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LDS Therapists Should Abandon Harmful Ex-Gay, Conversion, Reparative and Re-Orientation Therapies



Paul’s story is not uncommon.  I have heard it dozens of times since I came out last year in support and advocacy of our LGBT sisters and brothers.  Paul did not choose to be gay.  In fact, he did everything that his church leaders counseled him to do including getting married.   He was told that getting married along with prayer and fasting, would take care of “the problem”.  Finding that marriage and “praying the gay away” did not turn him straight, Paul eventually had the heartbreaking talk that no spouse wants to hear.  His wife was understandably upset, shocked, and shaken.  She too had been conditioned to believe that these “tendencies” were a matter of will power and choice and could be simply corrected through referrals by leaders to marriage and family relations classes and “reparative therapy”.  As is most often the case, the result did not meet expectations and she blamed Paul for his inability to become heterosexual.  She began to withdraw her support, believing that he simply wasn’t motivated enough to change his sexual orientation.  They ended up divorcing and Paul began to be engulfed in feelings of self-hatred and self-loathing.  Feeling abandoned and increasingly isolated, depression escalated to the brink of Paul having suicidal thoughts and planning to take his own life.  Such is the case with many of our loved ones, friends, and neighbors who are LGBT.  Tragically many of them do end up taking their own lives.  In fact, LGBT individuals who face rejection from their families are shown to have significantly higher suicide rates.  Many LDS mental health professionals, such as myself, have come to realize that it is not the orientation of an individual that can cause depression and suicide but more often it is the rejection of family and community, as well as the homophobic rhetoric and actions of others that push many LGBT individuals to the brink.  But now new information has recently become available that has and will continue to radically change the therapeutic landscape.

A few weeks ago, Robert Spitzer, a prominent psychiatrist and researcher who authored a controversial study in 2001, apologized to the gay community.  His 2001 study on “reparative”, “conversion”, or so called “reorientation” models of therapy supported the notion of Paul, his wife, and many local church leaders, that LGBT individuals could indeed become straight through these models of therapy.  Although many researchers and therapists thought the study was already on shaky methodological ground to begin with, there were also many therapists, researchers, and authors on the subject of homosexuality and mental health who referred to this study as the definitive proof that such models were scientifically acceptable, ethical, and competent.  In many respects it was the keystone study that most non-affirming models of therapy relied on.   It turns out that Spitzer was wrong, his study was flawed, and in an unprecedented mea culpa he withdrew his support for his own study and has now apologized to the LGBT Community.  The last thread of competent scientific support for these models of therapy has been cut.

            To be fair to Spitzer, he is also notable for his bold efforts in 1973 to take homosexuality out of the Diagnostic Statistical Manual (DSM) that mental health professionals use to diagnosis mental health disorders.  Spitzer should be credited for taking this important step.  However, many therapists and counselors were still slow to embrace this change and continued to see being LGBT as a mental health disorder that could be changed through counseling or as an addiction that could be managed.  With Spitzer’s notoriety and credentials as someone who clearly was not anti-gay, his 2001 study accelerated the use of “reparative” therapies.  Books were written.  Success stories were hailed.  Money was made off of the hope for a supposed cure or control for homosexuality.  Thankfully, Spitzer in the end did not want his legacy or his name tied to this movement.  Likewise, do we who are LDS mental health professionals want to be tied to a legacy of unfounded, non-evidence based models of treatment that are ineffective at best and at worst destructive to the mental and emotional well-being of LGBT individuals and their families?

In addition to Spitzer’s historic and monumental announcement, another study by Renee Galliher, Ph. D., John Dehlin, M.S., and Bill Bradshaw, Ph.D. has also come out showing empirical support that LGBT Mormons typically do not benefit from reparative therapy and many of them have in fact been harmed by those models.  The research is well worth reading and may be one of the first of its kind to assess the efficacy of different treatment modalities with the LGBT Mormon population.   Preliminary results of that study can be found here:   http://ldshomosexuality.com/wp-content/uploads/USU-LDS-SSA-Newsletter-v1.pdf

The Church Handbook of Instructions wisely advises ecclesiastical leaders to encourage members not to “use medical or health practices that are ethically or legally questionable” and instead encourage members “to consult with competent professional practitioners who are licensed  . . .” (CHI 2010, 17.2.6, pg. 162).  I can’t think of more ethically questionable models of therapy than ones that attempt to change orientation and are sometimes developed and run by unlicensed individuals.  I believe it is up to us as LDS mental health professionals to help educate the LDS Community to know what is helpful, ethical, competent, safe, and evidence based practice in mental health treatment for our friends and family members.  Promoting orientation as an “addiction” or telling individuals and families that non-credible treatment models are effective should not continue.

