American Psychological Association responds to "external organizations"

The American Psychological Association has issued a call for nominations titled: Call for Nominations for the Board of Director’s Task Force on Appropriate Therapeutic Responses to Sexual Orientation. The charge of the Task Force is threefold:

(1) To revise and update the APA resolution Appropriate Therapeutic Responses to Sexual Orientation (1997);

(2) To generate a report that includes the following:

(a) The appropriate application of affirmative therapeutic interventions for children and adolescents who present a desire to change either their sexual orientation or their behavioral expression of their sexual orientation, or both, or whose guardian expresses a desire for the minor to change;

(b) The appropriate application of affirmative therapeutic interventions for adults who present a desire to change their sexual orientation or their behavioral expression of their sexual orientation, or both;

(c) The presence of adolescent inpatient facilities that offer coercive treatment designed to change sexual orientation or the behavioral expression of sexual orientation;

(d) Education, training, and research issues as they pertain to such therapeutic interventions;

(e) Recommendations regarding treatment protocols that promote stereotyped gender normative behavior to mitigate behaviors that are perceived to be indicators that a child will develop a homosexual orientation in adolescence and adulthood;

(3) To inform the Association’s response to groups that promote treatments to change sexual orientation or its behavioral expression and to support public policy that furthers affirmative therapeutic interventions.

Why convene a task force?

The call for nominations refers to a need to revise the APA guidelines on therapeutic responses and to “research and scholarship” relating to conversion therapy. What I think is amazing is this lenghty sentence:

Several external organizations have recommended that APA update its policy, because of their concerns about the continued visibility of reparative therapy practitioners and treatment facilities and about the role of advocacy for reparative theory in attempts to shape public opinion about the nature of sexual orientation and to support an anti-gay activist role in legislative and judicial arenas.

I wonder which extermal organizations did the recommending? I wonder what they want the APA to say?

I know of several individuals that have asked the APA to consider the need for guidelines when religion and sexuality conflict. However, I do not see this issue in the call for nominations. I hope there will not be a move to prohibit sexual identity therapy.

UPDATE: 2/23/07 – Focus on the Family’s CitizenLink interviewed APA’s Clinton Anderson who identified PFLAG and the National Gay & Lesbian Task Force as two groups who recommended that the APA review their policies. This was a short report and so I understand my concerns over sexual identity therapy could not be fully articulated. As any regular reader of this blog will know, I am not an apologist for reparative therapy but I am concerned that advocacy groups can move the APA to form a task force to craft scientific policy for political use.

  • Sandy

    Once this committee’s work is done, the APA will be opposed to any efforts to live consistently with conservative religion in matters of sexuality.

  • http://www.exgaywatch.com Timothy Kincaid

    Sandy,

    I caution you not to adopt a victim mentality. It may well be that the APA instead adopts protocols for ethical treatment and I’m sure we would all welcome that change.

  • http://www.wthrockmorton.com Warren

    The APA currently has standards for gays and lesbians but little to no guidance when there are conflicts between religious values and sexuality. If the call for nominations indicated that the committee was charged to speak to this issue, I would be less concerned. However, despite the fact that the APA has been requested to address this issue, they have not. Instead they convene a committee at the behest of advocacy groups for the purpose of advocacy needs. This does not seem like a science based efforts to me and so I am concerned that the result will not be science based.

  • jag

    The APA has thus far been well ahead of the tide when it comes to advocating for the rights of gay and lesbian individuals – following science when the science was not popular. For example, removing gay/lesbian individuals from the DSM in the mid-70s. It was a move of destigmatizing a population that has no mental disorder, and removing it was unpopular (thus often politicized) but the right thing to do from a scientific perspective.

    I agree with Warren that when religious values and sexuality conflict, there are no specific guidelines. Although, I hope there need not be. There should be the expectation that when you see a person of science, what you receive will be unbiased and based in that science.

    Otherwise, you are not a psychologist…but a religious counselor? If you claim to follow science, it is only ethical to those who seek you, that you hold to this.

    I expect that the APA will do a fine job in doing what needs to be done. Warren, and just so you know, taking the time to listen to groups which support the basic civil rights of all citizens hardly seems contradictory to a scientifically based solution. Afterall, the APA has been on board with the largest scientific organizations in the country – the AMA, etc..whereas NARTH, Focus on the Family, etc…have so often strayed from science or the reporting of it, that they jeopardize ever reclaiming credibility.

