We conclude this three-part interview with Dr Rosik’s thoughts on “ex-ex-gays”, obstacles to research, and how to continue working in a “banned” enterprise. He says: “There is a lot more to learn that might improve outcomes and further minimize harms with patients who seek change, but for now, the professional and political climate is making such research next to impossible.”

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Q. There have been some high-profile defections from the ranks of ex-gays, and the dramatic shut-down of Exodus International by its president, Alan Chambers, after he repudiated its mission, as The Atlantic noted back in April. He told the magazine:“99.9 percent of people I met through Exodus’ ministries had not experienced a change in orientation.” What’s the hard evidence of success for this kind of therapy?

A. As I noted previously, there is evidence to suggest that same-sex attractions and behaviors can change, and therapeutic work may facilitate these shifts (Karten &Wade, 2010; Phelan, Whitehead, & Sutton, 2009; Santero, Whitehead, & Ballesteros, 2015).This research is not above critique, of course, as is the case with all research, but critics of this literature seem to view the presence of any study limitations as justification for complete dismissal of the findings.

You will notice that opponents have a much higher standard for methodological rigor when it comes to efficacy of change interventions than they do when addressing the potential for harm, as was the case with the APA (2009) Task Force Report (Jones, Rosik, Williams, & Byrd, 2010).They demand randomized, controlled research designs to prove efficacy and reject case studies of success, but are quick to tout anecdotal accounts of harm in the absence of any controlled, representative research showing harm. This is in spite of the APA’s (2009) conclusion that, “Recent SOCE (sexual orientation change efforts) research cannot provide conclusions regarding efficacy or safety” (p. 3).

It’s been years now since I and some colleagues have challenged anyone in the APA to do collaborative work with us to address the issues of efficacy and harm (Rosik, Jones, & Byrd, 2012), but we have not had a single hint of interest. This makes me question the sincerity of opponents’ demands for us to conduct the most methodologically rigorous forms of research, especially when many of these same folks are working to create a professional and legal environment completely hostile to the conducting of such studies. One can’t be faulted for wondering why anybody would want to conduct any sort of research on a subject that is caught in the legal and ethical crosshairs of politicians and the mental health associations.

Ex-ex-gays and gay ministries

Regarding some ex-gay leaders who have shifted their thinking about the possibility of change for anyone with unwanted same-sex attractions and behaviors, what you need to know is that most of these leaders operated in religious contexts, which sometimes contributed to unrealistic expectations for complete change and to feeling pressure to portray such change when this was not their experience.

Equally critical to recognize is that many of these “ex-ex-gays” never received any professional therapy with a licensed therapist knowledgeable about change in unwanted same-sex attractions and behavior. The implosion of some ex-gay ministries serves as a very useful warning that these religious organizations need to operate with a high ethical standard that is fully informed about the science pertaining to sexual orientation and same-sex attraction change.

At the same time, I would caution those who believe change can never occur against relying too much on overgeneralizations from the experience of certain ex-gay leaders. This approach could backfire. I would find it contemptible if someone inferred from the fact that some very influential gay rights leaders have been recently charged with felony sodomy and sexual abuse with teenage boys (Manning, 2014) and felony possession of child pornography (Ho, 2014) that therefore this must be the case for all such leaders. In a similar vein, one cannot possibly be an expert on everyone’s experience of same-sex attraction change. It just makes people look desperate to win a point when they leave the scientific record and engage in such ill advised generalizations.

Working under a ban

Q. What is the effect of the bans which are already in place?

A. The effect of the current ban on “sexual orientation change efforts” (SOCE) for minors is to make it impossible for these patients to pursue any treatment goal that involves the possibility of change, no matter how mainstream the interventions may be. I imagine that if such bans were ever extended to adult patients, the language and objectives would be the same.

In the short term, obviously, therapists like me should continue to operate with strict fidelity to our professional ethics codes and to what the science of sexual orientation change can say and cannot say. Perhaps we will need to reframe what we do somewhat away from changing sexual orientation, language which plays into impressions that only categorical change from all same-sex attractions to all opposite-sex attractions is successful change. I have for some time preferred to speak of change in unwanted same-sex attractions and behaviors as occurring on a continuum of change, since I think this makes for more realistic expectations for most people who pursue change.

As for the long term, since these laws are so vague, I do not think anyone can really predict the actual effect of such bans until we have a test case against a therapist. No one wants to be this person, of course, but it will take a real case against a real therapist to find out how actionable practices will be defined, if they can be. But I have no doubt that such a day is coming, given the fundamentalist-like zeal that groups such as the Southern Poverty Law Center have for restricting client and therapist liberty in this area.

