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Today in Your Health, a controversy that is both political and personal. Conversion therapy is a psychotherapy which aims to help gay men and women become straight. It's hardly new, but it's in the news again because the mental health clinic run by the husband of Republican presidential candidate Michele Bachmann reportedly provides such therapy.

This morning, NPR's Alix Spiegel has this look at the practice of conversion therapy, profiling the therapy experiences of two men.

ALIX SPIEGEL: At age 16, Rich Wyler sat down to calculate the cost of his attraction to men and came to a grim realization. There was no escaping it. The fact that he was gay was going to cost him.

Mr. RICH WYLER: It meant probably walking away from my religion, not having the wife and children of my future that I would expect, lots of shame and conflict with family and others. It was just devastating to contemplate.

SPIEGEL: Wyler had grown up a conservative Christian. He loved his community. He loved his faith. And while he knew that they couldn't accept him, the idea of leaving them behind was horrifying. Still, ultimately he decided there was just no ignoring reality.

Mr. WYLER: I remember distinctly looking in the mirror and saying, you're gay, that's it, stop trying to deny it, stop trying to hide it. That's who you are. And at least in that moment I looked and I felt really relieved and like go out and enjoy it.

SPIEGEL: And so after graduating from college, Wyler moved out to L.A. He lived on the edges of the gay community there. He went to clubs. He dated men. But always in the recesses of his mind, he says, he missed his old life. He missed his friends, his family, his religion.

Mr. WYLER: It just didn't feel fulfilling. It wasn't comfortable because it was unfamiliar - a very different dynamic of people than I was used to socializing with in a lot of ways. I'm not saying that it's not right for anybody, but it didn't feel right for me.

SPIEGEL: So Wyler was stuck. Half of him was a conservative Christian who thought that same-sex attraction was wrong. The other half was a gay man at odds with his faith.

Mr. WYLER: I remember for years thinking there is just no way out. I'm going to live like this, in this conflict, for the rest of my life.

SPIEGEL: Then in his 30s, Wyler heard of a counselor - a man who had apparently struggled with the same issue and said that he could help. Wyler called him and started one version of conversion therapy. Together they would sit and dissect what the therapist said were the causes of Wyler's homosexuality.

Mr. WYLER: My mother had been pretty domineering and controlling...

SPIEGEL: This therapist spoke to Wyler of his difficult mother, of his emotionally absent father, saying that this family dynamic had warped him. And slowly, Wyler says, through these conversations the way that he felt about things changed.

Mr. WYLER: The actual dynamic between me and the male world shifted. And my feelings for men shifted from fear and attraction to brotherhood and connection.

SPIEGEL: Today, do you feel attracted to men ever?

Mr. WYLER: I really don't. There's not a sexual component to it at all.

SPIEGEL: At all?

Mr. WYLER: No.

SPIEGEL: Wyler says he's now a heterosexual. And then there's the case of Peterson Toscano.

Mr. PETERSON TOSCANO: By age 17, I determined that I wasn't going to be gay. And I don't care what it takes. I'm going to find a cure.

SPIEGEL: Like Wyler, Toscano was a religious teen who discovered that he was gay and tried practically everything to change it. There were support groups and prayer groups and exorcism. Finally, after 15 years of therapies and a failed marriage, Toscano checked himself into a live-in treatment center run by a Christian group.

Like Wyler, at the center Toscano was taught to see his homosexuality as the product of family dysfunction, specifically a breach between him and his father. To narrow this breach, Toscano says, the patients were coached on how to act more masculine.

Mr. TOSCANO: They even had a football clinic to teach us how to play football. And they taught us how to change oil in our cars.

SPIEGEL: But the main meat of this program, says Toscano, were the confessional documents required of every patient.

Mr. TOSCANO: We had to write about every sexual encounter we had ever had. And I have literally three or four hundred pages of just these stories that we had to write for them.

SPIEGEL: Once the stories were written, the patients were asked to select the most humiliating one. Then during a family and friends weekend, they were told to stand and read that story aloud to everyone.

Mr. TOSCANO: They believed that by doing this it would release our shame. But it ended up multiplying our shame and then giving it to other people, so that my parents walked away with so much shame and guilt.

SPIEGEL: Toscano says that during his two years in this program he did stop thinking about men. And he believed, he said, that he was making progress.

Mr. TOSCANO: Well, I had done so much work, and so I had to believe that something was going to come out of it.

SPIEGEL: Then Toscano got out. And he says about two months after his treatment ended, he woke up one morning with a completely different perspective.

Mr. TOSCANO: It was literally that. I just woke up, and my brain was clear. And I asked myself: What the hell are you doing? This is crazy. You're not changing. You're not fooling anyone.

SPIEGEL: But, Toscano says, by that point it wasn't just a matter of walking away. It took years to get over.

Mr. TOSCANO: It took really hard work to get my brain back and to recover from the emotional and psychological damage that I had experienced under that care.

SPIEGEL: So these two men represent two sides of a debate that's been raging in psychological circles for more than a decade. One side feels that therapies which seek to make gay people straight are invariably harmful, the other, that those therapies can help gay people who are profoundly uncomfortable with their same-sex attraction.

And about two years ago, the American Psychological Association decided to weigh in. A taskforce was assembled and spent a year reviewing what evidence there was. The idea was to determine whether changing sexual orientation was possible and whether a therapist could ethically do the therapy. In 2009, they issued their findings. Lee Beckstead was part of the group.

Dr. LEE BECKSTEAD (Psychologist): We discourage psychologists from promising that sexual orientation change is possible through psychological interventions. A psychologist cannot say we can change your sexual orientation through these types of interventions, period.

SPIEGEL: So according to the taskforce, there is no compelling evidence that the kind of change Rich Wyler says he experienced is possible. But more, Beckstead - in a kind of fundamental way - called into question the very goals someone like Wyler brings to therapy.

Dr. BECKSTEAD: There are lots of reasons why an individual would not want to be gay, but those reasons aren't necessarily valid reasons. Clients request a lot of things based upon either lack of knowledge or ignorance or restricted understanding.

SPIEGEL: Therapists are not cosmetologists, Beckstead argues. They don't just do what people want. For example, he said, if a girl with an eating disorder came to a therapist saying she wanted to become thinner, the therapist couldn't ethically honor her request. From his perspective, the goal of people with same-sex attraction who wish to become straight is likewise distorted at its core. This, of course, doesn't sit well with someone like Rich Wyler.

Mr. WYLER: How dare they tell me that my goal is not legitimate. That is unethical.

SPIEGEL: Wyler points out that the American Psychological Association often says that one of their central ethics is client self-determination, that clients, not therapists, should decide what is right for them. And it really riles him that, for example, the APA is supportive of therapists who help transsexual or transgender clients meet their goals.

Mr. WYLER: They will help a man who comes in and says I want to be a woman. That, somehow, they're okay, and they'll say great. We can help you. But I want to be attracted to women - no, that's wrong. That makes no sense whatsoever.

SPIEGEL: But Peterson Toscano feels the APA position is necessary.

Mr. TOSCANO: The vast majority of people who try to change cannot. And the distress that's caused is real. It's not just that this doesn't work. It's destructive.

SPIEGEL: From Toscano's perspective, there might be a handful of people like Wyler who benefit from this therapy, but for every Wyler, there are dozens and dozens of gay men and women who will struggle through a process that asks them to annihilate a part of themselves.

Alix Spiegel, NPR News, Washington.

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