    If they ever had it to begin with.

  • ken

    Given how conversion therapy has been making news lately (Love In Action’s teen Refuge program, accusations of abuse within some Exodus ministries, Ted Haggard’s “miraculous” 3-week conversion, the debate on this blog about what “ex-gay” means) I don’t think it is unreasonable for the APA to be asked to review its stance on the matter. Nor do I think it is unreasonable for the APA to say “yes, we should review this matter.”

    As to the concerns about religion and sexuality, perhaps that is something you could recommend that the committee review as well.

  • gordo

    There should be the expectation that when you see a person of science, what you receive will be unbiased and based in that science.

    Otherwise, you are not a psychologist…but a religious counselor?

    I would be interested in hearing Warren and David’s opinion about this statement.

  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    Bias cuts both ways. It seems biased to assume one has no bias. The most scientific answer is we don’t know how flexible sexual attractions might be for any given individual. After assessment, we can make educated guesses but it is not scientific to go beyond the data.

  • David Blakeslee

    Gordo,

    Thanks for the invitation. You may be aware of psychology’s long skepticism and perhaps outright hostility toward traditional faiths.

    I have argued that such a bias has long been unacknolwedged and is diametrically opposed to the notion of psychology as a science. One need not be a person of faith to understand its highly adaptive nature and find plenty of evidence for it in culture, history and more recently in the social sciences.

    That being said, I have concerns with the paragraph you cite and with the mythology of psychology as an unbiased science. It is not now nor has it ever been.

    The social sciences generally are very weak examples of science. They are more theory and deduction without any rigorous methodology applied to clinical care (once licensed there are a wide range of theoretically sound but scientifically unproven interventions you are allowed to practice).

    Since it is a weak science at best, it is especially vulnerable to bias errors in it’s theoreticians, researchers and advocacy groups.

  • jag

    Warren and David -

    Of course everyone has biases…there are not exceptions to that. However, how we behave in response to those internal thoughts/beliefs can be somewhat regulated by guidelines. Attempting to create a consistent profession is admirable, although likely not attainable.

    Social sciences are somewhat weak in “science,” however, saying this – we have to have people at least willing to sign up to following the outcomes of the studies we do have.

    That seems a particular difficulty for individuals who believe that their faith can and should override professional guidelines and established ethics of practice.

    Be a person of faith (I am one of them), but give it your best not to use it as a prescriptive compass. Use things as well rooted in study as you possibly can. Yes, these can be weak…but they are certainly stronger science that an interpretation of an ancient text that you believe indicates that a behavior is a sin.

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  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    Jag – What you are saying sounds very much like our sexual identity therapy framework.

  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    Randy – Hey Randy, nice to have you stop by. I linked to the Citizen Link article in the post above.

    I should note that I was not completely accurate when I said the APA did not refer to research – indeed in the call for nominations they did. However, I know that research pretty well and I cannot see any studies that will allow much of a statement regarding reorientation therapy — unless they are going to say that (we don’t know enough and so let’s research some more before we give advocacy groups ammo they want).

  • jag

    I love the term “activist” or “advocacy” groups being used in a negative way….what are these homosexual activist groups advocating for? equal rights?

    please…

    is that soo bad?

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  • larrybailey

    The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential world-wide. Its some 38,000 members are mainly American but some are international. The association publishes various journals and pamphlets, as well as the Diagnostic and Statistical Manual of Mental Disorders, or DSM. The DSM codifies psychiatric conditions and is used world-wide as a key guide to diagnosing disorders.

    The abbreviation ‘APA’ is also in common and similar usage by the American Psychological Association and their ‘APA style guide’ for journal articles.

  • Katie

    Jag,

    Have you ever stumbled upon Joe Kort’s pages?

    He’s a gay therapist who feels it’s imperative that therapy be open to to the individual’s wishes and self-definitions.

    Will his form of working with sexuality issues also be considered prejudiced?

    And no, he doesn’t come from a religious background, he’s gay, he conducts gay affirmative therapy…. and also something much like Warren’s Sexual Identity Therapy.

    How is the average therapist to define “gay”?

    Will it be unethical to say anything other than that if a man has homosexua fantasies and/or behavior that you must provide encouragement and support to accept himself as a gay man? A bi man?