Q. Finally, given the prejudice and opposition, why do you bother with this work? 

A. In my work as a psychologist, I have been privileged to meet many religious leaders and others who sincerely desired to pursue the degree of change that might be possible for them and who wish to make professional therapy one aspect of their journey. It is to these individuals that I have dedicated my efforts in this area. It would be a great tragedy if the psychological professions abandoned these people, and for some time I have felt an obligation to represent their interests and aspirations in the professional arena.

I agree that it is a David and Goliath like pursuit which takes a little bit of courage, but I hope my observations above have suggested to your readers that there are sound arguments from both reason and science that can support this kind of therapeutic work. There is a lot more to learn that might improve outcomes and further minimize harms with patients who seek change, but for now, the professional and political climate is making such research next to impossible.

Understanding the other’s moral worldview

Finally, regarding the prejudice and opposition, I have found great insights for understanding such responses in Moral Foundations Theory (Haidt, 2012). Haidt has compiled an impressive database and identified left-of-center ideology as animated primarily by a morality focusing on the individual and emphasizing care for perceived victims of oppression. The welfare of the individual is overwhelmingly the primary moral concern for these people. They tend to support the use of government programs or changing social institutions to extend individual rights as widely and equally as possible and oppose institutional practices seen as victimizing people. The language of rights, equality, and social justice tends to be dominant in the moral argumentation of those on the left.

For those right-of-center, the welfare of the community (e.g., family, society) and the welfare of individuals are of equal moral concern and these people therefore have the often challenging task of balancing the desire to lessen harms to individuals with the desire to preserve the institutions and traditions that sustain a moral community. They generally believe the institutions, norms, and traditions that have helped build civilizations contain the accumulated wisdom of human experience and should not be tinkered with apart from immense reflection and caution.

They usually have the intuitive sense that damaging these institutions and traditions could in fact eventually result in greater harm to individuals as well.

Supporters of these bans place their emphasis on alleged widespread harms to minors from therapies that allow for change. Their sales pitch for such bans is generally focused on individuals and the potential for harm. They may not see group-enhancing moral concerns such as respect for authority, tradition, or religious values as moral issues at all. At the least, they are likely to place less emphasis on such concerns as parental authority or a desire to respect religious identities and values. In fact, these moral concerns may be viewed as immoral when they are perceived to interfere with the rights and welfare of individuals (Graham, Haidt, & Nosek, 2009; Haidt & Graham, 2007; Haidt, Graham, & Joseph, 2009).

This fuels both the passion of ban supporters and their zealous antagonism towards individuals and organizations that support professionally conducted therapies open to change. Opponents are animated by a strong moral sense but are essentially limited to intuitive moral concerns that focus on harm to the individual. Thus, their moral predisposition is to mock me or dismiss me as simply being a quack, hateful, and/or bigoted rather than comprehend me as a professional who is committed to both minimizing the risk of harm and respecting the equally important group-centered moral aspirations of these patients.

Moreover, since ban advocates typically do not recognize a community-centered morality as being a valid dimension of morality in this context, a client’s choice to pursue change in therapy when motivated by these group-enhancing moral concerns can only be comprehended by ban supporters as reflecting a response to social oppression rather than an autonomous exercise of self-determination. I am certain that readers who are able to step outside of their own moral lens and more objectively examine the comments sections following the three parts of this interview will see how the moral language of many commentators reinforces the truth of these realities.

Having some understanding of these moral dynamics is very helpful in maintaining humility and extending graciousness toward those who seem unwilling to reciprocate these attitudes. I have actually learned a great deal from opposing viewpoints and respect many of the concerns that emanate from those who may disagree with me. Hopefully, my thoughts here might help some readers not morally predisposed to my perspective realize there actually are good people doing this work and doing it with some real basis in the social science research literature. 

Christopher Rosik is a Phi Beta Kappa graduate of the University of Oregon and earned his doctorate in clinical psychology from Fuller Graduate School of Psychology.He is currently a psychologist and director of research at Link Care Center in Fresno, California, as well as a clinical faculty member of Fresno Pacific University. He has published more than 45 articles in peer reviewed journals and has served as President of the Western Region of the Christian Association for Psychological Studies. He is currently Past-President of the Alliance for Therapeutic Choice and Scientific Integrity.

The complete interview with Dr Rosik, including references, can be read here. 

https://www.mercatornet.com/articles/view/sexual-orientation-change-efforts-and-the-campaign-to-ban-them