Efficacy and risk of sexual orientation change efforts: a retrospective analysis of 125 exposed men

D Paul Sullins,Christopher H Rosik,Paul Santero

doi:10.12688/f1000research.51209.1

Abstract

Background: Voluntary therapeutic interventions to reduce unwanted same-sex sexuality are collectively known as sexual orientation change efforts (SOCE). To date almost all evidence addressing the contested question whether SOCE is effective or safe has consisted of anecdotes or very small sample qualitative studies of persons who currently identify as sexual minority and thus by definition failed to change. We conducted this study to examine the efficacy and risk outcomes for a group of SOCE participants unbiased by current sexual orientation. Methods: We examined a convenience sample of 125 men who had undergone SOCE for homosexual-to-heterosexual change in sexual attraction, identity and behavior, and for positive and negative changes in psychosocial problem domains (depression, suicidality, self-harm, self-esteem, social function, and alcohol or substance abuse). Mean change was assessed by parametric (t-test) and nonparametric (Wilcoxon sign rank test) significance tests. Results: Exposure to SOCE was associated with significant declines in same-sex attraction (from 5.7 to 4.1 on the Kinsey scale, p <.000), identification (4.8 to 3.6, p < .000), and sexual activity (2.4 to 1.5 on a 4-point scale of frequency, p < .000). Over 42.7% of SOCE participants achieved at least partial remission of unwanted same-sex sexuality; full remission was achieved by 14% for sexual attraction and identification, and 26% for sexual behavior. Rates were higher among married men, but 4-10% of participants experienced increased same-sex orientation after SOCE. From 0.8% to 4.8% of participants reported marked or severe negative psychosocial change following SOCE, but 12.1% to 61.3% reported marked or severe positive psychosocial change. Net change was significantly positive for all problem domains. Conclusion: SOCE was perceived as an effective and safe therapeutic practice by this sample of participants. We close by offering a unifying understanding of discrepant findings within this literature and caution against broad generalizations of our results.

Highlights

In 2009 the American Psychological Association released its report on Appropriate Therapeutic Responses to Sexual Orientation (APA, 2009, hereafter referred to as the Report), which attempted to summarize what could be definitively concluded from the existent scientific literature at that time
The Report concluded, “we cannot conclude how likely it is that harm will occur from sexual orientation change efforts (SOCE) (p. 42) and “Given the limited amount of methodologically sound research, we cannot draw a conclusion regarding whether recent forms of SOCE are or are not effective” (p. 83)
As early as 2002, Shidlo and Schroeder observed a fundamental truth about many consumers of SOCE, stating, “... we have found that conversion therapists and many clients of conversion therapy steadfastly reject the use of lesbian and gay” (p. 249, authors’ emphases)

Summary

Introduction

In 2009 the American Psychological Association released its report on Appropriate Therapeutic Responses to Sexual Orientation (APA, 2009, hereafter referred to as the Report), which attempted to summarize what could be definitively concluded from the existent scientific literature at that time. The Report concluded, “we cannot conclude how likely it is that harm will occur from sexual orientation change efforts (SOCE) The Report discouraged practices designed to facilitate change but fell short of recommending ethical or legal bans on any professional practices. Despite this internal restraint and external criticisms of the Report at the time (Jones et al, 2010), this document has weighed heavily in the escalating legal efforts to ban SOCE that have been waged in the past decade. We conducted this study to examine the efficacy and risk outcomes for a group of SOCE participants unbiased by current sexual orientation. From 0.8% to 4.8% of participants reported marked or severe negative psychosocial version 2 (revision)

Methods

Results

Discussion

Conclusion