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Extensive debate within professional literature

In 1997, the American Psychological Association stated “the ethics, efficacy, benefits, and potential for harm of therapies that seek to reduce or eliminate same-gender sexual orientation are under extensive debate in the professional literature and the popular media” [1] In 2000, the American Psychiatric Association issued a statement that said “the issue of changing sexual orientation has become highly politicized” and that there is no scientifically rigorous outcome studies that show whether or not reparative therapy is effective.[2]

Yet despite the reference to extensive debate, this article claims medical consensus on the subject and that the consensus is that the ethics and efficacy are rejected, not under extensive debate as has been stated. As evidence of the claim, the article sites Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel. This article advises educators about the aggressive promotion of reparative therapy. They state they “do not support efforts to change young people's sexual orientation through reparative therapy," saying that “the promotion of reparative therapy … is likely to exacerbate the risk of harassment, harm, and fear,” but say nothing of reparative therapy itself. It is the potential for harassment resulting from the aggressive promotion of reparative therapy that educators have the duty to protect their students against, not from reparative therapy itself. Nothing at all is said in regards to reparative therapy for adults.

Fireplace has argued against the existence of a debate, saying “the "debate" in the professional literature is limited to the one or two articles that Throckmorton and Yarhouse have published, and which have largely been ignored.” This is not true. First of all, Throckmorton (past president of the American Mental Health Counselors Association) and Yarhouse are members of the APA and there work has been published in peer-reviewed journals. Their opinions are valid, and not ignored. Second, they are not the only ones who have argued for reparative therapy. Here are some other people:

  • Robert Perloff, PhD (previous APA president) charged that APA is "too politically correct, too bureaucratic, too obeisant to special interests." He stated that APA’s view of Conversion therapy is "all wrong. First, the data are not fully in yet. Second, if the client wants a change, listen to the client. Third, you're barring research." Same office, different aspirations
  • Nicholas A. Cummings (another previous APA president) and Rogers H. Wright, Ph.D., Litt.D., wrote a book entitled Destructive Trends in Mental Health, which argues against APA’s current favoritism towards gay groups, arguing “Such efforts are especially troubling because they abrogate the patient's right to therapist and determine therapeutic goals.” [3][4]
  • Dr. Robert Spitzer , who was involved in the original declassification of homosexuality as a mental disorder, said "I'm convinced from people I have interviewed...many of them...have made substantial changes toward becoming heterosexual. I came to this study skeptical. I now claim that these changes can be sustained." (Quoted by Dr. Laura Schlessinger on her syndicated radio show, January 21, 2000.)
  • Dr. Brent Scharman, former president of the Utah Psychological Association, said that all homosexual individuals should have the right to pursue change. It is the client who should determine the direction of the treatment. [5]
  • Douglas Haldeman, a gay psychologist defended reparative therapy stating “this is not to say that I endorse these beliefs or share them myself; but neither do I endorse the prospect that we, as gay scholars and activists, should interefere with people's choices… For some it is easier, and less emotionally disruptive, to contemplate changing sexual orientation, than to disengage from a religious way of life that is seen as completely central to the individual's sense of self and purpose.” Gay Rights, Patient Rights, Implications of Sexual Orientation Conversion Therapy Presented at the American Psychological Association Annual Meeting, August 7th, 2000, Washington, D.C.
  • S. LeVay said “I believe that we should as far as possible, respect people's personal autonomy, even if that includes what I would call misguided desires such as the desire to change one's sexual orientation.” Sexual Orientation: The Science and its Social Impact
  • Ray Fowler, CEO of the American Psychological Association, states: “The APA’s position on reparative therapy is that those who wish to explore developing heterosexual feelings or behavior have a right to do so as part of every client’s right to self-determination. If an individual is comfortable with homosexuality, it is not the role of the therapist to convince the client otherwise. If one’s feelings are ego-dystonic and there is a desire to talk about changing, that is an acceptable choice and a psychologist may participate if he or she desires.” (The Utah Psychologist, Winter 1998, p. 11)
  • Dr. Martin Seligman, APA president, said that he felt a client had a right to request the type of therapy that he or she wants and receive it. He further states that those who have had fewer homosexual experiences, or who have bisexual feelings, would be most likely to successfully change and those who have had more long term, ingrained homosexual feelings and activity, would be less likely to change. (What You Can Change And What You Can't)

All of this is in addition to Throckmorton and Yarhouse’s work. The APA states that there is extensive debate within professional literature, and there is no evidence of a consensus of the efficacy and ethics, so I think we should represent this as a debate within the medical community.Joshuajohanson 01:56, 5 April 2007 (UTC)

You can also find a handful of prominent scientists who are skeptical about evolution or global warming. Nevertheless, a broad consensus in the medical community exists and that consensus is extensively cited throughout the article. There may be debate (though hardly "extensive") over some smaller questions (e.g., "should ethics codes explicitly forbid the practice?"), but on the larger scale there is broad agreement that the practice is unsupported by empirical data and that there are concerns over the ethics and motivations surrounding the practice. It is therefore incorrect to make a sweeping statement about "extensive debate" over reparative therapy in the medical community. Now, you're right insofar as the previous language ("reject") was inappropriately vague. I've replaced it with "No mainstream medical organization endorses reparative therapy and many have expressed concerns over the ethics and motivations surrounding its practice." Fireplace 03:01, 5 April 2007 (UTC)
It is the American Psychological Association that uses the words "extensive debate" and the American Psychiatric Association that says it is "highly politicized." Those are not my words. What evidence is there of a broad consensus? It is "extensively cited" throughout the article by refering to Just the Facts, which was aimed at the "agressive promotion" (again, not my words, but theirs) of RT in the schools. I've read "recommendations" to refrain, counsel that therapies directed specifically at changing orientation of young people are contraindicitive, warning not to practice RT without being trained, and an faq page stating that it is ineffective, but most say that there isn't enough evidence one way or the other. The only consensus that I do see is that it should not be treated as a mental disorder, and it doesn't require treatment. You wrote "No mainstream medical organization endorses reparative therapy and many have expressed concerns over the ethics and motivations surrounding its practice." I like the first part, but the ethics are still under extensive debate and I only have only seen LGTB groups complain of the motives. The article is still riddled with comments like "The medical and scientific consensus is that reparative therapy is not effective," when several sources say there is no evidence whether it is effective or not. This puts RT in a different category than evolution and global warming, because there is scientific for those debates.
This is more than just a handful of scientists. Don't forget that NARTH is also composed of professional scientists. They just haven't published as much in peer-reviewed journals, but they are still professional. They also have notable scientists like Nicolosi. How many scientists do you think are studying RT? It is a sizeable enough number to get more attention in the article. They are sizeable enough for the APA to classify it as an extensive debate.Joshuajohanson 18:41, 5 April 2007 (UTC)

Article length

On my last edit, I got a warning that the article is getting too long. There is a lot of information in here about ex-gays and ex-gay organizations. Though I agree that has a lot to do with reparative therapy, I think it would be better placed in the ex-gay page. Here are some of the sections I think would be better placed on the ex-gay page:

  • History and techniques practiced by ex-gay organizations, like Love in Action and Exodus.
  • Ethics guidelines with respect to ex-gay groups
  • Popular culture - most of it is about ex-gay organizations
  • Controversies, criticisms, and scandals
  • The debate seems to be focused against the Christian right and ex-gay movement
  • Scandals involving minors (almost all seems to be about ex-gay camps)
  • Relapses and ex-ex-gays (seems to go better with ex-gays)
  • Financial motivations (the only evidence is for an ex-gay organization)

Again, I am not saying that this doesn't have anything to do with reparative therapy. I think it should be summarized on this page with links to the appropriate section on the ex-gay page.Joshuajohanson 01:29, 10 April 2007 (UTC)

I disagree, for the reasons I've outlined at Talk:Ex-gay. In summary: (1) Reparative therapy and the ex-gay movements are inseparably intertwined phenomena, sharing many common motivations, assumptions, proponents, opponents, and criticisms -- some commentators (correctly or incorrectly) do not even distinguish between them, (2) the best way to get across the distinctions and similarities between RT and the ex-gay movement is in a section like Reparative therapy#Distinguishing between the reparative therapy and ex-gay movements, (3) maintaining independent, non-heirarchical articles leads to redundancy problems (see issue (1)), (4) and an unnecessary amount of cross referencing (that gets screwed up every time you adjust the section structures), (5) the pragmatic reason that the reparative therapy article is approaching WP:FAC status, whereas the ex-gay article is an unsourced, self-contradictory mess. Regarding article length, we're currently at 55k (including images), which is long but by no means unusual for Wikipedia articles. Anyways, the thought is to get all the content together under a broad Reparative therapy and the ex-gay movement (or whatever) article, and then to spin off subsidiary sections into secondary articles (another common article style on Wikipedia). This is the motivating thought behind the recent surge of edits. Fireplace 02:01, 10 April 2007 (UTC)
In response to your reasonings.
  • (1) Reparative therapy and the ex-gay movements are related, not intertwined. We have discussed this, but here we go again. Here are some summary points:
  • Definition: To me, the main difference is reparative therapy is a type of therapy that may or may not be applied towards ex-gays while ex-gays are people who may or may not have had reparative therapy. Not everyone going through RT becomes ex-gay, and not all ex-gays go through RT.
  • Foundation: RT has psychological roots with a strong foundation in Freud. It had been widely practiced in the secular world for years before the ex-gay movement even started. The ex-gay movement has its roots in the bible.
  • Methodology: RT focuses on psychoanalysis, while ex-gays focus on redemption through Christ. Some ex-gays may use RT, but others never ever see a psychologist.
  • Relationship to mainstream medical views: Medical organizations have put out several statements about RT, but the only one about transformational ministries is the Just the Facts pamphlet, in which a distinction is made between them and reparative therapies.
  • Ethical guidelines: Psychologist should obey guidelines. Ex-gay organizations are religious in nature, and so the guidelines do not apply. That would be like saying a padre or a pastor should abide by these guidelines during confessionals.
  • Criticisms: Some critics against RT, such as the procedures against Alan Turing, have nothing to do with ex-gay ministries. Likewise, some critics against ex-gay organizations, such as misrepresenting the fact that all Christians view homosexual activity as a sin, have nothing to do with RT.
  • (2) The section is helpful, but not sufficient. It would be way too easy for a casual reader to confuse the distinctions listed above. The current RT article does not do a good job in this distinction.
  • (3) We will have to be careful about this, but I think it would be better than confusing unrelated criticism.
  • (4) I think the ex-gay page should have one section on its relationship to reparative therapy and the RT page should have one section on its relationship to ex-gays. We can figure something out.
  • (5) I agree, but that doesn’t mean we ignore it. I have created a to-do list that should address these issues.
To summarize, I still disagree that ex-gays and RT should be merged. That will create confusion as to who is saying what to whom. You might be right about article length, but I still stand by these other points.Joshuajohanson 01:39, 11 April 2007 (UTC)

