The letter had two parts. In the first, she attempted to refute the claim that homosexual orientation is not a mental disorder and that attempts to change orientation has no scientific basis.

In the second part, she attempted to defend Liberty League's qualification for the grant.

This essay deals with the first part of her letter, in particular her citation of a study by Robert Spitzer. Specifically, she said this:

In a subsequent study where he investigated the claims of former homosexuals, Dr Spitzer concluded there was credible evidence that change was possible and that the homosexuality trait was not fixed. In an interview, he had said that those who denied change was possible "have not been honest and (have not) taken the time to do the research".

A disservice is done to the public by not disclosing the real state of affairs ­ good corporate governance calls for accuracy and transparency in media reporting so that it can better serve the people of Singapore.

Robert Spitzer was instrumental in 1973 in convincing the American Psychiatric Association (APA) to drop the classification of homosexuality as a mental illness. That he has suddenly become a darling of the anti-gay rightwing of the US (and their Singapore adherents) is due to a paper he presented at the May 2001 conference of the APA.

Ever since then, the anti-gay religious right has been citing his work to support their claim that homosexuals can change, with the implication that homosexuals SHOULD change. By further extension of the logic, since homosexuals should change, society and state should discriminate against gays and lesbians -- what better way of motivating them to change?

As you can see, Thio suggested that Today newspaper has not been accurate or transparent in reporting the latest scientific "facts", as reported by Spitzer, that homosexuality can be changed. (Or cured. Since to her it was a mental disorder, change must mean cure, right?)

This will not be the last time Spitzer's study is waved as "proof" of their anti-gay claims. There being no other available "evidence", the anti-gay right will continue to wave this study every time they have to make a "scientific" case for their claims. Thus it is important for everyone to be fully aware what exactly Spitzer found in his 2001 study.

 
What was the aim of the study?

At the May 2001 conference, Spitzer titled his talk "200 subjects who claim to have changed their sexual orientation from homosexual to heterosexual" [1]

This title is unusually clear. It tells us what he set out to study. He wanted to find out if there was any truth to the claims by ex-gay groups that they could successfully alter a person's sexual orientation. Thio and others will have us believe that he did find such proof, but a closer reading of this findings -- that's what this article is about -- will show us that

• the selection of respondents was probably too broad to yield reliable interpretation;
• the respondents were nowhere near representative of gay people generally;
• the study method was open to much criticism;
• and anyway he didn't find a lot of change, even when based on unverified self-reports.

Spitzer was fully aware of the study's limitations, at least post-facto, and he has been aghast at the way the anti-gay rightwing has been using his study. More below.

He reported in his presentation at the 2001 conference that it took him about 16 months to find enough volunteers -- yes volunteers, not a random sample -- for his study. Of the original 274 respondents, 200 met his inclusion criteria: "predominantly homosexual attraction" [2] prior to therapy and a change of "no less than 10 points" [3] towards the heterosexual end after therapy.

You'd notice the term "predominantly homosexual". As explained in the footnote, this unusual criterion resulted in a sample that seemed to have included a lot of bisexuals, for less than half of the 200 respondents said they had been "exclusively homosexual" prior to seeking therapy.

Spitzer didn't set out to prove that one could change a person's sexual orientation. His study was much more subtle than that. Note, for example, that he deliberately chose 200 people who, by their own self-reporting, claimed that had been changed, albeit that the level of change required for inclusion was unambitious.

If I have to characterise his study in another, cruder way, I would say this: Spitzer took 200 people who said their sexual orientation had been changed, and wanted to find out how many of them were either lying or deluded.

If the reparative therapies were all they made themselves out to be, the expected result should be something close to 0%. All, or nearly all 200 examples of changed orientations should be proven to be true.

 
Profile of the 200 respondents

Before moving too far ahead, let's take a look at the demographic profile of the 200 participants.

• There were 143 men and 57 women. 
   
• The average age of the men was 42, of the women, 44.
   