I believe we need to turn our backs on these models, as well as the equally ineffective or destructive view that somehow orientation itself is an addiction.  It is not unusual for LGBT Mormons to be referred to church sponsored addiction recovery groups and programs due to their orientation.  Like many other Mormon therapists have come to realize, I have found that there are more affirming models that will promote the mental and emotional well being of LGBT Mormons that are scientifically sound and also consistent with Christ-Centered principles.   I believe that 20-30 years from now the practice of reparative therapy for LGBT individuals will be viewed with ethical abhorrence in a similar way as we now look back at the eugenics movements of the early and mid twentieth century.

Thankfully, more affirming and evidence-based models of care for LGBT individuals and their families are being developed.  One of the most promising is the Family Acceptance Project developed by Dr. Caitlin Ryan and her colleagues.  Their family support work is based on rigorous research with LGBT youth, young adults and families. Their studies are published in peer reviewed journals starting with the first study on family rejection -- published in the distinguished journal Pediatrics in 2009 -- that showed a clear link between parental and caregiver rejection of lesbian, gay and bisexual youth with negative health outcomes such as drug use, depression, and suicide and HIV risk in young adulthood.  Thus, to a greater extent than was previously understood, the critical work that must be done is with the family and the community to help educate them on interactions that will be supportive and affirming.  For more information on The Family Acceptance Project and Dr. Caitlin Ryan’s research, please visit:  http://familyproject.sfsu.edu/.

Recognizing that spirituality can be one of many important protective factors against suicidal ideation, Dr. Ryan has attuned her work and research into being culturally sensitive to the religious and spiritual milieu of LGBT individuals and their families.  Her work will soon generate the first evidence - based education materials for LDS families with LGBT children followed by an education program specifically targeted and customized to the needs of LGBT Mormons and their families.   It is expected that her materials for Mormon families of LGBT individuals will start to be released in July 2012.

Educating families and other crucial members of an LGBT individuals’ support system may be one of our most important challenges and opportunities as LDS mental health professionals.  Families, school officials, community and church leaders need to know what interactions are potentially harmful and what interactions are helpful with our loved ones, students, and neighbors.  Knowing this could be a matter of life and death.  Many LDS therapists have already changed course and become more affirming of orientation in their practice.  These pioneering Mormon therapists search for safe pathways through a homophobic wilderness and a polarizing political, cultural, and religious climate.  LGBT Mormons are particularly vulnerable.  On one hand they hear loud angry voices telling them to leave their “hate filled” religion, and on the other hand religious, cultural, and political extremists in the church continue to use the church to promote fear, long dispelled myths about being gay, and even hateful words and actions towards LGBT Mormons.  Dr. Ryan’s evidence – based, competent research and compassionate family intervention approach will only bolster those therapist’s conceptual models and effectiveness in helping their LGBT clients navigate these challenges as well as the essential component of educating family members how to become a safe and protective shield for their loved ones against these angry voices.

Now more than ever before, competent, fair-minded, LDS mental health professionals need to protect the emotional and mental health of our LGBT clients and educate families, community, and church officials in the LDS Community.  I am confident that as LDS therapists take these steps, not only will we be more competent and effective in helping individuals such as Paul and his family members, but we will also help save lives.

Kevin Kloosterman, LMFT is a mental health professional in Illinois who works in an outpatient mental health hospital setting and in private practice.  He has been a licensed marriage and family therapist for 12 years and is an advocate and ally for LGBT individuals in and out of the church.

7 comments:

Anonymous said...

Thank you Kevin for writing this.

Anonymous said...

