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Therapy for Same-sex Attraction

Gender-affirmative therapy can help you clarify your identity and make life choices that are consistent with your personal values.

Clinical experts often note that homosexuality isn't about sex–it is about relationships and gender identity. Gender has implications far beyond the physical characteristics that designate an individual as biologically male or female. Gender is a role with specific responsibilities and characteristics, including fatherhood and motherhood.

Men are typically expected to cultivate the attributes of fatherhood that include, but are not limited to, leading his family in love, acting as a provider, and being a protector of those for whom they have responsibility. Women cultivate the attributes of kindness, compassion, and nurturing, particularly for children. 

A key component in confronting same-sex attraction is therapy—both individual and group therapy. In addition to individual study and support groups, therapy is necessary because there are usually issues that can only be dealt with effectively in sessions with a trained therapist. Therapy can help you clarify your identity and make life choices that are consistent with your personal values. It is a process of self-understanding, self-acceptance, and growth. For most people, it means difficult, painful compromises. Although your life becomes more clear, it may not become easier; there are no shortcuts to personal growth. Human emotions are complex and difficult situations are not easily unraveled. This section explains different therapeutic approaches and gives information on choosing a good therapist. It then discusses individual and group therapy and explains how each can be beneficial.

Modern Therapeutic methods

Modern therapy for those who experience same-sex attraction bears little resemblance to the sordid history of treatment for emotional problems. In the late nineteenth and early twentieth centuries, the medical profession regarded same-sex attraction as a mental illness and attempted to cure it by drastic measures such as electroshock therapy, hormone injections, castration, hysterectomy, and even lobotomy. (Dudley, p. 125)  Read more about Aversion ("Shock") Therapy and about the Ethics of Therapy.

Today, professionals use more humane approaches to help people understand and deal with their feelings. There is no need to fear therapy and certainly no reason to feel inadequate because you see a therapist. In today’s complex world, most people can benefit from therapy for some reason at some time in their life. If you consider the suggestions in this section and choose your therapist wisely, it can be a richly rewarding experience.

Within psychotherapy, there is a broad range of treatment approaches. The approach to take depends on your desired outcome.

  1. Some therapists encourage individuals to "come out of the closet" and accept a homosexual orientation and a gay identity. Their approach assumes that homosexuality is a natural sexual variation and that the reason people are unhappy with homosexuality is because of their own self-hate and because of society’s anti-gay prejudices. The goal of such therapy is to help people accept themselves in their current state and accept a gay identity.
  2. Other therapists may desire to help individuals understand their gender development and assist them in making choices congruent with their personal value system. The basic premise of such therapy is that social and emotional variables affect gender identity, which in turn determines sexual orientation. The goal of such therapy is to help people fully develop their masculine or feminine gender identity.

If you have decided that same-sex attraction does not fit within your personal values, the second type of therapy can help you learn to love yourself, appreciate your gender, and grow in self-worth through becoming congruent with your personal values. You should look for a therapist who will help you explore your personal values, develop nonerotic same-sex relationships, become more secure in your gender-identity, and enjoy heterosexual relationships.

Read about professional ethics and therapy for same-sex attraction.

Choosing a therapist

Choosing a good therapist is critical because the wrong therapist can do you more harm than good. Since gay-affirmative therapy is the most widely practiced, it may be easy to find such a therapist. However, gender-affirmative therapy is not as widely practiced and you may have to search to find such a therapist.

Choose a therapist who can understand and support you in your personal values. If you are a strongly religious person, the ideal counselor for you would be one who upholds your religious values. He/she needs to understand and support your spiritual motivations to change. Your therapist needs to understand and be able to support you in the divinely-appointed roles of men and women and he/she needs to be a good role model of a man or woman because in many ways he/she will be your friend and mentor. Dr. Elizabeth Moberly advises that the therapist is emotionally involved in the process, within therapeutic guidelines.

Consider what type of therapist you need. Psychiatrists are medical doctors specializing in treating individuals with emotional problems and thus can prescribe medication if necessary. Psychiatrists usually charge higher fees than other practitioners. Clinical psychologists usually have an academic doctoral degree (Ph.D.) and are trained in testing and individual therapy. Social workers may have doctorates or Master of Social Work degrees, and may counsel individuals, work with small groups or troubled families, and handle much the same range of emotional problems as these other practitioners.

