have grappled separately with for decades. Central to the debate is a conundrum that continues to linger: should homosexual behavior be accepted and even promoted in society when the feelings can be reduced or eliminated?

To better understand, it’s helpful to observe America’s recent history with this problem. After Stonewall in 1969 and the beginning of the early LGBT civil rights movement, activists demanded that homosexuality be removed from the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual (DSM), its formal listing of psychological diagnoses. Up to that time, homosexuality had been classified as pathology, or a mental illness, in the DSM. Beginning in 1970, political activists protested against the APA and began disrupting their meetings based upon the belief that the APA was largely to blame for anti-homosexual social stigma.

Charles W. Socarides, M.D. was a psychiatrist during this time who addressed homosexuality in his private practice and as a university instructor. He records,“Those of us who did not go along with the political redefinition were soon silenced at our own professional meetings. Our lectures were canceled inside academe and our research papers turned down in the learned journals… Mainstream publishers turned down books that objected to the gay revolution.”[1]

By 1973, the public pressure on the American Psychiatric Association’s leaders ultimately resulted in their desired outcome: declassifying homosexuality as sociopathological disease. In 1975, the American Psychological Association followed the American Psychiatric Association in declaring homosexuality was not pathological. In the DSM-II homosexuality was replaced with the phrase, Sexual Orientation Disturbance (SOD), which applied to individuals who were conflicted over their homosexual feelings. It was hoped that this move would improve the rights of LGBT-identifying people. But it did not immediately change the professional, scientific opinion. A survey of 10,000 APA members in 1977[2] records that 69% of responding psychiatrists continued to believe homosexuality was disordered (“a pathological adaptation”) despite this change. Then, in 1980, “Ego Dystonic Homosexuality,” replaced SOD with the publication of the DSM-III. However, that was finally removed in 1987.

Professional psychology and psychiatry were undergoing changes. The professions themselves, as well as the history of psychological diagnostics, were being scrutinized by society[3]. A re-evaluation of what constitutes psychopathology was underway, and it was concluded that homosexual behavior was not disordered. That is, it did not negatively impact a person’s ability to function interpersonally or as a contributor to society. A close look at the restructuring of the science of psychology of homosexuality as a result of the upheaval of the 1970s could provide clues to where culture (and especially Christianity) is headed.

The political pressure that removed homosexuality from the DSM continued to cause a very great shift in how psychologists addressed homosexuality. No longer considered abnormal or harmful according to their evaluative standards, psychologists would have less reason to address it. And, because mental health insurance coverage demanded diagnoses according to the DSM, any treatment for homosexuality was defunded. As a result of ongoing activism within these professions, the psychology of homosexuality has had an affirming bias ever since.

The American Psychiatric Association and the American Psychological Association redirected psychological training in how homosexual behavior was addressed. Though psychological and biological study of homosexuality continued, attempts to resolve or redirect sexual orientation were excluded. Very simply, a vacuum was created, in which in-depth and exhaustive study of orientation change was disempowered, marginalized, and even discredited because of ongoing gay activism. Little professional training or research has been focused on the topic. Research continues to be conducted, and treatment methods continue developing, but fewer professionals providing therapy for sexual orientation change are receiving advanced training.

In the nearly 50 years since declassifying homosexuality as a disorder, advances in psychological care have greatly expanded. Psychological health and the sciences around it have become a central factor in modern self-care. What we know about trauma care and bodywork, neurofeedback, psychopharmacology, neuroplasticity, and changing our neural pathways is so much more advanced than in the 1970s. The reality is that, unfortunately, LGB-identifying people have suffered from the exclusion of homosexuality from the DSM. They have not benefited from advances in areas where research and care could be most impactful: sexual formation. And rates of suicide, co-occurring mental health issues, and maladaptive behaviors continue to remain high, pointing directly to the poor mental, behavioral, and relational health of those who experience same-sex attraction and gender confusion. Highlighting social stigma rather than mental health as primary causation for suicide rates harms the LGBT community by misdirecting prevention and care.

This same avoidance by the APAs is also evident in approaches to gender identity (T), which failed to stem even higher rates of emotional instability among the transgender-identifying population. There are even more severe consequences as individuals are directed to physically modify their bodies for the sake of mental well-being. Culture’s embrace of these life-altering paths, partnered with the intentional indoctrination of young children to question their gender, is a pandora’s box.

What we presume is impossible, according to the APAs is based upon nearly a half century-year-old supposition. Because of ideological changes and shifts, the APAs have seemed undermotivated to investigate causes of homosexuality and of the mental health problems of this population. So, even though the APAs are some of the biggest advocates for the LGBT community, in my opinion the APAs share blame for the ongoing (even increasing) suicidality, mental, physical and relational issues suffered by LGBT-identifying people. Psychiatry and psychology appear to have completely abandoned LGBT-identifying people in their pursuit of social normativity—except to affirm homosexuality as “natural” and “good.”

Is “Homo” sexual behavior immoral?

There is an ongoing but unspoken moral question behind normalizing homosexual behavior among those who identify as LGBT. This is evidenced by the continual pursuit of biologically natural family relationships. The LGBT community has largely co-opted the JudeoChristian family structure. Gay marriage and the adoption debate expose the unspoken longing LGBT-identifying people have for a family-based social structure that they feel largely (biologically) excluded from. They can, through law and science, create a near-normal appearing family life patterned after traditional JudeoChristian values. Nevertheless, they will always be excluded from the genetic legacy and extended family heritage that is only available through heterosexual union. The symbiotic and teleological necessity of our family-based social structure will never be satisfied by same-sex sexual unions. This painful reality could be addressed by modern psychology and psychiatry, if only therapists would.