• Before beginning therapy, 21% of the men and 18% of the women were married. (Later, at the time of the interviews, 76% of the men and 47% of the women were married)
   
• 67% of the men and 35% of the women said they were motivated to seek conversion therapy because they felt their homosexual urges were an obstacle getting married or staying married, indicating that being in an opposite-sex marriage was extremely important to them.
   
• 97% were of Christian background and 3% Jewish.
   
• 93% of them said that religion was "extremely" or "very" important in their lives. 
   
• 79% of them said they were motivated to seek conversion therapy because homosexuality conflicted with their religious beliefs.
   
• 19% of the participants were mental health professionals or directors of ex-gay ministries themselves.
   
• 37% of the men and 35% of the women reported that at one time, they had seriously contemplated suicide due to dissatisfaction with their unwanted attractions.
   
• 78% had spoken in public in favour of efforts to change homosexual orientation.
   
• 42% of the men and 46% of the women rated themselves as "exclusively homosexual" before they sought therapy -- this means that a majority of the 200 were bisexual [5]

It's important to grasp the profile as pictured above. This group of 200 volunteers were not your everyday gay and lesbian people. To begin with, bisexuals were the majority. They desperately wanted the social recognition that came with being married (in the conventional sense). They were unusually religious and had been seriously depressed, to the point of suicide in some cases. Many had been involved in promoting the ex-gay cause themselves.

 
Method

The study was conducted through telephone interviews, lasting about 45 minutes, and comprising 60 questions. Respondents' answers were accepted at face value with no means to verify their answers through physiological tests.

One criticism has been that there was no long-term follow-up interview with these respondents to check consistency of their answers.

Another has been that there was no control group.

It should also be noted that the study participants did not have the benefit of anonymity. After all, they had volunteered.

Hence, a serious doubt lies over the veracity of the self-reports given in the telephone interviews. Could they be giving answers that they felt ought to be given? Beyond the lack of anonymity, their very inclusion in the study was in the first place based on the claim that they had changed. Wouldn't it be difficult to give answers during the interview proper that might seem to contradict that initial claim?

Moreover, 78% had spoken publicly in favour of reparative therapy. Wouldn't it be hard to give answers to the interviewer that contradicted what they were saying in public?

For these reasons, critics of the study felt it was impossible to rely on the findings.

 
Findings

Given all the above caveats, one should be expecting the results to show a 100% success rate. But amazingly, they did not.

After therapy, 63% of the 200 subjects (and 86% of the 143 men) reported that they still had feelings of attraction towards the same sex. In other words, they were, at best, bisexuals. Do recall, however, that the study started with about 57% bisexuals (see profile above) though Spitzer resisted using the term.

As a specific example, we can look at the answers to the question about masturbation. Of the 143 men, 112 acknowledged that they masturbated. Of these 112 men, 31% said they almost always had same-sex fantasies while masturbating. Another 56% said they used homosexual fantasies "some of the time".

After therapy, 66% of the men and 44% of the women had "good heterosexual functioning", which was defined as being in a sustained, loving heterosexual relationship for the past year, deriving emotional satisfaction from it, having satisfying heterosexual relationships at least once monthly without (or rarely) thinking about homosexual fantasies while having heterosexual sex.

Considering that the study started off with about 57% bisexuals, who are always potentially capable of having a satisfying relationship with the opposite sex, reaching 66% and 44% (men/women respectively) "good heterosexual functioning" really wows me off my feet.

After therapy, 16 (11%) men and 21 (37%) women reported that they now had a heterosexual orientation. To be more precise, Spitzer found that this group had "no homosexual indicators" after therapy. The four indicators he used were 

• lustful thoughts of the same sex 
• yearning for romantic intimacy with a partner of the same sex 
• homosexual fantasies during heterosex 
• use of gay porn

* * * * *

 
In short, here was a study of 200 ultra-religious, disproportionately depressed people -- and you could add 'self-hating, internalised homophobic' -- who claimed they had had their sexual orientation changed after reparative therapy. Nearly 4 in 5 of them had proclaimed this success publicly. One in 5 of them derived employment in a way related to this ex-gay movement.

