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Saturday, September 12, 2009

The Harm of Reparative Therapy / Reasons to think Social Discrimination is not important in Homosexuals' Health Problems

"We're actors - we're the opposite of people." - Tom Stoppard


A: I'm interested in finding out whether there's any evidence for (or against) reparative therapy aimed at changing an individual's sexual orientation (besides studies from NARTH).

According to the APA (American Psychiatric Association): "the potential risks of reparative therapy are great (including depression, anxiety and self-destructive behavior) since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient". Unfortunately I haven't been able to find convincing evidence against reparative therapy (e.g.: studies published in peer-reviewed journals).

B: *list of articles*

A: I actually did a PsychInfo search and read some of the articles. I'm a little surprised (and disappointed) at the dearth of evidence either way. The study by Spitzer (2003) has serious methodological flaws. Yet, most of the papers I found were commentaries/ editorial articles and not empirical studies. I wanted to find some evidence showing that reparative therapy is actually harmful and has negative consequences. Will continue looking.

I just attended a training session by a very well respected clinical psychologist (with a phd) who believes in reparative therapy (Ignorant? Maybe. Primitive? I don't really think so). I actually wanted to find evidence to challenge his beliefs, but sadly couldn't find anything really convincing. Ah well.

In the wake of that thread, here're some bits I dug up:

Same-Sex Sexual Behavior and Psychiatric Disorders: Findings From the Netherlands Mental Health Survey and Incidence Study (NEMESIS)

"It has been suggested that homosexuality is associated with psychiatric morbidity. This study examined differences between heterosexually and homosexually active subjects in 12-month and lifetime prevalence of DSM-III-R mood, anxiety, and substance use disorders in a representative sample of the Dutch population (N = 7076; aged 18-64 years)... Psychiatric disorders were more prevalent among homosexually active people compared with heterosexually active people... The findings support the assumption that people with same-sex sexual behavior are at greater risk for psychiatric disorders"

[Addendum: Bear in mind that the Netherlands is possibly the most gay-friendly place in the world and yet even there homosexuals have more mental health problems.

Another extract from the paper: "Biological and genetic factors in the causes and development of homosexuality might also predispose homosexual people to developing psychiatric disorders. This is in line with the higher prevalence of bipolar disorder we found in homosexual men compared with heterosexual men, which is generally considered to be largely congenital... The fact that homosexual men showed higher prevalence rates of disorders that are characteristic for women in general, whereas homosexual women showed higher prevalence rates of disorders that are characteristic for men in general, is in line with the theory that sex-atypical levels of prenatal androgens play a major role in the causes and development of homosexuality"

In other words homosexuality could make one susceptible to mental disorders through biological and developmental channels, rather than purely through discrimination.

See also: On Bullying and Discrimination of Gay Kids and Gay Suicide / The Oppression Olympics]

More interesting, though, is this extract from "Homosexuality and family relations" (Frederick W. Bozett, Marvin B. Sussman / 1990):

"Weinberg and Williams (1974) found that, in general, their data were not as expected in terms of the societal reaction so much as to how the individual reacts to that societal reaction: in other words, the individual holds the clues to the situation.

Societal reaction theory holds that homosexuals in more anti-homosexual societies will have worse psychological adjustment, in particular be less self-accepting, have less self-esteem, and feel more badly about homosexuality, than those in more accepting societies. However, Weinberg and Williams (1974) found this was not the case in the three societies they looked at (the United States, Denmark and the Netherlands). Following this, Ross (1978) suggested that the critical variable was not the actual societal reaction, but the way the homosexuals perceived it. It subsequently turned out that perceived societal reaction did predict a significantly lowered state of psychological well-being, although actual societal reaction did not."

[Addendum: By analogy: if I postulate that cigarette smoking is bad for me, then I should see differences in my health if I smoke 1 cigarette a day versus 1 pack a week versus 1 pack a day versus 2 packs a day. If smoking more cigarettes does not worsen my health, then I would be very skeptical about the claim that cigarettes affect my health.

Also see Dutch study on younger and older homosexuals being at equal risk of suicide and perceived discrimination being the determining criterion]

In other words, what matters is not whether you are being discriminated against, but rather whether you *think* you are discriminated against.

There is an interesting parallel with self-fulfilling prophecies here.

Keywords: amsterdam, gays, discrimination
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