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Dale's Web Pages ONE OUT OF TWO

CHANGE OF SEXUAL ORIENTATION REVIEW OF THE LITERATURE

By NARTH


CHANGE OF SEXUAL ORIENTATION

REVIEW OF THE LITERATURE

NARTH

Table of Contents

Introduction

Is it possible for therapy to produce a change in sexual orientation? Is such therapy ethical?

C.A. Tripp in a 1971 debate with Lawrence Hatterer insisted that "there is not a single recorded instance of a change in homosexual orientation which has been validated by outside judges or testing." Tripp claimed to have treated patients supposed cured by other therapists, who came to him because they do not want to disappoint their previous therapists. Tripp's statement has been widely quoted, but the full text of the debate reveals Tripp was offered clinical evidence of change by Hatterer. Hatterer's book published in 1970 contains extensive case material drawn from tape recorded sessions and follow-up information.

Warren Throckmorton, who has reviewed the literature, sums up the evidence:

"Narrowly, the question to be addressed is: Do conversion therapy techniques work to change unwanted sexual arousal? I submit that the case against conversion therapy requires opponents to demonstrate that no clients have benefited from such procedures or that any benefits are too costly in some objective way to be pursued even if they work. The available evidence supports the observation of many counselors -- that many individuals with same-gender sexual orientation have been able to change through a variety of counseling approaches."

This report contains numerous reports of change of orientation and this list is by no means exhaustive. The material is sufficient to demonstrate that change is possible and that many forms of therapy -- including some that are no longer used -- have produced change. Some therapists appear to be more successful than others. The reports of change are well documented, backed up by case histories, extensive follow-up, and autobiographical material.

The surveys and analyses of collected data provide evidence that approximately 30% of those who enter therapy and persist can expect to experience a change of orientation. Even taking the extreme position that change applies only to an individual who was in behavior, attraction, and fantasy exclusively homosexual for a significant period of adult life and became exclusively and permanently heterosexual in behavior, attraction, and fantasy, it is clear that such persons do exist. The prognosis is more positive for those who had heterosexual experiences. Given the make-up of the human brain and the power of habit, occasional homosexual attraction experienced in times of stress for a number years after the cessation of homosexual behavior should not be surprising. Ex-Gay ministries counsel members that full freedom may take years.

Behavior modification techniques for eliminating homosexual behavior and attraction have largely been abandoned, nonetheless the numerous reports of their use from 1946 to 1976 points to the desire of homosexual men to rid themselves of unwanted thoughts and behaviors. These men appear willing to try anything. The fact that some succeeded may be attributed to their desire for change, their willingness to seek help, the effect of revealing to the therapist of the nature of the problem, and the confidence of the therapist that change is possible. In some cases, it may be that a man, who believed that he was incapable of being excited by women, was surprised to discover that his body was capable of heterosexual arousal and that this helped to overcome a phobia-rooted homosexuality.

It is also worthy of note that a number of studies contain reports on clients who entered therapy seeking help for other problems for whom the change of sexual orientation was an unexpected outcome. There is also evidence that change occurs spontaneously.

References to autobiographical accounts of religiously medicated change have been included in this report. While this type of change has not received extensive scientific study, many of those claiming religiously mediated change have testified publicly and their claims can be documented.

None of these studies claim that every person who seeks change will succeed. Given the reported failure rates, one would expect to find a large group of homosexuals who were dissatisfied with therapy. These could be the source of Tripp's anecdotal evidence.

CRITICS OF CHANGE

The critics of therapy claim that studies report only changes of behavior and that the underlying "orientation" or sexual attractions remain untouched. This is simply untrue. Many of the therapists query clients about homosexual attractions and fantasy. And many therapists do not consider a person fully "changed" unless the attractions and fantasies were also exclusively heterosexual.

The opponents of change have criticized the studies which claim to document change on the grounds that the rely on the testimony of therapists. However in 1998, when a large group men and women who were once homosexuality attracted or active publicly announced that they are "ex-gay," their testimony was derisively dismissed. Homosexual activists pressured networks to refuse to air commercials containing "ex-gay" testimonies. The "ex-gays" were accused of never being really homosexual or of "suppressing" their gayness. The intensity of the reaction against ex-gays suggests that those who "accept" their homosexuality feel threatened by the possibility of change.