    Or will he be allowed to get support as a straight man who has homosexual fantasies and or/behaviors?

    Joe Kort ends up seeing lots of men who are referred out to him because they’re seeing therapists who become frustrated that they won’t come out of the closet, and how mistake “reorientation” therapy with working with the complexities of sexuality.

    Take care,

    Katie

  • Katie

    Jag,

    Also, how does science explain Ancient Greece?

    Until science can explain Ancient Greece, then it hasn’t come very far along in explaining sexual orientation.

    So, how do you explain Ancient Greece?

    Katie

  • David Blakeslee

    @Katie…

    What does science need to explain about Ancient Greece?

  • Jayhuck

    Katie,

    Jag doesn’t post here anymore – fyi!

    Here’s where I have a problem with the, meeting the client’s wishes/desires style therapy. Doesn’t a therapist have the responsibility to look at the reasons behind a client’s wishes/desires and decide FIRST if those desires are indeed healthy? OR, do we simply allow therapists to cater to any desires/wish/whim that an individual has – carte blanch – without questioning the motivations behind such desires?

    And all the while the therapists must realize and accept that being gay is NOT a disease that needs to be cured. I’m fairly certain you aren’t championing such an idea, but that is the foundation, IMHO, for all secular therapy regarding sexual orientation and homosexuality.

    Is sexuality a complex issue – Yes. I’ll never disagree with you on that. And defining the word GAY is as complicated as defining the word heterosexual. BUT, therapists do have a responsibility not just to the people they see in therapy, but to any of the people who might enter into a relationship with the person they are counseling.

    Perhaps we need to get rid of terms like gay AND straight – although I think they serve a purpose!

    I would need to know more specifics about Joe Kort’s type of therapy before I could ever support it.

  • Katie Cannon

    David,

    For the people who seem to think that all forms of homosexuality have an early bio-chemical predisposition as an influence, then they’d have to content with the wide-spread practice of homosexuality in Ancient Greece — which, of course was pederastry by our standards, but maybe not by theirs.

    And, based on the existing cultural artifacts, both written and artistic imagery, it wasn’t as though the Greeks merely practiced ritualized homosexuality divorced from an assessment of the beautiful, like many others cultures have done, and do.

    Not unlike the differing standards of female beauty in different historical epochs, it seems the Greeks were pretty successful at creating a cultural standard of beauty out of the male form. There doesn’t seem to have been the divide between female as beautiful and male as handsome like we live today.

    Anyway, it’s obvious, and the Greeks are but one example of this, that not all forms of homosexuality has a strong, early, bio-chemical underpinning.

    And if not all forms have a strong bio-chemical underpinning, then the argument that any engagement in questioning, and thus modifying, one’s pattern of attractions doesn’t do undue harm to all people because it’s merely a harmful attempt to modify a biologically driven aspect of a person that can’t really be changed anyway.

    A Greek man could have stepped back from his culture’s mandates and questioned the politics behind compulsory homosexuality. And some did.

    I doubt they were harmed in doing so.

    The more modern practice found in certain areas and within certain socio-economic groups in Mexico is another interesting case in point. It’s common practice for older boys to take as “lovers” younger boys. The older boy is to relate to the younger boy as though the latter were a girl. That is, the older boy is only to be the top, the younger, the bottom.

    The older boy is permitted to then go on and marry and be straight. The younger boy is not supposed to go on and be marry. Because of the social prohibition against marriage, and because he’s not considered able to take on the mantle of full masculinity, he’s often restricted to the most menial jobs and often prostitution.

    Again, I doubt that men coming from this background who decide to step back from his cultures definition of him as gay, and inherently so, would do himself grave harm.

    In fact, the lack of resources for him to get social and emotional support in doing so if he wishes seems to be the greater harm.

    Take care,

    Katie

  • Katie Cannon

    Jayhuck,

    No I don’t champion the idea that all forms of homosexuality is a disease — nor even any forms of homosexuality.

    But, like certain forms of heterosexuality, I think certain forms of homosexuality aren’t exactly filled with sunshine and light and all things good.

    Nor do I think that all forms of heterosexuality and homosexuality are grounded in either genetics or fetal hormonal washes.

    So I don’t think that all forms of questioning one’s sexual attractions is doing harm to a biological drive that can’t be changed anyway.

