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Author Topic: APA Condemns Reparative Therapy
hobsen
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The New York Times reports,
quote:
The American Psychological Association declared Wednesday that mental health professionals should not tell gay clients they can become straight through therapy or other treatments.
But the American Psychological Association report seems more nuanced than similar statements in the past,
quote:
Judith Glassgold, a psychologist in Highland Park, N.J., who led the panel, said she hoped the document could help calm the polarized debate between religious conservatives who believe in the possibility of changing sexual orientation and the many mental health professionals who reject that option.

“Both sides have to educate themselves better," Ms. Glassgold said. “The religious psychotherapists have to open up their eyes to the potential positive aspects of being gay or lesbian. Secular therapists have to recognize that some people will choose their faith over their sexuality.”

http://www.nytimes.com/2009/08/06/health/06gay.html?_r=1&hp
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KnightEnder
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"Faith over sexuality". What a horrible choice to have to make. And we've seen the horrible results that happen to the people and their families that make this decision.

KE

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aupton15
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I think APA gets it right when they really put mental health first. Individual psychologists have greater difficulty because they bring in their own previous experiences and agendas. It's hard to separate our values from the process, and in training we (should) spend a lot of time talking about that with supervisors. I get nervous about the psychology factory schools that operate as businesses, because they focus on a few "empirically-supported treatments" and less on issues like these that can easily enter into a therapy experience. It can be quite unpleasant for both clients and therapists if not handled appropriately. I'm happiest for this statement by APA because it does away with the naive idea held by many that psychology, as a science, should be divorced from religion. But therapy, as a practice, has to focus on all aspects of what a client and therapist bring into the room with them.
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scifibum
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"It's hard to separate our values from the process..."

I have a feeling that's an understatement. I don't know much about psychotherapy, though I was a half hearted client of two or three therapists, but as a layman it's extremely hard for me to set aside my judgments about people's beliefs when I try to see inside their minds.

I can hear people say they are very happy and that they have no problem with the way their worldview fits the, you know, world. Yet if I think they are deeply mistaken about something important, in creeps the suspicion that they are petty, or stupid, or miserable. (Petty if they dismiss the importance of problems I think they should confront. Stupid if they don't recognize them. Miserable if they do recognize them, give them weight, and have to live with the cognitive dissonance.)

(I tend to relate to this issue although I have not dealt with any pressure to change my orientation. My first therapist was probably convinced that I should not worry about the conflict between my sexual needs and my religion. But I'm just reading his mind; he never said so. He just seemed frustrated at times. I now think he was holding back from helping me to explore whether the religious rules were actually helpful or healthy in my case. Probably didn't feel he could contravene my religion.

Another therapist simply represented the religion; in fact I was referred to him by my bishop. His approach to therapy was pretty much derived from scripture instead of his professional training, I think. It was quite unpleasant.)

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TommySama
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Wait, are you gay scifibum?
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scifibum
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Only for you, Tommy.

I'm talking about how I was a normal horny kid and my religious beliefs (with related familial and personal distortions) made me feel like a horrible person for doing something about it. In my case I wasn't(am not) gay, though.

I hesitated to make the comparison, because I think it's probably an order of magnitude harder for gay folks whose religion tells them they can never do what their sexual urges tell them to do (instead of just waiting for marriage). But my point is that I relate to having your sexuality run up against religious prohibition, and dealing with that with a therapist, even if my situation wasn't as difficult.

[ August 07, 2009, 02:14 PM: Message edited by: scifibum ]

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NobleHunter
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I think that's what I really don't like about most religions' view of same-sex activity.

For Christianity, the bible is pretty clear that marriage exists, at least in part, to provide an outlet for sex. "It is better to marry than to burn." One of the Church Fathers phrased it: "if you burn, marry," but I don't remember who.

If you're gay, though, you must be chaste, continent and celibate. Especially if you can't function with the opposite sex at all. It seems like there's the admission that controlling sexual impulses is so hard that special concessions are made to avoid it, but there's a class of people who can't use that concessions and thus must be saint-like in order to avoid damnation.

