Tag Archives: reparative therapy

Fighting a losing battle

As I’ve said repeatedly since I began blogging, we’re in the midst of rapid-fire change when it comes to LGBTQ rights. Sometimes I read the news headlines, or scan my Facebook news feed, and I feel like Billy Joel’s singing a contemporary version of “We Didn’t Start the Fire.” (Pennsylvania, Oregon, trans exclusions all gone! Football, RuPaul, Hedwig’s angry inch. Not bad, huh?) This week, three of those events caught my attention:

  • Last weekend, the Texas Republican Party adopted a party platform for 2014 that includes support of reparative therapy, a psychological approach that claims, despite being heavily discredited, to be able to change a person’s sexual orientation from gay to straight.
  • This past week, the Wall Street journal ran an opinion piece written by Dr. Paul McHugh, former chief psychiatrist at Johns Hopkins Medical Center. This piece was likely written in response to the Obama administration’s decision to reverse a 1981 policy that excluded gender reassignment surgery from coverage under Medicare. McHugh, in contrast, believes strongly that being transgender is “a mental disorder that deserves understanding, treatment and prevention.”  (A New York Times editorial, which ran a few days earlier, provided a much more pro-transgender perspective on this issue).
  • And last Thursday, former Secretary of State Hillary Clinton was interviewed by Terry Gross on Fresh Air. In that interview, when asked about her decision to include transgender rights along with lesbian, gay, and bisexual concerns, she said, “LBGT includes the “T,” and I wanted to stand up for the entire community. I don’t believe that people who are the L, the G, the B, or the T should be persecuted, assaulted, imprisoned, even killed for who they are.” (Full disclosure: She then, in a heated exchange with Gross, embarked on a clunky defense of her initial opposition to same-sex marriage.)

So hold on a minute. The Texas Republican party is supporting reparative therapy, even though a lot of highly respected professional organizations have issued public statements about how dangerous it is? A major news publication is running a piece declaring that transgender people are, by definition, mentally ill – even though the DSM-5 doesn’t include “transgender” as a mental disorder? Except for Hillary Clinton’s breath of fresh air (pun absolutely intended), these news articles seem like they could have been written 30 years ago.

Except they weren’t. This is happening today, in 2014. After the Supreme Court has overturned DOMA, and so many states have legalized same-sex marriage. After two states have banned reparative therapy for minors. After we’ve been closer than ever to passing an inclusive version of the Employment Non-Discrimination Act (ENDA). Of course, lots of people have continued to believe that being gay, or lesbian, or bisexual, or transgender, or in any way gender nonconforming, is sinful, wrong, or sick, and that granting rights to LGBTQ people merely enables our “condition.” But coming out publicly, on large political and media stages, and stating these views is rising to new levels. It’s almost like the anti-LGBTQ rights folks are saying, This shit’s gotta stop. Time to end this nonsense. 

Some might say that this is a perfect example of a backlash – a powerful, almost violent, reaction against progressive change. Back in 1991, Susan Faludi wrote a bestselling book titled Backlash: The Undeclared War on American Women, in which she discusses the conservatism of the 1980s as a reactive response against the gains of various social movements of the 1960s and 1970s. But I’m not sure “backlash” is the most accurate term. It’s more like a last, desperate gasp for air. These folks see that “one-man-one-woman” marriage statutes are tumbling down like dominoes. They see that ENDA now has bipartisan support in Congress. They see transgender rights gaining serious traction. And then they see Laverne Cox on the cover of Time magazine (oh, HELL no!), and seeing how close they are to the tug-of-war pit, they gather up every last bit of strength and start yanking on that rope as hard as they can.

What makes people dig their heels in so deeply, even though they know they’re fighting a losing battle? Why doesn’t someone like Paul McHugh budge – even just a little – on his beliefs, even when they conflict with the scientific consensus? Why does some factions of the Republican Party swing further to the right, even though they’re losing constituency groups? They’re on a sinking ship – why don’t they jump off?

I’ve scoured the psychological literature, in search of an answer to this question. And unfortunately, it hasn’t offered much. Some researchers point to personality characteristics, like the “authoritarian personality” – what psychologist Theodor Adorno thought reflected the “potentially fascistic individual.” From this standpoint, certain types of people are just more likely than others to dig in their heels and stay there. Other researchers view this stubbornness as a variation of the fight-or-flight response, a reaction to a perceived imminent threat. What that threat is certainly is up for debate; it could be a threat to one’s status and power, or it could be a more intrapsychic threat – a threat to one’s masculinity, for example, or a threat to one’s heterosexuality. Perhaps it’s a form of aggrieved entitlement, a variation of fight-or-flight and a concept I’ve written about in past blog posts – a feeling that one’s identity, status, and culture is being taken away from them, and a need to stand one’s ground against those changes.

Maybe it’s all of these. Or perhaps it’s none of these. Either way, research isn’t offering me great answers. At least, nothing that’s making me feel better.