    I support gay positive therapy. I support gay marriage. I’m not religious. Consider myself on the very far left politically. Etc…. Pretty much a card carrying Liberal who don’t think the average Liberal is liberal enough.

    And I think that a guy who’s homosexuality is problematic for him should be able to have social support in building a life that feels less problematic for him.

    Just as I think a guy who feels his heterosexuality is problematic — like the closeted gay guy who feels compelled to practice heterosexuality because of the dominant, and largely heterosexist culture in which he grows up puts undue pressure on him to do so.

    But putting undue pressure on a guy who has homosexual fantasies and/or behaviors to identify as gay doesn’t solve the above problem.

    Supporting self-determination and respecting the feelings of individuals, while not perfect, is probably as good as it gets.

    And yes, a therapist should allow their clients to challenge their beliefs. That’s part of what therapy is — hopefully.

    But the role of the therapist should be helping their client to challenge their own beliefs for themselves.

    They shouldn’t be taking a patronizing role in which they know better than their clients, because lots of therapists are at least as crazy as their average client.

    The average client isn’t all that crazy. The really crazy people don’t tend to seek out therapists.

    So most clients are probably deserving as being viewed as having both their intellect and emotions pretty well intact. Even if that means they might make a mistake, just like therapists are apt to do.

    But mostly — not allowing questioning one’s identity in a therapeutic way assumes it’s harmful to do so…. Why?

    Because it seems to me that we assume that all forms of homosexuality is the unfolding of a biological truth.

    But it’s obvious that’s not the case in all forms of homosexuality.

    And if it’s not, who’s to decide which is which? The therapist?

    Or the client?

    Take care,

    Katie

  • David Blakeslee

    Thanks Katie,

    What if we just call the Greek behavior as Same Sex gratification…rather than homosexuality….or pedastry?

    It seems the word “homosexuality” for same sex behavior is a way to broadly define a group.

    Same sex behavior…and the possibility of being coerced into it as a young man or encouraged to participate in it in Greek culture, are two good examples of “what science has not examined.”

  • Evan

    Katie Cannon,

    Nice points on therapy. I agree with most of them. Too bad there’s too much advocacy and agenda on this issue that can prevent someone from getting professional support when it’s needed.

    You brought the subject of ancient same-sex behaviours. I think it’s more to them than we see from the modern perspective of sexual identity(ies). Ancient Greek men, not all of them, apparently used the practice to regulate some group and social power relations. One major difference from modern homosexuality is that it wasn’t a question of consenting adults, based on sexuality. Average life expectancy for men in that time was short, ~40 yrs, so many boys lost their fathers before reaching adult age, which posed a problem for the very citizenship-oriented Greeks. It is theorised that they used these bonds to ease a boy’s transition from puberty age to maturity, based on the fact that the man was required to attract the boy using gifts that would help him in his development. Anal sex was out of the question and sexual passivity in general was considered shameful. Once the boy grew up into an adult citizen he was expected to marry and cease the same-sex relations, those who did not and remained celibate ran the risk of becoming the laughing stock of the city. These relations were not so exclusive, that is, they didn’t put female prostitution out of business. And marriages were a lot more important than they are today.

    Anyway, by today’s scientific criteria, if some ancient Greek men’s attractions were exclusive for boys, they’d be more probably classified as ephebophile or hebephile. Male exclusive adult homosexuality would probably be as rare in Ancient Greece as it is in modern Greece. And, as you mentioned, it was mostly a phenomenon restricted to aristocractic people, because they were very concerned about keeping the number of heirs under strict control. Here’s a short paper, that gets into more detail on this issue.

    On this issue of age, I once saw a documentary on paleolithic living in Scandinavic regions and I remember, among other things, that some scientists claimed after studying human bones from that period that the age of sexual initiation and onset of puberty came much earlier for ancient females because they had a very short time frame. According to them, females were sexually active as early as 11-14 years of age and were expected to attract men and bear children way before their twenties, because infant mortality was very high and they had to make sure they see at least one child survives and is able to reach adulthood before their death. So, it seems that for women a short life span can compress some stages, lowering the age of sexual maturity, and eliminate menopause. If that impacted women’s sex lives, it is possible that dealing with sexual “orientation” was urgent enough for men to make sure that a boy gets beyond the same-sex stage quite fast and early. There is some evidence that this was performed as a ritual in less advanced tribes in which boys were first required to go through sexual initiation with men before they became mature enough to look for a woman.

