The Alliance for Therapeutic Choice and Scientific Integrity (ATCSI), which until 2014 was known as the National Association for Research & Therapy of Homosexuality (NARTH), also known as the NARTH Institute, is a US organization that promotes conversion therapy, a pseudoscientific practice used in attempts to change the sexual orientation of people with same-sex attraction. [1] NARTH was founded in 1992 by Joseph Nicolosi, Benjamin Kaufman, and Charles Socarides. Its headquarters were in Encino, California, at its Thomas Aquinas Psychological Clinic. [2] [3] NARTH has not been recognized by any major United States–based professional association. [4]
NARTH's promotion of conversion therapy as a scientifically supported therapeutic method is contradicted by overwhelming scientific consensus. [5] For example, the American Psychological Association (APA) states that homosexuality is a normal and positive variation of human sexual orientation, and is not a mental disorder. [6] The APA's Task Force on Appropriate Therapeutic Responses to Sexual Orientation affirms the tension between some religious values and other organizations and the existence of a subset of individuals who are distressed about their same-sex attraction, but it says it has not found adequately rigorous studies that suggest sexual orientation change efforts are successful. The APA Task Force has also found that some individuals reported being harmed by sexual orientation change efforts. [6]
NARTH was founded in 1992 by Benjamin Kaufman, Charles Socarides, and Joseph Nicolosi. In an article titled "In Defense of the Need for Honest Dialogue", Kaufman wrote that the three of them founded NARTH because the American Psychiatric Association and similar professional organizations "had totally stifled the scientific inquiry that would be necessary to stimulate a discussion" about homosexuality. [7]
The organization had 501(c)(3) tax exempt status, which was revoked by the Internal Revenue Service in September 2012 due to ongoing failure to file required paperwork. [8]
NARTH claimed to be a secular organization, differentiating it from other ex-gay groups that were primarily religious in nature. Nevertheless, NARTH often partnered with religious groups, [9] such as Jews Offering New Alternatives for Healing, Joel 2:25 International, and Evergreen International in Positive Alternatives to Homosexuality.
In July 2011, NARTH failed to pay its dues to the California Board for Behavioral Sciences and was removed from the list of groups that provide continuing education credits to therapists in California. NARTH had been an approved continuing education provider since 1998. [10]
No schools, universities or professional programs currently train counselors in reparative therapy. [11]
NARTH had several connections to Evergreen International and the Church of Jesus Christ of Latter-day Saints. The Evergreen website referenced the therapeutic methods of NARTH founder Joseph Nicolosi as "beneficial". [12] Nicolosi worked with A. Dean Byrd (an Evergreen Board member, Director of Clinical Training for LDS Social Services, Brigham Young University professor, and founder of the Foundation for Attraction Research) to author several papers on reparative therapy. [13] Byrd also served as president of NARTH and also published an article [14] in the LDS church's September 1999 Ensign. [15]
In 2003, the leaders of Positive Alternatives to Homosexuality (PATH) made NARTH a member.
