Overcoming Same Gender (SGA) Attractions

by Jayson Graves, M.MFT, of Healing for the Soul Early beginnings I remember the first boy I ever had a crush on: his name was Robby and we were both 12 to 13. I just remember noticing him in a different way and wanting to be close to him. I wouldnt call it necessarily a thing although Im sure he may have showed up that way in dreams. Rather, the feelings I had towards him were more about wanting what he had: he always seemed to be very positive and confident and was one of the popular kids yet showed kindness to the likes of nerdy little me. Looking back at that today as a counselor who specializes in helping men with sexual addictions and unwanted same-gender attractions, I can see that it was part of the beginnings of the distress I would feel about these feeling over the next 2 decades. The beginnings had roots in more than just feelings, howeverthey were the result of many factorsunderstanding these and seeking the road map to Gods grace has been the key to overcoming. Understanding the roots I have come to understand my sexual confusion/disorientation as a form of sexual addiction. From what I have learned treating sex addicts of all sorts for the past 3 years, there are essentially 5 common types of sexual addiction: Neurological, Psychological, Trauma-induced, Intimacyaversive, and Mood-affective. I will explain these, using my own story to hopefully give you a good grasp at understanding your own and that of those who struggle similarly.

Ring the bell, feed the dog

First, the most common type, Neurological, can be understood as addiction thats created behaviorally. This happens primarily as a result of masturbation and fantasy and as the brain is conditioned through ejaculation/orgasm to respond to the images, (imagined or actual pornography that are in the brain at the moment of chemical impact. This impact, a combination of endorphins and enkephalins not only explains why the release feels so good but represents the highest chemical reward the brain can achieve naturally. This is also why the images that weve acted out with in the past can seems so vivid even todaytheyve essentially been burned on our brain through this reinforcing process. Remember Pavlov and his dogs? My own experimentation with masturbation started earlier than normalthe average age to start seems to be around 11 to 14and it became more pronounced and regular for me at about 11 or 12 and eventually becoming a daily habit through my teens and tapering off in my twenties. I know I looked at a lot of pornography and remember focusing mainly on the men in the pictures. I think this was because they were less prevalent than women and I was curious about what they

were doing and what I might be expected to do myself. The sense of freedom and adventure they seemed to have been also very alluring to me. So I would go back, sometimes daily to my secret stash and fixate on these pictures, and regularly sealing the images in my brain through masturbation. This habit continued for me even after being saved at age 21primarily because no one ever told me how harmful it could beeven though I always somehow (thank you Holy Spirit) felt guilty about it and would try to stop but only with mixed results. Even though the pornography and acting-out with others stopped, I still had the images in my fantasy world and this kept me attached. Psychological deficits The second most common type of addictionpsychologicalis created when sex is used to medicate against painful memories or relational experiences from childhood in adulthood. In other words, we all have emotional/relational needs that must be met developmentally: affirmation, attachment/bonding, gender affiliation, trust, responsibility, honesty, and others. When these needs are not met or when we develop scarring as a result of abuse or neglect, the result is pain. You could call this soul pain and a soul in pain will seek medication. So, the addict has chosen sex as his poison to cover up the effects of this psychological pain instead of facing the pain and growing through it. For me, the main sources of pain were my relationships with parents and peers. My parents loved me and I knew that, however, they were limited in what they could give me and sometimes what they gave me was harmful. My dad was a bit relationally stunted and passive: he was very fun and likeable but unable to connect on a heart-to-heart level with me or show me how that was done as a male. My mother, also fun-loving and caring, had an anger issue and would sometimes get controlling and violent. My peers were merciless from 6th grade through 10th when I was bullied and called names that were terribly feminizing and confusing. The net effect was that I had a love-hate relationship with men, looking for them to rescue me, while waning in my ability to respect them. When it came to women, I was not interested in anything other than friendships because that felt like healing and not something that would consume or violate me. And as far as peers were concerned, Ive had to work through trust issues and take risks to be fully-known and fully accepted (the very definition of intimacy). Furthermore, the confusing attractions towards men came from the need to be affirmed in my own masculinity and have a sense of mastery over lifesomething that good looks, big muscles, a sense of freedom and adventure and all the other things I was attracted to in males was trying to give me in a false or counterfeit way. Part of this root came also by way of comparison/contrast in my relationship with peers and being a late-bloomer. Puberty came later than normal for me and this, coupled with having to shower after gym class every day in 7th and 8th grade, created a

sense of inferiority, jealousy and strife around things sexual and anatomical. The mix of this psychological deficit and the regular practice of masturbation with the images of the other, more developed and endowed boys, made for a very powerful longing for what I didnt seem to have and an attachment to what they appeared to. The Trauma factor The third most common type of sexual addiction is called Trauma-Induced and is the result of sexual trauma. Sexual trauma means any event that alters or damages a persons self-perception or understanding of healthy sexuality. This can range from normal childhood experiences like playing doctor or exploring to actual acts of rape, incest or molestation. Something can become traumatic when there is either a power differential or emotional distress in the experience: either someone else initiated it, they were bigger or stronger or older or simply more experienced than you or you felt scared, guilty or shameful during or as a result. The addiction lies in the compulsion to repeat the trauma so if you can look at your acting-out behaviors and see patterns that are similar to or quasi- experiences in your younger, more impressionable years (often into early adulthood), there may be some trauma to address. I can see this in my own story in that not only was I molested by a male scout leader and a female babysitter around 8-10 years old but I began being sexual with boys and girls in the neighborhood shortly thereafter on a daily basis until I was about 15 or 16. This tapered down in late high school and early college (sounds ironic, huh?) but while the behaviors became more sporadic, I was still trying to recreate the same things from childhood as an adult in an attempt to feel like I was in control or to give me the illusion of power, affirmation and value. Fear of intimacy Intimacy-aversive (sometimes called Sexual anorexia) addicts have more trouble with acting-in than acting-out in the context of a relationship. This can be evidenced by behaviors that tend to sabotage or erode the intimacy in that primary romantic relationship: withdraw, withholding, blaming, shaming, avoiding, hiding, controlling, etc. Sound familiar? Nearly 40% of all sexual addicts also deal with Intimacy-aversion. There are 3 common roots of Intimacy-aversion: 1) attachment disorder with one or both parents, 2) sexual trauma and 3) reflexive/reaction to the sexually-addictive behaviors. While I dont think I personally deal with this type at a significant level, I can see that I was a prime candidate: my relationship with my mother growing up was volatile and with my dad it was shallow; I was sexually traumatized to a significant level as described earlier; and I experienced overwhelming shame guilt and fear towards my wife early on in our marriage because I was still walking in the addiction and acting out. Even today, I have to be on guard for ways that I can tend to subconsciously sabotage the intimacy in our relationship through blaming and controlling, behaviors common amongst those of us dealing with same-gender attractions.

Mood swings The last common area, which I can relate to, is Mood-affective sexual addiction. This type is characterized by a pattern of using sex to placate or control the highs and lows of mood swings. The two most common medical diagnoses related to this pattern are depression and bipolar disorders. The fact is that sex addicts deal with mood issues at a rate of nearly 4 times the general male population 26% for the former, 7 for the latter. Thought that often accompany the acting-out range from This will make me feel better to Well, if I just get it over with Ill be able to go to sleep. I have dealt with depression and anxiety and have benefited greatly from using a drug called Wellbutrin (especially during the winters) to combat Seasonal affective disorder (SAD). Before recovery, I would use masturbation to comfort myself when feeling down, depressed or simply lethargic instead of finding someone to talk to, workout or experience adventure. Now, I am living the real and engaged life I always wanted: running, hiking, skiing, and pursuing new adventures regularly instead of using the escape of masturbation and fantasy as a counterfeit source of adventurous fun and exercise. Getting better I was eventually able to deal with my confusing attractions towards other males and walk in a Godly attraction to my wife by bringing those under the Lordship of Jesus Christ. Hes encouraged me that there is no condemnation for those is Christ and there is no temptation that has ceased you except that which is common to man. Healing has come through prayer, scripture meditation and Godly mentors and friends but the healing required more than just spirituality: 1 Thessalonians 5:23 says May God himself, the God of peace, sanctify you through and through. May your whole spirit, soul and body be kept blameless at the coming of our Lord Jesus Christ. In other words, being sanctified (or cleaned-up) involved a more holistic approach that focuses on spirit, soul (thoughts and feelings), AND body! I started over 10 years ago by casually attending a local Exodus International group. That helped me to learn that I was not alone. But it wasnt until I got into a formal recovery program that I started to live in freedom. I got into a group where I was actually accountable for walking with integrity in my boundaries (avoiding the a/o behaviors or even getting close to them), regular recovery work, physical exercise, adventurous fun and connecting regularly with others during the week. I also had been doing therapy for years but when I got serious about recovery, chose to seek out someone who had experience with recovery from sexual addictions and same-gender attractions specifically. This included the therapy technique called EMDR which helped me process the trauma I experienced at a whole level and in a completely different way. Recommendations If you are dealing with the same-gender form of sexual addiction, I would recommend starting

with an initial assessment by a therapist who specializes in this specific field. This issue is far too complex for a counselor with a general practice and no training in recovery from SGA. Second, it is important to get into a recovery group that is based in true accountability, commitment, interaction, and (meaning that it involves the actual numbers regarding your plan, asks its members to be there every week and speak into each others lives vs. complaining, drop-in, no-feedback groups). Our ministry, Healing for the Soul (www.healingforthesoul.org) provides both therapy and groups OVER THE TELEPHONE! It is effective in that non-verbal distractions dont get in the way and its convenient in that you dont have to commute to some office or meeting place back and forthwe call you at your private home or office at a time that is convenient for your schedule, Monday through Friday. If youd like to schedule an initial assessment, you can either email us at help@healingforthesoul.org or call our office at 719-590-7685. Youre also welcome to call-in as a visitor to one of our professionally-facilitated, confidential teleconference groups for free so you can experience what its like for yourself. Many of our men have been free for months and years and gone on to do some amazing things in their family, communities and our culture! There is hope for you too!! I hope you have been sensing hope for yourself and are willing to pursue and catch a vision for yourself: a vision for recoverywhat youre recovering from AND that which youre recovering to! Jayson Graves, M.MFT, husband of Susan and father, is a Christian Psychotherapist specializing in Sexual Addictions Recovery and Unwanted Same-Gender Attractions. He enjoys helping his clients from both a clinical and personal frame as a person in recovery himself. He is the founder and director of international counseling ministry "Healing for the Soul Counseling & Coaching, LLC" (www.healingforthesoul.org) offering telephone therapy and his first original idea: Teleconference Recovery Groups for men and for wives in recovery worldwide. HFTS is a member ministry of Exodus International and the AACC. Jayson also serves as a national Program Director for New Life Ministry's Every Man's Battle intensive workshops (www.everymansbattle.com) and is the founder and host of The Blazing Grace Show, a weekly radio program focusing on sexual brokenness and recovery (www.blazinggrace.org/radio.htm).

