NEAL CONAN, HOST:
This is TALK OF THE NATION. I'm Neal Conan in Washington. In the larger battle over gay rights, some argued that gay men and lesbians could change. Advocates of so-called conversion therapy cited the work of Dr. Robert Spitzer, one of the giants of American psychiatry, who conducted a study of 200 ex-gay men and published his conclusions nine years ago.
From the start, critics attacked Dr. Spitzer's work and his conclusions. Now 80 years old and suffering from Parkinson's disease, Dr. Spitzer concluded earlier this year that they were right. He's drafted a letter recanting his study and issued an apology.
We want to hear from both sides of the couch. Therapists, how did Dr. Spitzer's study affect your work? And if you've participated in conversion therapy, what happened to you? 800-989-8255 is our phone number. Email us, firstname.lastname@example.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.
Later, former Secretary of State Madeleine Albright and the future of NATO on The Opinion Page this week. But first, Dr. Robert Spitzer joins us from Princeton, New Jersey. And Dr. Spitzer, nice to have you with us today.
ROBERT SPITZER: Nice to be here. My birthday is tomorrow, not today.
CONAN: Oh, well then, premature congratulations, and happy birthday.
SPITZER: Thank you.
CONAN: Why did you change your mind?
SPITZER: What's that?
CONAN: Why did you change your mind?
SPITZER: I changed my mind because I had been bothered for several years about it, and then when I was visited by Gabriel, who I gather you're having on the program...
CONAN: Gabriel Arana, who's going to be with us a bit later.
SPITZER: Right, and he described what it was like to be in therapy when he really didn't get any benefit from it at all, and he asked me about my concerns with the study, and I just realized that I had to make - explain to people why I think I made a big mistake.
CONAN: A mistake that's had some important consequences.
SPITZER: Well, I guess so. And that's why I wrote an apology both to the gay community and to individual gays who may have been wasting their time in this kind of therapy because they thought I had proven that it was valuable and useful.
CONAN: You obviously could not control how others used your study, and as you know, it was used as quote-unquote proof that homosexuality was a choice.
SPITZER: Right, right.
CONAN: And I know you said that's not what my study was about. After...
SPITZER: They also gave the impression that my study showed that it was common to be able to change, and I made it very clear, actually in the study discussion, that although it could happen, I thought it was very rare.
CONAN: Do you think homosexuality is a choice?
SPITZER: Is a choice? No, for sure, that's the one thing I have no doubt about, it's no choice.
CONAN: And in a distinguished career, this has been, I guess, an unfortunate last chapter.
SPITZER: Well, it's unfortunate in one sense, but I feel very relieved and very grateful to the many people who have told me or written to the New York Times that I did the right thing, and I think I did.
CONAN: What's been the reaction there in Princeton?
SPITZER: In Princeton, well, the reaction has been actually, ever since it happened, yesterday afternoon a gay couple came, and they said they wanted to thank me for what I had done, and they - she introduced me to her partner, and we're having them for dinner tomorrow night.
CONAN: Dr. Spitzer, thanks very much, that's a nice story, appreciate - and we know you're at your doctor's office. We hope things work out well for you.
SPITZER: Thank you.
CONAN: Dr. Robert Spitzer, retired Columbia University professor of psychiatry and psychology, a major architect of the modern classification of mental disorders, 2001 study supported conversion therapy, as you just heard from him. He now feels that he made a big mistake, and he's issued an apology for his work.
Benedict Carey is a science writer at the New York Times. He wrote the article "Psychiatry Giant: Sorry for Backing Gay 'Cure'." He joins us from a studio at the Times. Nice to have you with us today.
BENEDICT CAREY: Thanks, good to be here.
CONAN: And remind us just how important a figure Dr. Spitzer is.
CAREY: Well, he's one of, if not the most important figure in psychiatry in the second half of the 20th century, I would say; he rewrote the manual of diagnostic - diagnostic manual, the manual of mental disorders, which people know a lot about today, but back when Dr. Spitzer began his project to reshape that manual, it was a very obscure thing.
And he really rewrote the entire thing top to bottom and turned it into a much more rigorous document, a more readable one, a more accessible one, one that doctors could agree on. And it became really a standard for any manuals in this area that would be later written.
CONAN: And one of the primary changes he made was removing homosexuality as a disorder.