Section 8 of this report contains quotes from writers who oppose therapy for change. A number of these writers admit that change is possible, but condemn therapy even when the client wants change because the availability of therapy oppresses homosexuals who don't want to change. According to Begelman (1977), who condemns therapy for change as unethical:

"Administering these programs means reinforcing the social belief system about homosexuality. The meaning of the act of providing reorientation services is yet another element in a causal nexus of oppression."

Therapists who view homosexuality as a normal variety of sexual orientation insist that there is no "excess" psychopathology among homosexuals and then discuss at length the psychological problems associated with "internalized homophobia," a condition, which, according to them, effects most homosexuals. Those who normalize homosexual orientation, usually also normalize sexual promiscuity and extreme sexual practices since homosexuals routinely engage in these behaviors. There is the overwhelming evidence that during early childhood homosexual men had negative relationships with their fathers and that their mothers who did not support their masculine identity development. This forces homosexual activists, like Gerald Davison(1982), to argue such childhood experiences don't cause with excess pathology because they are part of the histories of homosexuals and homosexuality is normal. By this reasoning Davison dismisses the accumulated research of developmental psychologists and the pain of the children.

RELIGION AND THERAPY

If therapy for change is declared unethical or illegal, persons whose religion opposes all sexual activity outside traditional marriage would be denied their right to receive therapy consistent with their faith. It is interesting to note that a number of those who oppose therapy to change sexual orientation, support therapists who try to change their clients' religious beliefs. This includes encouraging therapists to tell their clients that Christian teaching permits homosexual activity. James Nelson, a professor of Christian Ethics at United Theological Seminary of the Twin Cities MN, is among those who supports telling clients that Christianity doesn't consider homosexual sexual activity, including non-monogamous activity, sinful.

It appears inconsistent for a society which supports a client's right to controversial therapies, such as sex change operations, extensive plastic surgery, and reproductive technologies, to deny clients who desire a change of sexual orientation access to therapies known to be effective.

Currently individuals seeking change are forced to contact a shrinking pool of therapists willing to take on this work or to seek religiously mediated change through support group membership. Those who are not interested in adopting a religious world view may feel uncomfortable in a religiously based ex-gay ministry. For example, Homosexuals Anonymous adopts some of the traditions of AA, but combines these with an explicitly Christian world view. Alan Medinger, an ex-gay and leader of the religion-based Regeneration Ministries, has expressed concern for non-Christian homosexuals seeking help. He is concerned that those who are not religious currently have no support groups available to them. On the other hand those who wish to be free from homosexual behavior for religious reasons feel abandoned by the mental health profession.

The public and homosexuals have a right to know that successful change is possible. Homosexuals, who desire treatment, have the right to the best treatment available.

This report contains information on and excerpts from articles, books, and studies on treatment for homosexuality -- including those opposed to treatment. Not all the studies contain positive results. A wide variety of treatments and theoretical approaches are represented. Some of the authors have changed their point of view on treatment. The information on change has been arranged in the following manner.

1) Reviews of the literature on therapy and change - Some of these are written by therapists who include their own experience and case material.

2) Surveys and meta-analysis of studies - Most of the studies included in the meta-analysis are referenced individually. It should be noted that a number of studies appear in several meta-analyses.

3) Reports from therapists who treated homosexual clients with some form of individual psychotherapy. It should be noted that a number of theoretical approaches are employed. In some cases change of orientation was not the therapist's or client's goal. Extensive case histories and client/therapist exchanges are included in a number of the articles and books in this section.

4) Reports from therapists who treated homosexual clients with some form of group therapy. -- Group therapy was sometimes combined with individual therapy or behavior modification. Some groups involve only homosexuals, in other cases homosexuals are included in heterogeneous groups.

5) Studies in which some form of behavior modification therapy was the primary treatment method -- It should be noted that most of these therapies were short term, although some employed "booster sessions." Most of the methods employed are considered by the pro-gay activists to be degrading and inhumane. Many psychotherapists consider these techniques to be superficial, leaving untouched the underlying problems. Those associated with ex-gay ministries find many of the methods and goals to be morally unacceptable.

