Some of the most compassionate and courageous—and least politically correct—people in the country are mental health providers who assist clients with unwanted same-sex attractions. I had the privilege of spending time with some of them on October 5 and 6 in Orlando, at the annual conference of the Alliance for Therapeutic Choice and Scientific Integrity (“The Alliance,” formerly known as the National Association for Research and Therapy of Homosexuality, or “NARTH”).

Although LGBT activists have been critical of sexual orientation change efforts (SOCE) for decades, the threat to such therapy has become an existential one only in the last six years, as several states have enacted laws prohibiting licensed mental health providers from engaging in SOCE (often referred to by critics and the media with an outdated term, “conversion therapy”) with minors. However, this year’s Alliance conference came in the wake of an unexpected win, when an even more extreme therapy ban proposal in California was withdrawn by its sponsor, Assemblyman Evan Low, on August 31 (the last day of the legislative session).

The conference featured a variety of presentations and workshops touching on medical, clinical, and cultural issues, as well as research. Attorney Geoff Heath gave an overview of the therapy bans—including several different arguments as to why they should be found unconstitutional. He touched on ways in which they infringe freedom of speech and the free exercise of religion, in addition to noting the more technical legal principle that they may be “void for vagueness.”

It is ironic that attacks upon such therapies have grown ever more extreme, even as the therapists themselves are becoming ever more scrupulous about following “best practices” that avoid the kind of behaviors (such as “coercion” of clients or “guarantees” of complete transformation) of which they are regularly accused. Christopher Rosik, Ph.D., introduced an updated set of Guidelines for the Practice of Sexual Attraction Fluidity Exploration in Therapy (or “SAFE-T,” an acronym coined by the Alliance to better describe the actual focus of such therapy). This carefully reasoned and thoroughly documented 62-page document (not yet available on the Alliance website, at last check—an older version is here) features 13 specific guidelines to ensure that client goals are respected, fully informed consent is obtained, and any potential harm is avoided.

Several sessions addressed research questions. Philip Sutton, Ph.D., gave an introductory presentation with the explanatory title, “Are Same-Sex Attractions and Behaviors (SSA) REALLY Innate, Inconsequential, and Immutable? What Research and Demonstrable Clinical Experience Does and Does Not Show.” Key research findings he explained show that:

  • SSA is not innate.
  • SSA is consequential (that is, it does have many significant negative consequences and co-occurring difficulties—undermining claims that it is a “normal, positive variant of human sexuality”).
  • SSA is mutable (that is, it can change).
  • Some intended and beneficial changes in SSA (often along a continuum) occur through professional and pastoral assistance.
  • Therapeutically assisted change is not invariably harmful.

One of the conference keynote speakers, the Rev. D. Paul Sullins, Ph.D., discussed several research questions. He described existing research showing that the genetic influence on the development of homosexuality is relatively small, while showing that the influence of being a victim of child sexual abuse on developing a later same-sex orientation is significant—both of which undermine the theory that people are “born gay.” He discussed follow-up research he has done (but not yet published) concerning children in same-sex or opposite-sex parent households. He also discussed findings regarding the crisis involving sexual abuse of minors by Catholic priests. (Dr. Sullins is a Catholic priest himself, albeit an unusual one—he is married, having been a married Episcopal priest before converting to Roman Catholicism.)

Carolyn Pela, Ph.D., provided useful training on how to evaluate published research studies. She noted the existence of several different types of studies—exploratory, observational, quasi-experimental, and experimental. Exploratory studies are just that—they simply explore a topic, often through anecdotal accounts, but are incapable of arriving at conclusions that can be generalized to a larger population. Ironically, an often-cited 2002 article on the potential harms of change therapies by Ariel Shidlo and Michael Schroeder was, by its own account, merely an exploratory study, and thus offered no conclusions about the actual prevalence or likelihood of such harm.

Observational studies can demonstrate correlations between variables (“A is often accompanied by B”), but cannot definitively prove causation (“A causes B”). However, correlational studies can still be highly important—the conclusion that smoking is associated with lung cancer was based on correlational studies, for example. Only an experimental design can scientifically prove a causal relationship, but that requires the existence of a control group and random assignment to the study group or control group (this is how studies of new drugs are conducted, for instance). But for some research questions, a truly experimental design is either not practical or not ethical—studies of parenting outcomes, for example, would require that children be randomly assigned at birth to parents! Pela also reviewed questionable research practices that can be found in the areas of recruiting, research procedures, and reporting of results.

One of the clinical presentations was offered by Joseph Nicolosi, Jr., Ph.D. His father, one of the founders of the Alliance, died suddenly in 2017. Dr. Nicolosi, Jr. is carrying on his father’s work, but re-branding it—quite literally, in that he has trademarked the term “reintegrative therapy” to describe his approach (and to distinguish it from the ill-defined term “conversion therapy”). His father had coined the term “reparative therapy” in the 1990’s, but this was often (mistakenly) taken as implying a view that homosexuals were broken and needed to be “repaired.” Nicolosi, Jr. introduced an approach he calls the “reintegrative protocol,” which he insisted is not premised on any particular view of sexual orientation and can be used by therapists of any ideological persuasion. Its goal, he said, is not to change sexual orientation, but to heal trauma and sexual addiction—but a change in same-sex attractions may sometimes result when the protocol is followed. 

Two films were also screened at the conference. One, Voices of the Silenced, is an international effort produced by British expert Michael Davidson. It features personal testimonies from clients as well as from experts about the potential for sexual orientation change, while also placing the issue in a larger cultural and historical context, noting how the sexual revolution represents an effort to undo the advances made by Judeo-Christian culture and return to the pagan worldview of ancient Greece and Rome. The other, Free to Love (a 38-minute documentary that can be viewed free online), presents an overview of the debate over SOCE in the American context, and includes interviews with four ex-gay men as well as the views of attendees at a Gay Pride event.

Although geared largely for therapists, the Alliance conference is an important event every year for public education and networking as well. With the freedom to seek change ever more under attack, the Alliance is a vital ally in promoting the truth and protecting clients’ rights to self-determination.