Reparative Therapies
In this chapter, I focus on the movement to establish the contexts and details that are essential for understanding the ex-gay movement as a subculture of compassion within antigay Christian conservatism. Even as the more explicitly political segments of the Christian right have become more sophisticated in the construction and execution of punitive projects intended to stigmatize queer people and deprive them of equal rights, the ex-gay movement has developed and refined its compassionate approach to same-sex identity. Analyzing that approach requires understanding a number of facets of the movement: the relationship of the movement to antigay âscience,â the psychological infrastructure that justifies the extension of compassion, the ideological value of ex-gay testimonies, and the terms of the foundational ideology that inspires same-sex-attracted people to cooperate in the denigration of their sexual desire and intimate relations.
Because the American ex-gay movement is overwhelmingly Christian-identified, researchers legitimately can approach the movement as a religious social and cultural project. However, unlike postabortion ministries, the ex-gay movement boasts a significant arena of secular, scientific experts and expertise. These experts are dedicated to certifying same-sex sexuality as objectively abnormal and, in many cases, to transforming same-sex attracted people into functioning heterosexuals. Derived as it is from psychoanalysis, most of this secular ex-gay discourse is therapeutic, and some, which focuses on children's developmental dynamics, is prophylactic; thus, it expresses an ingroup therapeutic concern, not only with treating homosexuality but with preventing it in minors. On the other hand, no doubt because of the censure and criticism to which its practitioners have been subjected, some of this discourse also expresses outrage at the social and cultural damage these experts believe is committed by queers who assert their nonnormative sexuality and refuse to acknowledge the normality and superiority of heterosexuality.
By beginning this discussion of the ex-gay movement with these experts I do not mean to amplify their role in the movement or to dissociate them and the secular, scientific discourse they have created from the largely Christian ex-gay movement as a whole. To the contrary, I begin by demonstrating overlap and coordination between âsecularâ and Christian spheres of the movement that calls into question the claims of those on the ostensibly scientific side of the movement to intellectual independence and an objective basis for their antigay efforts. Compassion is a feature of both these arenas of the movement as experts, therapists, pastors, family members, and self-identified ex-gays minister to those members of their community with unwanted same-sex attractions. But given the substantial overlap and interpenetration of scientific expertise with Christian beliefs about sexuality, it is accurate to understand and analyze the compassion of the ex-gay movement as Christian compassion.
The stigmatizing of same-sex sexuality by the American mental health establishment and its treatment through reparative therapies dates to the early twentieth century in the United States1 A turning point in the politics of same-sex sexuality and its treatment came in 1973 when the governing board of the American Psychiatric Association voted to overturn the classification of homosexuality as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The decision was controversial, and was challenged by some members, but it was ratified a year later by a vote of the Association.2 Dissenters from this decision and other pro-gay statements by professional organizations such as the American Psychiatric Association and the National Association of Social Workers protested the decision by continuing to carry out âreparativeâ or âconversion therapiesâ with homosexual clients and by forming an alternative organization of mental health practitioners: the National Association for Research and Therapy of Homosexuality (NARTH).3
Reparative therapies are one form of treatment in the ex-gay movement's ensemble of interventions. Reparative therapists aspire to treat people who are unhappy with their same-sex desires, to reroute their sexual desires, and to turn them into functioning heterosexuals. A broad category, reparative therapies have enveloped a range of treatments from aversion therapies to a variety of outpatient and inpatient psychotherapies. And the therapies continue to be contested. The American Psychological Association has recently promulgated its most critical report to date on the practice and therapies designed to change sexual orientation from same-sex to opposite sex.4 Responding to criticisms of the therapies by major mental health associations, in 2012 the California legislature passed a law banning the use of reparative therapies with minors. The law has been challenged by NARTH, the American Association of Christian Counselors, and the Pacific Justice Institute.
Today, NARTH is the major international secular institutional center and clearinghouse for reparative therapies. NARTH is widely understood to be a secular organization whose objections to same-sex sexuality are scientific rather than religious, but this identity belies the deep links and cooperation that prevail between the conservative Christian ex-gay movement and NARTH and its affiliated mental health practitioners. These points of contact fall into four categories: fundamental beliefs that cannot be established scientifically, the transfer of ideas from psychological researchers to the religious community, shared personnel, and the ideological perspectives that NARTH and the Christian right share.