http://www.blazinggrace.org/cms/bg/homosexualityrecovery

Psychotherapy for Gay, Bi, Questioning Clients, and People with Gender Issues
Last week, I was contacted by a sincere, heartful, intelligent man who wanted to hire me for EMDR consultation. After a 45 minute conversation, I turned him away because he doing reparative therapy, seeking to "help" gay people become straight. He uses EMDR and other methods to target the attachment issues of gay men, so that they heal their same-sex attraction and are able to function in heterosexual relationships. (Here's a link to wikipedia) This man uses EMDR, and uses one of my EMDR techniques, the Two-Hand Interweave in some of his work, which I find appalling. Why am I appalled? This man is using an outdated, disproven Freudian lens through which to see his clients. According to him, gay men got that way by having overbearing mothers and distant fathers. He thinks if he clears up the relational issues with EMDR and nurturing, and he'll get a straight man. I think his skill and empathy and the therapeutic relationship push people into the boxes that his religious beliefs say they should fit in. That Freudian paradigm has been soundly disproven. Every year brings more evidence for uterine influences of androgens and other hormones, in the etiology of gender identification and sexual orientation.(Wikepedia post w/ references) (Psych Today: Finger Length) Like Lady Gaga says, were all Born That Way: Gay, Straight, Bi, feminine, studly, androgynous (having both high female and male characteristics) and feeling male or female. I have worked with sexual minority clients for my entire career. I have read extensively about, taken classes on, taught classes on, and written about these clients. In 1981-83, I ran one of the world's first day treatment programs for seriously mentally ill sexual minority clients. Several of our sickest clients (bipolar, borderline, schizoid, etc.) graduated from the program into jobs, school, and weekly individual therapy. Many had thought they couldn't be sane if they were gay, bi, or had gender issues. When they were able to accept themselves, and to know that their sexual or gender feelings weren't crazy, they were able to do the trauma work, attachment work, or medication regimens that allowed them to heal and function in the world. When I work with someone who is uncomfortable with his or her orientation or gender, we explore it, and look at the contexts in which the discomfort has arisen: family, religious belief, social expectations at work, with friends, etc. We discuss orientation. I never tell someone what they are. I do explain the oft-replicated Kinsey Scale: 0=absolutely no homosexual thoughts, dreams, activity. 6=only homosexual fantasies, dreams, activities. 3=bisexual, can go either way or both ways. People might move a bit up and down the scale during their lives. But 0's don't become gay. 6's don't become straight. I tell them about the newest research. I ask clients where they think they fit today on the scale. And I ask them how they feel about it. That feeling may become the focus of therapy. I often see people go through all the stages of grief: NO! ; Oh shit!; Sadness; Growing Acceptance; Joy. Some people skip quickly through the stages, coming quickly to joy that they dont have to try anymore to be other than they are. I never tell clients what or who they should be or love. They realize it and tell me. When people come in with gender issues (Am I a man or a woman? Can I be man and be effeminate, a woman and "butch"?) we discuss the 3 different scales: 1. Orientation: Who attracts you? 2. Gender: What gender feels right? I've found very few people, including transgender people, to be confused about this question. 3. Society's Gender Expectations: Are you more traditionally "male" or "female". Are you androgynous, with both traditional male and female attributes? Are you "man's man", a "girly girl", a man with traditionally female pursuits and temperament, or a woman who is doesn't fit

her traditional gender role?

Examples across the 3 spectrums:

My husband is a Kinsey 0. He says that he doesn't understand why anyone would sleep with men, though he's glad that women do. He's happy with his male body. As a slight, sensitive, emotional, artistic, introvert, he has had mostly female friends, was happy playing with dolls and girls as kid, has no interest in team sports (playing or watching), and is uncomfortable with displays of machismo. Hes very male in his single-mindedness, tenacity, and sense of stewardship and responsibility. When I read the new research on prenatal influences of androgen I realized that my male twin that died in utero may have provided me with the androgens that made me how I am: Kinsey 2 , in a tall mannish body, with highly androgynous interests:. In grade school, I had crushes on girls and boys. When the hormones hit, I thought everyone was cute, and still do. I've been in relationships with women and men. I've had this female body a long time, but I'm not that attached to it, or to being male. I think I could be happy either way. Only on camping trips, did I wish I had different plumbing. I'm tall, broad-shouldered, thin-hipped. Because I don't dye my hair, nor wear make-up very often, and can dress androgynously, I get "sirred" often. (Can I help you, sir?) I never had girly interests. I brought home snakes and frogs. I'm bossy, can be aggressive, can be soft and nurturing, can act like a guy around guys,. I've learned to "pass" as more female than I feel, using the gay male idea of "drag": any thing you wear, any way you look is a chosen persona. So I can do girly drag, professional drag, or wear whats most physically comfortable. I was lucky to have parents who let me be as nerdy and idiosyncratic as I turned out to be, so that I never needed psychotherapy to reconcile my gender, sexuality, and cultural issues. A male friend is a Kinsey 6. He says that he has always known he was gay. He thinks women are beautiful, and could not imagine having sex with one. He falls in love with men. He loves his male body. He loves to play through the gender roles, going from black leather macho "drag" to pretty-boy soft fabrics. He goes from nurturing sweet artist to macho man in five seconds. Thirty years ago, he and I did "high drag" together, wearing hyper-feminine drag queen apparel and make-up. We looked like twins of indeterminate gender. A female friend was a sexually abused by nearly every male in her extended family. She thought she was gay by default: women werent frightening to her, men were. When she cleared her sexual abuse in years of EMDR therapy, she found out that she was really was a lesbian. Her friends, including me, thought her predilection for highly feminine partners (lipstick lesbians), tomboy sports, and a construction jobs made her an absolutely stereotypical dyke. It turns out she is. Her lover is highly feminine, in the arts, loves her femaleness, and as a Kinsey 6, defies all stereotypes. A coworker from years ago, was a very feminine boy, who as soon as he left home, took on a female persona when not at work. He hated everything male about his body. It was not me. After going to a support group for transgender people and years of therapy, he decided to transition to a female body. Now, she feels at home in her body and is searching for Mr. Right. In the early 1980s, another acquaintance, after decades living as a very butch lesbian, transitioned to a male body, finally coming home to himself. His lover of 25 years, a tiny feminine woman, stayed with her partner throughout the transition. After partner #1 became legally male, they were legally married and shortly thereafter, left the gay community to pass

out in the suburbs.

Therapy Issues
Dont project that these clients are coming with issues about their orientation. They may be fine with being gay, bi, or gender variant. They may be coming in with PTSD, anxiety, depression, addiction, or grief. Dont miss the milestones. When I do an intake on gay, bi, or transgender people, I often ask when they first knew, when they first told someone, and when/if they are out in their lives, and what kind of discrimination they experienced. Often there is trauma, grief, or ongoing anxiety. Imagine not knowing how each new person will respond to who you are. Or fearing firing, violence, or death, for being who you are. Do notice and acknowledge ongoing stress and fear about being a targeted minority. Coming out is differentiation: Im here. Im queer. Deal with it. Differentiation means accepting oneself, even when others dont. First coming out to self. Then others. And for many, coming out to everyone. Im out means to anyone who wants to know. Coming out can be dangerous. Never push clients to come out. Always acknowledge clients fears of coming out: rejection, judgment, loss of relationships, even violence. Ive had friends and clients lose their families, experience shunning by their church communities, and lose jobs. Ive known military people who lost their positions and their health care and their pensions. And this week is the 13th anniversary of the murder of Matthew Shepard, killed by homophobes in Wyoming. Coming out can be exhilarating and empowering. Heres the subtext: Im here. This is me. I care about you enough that I want you to know me. Im willing to risk our relationship in order to be known. And it, in the best of circumstances, coming out becomes mundane: My husband/wife/partner and I saw a great movie last night. Or, Yeah, I look familiar because I used to be Mary and now Im Marvin. Things are changing, but not fast enough. Dont Ask, Dont Tell is gone. Gay marriage is now acceptable to about 50% of Americans. Sitcoms with gay characters are normal and popular. Rosie and Ellen are icons. Chaz Bono is dancing with the Stars. And kids are still being bullied to death, thrown out of families, and fearful of growing up alone and weird. Gay people are vilified from many pulpits. Thats so gay! isnt a nice thing to say about anything. One of my favorite referrals is to Dan Savages It Gets Better campaign. Gay, bi, and straight people giving messages of encouragement to gay kids: Hang in there. It gets better when you grow up. Youll find love. I made it. You can too. There are thousands of videos, some of them musical, all testimonies to the future. Community can be powerful. There is no one sexual minority, gay, bi, lesbian, or trans community (except in the minds of certain right wing opposition). There are many groups. And it's a thrill for an isolated person to find "people like me". Back in my day, it was support groups. Now, online communities can be a first step for people looking for support, information, acceptance, and relationships. I warn newly exploring people to watch out for jerks and crazy people. I say, "Just because they share an attribute with you, doesn't mean they aren't out to exploit you. Pay attention! Look for smart, kind, honest people, whether online or in person." Steer your clients towards themselves. Be curious. Support. Use your tools towards healing in everyway. I tell my clients of whatever orientation, "When you lay me off, I want you to be as weirdly idiosyncratic as you were always meant to be, and absolutely accepting of all of it."