CAREY: It was. That was the thing that got him started. It was an argument he made to the board of trustees, I think, of the American Psychiatric Association. But he engaged in a debate, a very bitter debate, about this, arguing that homosexuality was not a disorder like the others in the manual. It didn't cause generalized distress on its own and that it should be taken out. And he won that argument against some very senior and very influential psychiatrists at the time. And - go ahead.
CONAN: I was just going to say, but that's what made his more recent study on so-called conversion therapy all the more prominent, because this was, after all, the man who'd taken homosexuality out of the DSM.
CAREY: Right, exactly. This was the guy who was a kind of hero, at least to those gay leaders who were paying attention to this stuff. He'd made the - he'd taken it out of the DSM, and now he was turning around and shooting them in the back. That's the way they felt about it.
CONAN: And as this - it's not to say that this movement of conversion therapy wouldn't have happened without his work, it certainly would have, but it gained a lot of momentum as a result.
CAREY: Right, just because of who he is, who he was. And, you know, this was, well, not only the architect of the DSM, but he was a kind of figure that was, you know, a sort of dominant sort of personality in the field, I think loved by some and hated by others but thought to be kind of an enforcer of rigor in psychiatry. And so to have him really to do this and put his name on it was a big deal.
CONAN: And you're looking back at the study that he conducted when he interviewed those 200 ex-gay men, and in retrospect it looks pretty sloppy.
CAREY: It does. There were men and women. I think about two-thirds were men, 200 in all, and it was a survey. It was a phone survey, I think a pretty in-depth one. He used a survey questionnaire instrument, they call them, it's a list of questions, so that he could compare responses.
But essentially it was - they were questions asking people how they change, how they felt, did they feel, you know, any more or less homosexual after the therapy than they did before. And so one problem, of course, is, you know, we change our opinions about these things, we lie to ourselves and others. We may change it depending on our mood or just the personal narrative we want to present.
And so there's no way that an interview like that can determine real change.
CONAN: How did a study like that get published?
CAREY: Well, this was Bob Spitzer. He had a whole lot of connections and power, and he called a friend, a doctor named Ken Zucker up in Toronto, who - Ken was, and still is, I think, the editor of the Archives of Sexual Behavior, which is an influential journal in the field. And, you know, this sometimes happens in science. It's like every other field where, you know, if you're a big shot, you know, you can move the wheels sometimes in a way that others can't.
And so Dr. Zucker put - agreed to publish the study in his journal on the condition that he also could publish commentaries, many of which were very critical, along with the study. It did not go through what they call peer review, which is when, you know, other scientists look at the study before it's published and make criticisms.
CONAN: But those kinds of distinctions did not stop those who advocated this kind of therapy from waving this study in the air and saying here's proof.
CAREY: Of course not. I mean, you know, it's published, and there it is. And if you want to believe that, if you want to - whatever you believe, if you see a study supporting it, I think you don't pay so much attention to the small print.
CONAN: Yet more and more criticism was coming out, more and more conclusions. The state of California, the legislature, is now debating a bill that would ban conversion therapy as something that is dangerous and unfounded, and indeed all kinds of groups were coming out with statements very, very critical.
CAREY: That's right. I think he - you know, it just wouldn't go away. You know, clearly gay issues are sort of bubbling up through the politics all the time, and any time this came up, this question about therapy, there it was. There was the study, and you know, people who disapprove of gay lifestyle, as they call it, would cite it, and those who are concerned about anti-gay bias would turn around and say, well, this is, you know, this is nonsense, it proves nothing.
So it was the kind of thing that just - it just wouldn't disappear into the past. It kept coming up. And I think since - he couldn't - he couldn't run away from it.
CONAN: And we heard him just a few minutes ago say if there's one thing he is sure of, it's that homosexuality is not a choice. Had you heard him say that before?
CAREY: I didn't hear him say that when I talked to him. I - but it certainly is not in the - he doesn't say that in the study. So I haven't heard it from him.
CONAN: We're talking with Benedict Carey, science writer for the New York Times, whose cover story on the decision by Dr. Robert Spitzer to recant his study on conversion therapy for homosexual men and gay women, well, it's caused quite a stir. When we come back after a short break, we'll be talking with the man that Dr. Spitzer credited with making him make that decision. Gabriel Arana joins us. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.
(SOUNDBITE OF MUSIC)
CONAN: This is TALK OF THE NATION from NPR News. I'm Neal Conan. A decade ago, Dr. Robert Spitzer's research was seized upon by many in the ex-gay community as proof that homosexuality could be cured. As we heard from him earlier, Dr. Spitzer now says he was wrong and apologizes in a letter to be published later this month.