Ethics guidelines

Just to be clear, here is a summary of the ethics guidelines from the major organizations:

  • American Psychiatric Association: "In the last four decades, "reparative" therapists have not produced any rigorous scientific research to substantiate their claims of cure. Until there is such research available, APA recommends that ethical practitioners refrain from attempts to change individuals' sexual orientation, keeping in mind the medical dictum to first, do no harm." Gloss: At present, don't do it.
  • American Psychological Association: They list a series of general ethical principles which all members should be following. Their tone is generally negative of the practice as it happens in the real world (citing "societal ignorance and prejudice", peer pressure and lack of legal protections for youth, people like Socarides treating homosexuality as a disorder), but they do not say that reparative therapy per se violates its ethics guidelines. [6] Elsewhere, they state that "'reparative therapy,'... is based on an understanding of homosexuality that has been rejected by all the major health and mental health professions." [7]. Gloss: Don't do it the way it's currently done by a lot of people.
  • American Counseling Association: "ACA Ethics Committee strongly suggests that ethical professional counselors do not refer clients to someone who engages in conversion therapy or, if they do so, to proceed cautiously only when they are certain that the referral counselor fully informs clients of the unproven nature of the treatment and the potential risks and takes steps to minimize harm to clients." Regarding these referrals, they state "Any professional who engages in conversion therapy is not offering the professional standard of care and would need to include that he or she is offering it not as a professional counselor but is providing counseling within the scope of practice of some other profession (i.e., Christian counselor)." [8] Gloss: Don't do it in your capacity as a professional.
  • American Academy of Pediatrics: "Therapy directed specifically at changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation." [9] Note that contraindicated is a medical term to indicate a situation in which a medication or treatment should not be administered. Gloss: Don't do it to youth.

I'm writing these all down as a point of reference. But generally, in areas that require a gloss on the ethics guidelines (such as the introduction or in related articles) I believe an accurate one is: "The ethics guidelines of major mental health organizations discourage, and sometimes prohibit, reparative therapy," with a link to the Ethics section in reparative therapy. Fireplace 15:52, 12 April 2007 (UTC)

First of all, these aren't ethics guidelines, but position statements and recommendations. Ethic codes are the rules counselors must follow, not the organizations' position on therapies. See [10] Here are my counterarguments:
  • American Psychiatric Association: That is only a recommendation. It states to first, do no harm. Haldeman clarifies this by saying "For some it is easier, and less emotionally disruptive, to contemplate changing sexual orientation, than to disengage from a religious way of life that is seen as completely central to the individual's sense of self and purpose.” If that is not enough, Ray Fowler, CEO, stated “The APA’s position on reparative therapy is that those who wish to explore developing heterosexual feelings or behavior have a right to do so as part of every client’s right to self-determination." Gloss: Refrain from doing it, but respect the client's right to reparative therapy.
  • American Psychological Association: I agree the tone is generally negative, but the fact is that they allow it and have established guidelines on how to do it. Gloss: If you are to do it, make sure you do it the right way.
  • American Counseling Association: They state "any professional engaging in conversion therapy must have received appropriate training in such a treatment modality with the requisite supervision." That doesn't mean they can't do it. What does mean they can't do it is the fact that there is "no professional training .... that would prepare counselors to provide conversion therapy." The objection is not reparative therapy itself or the client's right to self-determination, but simply a lack of research and training. Note that this position is not shared by other professional organizations and is hardly a medical consensus. Gloss: Conversion therapy is okay if the counselor is trained, the only problem is that there is no training available.
  • American Academy of Pediatrics: Conversion therapy should not be directed specifically at changing sexual orientation. Most reparative therapies agree with this. Instead they work on underlying causes, such as sense of masculinity (or feminity), sense of self within one's gender, healing relationships with parents, changing homosexual behavior and lots of other techniques that aren't directed specifically at changing orientation. Their belief is that once these issues are solved heterosexuality may come as a result. Note that heterosexuality may not even be a goal for a client going to a reparative therapist. Gloss: Don't aim your conversion treatments specifically at changing sexual orientation.
I am not arguing that there tone isn't negative, but just that it should be clear that they allow it. I think the gloss should be "Reparative therapy is discouraged by major mental health organizations, but permited under certain guidelines." That also makes clear that it is prohibited when the guidelines aren't followed.Joshuajohanson 17:29, 12 April 2007 (UTC)
The ACA and AAP glosses you suggest don't convey the strong anti-RT positions explicitly made by those two organizations. See above. The American Psychological Association gloss you suggest assumes that the APA thinks there is a "right" way to do it -- and that is not the tone of the position statement. Rather, they explicitly say that there are many wrong ways to do it, and remain silent on whether there is any appropriate way to do it. Regarding your 'overall gloss', three of the above don't "permit" it "under certain guidelines" (APA 1, ACA, AAP) and the third regards it as unethical it under certain circumstances, without stating whether it is unethical in all cases. Fireplace 18:10, 12 April 2007 (UTC)
I agreed that they discouraged it, but they still permit it. Remaining silent on whether there is any appropriate way to do it is in a sense permiting it, especially given the client's right to self-determination. If they didn't permit it, they would have to prohibit it. The fact is that most psychiatrists who practice reparative therapy (such as those at NARTH), do so under the licenses given out by these organizations. If these organizations didn't permit it, how could NARTH "advise its members to provide psychological care in a professional, ethical manner which is consistent with the codes of ethics of the national mental health organizations and state licensing boards."[11] It is true that Richard Cohen was suspended for violating code of conduct, but his methods were also denounced by NARTH. The gloss you suggest doesn't reflect a psychiatrist's duty to respect a client's right to self-determination.Joshuajohanson 18:53, 12 April 2007 (UTC)
I agree with Fireplace. I also would like to point out that the ACA statement doesn't necessarily mean that they believe that an appropriate treatment could ever be developed. In light of the following statements from the ACA (both from here), I think Fireplace's interpretation is more true:
"The belief that same-sex attraction and behavior is abnormal and in need of treatment is in opposition to the position taken by national mental health organizations, including ACA."
"To refer a client to someone who engages in conversion therapy communicates to the client that his/her same-sex attractions and behaviors are disordered and, therefore, need to be changed. This contradicts the dictates of the 2005 ACA Code of Ethics."
I think that the guidelines could best be described as a form of risk management. The organizations who signed on have spoken against reparative therapy because they find it at least, ineffective and at worst, damaging. They realize that some are still going to use the techniques, and thus it's better to lay out some guidelines than say nothing. Joie de Vivre 20:34, 12 April 2007 (UTC)
I didn't try to imply that the ACA believed appropriate treatment could be developed (it doesn't state they believe it couldn't either). That isn't what I was arguing. What I was arguing is the client has a right to self-determination and psychiatrists are permited to help them reach their goals. They can do that without saying same-sex attraction is a disorder and needs to be changed. Psychiatrists that operate under NARTH's rules practice reparative therapy without any problems from the APA, ACA, APA or AAP.
As far as effectiveness, they dismiss evidence as antecdotal (together with evidence of harm) and say there is no valid research supporting efficacy.[12] No proof for the effectiveness of RT doesn't equate to proof of ineffectiveness. Neither does proof of ineffectiveness of some techniques previously employed by RT (like aversion therapy or other therapies directed specifically at changing orientation) disprove effectiveness of all techniques.Joshuajohanson 21:16, 12 April 2007 (UTC)

The Utah Psychologist

I've been trying to locate an original of this source: The Utah Psychologist, Winter 1998, p. 11. Neither google scholar nor lexisnexis turns up anything. In the meantime, here is an unofficial copy of that page, which does not include the quote recently added to the article: [13]. Fireplace 20:10, 13 April 2007 (UTC)

