Three gay Christians walk into a therapist’s waiting room.
It’s not the start of a joke but rather a serious conversation about whether particular counselling practices should be made illegal.
Reports in the media over the past 48 hours, combined with opinion and comment pieces from observers and those who claim to have been through such therapy, have put this subject back on the agenda again. But when people call for a ban on “conversion therapy”, what exactly is it that they want to prohibit and on what basis?
Let’s go back to our therapy centre. The first gay Christian sits down with the therapist and says, “I’m unhappy being gay – can you help me be straight?”
“Of course”, says the therapist as she opens the drawer of her desk and brings out a list of options. The menu of therapy is dazzling – it contains everything from strapping electrodes to genitals and administering shocks while viewing gay porn, full on exorcism sessions after a cleansing ritual, assertiveness and “manliness” courses, cognitive behavioural, gestalt, Jungian based and other such talking therapies. Right at the bottom is “Ignatian Retreat”.
Our therapee looks up bewildered. “You mean all these count as conversion therapy?” “Well yes, they’ve all at one point been referred to as conversion therapy, but they’re all very different therapeutic approaches. Some of them involve techniques that are used for other interventions very effectively”.
When people call for banning conversion therapy, what exactly are they asking? Is it a particular method that they want banned? Well if we look at our list we can see that some of the things are potentially illegal in and of themselves. Electrocuting someone for aversion therapy? That’s been abandoned by all psychiatrists and psychologists decades ago, though interestingly electro-convulsion therapy is still used to treat some forms of major depression.
Regardless, these kinds of clearly abusive techniques (one Liverpool church is alleged to have included rape as a method of curing lesbianism) are obviously wrong and are already dealt with by the law as it stands today.
What about different forms of talking therapy? Well I don’t think anybody is planning on banning approaches like cognitive behavioural therapy which is used by tens of thousands of people every week.
The argument is made that it’s not the therapeutic method itself that should be banned, but rather the goal of the therapy, in this case orientation change.
As one person said to me, “you can’t fix something that isn’t wrong”. The problem is that we need to ask whether we should in principle ban trying to “fix” all things that “aren’t wrong” and if not why is this particular thing, “homosexuality”, to be singled out?
After all, some women are dissatisfied with the size of their breasts and want to “fix” them by enlarging them, but if we are banning a talking conversion therapy on the basis that you shouldn’t try to fix things that aren’t wrong, we should also ban breast enlargements.
The response here is often that the difference between a breast enlargement and a talking conversion therapy is that trying to “cure” homosexuality is harmful. But the jury is actually still out on whether these forms of talking therapy cause any harm.
Is it harmful?
Most of the research in this area concentrates on collating people’s personal experiences recorded many years after the event and using these as evidence. So for example, someone might report to a researcher that going through a conversion therapy course made them feel depressed, but this is almost never followed up with a proper clinical examination of the person to see if they are depressed. Furthermore, often these anecdotes are historical, so impossible to verify. No assessment is made either as to whether the person telling the story was depressed before they started the therapy and whether the therapy actually made any change to that.
The reasons for banning “conversion therapy” are questionable
There has only been one good study in this area so far. Researchers Stanton Jones and Mark Yarhouse spent many years following two cohorts of “conversion therapy” course attendees, assessing all kinds of things about the participants before, during and after their therapy. One of the things that Jones and Yarhouse were particularly interested in was whether the course attendees were harmed by their participation, so they used some industry standard assessment tools to explore the mental health of the course members all the way through the process.
The surprising finding they discovered was that there was no evidence of participation in the course causing mental health issues, even several years afterwards and even among those who said the course hadn’t helped them at all. Jones and Yarhouse also found that there was no evidence of sexuality changing because of these courses, an observation that should be taken seriously.