There was one line in your article that I particularly cared for, "I believe we need to turn our backs on these models." This line was referring to models that we need to change our orientation. Won't it be nice when we get to the point, where, as a gay person, we can attend the Mormon church and not be expected to change our orientation, that we can choose good and live the gospel without the constant and nagging, "I'm not good enough for them" feeling. The things a gay person says in church would be just as important as a married man, that has 7 kids and holds a calling, both living the gospel. Won't that be nice! Thanks for a wonderful article.

Natasha Parker said...

Wonderfully written article. Thank you Kevin!

Anonymous said...

Kevin, you make some great points. I have worked with people with SSA for almost two decades. They are our brothers and sisters who deserve our compassion and respect. Because of my beliefs I am not a gay affirmative therapist as it sounds like you might be or are suggesting therapists should be. If a client wishes to do that I wish him the best of luck and point him/her in another direction or see if there are goals we can agree to work on. Still I have many clients who hope to change their sexual orientation. I am as upfront with them as I can be stating others have not been successful at that pursuit and some have. I tell them that even for those who have, the thoughts will probably never fully go away. For those who still want to pursue that goal I try and help them as best I can. I do however tell them that that should not be the main goal in therapy. As we work on increased self esteem, controlling addictions, better relationships, less hypersensitivity, better same sex relationships, better family relationships, etc; sometimes SSA thoughts diminish, but even if they don't they feel good about what they have accomplished.

Anonymous said...

Thank you for penning the opinions expressed in this article, Kevin. It is so re-assuring to know there are progressive Church members who espouse views other than conversion and re-orientation of LGBT members. I remember all to well the road I took when, as a gay, newly married man in my 30s, I tried to make things right in my life. My well-intentioned Bishop had told me the way to forgiveness for being gay and having had sexual relations with a man was to proceed with my marriage plans and to cease further relations with gay men at the risk of action against me by a Church disciplinary court. Months into the marriage, both my wife and I realized all was not right and we sought professional help to solve the sexual problems that I won't elaborate on here. At this point, I admitted to no one that I had a sexual attraction to men. I chose not to see the LDSSS professional in our Stake for fear of being told to pray and fast about the problem, which I had already been doing, or worse, be denounced to the Bishop. I spoke in confidence to 2 of the 3 professionals my wife and I consulted with (we moved across the continent shorly after meeting number 2) and was told straight out that getting married was a huge mistake for me. In desperation I sought the help of a hypnotist to see if he could not make me heterosexual. He said he could not and would not and added that there was nothing wrong with me. Conversion therapy, he noted, was outmoded and he said that referral to another psychiatrist was pointless. I needed to accept myself and get on with life. To make a very long story short, when the same-sex marriage debate raged in this country as the last decade drew to a close, I realized there was no place for me in the Church. I could no longer continue the artifice of a straight Church member who accepted the rhetoric and vitriol I was hearing from the pulpit, in our Bishopric meetings and in hate-mails I received from a league of anti-gay crusaders in the Church here. I also came out to my wife and we have stayed together throughout a very difficult period. We are now reasonably comfortable with our relationship, but disappointed that I made the decision I made to marry in an attempt to do what I thought was right. It made for terrible unhappiness, depression and a largley wasted life for my wife. For me, I lived many years under the weight of crushing guilt that was lifted off my shoulders when I finally accepted myself for who I am, and stopped trying to fool myself into believing I could be something else if I tried really hard. I hope these comments may be useful to those who struggle with same-sex attraction, or to anyone who is in a postion of trust in counselling them.

Randy Singleton said...

What the LGBT community needs now is the society's understanding and lessen the public's misconception towards them. We all deserve to be treated properly and justly since we are all dwelling in the same community the only difference is their sexual preferences.

Bryce Thomason said...

President Obama is firmly committed to the homosexual agenda and recent promises made to the LBGT and others have caused some in the conservative movement and the evangelical and Pentecostal churches to shudder. It is also clear that the church's concerns have little bearing on the President's position to throw the doors open for the "gay agenda by closing the steel doors around those who make so much as a whimper against the gays. Signing the untested and highly suspect Matthew Shepard act is the latest evidence of that.

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