The quote is contained in Respect and the Facts: How to Have Both in the Sexual Orientation Debate. This paper was presented at the National Education Association annual convention on July 7, 2004.Joshuajohanson 20:42, 13 April 2007 (UTC)
So we have two inconsistent secondary sources, and no primary source. My guess is that the language currently in the article was a paraphrase of the Utah Psychologist piece, which itself paraphrased a telephone conversation. It got passed around the internet a bunch of times (just google the language -- there are about 10 instances, often inter-citing) and eventually someone put quotation marks around it. Given the obscurity of The Utah Psychologist (no google scholar presence, no lexisnexis presence), I doubt Throckmorton or PFOX or any of the other people who cite it (except Brent Scharman) have seen the original. Fireplace 22:16, 13 April 2007 (UTC)
I imagine Scharman and PFOX's acoounts are paraphrased, but Respect and the Facts is definately a direct quote. I replaced the paraphrased quote with the direct quote.Joshuajohanson 18:08, 14 April 2007 (UTC)
Once again, here's a replication of the original source [14], and neither the original quote you inserted nor the new quote are attributed to Fowler as direct quotations. Instead, it says "He seemed to feel that..." This is why I doubt the accuracy of Throckmorton's paper, which cites the same source (namely, Utah Psychologist page 11). Fireplace 19:25, 16 April 2007 (UTC)
I don't understand. That isn't the original. The original isn't online. The authors of Respect and the Facts: How to Have Both in the Sexual Orientation Debate say it is a direct quote. They don't cite the NARTH article. They don't even mention it.Joshuajohanson 06:38, 18 April 2007 (UTC)
This appears to include a copy of the original source. In it, the "quote" is clearly not a direct quote, but rather Scharman's interpretation of what Fowler "seems to feel" based on a telephone call. Fireplace 09:50, 18 April 2007 (UTC)

Malleability of Sexual Orientation

A critical argument in the reparative therapy debate is whether sexual orientation is fixed or not. [15][16] Camille Paglia, a lesbian activist, used it in her arguments supporting reparative therapy[17]. In the opening paragraphs, it states that the medical consensus is that sexual orientation cannot be changed, but I can't find that anywhere. Since it is such a crucial element, we need a paragraph to explain exactly what the medical view of whether sexuality is changeable. This is a seperate argument from whether or not reparative therapies are effective, since many people think that sexual orientation changes naturally, and should not be forced.Joshuajohanson 23:22, 14 April 2007 (UTC)

"Can Therapy Change Sexual Orientation? No.... [it] is not changeable." [18], "There is simply no sufficiently scientifically sound evidence that sexual orientation can be changed." (American Psychological Association) [19]. If you want to add concise statement of what the mainstream position is about to what extent a person's sexuality changes outside the context of reparative therapy/ex-gay methods, that's fine -- but let's make sure it's a mainstream position. I have no idea what Paglia's theories are or whether they are representative of the scientific consensus. Same problem with Fritz Klein, and certainly the problem same with "fluid sexuality". Fireplace 23:39, 14 April 2007 (UTC)
I realize that American Psychological Association information page states that homosexuality is unchangeable, but others state there is no evidence one way or the other. I was not trying to represent the idea that orientation can change as the mainstream argument, just as a legitament counter viewpoint that is held by many outside of reparative therapy. The wording on the sexual orientation page that "Most specialists follow the general conclusion of Alfred Kinsey" was not my wording. I really don't care if this concept is called fluid sexuality or not, that is just what Wikipedia has been calling it. The concept still exists. I don't understand why this causes so much problems. I think this is an important issue that deserves to have its own section.Joshuajohanson 07:30, 16 April 2007 (UTC)
A few points. First, wikipedia articles are not reliable sources (see WP:CITE). Second, the fluid sexuality language you added came from a completely WP:OR article that was written in large part by you. Third, above you argued for a statement of what the view is on whether sexual orientation changes naturally over time. But the language you actually added to the article didn't address that: you merely put some quotes on different topics together without any clear structure. I'll also note that your citation to Paglia doesn't support your claims that she thinks orientation isn't fixed or that she supports reparative therapy. This is a regular issue with your citations. Fireplace 15:15, 16 April 2007 (UTC)
Fluid sexuality isn't WP:OR, and the parts I added all had references. I only "copied" the parts that were references, not the other parats. Simply being unaware of Fritz Klein and Camille Paglia, isn't enough reason to revert my edits. Alfred Kinsey also believes orientation is fluid, and Lisa M. Diamond tracts changes in attractions among women over a two year period.[20] The paper I referenced that quoted Camille Paglia said "Is the gay identity so fragile that it cannot bear the thought that some people may not wish to be gay? Sexuality is highly fluid and reversals are theoretically possible...there is an element of choice in all behavior, sexual or otherwise." How was I misquoting her?
When I try to paraphase what is said, you say I am misquoting, so lately I have been trying to get direct quotes and you say that they are strung together without any clear structure. If you don't like my structure, fix the structure, don't just revert all my edits.
I must admit that some of my additions have come from NARTH, which according to you is not "reliable", but the reliability should at least be that of anti-ex-gay propaganda, from which claims the APA says "create an environment in which prejudice and discrimination can flourish". Just the Facts is also horribly misquoted.Joshuajohanson 07:30, 18 April 2007 (UTC)
Sorry -- I was wrong about Paglia and sexuality not being fixed (I missed the quote, which was in a paragraph where her name wasn't used), although the source has other problems (namely, it includes no citation and comes from a highly biased source -- a google search for the quoted language turns up no other hits; if she said this, and it's important enough to include in the article, we should cite to the primary source). Regarding fluid sexuality and original research; yes, it was original research. "Fluid sexuality" is not a category or term widely used by mental health professionals, and the article, by stringing together a series of quotes about sexuality, tried to organize them into a demarcated theory called "fluid sexuality." Regarding the reliability of sources, there is no double standard: if an organization offers a direct quote from an official statement, I tend to accept is as a reliable source (especially absent any contrary evidence); if a speaker paraphrases a telephone conversation, I am not inclined to accept that paraphrasing as a direct quote. This is all straight out of WP:RS. Fireplace 10:13, 18 April 2007 (UTC)
Okay, I took out the words "fluid sexuality" and I reworded it so it clear that sexuality being fluid did not mean it could be changed by choice. If you don't like how I presented, how about you change it rather than just out-right deleting it. Funny how in the same response you say "there is no double standard" and a speech to the House of Representatives is unreliable because it comes "from a highly biased source," while 365Gay Newscenter isn't considered biased. Try googling just "Is the gay identity so fragile that it cannot bear the thought that some people may not wish to be gay?" You get 94 hits. I had it properly sourced to her book in fluid sexuality. I didn't ever put it in this article, but I am putting it in now under gay rights supporters. I have it sourced to her book, but if someone wants to look it up online they can see another source (since a member of the House of Representatives aparently can't be trusted to quote a book very well.)Joshuajohanson 02:39, 2 May 2007 (UTC)
Looks good! Fireplace 03:33, 2 May 2007 (UTC)

Merge and move

I'm proposing merging ex-gay into reparative therapy, and then moving the combined article to Reparative therapy and the ex-gay movement. Over the past few months I've brought the article from a mess to GA (and approaching FA, in my opinion) status. This merge/move is the next logical step for the reasons below. A little history: the articles were unmerged a month ago on an exploratory basis, and now, having lived with the unmerged articles for a while, I think they are better handled as one (but not, this time, categorizing one as a species of the other).

  • From a structural point of view, maintaining independent, non-heirarchical articles leads to redundancy problems and an unnecessary amount of cross referencing (just look at ex-gay). Not to mention, the reparative therapy article is approaching WP:FAC status, whereas the ex-gay article is a mess. The proper way to structure these articles is in a heirarchy, with secondary spinoff articles used as necessary ala WP:Summary style.
  • From a substantive point of view, reparative therapy and the ex-gay movements are inseparably linked phenomena, sharing many common motivations, assumptions, proponents, opponents, and criticisms -- some commentators (correctly or incorrectly) do not even distinguish between them. From a neutral, "view from nowhere" perspective, they are properly treated as two heads of the same dragon. There are differences, but the best way to get across both the distinctions and similarities between RT and the ex-gay movement is in a section like this (still under development), plus making the distinction in the article intro (like this).
  • Support per reasons above. Fireplace 20:33, 17 April 2007 (UTC)
  • Support per nom - well thought out reasons. -- SatyrTN (talk | contribs) 01:06, 19 April 2007 (UTC)
  • Oppose RT is a therapy or set of interventions. It is by meaning quite different from the ex gay movement. A movement is more of a political/sociological body. A therapy is a science/theology/psychology oriented set of recommendations. Length is also relevant here. Both distinct subjects require a lot of specific detail on their elements. RT is actually quite an in depth subject, that relates to psychology, social psych, spiritual ideals, and so on. Ex gay can involve RT, but RT doesn't have to involve gay (according to some views). I personally respect the view to merge, but I see that the subjects and the subject matter are so different/differentiatable that I probably wouldn't agree to the merge at any forseeable time. Docleaf 11:35, 19 April 2007 (UTC)
  • Support the merge. The two topics are barely different aspects of the same phenomenon. Any differences can be highlighted in the new article. In other words, Ex-Gays are, for the most part, former gays who have gone through some type of RT is a therapy. Linking the two in one article makes sense. I'd like to see a more concise article as well. LiPollis 00:37, 20 April 2007 (UTC)
  • Oppose. Consider cleaning up both articles. Ex-gay may have nothing to do with RT; treatments, ministries and scandals may not overlap. I agree with Docleaf. --Knulclunk 16:46, 30 April 2007 (UTC)
  • Oppose. I agree with Knulclunk. Heiko Evermann 20:18, 1 May 2007 (UTC)
  • Oppose. RT is only one of many methods used in the ex-day movement. In fact, RT appears to be fading out in favor of newer and more reputable theories and practices. User:richman9 11:45, 8 May 2007 (UTC)