Jack Drescher, a psychologist who has written extensively on antigay interventions in the mental health professions, notes that as the gap between antigay, âreparative,â psychological theory and the mainstream mental health profession has deepened, the organizations that represent these views behave more and more like âfundamentalist religious denomination[s].â5 What Drescher refers to is the commitment of reparative therapies proponents to beliefs that cannot be sustained merely by scientific evidence. So, for example, central to reparative therapies, and to the broader ex-gay movement, are beliefs about the necessity and naturalness of binary and complementary gender roles.6 Indeed, the movement is committed to supporting, elaborating, and even self-consciously staging gender role differentiation, a project that is evident in publications, ministries, and even the banter in which ex-gay aspirants engage in venues such as the annual meeting of Exodus International, the world's largest ex-gay ministry.7
Just as evident in a movement that advertises itself as âoffering help to those who struggle with unwanted homosexualityâ8 are the visceral denunciations of those who transgress normative heterosexuality. The reader can judge the prose style of this scientific writing from, for example, an essay on studies of lesbian parenting by Gerard J. M. van den Aardweg, a member of the NARTH Scientific Advisory Committee: âOf course, all damage by gay parenting will be blamed on malignant homophobia and not on the blind selfishness of ⌠lesbian mothers, who may imagine they love their children, but, in fact, do them serious injustice. They sacrifice their children, who are so vulnerable because they naturally love their mothers, on the altar of their âholy homophilia.â If this is not psychological violence, child abuse, what is?â9 Adherence toâor, for that matter, defiance ofâcreeds such as gender role complementarity and the essential depravity of homosexuals is more often associated with political activism than it is with science, and this adherence allies the researchers of NARTH with the Christian right and traditionalist believers.
In addition to fundamental beliefs that resist scientific proof in both movements, there are other connections between the âsecularâ proponents of reparative therapies and traditionalist religion. Second is the transfer of ideas, in which the Christian ex-gay movement relies on psychologists and psychoanalysts in the ranks of the antigay mental health community for its own theories about how same-sex attraction develops. This intellectual transfer has given the ex-gay movement a reliable source of ostensibly scientific ideas and arguments. These constitute a domain of âsuppressedâ âstigmatized knowledgeâ that conflicts with dominant academic and therapeutic knowledge.10 One example of such an expert is Joseph Nicolosi, a founder of NARTH, a psychologist by training and practice, and one of the principal successors of early antigay psychoanalysts. His writings provide key arguments about how particular gender and family dynamics cause homosexual desire, how it is that all people are heterosexual by nature, and why, although all of the major psychological professional associations disagree with the conclusion, homosexuality is an illness. But these ideas did not originate with Nicolosi. After Freud's ambivalent theorizing of same-sex sexuality, which was progressive for his time, a number of psychoanalysts took up the issue in a decidedly negative way. Among those who began in the 1960s to establish the key tenets of antigay psychodynamic theory that Nicolosi now disseminates were Sandor Rado, Lionel Ovesey, Irving Bieber, and Charles Socarides, another founder of NARTH.
Christian conservatives consistently have borrowed the arguments of these figures for over forty years. Major texts of the ex-gay movement demonstrate that as the antigay psychodynamic psychologies of same-sex attraction have changed in subtle ways, the conservative Christian ex-gay literature has changed to reflect the new psychological explanations. Anti-gay clinicians have produced a narrative of development that the Christian ex-gay movement relies on in its counseling of repentant homosexuals as well as in its literature on Christian parenting and childhood. The major themes of the narrative of development were well developed in midcentury psychoanalytic works. In the 1970s and 1980s antigay psychoanalytic and psychotherapeutic ideas were absorbed into a literature that mixed Christian moralizing and political attunement with developmental psychological theory.11 By the 1990s, such works almost uniformly offered critiques of mainstream scientific studies on the possible biological origins and immutability of same-sex sexual orientation.12
A third connection between the âsecularâ work of NARTH and its psychodynamic researchers and the antigay work of the Christian right involves the extensive elite personnel intersections between the two groups. Joseph Nicolosi was a frequent expert contributor at Focus on the Family's Love Won Out ex-gay conferences, where he spoke both as a psychologist and as a traditional (in his case, Catholic) believer. Child psychologist and Focus on the Family founder, James Dobson, provided a blurb for Nicolosi's book, A Parents' Guide to Preventing Homosexuality, and routinely recommended it to parents concerned with the nonnormative gender behavior of a child. Jeffrey Satinover, one of NARTH's prominent psychiatrists and a member of its Scientific Advisory Committee, once served as medical advisor for Focus on the Family. The website of NARTH's Janelle Hallman notes that âher passion is to share God's word in a way that speaks to some of the deepest needs of broken and hurting people. She has spoken for Focus on the Family, Exodus International, and other Christian organizations.â13
