Do clients who have sexual orientation distress feel pressured into reorientation counseling?

Warren Throckmorton, PhD

Grove City College

Paper based on research presented at the 2002, NARTH Annual Convention

Orlando, FL.

Published in the 2002 Collected Papers, by the National Association for the Research and Therapy of Homosexuality

Do clients who have sexual orientation distress feel pressured into reorientation counseling?

The mental health professions continue to wrestle with the controversial issue of how to respond to clients wanting to modify sexual identity. Recent reports in peer-reviewed journals have advocated the use of sexual reorientation interventions, either via mental health counseling or religious ministry (Throckmorton, 2002a; Yarhouse & Throckmorton, 2002). Other writers continue to assert that such interventions are harmful to homosexually oriented clients and therefore should be discouraged or unavailable (Tozer & McClanahan, 1999; Schroeder & Shidlo, 2002).

The human context of this debate is a large number of current and former consumers of counseling services on both sides of the issue. Ex-gays, those individuals who have experienced same sex attraction but do not wish to orient their lives around those sexual feelings, are adamant that sexual reorientation counseling be available (Throckmorton, 2002a). Others, often referred to as “ex-ex-gays,” often report feeling harmed by interventions that have had as their aim, the development of an opposite sex sexual orientation (Human Right Campaign, 2002; Schroeder & Shidlo, 2002). Objectivity on the issue is often further clouded by the current cultural climate that has put homosexual issues in the midst of many political debates. Some gay activist groups have made the elimination of sexual reorientation counseling a central focus of their advocacy efforts (e.g., Human Rights Campaign, 2002).

One issue that is central to the debate over providing sexual reorientation counseling is that of informed consent. Writers on both sides of this issue describe the importance of informing clients about the relevant research and literature concerning sexual orientation and efforts to modify this aspect of personality. Those opposed to sexual reorientation often assert that the primary reason clients enter into such interventions is because they feel coerced to do so (Haldeman, 1994; Tozer & McClanahan, 1999). Such coercion would be antithetical to the clinical application of informed consent principles.

Are there any empirical data to support claims of coercion into reorientation counseling? Schroeder and Shidlo (2002) indicate that many of their subjects felt pressured to enter sexual reorientation counseling. They note that some clients felt coerced to enter reorientation counseling by their religious college administration as a requirement to remain enrolled. The number of research participants were not reported. They only quantified one type of client that may have felt some coercion. Some clients who may be ambivalent about sexual orientation seek treatment primarily to treat a variety of mental health complaints. Upon disclosing the issue of same-sex attraction to their counselors, 26% of the clients felt that their counselors initiated reorientation interventions. Suggestions from counselors may be taken by some as pressure but may be welcomed by other clients. Thus, there is no way of knowing what percentage of the total group felt coerced to enter reorientation efforts.

I have been unable to locate any empirical reports suggesting the degree to which those who identify as ex-gay have felt pressured into entering reorientation counseling. To provide an empirical look at this important component of the issue of reorientation counseling, I asked a group of research participants who identified as ex-gay to describe the degree and source of pressure to enter reorientation counseling. I also asked them to describe any pressure they felt not to reorient their sexuality. As an exploratory study, I only hypothesized that such pressure would exist although I could not predict the frequency of pressure. I also did not have any basis for predicting which type of pressure would be more frequent, pressure to enter reorientation counseling or pressure not to enter such efforts.

METHOD

Participants

The participants were 19 men and 9 women who at one time identified as gay or lesbian but identified as heterosexual at the time of the research project. The average age was 39. The sample was quite religious in that 100% said religion was at least “important” in their lives. Fifty-five percent of the participants were or had been married. The sample was overwhelming white (89%) with all having at least some college education.

Instruments

The participants were taking part in a larger study concerning their preferences in counseling (Throckmorton, 2002b). They completed a lengthy survey and then answered questions concerning any perceive coercion into either gay affirming counseling or reorientation counseling. The questionnaire asked the participants to rate on a 4 point scale the degree to which they felt coerced by gay or ex-gay groups, parents, other family members, ministers, church friends, non-church friends, counselors and professors.

Procedures

Each subject was either interviewed over the phone for an average of 45 minutes. Some subjects simply completed the questionnaire and mailed it back. The salient part of the questionnaire is described above.