It is advisable that men choose a male therapist and that women choose a female therapist for several reasons. Since part of the problem for men is due to defensive detachment from men, a male therapist is in a better position than a woman to help a man work through some of the developmental blocks he may have had with his father or with other men. The same is true for women. A therapist of the same gender is also in a better position to help you understand your gender and guide you into relationships with them. If your therapy experience is successful, the intimate relationship you develop with your therapist will be healing in itself and will encourage you to develop relationships with others of your gender.

Many of the organizations listed can provide recommendations of therapists who fit the descriptions above.

Therapists may want to refer to the Best Practices Document: Principles and Practices for Mental-Health Professionals Helping Latter-day Saints Respond to Same-Sex Attractions. Although it was written for therapists who treat Latter-day Saints (Mormons), its principles apply to any faith.

Since therapy is a major investment of time and money, be sure that your therapist will be able to provide you the help you need. Discuss with him/her how he/she will approach therapy with you. Talk about your value system and what you expect from therapy. Don’t hesitate to talk about the finances involved and be sure they fit within your budget. Your medical insurance may cover some of the visits.

The therapeutic process

Part of the therapeutic process may be to explore the past. Joe Dallas writes that "we can learn from the past and thus improve the present." Further, "the past helps us to understand the present. And what we understand, we can deal with." (Dallas 1991, p. 87) Understanding the past is helpful to many people, however, there are four cautions:

Don’t blame the past for your situation and assume the role of a victim who has no control over the present. No matter how painful the past has been, you cannot avoid responsibility for what you do in the present. Your goal now is to try to understand the causes of your struggle to learn what you can do to resolve them.

Watch out for invented memories. There is a tendency to invent past experiences to explain the present. If you read that certain childhood experiences can cause certain reactions, you may come to believe that those things happened to you in your childhood. You may reinterpret or skew the past or even invent in your mind events that never happened, all in an effort to make sense of the present.

Not finding all the answers in the past does not mean you can’t resolve the present. At one point during my therapy I was trying to understand why I developed certain feelings during grade school. My therapist gave me an assignment to go back to my elementary school and spend an hour walking around the playground and try to recreate the feelings I had during a certain event. I did as he suggested, but never found any clues. To this day, I don’t understand why I reacted to the event the way I did. Although I didn’t find any clues to the present, I don’t let that bother me. The past doesn’t need to be completely explained.

Don’t concentrate on the past to the exclusion of the present. Although the past may hold keys to help you understand the present, concentrate the majority of your time on your current feelings, actions, plans, failures, and successes. The past is only valuable inasmuch as it helps you to deal with the present. The extent to which the past is important depends on the level of trauma in the past. If you have not suffered abuse, you may not need to spend much time dealing with the past. If you have been abused, you may need to grieve and resolve past trauma.

Questions to ask yourself after your first session: (1) Does the therapist seem to understand and care how I feel? (2) Does he or she see clearly what is going on? (3) Do this person’s ideas make common sense, or do they seem strange, dumb, or outrageous? If the answers to these questions are not satisfactory, you probably should not trust the therapist and should look for another. You should expect some improvement in your problem by the fourth session. If nothing good is happening, have the courage to quit. Don't be intimidated by the strategy of certain counselors who imply that the real problem is your moral or religious hang-ups. Reject any diagnosis which suggests that unless you adopt the counselor’s philosophy or life-style, you cannot be helped. Don’t be afraid to stand your ground if the counselor’s requests violate your own values or standards. The best counselors will respect your position even if they don't share it.

If therapy is not available to you

If you cannot afford therapy or if there is not a good therapist available, you can still benefit by reading carefully-selected self-help books, journaling, and trying to analyze your life. Set up a plan of action and follow through on that plan. Look at your life as though you are watching a video and identify the things you want to change, then make specific assignments to yourself to develop relationships and do things to build your self-image. You can be accountable to God through prayer, to yourself by using your journal, and to a friend in person or by telephone, letters, or e-mail. However, be careful not to let e-mail, letters, or even the telephone replace face-to-face contact with others of your gender because this personal interaction is critical.

