Reparative therapy

Reparative therapy is a type of therapy designed to change a client's sexual orientation from homosexual to heterosexual. It is usually of a religious nature, and is not endorsed by professional psychological organisations, such as the American Psychological Association or the American Psychiatric Association.

Origins
Before 1973, homosexuality was considered a mental disorder by the American Psychiatric Association, and was present in the association's Diagnostic and Statistical Manual of Mental Disorders (DSM). Certain methods, as extreme as electroshock therapy, aversion therapy, or castration, were sometimes used in attempts to change a client's orientation. In 1973, homosexuality was removed from the DSM because it had been demonstrated that there was no scientific basis for such a classification. Many therapists disagreed with the decision to remove homosexuality from the DSM &mdash; for example, Charles Socarides (who has an openly gay son) and Bieber. The fact that the APA no longer classed homosexuality as a disorder meant that there was no approved therapies available for gay people who wanted to attempt to change orientation. This lead to the beginnings of the "ex-gay" ministries, the first of these being Love in Action.

Advocates of reparative therapy and "ex-gay" ministries
There are many groups that advocate and provide reparative therapy. The National Association for Research and Therapy of Homosexuality (NARTH) is one such group, whose current president is Joseph Nicolosi. NARTH is not an openly religious ministry. The biggest ex-gay ministry is Exodus International, an evangelical Christian ministry that promotes "freedom from homosexuality". Other groups include Parents and Friends of Ex-Gays (PFOX), Evergreen International (a group for Mormons), and Homosexuals Anonymous.

Ideas and methods
Most reparative therapists promote the idea that male homosexuality is caused by a lack of bonding with the father, which causes the male to seek affection from other men, causing homosexual attractions. This idea is without merit, however, because there is no scientific support for such a claim. In addition, expected trends (such as increase in homosexual males that grew up without fathers during WWII) have not been demonstrated, and appear to be non-existent.

Methods based on this hypothesis involve attempting to get the male to form a nonsexual bond with a person of the same sex, replacing the love and affection the homosexual never had in childhood. The treatment also often involves attempting to get gay men to behave in a more masculine manner.

Reparative therapy of female homosexuality is along similar lines, with the female not forming the correct bonds with the mother rather than the father.

Success rates
There is very little evidence to suggest that homosexuals can successfully change orientation. In 2001, Dr. Robert L. Spitzer presented a study claiming that some of his clients could change, claiming that 66% of the males and 44% of the female clients in his study claimed "good heterosexual functioning". The study was heavily criticized for several reasons: Even if these problems were overcome, Spitzer's methodology was merely talking to each client for 45 minutes on the telephone, with no follow-up interviews. Self-reporting is unreliable, especially in this case, as 78% of participants had publicly spoken positively about attempts to convert homosexuals to heterosexuality. In fact, Spitzer himself did not claim that his results were representative of participants in ex-gay therapy, or that most of clients who go through reparative therapy can successfully change.
 * 1) The clients appeared to be handpicked from a large number of people that entered the ministries.
 * 2) Many of the participants were referred from ex-gay ministries, who were likely to send only the most successful clients.
 * 3) Many of the clients &mdash; up to 60% of Spitzer's participants &mdash; were bisexual, which would cause an inflation of success rates.

In 2002, two psychologists, Shidlo and Schroeder, published a study about the experiences of 202 clients of reparative therapy. They reported that only 8 of those 202 claimed to have changed sexual orientation, and 7 of those had positions in ex-gay ministries.

Evidence of harm
There have been many suggestions and indications that reparative therapy actually causes harm to clients. Shidlo and Schroeder found that the vast majority of their clients were harmed by the attempt to change. These harms involved:
 * Depression, suicidal feelings and suicide attempts after failure to change orientation;
 * Lowered self-esteem and reinforcing of already internalized homophobia, as therapists often had very strong anti-gay biases;
 * Distorted perceptions that curing homosexuality would sort out other life problems that are unrelated;
 * Intrusive imagery and sexual dysfunction;
 * Monitoring of effeminate or butch tendencies;
 * Harm to relationships with parents as they were often blamed during therapy for the homosexuality;
 * Alienation, loneliness and social isolation;
 * Interference with relationships and friendships;
 * Fear of being a child abuser;
 * Delay of emotional development due to not coming out;
 * Loss of religious faith;
 * Excommunication and abandonment by religious groups.

There have also been problems with certain ex-gay counselors abusing clients sexually. For example, Chris Austin was recently arrested for this crime.

There have also been anecdotal accounts of suicides. For example, Stuart Mathis, a gay Mormon, killed himself over his failure to change.

Many people believe reparative therapy, even if successful, to be unethical, because there is no real reason for a person to intentionally try to change sexual orientation.