6) Reports of religiously mediated change, including studies and autobiographical material -- Celibacy and marriage are both viewed as acceptable outcomes.

7) Reports of spontaneous or adventitious change of sexual orientation. -- Various studies of sexuality suggest that some persons engage in exclusive homosexuality during adolescents and early adulthood and then move on to exclusive heterosexuality. Change of orientation has occured when no change was sought or expected.

8) Articles by persons who oppose therapy with the goal of change or believe that change is impossible -- These articles focus on the psychological effects of therapy on those who fail to achieve their goal and on those who do not want such therapy.

9) Responses to critics of change


Within each grouping the sources are arranged alphabetically by author. Additional works by the same author are included since many of the authors discussed the same cases in a number of articles and books. It should be noted that each author has his own definition of improvement and/or change.

The subtitles in capital letters are provided to help the reader find information on specific topics. Material in quotations marks are quoted directed from the original source. Page numbers are in parentheses at the end of the quotation.

This is a work in progress. At this date, not all of the original articles have been found and reviewed and not all the bibliographic information is complete. The incomplete information has been included as a guide to those who may wish to do more research. Those articles or books which have been reviewed and are in the Irving Bieber Memorial Library East Coast are marked with @ in the bibliography.

=======================================

1) REVIEW OF LITERATURE

======================================

Acosta, F. (1975) Etiology and treatment of homosexuality: A review. Archives of Sexual Behavior. 4,1: 9 - 27.

ABSTRACT: "The major causal theories of and treatment approaches to male and female homosexuality are critically reviewed. Neither biological, psychoanalytic, nor learning and social-learning theories are found to provide convincing evidence for the etiology of homosexuality. All of these accounts, however, are viewed as providing mixed empirical support for their predictions, with social-learning research presenting the most consistent evidence. It is argued that both social learning research findings and results from retrospective studies suggest that homosexuality may best be linked to the early qualitative learning and development of one's gender identity and gender role. Both psychoanalytic therapy and the behavior therapy are found to have minimal successes and many failures. Most therapeutic success seem to be with bisexuals rather than exclusive homosexuals. The combined use of psychotherapy and specific behavioral techniques is seen to offer some promise for heterosexual adaptation with certain kinds of patients. However, it is argued that better prospects for intervention in homosexuality lie in its prevention through the early identification and treatment of the potential homosexual child." (9)


=======================================

Barnhouse, R. (1977) Homosexuality: A Symbolic Confusion. NY: Seabury Press.

ADOLESCENCE: "The crucial fact is that , while homosexual behavior may be only experimental in adolescence, it can all too easily become a fixed pattern because of the great importance of learning, experience, and habituation in the development of human sexuality. Many men come for treatment who regret having made the homosexual choice at an age when they were too immature to understand its full implication." (60)

CHANGE: "Approximately thirty percent of those coming to treatment for any reason can be converted to the heterosexual adaptation. Of course these figures cannot speak to the question of those persons whose homosexuality is relatively encapsulated in an other wise functional personality and who therefore are less likely to seek psychiatric help. Strong motivations do sometimes cause such people to request psychotherapy in order to change their sexual orientation. Their reasons may be religious or social and may even include having formed a sufficiently deep friendship with someone of the opposite sex so that marriage could be contemplated if they were only able to engage in sexual relations. In such instances the prognosis for a successful therapeutic outcome is extremely good. This conforms to the general principle that a very well motivated individual seeking help for an isolated symptom, whose personality is otherwise intact, is always among the best candidates for successful psychotherapy or psychoanalysis. These facts and statistics about cure are well known and not difficult to verify. In addition, there are many people to have experienced their homosexuality as a burden either for moral or social reasons who have, without the aid of psychotherapy, managed to give up this symptom; of these, a significant number have been able to make the transition to satisfying heterosexuality. Quite apart from published studies by those who have specialized in the treatment of sexual disorders, many psychiatrists and psychologists with a more general type of practice (and I include myself in this group) have been successful in helping homosexual patients to make a complete and permanent transition to heterosexual."

ANTI-CHANGE: "The distortion of reality inherent in the denials by homosexual apologists that the condition is curable is so immense that one wonders what motivates it." (109)


-----------------

Barnhouse, R. (1984) What is a Christian view of homosexuality? Circuit Rider, Feb. 12 -15.