RESULTS

As can be seen from Table One, participants were far more likely to feel coerced not to enter reorientation counseling than felt coerced to pursue it. The percentages are expressed as a percentage of the total n that felt pressured by a given person or source.

[Insert Table One about here]

The strongest pressure to enter reorientation counseling came from religious sources (church friends – 21.4% and ministers – 14.2% of total sample) and from parents (21.4%). Strikingly, none of the 28 subjects felt pressure from counselors or professors to enter reorientation counseling whereas 39.2% of the sample felt pressured from counselors not to enter such counseling. Non-church friends exerted the greatest influence (46.4%) and members of groups advocating for gay causes were implicated by 28.5% of the sample.

While the degree of pressure felt was fairly consistent across sources, non-church friends and the advocacy groups were reported to exert the most pressure (3.5 rating out of 4 which equaled “a great deal” of pressure).

DISCUSSION

This brief article examined the self-report of 28 men and women who experienced coercion and pressure surrounding their decision to enter reorientation counseling. Whereas some previous reports (HRC, 2002; Tozer and McClanahan, 1999) have reported that clients have felt pressured into entering reorientation programs, this study of those considering themselves former homosexuals finds considerable pressure not to reorient sexuality. While some former gays reported some pressure to go into ex-gay counseling, the percentage of the sample reporting such pressure was not significantly greater than reported in other populations for other referral reasons.

Given the mental health professions’ emphasis on autonomy and choice, it is striking that the second greatest source of coercion came from mental health professionals. Subjects reported that counselors told them they could not change their sexual identity and that it would be harmful for them to try.

Given that the participants in this study generally found their counseling experiences helpful, the warnings did not fit their experience. This fact could make their recollection of coercion even more striking and contributed to the frequency of such recall.

The source of the data in this study was self-report with all its potential problems. Of course it is possible that bias may contaminate the recall and subsequent reconstruction of events from the current perspective of viewing oneself as straight or ex-gay. Some participants may be less concerned with pressures to seek reorientation since they now view such an approach as a good one. On the other hand, the prevalence of pressure not to enter reorientation counseling is unlikely due to differences in recall caused by cognitive dissonance. Rather, it appears that for this particular group, their social context was much more heterophobic than homophobic prior to entrance into reorientation efforts

References

Haldeman, D. (1994). The practice and ethics of sexual orientation conversion therapy.

Journal of Consulting and Clinical Psychology, 62, 221-227

Human Rights Campaign. (2002). Finally free: How love and acceptance saved us

from the ex-gay ministries. Washington, DC: Author.

Schroeder, M. & Shidlo, A. (2002). Changing sexual orientation: A consumer’s report.

Professional Psychology: Research and Practice, 33, 249-259.

Throckmorton, W. (2002a). Initial empirical and clinical findings concerning the

change process for ex-gays. Professional Psychology: Research and Practice, 33,

242-248.

Throckmorton, W. (2002b, November). What works in reorientation counseling.

Presentation at the NARTH Annual Conference, Orlando, FL.

Tozer, E.E. & McClanahan, M.K. (1999). Treating the purple menace: Ethical

considerations of conversion therapy and affirmative alternatives. Counseling

Psychologist, 27, 722-742

Yarhouse, M. & Throckmorton, W. (2002).Ethical issues in attempts to ban

reorientation therapies. Psychotherapy: Theory/Research/Practice/Training,

39, 66-75.

TABLE ONE

Pressure/influenced to seek reorientation

N = 28	Source of pressure as a % of total N
Total Describing Pressure	Ex-Gay Group	Parents	Other Family Members	Minister	Church Friends	Non-Church Friends	Counselors	Professors
8 (28.6%)	7.1	21.4	14.2	14.2	21.4	7.1	0	0
Degree of Pressure
3.04	3.5	2.8	3	3	3	3.5	0	0

Degree of pressure 1= None 2 = Very little 3 = Some 4 = Great deal

Pressure/influenced NOT to seek reorientation

N = 28	Source of pressure as a % of total N
Total Describing Pressure	Gay Advocate Group	Parents	Other Family Members	Minister	Church Friends	Non-Church Friends	Counselors	Professor
21 (75%)	28.5	10.7	17.8	17.8	14.2	46.4	39.2	10.7
Degree of Pressure
3.21	3.5	3.3	3	2.8	3	3.5	3	3.3

Degree of pressure 1= None 2 = Very little 3 = Some 4 = Great deal