Robin Shapiro's psychotherapy book reviews, training reviews, clinical experience, and musing about trauma, attachment, and affect-based therapies
http://traumatherapy.typepad.com/trauma_attachment_therapy/2011/10/psychotherapy-for-gay-biquestioning-clients-and-people-with-gender-issues.html

The 'ex-gay' agenda

The Gay & Lesbian Review Worldwide , November-December 2005

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The 'ex-gay' agenda LAST MONTH, the Montgomery County Board of Education in suburban Maryland settled a lawsuit over sex education in the county's public schools, brought in part by PFOX (Parents and Friends of ExGays and Gays). The group is a branch of a national network of "ministries" that claim homosexuality is a chosen and dangerous lifestyle, and that through "reparative therapy" a gay person can be turned straight--into an "ex-gay." PFOX won a restraining order in May and successfully halted the county's new sex ed curriculum, intended, among other things, to promote tolerance toward gays by treating homosexuality as natural and benign. A judge concluded the school curriculum did exclude other views on homosexuality--namely, those of PFOX. Under the settlement last month, the county agreed to pay $36,000 of PFOX's legal expenses. The group also gets a seat at the table in drafting a new sex ed curriculum for county schools. With homosexuality and gay marriage at the vortex of the culture wars, religious conservatives say the victory in Montgomery County will be the shot heard around the world. "This has national significance because Montgomery County is a wealthy, influential school district and the lid has been ripped off an agenda that has crept into schools nationwide," declared Robert Knight, director of the Culture and Family Institute at Concerned Women for America. "We are going to march across the country and we are going to help parents organize in every county," says Richard Cohen, president of PFOX. "We want parents to check out the curriculum in every place

where sex ed is being taught, and if they are advocating homosexuality without any other diverse views being offered to the children, we will help them with a legal defense." Cohen says he will press Montgomery County to teach that homosexuality is an unhealthy lifestyle that can be fixed. "With respect to the risks of homosexual behavior, that would be fair," he says. A PFOX pamphlet states that homosexuality is a "developmental process not genetically determined" and can be treated with therapy. It notes thatgay sex results in surging AIDS rates, drug abuse, "gay bowel syndrome," psychological problems, and violence. The pamphlet insinuates that men having sex with men is what causes AIDS. It fails to mention that HIV can be transmitted through either heterosexual or homosexual contact. It does not acknowledge that of the fifty million people currently living with HIV--three million of whom die annually--nearly half are women. Nor does it point out that officials worldwide are most alarmed by the rise in AIDS among girls and that AIDS rates among homosexual men in the United States have fallen 27 percent since 1990. Despite the Maryland settlement, PFOX's claims about homosexuality are, according to virtually all mental health professions, wrong, bizarre, and potentially dangerous. "I can give you a short answer of where reparative therapy fits in with the modern mental health profession: It does not," says Dr. Douglas Haldeman, president of the Association of Practicing Psychologists, a group affiliated with the American Psychological Association. "These theories have been discredited for years." THE THEORY AND THE THERAPY For all their dubious scientific and therapeutic standing, reparative therapy ministries, some of which accept kids and operate like a cross between churches and boot camps, largely function without oversight and licenses. Not that science or psychiatry has ever been a roadblock to the religious right. In the nation's divisive culture wars, gay issues have proved to be winners for Christian conservatives, who helped power rightwing Republicans into control of two branches of the federal government (the third may soon be in hand). In the last election, gay-marriage bans passed in all eleven states where they were on the ballot. Religious conservatives are on a mission to ban more than gay marriage. They want to outlaw civil unions giving same-sex partners some of the legal privileges of married heterosexuals, reinstate state sodomy bans, and defeat hate-crimes legislation that would increase penalties for violence against gays. They are also taking their battle to the states. This spring, the Texas House considered a measure that would have banned gays from becoming foster parents. Opponents argued the measure would uproot 3,000 foster kids. It didn't pass. The Christian right's political agenda rests on its contention that sex is natural only among heterosexual couples. A sexual preference for partners of your own gender is therefore a psychological disorder and a sin. In the words of the Rev. John J. Smid, who left "homosexuality and its entanglements in February of 1984," and is now the executive director of Love in Action International, a reparative therapy group in Memphis, people who identify themselves as gay or lesbian are in the hands of the devil: "Satan, working behind the scenes, has succeeded in redefining the meaning of key words, and therefore we only reinforce and strengthen a false identity by calling individuals by a name that does not apply." In the trenches to change gays is a loose network of organizations and individuals. Licensed counselors may charge 200 dollars an hour for treatment in an office, complete with a sofa; Bible study support groups may meet for free in a church basement; and Christian ministries will provide inpatient care that can last years and cost thousands of dollars. Exodus International is the umbrella group for reparative therapy ministries, a clearinghouse for information and a referral service for counseling. The group claims over 120 ministries in the United States and Canada with links to thirty more in seventeen countries. "Reparative" or "conversion" therapy, as it's called by its practitioners, resembles something like

Freudian psychoanalysis mixed with a dose of Christian theology. The basic theory is that a young boy's futile search for love and affection from an emotionally unavailable father gets contorted into sexual desire for men. "What we are seeing, almost without exception, is the classic triadic family pattern," says Dr. Joseph Nicolosi, president of NARTH (National Association for Research and Therapy of Homosexuality). "That is, a distant, detached, critical father, an over-involved, intrusive, domineering mother, and a temperamentally sensitive, introverted artistic son." As for women, "We see a breach between the mother and the daughter at an early age." This summer, the ministries' controversial methods flared up in public. Gay rights protesters hounded Love in Action after the parents of a sixteen-year-old boy, "Zach," sent their son to Refuge, an intensive Love in Action therapy program--apparently against his will--after he told them he was gay. Just before going into the eight-week program, Zach wrote in his blog, "I can't help it, no, I'm not going to commit suicide, all I can think about is killing my mother and myself. It's so horrible," he wrote. According to Love in Action's rules, posted on Zach's blog, clients must report sexual fantasies to the staff. The program specifies the exact length of haircuts and how many times men must shave each week (seven). Love in Action bars jewelry and clothing by Abercrombie and Fitch. The rules prohibit "campy gay/lesbian behavior and talk." New clients are not allowed to talk to or make eye contact with anyone for the first three days. Clients have to wear pajamas to bed, and if they get too cozy they "must always have exactly one person between them." Clients cannot keep a diary, and all their belongings are searched every morning by the "Chain of Command." All secular media, including music and movies, are forbidden. Also, during counseling--no "disgusting" faces. The Refuge program is "like a boot camp, but worse," Zach wrote. "What is it with these people? How could you support a program like this?" The Tennessee Department of Children's Services investigated the Love in Action facility for possible child abuse but discontinued it because of lack of evidence. The brouhaha exposed an oddity of the exgayministries: they are largely unregulated. Ministries claim they are not hospitals or any other facility that would typically require regulatory oversight or licensing. Love in Action spokesman Tommy Corman says the facility does not need to be licensed by the state at all because it is not doing anything "therapeutic." A bold declaration, considering the group promotes "the prevention or treatment of unhealthy and destructive behaviors facing families, adults, and adolescents," according to its website. But the ministries do fall into a regulatory blind spot. "There has been some question of who licenses that facility," said K. Danielle Edwards, a spokeswoman for the Tennessee Department of Children's Services. "This would not be under our jurisdiction. I have not been able to ascertain who licenses that facility." On July 11, the Tennessee Department of Mental Health and Developmental Disabilities sent a letter to Love in Action, warning the facility that it may be operating without a required license. Results of the investigation are pending. James Dobson's powerful lobby, Focus on the Family, claims that "thousands" of gays and lesbians have been changed. But statistics are hard to come by, and change is hard to measure. Many of those who have been enrolled in the ministries say conversion programs are emotionally destructive and destined to fail. Writer, actor, and comedian Peterson Toscano did a two-year stint at Love in Action in an effort to cure his homosexuality. "I felt like I was in a biblically induced coma," he says. Toscano, a Christian, struggled with his homosexuality as a young man and even considered throwing himself in front of a train. It was only after leaving Love in Action that he gained peace of mind and accepted his sexuality. He says that even if the reparative programs do convince gays and lesbians that they are cured, "It is a ruse because they have to give up their sexuality." Wayne R. Besen, author of Anything but Straight (2003), which documents scandals inside conversion groups, says much of the close coordination between ex-gay groups and the religious right started in

1998, when a conglomeration of fifteen religious organizations sought new traction in the culture war, launching a $600,000 ad campaign in major U.S. newspapers, touting the achievements of the ex-gay ministries, complete with a photo of a crowd of beaming ex-gays. Besen quotes Robert Knight, then with the Family Research Council, who called the ad campaign the "Normandy landing in the larger cultural wars." During a flurry of media coverage that followed the ad blitz, Newsweek put the ex-gay issue on its cover, along with a picture of Exodus International chair John Paulk and his wife Anne, who had both allegedly left homosexuality behind. In his book, Besen photographed John Paulk cruising in a Washington, D.C., gay bar while he was still chair at Exodus and worked for Focus on the Family. Besen tracks down a dizzying array of former ex-gayleaders who later came out of the closet for good, including the two founders of Exodus. Besen also nails current PFOX president Richard Cohen, who is leading the charge against liberal sex ed in Montgomery County. He writes that Cohen is a former Moonie and an acolyte of the Wesleyan Christian Community Church on Vashon Island near Seattle. According to Besen, citing a 1977 Associated Press report, the group was exiled from an Illinois church for allegedly practicing therapy sessions where men, women, and children breast-fed on women stripped to the waist. Cohen responds that he did get therapy from the Wesleyan church but witnessed no such activity. "I have no idea of such nonsense," he says. "I have not a clue what [Besen] is talking about. I got counseling from a religious organization that he tried to call a cult. Wayne is a little boy whose main cult is character assassination." Besen argues that the religious right is pushing the ex-gayphilosophy particularly hard right now to buttress its aggressive agenda ongay marriage: "They are really getting behind this." Exodus spokesman Randy Thomas responds that his group aims to help people and not to serve as a political foil to advance the policy positions of the religious right. "I know a lot of people think that we are pawns of the religious right, but we are not," Thomas says. (The Exodus website does include some reports on policy issues, like opposing hate-crimes legislation. "The hate experienced, in the majority of hate crimes, is not necessarily coming from those who disparage others as much as it is from the victim toward himself," one report reads.) The nation's two mainstream psychiatric and psychological associations, the American Psychiatric Association and the American Psychological Association, deny reparative therapy's very premise. Along with the National Association of Social Workers, these groups say homosexuality simply is not a mental disorder. Being gay by itself is not a problem, they point out; rather, the negative mental health consequences of discrimination have been well established and cited as a factor in higher suicide rates among gays. Therapy to change homosexuality may simply telegraph to patients they are sick when they are not, that they can fundamentally change their sexual orientation when they cannot. If so, failed efforts to change could prove disastrous, particularly for deeply religious gays. "The mental health professions in this country do not value or credit conversion therapy at all. And we are increasingly aware of the potential harms of this misguided treatment," says Haldeman, of the Association of Practicing Psychologists. "There are a substantial number of people who go through this who are harmed for some period. This is just a dressing up of old, old theories that have never been proven." The American Psychiatric Association has asked its members to avoid reparative therapy. "We are finding that the numbers of people claiming to be harmed by reparative therapy are increasing," says Dr. Jack Drescher, chair of the American Psychiatric Association's Committee on Gay, Lesbian and Bisexual Issues. "I don't know about the suicides because it is hard to determine why somebody killed themselves afterward. But the harm is increasing." The legislative body of Drescher's APA approved a