The founders held that homosexuality is a treatable mental illness and that a person's sexual orientation can be changed through therapy. Such conversion therapy is pseudoscientific, [1] harmful, and unethical according to major medical and psychological organisations in the United States [6] [16] [17] and elsewhere. [18] [19] Socarides in particular said in the mid-1990s that he had treated about a thousand homosexual patients, and cured over a third by dealing with the parental causes of an absent father and overbearing mother. [20]
Claims that pathologize homosexuality and state that it can be changed through therapy have been denounced by almost every major US medical association, including the American Medical Association and the American Psychiatric Association. [17] [21] In 2006 the American Psychological Association declared that NARTH created "an environment in which prejudice and discrimination can flourish". [22] The Southern Poverty Law Center (SPLC) singled the group out as a main source of junk science used by hate groups to justify anti-gay rhetoric. [17] NARTH was accused of employing abusive methods to attempt to change sexual orientation by the Human Rights Campaign and Truth Wins Out. [23] [24] [25]
In 2010, NARTH’s executive secretary Abba Goldberg disclosed a 1991 criminal conviction for conspiracy and fraud, for which he served 18 months in prison. [26]
George Rekers was a former officer and scientific advisor of the NARTH. [27] [28] Rekers has testified in court that homosexuality is destructive, and against parenthood by gay and lesbian people in a number of court cases involving organizations and state agencies working with children. [29] In May 2010, Rekers employed a male prostitute as a travel companion for a two-week vacation in Europe. [30] [31] [32] Rekers denied any inappropriate conduct and suggestions that he was gay. The male escort told CNN he had given Rekers "sexual massages" while traveling together in Europe. [33] Rekers subsequently resigned from the board of NARTH. [30] [34]
In April 2005, NARTH published on its website an essay titled "Gay Rights and Political Correctness: A Brief History", written by Gerald Schoenewolf, a member of NARTH's Science Advisory Committee. The essay made several controversial claims, including that the civil rights and gay rights movements are "destructive", that the American Psychological Association "has been taken over by extremist gays", and that Africans were fortunate to have been sold into slavery. [35] The SPLC called it an angry polemic that made outrageous historical claims and criticised both NARTH and Schoenewolf. The essay drew little attention until a letter of protest was presented to NARTH by the National Black Justice Coalition in mid-September 2006. Truth Wins Out then called on Focus on the Family to cancel a planned appearance by Nicolosi at their conference. Nicolosi appeared as planned but the Schoenewolf essay was removed from the NARTH website the same day. On October 6, 2006, NARTH published a statement: "NARTH regrets the comments made by Dr. Schoenewolf about slavery which have been misconstrued by some of our readers." [35]
Conversion therapy is the pseudoscientific practice of attempting to change an individual's sexual orientation, romantic orientation, gender identity, or gender expression to align with heterosexual and cisgender norms. Methods that have been used to this end include forms of brain surgery, surgical or chemical (hormonal) castration, aversion therapy treatments such as electric shocks, nausea-inducing drugs, hypnosis, counseling, spiritual interventions, visualization, psychoanalysis, and arousal reconditioning. There is a scientific consensus that conversion therapy is ineffective at changing a person's sexual orientation or gender identity and that it frequently causes significant long-term psychological harm. The position of current evidence-based medicine and clinical guidance is that homosexuality, bisexuality, and gender variance are natural and healthy aspects of human sexuality. An increasing number of jurisdictions around the world have passed laws against conversion therapy.
The American Psychological Association (APA) is the main professional organization of psychologists in the United States, and the largest psychological association in the world. It has over 157,000 members, including scientists, educators, clinicians, consultants, and students. It has 54 divisions, which function as interest groups for different subspecialties of psychology or topical areas. The APA has an annual budget of around $125 million.
The field of psychology has extensively studied homosexuality as a human sexual orientation. The American Psychiatric Association listed homosexuality in the DSM-I in 1952 as a "sociopathic personality disturbance," but that classification came under scrutiny in research funded by the National Institute of Mental Health. That research and subsequent studies consistently failed to produce any empirical or scientific basis for regarding homosexuality as anything other than a natural and normal sexual orientation that is a healthy and positive expression of human sexuality. As a result of this scientific research, the American Psychiatric Association removed homosexuality from the DSM-II in 1973. Upon a thorough review of the scientific data, the American Psychological Association followed in 1975 and also called on all mental health professionals to take the lead in "removing the stigma of mental illness that has long been associated" with homosexuality. In 1993, the National Association of Social Workers adopted the same position as the American Psychiatric Association and the American Psychological Association, in recognition of scientific evidence. The World Health Organization, which listed homosexuality in the ICD-9 in 1977, removed homosexuality from the ICD-10 which was endorsed by the 43rd World Health Assembly on 17 May 1990.