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KnightEnder
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Which probably explains why so many of them become priests. Celibacy and all. And then after years of living celibate and believing yourself to be an evil person it's no wonder that when their urges overtake them they target those that can't expose them to other adults as the monsters they believe themselves to be. A self-fulfilling prophecy. [Frown]

I'm sure their will be those who pooh pooh this believing pedophilia to be a disease just as there are those that believe alcoholism is a disease but the staggering number of homosexual pedophile priests argues for a different explanation.

KE

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TommySama
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Scifi, that explains those pictures you sent and the late night video chat requests [Wink]

"I'm talking about how I was a normal horny kid and my religious beliefs (with related familial and personal distortions) made me feel like a horrible person for doing something about it. In my case I wasn't(am not) gay, though. "

You grew up Mormon, right? I don't remember this being a problem. But I stopped believing in God when I was like 12 (but I got involved in porn when I was 8 [Smile] ).

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KnightEnder
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Well, that's the one thing I can say my dad wasn't wrong on. Though giving me attaboys for having sex with 15 year old girls when I was twelve was probably wrong. [Smile]

KE

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TommySama
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Well I got it from my friends dad, but my dad did tell me he'd hook me up if I was curious when I was in 8th grade [Wink] . My dad's only comment about sex was, "I picked some coke cans up in your room today, so it should be more clean now. And the condom that was stuck to one of them." "Oh."
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KnightEnder
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My boys waited until they were like eighteen. I don't know where I went wrong.

KE

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TommySama
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Loved and paid attention to them? You really stunted their promiscuity, man. Ed. to add: they're probably gonna be like serial killers when they grow up. If they aren't already.

[ August 07, 2009, 03:44 PM: Message edited by: TommySama ]

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aupton15
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Scifi, it's a major understatement, especially when you spend your days with so many different clients. Each one brings their own values conflict. If you're really lucky most of them will end up being the same so you can deal with them all at once (e.g., they are all extremely religious and you are not). That's been rare in my limited experience. What you have to do is put the idea behind this APA thing into practice. Basically you have to think about their health and happiness as the most important thing, even more important than setting them on the "right path" as you see it. Of course, that doesn't prevent you from having opinions about where they are wrong.
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Jordan
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Since this has departed from the original issue to rather baser matters: my first, and thankfully almost only, exposure to hard-core pornography was provided courtesy of my mother. For my fifteenth birthday. As a joke.

Seriously.

She arranged for a friend to procure a porn video and they gave it to me under the pretext that it was a birthday present, a fairly recent Star Trek film (Insurrection) I hadn't seen. I loaded it into the VCR, and… Well, I couldn't quite believe what I was seeing. It was astonishing, really. For perhaps five seconds I sat and watched—then I shrieked, ejected the tape, and ran downstairs to find my mother and said friend clutching their sides with laughter. "This isn't Star Trek! This isn't Star Trek at all!" I moaned, whereupon they redoubled their hysterics. When they finally managed to compose themselves a few more inches (by which I mean sit up straight, since they had long since abandoned standing), they handed me the real tape with the film.

My mother and I, as it happens, love each other enormously and are very different people. [Smile]

And scifi-kun! I'm horrified! Whatever would your wife think if I told her you were flirting with that lecher Tommy instead of me?! [Eek!]

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JoshuaD
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quote:
Originally posted by KnightEnder:
"Faith over sexuality". What a horrible choice to have to make. And we've seen the horrible results that happen to the people and their families that make this decision.

KE

No. You've seen a few bad results of the people who've made those decisions and have had it turn out badly. You don't see the ones that turn out fine.
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TomDavidson
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Except that the APA has, and has concluded that the number of such people is statistically insignificant.
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Rallan
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quote:
Originally posted by JoshuaD:
quote:
Originally posted by KnightEnder:
"Faith over sexuality". What a horrible choice to have to make. And we've seen the horrible results that happen to the people and their families that make this decision.

KE

No. You've seen a few bad results of the people who've made those decisions and have had it turn out badly. You don't see the ones that turn out fine.
Actually I've met a few guys who thought being sent to this sort of counselling was the best thing that ever happened to them. They lived in deeply conservative towns where everyone knew each other's business, and ex-gay counselling let them know they weren't alone and gave them a safe place to pick up [Smile]
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TommySama
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Lawl
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hobsen
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Is that supposed to be an oddly matched couple, TommySama? And if so, what gender is the bird? For that matter, what species is the bird?
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Rallan
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quote:
Originally posted by hobsen:
Is that supposed to be an oddly matched couple, TommySama? And if so, what gender is the bird? For that matter, what species is the bird?