ANTI-CHANGE: "The frequent claim by 'gay' activists that it is impossible for homosexuals to change their orientation is categorically untrue. Such a claim accuses scores of conscientious, responsible psychiatrists and psychologists of falsifying their data."


======================================

Berkowitz, B., Newman, M. (1971) How to be your own best friend. NY: Lark.

CHANGE: "We've found that a homosexual who really wants to change has a very good chance of doing so. Now we're hearing all kinds of success stories."


======================================

Crawford, D. (1979) Modification of deviant sexual behavior: The need for a comprehensive approach. British Journal of Medical Psychology. 52:151 - 156.

ABSTRACT: This paper gives four main lines of evidence to support the view that it is too simple to view sexual deviance as a problem of deviant arousal only. Firstly, clinical experience leaves the clear impression that sex offenders are not stable, well adjusted men with sexual arousal problems, but have difficulties in many areas of their lives. Secondly, research on human sexuality has resulted in a greater appreciation of the complexities of sexual behaviour. It is inconsistent to accept that "normal " sexual behaviour is complex and varied but maintain that deviant sexual behavior is just an inappropriate penile response. Thirdly, treatment studies aimed at modifying homosexual behavior have found that changes in heterosexual measures are most important. This suggests that for sex offenders most attention should be paid to increasing non-deviant arousal and interests. Fourthly, studies of sex offenders have consistently reported that they experience of wide variety of problems. It is unrealistic to consider the problem of deviant sexual behaviour in isolation from these other problems.

It follows that comprehensive treatment programmes will be necessary, covering such problems as sexual dysfunction, anxiety, deficient social skills, inadequate sexual knowledge, poor self-control, lack of non-deviant sexual arousal as well as the presence of deviant sexual arousal.


======================================

Fine, R. (1987) Psychoanalytic Theory (in Diamant L. (ed) Male and Female Homosexuality: Psychological Approaches. Washington: Hemisphere Publishing.) 81 - 95.

CHANGE: "Whether with hypnosis..., psychoanalysis of any variety, educative psychotherapy, behavior therapy, and/or simple educational procedures, a considerable percentage of overt homosexuals became heterosexual... If patients were motivated, whatever procedure is adopted a large percentage will give up their homosexuality... The misinformation that homosexuality is untreatable by psychotherapy does incalculable harm to thousands of men and women... All studies from Schrenk-Notzing on have found positive effects virtually regardless of the kind of treatment used."


=======================================

Glover, B. (1953) Observations on homosexuality among university students. Journal of Nervous and Mental Disorders. 113: 377 - 387.

CHANGE: "... the lassitude and inertia of homosexuals greatly contribute to the poor psychotherapeutic results. They respond to the preliminary work of preparing them for their ecological change during the heat of remorse at being publicly exposed or legally punished, but the stigma of their pattern follows them in time, and their socialization is most difficult thing even in the relatively enlightened atmosphere of the university. Those who have sought help without public pressure also quickly deteriorate in strength and vigor of their efforts. In the course of the first year Glover found significant improvement in only 1 of his 12 patients."


---------------

Glover, E. (1960) The Roots of Crime: Selected Papers on Psychoanalysis. Vol.11. London: Imago Publishing.

CHANGE: "Psychotherapy appears to be unsuccessful in only a small number of (homosexual) patients of any age in whom a long habit is combined with psychopathic traits, heavy drinking or lack of desire to change."


=======================================

Harvey, J. (1987) The Homosexual Person: New Thinking in Pastoral Care. San Francisco: Ignatius Press.

-----------

Harvey, J. (1996) The Truth about Homosexuality: The Cry of the Faithful. San Francisco: Ignatius.

REVIEW: Review of the literature on change, including authors who denied change was possible, secular therapists, and therapists who use secular insights in combination with Christian principles.


======================================

Hinrichsen, J., Katahn, M. (1975) Recent trends and new developments in the treatment of homosexuality. Psychotherapy: Theory, Research and Practice. 12, 1.

REVIEW: Reviewing work of authors who supported replacement of homosexuality by heterosexuality. Methods of treatment discussed included: analytic psychotherapy, existential-transactional therapy, hypnotherapy, brain surgery, aversion procedures, desensitization, combined approaches, and group therapy.