  • Jayhuck

    Too bad there’s too much advocacy and agenda on this issue that can prevent someone from getting professional support when it’s needed.

    Evan,

    What do you mean by this? Obviously there is advocacy and agenda from both sides of this issue. I agree with most of Katie’s ideas regarding therapy as well, but we have to be careful about that kind of therapy.

    When we talk about the way other cultures have dealt with homosexuality, we usually aren’t talking about whether a man who was primarily homosexual was happy in a relationship with a woman (and that goes for Ancient Greece), or if a man who was primarily heterosexual was happy having relations with men – we are talking about cultural norms and expectations. Ancient Greek culture expected men to eventually have long-term relationships with women. Today, things are different. We have men who have primarily SSA who are saying – and who have a culture to back them up – that they prefer to have long-term relationships with men. This is fairly new – most societies weren’t open to that kind of thing – even in ancient Greece. People are actually allowed today to deal with the possibility of being with the person they love instead of the person that society dictates they be with.

    I agree with the following absolutely Katie :)

    And I think that a guy who’s homosexuality is problematic for him should be able to have social support in building a life that feels less problematic for him.

    Just as I think a guy who feels his heterosexuality is problematic — like the closeted gay guy who feels compelled to practice heterosexuality because of the dominant, and largely heterosexist culture in which he grows up puts undue pressure on him to do so.

    As long as we realize that the guy who feels his homosexuality is a problem may not need therapy other than something that is gay-affirming. Not all gay men who struggle with their orientation need to be changed or moved in a direction that doesn’t support their feelings – they need therapists who help them deal with the reality of their orientation. BUT, this doesn’t take away from the fact that some gay men may need something more in line with Warren’s SIT. I get that :)

    AND, as you said, there are probably plenty of gay men leading heterosexual lives who are having trouble with that as well – and may need to move in a different direction!

  • Jayhuck

    Because it seems to me that we assume that all forms of homosexuality is the unfolding of a biological truth.

    The same thing can be said of heterosexuality as well. From what you said earlier I know that’s something you realize, but its not often said – when it should be :)

  • Katie Cannon

    Jayhuck,

    Yes, I don’t assume all forms of heterosexualtiy is simply an unfolding of biological truth.

    I actually don’t believe — cuz I just don’t feel like it’s the case — I was simply born straight. I too readily remember my own development. Yes, this development might have been the development of my biological truth. And I can’t know this for sure one way or the other. But it sure FELT like a developmental path more driven by psychological factors.

    So for now, I’m going with that. For me, in my case.

    For those who feel they were simply born straight or gay, I take no issue whatsoever. I’m me and they’re they.

    I tend to go towards the easy cases first. So the type of problematic homosexuality I have in mind is more along the lines of the guy who is married, loves his wife, is spontaneously attracted to women romantically, yet can’t stay away from glory holes.

    The gay positive movement has a tendency to assume the only problem this guy has is internalized homophobia which blocks his own knowledge of his heart’s intent.

    And our fear of sinking back into Victorian shackles has a tendency to assume that all sex is good sex as long as it’s between adults and results in an orgasm.

    I understand the fear that gay men have when the specter of SOME people who probably really do experience their homosexuality as a fetish might lead us back to the days when all forms of homosexuality was assumed to be little more than a fetish.

    Then again, I’m not sure gay men REALLY want men who need to objectify men to be considered fully gay, any more than a straight guy who can ONLY objectify women would be considered fully straight.

    Nor, bi for that matter.

    Even within the most mechanistic takes on sexual orientation, the theme of emotional and moral development keeps coming back. Like most people who hold very mechanistic beliefs when it comes to attraction to adult men and women, still don’t consider the exclusive attraction to shoes an “orientation”.

    There’s a good argument to be made that Ted Bundy didn’t have a developed orientation, and neither did Jeffry Dahmer — though they both killed only one sex.

    K.

  • Jayhuck

    Then again, I’m not sure gay men REALLY want men who need to objectify men to be considered fully gay, any more than a straight guy who can ONLY objectify women would be considered fully straight.

    I agree! BUT, I know of no one, gay or straight, who hasn’t had problems with objectifying people. If its a case of them ONLY being able to do that I suppose it would be different, but I’ve never met anyone like that either.


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