Individual therapy

A trained therapist can guide you through your personal growth process. He is your personal counselor to help you put all the pieces of the puzzle together. He can help you see how to integrate your personal study, spiritual growth, support groups, personal relationships, and behavior modification. He can help you see in an objective way how to keep your life in balance. He can be your mentor and your confidant.

Individual therapy is an essential part of the process of resolving same-sex attraction issues. Although it will not take care of all your needs, it can give direction to all your activities. For example, if you also participate in a sports program, group therapy, support group, or a community men’s group, your therapist can help you see how all these pieces fit together and help you keep them in balance.

As you talk with your therapist, you will discover things about yourself. Often, because of shame or guilt we have buried some things so deep within us that we don’t even realize them ourselves. The therapist is trained to ask the right questions to help you see things in perspective and guide you through the process. Use him as a sounding board. Be honest with him about your problems, concerns, and fears. Don’t keep any secrets from him. Therapy will be most effective when you have a completely open and honest relationship. The therapist is bound by ethical standards to keep everything you say confidential. He can’t even tell another person that you are seeing him. Together you can develop action plans to take you through each step of the process and you can report back to him on both your successes and failures. The journey won’t seem so lonely or so hard if you have a therapist by your side the whole way. Individual counseling can help you to:

  • identify and resolve personal issues and underlying factors.
  • identify and clearly define your personal goals.
  • develop a personal action plan then help you keep working on the plan.
  • identify and work around the roadblocks.
  • receive encouragement when you get discouraged.
  • increase your awareness of things you need to work on.
  • give insight into your feelings and actions.
  • give an outside perspective (help you see black and white when all you see is gray).
  • identify your personal strengths and weaknesses.
  • give a forum to talk things out and get feedback.
  • give someone to be accountable to for your behavior, growth, and personal plan of action.
  • learn to generalize lessons learned to other situations.
  • learn to internalize new information (make your heart believe).
  • learn how to live congruently with your personal values and belief system.
  • learn to control compulsive behaviors and overcome addictions.

Make your sessions count. Not only are these therapy sessions an expense, but if change is important to you, do all you can to make them as helpful as possible. I found it helpful to make written notes about my sessions and refer to them often. I wrote in my journal as much detail about each session as I could. It was helpful to review the things we discussed and it gave me something to refer back to later and monitor my progress. I especially made notes about things I wanted to think about further or pursue in a future session. I did not want to let fleeting ideas escape me; they were often inspiration that turned out to be helpful. Be sure to write down the assignments you receive from your therapist and be sure you follow through with them.

Group therapy

Group therapy can also be helpful, but is of secondary importance to individual therapy. Group therapy has some of the same advantages as a support group. The difference is that group therapy is always run by a trained therapist who is there to facilitate the discussion in meaningful ways. Since support groups are not guided, it may be easy for members of the group to hide or even deny their feelings. But in a therapy group, the therapist can help members confront issues head-on and then be sure the issues are brought to healthy conclusions.

If you are involved in group therapy, it is important that you also receive individual therapy so you can work out issues that come up in the group setting. Group therapy can help you to:

  • get the mutual support of others who share your struggle.
  • hold each other accountable.
  • learn to accept others and feel accepted by them.
  • learn to disclose.
  • discuss issues of importance and get the feedback of others.
  • learn to generalize to other situations the lessons you learn.
  • learn to internalize new information (make your heart believe).
  • learn relationship and communication skills.
  • learn to be assertive.
  • reinforce newly learned traits.
  • experience relationships and activities in a safe environment, as a bridge to the real world.
  • learn compassion for others as you begin to see their challenges from their perspective.

My friend Todd had been so closed up that no one in his life really knew much about him. Then he went to group therapy where he had the chance to explain his troubles to others and he began to open up. He wrote, "Each time, it became a little easier. I noticed that rather than being dangerous, opening up and sharing feelings and being really close to people on an emotional level was kind of nice. For the first time in my life, I no longer felt like I was unacceptable because I started to find out that people could know everything about me and still want to be my friend. In fact, through the sharing of deep emotions, I gained some of my closest friends."

For further reading: "Don't Forsake Homosexuals Who Want Help."