Closed due to lack of consensus. Fireplace 22:03, 12 May 2007 (UTC)

Definition of success

I added references to Haldeman who says success in reparative therapy varies between (1) eradication of attractions (2) ability to function as a heterosexual and (3) being able to refrain from homosexual activity. It was reverted, saying it was repetitive. The current version states "Reparative therapy (also called conversion therapy and reorientation therapy) refers to methods aimed at eliminating same-sex sexual desires". This is only one type of reparative therapy. Please let me add the additional information so the reader can better understand all of the different types of reparative therapies.Joshuajohanson 07:37, 18 April 2007 (UTC)

The article also says "Today... [t]here is often an emphasis on minimizing and not acting on same-sex attractions, rather than eliminating them outright" and "For some ex-gay groups, merely choosing not to act on one's same-sex desires counts as a "success" whereas reparative therapists tend to understand success in terms of actually reducing or eliminating those desires." Also, note that in the Haldeman source, celibacy seems to fit under the ex-gay project rather than the RT project. It's also not clear that he's saying that these are two/three different doctrinal views or whether he's merely criticizing the empirical research methodology. Fireplace 10:31, 18 April 2007 (UTC)
Well that says what the stance of ex-gays groups are, not the goal of reparative therapy. Haldeman doesn't mention anything about ex-gay groups. He mentions that some religious and pastoral counselors might advocate celibacy, but they are still advocating the particular method within conversion therapy. Just because it might be inspired by religious thought doesn't mean it isn't within RT. Also, the religious position is different than the ex-gay movement. Not all religious people who advocate RT advocate the ex-gay movement. This article does not reflect the differences within RT itself and the introductory sentence doesn't even cover the "typical" case. Haldeman says:
"What constitutes sexual orientation change? This basic question is addressed to varying degrees in studies of conversion therapy. In some reports, the eradication of same-sex fantasies and behavior are the criteria for sexual orientation change. In other studies, the criteria are far more lenient. Typically, conversion therapists expect that patients’ homoerotic fantasies may continue but that they will be able to manage the fantasies so that they may legitimately claim a heterosexual identity, or at least function in a heterosexual relationship. Yet another option that some religious and pastoral counselors might advocate is celibacy. This option does not permit any interpersonal sexual expression at all, but it is thought of as preferable to the sin of homosexuality in some religious contexts."[21]Joshuajohanson 16:41, 18 April 2007 (UTC)
You make a good argument for merging the articles. My original arguments about Haldeman stand. Regarding the first sentence, see [22] ("The term "reparative therapy" refers to psychotherapy aimed at eliminating homosexual desires"), [23] ("Some therapists who undertake so-called conversion therapy report that they have been able to change their clients' sexual orientation from homosexual to heterosexual."), [24] ("...treatments that attempt to change a persons sexual orientation, also known as reparative or conversion therapy."). It's perfectly appropriate to address variations on this theme within the article, and the article does this. I think the Doctrine section would be a good place to add more, if you think it's currently unclear. Haldeman, for the reasons I gave above, doesn't strike me as a good source though. Fireplace 16:59, 18 April 2007 (UTC)
I think its ok to say that some therapists report certain anecdotal views. I also think that should be stated with respect to the majority (science) view. RT is pretty much discredited according to serious psych research. The science view really should get its airtime. Docleaf 11:39, 19 April 2007 (UTC)

Aversion Therapy

Is aversion therapy a type of reparative therapy? If so, it needs to be better explained. It had been used for a long time before the declassification of homosexuality as a mental disorder. The way it is treated right now it seems like it was never used by mainstream medical associations, which makes it seem like it was made up by ex-gay groups, when in fact they were just following a standard procedure that seemed promising at the time. I notice in general this article tries to disassociate mainstream medical organizations from reparative therapy.Joshuajohanson 10:25, 21 April 2007 (UTC)

Third opinion

This article really is in pretty good shape. I look forward to seeing it on the main page in the near future. :) This being said, its conclusions are well-sourced and appear to me to be correct. It does report on the techniques and views of the proponents, while making sure not to give undue weight to them, and properly reports that mainstream science and medicine basically consider it to be at the very least impossible and more likely actively harmful. Basically, it's a fringe theory, and is treated well in accordance with both WP:FRINGE and WP:NPOV. That should continue. Seraphimblade Talk to me 11:44, 21 April 2007 (UTC)

Reaction by reparative therapists

It has been suggested that the section on reaction by reparative therapists was given undue weight. I think a response from all of the accusations presented in this article is necessary.Joshuajohanson 07:47, 29 April 2007 (UTC)

The purpose of the article isn't to catalog the dialectic, but to provide an overview of the subject from an objective perspective. The language you're inserting has been repeatedly removed from the NARTH article by multiple users -- it's not a clear point-by-point response, but a long series of quotes and a bibliographical references repeating what has already been said in far fewer words. I've integrated the new info from the paragraphs into the previous version of the section. Fireplace 14:22, 29 April 2007 (UTC)
Maybe I'd buy that if your "integration" actually was objective. Your "integration" doesn't talk about the criticism received from scaring the pyschologists away from research, preventing NARTH from representing its point of view, or denying data pointing to the effectiveness of reparative therapy. Also, being able to choose to enter into reparative therapy, which is where the pyschologist's purpose is to change the client's orientation, is different than the self-determination argument which is to allow the client to persue a change in orientation. It also obscures who is saying what. Reparative therapists aren't the only ones who think it is heavily politically based.Joshuajohanson 00:59, 2 May 2007 (UTC)
Archive 1Archive 2Archive 3Archive 4Archive 5→Archive 10

Egodystonic

Egodystonic is used for a variety of unwanted desires in conflict with the ego. It gets 50,000 hits on Google (reparative therapy itself only gets a bit more with 80,000.) It is also the technical defintion for those with an unwanted sexual orientation. It was used in the DSM and is still used in the ICD. It might not be used much in the US, but it is used anywhere where they use the ICD.Joshuajohanson 01:18, 24 May 2007 (UTC)

  • I'm skeptical about this term. It gets 10 hits in PubMed, three from the 1990s, and zero since 1998. Furthermore, reparative therapy is often used on individuals against their consent. See Zachary Stark and Alan Turing, for example. Therefore, reparative therapy is not exclusively used when individuals are not happy with their own sexual orientation, and the term is imprecise. eaolson 04:47, 24 May 2007 (UTC)
That is because the APA opposes it, so most of the US also does not use it. However, the ICD has wide usage outside of the USA. You are right that reparative therapy is also used on other homosexuals, but that isn't the typical case.Joshuajohanson 05:23, 24 May 2007 (UTC)
Please see comments belowLCP 17:51, 24 May 2007 (UTC)

WHO and reparative therapy

The WHO says in the ICD, (F66.1) that those with an ego-dystonic sexual orientation "may seek treatment in order to change it." How is it OR to say they support reparative therapy?Joshuajohanson 01:21, 24 May 2007 (UTC)

