Friday, May 18, 2012

Dr. Robert L. Spitzer - “I owe the gay community an apology.”




The New York Times
 BENEDICT CAREY 
has just published (May 18, 2012) an important item, which is summarized below, with a link to the Times piece at the bottom of this post.

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The Apology

Prominent psychiatrist, Dr. Robert L. Spitzer has rejected so-called reparative therapy, a prominent concept touted as a “cure” for homosexuality, which is linked with a paper Spitzer published in 2001.

Having learned that a World Health Organization Report
 was to be released, which called his therapy “a serious threat to the health and well-being — even the lives — of affected people” Spitzer acted in advance of the report.

He wrote a short letter to be published in the journal in which he had placed his injurious, report.

The letter states:

“I believe I owe the gay community an apology.”

The Background

Until the 1970s and despite the strenuous objections of gay people and their advocates, psychiatry officially described homosexuality as a “sociopathic personality disturbance.”

In this context, a young Dr. Spitzer compared homosexuality with other conditions defined as disorders. His efforts led to the rewriting of the field’s diagnostic description of homosexuality as  “sexual orientation disturbance.”
This redefinition meant that homosexuality was no longer a “disorder.” 

"The declassification of homosexuality was widely celebrated as a victory,” said Ronald Bayer of the Center for the History and Ethics of Public Health at Columbia.

Partly as a result, Dr. Spitzer took charge of the task of further updating the diagnostic manual. 

In 1980 the 567-page revised manual was well received and garnered Dr. Spitzer, still not yet 50, international recognition.
Still eager to extend the frontier of psychiatric therapies challenge common assumptions, Spitzer, in 1999, met with a group of self-identified "ex-gays."

Reparative Therapy / Sexual Reorientation / Conversion

This encounter convinced Dr. Spitzer to take more seriously the Freudian idea that people are innately bisexual. He solicited individuals under treatment by the National Association for Research and Therapy of Homosexuality (Narth), which - working with conservative advocacy groups - widely advertised its success in 'curing' homosexuality. 

Dr Spitzer conducted a study by interviewing 200 individuals under treatment at Narth, Exodus International and elsewhere. Spitzer questioned each interviewee about their sexual urges and any differences in behaviors before and after 'reorientation' therapy.  

Spitzer rated responses on a scale of his own invention and in 2001, asserted that a majority of participants in his study reported a change from a homosexual orientation to a heterosexual one.

Ex-gay advocacy groups touted the Spitzer report as scientific confirmation.

Leaders of gay organizations denounced Spitzer and his report.

In fact, the study suffered from a number of methodological problems:

- people reported on what they remembered feeling years before 
- some of the study participants were politically active advocates of 'conversion' therapies
- half the participants had received treatment from a credentialed therapist while the other half had been seen by pastoral counselors, or had taken part only in Bible studies
- the paper in which Dr. Spitzer's reported his findings did not go through a peer review process (unidentified experts provide a pre-publication critique)

The most fundamental criticism seems to be this: asking people if they are changed is no evidence of change. 

Nevertheless, the study was published, accompanied by a number of critical "commentaries," which seem to have been meant as a substitute for a peer review process.

One such commentary was submitted by 15 researchers at 
the New York State Psychiatric InstituteThey stated: 

“We fear the repercussions of this study, including an increase in suffering, prejudice, and discrimination.” 

The fact of publication permitted gay-cure advocates to assert that the prestigious Dr. Robert L. Spitzer had determined that homosexuality could be cured by the right therapy.

Dr. Spitzer himself retained some hesitations about the published findings.  “How do you know someone has really changed?” he asked himself. 

He did not publicly state his doubts for eleven years. 

He was prompted to go public when he was interviewed by a journalist, Gabriel Arana, who is gay and who, in his teens, went through "reparative therapy" as a result of Dr. Spitzer's study. Gabriel Arana  let Dr. Spitzer know that "reparative therapy" had delayed his self-acceptance and had prompted thoughts of suicide. Arana, who writes for The American Prospectwrote about his own experience  in April 2012.

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