=======================================

John J. (1989) Once Gay... Always Gay. Reading PA: Homosexual Anonymous.

QUOTATIONS: From: Barnhouse, Berkowitz, Bergler, Bieber, Bieber, T., Cappon, Caprio, Ellis, Feldman, Fine, Freeman, Freud, Fried, Hadden, Hadfield, Hatterer, Janov, Karpman, Kaye, Keefe, Kinsey, Kronemeyer, Marmor, Masters, Mayerson, Mintz, Pattison, Siegel, Socarides, Stekel, van den Aardweg, Williams, Willis, Wilson


========================================

Lowenstein, L., Lowenstein, K. (1984) Homosexuality -- A review of research between 1978 - 1983. Projective Psychology. 29, 2: 21 - 24.

REVIEW: A listing of the wide variety of literature on the treatment of homosexuality -- very little detail.


======================================

Marmor, J. (1965) Introduction (in Marmor, J. Sexual Inversion: The Multiple Roots of Homosexuality. NY: Basic) 1 - 26.

CHANGE: "The clinicians represented in this volume present convincing evidence that homosexuality is a potentially reversible condition. There is little doubt that much of the recent success in the treatment of homosexuals stems from the growing recognition among psychoanalysts that homosexuality is a disorder of adaptation." (21)

"It is to be hoped that the following chapters may contribute to better understanding of some of the complex factors that enter into the development of patterns of homosexual behavior and so enable us ultimately to institute more effective means of prevention than now exist." (22)

THEORY: "We are probably dealing with a condition that is not only multiply determined by psychodynamic, sociocultural, biological, and situational factors but also reflects the significance of subtle temporal, qualitative, and quantitative variables. For a homosexual adaptation to occur, in our time and culture, these factors must combine to (1) create an impaired gender identity, (2) create a fear of intimate contact with members of the opposite sex, and (3) provide opportunities for sexual release with members of the same sex."


--------------

Marmor, J. (1975) Homosexuality and sexual orientation disturbances. (in Freedman et al (ed) Comprehensive Textbook of Psychiatry II Baltimore: Williams and Wilkins) 1519.

ANTI-CHANGE: "The conviction of untreatability also serves an ego-defensive purpose for many homosexuals."

CHANGE: "As the understanding of the adaptive nature of most homosexual behavior has become more widespread, however, there has evolved a greater therapeutic optimism about the possibilities for change, and progressively more hopeful results are being reported. There is little doubt that a genuine shift in preferential sex object choice can and does take place in somewhere between 20 and 50 percent of patients with homosexual behavior who seek psychotherapy with this end in mind. the single most important prerequisite to reversibility is a powerful motivation to achieve such a change."

"The myth that homosexuality is untreatable still has wide currency among the public at large and among homosexuals themselves. This view is often linked to the assumption that homosexuality is constitutionally or genetically determined. This conviction of untreability also serves an ego-defensive purpose for many homosexuals. As the understanding of the adaptive nature of most homosexual behavior has become more widespread, however, there has evolved a greater therapeutic optimism about the possibilities for change, and progressively more hopeful results are being reported... There is little doubt that a genuine shift in preferential sex object choice can and does take place in somewhere between 20 and 50 per cent of patients with homosexual behavior who seek psychotherapy with this end in mind."


========================================

Rekers, G. (1988) The formation of homosexual orientation. (In Fagan, P.(ed.) Hope for Homosexuality. Washington DC: Free Congress Foundation.)

THEORETICAL INTEGRATION OF THE DATA: "The review by Acosta (1975) argued that the best intervention for homosexuality lies in its prevention "through the early identification and treatment of the potential homosexual child." Davenport (1972) offers a similar analysis. Since 1970, I have published 50 academic articles and book chapters on my research on the assesment and treatment of childhood gender identity and behavior disorders (Rekers 1975, 1976, 1977a, 1977b, 1977c, 1977d)... With major research grants from the National Institute of Mental Health, I have experimentally demonstrated an affective treatment for "gender identity disorder of childhood" which appears to hold potential for preventing homosexual orientation in males, if applied extensively in the population."


