Ikke bevis for at konverteringsterapi er skadelig

Foto: Toa Heftiba fra Unsplash
Foto: Toa Heftiba fra Unsplash

Til tross for høyere eksponering for faktorer som forutsier atferdsskade – minoritetsstress, motgang i barndommen og svakere sosioøkonomisk bakgrunn – led ikke seksuelle minoritetspersoner som hadde gjennomgått mislykket konverteringsterapi større psykologisk eller sosial skade. Begrunnelsen om å begrense eller forby konverteringsterapi på grunn av økt skade er ubegrunnet. Det viktigste argumentet for å forby konverteringsterapi, synes derfor ikke å holde vann.

Les det interessante intervjuet Ian Paul hadde med dr. Paul Sullins, seniorforsker ved Ruth Institute og forskningsprofessor i sosiologi ved det katolske universitetet i Amerika.

The UK Government has been holding a consultation on the possibility of making illegal ‘conversion therapy’, a provocative term for what is more widely known (in the literature) as SOCE (sexual orientation change efforts), which ends tonight (4th February 2022). Because the term is poorly defined, and explicitly includes ‘talking therapies’ which could include pastoral conversation, several thousand Christian ministers from across churches and traditions have signed a letter to the Home Secretary which you can read here.

There have also been serious questions raised about the methodology involved in framing the questions in the consultation itself, for example issues around the definition of terms, the language used, and the research based, posed by Dr Vincent Harinam of the Cambridge Centre for Evidence-based Policing.

I was therefore very interested when I came across this new research evidence, published two days ago, on the overall harm of SOCE amongst those for whom it has not had the desired effect. The paper concluded:

Despite higher exposure to factors predicting behavioral harm—minority stress, childhood adversity, and lower socioeconomic background—sexual minority persons who had undergone failed SOCE therapy did not suffer higher psychological or social harm. Concerns to restrict or ban SOCE due to elevated harm are unfounded. Further study is needed to clarify the reasons for the absence of harm from SOCE.

Since this appears to be such a sharp contrast to anecdotal accounts of stress and harm from SOCE, I was grateful to be able to ask the author, Dr Paul Sullins, about his research.

IP: What is your background in this area? Why do you have an interest in the question of ’sexual orientation change efforts’ (SOCE), sometimes described as ‘conversion therapy’?

PS: I am a retired professor of sociology from the Catholic University of America.  In my active academic career I studied the intersection of gender and religion, publishing studies on such things as women clergy career paths (“The Stained Glass Ceiling”, 2000) and why women are considered more religious than men (“Gender and Religion” 2006).  In 2015 I retired early to devote myself to addressing issues of sexuality and gender that are entwined with Christian faith and witness today, such as child well-being with same-sex  parents, the effects of divorce on children and of abortion on women, the link between homosexual clergy and child sex abuse in Catholic settings, and whether homosexuality is a fixed innate condition.  The debate over “conversion therapy” goes directly to this last issue.  If someone can change their sexual orientation, and do so intentionally with therapeutic help, then it cannot be a fixed innate condition for that person, and perhaps persons are more free to reject being homosexual than is currently believed in mainstream culture.

IP: How did you undertake this particular piece of research? What was striking about its findings—and how does it differ from previous research? Is there an explanation for these differences?

PS: The premise of almost all research on SOCE therapy outcomes is that homosexual orientation cannot really be changed, so that an attempt to do so results only in self-deception and serious psychological harm.  We hear many stories of LGBT persons about having become suicidal after undergoing SOCE, which pretty accurately reflects the prevailing research evidence, almost all anecdotal or qualitative reports based on small samples.

IP: The article has been published in a peer-reviewed online journal. Why is this important in the current context?

PS: Peer review provides some level of assurance that a study meets minimum standards for quality and objectivity.  It will encourage those skeptical of the study to pay more attention to it.  However, in research on same-sex issues peer review has become highly politicized, with the result that many weak studies are prominently published while strong studies that challenge the prevailing narrative are rejected out of hand for spurious reasons.

On surveys, a majority of secular social scientists say they would consider rejecting a study that they disagreed with, even if it had strong evidence behind it.  Social scientist Jonathan Haidt has written a couple of books about the problem of trenchant confirmation bias throughout the social sciences, which often vitiates the value of peer review today. Some have already predicted that LGBT advocates will call for this study to be retracted.  We will see. 

IP: Here in the UK, we read frequent reports of examples of ‘conversion therapy’ which those involved subsequently regret and, with hindsight, feel were harmful or abusive. How do these examples relate to your overall findings?

PS: Those frequent reports are highly biased and do not present an accurate picture.  This is obvious in two ways.  First, all or almost all the persons we hear expressing regretful hindsight are currently LGBT, which means that (by definition) the SOCE was not successful in their case.  This is like evaluating marriage counseling by getting reports only from couples who subsequently divorced.  Could it be that persons who went through SOCE more successfully, and now identify themselves as heterosexual or ex-gay, might have had a more positive experience?  The LGBT fundamentalists, abetted by media who screen out and cancel such stories, want us to believe such persons don’t exist, but several books of their stories have now been published.  Two academic studies of successful SOCE alumni have come out in the past year, both reporting net positive psychological effects (Sullins and Rosik 2021, “Efficacy and Risk of SOCE“; Pela and Sutton 2021, “Sexual Attraction Fluidity and Well-being in Men“).  British population data tell us that more people have left same-sex partnerings to take up heterosexual partnerships than have remained with that behavior (the linked article reports (p. 1784) that while 8% of currently sexually active British men have ever had a same-sex partner, only 2.6% have done so in the past five years.  The corresponding figures for women (p. 1786) are 11.5% lifetime, 3.2% past five years).  But have you ever heard even one popular media story of a happy ex-gay who is thankful for his SOCE experience? We are only getting one side.