We're talking today about his effect in the wider debate over what's known as conversion or reparative therapy. We want to hear from both sides of the couch. Therapists, how did Dr. Spitzer's study affect your work? And if you've participated in conversion therapy, what happened? 800-989-8255. Email email@example.com. You can also join the conversation on our website. That's at npr.org.
Our guest is New York Times science writer Benedict Carey, who wrote about Dr. Spitzer in the recent article "Psychiatry Giant: Sorry for Backing Gay Cure." There's a link to it at our website, again that's at npr.org. But joining us here in Studio 3A is Gabriel Arana, Web editor at the American Prospect, who wrote about his own experience with conversion therapy recently in an article titled "My So-called Ex-gay Life." And thanks very much for coming in today.
GABRIEL ARANA: Thanks for having me.
CONAN: And Dr. Spitzer mentioned an interview you had with him I guess earlier this year. How did that come about, and what happened?
ARANA: So I had undergone (unintelligible) therapy for three-and-a-half years when I was in high school, and I was actually referred to this famous 2001 study by Dr. Spitzer as a success story. Later, I ended up coming out, I married a man and became a journalist, not necessarily in that order.
(SOUNDBITE OF LAUGHTER)
ARANA: And so I was writing a piece half-personal. Most of it was personal, well, half personal, the other half was about the politics of the ex-gay movement, which the Christian right adopted in the late '90s. And what it allowed the Christian right to do is put a more benevolent face on anti-gay prejudice.
CONAN: You describe it as a kind of jujitsu in your article.
ARANA: Yes, so instead of angry denunciations from the pulpit, the Christian right could then say that they were actually caring for homosexuals, that they wanted to help gay people and that they wanted to help cure them. So I was in therapy for three-and-a-half years with Dr. Nicolosi, who was then the president of the National Association for the Research and Therapy of Homosexuality, the nation's largest group of practitioners of ex-gay therapy.
So I got this assignment, and Spitzer's place in this debate is really hard to overstate. So he was instrumental, as was mentioned before, in declassifying homosexuality as a mental illness, and then in 2001, the gay community felt that he stabbed them in the back by coming out with a study saying that at least for a few highly motivated individuals, change was possible.
And so I had a few questions for him. I didn't go with the expectation of confronting him. I was curious what motivated him to undertake this study and then what led him to believe that these self-reports from people in ex-gay therapy, what led him to believe that they were credible? Because I know had I spoken to him at the time, I probably would have said that I thought I was making progress.
CONAN: And you were recruited to be part of that study though you in the end didn't participate.
ARANA: That's right, as an irresponsible teenager, I never called him.
(SOUNDBITE OF LAUGHTER)
CONAN: So when you went to see him, what happened?
ARANA: So we first had lunch before we really got into the meat of the interview, and during that time, he asked me about - turned the tables and asked me about what it was like going to therapy with Dr. Nicolosi, whether I had experienced any change, and I said that after years of trying, after years of talking about my masculine identity - the underlying theory behind ex-gay therapy is that for men, men don't have a close enough relationship with their fathers, they may be too close to their mother, and that leads to gender misidentification.
So despite years of trying, and I tried in earnest, I never experienced any change. And the overall effect was there was a period between when I stopped therapy and when I accepted my gay identity that I just thought I had a disease with no cure.
So I talked to him about this, and then I started to ask him about the criticisms leveled at his study, and it was then that he said that he thought they were largely correct.
CONAN: And how did you respond?
ARANA: I was a bit - I was a bit taken aback because I expected him to push back and tell me why he thought these self-reports were credible. For many years, he had defended the study, which as he said a bit earlier on this program, he didn't intend as a study about the overall efficacy of whether - of ex-gay therapy. He wanted to know: Is it the case that anyone - that no one who has ever gone to this therapy has ever experienced any change?
And, you know, in the study he said that at least some people did. And now he's walked that back and said it's impossible to know from self-reports whether somebody has really changed their sexual orientation.
CONAN: And Benedict Carey, your article cited a letter from the World Health Organization, a report to be released on Thursday, that calls this therapy a serious threat to the health and well-being, even the lives of affected people. So this is, well, to the degree that this study by Dr. Spitzer promulgated or legitimized this therapy, it caused some serious damage.