It's a variation on an internet meme. "I See What You Did There" (with an accompanying pic of a person or animal who looks like they know what's going on) is a stock response when someone gets subtle, clever, or takes an idea in an unexpected direction.

It's also a sarcastic stock response for when someone fails utterly at those things. Context is everything with memes.

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TommySama
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Rallan. I couldn't figure out how to explain that. (I don't think you failed. I thought it was a lollercopter).
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Rallan
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On a more sensible response to JoshD (couldn't resist being silly the first time), even the therapists and the reclamation ministry people admit that they can't make gays stop lusting after gay sex. They made the mistake of promising that back in the early days of the movement, with predictably hilarious results.

These days they'll flat out tell their clients (or parishioners, or whatever) that the best these programs can do is let them "manage their homosexual tendancies" as if it were an addiction like alcoholism or compulsive gambling. It's all about avoiding temptation (don't go to gay bars, dump your gay friends who aren't in the program, install Net Nanny), constantly reminding yourself that your attraction to other men is "harmful", being encouraged to seek support when you're feeling extra-special tempted, and trying to focus on platonic love and the rewards of family life when you're with your new equally unfulfilled ex-lesbian wife.

I'm sure some homosexuals in these programs do turn out "fine" (by which I assume Josh means "celibate and not suicidally depressed"), and are able to come to terms with treating their sexuality as a drug addiction for the rest of their life, but that sort of "One Day At A Time!" struggle against the lure of hot dickings is about the best anyone can look forward to.

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RickyB
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hobsen, not really nuance professionally - just acknowledging realism.

"the polarized debate between religious conservatives who believe in the possibility of changing sexual orientation and the many mental health professionals who reject that option."

Religious ideologues on one hand, mental health professionals on the other. They're not saying that for anyone, the religious approach will produce the best results - just that some patients may insist, and that in those cases the only actually helpful thing to do would be to minimize the suffering within that framework.

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TommySama
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Rallan, I think Josh meant gays who reconciled their non-homophobic religious beliefs with their sexuality. Not squashing their homosexuality for their religion.
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KnightEnder
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Tommy, I'm not sure where you are getting that. I think Rallan had it pretty dead on.

And I'm not just talking about the homosexual guys that were forced or forced themselves to be straight for a while by their religion, hurting themselves (suicides) or others (bell tower, serial killers), I'm also talking about the ones that so thoroughly fool themselves and repress their true nature that they have wives, children, and seemingly [i]normal[i] lives until one day they can't take it anymore and they accept their true selves. Thus ruining the lives of their wives and children and having to live with that guilt and shame for the rest of their lives.

No, there are a lot of different ways that "forcing" someone to be who or what they are not can have horribly damaging affects on that person, people that care about them, and society.

All that for no good reason other than some religious people with such a vested interest in filling the pews and venerating an old book and almost as old morals "feel" it is their "sacred duty" to **** up other peoples lives. In the name of GOD no less. [Roll Eyes]

KE

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Mormegil
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Perhaps you all can enlighten me on something. A standard religious position is something like this:

Who you are attracted to is not your choice. However, whether you act upon it is. If you are attracted to the opposite sex, you cannot engage in sex until you marry. If you are attracted to the opposite sex, you cannot engage in sex at all. If you are attracted to children, you cannot engage in sex at all.

It is, at least a consistent philosophy: married heterosexual sex good, everything else bad.

But the pro-homosexuality position seems to be this:

If you are attracted to the opposite sex, you may have sex. If you are attracted to the same sex, you may have sex. If you are attracted to children, you may not have sex.

Now, there is a consistency there too: you can engage in adult consensual sex, but sex with children is by definition non-consensual and therefore bad. So both groups make a moral judgment about sex, they just have different standards for their beliefs.

Now the thing I don't get is, BOTH sides think that some people, while attracted to a certain class of people, are nevertheless morally required to NOT act on their attraction. Is it not the case that someone who is a pedophile may never be "cured" of their attraction, which they may never act on, and never even want to have? That they must spend their life holding it in check?