First off, given how quickly NARTH, et al., jump over any mainstream statement that could be stretched to support their position, don't you think they would have picked up on this if the WHO actually supported RT? Now, addressing your point directly, F66.1 says that the desire to change one's settled gender identity or sexual orientation is itself is a disorder. Fireplace 01:36, 24 May 2007 (UTC)
Exactly! They are disordered and can seek treatment to change their orientation (it NEVER said "settled"-those are your words). Hence they can undergo reparative therapy. My edit made clear that just having a sexual orientation wasn't a disorder, it is being ego-dystonic.Joshuajohanson 03:34, 24 May 2007 (UTC)
No. I'll try again: F66.1 does not say that people who want to change their gender identity/sexual orientation can, under the WHO's approval, attempt treatment to change it. It says that the desire to change (and the seeking of treatment to change) is itself a disorder. (In other words, some transgender people and some "ex-gays" are disordered in virtue of wanting to change their gender/sexuality.) The disorder to be repaired is the desire to change, not the gender/sexual orientation. This is why some LGBT-rights people don't like this clause -- not because it supports reparative therapy (it doesn't), but because it implies that trans people have a disorder. Fireplace 14:21, 24 May 2007 (UTC)
I think you both are slightly off. First, I think that, as Fireplace suggests, “and may seek treatment in order to change it” is not an endorsement of treatment seeking. None of the other F66 disorders mention treatment options. (However, I have not read the entire IDC doc. Am I missing something?) Instead, the statement is probably an example of unclear writing. Replace “may” with “sometimes,” and, based on the context, you’ll probably have the correct meaning.
Second, I think we are having this discussion because the IDC waffles. While “Egodystonic sexual orientation” is mentioned under the header, “Psychological and behavioural disorders,” UNLIKE EVERY OTHER DISORDER LISTED, the IDC does not label “Egodystonic sexual orientation” a “disorder.” It is an “orientation.” That is a gigantic omission in this type of bureaucratic document.
Correctly represented, I think “Egodystonic sexual orientation” is a very big deal and should be included in the article. Perhaps a modified version Joshuajohanson’s statement:
“Reparative therapy is usually used in treating ego-dystonic sexual orientation, which is the wish of an individual that his or her sexual orientation were different, though it has been used on egosyntonic homosexuals. The World Health Organization lists ego-dystonic sexual orientation in its International Classification of Diseases.
The following statement should (perhaps?) be included elsewhere: The American Psychological Association dropped homosexuality from the Diagnostic and Statistical Manual of Mental Disorders in 1987 and opposes its diagnosis.[1] American mainstream….”
Finally, I have problems with Fireplace’s statement about NARTH. It is an argument from ignorance (which is logically fallacious). While he may be correct in spite of this, I think if the argument is going to stand, it needs to be sound.
By the way, eaolson's appeal to PubMed in the previous topic is also another argument from ignorance. For inclusion, only one reputable, NPOV source is required. That “Egodystonic” doesn’t come up frequently in PubMed only means that, for whatever reason, researches are not terribly interested or those that are interested haven’t been able to get funding.
LCP 18:01, 24 May 2007 (UTC)
Regarding my NARTH argument, it wasn't intended to be deductively valid (which, as you point out, would be incorrect). But, the observation about NARTH, et al., is nevertheless strong evidence in favor of the conclusion. (I don't think this matters much as we largely agree in our reading of F66.1.)
I have no problem bringing up egodystonic-something in the article, but I object to giving it prominence in the lead. As Eaolson and I have both pointed out, the term is relatively uncommon. Under WP:NPOV and specifically WP:UNDUE, the term should not be given undue weight. Fireplace 18:16, 24 May 2007 (UTC)
I don’t really understand your objection to “egodystonic” or “ego-dystonic sexual orientation” (granted it is used correctly). The terms are scientific and perfectly describe the conflict reparative therapy seeks to resolve. It seems to me that that is exactly the type of thing that should be in the lead. Perhaps I am missing what is at stake? Regarding eaolson’s comment, 2/3 of his post had to do with objections against reparative therapy itself. The first 1/3 is an expression of skepticism based on an demonstrably unsound argument. Apart from being scientific, “egodystonic” comes up ~50,000 times in Google (according to Joshuajohanson). That makes it pretty darn popular, and that eliminates the UNDUE objection. “Ego-dystonic sexual orientation” is scientific, merely descriptive, and used by the IDC. Because the IDC is a MAJOR player in this arena, their use removes the UNDUE and non-NPOV objection. What am I missing?LCP 18:39, 24 May 2007 (UTC)
First off, I'm hesitant to call the IDC a "MAJOR player in this arena." In theory it could have been, but in actuality there is very little mention of F66.1 in the literature, whereas the DSM-IV (which is used worldwide) is very frequently referenced in the literature. Second, a google search for "ego-dystonic" is overbroad, as "ego-dystonic" is used in contexts outside of homosexuality or reparative therapy. A search for ego-dystonic "reparative therapy" -wiki comes up with 928 hits, many of them discussing the term as it was used in the outdated DSM-III. If we add -narth (which is not a mainstream organization) to the search, the number drops to 467. Third, look at how the mainstream, reliable sources describe reparative therapy: "treatments to alter sexual orientation" ([25]), "psychotherapy aimed at eliminating homosexual desires" ([26], a statement endorsed by 10 such organizations), "change... clients' sexual orientation from homosexual to heterosexual" ([27]), "change his/her sexual homosexual orientation" ([28]), "the basic goal of reparative/conversion therapy... is to change an individual's sexual orientation from homosexual to heterosexual" ([29]), "'Reparative Therapy'... Therapy directed specifically at changing sexual orientation is contraindicated..." ([30]). Fireplace 19:00, 24 May 2007 (UTC)
Sorry if I am being dense, but I still do not understand what would be wrong with using the following in the lead:
“Reparative therapy is usually used in treating ego-dystonic sexual orientation, which is the wish of an individual that his or her sexual orientation were different, though it has been used on egosyntonic homosexuals. The World Health Organization lists ego-dystonic sexual orientation in its International Classification of Diseases.”
The statement does not endorse RT and sounds to me like an objective statement of fact. Perhaps Joshuajohanson can help me to understand by sharing why he wants it included.LCP 19:12, 24 May 2007 (UTC)
No worries. The problem is that the "ego-dystonic" language is not the standard way of describing reparative therapy, but instead relies on a term used by an outdated source (DSM-III), a (confusing) source not prominent in discussions of reparative therapy (F66.1), and fringe groups (e.g., NARTH). The standard description of reparative therapy defines it as therapeutic attempts to change sexual orientation, as I cited above. Fireplace 19:42, 24 May 2007 (UTC)
I don't think you should discount WHO because it is "confusing", nor should it be discounted as a major player. The Chinese Classification of Mental Disorders also uses ego-dystonic as a type of homosexuality[31] and has stated "Treatment can include therapy meant to change a patient's orientation to heterosexual."[32] India classifies it as ego-dystonic.[33] The introductory section has already made it clear that the APA does not support reparative therapy. To be NPOV it should also have that WHO has stated that homosexuals may seek treatment in order to change their sexual orientation under the diagnosis of a mental disorder. I thought a discussion of ego-dystonic sexual orientation would make it clear that WHO does not support reparative therapy for egosyntonic homosexuals.Joshuajohanson 23:13, 24 May 2007 (UTC)
First, you still seem to be interpreting F66.1 as approving of reparative therapy. See above. Second, the "confusing" comment was directed at readability (everyone understands "therapy to change sexual orientation" - but "therapy to cure ego-dystonic sexual orientation, which is the condition of being unsatisfied with one's sexual orientation" is exceptionally unclear). Third, sure, some people cite the ICD-10 in discussing reparative therapy. Most discuss the DSM-IV (including the links you provided, by the way). Fireplace 23:27, 24 May 2007 (UTC)

(unindent) The issue of how F66.1 is being interpreted aside, I don't think the second version is "exceptionally unclear." However, the first version is definitely more clear. Nevertheless, I support the inclusion of "ego-dystonic sexual orientation." However, so does Fireplace, just not in the lead. Joshuajohanson has evidence that it is a viable term, and putting it in the lead may be warranted. I think perhaps that someone else needs to take a look at this issue.LCP 23:36, 24 May 2007 (UTC)

On the issue of F66.1, let's say it is used to treat ego-dystonic sexual orientation and then let the reader decide which interpretation it should be.Joshuajohanson 16:25, 25 May 2007 (UTC)
I would recommend putting in direct quotes from the WHO report and allowing the reader to reach any conclusion the reader wishes to reach. To interpret the WHO report or intentions or to try to say what it "means," probably would be considered OR. DPetersontalk 18:29, 25 May 2007 (UTC)
I am uncomfortable with this unless the whole statement is quoted without a context that implies one thing or another. That might work. Regardless, although I wish and hope it to be true that sexual orientation be subject to the will, I do not think that the WHO statement endorses treatment seeking. It merely describes treatment seeking as a behavior that might accompany the disorder. "I think that, as Fireplace suggests, 'and may seek treatment in order to change it' is not an endorsement of treatment seeking. None of the other F66 disorders mention treatment options. (However, I have not read the entire IDC doc. Am I missing something?) Instead, the statement is probably an example of unclear writing. Replace ‘may’ with ‘sometimes,’ and, based on the context, you’ll probably have the correct meaning." On the other hand, "ego-dystonic sexual orientation" is presented uniquely, not as a "disorder." So perhaps in this case, albeit doubtful (for the reason I have stated), they are recommending treatment. I think the stake-holders in this case need to look at whether the doc presents treatment options in the listings of other conditions. If not, then I think it is very clear that Fireplace's interpretation is correct.LCP 19:35, 25 May 2007 (UTC)
It's strange that the drafters let this language fly. I have some experience seeing U.N. negotiations and their results, and my best guess here is that there were two (or more) opposing camps within the WHO, and the only compromise language they could agree on was this muddled result. Anyways, I'm happy with the current version (Joie's edit). Fireplace 20:59, 25 May 2007 (UTC)
Thanks! Joie de Vivre 21:03, 25 May 2007 (UTC)

I agree with LCP that the language of the report does 'not' endorse treatment or seeking treatment. I suggest romoving the statement entirely until agreement on language can be achieved. DPetersontalk 21:43, 25 May 2007 (UTC)

Of course it is talking about treatment to change sexual orientation. It is under this diagnosis that India practices reparative therapy.[34] Even the APA allows reparative therapy and gives guidelines on how to do it.[35] It just opposes officially classifying ego-dystonic sexual orientation. All the reparative therapists operate under licenses issued by the APA. Anyway, the WHO does allow some sort of treatment and that needs to be in there. If the way I have put it in there favors my interpretation, then maybe someone else should put it in there so it doesn't. But either way, it needs to be in there.Joshuajohanson 15:56, 28 May 2007 (UTC)
Yes, the F66 mentions treatment. That is not the issue. The issue is that the statement is descriptive, not proscriptive. I’ve demonstrated why there is no warrant for your reading. Your interpretation of the statement is not warranted by the content surrounding the statement, and so your claim is completely gratuitous. Please find other instances where a treatment is proscribed, in the section of the IDC document where disorders are described, and then your assertion may have a leg to stand on.LCP 17:25, 28 May 2007 (UTC)
I disagree with Joshua...where does APA specifically state in that document that "APS allows reparative therapy," and what specific guidelines does it offer for the use of reparative therapy? I just don't see that in the link. DPetersontalk 17:28, 28 May 2007 (UTC)
All of the papers that I found that comment on the interpretation of the WHO statement see it as classifying ego dystonic homosexuality as a disorder. Combat law says the ICD-10 "distinguishes between ego syntonic and ego dystonic homosexuality, and specifically mentions ego dystonic homosexuality, bisexuality and heterosexuality as psychiatric disorders. "[36] After saying homosexuality was dropped as a disorder from the ICD-10, Dr. Martell said a "related disorder “ego-dystonic sexual orientation” remains in the International Statistical Classification of Diseases."[37] The International Gay and Lesbian Human Rights Commission goes as far as to say "This diagnosis can allow families to commit young persons who are just “coming out” and experiencing guilt or uncertainty."[38] The Alternative Law Forum (a very pro-gay law organization) states the "ICD-10 clearly includes even ego dystonic heterosexuality as a disorder." It futher states the ICD-10 "distinguishes between “ego syntonic” and “ego dystonic” homosexuality and categorises ego dystonic homosexuality, bisexuality and heterosexuality as psychiatric disorders. In ego dystonic homosexuality, bisexuality or homosexuality, the gender identity or sexual preference is not in doubt, but the individual wishes it were different and seeks treatment. In ego syntonic homosexuality, by contrast, the individual is comfortable with his or her sexual preference or gender identity. Psychiatric treatment to change the patient’s identity or sexual preference is warranted in the case of ego dystonic sexuality of any kind.[39]" I have not seen any legal analysis that would contradict my interpretation. Joshuajohanson 03:05, 30 May 2007 (UTC)
A quotation from page 20 of that document:
If the patient is ego dystonic, then doctors have various options, including prescription of drugs, cognitive behavioral therapy and aversion therapy. This type of therapy exposes the person to visual images of the disorder he/she is dealing with, followed by a mild electric current so that the image is associated with discomfort. For example, if a person with homosexual fantasies is shown a picture of an attractive man and simultaneously administered a mild shock the frequency of the homosexual desire comes down. Prior to the prescription of treatment such as behavioral therapy, the doctors are expected to get the consent of the patient to the prescribed treatment.
-- Joie de Vivre 03:36, 30 May 2007 (UTC)