As gene studies continue to fail to explain sexual orientation, there should be a growing discussion of the environmental and cultural factors that lead to homosexual behavior. Notably in the most recent gene study, Science Magazine writes,

“...although they did find particular genetic loci associated with same-sex behavior, when they combine the effects of these loci together into one comprehensive score, the effects are so small (under 1% [of sexual behavior for our total population]) that this genetic score cannot in any way be used to predict same-sex sexual behavior of an individual… Ganna et al. did not find evidence of any specific cells and tissues related to the loci they identified… this study serves as a guide to the potential magnitude of genetic effects we may eventually measure and a sign that complex behaviors continue to have small, likely polygenic, influences. Future work should investigate how genetic predispositions are altered by environmental factors, with this study highlighting the need for a multidisciplinary sociogenomic approach.”[4]

The environmental factors that influence one’s sense of identity and corresponding sexual expression are a central focus in the efforts that LGBT activists call “conversion therapy.” All of us who have successfully followed Christ, leaving behind LGBT identity and behaviors, and even experiencing shifts in sexual desires, have focused largely on childhood emotional development and cultural factors such as bullying and isolation. We have gone so far as to recognize that we are simply normal men and women. This is substantiated by Ganna’s study. It exposes the reality that homosexual men and women have the same genome as everyone else.

“The study found that a person's developmental environment--the influence of diet, family, friends, neighbourhood, religion, and a host of other life conditions--was twice as influential as genetics on the probability of adopting same-sex behaviour or orientation. The genetic influence did not come from one or two strong sources but from dozens of genetic variants that each added a small increased propensity for same-sex behaviour.
A genetic arrangement based on a large number of markers across the genome means that virtually all human beings have this arrangement, or large portions of it. In other words, not only did the study fail to find some controlling gene for gay identity, it also established that gay persons are not genetically distinct from all other human beings in any meaningful sense.
Gay persons, we might say, have a perfectly normal human genome.”[5]

Changes in sexual behavior, identity, and even attractions DO happen for many. This change often occurs through a process that partners a moral standard with exploration of early childhood experiences, relationship patterns, emotional distress, and other factors, often linked to shame, speaks volumes to the need for more honest study. LGBT activists would instead prefer to settle the matter through biology, yet little in science supports that focus. And, since the APAs continue to steadfastly downplay publicly the degree to which sexual attraction and behavior and gender identity (like gender stereotypes) are shaped by cultural and environmental factors, there is an impasse. There may never be a consensus as moral values continue to diverge. Only the re-establishment of value for a consistently stable emotional and biologically linked family unit can resolve this controversy.

So, where does the term “Conversion Therapy” come from?

I believe the term “conversion therapy” is a marriage of 1970s anti-APA rhetoric and international anti-conversion laws. Across the world, most notably in India, anti-conversion laws support nationalism by suppressing minority religions. For example, Christianity and Islam are the two primary targets of Hinduism, India’s majority (national) religion. The term conversion therapy combines LGBT activist animosity against psychological therapy and religious faith; both are targets because they can powerfully and reasonably prove homosexuality should not be promoted or normalized. Anti-conversion therapy legislation and like-minded rhetoric seek to justify a cultural dynamic. Activists literally are fighting for the right to exist as LGBT without criticism and to strengthen the LGBT subculture. As they do, they seek to shut down any opposing voices through government censorship that is eerily similar to these anti-conversion laws. There is no opportunity for dissent.

Ironically, the conflict over conversion therapy is partly over the right to belong to broader culture versus the right to be different. So-called conversion therapy, which is really change-allowing and exploration therapy, is largely an effort to bring relational wholeness and wellbeing to people who experience undesired same sex attraction so that they can live “normal” lives, incorporated into broader society without the LGBT label. As I wrote above, it addresses the “environmental factors” that the latest gene studies point to. One of the primary emotional dramas of the LGBT experience is perceived rejection. Many feel “other than” and “unable to belong.” A very great strength of the LGBT subculture is the feeling of belonging and familial safety that it cultivates. Laws such as HR-5, “The Equality Act,” create a tenuous salve for this sense of rejection.

In the end I fear that legislation alone will not satisfy, nor will normalizing LGBT identity within religious and cultural circles. The LGBT persona perpetuates the “outsider” identity and effectively blocks one’s deep teleological desire to belong meaningfully among the rest of society. Without realizing it, the LGBT community may be deepening its wounds of shame and rejection as it strengthens its cultural presence.

[1] http://theroadtoemmaus.org/RdLb/22SxSo/PnSx/HSx/SocrdsHowAmerGay.htm

[2] 1977 November. Sexual Survey #4: Current Thinking on Homosexuailty. Medical Aspects of Human Sexuality, p110.

[3] Bayer R. Homosexuality and American Psychiatry: The Politics of Diagnosis. Basic Books; New York, NY, USA: 1981. [Google Scholar]

[4] Ganna, Andrea et. al. “Large Scale GWAS reveals insights into the genetic architecture of same-sex sexual behavior” Science Magazine, Vol 365, Issue 6456, 30 August 2019 https://science.sciencemag.org/content/365/6456/869

[5] Sullins, Paul “The gay gene myth has been exploded” Mercatornet, Sept 3 2019,

https://www.mercatornet.com/conjugality/view/the-gay-gene-myth-has-been-exploded/22824

Elizabeth WoningOctober 17, 2019