========================================

Rogers, C., Roback, H., McKee, E., Calhoun, D. (1976) Group psychotherapy with homosexuals: A review. International Journal of Group Psychotherapy. 31,3 : 3 - 27.

CHANGE: "In general, reports on the group treatment of homosexuals are optimistic; in almost all cases the therapists report a favorable outcome of therapy whether the therapeutic goal was one of achieving a change in sexual orientation or whether it was a reduction in concomitant problems."


==========================================

Satinover, J. (1996) Homosexuality and the Politics of Truth. Grand Rapids MI: Baker.

CHANGE: "...in the eight years between 1966 and 1974 alone, just the Medline database -- which excludes many psychotherapy journals -- listed over a thousand articles on the treatment of homosexuality... These reports clearly contradict claims that change is flatly impossible. Indeed, it would be more accurate to say that all the existing evidence suggests strongly that homosexuality is quite changeable. Most psychotherapists will allow that in the treatment of any condition, a 30 percent rate may be anticipated."

"I have been extraordinarily fortunate to have met many people who have emerged from the gay life. When I see the personal difficulties they have squarely faced, the sheer courage they have displayed not only in facing these difficulties but also in confronting a culture that uses every possible means to deny the validity of their values, goals, and experiences, I truly stand back in wonder... It is these people -- former homosexuals and those who are still struggling, all across America and aboard -- who stand for me as a model of everything good and possible in a world that takes the human heart, and the God of that heart, seriously. In my various explorations within the worlds of psychoanalysis, psychotherapy, and psychiatry, I have simply never before seen such profound healing."


========================================

Socarides, C. (19** ) A survey of treatment results. Understanding Homosexuality. Encino CA: NARTH.

CHANGE: "An unpublished and informal report of the Central Fact-gathering Committee of the American Psychoanalystic Association (1956) was one of the first surveys to compile results of treatment. I showed that of 56 cases of homosexuality undergoing psychoanalytic threapy by members of the Association, they describe 8 in the completed group (which totalled 32) as cured; 13 as improved, and 1 as unimproved. This constitutes one third of all cases reported. Of the group which did not complete treatment (total of 34), they described 16 as improved, 10 as unimproved, 3 as untreatable, and 5 as transferred. In all reported cures, follow-up communications indicated assumption of full heterosexual role and functioning."


========================================

Throckmorton, W. (1996) Efforts to modify sexual orientation: A review of outcome literature and ethical issues. Journal of Mental Health and Counseling. 20, 4: 283 -305.

REVIEW: A review of the literature and the debate over treatment, discussion of sexual orientation, and religious issues.

THERAPY: "Neither gay-affirmative nor conversion therapy should be assumed to be the preferred approach."

RELIGION: "Therapists should inform clients of different opinions and "suggest clients choose consistent with their values, personal convictions and/or religious beliefs. Since religion is one of the client attributes that mental health counselors are ethically bound to respect, counselors should take great care in advising those clients dissatisfied with same-gender sexual orientation due to their religious beliefs."

ANTI-CHANGE:"Broadly, opponents of shifting sexual orientation as a therapeutic goal express doubts that sexual orientation can be changed by any means. From the gay affirming perspective, Martin (1984) and Haldeman (1994) review studies that claimed to demonstrate change in sexual orientation. Their view is that there were no empirical studies that supported the idea that conversion therapy can change sexual orientation. However, they omitted a number of significant reports and failed to examine the outcomes of many studies that have demonstrated change.

CHANGE: "Narrowly, the question to be addressed is: Do conversion therapy techniques work to change unwanted sexual arousal? I submit that the case against conversion therapy requires opponents to demonstrate that no clients have benefited from such procedures or that any benefits are too costly in some objective way to be pursued even if they work. The available evidence supports the observation of many counselors -- that many individuals with same-gender sexual orientation have been able to change through a variety of counseling approaches."


======================================

Welsh, A. (1994) On the origins and treatment of homosexuality: Change is possible. Social Justice Review. 39 -40.

REVIEW: Short article reviewing key studies.


=======================================

West, D. (1977) Homosexuality re-examined. London: Duckworth.

CHANGE: "Although some militant homosexuals find such claims improbably and unpalatable, authenticated accounts have been published of apparently exclusive and long-standing homosexuals unexpectedly changing their orientation."