The ex-gay movement consists of people and organizations that encourage people to refrain from entering or pursuing same-sex relationships, to eliminate homosexual desires and to develop heterosexual desires, or to enter into a heterosexual relationship. Beginning with the founding of Love In Action and Exodus International in the mid-1970s, the movement saw rapid growth in the 1980s and 1990s before declining in the 2000s.
Exodus International was a non-profit, interdenominational ex-gay Christian umbrella organization connecting organizations that sought to "help people who wished to limit their homosexual desires". Founded in 1976, Exodus International originally asserted that conversion therapy, the reorientation of same-sex attraction, was possible. In 2006, Exodus International had over 250 local ministries in the United States and Canada and over 150 ministries in 17 other countries. Although Exodus was formally an interdenominational Christian entity, it was most closely associated with Protestant and evangelical denominations.
Robert Leopold Spitzer was a psychiatrist and professor of psychiatry at Columbia University in New York City. He was a major force in the development of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Joseph Nicolosi was an American clinical psychologist who advocated and practised "reparative therapy", a form of the pseudoscientific treatment of conversion therapy that he claimed could help people overcome or mitigate their homosexual desires and replace them with heterosexual ones. Nicolosi was a founder and president of the National Association for Research and Therapy of Homosexuality (NARTH). Medical institutions warn that conversion therapy is ineffective and may be harmful, and that there is no evidence that sexual orientation can be changed by such treatments.
Charles William Socarides was an American psychiatrist, psychoanalyst, physician, educator and author. He focused much of his career on homosexuality, which he believed could be altered. He helped found the National Association for Research & Therapy of Homosexuality (NARTH) in 1992 and worked extensively with the organization until his death.
George Alan Rekers is an American psychologist and ordained Southern Baptist minister. He is emeritus professor of Neuropsychiatry and Behavioral Science at the University of South Carolina School of Medicine. Rekers has a PhD from University of California, Los Angeles and has been a research fellow at Harvard University, a professor and psychologist for UCLA and the University of Florida, and department head at Kansas State University.
Ego-dystonic sexual orientation is a highly controversial mental health diagnosis that was included in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) from 1980 to 1987 and in the World Health Organization's (WHO) International Classification of Diseases (ICD) from 1990 to 2019. Individuals could be diagnosed with ego-dystonic sexual orientation if their sexual orientation or attractions were at odds with their idealized self-image, causing anxiety and a desire to change their orientation or become more comfortable with it. It describes not innate sexual orientation itself, but a conflict between the sexual orientation a person wishes to have and their actual sexual orientation.
Love Won Out was an ex-gay ministry launched in 1998 by Focus on the Family, an American conservative Christian organization. It was taken over by Exodus International in 2009 and then shut down at the same time Exodus International was disbanded, in 2013.
Gay affirmative psychotherapy is a form of psychotherapy for non-heterosexual people, specifically gay and lesbian clients, which focuses on client comfort in working towards authenticity and self-acceptance regarding sexual orientation, and does not attempt to "change" them to heterosexual, or to "eliminate or diminish" same-sex "desires and behaviors". The American Psychological Association (APA) offers guidelines and materials for gay affirmative psychotherapy. Affirmative psychotherapy affirms that homosexuality or bisexuality is not a mental disorder, in accordance with global scientific consensus. In fact, embracing and affirming gay identity can be a key component to recovery from other mental illnesses or substance abuse. Clients whose religious beliefs are interpreted as teaching against homosexual behavior may require some other method of integration of their possibly conflicting religious and sexual selves.
Albert Dean Byrd was a former president of the National Association for Research & Therapy of Homosexuality (NARTH), a research organization that advocates sexual orientation change efforts (SOCE). He was a psychologist who focused on SOCE, and wrote on the topic. Although raised by a Buddhist mother and a Baptist father, Byrd converted to the Church of Jesus Christ of Latter-day Saints and was very active in the debate within the church on issues involving homosexuality.
