Ex-Gay Therapy And Kinds Of Evidence

Making the scientific sausage

Photo by Daniel Olah on Unsplash.

An interesting thing about the American Psychological Association’s report on sexual orientation change efforts (i.e. ex-gay therapy) is how weak all the evidence is. Seriously, read it! For something usually cited as showing that the scientific consensus is that ex-gay therapy doesn’t work and is harmful, what it actually finds is:

1. Behaviorist therapy techniques that no one uses anymore harm patients and show very low success rates.

2. There are almost no studies of modern reparative therapy techniques, and the studies that exist are bad.

3. Some people anecdotally report experiencing harm from reparative therapy, and some people anecdotally report experiencing benefits.

Normally, this set of evidence would lead you to call for more studies, not to go “this should be banned.”

Of course, we actually have very good evidence that ex-gay therapy doesn’t work and is harmful. Almost all of the big names in the ex-gay movement—John Paulk, Alan Chambers, the founders of Exodus International, dozens of more minor celebrities—left, apologized, and said that no one ever became straight but lots of people became suicidal. At present, the ex-gay therapy community consists of like six straight psychologists and Anne Paulk.

Celebrity ex-gays had a lot invested in the therapy working. Most of them had careers as ex-gay speakers or lobbyists, often for their entire adult lives, with few job prospects if they left. They had to leave their religions, their communities, and their friendships; they risked rejection from their families; often, they had to divorce their spouses. And, of course, few people have the guts to admit that they have been wrong, for years or decades, in a way that drove vulnerable people to suicide.

And yet the weight of their personal experience was overwhelming: ex-gay therapy does not work.

I don’t actually think an intellectually honest person can look at the world and conclude that ex-gay therapy (a) makes people straight or (b) helps people, except insofar as it is less homophobic than the community they would be otherwise spending time in. However, the evidence that exists is not scientific evidence. The American Psychological Association can’t go “this shit is bad. Source: everyone who advocated for it begs for forgiveness a decade later.” They need control groups! P-values!

So they misrepresent things, a little bit. They commission a lit review that accurately summarizes the state of the scientific evidence. They say, accurately, that there is overwhelming evidence that ex-gay therapy is ineffective and harmful. And they hope that no one notices that these two true things aren’t really connected to each other.

This is a subject I happen to know a little about, which is how I noticed. But I think something like this is how the scientific-consensus sausage gets made.