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I thought I would write some thoughts on “Reparation Therapy”. For those who may not know what this is, this is an alleged treatment to ‘cure’ people of homosexuality. Those who administer it claim it can get a person to have only heterosexual desires.
The American Psychiatric Association and the American Psychological Association (and I believe the Social Workers’ equivalent) all have formal statements it does not work. There are no good studies or data showing it has efficacy. These formal organizations also have statements saying these sorts of treatments are not condoned or supported by any of these institutions. Those who choose to go through such treatment – or administer such treatment – are going outside standard protocol and accepted standards of practice. That is always a risky endeavor, an easy target for malpractice.

As a health care professional, I try to be ethical and recommend what is practical and has scientific backup for legitimacy. Patients merely wanting something doesn’t mean thething is ‘right’ for them. (Heavens, if that were so, all my patients would be on Xanax!). I give options of what I believe is right for their condition or diagnosis.

Almost by definition I wouldn’t see people who want reparation therapy. If I did, I would be obliged to make them aware of its faults and my views on it. If they insist, they have to go elsewhere.

Reparation therapy is biased from the beginning as it is done by people who believe it will work, done to people (usually) who want it to work. That combination is not uncommon in psychology, and the outcome is usually effective – for a while. What is needed in any treatment is objective long term data, which is often difficult to obtain. When I see a new treatment, I want to know about the number of participants in the study, how they were picked, who administered the tests, and what do they mean by “long term results”. I know of no long term data for reparation therapy.

At the heart of this controversy is the complex and mysterious etiology of human sexuality and sexual preference. We do not know why some people prefer members of their own sex. We have clues of the components, but human sexuality does not fit nicely into one hypothesis; it is neither purely genetic or dynamic in origin. I know no one who choses their sexual preference. However, people do choose (or not) to act on their preferences, a different matter altogether.

What do you call Ancient Athenian men who often had young boys, but these boys were obliged to marry and get their own boy? What do you call people like Churchill who admitted to trying homosexuality? What do you call Oscar Wilde who was married for a very long time prior to turning to young men? What do you call my friends “Jane” and “Tom”? Jane was with a woman for 20 years. Tom was in a three way with 2 other men for over a decade. J and T are now married to each other and (so far as I can tell) happy in their monogamous heterosexual relationship. What do you call my 70yo patient who ‘came out’ at this age after living a straight life for seven decades?

Sexuality evolves. While most are firmly in one set or the other, there will always be people who either weren’t ‘that gay to begin with’ going to full heterosexuality. And vice versa. Remember the Kinsey survey. It has its faults but it showed most people do not fit nicely into ‘straight’ or gay’.I have known many women who tried/adopted lesbian relationship/affairs out of violence from straight male relationships. I’ve known lots of gay men who have dated/married women; and I suspect most straight people have tried homosexual activities at one point. People are complicated.

In this paranoid era for simple answers and clean truths putting people into one category or the other is tempting but ultimately useless.

Through willpower and conditioning people can believe – or at least do – a lot what they want to do/be. So, when I hear of person ‘cured’ of homosexuality I suspect for practical purposes he is. You can’t make a race horse out of a pig, but you can make a very fast pig – and perhaps in the speed it can pass as a horse for practical purposes. Perhaps these “cured” people were not too much gay to begin with, or are very suppressed. But are they truly‘changed”?

I wonder how many women would be glad to marry such a fellow.

Homosexual people can be threatened by testimonies of ‘cured’ straights as it implies homosexual attractions can be changed, and the fear society will make them change. Heterosexual people can be threatened by gay people as it threatens their paradigm of how the world should be. If being gay isn’t a choice or a sickness per se, then it can’t be ‘cured’ or simply unchosen.

Perhaps Gore Vidal said it best: “There is no such thing as a homosexual or a heterosexual person. There are only homosexual and heterosexual acts, and what one does with another at one time in space doesn’t matter in the true sense of the universe”.

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June 2007

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