So already we have a situation where the reasons for banning “conversion therapy” are questionable. First, no-one has adequately defined what it is they want to ban (what specific practices), when they instead concentrate on banning the goal of the therapy and not the specific practice there isn’t a good reason why this particular goal should be banned among other things that “don’t need to be fixed” and the last argument, it causes harm, cannot be supported by the research evidence.
Indeed the UK Royal College of Psychiatrists admit as such and now say that conversion therapy “may cause harm”, accepting that the anecdotal evidence most people rely on to make this claim is substantial enough to support it.
Your sexuality can change
The problems with this proposal don’t stop there however. As we return to our therapist we meet the second Gay Christian who sits down with the counsellor and says, “I’ve noticed over the past year that I’m suddenly finding women sexually attractive and I like it. Can you help me explore this and see where it could take me?” If we ban conversion therapy, would the counsellor be able to give an affirmative response?
The notion that some people’s sexuality changes is pretty well established in the research literature. The lesbian academic Lisa Diamond at the University of Utah is at the forefront of this research and has demonstrated in some large quantitative studies that the sexual practices of men and women who identify as exclusively gay / lesbian is actually quite flexible. Before her, researchers like Dickson demonstrated that many people in their teens, 20s and 30s can have sexuality identities and experiences that change drastically over time.
For example, Dickson found that in a cohort of lesbians in their early 20s, less than a decade later only a third were still identifying as exclusively attracted to women.
Many people in their teens, 20s and 30s can have sexuality identities and experiences that change drastically over time
So some people do see changes in their sexuality and they should be able to find therapeutic support in exploring that natural change. How would those who propose to ban “conversion therapy” distinguish between this group of people and others?
By essentially shutting down any discussion of sexuality change you would be endangering therapeutic support for a huge cohort of LGB people who aren’t advocates of “trying to change” but still find their sexual desires and identities altering over time.
Grappling with complexities
Now to our third client in the therapists’ waiting room. She lies herself down on the couch and says “I’m finding myself becoming more heterosexual and I don’t like it. How can I stop this happening?” What is the answer here? If it’s OK to help this lady explore how to rediscover her lesbianism, why would it be wrong to help someone explore their heterosexuality? If it’s not OK to help this lady, what is the place of gay affirmative psychotherapy in the wider counselling discussion? Why is it good to affirm one sexuality but not the other?
The point of these examples is not to make the case for conversion therapy (I don’t think much of a case can be made for it and there are definite spiritual and pastoral dangers in promising people that you can “change” their sexuality) but rather to raise the wider issues involved.
It’s one thing to say “let’s ban conversion therapy” but in reality those who do so are not clear at all on the specifics of how to achieve that, or even what they mean by conversion therapy. What’s also lacking in the debate is a deeper argument as to why this particular therapeutic goal should be banned but not others.
Questions we must ask
Those who support the Government's move should ask themselves the following:
- If conversion therapy should be banned because it doesn’t work, why don’t we ban astrology or homeopathy or alcoholics anonymous (which has a massive drop out and failure rate)?
- If it should be banned because it causes harm, what is the evidence for that (the UK RCP doesn’t think that evidence exists) and why aren’t we banning other things that are harmful (again, we can listen to the personal stories of those who claim they were harmed by normal talking therapy for things as different as grief or weight loss – why are these things not banned)?
- If it’s because “you shouldn’t fix things that aren’t wrong”, let’s ban cosmetic surgery and similar attempts to change things that aren’t actually a medical problem.
Three gay Christians walk into a therapist’s waiting room, and the right response to each of them shouldn’t be dictated by knee-jerk politics and social campaigners. If we want to ban certain forms of therapy we should make sure we have a coherent and well-argued reason for doing so and that we apply that reason consistently across the entire therapeutic space. Anything else looks like an attempt to make a political point rather than a apply a properly thought our mental health strategy.
The Revd Peter Ould is a Church of England priest, a consultant statistician and a Primary School Governor. He has been writing and broadcasting on issues of Christianity, sex and gender for almost two decades. He writes here in his personal capacity.
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