statement this past spring that endorsed gaymarriage to help reverse gay stigma. They also cite evidence that stable, monogamous relationships are beneficial for mental health, whether gay or straight. It was the de-listing of homosexuality as a mental disorder that launched the "ex-gay" movement in the first place. In 1973, the American Psychiatric Association removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders. But a relatively small group of mental health professionals rejected that move, arguing that the APA caved in to aggressive political pressure from the gay rights movement, as opposed to science. "That opinion is a political and not a scientific position," says Nicolosi from NARTH. "These major mental health associations have been hijacked by small political interest groups." That's nonsense, says Drescher. However, Drescher says the mental health profession does agree with the reparative therapy crowd about one thing: No one knows for sure what guides sexual orientation, gay or straight, but mounting evidence suggests a biological component. "We do know there is a very good likelihood that [homosexuality] is biologically related. We do have some studies that indicate a biological component," he says. That homosexuality may be innate, Drescher says, bolsters the argument for gayrights. "And that's what the religious right is fighting against," he says. But he adds that whether you take the nature or nurture side of the argument doesn't matter when it comes to protecting the health and civil rights of gays and lesbians. "Even if homosexuality is not innate, you could still argue for civil rights." MY GAY THERAPY SESSION Barry Levy, a Christian counselor and licensed clinical social worker, is explaining to me what causes homosexuality. "Take the young boy who is more sensitive, more delicate, who doesn't like rough-andtumble, who is artistic," he says. "He can't hit the ball, fire the gun or shoot an arrow. There is a high correlation between poor eye-hand coordination and same-sex attraction." I was referred to Levy by the conservative Christian group Focus on the Family, which claims on its website that homosexuality can be treated and prevented. "While the Bible clearly states that homosexuality runs contrary to God's plan for relationships, those who struggle with homosexual feelings are still God's children, in need of His forgiveness and healing," the group states. Conservative Christians say curing gays comes from loving them. "Compassion--not bigotry--compels us to support the healing of homosexuals," says the Family Research Council. Levy practices what is called "reparative" or "conversion" therapy, which allegedly helps homosexuals become heterosexuals. The theory that homosexuality is a mental disorder that needs to be cured is the moral underpinning of the Christian right's crusade against gay marriage, sodomy laws, gay adoption and sex ed curriculums in schools. While all major modern mental health professions say conversion therapy is baseless and potentially dangerous, I wanted to experience for myself what is going on behind counselors' closed doors. When I arrived in Levy's office, I was asked to fill out roughly fifteen pages of questions about myself and my family. Mostly the questions centered on how I got along with my folks. In a section about my problems, I wrote "possible homosexuality." The fact is, I'm straight, I'm married to a woman, and I have a three-year-old daughter and a son due in October. I wrote on the form that I was married with a kid. But I lied and said I was also living a secret life, that I harbored homosexual urges. According to the Bible, Levy says, homosexuality "is not consistent with the manufacturer's desire. It is not what the body is for. It is not what procreation is for. It is not what life energy is for. I am going to draw you out of that because the people around you are into that." To receive God in his holiness, Levy tells me, to experience the ultimate happiness for which God created men and women, a person needs to overcome any homosexual feelings. Homosexuality, Levy asserts, is a mental disorder, a certifiable neurosis. "The psychoanalytic perspective has always considered homosexuality and same-sex

attraction to be a neurosis. They still do and they still treat it." (In fact, mental health associations do not consider homosexuality a neurosis and do not "treat" patients for it.) Levy informs me that homosexuality is difficult to treat because it is about more than sexuality--it is about a way of life. "I want to make a distinction between same-sex attraction and being gay," he says. "That is a whole ideology. It is a lifestyle. It becomes the locus, or organizing principle, of the identity of the human personality." Reparative therapy focuses on getting gays and lesbians to stop talking or walking "gay." Refuge, an "ex-gay" program in Memphis, bars men from wearing jewelry, donning Calvin Klein clothes, and listening to secular music. The causes of homosexuality, Levy explains, are many, but childhood loneliness figures prominently. "When a child is neglected--if not abused, then neglected or isolated--loneliness is often experienced as genital tension," Levy says. "When kids are under-stimulated, they play with themselves, and the source of greatest stimulation is obviously your genitals or your mouth." I tell Levy I did not think I was a lonely kid. "There are more reasons," he responds. "I got more." He suggests that I may lack confidence and am turning my admiration for bold and masculine men into sexual desire for them. "I call it the Wizard of Oz principle," he says. "The lion wants courage so he can be the most courageous one on the journey. Some people call it the 'cannibal compulsion.' Cannibals will eat people, but only the enemies they admire. If their enemies are courageous, cannibals will eat their heart. If they are strong, they'll eat their muscles. There is a compulsion to take into yourself the qualities you feel you're lacking and someone else has. Eroticization is one of the ways to do that." He turns to a central theory of reparative therapy, which is that a son's unrequited love for an emotionally unavailable father gets transferred into sexual desire for men. Homosexual feelings can arise, Levy says, "when a boy is not affirmed in his gender by the father, who might be mean, who might be cruel, who might be absent. Often, there is a highly conflicted relationship where the mother disparages the father. She misidentifies with the marriage and might even start to identify with the son." Under those circumstances, Dr. Joe Nicolosi, president of the National Association for Research and Treatment of Homosexuality, later tells me, "temperamentally sensitive" boys become vulnerable to homosexuality. Levy says reparative therapy is effective but that a cure for homosexuality takes at least two years of weekly counseling. (My one hour cost Salon $140.) He says that if I stay in therapy, I will either turn straight or get "significant relief." The success or failure rate for changing gays is difficult to quantify. One study, often cited by conservative groups like Focus on the Family, shows incremental success from reparative therapy. But critics point out that the study was based solely on interviews with subjects arranged by ex-gay ministries; in fact, many of them worked at the ministries. Levy tells me that reparative therapy can be a lonely business. "There are not a lot of us who do this work," he says. "It is politically incorrect. And it is difficult." He also admits that "not everybody who starts down this road gets cured. This is not a sure-fire cure. I wish I could tell you that it is, but it is not." But he remains committed. Homosexuality "is not just another flower in God's garden," Levy says. "This is something that happens to people that can be fixed. And if someone comes seeking relief from this suffering, we would be wrong not to offer them relief." TRUE CONFESSIONS On the front page of the Exodus International website is a photograph of several dozen men and women. The allegedly changed homosexuals, or newly minted ex-gays, are beaming at the camera, apparently celebrating their newfound freedom from homosexuality. Standing in the center of the photograph is 29-year-old Shawn O'Donnell, who was enrolled in Exodus programs on and off for ten years. Exodus is the umbrella organization, information clearinghouse and referral service for "ex-

gayministries." These organizations claim they can help gays and lesbians become heterosexual. Exodus was founded in 1976 as part of a backlash against the American Psychiatric Association's 1973 determination that homosexuality is not a mental disorder. Exodus leaders are embraced by the religious right, including the politically influential Focus on the Family, which holds conferences touting the success of the "ex-gaymovement." The only problem with the Exodus photo is that O'Donnell is still gay. In fact, he is out of the closet and says he is the happiest he has ever been in his life. The efforts to change him from gay to straight were what sank him into despair. At age 21, in his bedroom at his parents' house, O'Donnell slashed his arms. "No one was home," O'Donnell says. "I was in my room and just started cutting. I definitely did not want to live anymore. I bled through my clothes. I had pretty deep cuts." O'Donnell's parents rushed him to the hospital, and he spent a week in a psychiatric ward. At the time, he was getting counseling from a group called Overcomers Ministries. O'Donnell grew up Elgin, Ill., about forty miles outside Chicago. He mostly attended Pentecostal churches as a kid. As for his sexuality, he says he knew something was up at age six. But he was told that being gay was a sin. At age eighteen, he began counseling to overcome homosexuality at Leanne Payne Ministries, which he visited once or twice a week for two years. In ten years of therapy, O'Donnell was told that a bad relationship with his father may have made him gay, that he may have been sexually abused, and that his mother was overbearing. He says none of those things are true. "At times I was told that I just wasn't praying hard enough or reading the Bible enough," he says. But O'Donnell says his sexual orientation did not change. Like a half-dozen gay Christian men I interviewed who participated in ex-gay programs, O'Donnell felt trapped between his faith and his sexuality. "At the time, I could not be gay and I could not be a Christian," he says. "I could not stop being gay and I did not want to give up my faith." Even after his first suicide attempt, O'Donnell tried to change from gay to straight. For three years, he went through therapy with New Hope Ministries. This time, O'Donnell was an inpatient, so he could get round-the-clock help. And again, the therapy didn't work. While he was there, he made a second suicide attempt, although this time the slashes to his wrists didn't require him to be hospitalized. He eventually gave up trying to change. "After three years, I finally went AWOL," O'Donnell says. He adds that he now happily attends a church that welcomes him and his sexuality. Recently, O'Donnell asked Exodus president Alan Chambers to take his photo off the Exodus website. But Chambers, O'Donnell says, told him that Exodus owns the picture and it still signifies that people can change. "I said, 'How can you say that is true when I know there are at least three people in that picture who have not changed?'" Exodus did not return my calls seeking comment about the photo. Christian counselors who practice reparative therapy or other techniques to change gays say it is their clients' unnatural homosexual behavior that causes them emotional pain, not guilt or stigma. Gays can change, they say. As counselors, they say they have a right and a duty to relieve the mental anguish inherent in homosexuality. Dr. Joseph Nicolosi, president of the National Association for Research and Treatment of Homosexuality, says that gays who are unhappy with efforts to change their sexual orientation are no different from patients who are disgruntled by some other medical treatment. "That can happen in any treatment," Nicolosi says. "You name any kind of procedure or treatment, and you are going to find people that are really dissatisfied with it." He dismisses any alleged harm caused by his methods. "They say we are doing harm," Nicolosi says. "There is not one case against me. There is not one legal or ethical case against me. Where are all these people who have been harmed? There should be a small busload." I tell Nicolosi I have spoken to a half-dozen people who have been through reparative therapy. All are still gay. All feel hurt by the therapy. None aregay rights' advocates. Nicolosi's group