The other indication of bias is the infrequency of accounts, and the complete absence of any negative accounts, of outcomes following gay-affirming therapy.  We know that affirming same-sex attraction or gay identity has negative results for some people.  Ex-gays often report that this was true for them.  In my recent findings, almost a third of LGB persons, four times more than underwent SOCE, reported that they had tried to stop being attracted to persons of the same sex.  A study by pro-gay scholars last Spring reported that suicide attempts were 45% higher among LGB persons who came of age in the early 2000s, when society was more affirming of homosexuality, than they were among those who came of age in the 1960s, when intolerance was much higher. This bias is absolute in the scholarly literature; while there have been dozens of studies of outcomes following SOCE, I do not know of a single study of outcomes following gay-affirming therapy.  In the data I examined, which came from the Williams Institute, a large pro-gay advocacy and research institute, they did not even ask about it.

Every therapy strategy has successes and failures, and you can always find someone to praise or blame it.  The importance of my recent findings is that they look at a random sample of the relevant population, to compare the rate of benefit and harm for LGB persons who have undergone SOCE and those who haven’t, and finds that, on balance, the two groups are statistically identical for multiple measures of current behavioral harm, including suicidal morbidity, self-harm (cutting), and substance abuse. The probability of harm is not increased by having undergone SOCE.

This finding is notable because the SOCE participants experienced higher minority stress, negative childhood conditions and lower socioeconomic status, all of which predict higher harm or lower well-being, yet following SOCE their level of harm was no higher than their peers who had not experienced these conditions.  This suggests that undergoing SOCE may alleviate or protect against harm from other causes.

This conclusion contradicts a large number of studies that report substantial harm following SOCE, particularly increased suicidal behavior.  Only four such studies used a representative (random) sample, however, and all four failed to distinguish suicidal behavior before SOCE from that following it.  I found that suicidal behavior is much higher before SOCE (perhaps prompting the recourse to therapy) but not afterward.  In fact, suicide attempts are significantly reduced following SOCE—the opposite of what is widely claimed.

IP: What can churches and those involved in ministry learn from both your research and the examples we hear about?

PS: I think the most important result of my research for ministry is that it confirms that what the Bible teaches about homosexuality is true.  Isolation, struggle, the importance of men and women for each other and for their children, the power of the truth of the body and consequences for rejecting it, all are highlighted both in scripture and in the empirical data.  We are bombarded with so much propaganda to accept homosexuality as normal, even benevolent, for persons who experience it.  In many settings there are calls for the Biblical understanding to be “updated” with a supposedly softer approach to homosexuality that does not see it as sinful.  My research confirms the idea that this is actually more harmful to homosexual persons, whether struggling or not, than the Bible’s account of sin, grace and redemption.  If I don’t think my sin is really sin, then I am stuck in it forever, but when I learn the truth, even hard truth, I can be set free.  I recently saw a sign at a church that says it well on this point: “Don’t change the message; let the message change you.”

IP: You might be aware that the UK Government is currently undertaking a consultation on outlawing ‘conversion therapy’—and other countries have already enacted such laws. Does your research have any bearing on these proposals?

PS: Certainly.  To the extent that a ban is motivated by avoiding harm it is unnecessary, if my findings are correct.  In fact, such a ban may do more harm than good.  For at least two of the four other representative sample studies in this area, the failure to account for pre-existing distress is not inadvertent, but intentional, by scholars who maintain that even prior distress invalidates SOCE.  This backwards logic may bring about the very harm such scholars and advocates say they want to prevent. I argue: “It would be a perverse policy indeed, for example, for heart surgery to be discouraged or even banned because those undergoing it experienced higher rates of cardiac dysfunction than the general population before the surgery.” And conclude: “Concerns to restrict or ban SOCE due to elevated harm are unfounded.”

IP: What further areas of research do you think are needed here? What further research are you planning?

PS: The politicized debate over SOCE has distracted research and policy from the startling fact that the suicide rate for LGB persons is over five times that of the general population, and is growing.  Almost a third (30%) of under-30 LGB persons have attempted suicide, compared to under 5% of all youth.  Meyer (2021) calls that fact “alarming”, and calls for further research on why LGB persons are prone to suicide.  I agree.  I think part of the problem, though, is Meyer’s minority stress theory, the idea that negative outcomes for LGB persons are due largely or wholly to societal stigma, which forestalls research into the real reasons, or more likely causes, that LGB persons are prone to suicide.  If you have already decided that LGB persons’ problems are due entirely to their social environment, you end up not exploring things that they could do to better their own health and wellbeing.  I am currently working on this question, as well as an examination of population trends in sexual orientation change.



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