Finally, viewing NARTH as a text clarifies the deep connectionsâindeed, coconstructionâof the ostensibly secular and religious arms of the antigay movement. I surveyed the NARTH website as I began to write this chapter, and the NARTH homepage for September 12, 2006, included the following headlines: âUK Christian Faces Court for Handing Out Bible Verse Leaflets at Gay Rally,â âExodus [International] Releases First Book: A Guide to Help Evangelicals Reach the Gay Community,â and âChristian Psychologist Suspended by Police over Former Affiliation with Pro-Family Group.â Other headlines directed readers to such sources as Christian-NewsWire, LifeSite (âYour Life, Family, and Culture Outpostâ), and Focus on the Family's Newsletter, CitizenLink, for articles whose themes were Christian conservative, rather than scientific. In August 2011, NARTH featured a news item, âPresidential Politics Places NARTH Issues on Front Page!â that focused on the presidential candidacy of Republican Michele Bachmann. As the title suggests, the article highlights NARTH's framing of same-sex sexuality, but the reparative therapy that initiated mainstream news interest in Bachmann's husband, Marcus, was being performed at the Bachmanns' Christian counseling clinic.14
The Christian conservative and scientific parts of the antigay movement have been inextricably related toâindeed, dependent onâeach other. The Christian ex-gay movement has relied for its intellectual underpinnings on ostensibly secular knowledge about human development and teleology, even though much of that knowledge is repudiated by the contemporary scientific community. Although compassion has not been a prominent part of the rhetoric associated with the antigay psychiatric literature and with âsecularâ reparative therapies, there is a protocompassionate element to the literature and therapies. These clinicians believe that people who do not experience opposite-sex desire are both profoundly damaged and unable to create and enjoy foundational human relationships. The attempt of reparative therapists to therapeutically repair developmental damage and enable heterosexual love does suggest the kind of compassionate concern that's often associated with the clinical relationship. The Christian conservative ex-gay movement incorporates salient aspects of secular literature and clinical practices and integrates them with a message of God's commandments and Christian compassion for homosexuals. What results from this convergence are narratives of development that hold out hope that damaged gays can become, if not healed former gays, at least people who better understand the environmental dynamics that can predispose them to tenacious same-sex desire.
The Narrative of Development
The Christian ex-gay movement long has been âthe right's kinder and gentler anti-gay campaign.â15 This descriptor suggests that other precincts of the Christian right's antigay movement are less kind and gentle, and so they are. When Didi Herman mapped the changes in the orientation of the Christian right over a period of fifty years, she found that in the early years of Christian conservative attention to the problem of homosexuality, pity coexisted with firm resistance to normalization. By the early 1970s, the concern with âgay militancyâ was rising among Christian conservatives, and compassion would give way, at least in the explicitly political sectors of the movement, to the conception of same-sex sexuality as âa sin with a movement behind itâ that must be fought.16 Even as the larger Christian right movement mobilized against homosexuality, however, the ex-gay movement continued to cultivate compassionate dimensions.
The 1970s saw the first Christian ministries to homosexuals seeking to become heterosexual, and the movement was quickly institutionalized, first by the founding of Exodus International in 1976 and, second, by the establishing of the first ex-gay residential ministry, Love in Action, in 1979.17 In the early years, Christian counselors applied an exclusively spiritual message of change that promised reformation of sexuality without inquiring into the psychological dynamics of same-sex attraction.18 And as the movement matured into the 1980s the literatures and therapies of the Christian ex-gay movement came to reflect psychodynamic explanations produced by antigay psychiatrists and psychoanalysts, now embedded in a context of Christian conservative spirituality and exhortation.19
For believers, compassion follows from the understanding that same-sex desire is usually a matter of unchosen developmental dynamics. The explanation for lesbian desire includes developmental failures but is often more complicatedâor incoherentâand in addition to interpersonal family dynamics includes the likelihood of sexual trauma.20 Because unchosen developmental issues are understood to cause same-sex desire, the narrative of development relieves same-sex-attracted (often shortened to SSA) people of responsibility for their ...