claims that 25 to fifty percent of those seeking treatment get "significant improvement." So I ask him if he can introduce me to any men or women who have been converted from gay to straight who are not on the payroll of an ex-gayministry. He responds that his patients will not talk to me because they don't get a fair shake in the press. They are done with homosexuality and have moved on with their lives. They don't want to talk about it now. Exodus spokesman Randy Thomas also declines to help me meetex-gays to interview. He says that I can read about the experiences ofex-gays on the Exodus website. The testimonials are written by those who say they've had troubled relationships with parents or gay and lesbian friends. Some say they were molested as kids, and as adults have had hundreds of sexual partners and used drugs. They describe significant improvements in their mental health when, through therapy, they were able to overcome their homosexuality. In his testimonial, Tom Cole, the director of Reconciliation, an Exodus ministry in Detroit, says he was harassed, called a "fag," and beaten up at school because of his femininity. He says he was sexually molested by an older boy in his neighborhood and soon started having sex with other boys. To ease his emotional pain, he says, he had "300 to 400 sexual partners," hung out in gay bars, drank heavily, and used cocaine. A friend turned him on to a Christian church, and he soon met a "former lesbian" woman, Donna. "After two years of studying the Bible and praying together, I knew my feelings for her were more than friendship," he writes. "One day Donna came to visit me at work. For the first time, I noticed her well-endowed figure and felt strongly attracted to her. Irealized that, at age 26, I was experiencing something most boys go through at puberty. Soon Donna and I were dating. Three months later, we were married. Today, our vision is to help Christians who long for change in their homosexual desires." In his testimonial, Exodus president Alan Chambers says his "desires" have changed since he left homosexuality. However, he notes, "a struggle-free life is not what I have found. What I have found is freedom in the hope that after this short life, God will fulfill His promise of healing to completion." Damon Bishop, 35, was involved in Joshua Fellowship, a program under the Exodus umbrella, in 1994. He grew up in San Francisco and went to Bible school in Tulsa. He felt that he might be gay from a young age. At sixteen, he says, his dad found a men's underwear catalog in his bathroom and threatened to kill him. "He was an ex-Marine and he was a lot bigger than me," Bishop says. "He said, 'I brought you into this world and I will bring you out of it. This will not be an issue.' Talk about being scared straight." Bishop willed himself into a marriage, but it soon fell apart. In a desperate act to save his marriage, he got involved in the Fellowship. "When Exodus came on the scene, it seemed like a godsend," he says. "I thought, 'This is a panacea. This is going to save my marriage.' You are at this perfectly vulnerable place when you get to Exodus." Bishop says he dropped out when he learned that his counselor was still tempted by gay sex ten years after claiming to be changed. Others in his therapy group had been trying to get "cured" for years, to no avail. Bishop never became suicidal, but he understands how reparative therapy can lead to despair. "There is something implied in all of it that you are not good enough, that you did not try hard enough," he says. "That can lead to despair and suicide. I have friends who are living their whole lives feeling like shit." Many of the men I interviewed were profoundly dedicated to Christianity. What left them feeling so distraught, they said, was when people told them that, according to Christianity, they were sick. Peterson Toscano says that reparative therapy thrives, in part, because the gaycommunity does a poor job of welcoming gay Christians. "If we took better care of our own, we would put these programs out of business," he says. Bob Gratcyk, a pastor at Chicago's Open Door Community Church, is trying to do just that. As a teenager, he struggled with the guilt and shame of being gay. He grew up in Parma, a suburb of Cleveland. At age seventeen, he went to Bible college, There, he pulled the APA's Diagnostic and

Statistical Manual of Mental Disorders from the library shelves. It was 1973, the same year the APA determined that being gay was not a disorder at all. Gratcyk's copy didn't contain that key change. "All it said was that it was a mental health disease," he says. "I decided I must be a horrible person. I decided to pursue the Christian side of my life." At one point, Gratcyk underwent five weeks of intensive therapy that was supposed to cure him of his homosexuality. "You are put in a situation where you, by nature, are considered evil," Gratcyk says. "The Christian version is that you are not evil, but your actions are evil. But you cannot separate the two." Today, Gratcyk, 48, lives with his partner and has reconciled his sexuality with his faith. "I am a man who is loved by God and loves God," he says. This article first appeared in Salon.com, at www.Salon.com. An on-line version remains in the Salon archives. Reprinted with permission. Mark Benjamin, based in Washington, D.C., is a national correspondent for Salon.com. Benjamin, Mark Full Text: COPYRIGHT 2005 The Gay & Lesbian Review Worldwide. http://www.glreview.com/

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References Greenberg, G. (2007). gay by choice?. Mother Jones, 32(5), 60. <!--Additional Information: Persistent link to this record (Permalink): http://proxy.pba.edu/login? url=http://search.ebscohost.com/login.aspx? direct=true&AuthType=ip,uid&db=ulh&AN=26265331&site=ehost-live End of citation-->

gay by choice? If science proves sexual orientation is more fluid than we've been led to believe, can homosexuality still be a protected right? WHEN HE LEAVES his tidy apartment in an ocean-side city somewhere in America, Aaron turns on the radio to a light rock station. "For the cat," he explains, "so she won't get lonely." He's short and balding and dressed mostly in black, and right before I turn on the recorder, he asks me for the dozenth time to guarantee that I won't reveal his name or anything else that might identify him. "I don't want to be a target for gay activists," he says as we head out into the misty day. "Harassment like that I just don't need." Aaron sets a much brisker pace down the boardwalk than you would expect of a doughy 51-year-old, and once convinced I'll respect his anonymity, he turns out to be voluble. Over the crash of the waves, he spares no details as he describes how much he hated the fact that he was gay, how the last thing in the world he wanted to do was act on his desire to have sex with another man. "I'm going to be perfectly blatant about it," he says. "I'm not going to have anal intercourse or give or receive any BJs either, okay?" He managed to maintain his celibacy through college and into adulthood. But when, in the late 1980s, he found himself so "insanely jealous" of his roommate's girlfriend that he had to move out, he knew the time had come to do something. One of the few people who knew that Aaron was gay showed him an article in Newsweek about a group offering "reparative therapy"--psychological treatment for people who want to become "ex-gay." "It rums out that I didn't have the faintest idea what love was," he says. That's not all he didn't know. He also didn't know that his same-sex attraction, far from being inborn and inescapable, was a thirst for the love that he had not received from his father, a cold and distant man prone to angry outbursts, coupled with a fear of women kindled by his intrusive and overbearing mother, all of which added up to a man who wanted to have sex with other men just so he could get some male attention. He didn't understand any of this, he tells me, until he found a reparative therapist whom he consulted by phone for nearly 10 years, attended weekend workshops, and learned how to "be a man." Aaron interrupts himself to eye a woman in shorts jogging by. "Sometimes there are very good-looking women at this boardwalk," he says. "Especially when they're not bundled up." He remembers when he started noticing women's bodies, a few years into his therapy. "The first thing I noticed was their legs. The curve of their legs." He's dated women, had sex with them even, although "I was pretty awkward," he says. "It just didn't work." Aaron has a theory about this: "I never used my body in a sexual way. I think the men who actually act it out have a greater success in terms of being sexual with women than the men who didn't act it out." Not surprisingly, he's never had a long-term relationship, and he's pessimistic about his prospects. "I can't make that jump from having this attraction to doing something about it." But, he adds, it's wrong to think "if you don't make it with women, then you haven't changed." The important thing is that "now I like myself. I'm not emotionally shut down. I'm comfortable in my own body. I don't have to be drawn to men anymore. I'm content at this point to lead an asexual life, which is what I've done for most of my life anyway." He adds, "I'm a very detached person." It's raining a little now. We stop walking so I can tuck the microphone under the flap of Aaron's shirt pocket, and I feel him recoil as I fiddle with his button. I'm remembering his little cubicle of an apartment, its unlived-in feel, and thinking that he may be the sort of guy who just doesn't like anyone getting too close, but it's also possible that therapy has taught him to submerge his desire so deep that

he's lost his motive for intimacy. That's the usual interpretation of reparative therapy--that to the extent that it does anything, it leads people to repress rather than change their natural inclinations, that its claims to change sexual orientation are an outright fraud perpetrated by the religious fight on people who have internalized the homophobia of American society, personalized the political in such a way as to reject their own sexuality and stunt their love lives. But Aaron scoffs at these notions, insisting that his wish to go straight had nothing to do with right-wing religion or politics--he's a nonobservant Jew and a lifelong Democrat who volunteered for George McGovern, has a career in public service, and thinks George Bush is a war criminal. It wasn't a matter of ignorance--he has an advanced degree--and it really wasn't a psychopathological thing--he rejects the idea that he's ever suffered from internalized homophobia. He just didn't want to be gay, and, like millions of Americans dissatisfied with their lives, he sought professional help and reinvented himself. Self-reconstruction is what people in my profession (I am a practicing psychotherapist) specialize in, but when it comes to someone like Aaron, most of us draw the line. All the major psychotherapy guilds have barred their members from researching or practicing reparative therapy on the grounds that it is inherently unethical to treat something that is not a disease, that it contributes to oppression by pathologizing homosexuality, and that it is dangerous to patients whose self-esteem can only suffer when they try to change something about themselves that they can't (and shouldn't have to) change. Aaron knows this, of course, which is why he's at great pains to prove he's not pulling a Ted Haggard. For if he's not a poseur, then he is a walking challenge to the political and scientific consensus that has emerged over the last century and a half: that sexual orientation is inborn and immutable, that efforts to change it are bound to fail, and that discrimination against gay people is therefore unjust. But as crucial as this consensus has been to the straggle for gay rights, it may not be as sound as some might wish. While scientists have found intriguing biological differences between gay and straight people, the evidence so far stops well short of proving that we are born with a sexual orientation that we will have for life. Even more important, some research shows that sexual orientation is more fluid than we have come to think, that people, especially women, can and do move across customary sexual orientation boundaries, that there are ex-straights as well as ex-gays. Much of this research has stayed below the radar of the culture warriors, but reparative therapists are hoping to use it to enter the scientific mainstream and advocate for what they call the right of self-determination in matters of sexual orientation. If they are successful, gay activists may soon find themselves scrambling to make sense of a new scientific and political landscape. IN 1838, A 20-YEAR-OLD Hungarian killed himself and left a suicide note for Karl Benkert, a 14year-old bookseller's apprentice in Budapest whom he had befriended. In it he explained that he had been cleaned out by a blackmailer who was now threatening to expose his homosexuality, and that he couldn't face either the shame or the potential legal trouble that would follow. Benkert, who eventually became a writer, moved to Vienna, and changed his name to Karoly Maria Kertbeny, later said that the tragedy left him with "an instinctive drive to take issue with every injustice." And in 1869, a particularly resonant injustice occurred: A penal code proposed for Prussia included an anti-sodomy law much like the one that had given his friend's extortionist his leverage. Kertbeny published a pamphlet in protest, writing that the state's attempt to control consensual sex between men was a violation of the fundamental rights of man. Nature, he argued, had divided the human race into four sexual types: "monosexuals," who masturbated, "heterogenits," who had sex with animals, "heterosexuals," who coupled with the opposite sex, and "homosexuals," who preferred people of the same sex. Kertbeny couldn't have known that of all his literary output, these latter two words would be his only lasting legacy. But while homosexual conduct had occurred throughout history, the idea that it reflected fundamental differences between people, that gay people were a sexual subspecies, was a new