CASE: Man exclusively homosexual for 8 years became heterosexual; Man homosexual became heterosexual when his mother stopped trying to dominate him.

RESULTS: West summarizes the results of studies: behavioral techniques have the best documented success (never less than 30%); psychoanalysis claims a great deal of success (the average rate seemed to be about 25%, but 50% of the bisexuals achieved exclusive heterosexuality.)

CHANGE: "Every study ever performed on conversion from homosexual to heterosexual orientation has produced some successes."


==========================================

2) SURVEYS AND META-ANALYSES

======================================

Bieber, I. et al. (1962) Homosexuality: A Psychoanalytic Study of Male Homosexuals. NY: Basic Books.

METHOD: Reports from psychoanalysts who treated homosexual men, compared with a control group of heterosexual men in therapy.

SUBJECTS: 106 homosexual men. 100 heterosexual controls. All patients in psychoanalysis

RESULTS: 35 changed (peer reviewed with 5 year follow)

CHANGE: "The therapeutic results of our study provide reason for an optimistic outlook. Many homosexual became exclusively heterosexual in psychoanalytic treatment. Although this change may be more easily accomplished by some than by others, in our judgment a heterosexual shift is a possibility for all homosexuals who are strongly motivated to change."


=======================================

Canton-Dutari, A. (1976) Combined intervention for controlling unwanted homosexual behavior: An Extended Follow-up. Archives of Sexual Behavior. 5, 4: 269 - 274.

RESULTS: Of 49 patients... 31 (63 percent) were contracted for follow-up. The average period since the end of treatment was 4 years. 19 subjects (61 percent) have remained exclusively heterosexual, whereas 9 (29 percent) have had homosexual intercourse. Heterosexual intercourse was reported in 28 including the previous 9 subjects. Three (10 percent) subjects have had neither homo nor heterosexual intercourse.


=======================================

Clippinger, J. (1974) Homosexuality can be cured. Corrective and Social Psychiatry and Journal of Behavior Technology Methods and Therapy. 21, 2: 15 - 28.

REVIEW: Hadfield, Bieber, Socarides, Bergler, associates of Bergler, Mayerson, Hatterer, Cappon, Hadden, Birk, Feldman, Cautela.

SUBJECTS: In 12 studies of therapy the percentage changed was included. For ten of the studies the number of patients was also included - the total was 785 patients treated.

METHODS: A number of different therapy methods were used.

RESULTS: "Of 785 patients treated, 307 - or approximately 38% -- were cured. Adding the percentage figures of the two other studies, we can say that at least 40% of the homosexuals were cured, and an additional 10 to 30% of the homosexuals were improved, depending on the particular study for which statistics were available."


=========================================

Goetze, R. (1997) Homosexuality and the Possibility of Change: A Review of 17 Published Studies. Toronto Canada: New Directions for Life.

METHOD: A carefully designed meta-analysis of 17 studies. The author focused on the studies where it could be determined that the clients were exclusively or predominantly homosexual and results could be determined, and did not use studies without data or poorly defined categories. Carefully sought to determine Kinsey rating before and after therapy and follow-up information.

REVIEW: Bieber, Birk, Freeman, Hadden, Hadfield, Hatterer, Kaye, MacIntosh, Masters, Mayerson, Mintz, Pattison, Poe, Socarides, van den Aardweg, Wallace, Wolpe.

RESULTS: 69 persons who were exclusively or predominantly homosexual acquired heterosexual behavior

283 persons who were exclusively or predominantly homosexual experienced a partial shift in sexual orientation

A total of 44 persons who were exclusively or predominantly homosexual experienced a full shift of sexual orientation.


------

Goetze, R. (1996) A developmental view of homosexuality. Toronto: New Direction for Life.

=========================================

James, E. (1978) Treatment of Homosexuality: A Reanalysis and Synthesis of Outcome Studies. Dissertation presented to the Dept. of Psychology, Brigham Young U.