Organizations

I edited the para to change professional counseling organizations to organizaitons. Professional organizations usually refer to such groups as APA, NASW, etc....See List of professional organizations [[40]] for other examples. DPetersontalk 12:25, 26 May 2007 (UTC)

NPOV

Reparative therapy is under extensive debate. This does not represent both sides of the debate. Even the techniques and reaction by reparative therapists sections only reference those against it. Every effort to add both sides of the debate have been censored. Until this censoring stops, I am marking this as NPOV.Joshuajohanson 15:59, 28 May 2007 (UTC)

This kind of broad assertion of an NPOV violation isn't helpful. The views of the major reparative therapists seem reasonably well represented in the article, as do the standard responses they make to the skepticism from the medical community. No one is "censoring" anything (please AGF)-- reparative therapy is a fringe view within the medical community, and the article accurately represents it as such. Fireplace 20:28, 28 May 2007 (UTC)
I shouldn't have said censored. I must admit that I allowed my comments to reflect the frustrations that I feel.
However, I do not agree with your assertion that it is a fringe view. Before 1973, virtually every medical organization, including the APA, considered homosexuality an illness. How does it go from mainstream to fringe that short of time? There are several countries where their mainstream medical organizations use reparative therapy (like India)[41]. I don't think you can call countries fringe groups. Even the Department of Defense considers homosexuality a mental disorder.[42]
I also don't think it even accurately reflects the APA position. The APA has printed articles in favor of reparative therapy[43] and the ACA printed an article where it lists ex-gay organizations like Courage International with other religious sources to refer their patients to.[44]
I also argue that it doesn't even accurately reflect the reparative therapists point of view. Way too much time is spent on aversion therapy, which is rarely used. The Psychoanalysis section only references those who are against reparative therapy. Citations by those involved in reparative therapy have been removed. [45] [46] [47] Joshuajohanson 02:54, 30 May 2007 (UTC)
No worries re: "censored." Taking your other points one by one... that RT is currently a fringe view is reflected by the many, many citations to multiple mainstream medical organizations that have expressed negative/skeptical views towards it. The India source doesn't support the claim that mainstream Indian medical organizations support RT -- only that some mental health professionals over there are using it. Further, on an international level, do any these Indian professionals carry the prominence and authority of the APA, the other APA, the AMA, the WHO, etc.? I'm not certain, but I doubt it. Same with the Dept of Defense. Regarding the APA position -- APA policy statements reflect their official position; articles published in APA journals do not necessarily reflect their position. As for the ACA, their official position is explicit (see the ref in the article). Regarding the diffs you cited, there's no evidence provided that those theories have gained much notability or widespread use or widespread discussion. Nor have they been influential in the doctrinal development of RT. Fireplace 04:43, 30 May 2007 (UTC)
Each of these points need resolving. I have split them up below.Joshuajohanson 06:03, 30 May 2007 (UTC)

Representation of American medical associations

I have read the refs and I still disagree with this article's interpretation of those refs. I cited those sources, not as official position statements, but as evidence that the article's current interpretation is flawed. The president of the APA, Gerald P. Koocher, stated "The APA has no conflict with psychologists who help those distressed by unwanted homosexual attraction." He later clarified this to say "In a full, multifaceted therapeutic relationship, the therapist has every duty to respond to patient choice and to help patients achieve their goals." [48] [49] Even Wayne Besen states this statement only reaffirms "the APA's long-standing principle that patients have the right to seek virtually any type of therapy they want, so long as the therapist explains the APA's current position and warns the patient of the potentially harmful consequences such therapy may produce."[50] The way the article stands, it makes it seems like the APA has a conflict with therapists helping patients acheive their goals.Joshuajohanson 06:03, 30 May 2007 (UTC)

You and I have been over all this before, and the current Ethics section reflects the current state of affairs. The first Koocher quote you cite was an off-the-cuff remark that he immediately clarified after NARTH, et al., jumped all over it -- citing it in a discussion over the official APA position is disingenuous. Further, the point of his clarification wasn't to reiterate his remarks, as your gloss suggests, but to emphasize that

One: The therapist has an obligation to carefully explore how patients arrive at the choices they want to make. Therapists must determine whether patients understand that their motives may arise purely from the social pressures of a homophobic environment. No type or amount of individual therapy will modify societal prejudices.

Two, informed consent: Patients must understand the potential consequences of any treatment, including those intended to modify sexual orientation. Patients must understand that such treatments lack a validated scientific foundation and may prove psychologically harmful.[51]

By the way, the day before, the APA issued an official statement that

For over three decades the consensus of the mental health community has been that homosexuality is not an illness and therefore not in need of a cure. The APA's concern about the position's espoused by the National Association of Research and Therapy of Homosexuality and so-called conversion therapy is that they are not supported by the science. There is simply no sufficiently scientifically sound evidence that sexual orientation can be changed. Our further concern is that the positions espoused by NARTH and Focus on the Family create an environment in which prejudice and discrimination can flourish."[52].

Now, yes, the APA does not prohibit practicing RT per se, but they require strict compliance with its ethics guidelines and they strongly suggest that NARTH's people are not doing that. And, that is how the article describes the state of affairs. Fireplace 12:22, 30 May 2007 (UTC)
You claim that citing a statement by the president of the APA at the APA's annual convention in a discussion over the official APA position is disingenuous??? I am sorry, I just see NO basis for that argument. I doubt with all the protests going on, with all the politics involved, that that statement was "off-the-cuff." Nor did Koocher counter that statement afterwards. He did counter NARTH's assertion that the APA was changing its direction, but that is a completely different point, as is the fact that the position taken by NARTH and Focus on the Family (not all groups as the article claims) create a homophobic environment. I am not arguing that. Sure, Koocher said a therapist should make sure the desire to change wasn't out of societal pressures, the patient understand the risks, lack of evidence and issues. I am not arguing that, but it doesn't change his original statment that the APA has no conflict with psychologists who help those distressed by unwanted homosexual attraction. This article takes some objections the APA has with reparative therapy and applies it to all of reparative therapy. There are plenty of negative statements made by the APA without you making up some more. So yes, the APA does have some objections to some of the methods used by some reparative therapists, but otherwise sees no conflict with it, nor does it interfer with the patient's right to seek virtually any type of therapy they want. Joshuajohanson 02:06, 31 May 2007 (UTC)
There's nothing I can say to the three-question-mark argument. I think a lot of what you just said is false, for reasons given many times on this talk page, in edit summaries, and in the sources themselves. I don't see any point in continuing a circular discussion that is largely divorced from the article content, so I won't. Fireplace 02:29, 31 May 2007 (UTC)

Representation of reparative therapy

I think the deleted edits were a heck of a lot more representative of RT than the instance where a "girl was held down while staff members screamed at her until she admitted that she was hurting her family by being a lesbian", the leader who was "having sex with women for the purpose of getting close to lesbians to convert them to heterosexuality", having women "apologize to the men for the feminist movement", buddah therapy, the man who "impulsively underwent an incomplete sex-change operation", or the account where "One man slashed his genitals with a razor and poured Drano on his wounds." Seriously, this is not typical of reparative therapy and totally misrepresents it. How is that not POV? Joshuajohanson 06:03, 30 May 2007 (UTC)

The article mentions those in several contexts, none of which being "this is how RT is practiced today." Except for "buddah therapy" (which I didn't add and know nothing about), they do represent an extreme, but they are from reliable sources (mostly academic journals) and it's appropriate to talk about them as such. Now, the examples you cited had specific reasons (given in the edit summaries) for deletion ("this list wasn't in reference to psychoanalysis. anyways, nicolosi/socarides are much bigger players in the field than throckmorton", "tenatively removing this paragraph... it seems like just more of the same, and from a less prominent figure", "rm paragraph -- more info here is generally good, but this paragraph didn't actually describe any techniques. also, the sources are dead links"). Fireplace 12:32, 30 May 2007 (UTC)
Reliable??? Ferber was a gay actor who went undercover to get material for a movie mocking ex-gay groups. Can you say he is reliable? Michael Bussee left the ex-gay movement and works to oppose it, but is given the misleading (although true) aire of authority by calling him the founder of Exodus. Is he reliable? Although other quotes may have been from academic journals, they are from those opposed to reparative therapy, and again I question their impartiality. I know reasons were given for deleting every single attempt to add something about RT from reparative therapists themselves, but I disagree with those arguments. It is fine talking about some extreme situations, but the article focuses on those extreme cases, while other treatments (for whatever reason) are removed.Joshuajohanson
You're welcome to add information from reliable sources accurately describing current trends in RT. This is difficult to do because reparative therapists typically operate on the boundaries of the medical profession, and reliable sources about broad trends are very hard to come by. Fireplace 02:29, 31 May 2007 (UTC)

Fringe Groups???