one. Kertbeny wasn't alone in creating a sexual taxonomy. Another anti-sodomy-law opponent, lawyer Karl Heinrich Ulrichs, proposed that homosexual men, or "Uranians," as he called them (and he openly considered himself a Uranian, while Kertbeny was coy about his preferences), were actually a third sex, their attraction to other men a manifestation of the female soul residing in their male bodies. Whatever the theoretical differences between Ulrichs and Kertbeny, they agreed on one crucial point: that sexual behavior was the expression of an identity into which we were born, a natural variation of the human. In keeping with the post-Enlightenment notion that we are morally culpable only for what we are free to choose, homosexuals were not to be condemned or restricted by the state. Indeed, this was Kertbeny and Ulrichs' purpose: Sexual orientation, as we have come to call this biological essence, was invented in order to secure freedom for gay people. But replacing morality with biology, and the scrutiny of church and state with the observations of science, invited a different kind of condemnation. By the end of the 19th century, homosexuality was increasingly the province of psychiatrists like Magnus Hirschfeld, a gay Jewish Berliner. Hirschfeld was an outspoken opponent of anti-sodomy laws and championed tolerance of gay people, but he also believed that homosexuality was a pathological state, a congenital deformity of the brain that may have been the result of a parental "degeneracy" that nature intended to eliminate by making the defective population unlikely to reproduce. Even Sigmund Freud, who thought people were "polymorphously perverse" by nature and urged tolerance for homosexuality, believed heterosexuality was essential to maturity and psychological health. Freud was pessimistic that homosexuality could be treated, but doctors abhor an illness without a cure, and the 20th century saw therapists inflict the best of modern psychiatric practice on gay people, which included, in addition to interminable psychoanalysis and unproven medications, treatments that used electric shock to associate pain with same-sex attraction. These therapies were largely unsuccessful, and, particularly after the Stonewall riots of 1969--the clash between police and gays that initiated the modem gay rights movement--patients and psychiatrists alike started questioning whether homosexuality should be considered a mental illness at all. Gay activists, some of them psychiatrists, disrupted the annual meeting of the American Psychiatric Association for three years in a row, until in 1973 a deal was brokered. The APA would delete homosexuality from its Diagnostic and Statistical Manual of Mental Disorders (DSM) immediately, and furthermore it would add a new disease: sexual orientation disorder, in which a patient can't accept his or her sexual identity. The culprit in SOD was an oppressive society, and the cure for SOD was to help the gay patient overcome oppression and accept who he or she really was. (SOD has since been removed from the DSM.) The AVA cited various scientific papers in making its decision, but many members were convinced that the move was a dangerous corruption of science by politics. "If groups of people march and raise enough hell, they can change anything in time," one psychiatrist worried. "Will schizophrenia be next?" And their impression was confirmed when the final decision was made not in a laboratory but at the ballot box, where the membership voted by a six-point margin to authorize the AVA to delete the diagnosis of homosexuality. It may be the first time in history that a disease was eliminated by the stroke of a pen. It was certainly the first time that psychiatrists determined that the cause of a mental illness was an intolerant society. And it was a crucial moment for gay people, at once getting the psychiatrists out of their bedrooms and giving the weight of science to Kertbeny and Ulrichs' claim that homosexuality was an identity, like race or national origin, that deserved protection. THREE DECADES TAXER, at least one group is still raising hell about the deletion: the National Association for the Research and Therapy of Homosexuality (NARTH), an organization founded by Charles Socarides, a psychiatrist who led the opposition to the 1973 APA vote. "They will wipe the floor with us," Socarides (who died in 2005) once said, "but we will wear our wounds as badges of

courage," and at NARTH's November 2006 national meeting in Orlando, Socarides' firebrand rhetoric is still in the air. You hear it when Joe and Marian Allen take to the lectern to tell us how God has called them to "give testimony" about their gay son who was murdered by his lover, a tragedy that they manage to twist into a cautionary tale about what happens when a "struggler" is told by a "wellmeaning therapist" that he was "born gay" and can't change it. Or when a minion of James Dobson's Focus on the Family cheerfully explains the Gay Agenda to me" "It's doing whatever you want, whenever you want, with whoever you want, wherever you want." "Well, just for the sake of argument," I ask, "what's wrong with that?" "I'm sure the people who follow that agenda believe what they believe, but they don't realize that they're pawns in a great cosmic battle, that they are perpetrating a lie." "Pawns of?..." "Satan," he informs me, "is the author of lies, chaos, and confusion." But the men of NARTH (nearly all the 75 attendees are white men) aren't spewing nearly as much hellfire and brimstone as I expected. They do seem to hug a lot--many reparative therapists are ex-gay themselves, and, someone explains, part of being ex-gay is learning to be same-sex affectionate without being same-sex sexual--and maybe some of those hugs last a little too long, but it's mostly like every other convention: bad coffee, worse Danish, dry-as-dust lectures. NARTH'S president-elect, A. Dean Byrd, a psychologist and professor at University of Utah Medical School, methodically lays out his case that sexual orientation is malleable in his daylong seminar on how to treat unwanted same-sex attraction. If NARTH's strategy is to seek a place at the table by demonstrating its scientific seriousness, Byrd's modulated approach, tedious as it may be, is just what the doctor ordered. Sometimes he's puckish--as when he says, "When it comes to homosexuality, I'm pro-choice"--a comment sure to get a rise out of a crowd well versed in the other moral disaster of 1973--and sometimes glib ("the proper answer to the nature/nurture question is yes"), but mostly he's just workmanlike as he reviews the research--much of it, he is delighted to point out, conducted by the "activists themselves." He cites a study from Denmark--the first place that legalized civil unions and perhaps, he says, the most gay-friendly place in the world--in which gay people turned out to have mental illness at a higher rate than straights, which proves, he says, that an intolerant society is not the culprit when gay people suffer. He describes studies that show that the identical twin brother of a gay man has only a 50 percent chance of being gay himself, which may be twice the rate among fraternal twins, but still, he argues, far from the 100 percent you would expect if sexual orientation is purely genetic. He even shows us video of one of his treatment sessions, and gives a plausible-sounding assessment of the prospects for patients of reparative therapists--that one-third of them will become heterosexual, one-third will remain gay, and one-third will move a few notches along the Kinsey scale, enough to leave the lifestyle and limit their unwanted feelings and behavior. Byrd, like everyone else here, is very excited about an article that appeared in Archives of Sexual Behavior in 2003. It was a small study--200 subjects--but it concluded that gay people could in deed change their sexual orientation, that the change was not merely religiously motivated repression or politically motivated bluster but rather some fundamental shift in desire. The researcher concluded that even the people who showed little benefit from reparative therapy didn't seem to be harmed by it, and that much more research needed to be done. The study was full of caveats and received withering criticism from scientists who claimed that it relied on a skewed sample--mostly people handpicked by reparative therapists like Byrd--but it had passed peer review, and, even more importantly, it had been conducted by none other than Robert Spitzer, the same psychiatrist who had brokered the deal that deleted homosexuality from the DSM. Spitzer also called for an end to the ban on research into reparative therapy, and one psychologist who

has taken him up on that call is welcomed in Orlando like a conquering hero. Elan Karten is an unassuming young man who wears a yarmulke and recently got a doctorate from Fordham after writing a dissertation on ex-gay men. Karten only got the go-ahead for his study by positioning it as an inquiry into the type of people who seek reparative therapy rather than as an exploration of its efficacy. He did manage to sneak in some of that research as well, and reached conclusions similar to Spitzer's--though peer reviewers objecting that it revives the notion that homosexuality is a mental illness have thus far prevented Karten, an academic unknown, from publishing his work. ~~~~~~~~ By Saturday morning, gay activists have begun to gather outside the hotel to protest NARTH. We are instructed not to respond to them ("Sing a hymn or pray instead") as they put on duck outfits, hoist their signs (Stop Ducking the Truth; NARTH Is Goofy), make quacking noises, and yell "Shame!" in our general direction. Byrd looks out the door, shakes his head, and laughs when a man behind him says, "Quack, quack? They're the queer ducks." I wait until the foyer is empty before I head out to talk to Wayne Besen, a tall man in a polo shirt, who is pulling the props and costumes out of his car trunk. He runs Troth Wins Out, an organization devoted to debunking the research of the ex-gay movement. He minces no words about Spitzer's research--"one of the most poorly constructed studies in the history of science, a travesty"--and he calls reparative therapy "intelligent design for gay people." Besen thinks the stakes of the scientific battle are impossible to overstate. "Americans are not creel. If they think that being gay is inborn and can't be changed, they are going to be very sympathetic to full equality for gay people," he says. "We win this argument, the gay rights struggle would be done." Besen is sure that science is on the verge of giving gay people their slam dunk. After all, he says, study after study shows that homosexuality is biological in origin. In the last 15 years, researchers have discovered differences in brain anatomy between gay and straight men--and found that the 6 percent of rams that have sex exclusively with other rams (just one of hundreds of species in which homosexual behavior has been observed) have a similar neuroanatomical difference; identified a gene sequence on the X chromosome that is common to many gay men; traced genealogies to show that homosexuality runs in families, on the maternal side; proved that a man's likelihood of being gay increases with the number of older brothers he has, which scientists attribute to changes in intrauterine chemistry; and learned how to use magnetic resonance imaging to detect sexual orientation by watching the brain's response to pornography. Findings in the field of anthropometrics have yielded intriguing results: Gay men's index fingers, for instance, are more likely than straight men's to be equal in length to their ring fingers; gay men have larger penises than straight men. These findings all seem to support Besen's contention that being gay is essentially biological and should remain beyond the reach of law, morals, or medicine. But some activists are more reluctant than Besen to rely on this line of reasoning. "One thing I find troubling within the gay community is a lot of people feel if they can make that claim strongly enough that's going to give them equal rights," Sean Cahill, former director of the National Gay and Lesbian Task Force Policy Institute, told me. "But I don't think it really matters," he says, pointing out that believing that sexual orientation is biological doesn't cause one to support gay rights. Indeed, many social scientists think that the beliefs are merely correlated, that people who hold one tend to hold the other. Some gay rights lawyers point out that whatever biology's role in sexual orientation, it should not be legally paramount. The Supreme Court has ruled that the immutability of a group's identifying characteristics is one of the criteria that entitle it to heightened protection from discrimination (and some cases establishing gay rights were decided in part on those grounds), but, according to Suzanne