If we are prepared to ask them to do that, why is such a request so awful when aimed towards homosexuals? Because homosexual activity isn't wrong, you say. Okay, but then *that* should be the point of debate, right?

Not how harmful self-repression is, because in other areas of sexual expression, you are in fact in favor of self-repression, right?

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TommySama
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"If we are prepared to ask them to do that, why is such a request so awful when aimed towards homosexuals? Because homosexual activity isn't wrong, you say. Okay, but then *that* should be the point of debate, right?"

At least in our culture, having sex with a child is very likely to be emotionally (if not physically) harmful. Plus children are assumed not to be able to decide things like that until a certain age. Adults can decide, so if two adults have sex it is not frowned upon as much. I guess I would say it really comes down to ability to chose and consent, which we generally agree kids aren't able to. This gets fuzzy as the child gets older, but you shouldn't do something that ignores the rights of another person.

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scifibum
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Mormegil, I think you answered your own question. I think most people who are OK with homosexual sex but not OK with adults having sex with children consider the latter to be harmful (to the children. It is possible but irrelevant that it also harms "society" - don't need to debate that, because it does harm the kids), and the former to not be harmful.

So yeah, sexual repression is fine and dandy if what you are repressing is the desire to harm another person. I'm also in favor of murder repression, rape repression, etc. [Smile]

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DonaldD
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Well, it's more the fact that society considers children to have only a limited capacity to provide informed consent.

As long as a person is capable of truly consenting to an action, harm is not an issue. The challenge is in identifying a person's ability to give informed consent when their actions seem to suggest that there are real questions regarding their ability to provide consent in the first place.

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scifibum
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I think the only reason we worry about the kids' ability to provide consent is the potential harm they might experience, though. We don't care if kids can consent to being given vegetables to eat.
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RickyB
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Mormegil, we don't allow adults to have sex with children of the opposite sex either. Is that ok from an anti-gay sex pov because "we allow ourselves to deny sex anyway"? You wouldn't tell Adam and Eve not to have sex, but Adam and Julie is a no-no?

And yes, a pedophile has urges that involve a non-consenting partner, and therefore must deny himself, same as a rapist. It really is simple.

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Mormegil
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My issue is not why homosexuality is okay but child sex isn't. I said so already, hoping to stave off the obvious (but irrelevant to my point) riposte...

My issue is why, given that you believe self-repression is okay and expected for one immoral behavior, you then act like self-repression is a priori ludicrous when someone else tries to suggest it as an alternative to (what they perceive as) immoral behavior.

Basically you act like people advocating self-repression for homosexuals are scumbags but you advocate it yourself for something else.

I mean, I get that you don't agree with the Reparative Therapy point of view, but can you acknowledge that its failure (in your opinion) is in identifying homosexuality as an immoral behavior, and not act like what they are trying to do about it is just plain ridiculous?

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MattP
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quote:
My issue is why, given that you believe self-repression is okay and expected for one immoral behavior, you then act like self-repression is a priori ludicrous when someone else tries to suggest it as an alternative to (what they perceive as) immoral behavior.

Because non-religious concepts of morality tend to be concerned with only tangible harms. Religious morality, however, is also concerned with abstractions like "purity" which are only meaningful in the context of a given religion. Additionally, the religious response to these intangible acts of immorality often produce tangible harm.

From the point of view of someone who objects to Reparative Therapy, the moral imperative to conduct such therapy is like a moral imperative to deny blood transfusions or stone a girl who is caught alone with a boy - there is a tangible harmful outcome which is ignored or minimized in the name of an intangible moral abstraction.

[ August 11, 2009, 10:39 AM: Message edited by: MattP ]

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Jordan
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Fair warning, this has been written in odd moments snatched between tasks, and is subject to incoherence and rambling. Some more time spent organising my thoughts would help, but I'm a little short on that right now! [Smile]


quote:
Mormegil:
If we are prepared to ask them to do that, why is such a request so awful when aimed towards homosexuals?

First, you have my compliments for your clearly and gently set-out reasoning, Mormegil.

Second, although you answer yourself, it's my guess that this is the central question concerning which you requested enlightenment, so I'll respond on that basis.

