NYT: Recanting on gay ‘cure’

“People with a shared worldview basically came together and created their own set of experts to offer alternative policy views,” said Dr. Jack Drescher, a psychiatrist in New York and co-author of “Ex-Gay Research: Analyzing the Spitzer Study and Its Relation to Science, Religion, Politics, and Culture.”

To Dr. Spitzer, the scientific question was at least worth asking: What was the effect of the therapy, if any? Previous studies had been biased and inconclusive. “People at the time did say to me, ‘Bob, you’re messing with your career, don’t do it,’ ” Dr. Spitzer said. “But I just didn’t feel vulnerable.”

He recruited 200 men and women, from the centers that were performing the therapy, including Exodus International, based in Florida, and Narth. He interviewed each in depth over the phone, asking about their sexual urges, feelings and behaviors before and after having the therapy, rating the answers on a scale.

He then compared the scores on this questionnaire, before and after therapy. “The majority of participants gave reports of change from a predominantly or exclusively homosexual orientation before therapy to a predominantly or exclusively heterosexual orientation in the past year,” his paper concluded.

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The study — presented at a psychiatry meeting in 2001, before publication — immediately created a sensation, and ex-gay groups seized on it as solid evidence for their case. This was Dr. Spitzer, after all, the man who single-handedly removed homosexuality from the manual of mental disorders. No one could accuse him of bias.

But gay leaders accused him of betrayal, and they had their reasons.

The study had serious problems. It was based on what people remembered feeling years before — an often fuzzy record. It included some ex-gay advocates, who were politically active. And it didn’t test any particular therapy; only half of the participants engaged with a therapist at all, while the others worked with pastoral counselors, or in independent Bible study.

Several colleagues tried to stop the study in its tracks, and urged him not to publish it, Dr. Spitzer said.

Yet, heavily invested after all the work, he turned to a friend and former collaborator, Dr. Kenneth J. Zucker, psychologist in chief at the Center for Addiction and Mental Health in Toronto and editor of the Archives of Sexual Behavior, another influential journal.

“I knew Bob and the quality of his work, and I agreed to publish it,” Dr. Zucker said in an interview last week. The paper did not go through the usual peer-review process, in which unnamed experts critique a manuscript before publication. “But I told him I would do it only if I also published commentaries” of response from other scientists to accompany the study, Dr. Zucker said.

Those commentaries, with a few exceptions, were merciless. One cited the Nuremberg Code of ethics to denounce the study as not only flawed but morally wrong. “We fear the repercussions of this study, including an increase in suffering, prejudice, and discrimination,” concluded a group of 15 researchers at the New York State Psychiatric Institute, where Dr. Spitzer was affiliated.

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Dr. Spitzer in no way implied in the study that being gay was a choice, or that it was possible for anyone who wanted to change to do so in therapy. But that didn’t stop socially conservative groups from citing the paper in support of just those points, according to Wayne Besen, executive director of Truth Wins Out, a nonprofit that fights antigay bias.

On one occasion, a politician in Finland held up the study in Parliament to argue against civil unions, according to Dr. Drescher.

“It needs to be said that when this study was misused for political purposes to say that gays should be cured — as it was, many times — Bob responded immediately, to correct misperceptions,” said Dr. Drescher, who is gay.

But Dr. Spitzer couldn’t control how his study was interpreted by everyone, and he could not erase the biggest scientific flaw of them all, roundly attacked in many of the commentaries: Simply asking people whether they’ve changed is no evidence at all of real change. People lie, to themselves and others. They continually change their stories, to suit their needs and moods.

By almost any measure, in short, the study failed the test of scientific rigor that Dr. Spitzer himself was so instrumental in enforcing for so many years.

“As I read these commentaries, I knew this was a problem, a big problem, and one I couldn’t answer,” Dr. Spitzer said. “How do you know someone has really changed?”

Letting go

It took eleven years for him to admit it publicly.

At first he clung to the idea that the study was exploratory, an attempt to prompt scientists to think twice about dismissing the therapy outright. Then he took refuge in the position that the study was focused less on the effectiveness of the therapy and more on how people engaging in it described changes in sexual orientation.

“Not a very interesting question,” he said. “But for a long time I thought maybe I wouldn’t have to face the bigger problem, about measuring change.”

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After retiring in 2003, he remained active on many fronts, but the reparative study remained a staple of the culture wars and a personal regret that wouldn’t leave him be. The Parkinson’s symptoms have worsened in the past year, exhausting him mentally as well physically, making it still harder to fight back pangs of remorse.

And one day in March, Dr. Spitzer entertained a visitor. Gabriel Arana, a journalist at the magazine The American Prospect, interviewed Dr. Spitzer about the reparative therapy study. This wasn’t just any interview; Mr. Arana went through reparative therapy himself as a teenager, and his therapist had recruited the young man for Dr. Spitzer’s study (Mr. Arana did not participate).

“I asked him about all his critics, and he just came out and said, ‘I think they’re largely correct,’ ” said Mr. Arana, who wrote about his own experience last month. Mr. Arana said that reparative therapy ultimately delayed his self-acceptance and induced thoughts of suicide. “But at the time I was recruited for the Spitzer study, I was referred as a success story. I would have said I was making progress.”

That did it. The study that seemed at the time a mere footnote to a large life was growing into a chapter. And it needed a proper ending — a strong correction, directly from its author, not a journalist or colleague.

A draft of the letter has already leaked online and has been reported.

“You know, it’s the only regret I have; the only professional one,” Dr. Spitzer said of the study, near the end of a long interview. “And I think, in the history of psychiatry, I don’t know that I’ve ever seen a scientist write a letter saying that the data were all there but were totally misinterpreted. Who admitted that and who apologized to his readers.”

He looked away and back again, his big eyes blurring with emotion. “That’s something, don’t you think?”

This article, “Leading Psychiatrist Apologizes for Study Supporting Gay ‘Cure,’” first appeared in The New York Times.

Copyright © 2012 The New York Times

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