Goldberg, director of the Sexuality and Gender Law Clinic at Columbia Law School, there's a far more fundamental reason for courts to protect gay people. "Sexual orientation does not bear on a person's ability to contribute to society," she notes. "We don't need the science to make that point." Jon Davidson, legal director of Lambda Legal, agrees, adding that if courts are going to ask about immutability, they shouldn't focus on biology. Instead they should focus on how sexual orientation is so deeply woven into a person's identity that it is inseparable from who they are. In this respect, Davidson says, sexual orientation is like another core aspect of identity that is clearly not biological in origin: religion. "It doesn't matter whether you were born that way, it came later, or you chose," he says. "We don't think it's okay to discriminate against people based on their religion. We think people have a fight to believe whatever they want. So why do we think that about religion and not about who we love?" Cahill--who says he doesn't think he was born gay--points out that even if it is crucial for public support, essentialism has a dark side: the remedicalization of homosexuality, this time as a biological condition that can be treated. Michael Bailey, a Northwestern University psychologist who has conducted some of the key studies of the genetics of sexual orientation, infuriated the gay and lesbian community with a paper arguing that, should prenatal markers of homosexuality be identified, parents ought to have the fight to abort potentially gay fetuses. "It's reminiscent of eugenicist theories," Cahill tells me. "If it's seen as an undesirable trait, it could lead in some creepy directions." These could include not only abortion, but also gene therapy or modulating uterine hormone levels to prevent the birth of a gay child. Psychology professor Lisa Diamond may have the best reason of all for activists to shy away from arguing that homosexuality is inborn and immutable: It's not exactly true. She doesn't dispute the findings that show a biological role in sexual orientation, but she thinks far too much is made of them. "The notion that if something is biological, it is fixed--no biologist on the planet would make that sort of assumption," she told me from her office at the University of Utah. Not only that, she says, but the research--which is conducted almost exclusively on men--hinges on a very narrow definition of sexual orientation: "It's what makes your dick go up. I think most women would disagree with that definition," she says, not only because it obviously excludes them, but because sexual orientation is much more complex than observable aspects of sexuality. "An erection is an erection," she says, "but we have almost no information about what is actually going on in terms of the subjective experience of desire." Diamond has spent the last 12 years doing her part to fill in this gap by following a group of 79 women who originally described themselves as nonheterosexual, and she's found that sexual orientation is much more fluid than activists like Besen believe. "Contrary to this notion that gay people struggle with their identity in childhood and early adolescence, then come out and ride off into the sunset," she says, "the more time goes on, the more variability comes out. Women change their identities and find their attractions changing." In the first year of her study, 43 percent of her subjects identified themselves as lesbian, 30 percent as bisexual, and 27 percent as unlabeled. By year 10, those percentages had changed significantly: 30 percent said they were lesbian, 29 percent said they were bisexual, 22 percent wouldn't label themselves, and 7 percent said they were now straight (the remaining 12 percent had left the study). Across the entire group, Diamond found that only 58 percent of her subjects' sexual partners were women; in year eight, even the women who identified as lesbians reported that between 10 and 20 percent of their sexual partners were men. Diamond concludes that the categorization of women into gay, straight, and bisexual misses an important fact: that they move back and forth among these categories, and that the fluidity that allows them to do so is as crucial a variable in sexual development as their orientation. Diamond cautions that it's important not to confuse plasticity--the capacity for sexual orientation to change--with choice--the ability to change it at will. "Trying to change your attractions doesn't work very well, but you can change the structure of your social life, and that might lead to changes in the

feelings you experience." This is a time-honored way of handling unwanted sexual feelings, she points out. "Jane Austen made a career out of this: People fall in love with a person of the wrong social class. What do you do? You get yourself out of those situations." For the women in Diamond's study who tell her, "I hate straight society, I don't want to be straight,'" Austen's solution is an effective treatment for unwanted other-sex attraction. "If you're around women all the time and you are never around men, you are probably going to be more attracted to women," she says. Such women sometimes end up falling in love with women, and their sexual feelings follow. And it can work the other way, Diamond says: Women who identify themselves as gay or bisexual sometimes find themselves, to their own surprise, in love with men with whom they then become sexual partners. Indeed, she says, "love has no sexual orientation." Which isn't all that different from what they say at NARTH--that people like Aaron who hate the gay lifestyle and don't want to be gay should leave the gay bars, do regular guy things with men, and put themselves in the company of women for romance. And indeed the NARTHites know all about Diamond's work. "We know that straight people become gays and lesbians," NARTH's outgoing president Joseph Nicolosi told the group gathered in Orlando. "So it seems totally reasonable that some gay and lesbian people would become straight. The issue is whether therapy changes sexual orientation. People grow and change as a result of life experiences, especially personal relationships. Why then can't the experience of therapy and the relationship with the therapist also effect change?" Diamond calls this interpretation a "misuse" of her research--"the fluidity I've observed does not mean that reparative therapy works"--but what is really being misused, she says, is science. "We live in a culture where people disagree vehemently about whether or not sexual minorities deserve equal rights," she told me. "People cling to this idea that science can provide the answers, and I don't think it can. I think in some ways it's dangerous for the lesbian and gay community to use biology as a proxy for that debate." AARON DOESN'T put it this way, but he thinks of himself as a member of a sexual minority--not forced into the closet by an oppressive society, but living under the restrictive view that sexual orientation is a biological category, something we are born with and that is impossible to change. When I tell him about some of what I saw at NARTH--like when Nicolosi, recalling one of his antagonists at the APA convention, said, "I knew that she was a lesbian--I don't know why; she was wearing a muscle shirt"--Aaron doesn't defend the organization. He knows that NARTH doesn't like gay people much (he's attended one of their meetings). But he's more concerned with a different kind of intolerance. "Not all homosexual men want to lead a gay lifestyle. Gay activists shouldn't be threatened by that. I mean, here I am, as a liberal, telling gay people to accept diversity." NARTH spares no opportunity to claim that it is a victim of political correctness, silenced by a science that gay activists hijacked in 1973 and have exploited ever since. It's a page fight out of James Dobson's playbook, but NARTH is right on at least one count: The complexity of sexual orientation surpasses the certainties of biology. To the extent that the struggle for gay rights rests on a scientific foundation, NARTH's strategy is bound to pay off. Gay activists will then be left to build on other sources of public sympathy, none of which has the appeal of science. After all, if sexual identity is more like religion than race, a matter of affiliation rather than birth, fluid rather than fixed, then finding a different basis for popular support--as well as for legislative and judicial protection--means confronting directly something Americans are perpetually confused about: the nature and boundaries of pleasure. NARTH is perfectly positioned to exploit this confusion by arguing that sexual orientation can be influenced by environmental conditions, and that certain courses are less healthy than others. That's how NARTHites justify their opposition to extending marriage and adoption rights to gay people: not because they abhor homosexuality, but because a gay-friendly world is one in which it is hard for gay

people to recognize that they are suffering from a medical illness. Of course, in deploying medical language to serve its strategic interests, NARTH is only following the lead of Kertbeny and Hirschfeld, the original gay activists, and their modern counterparts who, despite minimizing the importance of biology, resort to scientific rhetoric when it suits their purposes. "People can't try to shut down a part of who they are," says Sean Cahill. "I don't think it's healthy for people to change how their body and mind and heart work." But medicine, which is what we rely on to tell us what is "healthy," will always seek to change the way people's bodies and minds and hearts work; yesterday's immutable state of nature is tomorrow's disease to be cured. Medical science can only take its cues from the society whose curiosities it satisfies and whose confusions it investigates. It can never do the heavy political lifting required to tell us whether one way of living our lives is better than another. This is exactly why Kertbeny originated the notion of a biologically based sexual orientation, and, to the extent that society is more tolerant of homosexuality now than it was 150 years ago, that idea has been a success. But the ex-gay movement may be the signal that this invention has begun to outlive its usefulness, that sexuality, profoundly mysterious and irrational, will not be contained by our categories, that it is time to find reasons other than medical science to insist that people ought to be able to love whom they love. PHOTO (COLOR) ~~~~~~~~ By Gary Greenberg ILLUSTRATIONS BY Jonathon Rosen

Copyright of Mother Jones is the property of Foundation for National Progress and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. http://www.psychologytoday.com/articles/200506/sexuality-your-telltale-fingertips <img src="http://b.scorecardresearch.com/p?c1=2&c2=9980773&cv=2.0&cj=1" />

Sexuality: Your Telltale Fingertips

How your hands are a marker for behavior. Relative finger lengthor digit ratiois a marker for brain differences molded by hormones. By Willow Lawson, published on July 01, 2005 - last reviewed on November 09, 2010

Look down at your right hand. Is your ring finger longer than your index finger? Or vice versa? To be certain, take a ruler and measure from the bottom crease of each finger to the tip. The measurements tell you something about the environment of your mother's womb just weeks after your conception, a time when your fingers, and more importantly, your brain, were developing. Because of the influx of sex hormones at this prenatal stage, men tend to have ring fingers that are slightly longer than their index fingers. In women, these fingers are usually the same length or the index digit is just a bit longer.