Sexual Identity Therapy (SIT) is a framework to "aid mental health practitioners in helping people arrive at a healthy and personally acceptable resolution of sexual identity and value conflicts." It was invented by Warren Throckmorton and Mark Yarhouse, professors at small conservative evangelical colleges. It has been endorsed by former American Psychological Association president Nick Cummings, psychiatrist Robert Spitzer, and the provost of Wheaton College, Stanton Jones. Sexual identity therapy puts the emphasis on how the client wants to live, identifies the core beliefs and helps the client live according to those beliefs. The creators state that their recommendations "are not sexual reorientation therapy protocols in disguise," but that they "help clients pursue lives they value." They say clients "have high levels of satisfaction with this approach". It is presented as an alternative to both sexual orientation change efforts and gay affirmative psychotherapy.
Sexual fluidity is one or more changes in sexuality or sexual identity. Sexual orientation is stable for the vast majority of people, but some research indicates that some people may experience change in their sexual orientation, and this is slightly more likely for women than for men. There is no scientific evidence that sexual orientation can be changed through psychotherapy. Sexual identity can change throughout an individual's life, and does not have to align with biological sex, sexual behavior, or actual sexual orientation.
Homosexuality was classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) beginning with the first edition, published in 1952 by the American Psychiatric Association (APA). This classification was challenged by gay rights activists during the gay liberation following the 1969 Stonewall riots, and in December 1973, the APA board of trustees voted to declassify homosexuality as a mental disorder. In 1974, the DSM was updated and homosexuality was replaced with a new diagnostic code for individuals distressed by their homosexuality, termed ego-dystonic sexual orientation. Distress over one's sexual orientation remained in the manual, under different names, until the DSM-5 in 2013.
Ferguson v. JONAH, New Jersey Superior Court No. L-5473-12 is a landmark LGBT civil rights case in which a New Jersey jury unanimously determined that conversion therapy, also called "reparative therapy," "reorientation therapy," or "ex-gay therapy" constituted consumer fraud.
Because of its ban against same-sex sexual activity and same-sex marriage the Church of Jesus Christ of Latter-day Saints has a long history of teaching that its adherents who are attracted to the same sex can and should attempt to alter their feelings through righteous striving and sexual orientation change efforts. Reparative therapy is the pseudoscientific practice of attempting to change an individual's sexual orientation from homosexual or bisexual to heterosexual, or their gender identity from transgender to cisgender using psychological, physical, or spiritual interventions. There is no reliable evidence that such practices can alter sexual orientation or gender identity, and many medical institutions warn that conversion therapy is ineffective and potentially harmful.
Many health organizations around the world have denounced and criticized sexual orientation and gender identity change efforts. National health organizations in the United States have announced that there has been no scientific demonstration of conversion therapy's efficacy in the last forty years. They find that conversion therapy is ineffective, risky and can be harmful. Anecdotal claims of cures are counterbalanced by assertions of harm, and the American Psychiatric Association, for example, cautions ethical practitioners under the Hippocratic oath to do no harm and to refrain from attempts at conversion therapy.
The history of conversion therapy can be divided broadly into three periods: an early Freudian period; a period of mainstream approval of conversion therapy, when the mental health establishment became the "primary superintendent" of sexuality; and a post-Stonewall period where the mainstream medical profession disavowed conversion therapy.
The harm such therapies can cause to individuals, the contribution they make to the misrepresentation of homosexuality as a mental disorder, and the prejudice and discrimination that can flourish through the use of such therapies has led all major medical organisations to oppose the use of sexual orientation change efforts.
Recommendations
* The RANZCP does not support the use of sexual orientation change efforts of any kind
* Mental health workers must avoid misrepresenting the efficacy of sexual orientation change efforts when providing assistance to people distressed by their own or others' sexual orientation
* Mental health workers should assist people distressed by their sexual orientation by care and treatment approaches that involve acceptance, support, and identity exploration. These should aim to reduce the stigma associated with homosexuality and respect the person's religious beliefs.
[S]exual orientation change efforts, or often non-consensual therapies intended to change the sexual orientation of a person, are now broadly understood to be harmful and unethical