I know India and the Department of Defense don't have the prominence of the APA, but my argument was that they weren't fringe groups (even the WHO's position is still under debate.) In Asia, there are only 5 regions that officially do not consider homosexuality a disorder (Japan, Korea, Taiwan, Hongkong and mainland China).[53] Even so, China still has stated "Treatment can include therapy meant to change a patient's orientation to heterosexual."[54] It just doesn't seem like a fringe group.Joshuajohanson 06:03, 30 May 2007 (UTC)

Once again, you're playing fast and loose with sources. First, China doesn't "say" anything. Rather, the person quoted in the source says "Treatment can include therapy meant to change a patient's orientation to heterosexual, Chen said. He said such therapy is rare in China, and he declined to discuss it in detail, saying he was not an expert in it." (emph added) Fireplace 12:34, 30 May 2007 (UTC)
Fine, it wasn't China that said it, but the vice president of the Chinese Psychiatric Association representing the medical community in China. He might not be an expert on reparative therapy, but he knows enough to find out whether treatment can include treatment meant to change a patient's orientation before he goes to an interview about it. Medical treatment of ego-dystonic homosexuality in China includes treatments meant to change a patient's orientation-end of story. In other countries, the IGLHRC found that "homosexuality remains classified as a disorder, opening the possibility of forced incarceration and forced treatment, including shock therapy and other forms of "aversion therapy." That of course is the extreme case, but still exists in places like the Middle East. Other organizations, like the WHO and Chinese Psychiatric Association classify ego-dystonic sexual orientation as a disorder and at least talk about treatment for it. Beyond those, you still have other reparative therapists who don't even consider homosexuality of any type a disorder. Several major religious organizations have also talked about seeking a change in orientation. Just doesn't seem like a fringe group.Joshuajohanson 02:12, 31 May 2007 (UTC)
This has become a debate for the point of debating (nothing turns on the label "fringe", as WP:UNDUE applies to all articles). I'm backing out. Fireplace 02:29, 31 May 2007 (UTC)

Unchangeable?

Where does it state that orientation is unchangeable? Even the American Psychological Association only states it it is not a conscious choice that can be voluntarily changed, which is different than saying it is immutable. Both sponsored a document that stated that "Sexual orientation develops across a person's lifetime".[55] Most just say there is no scientific evidence one way or another. To say it is unchangeable is to push one POV.Joshuajohanson 16:12, 28 May 2007 (UTC)

I think Kinsey Institute research supports your assertion. Perhaps you can find the research and, since people have been averse to your edits, include the text here for review before you include it.LCP 17:48, 28 May 2007 (UTC)
I do need to do more research on the Kinsey Institute, but my question is with regard to the APA. The only place where the APA says it is not changeable is in context of whether RT works or not. I agree the APA has statements indicating therapy cannot change orientation, but that doesn't mean orientation is unchangeable. Clinton Anderson, director of the APA Lesbian, Gay and Bisexual Concerns Office, said "I don't think that anyone disagrees with the idea that people can change because we know that straight people become gays and lesbians, so it seems totally reasonable that some gay and lesbian people would become straight. The issue is not whether sexual orientation changes. We know that the issue is whether therapy changes sexual orientation, which is what many of these people claim."[56] I think there is some discongruence here between the article's take that "The mainstream view is that sexual orientation is unchangeable" and Anderson's take that no one disagrees with the idea that people can change.Joshuajohanson 02:13, 31 May 2007 (UTC)
Almost nothing in life is unchangable. It seems silly to suggest that something as complex as sexuality is unchangable. In fact I don't think we need to look far to see that peoples sexuality develops and changes. I'm not making an ethical argument here but simply a common sense one. I think it is most likely that people can move from one sexual orientation to another in both directions.
I agree with your common-sense, but this, unfortunately, is a highly sensitive issues for many people, and nothing short of thoroughly documented positions are included in the article.LCP 15:55, 6 June 2007 (UTC)

14 links to RT organizations, and counting. Wikipedia is not a directory. External links says:

  • Links should be kept to a minimum.
  • Long lists of links are not appropriate: Wikipedia is not a mirror or a repository of links. If you find a long list of links in an article, you can tag the "External links" section with the {{linkfarm}} template. Where editors have not reached consensus on an appropriate list of links, a link to a well chosen web directory category could be used until such consensus can be reached. The Open Directory Project is often a neutral candidate, and may be added using the {{dmoz}} template.
Links normally to be avoided:
  • Any site that misleads the reader by use of factually inaccurate material or unverifiable research. See Reliable sources for explanations of the terms "factually inaccurate material" or "unverifiable research".
  • Links to sites that primarily exist to sell products or services.

I support using the {{tlp|dmoz}} template for the RT organizations. Response? Joie de Vivre 02:17, 31 May 2007 (UTC)

The external links/WP:NOT point you raise seems right... I don't know about a dmoz link though, as the reparative therapy directory only has two entries. Fireplace 02:35, 31 May 2007 (UTC)
The only dmoz I could find was Society: Issues: Gay, Lesbian, and Bisexual: Opposing Views. Is that close enough or should it be blank? Joie de Vivre 02:40, 31 May 2007 (UTC)
Those seem off topic... I took it out and put NARTH, Exodus back in. Fireplace 02:50, 31 May 2007 (UTC)
Nice work. I think it looks much better. Joie de Vivre 03:00, 31 May 2007 (UTC)

AMA, etc

Thanks for getting that source. This is what it says: "[The AMA] opposes, the use of "reparative" or "conversion" therapy that is based upon the assumption that homosexuality per se is a mental disorder or based upon the a priori assumption that the patient should change his/her homosexual orientation."
Do you think that wording is expressed the same way in our WP article? Or do we need to couch our words better? --Knulclunk 19:21, 2 June 2007 (UTC)

Yeah, I've put it in more general terms now. Fireplace 19:30, 2 June 2007 (UTC)
Deleted "falsely," Provide a specific quote if you can. The reparative therapists assume, period. DPetersontalk 22:19, 5 June 2007 (UTC)
You can not say reparative therapists falsely assume that change is desirable. Whether change is desirable for a particular client is for that client to decide and that client alone.[57] The APA has stated that the "therapist has every duty to respond to patient choice and to help patients achieve their goals."[58] The APA has stated it is not their duty to decide what is desirable for the client and it definitely is not Wikipedia's job. What the APA does object to is the assumption that it is a mental illness. Joshuajohanson 23:16, 5 June 2007 (UTC)
I tend to agree with Joshuajohanson, and I wonder if the problem can't be gotten around by changing the introductory sentence which currently states, "Major medical organizations and others do not accept the anecdotal evidence offered by reparative therapists and ex-gay groups for reasons including". Or, perhaps Joshuajohanson can submit a revised version of the sentence here.LCP 23:58, 5 June 2007 (UTC)

While we are on the topic, does it bother anyone that the main source Wikipedia is using to say "medical and scientific consensus" is a brief handout by the APA and GLSEN?[59] The "Just the Facts Coalition" describes itself:

"In November of 1998, a conservative political organization sponsored a conference near Columbus, Ohio with the goal of encouraging the promotion of "reparative therapy" programs in public schools. Staff from the Gay, Lesbian and Straight Education Network (GLSEN) attended this event and were disturbed at what they learned. In December of 1998, Kate Frankfurt, GLSEN's Director of Advocacy, shared the content of this initiative and the November conference with a number of national education, health and mental health organizations at a meeting in Washington, D.C."