CAREY: It did, and as I said before, I mean, it wasn't going away. I mean, these issues are sort of right close to the surface, politically and scientifically. That WHO report you're talking about came out I think last Thursday.
CONAN: Last Thursday, yeah.
CAREY: Right, and so there's some consensus that's tipping over and saying, you know, this is possibly a very dangerous thing, and I think Gabriel can talk about that, too. But it certainly wasn't something he could - he felt he could escape, meaning Spitzer.
CONAN: Gabriel, was it dangerous for you?
ARANA: Yes. So I think that for many years, it stopped me from accepting myself, it lowered my self-esteem. As I said earlier, it made me see myself as, as I said in my piece, as a leper without a cure. And encouraging - I mean, and the premise of therapy is that there is something wrong with - fundamentally and innately wrong with the person, and if you can't change it, then you're sort of left with this disease that has no cure. And I think that that's very - that affected very much as a young adult.
CONAN: Let's get some callers in on the conversation, 800-989-8255. Email firstname.lastname@example.org. John's(ph) on the line with us from Burlington, Vermont.
JOHN: Hi, Neal, thanks for taking my call.
JOHN: I'm calling because I work for an organization called Truth Wins Out, that fights the ex-gay myth and the ex-gay industry all around the country and so we deal with these issues a lot. And with people who have survived these therapies, with the victims, we hear all the time from them about their ordeals and their trials and tribulations as they attempt to pray away the gay.
So this is a huge, huge step towards the eradication of that ex-gay myth, and it brings Dr. Spitzer into line with every major medical and mental health organization that rejects reparative therapy as harmful and potentially dangerous to its patients. It's interesting, as well, that major, major, anti-gay right wing organizations around the country, including SPLC-certified hate groups, continue to cite Dr. Spitzer's study as justification for their anti-gay beliefs.
So the fact that he came out on record and repudiated it is a huge, huge watershed moment in the struggle to create a world where LGBT people are not any longer told that they're sinful or broken or that they can change.
CONAN: John, thanks very much for the call, appreciate it. Let's see if we can go next to - this is Damon(ph), Damon with us from Pinehurst in North Carolina.
DAMON: Yeah, I have a lot of thoughts on this issue. I've done quite a bit of research on this. I'm a therapist, heterosexual, and I've worked with people on - coming from multiple different areas dealing with this issue. I guess a couple of thoughts. One, I feel like the research is just very clear that reparative or conversion therapies are really damaging and generally not helpful.
But at the same time, I think there's a tendency to paint this as a black-and-white thing, when the research also shows very clearly that sexuality is a static thing, period, that there's a spectrum from homosexual to heterosexual, but we all fall somewhere on that, and we in fact fluctuate throughout the duration of their lives. And there are people who at one time with identify as gay, another time will identify as heterosexual and go back and forth.
I'm a heterosexual. I think at some point, I could potentially identify as homosexual and then maybe come back. So I guess it's not as black and white as we point out. But a lot of my experience with clients that I work with is that there's a bias that goes the other way, which is there's so many reasons why someone can experience same-sex attraction, and it doesn't always mean that you are gay. B -ut there's a strong, strong bias in the therapeutic community that a client comes in and they say I'm attracted to men or I'm attracted to women and I'm a woman, and the therapist says, well, let's put you on the path to homosexuality because that is your identity. And I think that is equally as damaging, and we all want to look at it as - it's black or white, but it's just not. It's much more complex.
And at the end of day, we just need to value where these people are, and I think there's, you know, if somebody wants to embrace a gay identity, then the therapist's role is to assist them with that. If - while I think restorative and reparative therapies are damaging, I think there are some emerging models out there that are really helpful which are the idea is if a client comes in and that they're not having same-sex attraction - and I want to manage that because I value my religion or my culture, as it stands right now, above the same-sex attraction. I think it's the sex therapist's responsibility to honor that and help them manage the same-sex attraction and try and live a heterosexual life, but not to say you're choosing to be gay or you're choosing to be heterosexual, but I think there's nothing wrong with - that that should be honored, and we tend - and that, you know, it's just not working right. It's not that black and white.
CONAN: I think we get the point, Damon. Thanks very much for the phone call. Benedict Carey, is it treated as a black-and-white issue, and is that a step on the slippery slope towards reparative therapy?