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Digits are subtly affected by testosterone and estrogen produced in the womb by the fetus (not by the mother). Between weeks 8 and 14, tiny fetal testes, ovaries and adrenal glands secrete the baby's own supply of sex hormones. These chemical messengers, particularly testosterone, cause chain reactions in the body, spurring the growth of the genitals, encouraging and inhibiting growth in brain regions and causing changes in the fingers. Many scientists believe relative finger lengthor digit ratiois a marker for brain differences molded by hormones. Like a bit of prenatal graffiti, a longer ring finger says, "Testosterone was here." John Manning, a biologist at the University of Liverpool, first identified digit length as a sign of prenatal hormones eight years ago. He believes digit ratio is an important, if indirect, tool for studying

the fetal brain and the womb, an environment that's off-limits to scientists except for analysis by amniocentesis. (And even then, because sex hormones fluctuate hour by hour, amniocentesis is a poor indicator of testosterone exposure.) "Early sex hormones have an organizing effect on the brain that's permanent," Manning says. But the differences between the sexes aren't all that interesting to biologists. More telling are the variations within each sex. Females with masculine digit ratios have more masculine behaviors, he says. Likewise, males with a typically female ratio exhibit more typically feminine behaviors. A study of digit ratio in Scottish preschool children between the ages of 2 and 4 found strong relationships between digit ratio and gender-normative behavior. Girls with masculine-type finger ratios tend to have higher hyperactivity scores and more problems relating to their peers than do other girls. The same study, published in Early Human Development, found that boys with female-type finger lengths are on average more emotional than other boys. "They tended to be very sensitive," says Manning. Except for genitalia, relative finger length is the only physical trait fixed at birth that is sexually dimorphicmeaning males and females show typical gender differences. Other sexually dimorphic traits, such as height and waist-to-hip ratio, don't appear until puberty. "Everything you see as far as sex differences in the behavior of toddlers is an aftereffect of prenatal testosterone," says Dennis McFadden, a psychology professor at the University of Texas at Austin. Manning and others have linked finger length ratios to aggression, left-handedness, heart disease, autism and attention deficit disorder, all traits that are more common in men. (Studies indicate they are most common in men with longer than average ring fingers.) A "masculine" finger pattern seems to similarly mark girls predisposed to hyperactivity and autism. Some scientists believe prenatal sex hormones are also part of the puzzle of homosexuality and that a high level of testosterone may wire the brain for attraction to the same sex. Intriguingly, research shows that a prenatal testosterone level is most strongly linked to homosexuality in women, according to an article in the Archives of Sexual Behavior. Lesbians are more likely than straight women to have a masculine finger ratio, says McFadden. The data in men, however, are more complicated and contradictory. Some studies have shown hypermasculine finger length in gay men, while other studies show the opposite, a female-like finger pattern. The picture is further muddied by geography. Race and ethnic differences seem to affect digit ratio, although scientists don't yet understand how. Still, even if prenatal testosterone is a factor in homosexuality, it's unlikely to be the only element. Studies indicate genes wield much influence. Even as digit ratio research flourishes and more behavioral links are established, the relationships will remain mere statistical correlations until researchers fully understand how sex hormones physically affect the brain. The reigning hypothesis is that testosterone encourages growth in the right side of the brain, while inhibiting growth in the left. Animal models using rats, mice and sheep show that testosterone boosts growth in a part of the hypothalamus involved in sexual behavior and fertility. In sheep, males with hypermasculinized brains are sexually attracted to other males. You may be tempted to draw conclusions from your own fingers. But it's impossible to do so accurately in a vacuum, cautions Manning. Fingers are an indication of the environment that molded the brain, but only if you know how you measure up to others. "You have to be careful," he says. "You can't look at someone's fingers and make a determination about whether they are heterosexual or lesbian, just as you can't decide whether they're neurotic. The

[sexuality indicators] are most certainly there, but they're not strong enough to allow us to make predictions."

Change in Sexual Orientation is Possible, Harm Unlikely, according to New Evidence of Long-Term Outcomes
Reviewed by Christopher H. Rosik, Ph.D. (October, 2011) The best-designed study of sexual-orientation change efforts (SOCE) to date, has just concluded in a follow-up report that some people can indeed move from homosexuality to heterosexuality, and that harm is unlikely to result from such efforts. The original study was published in 2007 by Stanton Jones, Ph.D., of Wheaton College, and Mark Yarhouse, Ph.D., of Regent University, in their book, Ex-Gays?. The follow-up study has just appeared in the Journal of Sex & Marital Therapy. In the Journal of Sex & Marital Therapy, the authors conclude: Evidence from the study suggested that change of homosexual orientation appears possible for some and that psychological distress did not increase on average as a result of the involvement in the change process (Jones & Yarhouse, 2011, p. 404). Study methods The authors followed 98 individuals (72 men and 26 women) who undertook SOCE through the assistance of a variety of Christian ministries over a period of 6-7 years. The authors motivation for conducting this study was, in part, that the American Psychological Association had gone on the record indicating that change in sexual orientation was not possible, and that risks to those who engage in such efforts could be significant. The authors note that the APA has moderated its viewpoint somewhat since then, fluctuating between statements that sexual-orientation change is uncommon, to the view that science cannot yet make conclusive statements about such change from the available literature. The rigor of their own research standards, Jones and Yarhouse indicate, in fact meets many of the requirements that the APA itself has asserted are necessary in order to make reasonably definitive conclusions about the actuality of such change. Participants in the Jones-Yarhouse study were first assessed at the beginning of their involvement in SOCE (from 1-3 years); again at 3 years, and again at the 6-7 year mark. Findings from the first two assessments were published earlier in the book, Ex-Gays? (2007). Standardized and widely accepted measures of sexual orientation and psychological distress were administered at each assessment period. At the final time of assessment, attrition had reduced the available sample to 64%, which is not unusual for longitudinal studies. Study findings

The results after 6-7 years of SOCE involvement, presented below, indicate that change does indeed occur, although not for everyone. Success: Conversion: 23% (n = 14) of the sample reported substantial reductions in homosexual attraction and subsequent conversion to heterosexual attractions and functioning. Success: Chastity: 30% (n = 18) reported that homosexual attraction was still present, but only incidentally or in a way that did not seem to bring distress, allowing them to live contentedly without overt sexual activity. Continuing: 16% (n = 10) reported modest decreases in homosexual attraction, but were not satisfied with their degree of change and remained committed to the change process. Nonresponse: 7% (n = 4) reported no significant sexual orientation change; they had not given up on the change process, but some were confused or conflicted about which direction to turn next. Failure: Confused: 5% (n = 3) reported no significant sexual orientation change, and had given up on the change process, but without yet embracing a gay identity. Failure: Gay identity: 20% (n = 12) had given up on the change process and embraced a gay identity. Jones and Yarhouse observed that from the point-of-view of the ministries involved in their study, 53% of the sample therefore had self-categorized as achieving some version of success, and 25% had selfcategorized as failure. As regards harm, the study participants on average did not report experiencing harm due to SOCE during the course of their pursuit of change. In fact, two of the indicators of psychological distress actually improved significantly over the time of the study. Discussion Jones and Yarhouse conclude that the findings of this study appear to contradict the commonly expressed view that sexual orientation is not changeable (p. 425). and that attempts to change are not likely to be harmful. While the authors believe their research clearly contradict the pessimism regarding SOCE that has been promulgated by the APA, they do acknowledge that their study has limitations. First, the average change in sexual orientation was modest, although they noted that this is likely to be an artifact of average change scores including some participants who made dramatic shifts away from homosexual orientation and fewer participants who reported dramatic shifts to a gay identity. In other words, the dramatic changes toward heterosexual response clearly made by some participants may have been offset by changes toward homosexual response in others, so that the overall average change in sexual orientation for the sample appeared to be modest. Second, participants who had begun the change process prior to the start of the study appeared to have disproportionately positive outcomes compared to participants inducted into the study early in their pursuit of change. This may indicate that some weeding-out of individuals who were not successful in changing sexual orientation occurred in the time between the onset of pursuit of change and the initial collection of data. Although there is no way to know this for sure, Jones and Yarhouse imply that it is probably wise to view their studys success rate for the change process undertaken in Christian ministries as a somewhat optimistic figure. A third limitation is the relatively small sample size, which makes any generalization of these findings to the population of individuals pursuing SOCE tentative. That said, the size of the sample is not

uncommon in the longitudinal research that has been widely accepted as representative of samples in other subject domains. Finally, the authors note that, given the study design, it was not possible to determine which components of the participants change process were responsible for the outcomes reported. Comment No doubt this study will be dismissed by skeptics who for ideological reasons remain dogmatically unwilling to acknowledge the reality of sexual orientation change in some people. However, Jones and Yarhouses study of SOCE should go a long way toward putting to rest two extreme positions: i.e., that change always occurs and is simply a choice, or that change never occurs and is generally harmful. It is also worth remembering that this study did not examine SOCEs that occur in the context of psychotherapy. The subjects in this study received their counseling in Christian ministries. It is certainly within the realm of plausibility that the inclusion of professional psychological care, over and above participants involvement in Christian ministries, would increase positive outcomes. The hallmark of a scientific organization that is not beholden to socio-political interests is a heightened curiosity at unexpected findings, and a subsequent dedication to understanding how such findings came to be. In the case of change in sexual orientation, which had been purported to be impossible, this implies a dedication to study those individuals who report change in order to identify the active ingredients of change and thereby maximize its potential among SOCE consumers. Unfortunately, however, the major mental-health associations appear to be moving further away from a purely scientific approach and toward one apparently directed by activists, whereby the purpose of their science does not seem to be understanding those who report change, but rather debunking, dismissing, and ignoring them. Thus while Jones and Yarhouse will win no accolades or awards from the APA, they will have the satisfaction of knowing that their research exemplifies the best in scientific curiosity and courage. Reference Jones, S. L., & Yarhouse, M.A. (2007). Ex-gays? A longitudinal study of religiously mediated change in sexual orientation. Downers Grove, IL: InterVarsity Press. Jones, S. L., & Yarhouse, M. A. (2011). A longitudinal study of attempted religiously mediated sexual orientation change. Journal of Sex & Marital Therapy, 37, 404-427. DOI: 10.1080/009263X.2011.607052