When I’m surrounded by disturbing, uncomfortable, or distressing behavior, I tend to seek solace in the intellectual. If I can explain it, my reasoning goes, then perhaps I can have some control over it – and understanding is a form of control. Freud called this “intellectualization,” or “flight into reason.” (Freudian scholars, just to be clear, don’t see this as a particularly healthy form of coping.) To be honest, I’m distressed by the GOP’s party-line endorsement of reparative therapy. I’m distressed by Paul McHugh’s pathologizing statements about transgender people and surgery. And here I am, trying to explain their behavior, partly in an attempt to educate, but mostly in an attempt to just feel better. Because having large groups of people hating on you and wanting to fix you just feels yucky.

How did the song go? Rock and roller cola wars, I can’t take it anymore! The Cola Wars may be over (or perhaps, in light of the New York City soda ban, we’re in a new Cola War), but I can absolutely relate to feeling overwhelmed by political attacks. Especially when those attacks my identity, and my family, and my community. Often, intellectualizing pulls me through. Direct action works wonders too. But sometimes, as odd as it sounds, giving myself the space to just feel yucky helps move me forward. Because really, the only way out of the yuckiness is through it. If I’m fighting a losing battle with my feelings, I’m being just as stubborn as the people that are causing me distress.

 

 

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Filed under activism, gender nonconformity, homophobia, human rights, mental health, psychological research, reparative therapy, same-sex marriage, transphobia

There oughta be a law . . .

A few weeks ago, in “Silence = Death,” I addressed Robert Spitzer’s retraction of his famous 2003 “ex-gay” study. Since then, Spitzer has issued a more formal retraction that was published in the New York Times, and he was interviewed by Neal Conan on NPR’s “Talk of the Nation” a few days ago. And while all of this has been going on, the California legislature has been debating SB 1172, a bill introduced back in February by Senator Ted Lieu (D-28th District). Essentially, three stipulations are made in this bill:

  1. It mandates that, prior to initiating any form of sexual orientation change efforts (SOCE), informed consent must be obtained from the patient. “Informed consent” means that the patient must be able to demonstrate an understanding of the risks and benefits before agreeing to any therapeutic intervention.
  2. It clarifies the fact that minors are unable to provide informed consent for SOCE. Because of this, the use of SOCE with minors is prohibited, regardless of the desire of the minor’s parents for such therapy.
  3.  If these provisions are violated in any way, affected patients have the right to sue for damages.

The rationale for SB 1172 rests heavily on the 2009 Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation, a 138-page review of research on SOCE. Shortly after this report was published, the American Psychological Association passed a resolution opposing any type of conversion therapy for homosexuality. The American Psychiatric Association, the American Academy of Pediatrics, the American Medical Association’s Council on Scientific Affairs, the National Association of Social Workers, and the American Counseling Association have also issued statements opposing efforts to change the sexual orientation of any individual.

However, not all professional organizations are unilaterally supporting this bill. The American Association for Marriage and Family Therapy, the California Association for Licensed Professional Clinical Counselors, the California Association of Marriage and Family Therapists, the California Psychiatric Association, and the California Psychological Association have all taken an “oppose unless amended” position, and are supportive of the intent of the bill. In some cases, the requested amendments involve taking a stronger stance against SOCE – the concerns of The American Association for Marriage and Family Therapy, for example, involve the ethical conflict posed by offering a harmful and ineffective form of treatment to an individual under any circumstances, even if the patient is requesting it and is aware of the potential risks. Other organizations have called for a clearer definition of “sexual orientation change efforts” so that the law isn’t inappropriately applied to sex offender treatment. In my opinion, these are important clarifications to make, and I’m grateful that these organizations are carefully considering the legal and ethical implications of this bill.

One of the more challenging concerns, however, involves a minor’s right to consent. Per SB 543, enacted in 2009, a minor who is 12 years of age or older may consent to mental health treatment or counseling services if, in the opinion of the attending professional person, the minor is mature enough to participate intelligently in the mental health treatment or counseling services. SB 1172 would create an exception to SB 543, and that is an issue that, from the perspective of these professional organizations, is a very important consideration.

Is it just me, or does this “parental consent” issue sound at all like the abortion argument to you? In fact, some of the most powerful arguments supporting SOCE sound eerily similar to the pro-choice “right to choose” rationale. Christopher Rosik, president of the National Association for Research and Therapy of Homosexuality (which, by the way, is the largest supporter of reparative therapy in the United States) issued the following argument against a potential ban against SOCE:

“[T]he majority of parents who bring their children to therapists for SOCE are conservatively religious. SB 1172 sponsors assume that with SOCE prohibited among licensed mental-health professionals, these parents would then bring their children to clinicians who would only provide care aimed at encouraging their children to embrace GLB identity and behavior. I think the more likely scenario is that these parents, many of whom are already suspicious of the mental health professions, will simply pursue SOCE for their children with unlicensed, unregulated, and unaccountable religious counselors that do not fall under the jurisdiction of this bill” (emphasis mine).

