Psychology Today Editor Defends Gender-Affirmative Therapy

It is ethical to treat individuals who choose for themselves to try to change their sexual orientation. Such efforts are both ethical and effective.

In an editorial titled "Am I Anti-Gay? You Be the Judge" in the Jan./Feb. 2003 issue of Psychology Today, editor-in-chief Robert Epstein, Ph.D., defends gender-affirmative therapy and responds to recent criticism from the gay community. The editorial was written after gay activists objected to his magazine's publication of a small ad for the book A Parent's Guide to Preventing Homosexuality by Joseph and Linda Nicolosi which describes ways parents help their children grow up with a secure gender identity.

According to an article on the NARTH Web site and a published report in the gay magazine The Advocate, psychologist Betty Berzon  was angered when she saw the ad, and called the magazine editor Bob Epstein at home on a Saturday. She demanded an explanation why Psychology Today accepted "such a heinous ad." She told Epstein that she was speaking for thousands of gays who were going to boycott the magazine "and worse." Even though Epstein is a social liberal and usual champion of gay rights, he received a stream of letters from gay activists which he describes as "the dark, intolerant, abusive side of the gay community."

Berzon claimed the Nicolosi's are bigots, that "no gay person had ever successfully become straight," and that "homosexuality was entirely determined by genes." She added that sexual conversion therapy had been condemned by the American Psychological Association. When Epstein disagreed with these assertions, Berzon sent a flurry of postings to gay and lesbian Internet sites, urging activists to harass him at home by telephone, Epstein says, and then to barrage him with complaint letters.

The Psychology Today editor subsequently received "threats, insults," and "brutal letters" from gay activists. "In all," Epstein says, "I received about 120 letters...Several writers suggested I was a 'Nazi' and 'bigot,' and one compared me with the Taliban. A surprising number of letters asserted that gays have a right to be rude or abusive because they themselves have been abused."

"But my caller was way off-base, on key points," Epstein notes. "The APA has never condemned sexual conversion therapy but has merely issued cautionary statements." In fact, one of those statements reminds psychologists "of their obligation to 'respect the rights of others to hold values, attitudes and opinions that differ from [their] own'–an obligation from which my caller clearly feels exempt."

"Although homosexuality was removed from the DSM [Diagnostic and Statistical Manual**] as a mental disorder in 1973," Epstein says, "all editions of the DSM have listed a disorder characterized by distress over one's sexual orientation, and some choose to try to change that orientation. Both gays and straights have a right to seek treatment when they're unhappy with their sexual orientation, and some choose to try to change that orientation. It would be absurd to assert that only heterosexuals have that right."

But can gays actually change? Epstein said that he had seen some "interesting data" supporting the ethics and effectiveness of reorientation therapy. He cited recent research featured on the NARTH Web site and just published in an APA journal by Warren Throckmorton, Ph.D.

In response to the charge by critics that therapy may change behavior but not fantasies, Epstein says that behavioral change is sufficient for many clients and is not an unethical form of treatment, because "it's common for people to ask therapists to help them suppress a wide variety of tendencies with possible genetic bases: compulsive shopping and gambling, drinking, drug use, aggressiveness, urges to have too much sex, or sex with children, etc."

Epstein also cites a new study by Robert Spitzer, M.D. of Columbia University. "Even though he has been under tremendous pressure by gay activists to repudiate his findings, Spitzer has concluded that sexual conversion therapy can produce significant, positive and lasting changes."

Epstein says it is time to review the sexual conversion issue again in his magazine. "We'll soon offer an objective, comprehensive look at the ex-gay issue, " he says, "and also give the factions space to vent."