In 1997 the American Psychological Association passed a resolution reaffirming that “homosexuality is not a mental disorder” and raising ethical concerns about attempts to change sexual orientation via psychotherapy (known as reparative or conversion therapy). Unfortunately, that was not the end of this questionable practice. Results of a survey conducted in London and published this year suggest that some therapists still see anything other than heterosexuality as pathological. Some therapists reported therapeutic goals of changing clients’ sexual orientation or helping to “curb homosexual feelings’. It is truly disheartening that any clinicians could see these as reasonable therapeutic goals, despite evidence that this approach is ineffective at best or extremely damaging at worst. For an in depth look at the subject, see Sexual conversion therapy: ethical, clinical, and research perspectives by Drescher, Shidlo and Schroeder.
As a rationale for trying to change sexual orientation, perhaps some therapists might argue that they would meet the client where he/she is at. What is an ethical therapist to do if a client presents with the goal of changing their own sexual orientation? Or with distress related to a lesbian or gay orientation?
As a trauma therapist I understand the individual within the context of multiple levels of oppression (and privilege). Many institutions and individuals within our culture continue to hold anti-gay biases such that growing up gay often is a stigmatized and traumatic experience, even if more along the lines of a small t versus a big T trauma.
Although this study was conducted in the UK, sadly the situation is no different in the United States. You would have to be completely media unplugged this past year to be unaware of the Proposition 8 activity and the extent of anti-gay biases still existing. Not surprisingly, around this same time the incidence of anti-gay hate crimes rose significantly.
In what felt like a poignant juxtaposition to me, I watched the movie Milk not long after the passage of Prop 8. Particularly heart wrenching to me as a psychologist with a career focus on trauma and the LGBT community were the depictions of gay youth feeling suicidal as a result of society’s messages that they must be sick, sinners, unworthy of love. I reflected upon how much, and sadly how little, has changed since the days of Harvey Milk. Suicide in LGBT communities continues to be a significant issue today.
My job is not just to meet a client where they are, but as a psychologist well versed in an anti-oppression model, to help individuals understand how cultural and institutional oppression impacts their sense of self and well being. Is the problem that someone is gay, lesbian, bisexual or that we still live in a world that discriminates against minority identity groups, sexual orientation being only one example. When considered this way it becomes clearer that our homophobic culture and ideas are what is in need of change.
thanks to Gareth for bringing this survey to my attention.