The simple answer starts by observing that what is considered to be the "correct" context for sexual relations depends upon the context in which the question is asked. If one takes a traditional Christian perspective, then the correct answer to who may have sex is closer to the first option than to the second. From the perspective of a civil libertarian, the second option is closer.

Similarly, the answer to why one should not expect greater restraint from homosexuals than is expected from heterosexuals—indeed, why they should not be expected to exercise the same degree of restraint expected of a paedophile—also depends on context. You will see this immediately if I spin the question around: if we are prepared to allow married, opposite-sex couples to have sex, why is it so awful to allow unmarried or homosexual couples to also enjoy sex? The answer, from a traditional Christian perspective, is very obvious.

The answer to your original question (why it is awful to prevent unmarried or homosexual couples to have sex, despite still preventing some) is equally obvious from the perspective of civil liberties, which I suppose is largely in accord with the values held by most modern non-theists. It is awful to prevent homosexuals and unmarried couples from having sexual relations when those relations do not violate the civil liberties of one or the other partner, because doing so is in itself a violation of civil liberties.

Of course, civil liberties hold little weight in a theological discussion, nor indeed in a discussion about psychological well-being. Going back to the topic at hand, I think the issue goes rather deeper than homosexual sex and attraction per se. To see this, first consider what constitutes a mental disorder:

quote:
"A mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as part of normal development or culture."—Mental disorder, Wikipedia
So if homosexuality does not cause distress or disability, it cannot easily be said to be a mental disorder. However, it could be argued that the condition of being distressed by one's acknowledge sexual orientation is a disorder—indeed, the WHO recognises ego-dystonic homosexuality as a mental disorder, as does the DSM IV in a round-about fashion. The two main avenues of treatment (in layman's terms) are to alter the client's sexual orientation, or to adjust the client's attitude so that they can be happy with their existing sexual orientation; the eventual goal, to reconcile the client's expectations with their sexual orientation, is the same in both cases.

It is interesting to note how positions are commonly polarised with regards to sexual orientation and sexual identity. On the one hand, those who oppose reparative therapy are likely to be in favour of sex-changes for sufferers of gender identity disorder; on the other hand, those who advocate reparative therapy are likely to also advocate that GID sufferers be reconciled with their apparent gender, instead of changing their gender to match their psychology. Initially it might seem that there is a disparity in both approaches, but in fact both follow a consistent philosophy: we have one group in favour of treating mental disorders by taking the route of "least psychological resistance," and another whose approach is to modify behaviours and perceptions to match externally normalised expectations.

The implications of these two approaches are far-reaching, and are probably at the heart of why this issue is so divisive. The first approach would tend to avoid pathologising that which does not actively distress or disable—and, thus, is more in line with current psychiatric thinking. The latter would pathologise several behaviours and conditions regardless of their effects, and thus would acknowledge a broader range of mental disorders on the basis that they do not conform with cultural expectations (or, at least, some set of expectations that are taken as normative).

From one perspective, it may be easier to change bodies to conform with gender identity, and easier to change individual expectations than sexual orientation. It is possible that individual psychiatrists might believe that, in some cases, it may be easier to change sexual orientation—or, at least, one's identification with or expectations of a particular orientation; but speaking purely from personal opinion, if this were simply a debate about the finer points of how to treat a particular mental disorder on an individual basis, it is unlikely that what is, after all, a medical matter would attract such public and contrasting attention. The real issue is that both camps have dramatically different expectations of how psychiatry should be employed in support of their own political agendas.

Psychiatry approaches disorder from a medical model that does not seek to pathologise conditions unless they are actually considered distressing or disabling, and this aligns well with a liberal perspective on homosexuality. On the other hand, more conservative perspectives approach the matter from a non-medical model of expected conduct, any deviations from which are considered "disordered" and in need of correction. Psychiatry does not align with this perspective, and thus the tension. This approach does align with religious perspectives on what constitutes "correct" and "incorrect" (i.e. "disordered") behaviour, however, from which viewpoint one could possibly reconcile the native concept of disorder with the medical concept to an extent by asserting that such behaviours are spiritually harmful, and that spiritual health is an important aspect of overall well-being.