REVIEW: 101 studies from 1930 to 1976. Studies involved behavior modification and psychotherapy. One or more articles with the following primary authors are included. Alexander, Bancroft, Barlow, Berg, Beaukenkamp, Bieber, Birk, Blitch, Braaten, Callahan, Cautela, Coates, Colson, Conrad, Curran, Curtis, Deutsch, DiScipio, Eliasberg, Ellis, Feldman, Fookes, Freeman, Freund, Gordon, Gray, Hadden, Hadfield, Hallam, Hanson, Hatterer, Herman, Huff, Ince, Jacobi, James, Kaye, Kendrick, Kraft, Lamberd, Levin, London, LoPiccolo, Mandel, Matetzky, Marquis, Mastellone, Mayerson, McConaghy, McCrady, Mintz, Moan, Monroe, Myerson, Ovesey, Pittman, Poe Quinn, Regardie, Rehm, Roper, Ross, Rutner, Salter, Sandford, Schmidt, Segal, Shealy, Skene, Smith, Socarides, Solyon, Stekel, Stevenson, Tanner, Thompson, Thorpe, Truax, Turner, van den Aardweg, Wallace, Woodward,

METHODS: Different forms of therapy

RESULTS: For combined studies: 37% of clients not improved; 27% improved; 35% recovered. Bisexuals, females, and clients participating in long-term therapy achieved great gains with respect to sexual reorientation.

"... slight, inconsistent indications that behavioral techniques (especially when a combination of procedures was used) were associated with more favorable outcome than traditional verbal psychotherapies."


========================================

Kaye, H., Beri, S., Clare, J., Eleston, M., Gershwin, B., Gershwin, P., Kogan, L., Torda, C., Wilber, C. (1967) Homosexuality in Women. Archives of General Psychiatry. 17: 626 - 634.

SUBJECTS: 24 female homosexual patients and 24 female nonhomosexual patients in therapy.

METHOD: An effort to replicate the Bieber study with homosexual women. Solicited case material on homosexual women in treatment from therapists.

REASON FOR THERAPY: "The primary reasons for our H[omosexual] group entering analysis were depression and anxiety. Only seven stated that they wanted their homosexuality cured, while ten definitely did not want their homosexuality cured; two were undecided. We had no answer to this question in five questionnaires."

RESULTS: "... the 15 cases in the homosexual range were reduced to eight at the end of therapy, approximating a 50% shift toward the heterosexual end of the spectrum. Furthermore, of the nine patients who were exclusively homosexual at the beginning of their analyses, only four were still exclusively homosexual either at the termination of treatment or at the time during their treatment when their analysts filled out their questionnaire."

CHANGE: "... this indicates a substantial positive treatment potential which should not be lost sight of in evaluating the treatability of female homosexuals who present themselves for therapy. Apparently at least 50% of them can be significantly helped by psychoanalytic treatment."

"Finally, we have indications for therapeutic optimism in the psychoanalytic treatment of homosexual women. We find, roughly, at least a 50% probability of significant improvement in women with this syndrome who present themselves for treatment and remain in it."


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MacIntosh, H. (1994) Attitudes and experiences of psychoanalysts. Journal of the American Psychoanalytic Association. 42, 4 : 1183 -1207.

METHOD: Survey of 285 psychoanalysts reported having analyzed 1,215 homosexual patients, resulting in 23% changing to heterosexuality and 84% receiving significant therapeutic benefit.

RESULTS: Asked analysts if homosexuals can change - 29.1% rarely or never, 68.5% sometimes or frequently.

Male Patients - 824 clients of 213 analysts; 197 (23.9%) changed to heterosexuality, 703 received significant therapeutic benefit

Female Patients - 391 clients of 153 analysts; 79 (20.2%) changed to heterosexuality; 318 received significant therapeutic benefit.


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Nicolosi, J., Byrd, A., Potts, R. (1998) Towards the Ethical and Effective Treatment of Homosexuality. Encino CA: NARTH.

METHOD: Survey of 850 individuals and 200 therapists and counselors -- specifically seeking out individuals who claim to have made a degree of change in sexual orientation.

RESULTS. Before counseling or therapy, 68% of respondents perceived themselves as exclusively or almost entirely homosexuality, with another 22% stating they were more homosexual than heterosexual. After treatment only 13% perceived themselves as exclusively or almost entire homosexuality, while 33% described themselves as either exclusively or almost entirely heterosexual. 99% of respondents said they now believe treatment to change homosexuality can be effective and valuable.


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