PSYCHIATRY AND HOMOSEXUALITY

https://en.wikipedia.org/wiki/Robert_Spitzer_(psychiatrist)#cite_note-19
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https://en.wikipedia.org/wiki/Homosexuality_in_DSM (APA Manual)

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On homosexuality[edit] (Quote from the above Spitzer article)

Spitzer led a successful effort, in 1973, to stop treating homosexuality as a mental illness.^[18][19]

It was partly due to Spitzer's efforts that homosexuality was "removed" (i.e. renamed as Sexual Orientation Disturbance) in 1974 DSM-II: "By withdrawing it from the manual, homosexuality was legitimized as a normal difference rather than a psychiatric behavior. This early powerful statement by institutional psychiatry that this is normal sped up the confidence of people in the movement." ^[4]

In 2001, Spitzer delivered a controversial paper, "Can Some Gay Men and Lesbians Change Their Sexual Orientation?" at the 2001 annual APA meeting; he argued that it is possible that some highly motivated individuals could successfully change their sexual orientation from homosexual to heterosexual.^[20]

A Washington Post article indicated that Spitzer held 45 min telephonic interviews with 200 people who claimed that their respective sexual orientations had changed from homosexual to heterosexual. Spitzer said he "began his study as a skeptic," but the study revealed that "66 percent of the men and 44 percent of the women had arrived at what [Spitzer] called good heterosexual functioning," defined as "being in a sustained, loving heterosexual relationship within the past year, getting enough satisfaction from the emotional relationship with their partner to rate at least seven on a 10-point scale, having satisfying heterosexual sex at least monthly and never or rarely thinking of somebody of the same sex during heterosexual sex."

Spitzer also found that "89 percent of men and 95 percent of women said they were bothered only slightly, or not at all, by unwanted homosexual feelings" but that "only 11 percent of the men and 37 percent of the women reported a complete absence of homosexual indicators, including same-sex attraction. ... Some 43 percent of the sample had been referred to Spitzer by 'ex-gay ministries. ... An additional 23 percent were referred by the National Association for Research and Therapy of Homosexuality." Spitzer has stated that his research "shows some people can change from gay to straight, and we ought to acknowledge that."^[21] Considering how difficult it had been to find 200 participants, and that they were considered the best cases of conversion therapy, Spitzer concluded that although change could occur, it was probably very rare.^[22][23]

The APA issued an official disavowal of Spitzer's paper, noting that it had not been peer reviewed and stating, "There is no published scientific evidence supporting the efficacy of reparative therapy as a treatment to change one's sexual orientation."^[24] Two years later, Spitzer's paper was published in the Archives of Sexual Behavior.

Two thirds of the reviews were critical, and the publication decision sparked controversy, with one member of the publication's supporting organization resigning in protest.^[25] The paper has been criticized for its sampling methods and criteria for success.^[26]

In a 2005 interview, Spitzer stated, "Many colleagues were outraged" following the publication of the study. Spitzer added, "Within the gay community, there was initially tremendous anger and feeling that I had betrayed them." When asked whether he would consider a follow-up study, Spitzer said no and added that he felt "a little battle fatigue."^[27] While Spitzer has said that he has no way of knowing whether the study participants were being honest,^[21] he has also indicated that he believed that the interviewees were being candid with him.^[27]

In a 2012 interview, Spitzer said he asked to retract the study and stated that he agreed with its critics:^[28]

"In retrospect, I have to admit I think the critiques are largely correct," he said. "The findings can be considered evidence for what those who have undergone ex-gay therapy say about it, but nothing more." He said he spoke with the editor of the Archives of Sexual Behavior about writing a retraction, but the editor declined. (Repeated attempts to contact the journal went unanswered.)

In a letter to Kenneth J Zucker, editor of Journal of Sexual Behavior, Spitzer wrote:

"Several months ago I told you that because of my revised view of my 2001 study of reparative therapy changing sexual orientation, I was considering writing something that would acknowledge that I now judged the major critiques of the study as largely correct. After discussing my revised view of the study with Gabriel Arana, a reporter for American Prospect, and with Malcolm Ritter, an Associated Press science writer, I decided that I had to make public my current thinking about the study. Here it is.

"Basic Research Question. From the beginning it was: "can some version of reparative therapy enable individuals to change their sexual orientation from homosexual to heterosexual?" Realizing that the study design made it impossible to answer this question, I suggested that the study could be viewed as answering the question, "how do individuals undergoing reparative therapy describe changes in sexual orientation?" – a not very interesting question.
"The Fatal Flaw in the Study – There was no way to judge the credibility of subject reports of change in sexual orientation. I offered several (unconvincing) reasons why it was reasonable to assume that the subject's reports of change were credible and not self-deception or outright lying. But the simple fact is that there was no way to determine if the subject's accounts of change were valid.
I believe I owe the gay community an apology for my study making unproven claims of the efficacy of reparative therapy. I also apologize to any gay person who wasted time and energy undergoing some form of reparative therapy because they believed that I had proven that reparative therapy works with some "highly motivated" individuals."^[29]