This APA consensus statement was in response to the inclusion of reparative therapy aimed at teens in public schools. A very specific, targeted abuse and perhaps not representative of the movement as a whole. --Knulclunk 01:50, 6 June 2007 (UTC)

The mainstream medical position is well-cited throughout the article and includes not merely the American Psychological Association's youth-related views, but also this, this, this, this, this, and this, as well as a host of academic, peer-reviewed journal articles and fact-checked newspaper stories discussing the mainstream medical position. Note also that the APA consensus statement includes position statements by major signatory groups that are not limited to youth-related contexts. Fireplace 02:43, 6 June 2007 (UTC)
One reason for giving the Just the Facts source a prominent position is that it includes a very large number of mainstream professional signatory organizations, and the language used as source material by the article isn't limited to youth contexts. This avoids having to include 5 or 6 refs from different organizations for a single claim. Fireplace 02:48, 6 June 2007 (UTC)
I think Fireplace makes a good point. And I also wonder if by giving “Just the Facts” such prominence we haven’t created a condition of internal contradiction in the article. (And perhaps this is Knulclunk's point.) On one hand, the article states that critics of reparative therapy criticize the idea because outcome data is anecdotal and/or not published in peer-review journals. On the other hand, we use a document that, regardless of other sources, is itself essentially only dogmatic as major warrant in several places. Even thought I agree that this is done for the sake of brevity, the contradiction is troubling. Because this is such a delicate issue, I would like to consider whether it would be more appropriate and helpful to readers for the article to cite actual research where it is available instead of "Just the Facts."LCP 16:06, 6 June 2007 (UTC)
Except those links don't make the claim that this article is making, as I explained here. If there is some outlandish claim that sexual orientation is unchangeable or the APA rejecting reparative therapy it should be properly sourced, especially when statements by the leaders seem to contradict that assertion. Talk:Reparative_therapy/Archive_3#Extensive_debate_within_professional_literature [60] [61] I don't think it should be too much to ask that all claims should be directly sourced.Joshuajohanson 21:27, 11 June 2007 (UTC)

Tags

Overall, this is a very good, extensive, well-sourced article. So, it's unfortunate that there are two big warning templates slapped on top of it (global and pov). Regarding POV, does anyone agree with Joshuajohanson that there are neutrality disputes over enough of the article to warrant this tag? Regarding global -- the article already discusses the DSM-IV and the ICD-10, which are major treatises used in most (all?) countries with advanced mental health systems. What more do we need to get rid of this tag? Fireplace 18:38, 6 June 2007 (UTC)

I think the article has changed since I added the global warning template. A concern is that so many of the citations are APA. However, a question that comes to mind is whether other countries even have "Reparative therapy", or is that just what the idea is called in the U.S.? I am assuming that even if not called RT, the idea must exist in other Western cultures.LCP 23:00, 6 June 2007 (UTC)
Someone removed the global tag without speaking to issues mentioned here. If the tag is to be omitted, I think the article need to speak explicitly to whether RT is primarily U.S. centric or international.LCP 02:56, 11 June 2007 (UTC)
I agree of course -- there are several international citations mentioned on this talk page and I've found a few articles from other English-speaking countries that can be incorporated. I removed the tag because we've already got the DSM-IV and the ICD-10, and article-wide tags should really be reserved major problems. Fireplace 03:26, 11 June 2007 (UTC)
I think I've finally realized what is troubling me. As I read the article, I come away with the impression that "Reparative Therapy" is _primarily_ a U.S. phenomenon. Is this so? If it is so, the lead should state as much. Thoughts?LCP 17:58, 11 June 2007 (UTC)
My concerns that I outlined in the NPOV section have not been addressed.Joshuajohanson 21:28, 11 June 2007 (UTC)
In that case the tags will have to go back. I will replace it now. DPetersontalk 21:42, 11 June 2007 (UTC)

Weasel words

Under the "Evidence cited by reparative therapists and ex-gays" section we have someone writing "one commentator argues". This sounds to me worryingly like "some argue". If we can't name this guy, we should rewrite the section.

Mondimore is the commentator -- see the ref in the subsequent sentence. Fireplace 16:21, 8 June 2007 (UTC)
Deleted adjective describing study. On what basis do you consider it an "important" study. I don't. It is a study, period. Furthermore, there are other aspects of this article that don't appear neutral, necessarily, to me. Maybe "disputed" would be a better tag? DPetersontalk 19:45, 10 June 2007 (UTC)
The word used wasn't "important" (which probably would be POV), but "influential", which is an objective characteristic. I'll add it back with a citation. Regarding the NPOV tag, can you explain what aspects are NPOV? Fireplace 03:18, 11 June 2007 (UTC)
Sorry. But "influential" is a judgement and so would be OR or an opinion. Thanks for adding the citation, that now makes it a verifiable statement, verifiable by a reputable source. I've also removed the tag. OK? DPetersontalk 12:05, 11 June 2007 (UTC)

Confused

What is a "patient rite to reparative therapy"? [62] Seriously, is this a religious phrase? Joie de Vivre 21:47, 11 June 2007 (UTC)

It should be right. It comes from the APA's code of ethics: "Psychologists respect the dignity and worth of all people, and the rights of individuals to privacy, confidentiality, and self-determination." [63] That is also how the APA leadership terms it.[64]Joshuajohanson 21:57, 11 June 2007 (UTC)

Ex-gay Identity

The article talks about an "ex-gay identity". I had never heard that before coming to Wikipedia. The article cited talks about shedding a gay identity, but doesn't talk about adopting an ex-gay identity. I must admit I am not familiar with all forms of reparative therapy, but I do know that from the several psychologists that I went to, none of them talked about adopting an ex-gay identity.Joshuajohanson 22:20, 11 June 2007 (UTC)

While I have found warrant for "ex-gay" and "ex-gay movement,” I have not seen any warrant for the term or idea of "ex-gay identity." Apart from that, the idea itself is flawed. If reparative therapists see sexual orientation as malleable, it is hard to imagine that they would condone using “gay” as a baseline against which to define identity. Furthermore, if I woke-up tomorrow and found that, overnight, I had developed a homosexual sexual orientation, I doubt that anyone would say that I have an “ex-heterosexual identity." Unless warrant can be found, the term should be rewritten.LCP 23:56, 11 June 2007 (UTC)
From the source's abstract: "However, within ex-gay narratives, religious discourse about homosexuality creates an inter-textual identity conflict and leads them to begin a complex process of re-naming and acquiring new discourse. Ex-gay narratives provide a significant opportunity to observe individuals using language as the primary tool to not only express identity but also create and transform it." Fireplace 04:30, 12 June 2007 (UTC)
Yes, transforming identity is crucial to the ex-gay movement, but I don't think it is an "ex-gay identity" that they are trying to transform into. I've learned about a masculine or feminine identity, heterosexual identity, or even more of a religious identity of being saved, born again, son or daughter of God and so on, but not an ex-gay identity.Joshuajohanson 06:32, 12 June 2007 (UTC)
Based in Fireplace's text, “ex-gay identity” should not be in quotes (unless I am missing something and it actually is a direct quote). Apart from that, I think I can see why Fireplace reads the text as connotative of “ex-gay identity,” but I think that interpretation is off. “Inter-textual identity conflict” would mean that subjects feel stuck between two conflicting identities, that they are unable to self-identify as either “gay” or “ex-gay.” In contrast, as Joshuajohanson states, “ex-gay identity” has a different meaning. It means one who is already settled into an identity and that identity is as an “ex-gay.” It is one who does not have a conflict. The point of reference is “gay,” and that is not what the text is talking about. I think I have actually seen such a thing, and it is a little sad. It is like the guy who identifies himself by a missing limb. “Hi, nice to meet you. Want to see my stump?” On the other hand, there can be a positive expression of such a thing. It would appear that people are encouraged to define themselves as “cancer survivors.” Granted that, I wonder if anyone has done research into “ex-gay identity.” That would be an interesting addition to the article. Regardless, that is not what is being spoken of by the text Fireplace quotes. So, I would if it be incorrect to say, “ex-gay groups tend to focus primarily on adopting an straight identity…”?LCP 15:35, 12 June 2007 (UTC)
Several points. First, whatever happens to the text, the word "primarily" should clearly go -- as far as I can tell, there isn't much homogeneity among ex-gay advocates or commentators on these sorts of issues. Second, I don't think the "straight identity" language is accurate either: many ex-gays don't claim to be "straight" insofar as being "ex-gay" doesn't preclude having homosexual desires or even acting on them. Third, I'm not at all wedded to the "ex-gay identity" language, although I think that is what Peebles is getting at, even without using those words. Another source which explicitly does use the term "ex-gay identity" is Straight to Jesus (reviewed here: "AA members refer to themselves as alcoholics even when they're not drinking, and, Erzen believes, "ex-gay" is a similar identity group, an unsettled and perilous condition rather than a firm relocation to heterosexuality. 'Recovery and relapse are built into the creation of an ex-gay identity," she writes, "and sexual falls are expected. Rather than becoming heterosexual, men and women become part of a new identity group in which it is the norm to submit to temptation and return to ex-gay ministry over and over again.'"). Fourth, what I want to get at with this language is their idea that the label "ex-gay" is somehow on equal footing with the label "gay", or that the "ex-gay rights movement" is somehow analogous to the gay rights movement. For examples of this, see here (where they go so far as to call "ex-gay" a sexual orientation) and here). Fireplace 23:12, 12 June 2007 (UTC)
Thanks for the research. I am comfortable with the current usage in the article. I'll leave "primary" and "secondary" up to you.LCP 00:27, 13 June 2007 (UTC)
Identifying as ex-gay is different than adopting an ex-gay identity. Anyway, I doubt that is their focus. Many ex-gay ministries actually disapprove of being called ex-gay. (For example see http://www.couragerc.org/FAQs.html.) I haven't seen any promotion of an ex-gay identity on Exodus or Evergreen International. PFOX seems to be an anomaly. I also disapprove of adopting a straight identity. I think it would be more appropriate to say they focus on abandoning a gay identity. In regards to Fireplace's fourth point of an ex-gay rights movement, I think it is valid but should be discussed on the ex-gay page.Joshuajohanson 20:50, 13 June 2007 (UTC)
It would be great if you could suggest how the "ex-gay identity" part of the lead can be improved/amended.LCP 20:53, 13 June 2007 (UTC)
"Ex-gay groups tend to focus primarily on abandoning a gay identity." That entails a change of identity without saying what that new identity should be.Joshuajohanson 21:32, 13 June 2007 (UTC)
  1. ^ Use of Diagnoses “Homosexuality” & “Ego-Dystonic Homosexuality” August 27 & 30, 1987
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