[ August 11, 2009, 10:53 AM: Message edited by: Jordan ]

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hobsen
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That is a very good question, Mormegil. My answer would be that repressing desires is always bad, in that such frustration can destroy the person's happiness and also lead him to harm others. But advocating repression may still be justified because the consequences of yielding to desires can be too serious. Looking around the United States, I am sure you could find a few people weighing over 800 pounds who still have an overwhelming desire to eat. Just the same, if they go on eating as usual, they are going to die. So unless people want to say such people should just die, they must be encouraged to lose that excess weight.

In relation to homosexuality, the belief that homosexual acts should always be avoided comes almost invariably from the Bible. (That is different from saying that particular homosexual acts may be bad for reasons similar to condemnations of particular heterosexual ones.) And the books of the Bible were written by half-civilized people who thought the customs of their tribe were universally true for all mankind, and in any case often disagreed on what those customs should be. So anyone who accepts those prohibitions as the last word on the matter shows he refuses to accept that lots of things in the Bible are contradictory and in many cases downright evil. Unless he wants to argue all abolitionists were monsters and enemies of God for trying to deprive slaveholders of their right to possess slaves and breed more of them, just as they had a right to do with any other farm animals.

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aupton15
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I think I get what you're saying Mormegil. A pedophile suppresses his urges to prevent harming a child. From the religious perspective, a homosexual should suppress their urges to preventing harming their own soul (or something along those lines). From that perspective, it's not substantively different, just that the harm is not overtly measurable in the here and now. I think what APA is now advocating actually balances the two possible views very nicely. They acknowledge that harm can come from either repressing your sexual urges OR renouncing your religious convictions. It's a difficult conflict for any individual and it should be handled with a little nuance and compassion. To me, it seems that therapists are encouraged to explore both broad sources of potential pain rather than leading every single person down the same path. This contradicts both reparative therapy as well as the opposite extreme of encouraging people to place free sexual expression above their religious convictions. Some will eventually choose to be celibate and true to their faith. Others might find other faith expressions that are more accepting of their sexual desires. This position seems to take power away from the church and the therapist (to the extent the therapist can execute it), and put it directly in the hands of the person in the conflict.
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scifibum
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quote:
I mean, I get that you don't agree with the Reparative Therapy point of view, but can you acknowledge that its failure (in your opinion) is in identifying homosexuality as an immoral behavior, and not act like what they are trying to do about it is just plain ridiculous?
Thanks for clarifying.

I'm not sure if my answer to this question can be a "yes." There are two reasons.

Consider someone who wears a tinfoil hat because he is convinced that it blocks out mind control rays. I could say his error is in believing that there are mind control rays that are subject to being blocked out by tin foil. Given that, what he's trying to about it seems reasonable. Wearing the hat isn't ridiculous.

...I just don't think it works. The motivation and the action aren't so separable. If I deeply disagree with the reasons for doing something, I'm not going to judge the resulting actions separately.

By which I mean to say that if I disagree with a group's reasons for thinking that homosexuality is immoral, I don't think it's likely that I can be reconciled to whatever the group chooses to try to do about it. I can find them well meaning but still wrong to act, if I disagree with their reasons for acting. This is the first reason I can't answer yes to your question. (Although, I would note, if this were the only thing I would gladly say reparative therapy is not 'ridiculous' - only wrong.)

The second reason is that even if the goal was one I could agree with, it seems like a really useless endeavor. I am only going by anecdotes and the statement from the APA, but my impression is that reparative therapy doesn't work, and in fact often makes things worse for the individual. I think it's a bit ridiculous to keep attempting to make gay people straight if it doesn't work.

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scifibum
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I meant to respond to this as well:

"Basically you act like people advocating self-repression for homosexuals are scumbags"

Who's "you"? I think 'scumbag' is far too strong a word. (Though I've noticed you tend to use it regularly.)

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RickyB
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"My issue is why, given that you believe self-repression is okay and expected for one immoral behavior, you then act like self-repression is a priori ludicrous when someone else tries to suggest it as an alternative to (what they perceive as) immoral behavior.

Basically you act like people advocating self-repression for homosexuals are scumbags but you advocate it yourself for something else."

Because we don't believe that B is immoral. Obviously if you believe homosexual intercourse is immoral, you should try to avoid it to the extent you wish to be moral. It is the very cataloging of homosexual sex as immoral which we find, as you put it, scumbaggish.

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