“While the ex-gay ministry believes we can be healed of our homosexuality, I realised that this ‘healing’ was actually the repression of my feelings and desires,” says Clive Vanderwagen, a South African man who was once part of the ex-gay ministry – one of many practices aimed at “changing” sexual orientation. “Like any form of repression, it has the potential to erupt at any time and, when it does, it can do damage.”

The American Psychiatric Association (APA) condemns these so-called “conversion therapies” which attempt to change the sexual orientation of a person from homosexual (or bisexual) to heterosexual. The APA argues that these therapies are based on the assumption that homosexuality is a mental disorder, despite the fact that it was removed from the Diagnostic and Statistical Manual of Mental Disorders in 1986.

The majority of those seeking treatment cite religious convictions as their main reason for wanting therapy, while others report a lack in emotional satisfaction from gay life and social pressures as factors which influence their choice.

Eugen Steinach, a twentieth-century endocrinologist from Austria, first attempted to change the sexual orientation of gay men by transplanting the testicles of straight men into them. Despite the failure of this experiment, Sigmund Freud was greatly influenced by Steinach. Freud believed that homosexuality could be cured through psychoanalysis and hypnosis and so started a trend which has survived into the 21st century.

Early forms of behavioural modification made use of aversive conditioning techniques which included the use of electric shocks and nausea-inducing drugs while exposing the individual undergoing treatment to erotic images of a homosexual nature. Later, the patient would be exposed to images of the opposite sex, without the negative conditioning, in an attempt to decrease their aversion to heterosexual feelings. According to psychologists at the time, this had a 58% cure rate.

American psychologist, Douglas Haldeman, maintains that such therapy endured by anyone other than the gay community would be considered “torture” and that this form of treatment does not promote heterosexuality, but instead leads to homosexuals becoming “shamed, conflicted and fearful about their homosexual feelings.”

“Reparative therapy” is a term which was coined in 1991 by well-known clinical psychologist Joseph Nicolosi. Nicolosi, the former president of the National Association for Research and Therapy of Homosexuality (NARTH) – the largest organisation for practitioners of ex-gay therapy – maintains that homosexuality can be cured by conditioning a man to his traditional masculine gender role. These forms of conditioning include participating in sports, avoiding contact with women unless it is for romantic reasons, learning how to mimic “masculine” ways of behaving, attending church, engaging in heterosexual sex and fathering children. These forms of conversion therapy are all based on the idea that homosexuality is a learned behaviour, despite criticism from the mainstream medical industry which refutes these claims.

Conservative religious groups which offer support and treatment are called ex-gay ministries. These groups remain the most outspoken advocates of conversion therapy. According to Vanderwagen, ex-gay ministries are very direct in their approach to conversion. “There are no claims that you will be straight and find women attractive: the belief is that God does not replace one lust for another but that you choose to walk away from the lifestyle of homosexuality. You are never straight, you become ex-gay.”

The APA warns against ex-gay ministries for fear that they could cause further social harm by reinforcing stereotypes about homosexuals and thus increase prejudice and stigma about homosexuality in society.

The most contemporary and controversial study of our time is that of Robert Spitzer, former Professor of Psychiatry at Columbia University. In his study “Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation”, Spitzer reports that 66% of men and 44% of women had been cured and experienced what he called “good sexual functioning” after undergoing treatment.

However, Spitzer’s study has been criticised for a number of reasons. Not only was it unclear what the treatment consisted of, but there was no control group nor were follow-ups conducted and there was a belief that participants may have been bisexual before undergoing the treatment. In 2012, Spitzer renounced his study and apologised to the gay community. In an interview with Gabriel Arana, former patient of Joseph Nicolosi and writer for The American Prospect, Spitzer said, “In retrospect, I have to admit I think the critiques are largely correct. The findings can be considered evidence for what those who have undergone ex-gay therapy say about it, but nothing more.”

Advocates for conversion therapy maintain that the treatment works for highly motivated individuals and that those seeking the treatment should be allowed to undertake it. Critics, on the other hand, have labelled any practitioners offering the treatment as unethical and as a result, it is considered a violation of the Hippocratic Oath. Jack Drescher, a psychiatrist and member of the APA, says that any supposed obligation to allow a patient the freedom of choice to undergo therapy is “outweighed by a stronger ethical obligation to keep patients away from mental health professionals who engage in questionable clinical practices.” Many would argue the questionable practices of treatment when they consider the amount of controversy surrounding advocates for conversion therapy. On 4 May 2010, the Miami New Times reported that a Baptist Minister and NARTH board member, George Alan Rekers (who previously testified in court that he believes homosexuality is a sin), was caught hiring a gay male prostitute to accompany him on holiday.

On 2 May of this year, The Christian Post reported that a law is currently being amended in California which would make conversion therapy more difficult to practise, by banning treatment of anyone under the age of 18.

“People should realise that LGBTI [lesbian, gay, bisexual, transsexual and intersexual] people are not ill,” says Lerato Phalakatshela, Vice-Chairperson of Up and Out, Tuks’ s official LGBTI society. Phalakatshela reiterates the belief that these therapies only offer false hope and could do more harm than good. “Being gay is not a choice. We really were born this way.”

Illustration: René Lombaard

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