More than half of them had not even claimed to be exclusively homosexual in the first place, before therapy.

Spitzer took their interview self-reports at face value. Despite the obvious potential for false or exaggerated responses, he had no way to verify them.

At the end of the day, he found that only 37 of them (17.5%) had none of the 4 indicators for homosexual attraction.

Are you as underwhelmed as I am?

The ex-gay movement and people like Thio Su Mien treat this study like some kind of irrefutable proof that reparative therapy works. Then they accuse the media of not being fair and accurate when this study is not highlighted every time anyone talks about the sham that is the ex-gay movement.

One cannot but ask how clouded are their minds.

Spitzer himself refuses to allow this study to be used in this manner. On 23 May 2001, the Wall Street Journal published a commentary [6] by him wherein he said,

My study concluded with an important caveat that it should not be used to justify a denial of civil rights to homosexuals, or as support for coercive treatment. I did not conclude that all gays should try to change, or even that they would be better off if they did. However, to my horror, some of the media reported the study as an attempt to show that homosexuality is a choice, and that substantial change is possible for any homosexual who decides to make the effort.

In reality, change should be seen as complex and on a continuum. Some homosexuals appear able to change self-identity and behavior, but not arousal and fantasies; others can change only self-identity; and only a very few, I suspect, can substantially change all four. Change in all four is probably less frequent than claimed by therapists who do this kind of work; in fact, I suspect the vast majority of gay people would be unable to alter by much a firmly established homosexual orientation. I certainly believe that parents with homosexually oriented sons and daughters should love their children -- no matter how their children decide to live their lives -- and should not use my study to coerce them into unwanted therapy.

The same year, the Finnish Parliament was debating a new law for same-sex civil partnerships and non-discrimination [7]. Conservative politicians, particularly those in Finland’s Christian Democratic Party, cited Spitzer's study as evidence that homosexuals can change, in their vehement denunciation of the proposed law.

When he learnt of this, Spitzer wrote to Kari Karkkainen, the lawmaker leading the opposition against the bill, saying that he was "disturbed" that his study results were being "misused by those who are against antidiscrimination laws and civil unions for gays and lesbians."

Spitzer explained that his study was "based on a very unique sample." Such results "are probably quite rare, even for highly motivated homosexuals," he said.

His letter added that "it would be a serious mistake to conclude" from his research that homosexuality is a "choice."

In fact, he "personally favor[ed] antidiscrimination laws and civil unions for homosexuals."

© Yawning Bread 

1. This website gives the text of the slides Spitzer used at the may 2001 conference.
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2. Spitzer defined "predominantly homosexual attraction as a rating of at least 60% on a scale of 0 to 100, where 0 represents exclusively heterosexual and 100 exclusively homosexual. 60 is not a high bar. Most bisexual persons would qualify. This is an important issue because bisexual persons can anyway function sexually with partners of the opposite sex. Repression of their homosexual side would be enough to make them "exclusively heterosexual". Critics of the Spitzer study have pointed out this weakness of the study.
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3. A change of only 10 points towards heterosexuality in a 100-point scale is also very unambitious.
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4. But the anti-gay religious right glosses over this and leaves people to believe that Sptizer's sample was meant to be representative of the gay and lesbian population. By doing so, they imply that the "change" that Spitzer demonstrated can be effected in the typical gay or lesbian person.
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5. Spitzer explained that he did not use the term 'bisexual' in his study at all, for the reason that it's very difficult to define the term. He used the term "predominantly homosexual" to describe his selected volunteers, i.e those who scored 60% or more on a scale of 100. See footnote 2 above.
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6. For an archived version online, see  www.christianmentalhealth.com/doc/robert.spitzer.response.htm  
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7. For a report on what happened in Finland, see http://pn.psychiatryonline.org/cgi/content/full/36/24/11 
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8. Other references: 
   www.ralliance.org/SpitzerStudy.html   
   www.religioustolerance.org/hom_spit.htm   www.theflipsideshow.com/Documents/RobertSpitzerOnHomosexuality.htm