In effect, Rosik is saying that parents have the right to seek safe SOCE for their children, and that they will resort to “back-alley” SOCE if safe SOCE by a trained professional is unavailable. In fact, NARTH’s mission statement is firmly anchored in the “right to choose” argument:

We respect the right of all individuals to choose their own destiny (emphasis mine). NARTH is a professional, scientific organization that offers hope to those who struggle with unwanted homosexuality. As an organization, we disseminate educational information, conduct and collect scientific research, promote effective therapeutic treatment, and provide referrals to those who seek our assistance.

“NARTH upholds the rights of individuals with unwanted homosexual attraction to receive effective psychological care and the right of professionals to offer that care. We welcome the participation of all individuals who will join us in the pursuit of these goals.”

How sad it is that we need to consider passing a law in order to uphold the Hippocratic Oath (“First, do no harm”). and Principle A of the APA Ethical Principles of Psychologists and Code of Conduct (“beneficence and nonmaleficence”). And how sad it is that organizations like NARTH still cling to the idea, even in the face of substantial contradictory evidence, that homosexuality is a mental disorder that can be successfully treated. Barry Goldwater may have said, “You can’t legislate morality,” but sometimes passing a law is the only way to enforce moral behaviors.

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Filed under homophobia, human rights, LGBTQ, LGBTQ youth, mental health, psychological research, reparative therapy, Uncategorized

Is “neutrality” really neutral?

Yesterday, in a New York Times article titled, “In Suburb, Battle Goes Public on Bullying of Gay Students,” Erik Eckholm reports that, in the Anoka-Hennepin School District in Minnesota, eight student suicides have taken place within the last two years. Four of those students who committed suicide had been struggling with their sexual identity. While suicide rates among LGBTQ youth have always been high (studies cite between a 30-42% suicide rate among gay kids), the fact that so many suicides have occurred within such a short period of time is disturbing. What’s particularly important to note is that the Anoka-Hennepin school district lies within Michelle Bachmann’s Congressional district. And therein lies the backdrop to the suicide contagion we’re seeing within this school district.

Michelle Bachmann and her husband, Marcus Bachmann, run a Christian counseling center that has been accused of providing “conversion therapy” to clients. While those allegations haven’t been clearly substantiated, Michelle Bachmann’s attitudes towards homosexuality leak out in her words. For example, in 2004 Bachmann was quoted as saying, “We need to have profound compassion for people who are dealing with the very real issue of sexual dysfunction in their life and sexual identity disorders” (emphasis mine). That homosexuality-as-pathology belief system has infiltrated the public school system, contributing to a heated debate resulting in a “gag order” on any discussion involving sexual orientation. More specifically, the Anoka-Hennepin school district has adopted a policy of “neutrality” regarding sexual orientation, stipulating that sexual orientation should not be taught in the schools in any way, and that school personnel shall remain neutral on issues involving sexual diversity. Although this seems on the surface to be the best “agree-t0-disagree” solution, I think it’s important to question whether a “neutrality” stance is truly neutral.

Anti-gay bullying is not a new phenomenon. High schools have been something of a battleground for gay teens (or teens who are perceived to be gay, regardless of their true sexual orientation). Teens repeatedly say things like, “That’s so gay!” They bully gay kids by using anti-gay epithets against them. LGBT teens get verbally harassed and physically assaulted, and they are routinely subjected to intimidation tactics. According to one study, 80% of gay youth are subjected to verbal harassment, 45% are threatened with physical violence, and 20% are physically assaulted. And sadly, many of these incidents – particularly those incidents involving anti-gay comments and name-calling, and incidents involving intimidation – result in no intervention whatsoever by school personnel. It’s not just the Anoka-Hennepin School District that practices a code of silence around LGBT bullying – it’s almost every school district in the country. And yet, when we stay silent about bullying, discrimination, and oppression, we are ultimately engaging in complicity. Sadly, the LGBT students end up being collateral damage.

What the “neutrality” policy does, in essence, is that it contributes to a hostile campus climate. It also straitjackets teachers who want to intervene on behalf of LGBT students. And it shuts down any potential for conversation.

I’m reminded of a distinction made by Gregory Herek, professor of psychology at UC Davis, who has conducted scores of research studies on sexual prejudice. In his arguments in support of overturning the U.S. military’s “don’t ask, don’t tell” policy, Herek underscores the difference between social cohesion and task cohesion. Social cohesion involves liking each other and forming close personal and emotional bonds. Task cohesion, on the other hand, refers to the shared commitment among group members to work towards a common goal. It seems to me that public schools need to step up to the plate and engage in task cohesion regarding ensuring the personal safety and respect of all students. And ensuring that personal safety requires that school personnel be able to exercise the right to intervene when an anti-gay bullying incident is occuring (or, for that matter, any bullying incident). A policy of neutrality does nothing to achieve that goal.

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Filed under anti-gay bullying, gay suicides, hate crimes, homophobia, LGBTQ youth, reparative therapy, Uncategorized