CAREY: Yeah. It seems to be a step on the slippery slope, but be careful answering this. I don't know. You know, these are very personal things that people decided for themselves. Let's say that at least the scientists who study this would say that the female sexuality is more fluid than male, meaning that at least, sort of, the science so far suggests that women may experiment more back and forth. I'm skeptical at what Damon says about, you know, men zigging and zagging back and forth between gay and homosexual.
I don't think that's the case. I think, with men, there's very little evidence that that happens. And, you know, I mean, think of yourself. You know, I mean, in your own history, we can all do that and try to imagine it. I guess, I would start with that.
CONAN: Benedict Carey, science writer for The New York Times, also with us is Gabriel Arana, a Web editor at The American Prospect, who wrote "My So-Called Ex-Gay Life," which appeared in the April 11th issue. You're listening to TALK OF THE NATION from NPR News. Let's go to Joel. Joel with us from South Bend.
JOEL: Hi. I just wanted to call in and glad to hear this topic and just say that I spent three years in ex-gay therapy with Exodus International - unsuccessful, I might add. And - but so much of it is really based in religion and biblical talk. And it's labeled as a sin, and therefore, if it's a sin, God can help you overcome it. And it's pretty much just that simple.
CONAN: And how - when did you start, Joel?
JOEL: Well, I was in my early 30s and came out - well, I didn't actually come out. I went to ex-gay therapy hoping to get this part of me fixed because I was a Baptist minister at the time.
CONAN: Because, obviously, this has any number of ramifications - spiritual, theological and professional - then?
JOEL: Exactly. Yes. It was a huge change and something very scary. But after spending three years in it and feeling like I was making just a drop in the bucket of what would be considered progress, I called my original counselor and just said can you please put me in touch with some guys that are much farther down the road than me. I need some encouragement because I don't feel like I'm getting anywhere. And basically, I was told, no, that they couldn't do that because, pretty much all of the success story they have - other than a few national speakers - was people that were afraid to talk to anybody about it because they say they would go right back into it. And I'm thinking, well, if that's their success story, then I don't want to live like that.
ARANA: So I think this brings up an interesting point, that...
Gabriel Arana, go ahead.
Yes - that the previous caller alluded to that there's a difference between how one identifies and whom one is attracted to. So even if one doesn't want to call oneself gay, you can still have homosexual attractions. And there are all this sort of weird - there's this weird terminology in the ex-gay movement, so people who experience same-sex attractions but don't embrace their gay identity are called non gay homosexuals. So try to make sense of that.
CONAN: You also...
JOEL: We would call strugglers.
CONAN: Gabriel, you described in your article a moment, I think, after your first meeting with the psychiatrist where you went to a group therapy session with other people who were also were participating in the conversion therapy, and these were, for the most part, older people. They knew who were - you said you looked at them and felt - heard about their difficulties, their loneliness. You said I don't want to participate in this lifestyle if I don't have to.
ARANA: Yes. So I think that the ex-gay movement trades in a lot of stereotypes and sort of preys on the misery of people in the gay community. So I went to a group therapy session where there were, I'd say, four or five 40- to 50-year-olds who are really unhappy, unhappy with what they call the gay lifestyle, which they thought was synonymous with promiscuity, with drug use. And as I started to meet gay people after I came out of the closet, I learned that that doesn't necessarily - that that doesn't have to be the case. I'm married. I don't use drugs. I'm not promiscuous. So I mean, what - there's no such thing as the, quote and unquote, "gay lifestyle."
CONAN: Joel, thanks very much for the call. Appreciate it.
JOEL: Thank you.
CONAN: And, Benedict Carey, this is a turning point, but this argument is not going away.
CAREY: It doesn't seem to be. Again, these things that are political loaded - I mean, they have a charge all of their own. And so, people just draw on the science as they interpret it. And so, you know, we - I think we have to wait and see whether Dr. Spitzer's apology really has any effect on this debate.
CONAN: Thanks very much for being with us today.
CAREY: You're welcome.
CONAN: Benedict Carey, science writer at The New York Times. There's a link to his piece at our website. Go to npr.org and click on TALK OF THE NATION. Our thanks as well to Gabriel Arana, a Web editor at The American Prospect, joined us here in Studio 3A. Thanks very much.
ARANA: Thanks for having me.
CONAN: When we come back, after a short break, we'll go to The Opinion Page. And former Secretary of State Madeleine Albright who talks about the future and the direction of NATO. World leaders are in Chicago, wrapping up a two-day NATO summit, as we speak. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.
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