Efficacy and risk of sexual orientation change efforts: a retrospective analysis of 125 exposed men

Abstract

Background: Voluntary therapeutic interventions to reduce unwanted same-sex sexuality are collectively known as sexual orientation change efforts (SOCE). To date almost all evidence addressing the contested question whether SOCE is effective or safe has consisted of anecdotes or very small sample qualitative studies of persons who currently identify as sexual minority and thus by definition failed to change. We conducted this study to examine the efficacy and risk outcomes for a group of SOCE participants unbiased by current sexual orientation. Methods: We examined a convenience sample of 125 men who had undergone SOCE for homosexual-to-heterosexual change in sexual attraction, identity and behavior, and for positive and negative changes in psychosocial problem domains (depression, suicidality, self-harm, self-esteem, social function, and alcohol or substance abuse). Mean change was assessed by parametric (t-test) and nonparametric (Wilcoxon sign rank test) significance tests. Results: Exposure to SOCE was associated with significant declines in same-sex attraction (from 5.7 to 4.1 on the Kinsey scale, p <.000), identification (4.8 to 3.6, p < .000), and sexual activity (2.4 to 1.5 on a 4-point scale of frequency, p < .000). Over 42.7% of SOCE participants achieved at least partial remission of unwanted same-sex sexuality; full remission was achieved by 14% for sexual attraction and identification, and 26% for sexual behavior. Rates were higher among married men, but 4-10% of participants experienced increased same-sex orientation after SOCE. From 0.8% to 4.8% of participants reported marked or severe negative psychosocial change following SOCE, but 12.1% to 61.3% reported marked or severe positive psychosocial change. Net change was significantly positive for all problem domains. Conclusion: SOCE was perceived as an effective and safe therapeutic practice by this sample of participants. We close by offering a unifying understanding of discrepant findings within this literature and caution against broad generalizations of our results.

A Critical Review of The “2021 Apa [American Psychological Association] Resolution on Sexual Orientation Change Efforts.”

“…In Schumm's (2022) recent re-analysis of Sullins et al (2021), even when the SOCE participants increased in their same-sex sexual orientation, a majority rated the experience as favorable, which would seem to be unlikely if they had felt that the experience had been stigmatizing.…”

“…Far from increasing suicidality, recourse to SOCE generally reduced it. Furthermore, in Schumm's (2022) re-analysis of Sullins et al (2021), he found that even among those currently in or who had already been in SOCE with a current age of 18-25 years, the reported positives experienced in self-esteem, social functioning, suicidality, and depression in general outweighed any negatives. Observed correlations between SOCE experiences and mental health distress do not prove causation, least of all for SOCE conducted by well-trained professionals (Rosik, 2020).…”

“…Researchers can easily find reported "harms" from SOCE by advertising for those who might have been harmed and looking for study participants at sites likely to be populated with persons who are not very religious and who are currently and probably were before SOCE strong in an LGB identity, that is, persons much less likely to experience sexual orientation change from SOCE (e.g., Shidlo & Schroeder, 2002). As Sullins et al (2021) observed regarding the disparate findings in the SOCE literature, "we propose a plausible explanation to harmonize this literature: Researchers are studying very different subpopulations of sexual minorities, distinguished in large part by their different experiences of contemporary, speech-based forms of SOCE, which should not be generalized to all sexual minorities" [emphasis added] (Sullins et al, 2021, Harmonizing the SOCE Literature section, para. 1).…”

“…While some participants have reported regret, others have reported satisfaction (Stanus, 2013). Both rely on self-reports, but the APA only chooses to take sides with those who provided negative reports and ignore those who discover positive accounts (Sullins et al, 2021;Rosik et al, 2021).…”

“…Psychotherapies in general have risks of deterioration, from 5-24% (Rosik & Popper, 2014). When SOCE was voluntary, non-punitive, and involved highly religious participants or participants who were anticipating heterosexual marriage, results have been positive (Bondy, 2021;Jones & Yarhouse, 2011;Karten & Wade, 2010;Pela & Sutton, 2021;Rosik et al 2021;Schumm (2022);Spitzer, 2003;Stanus, 2013;Sullins et al, 2021;Sullins, 2022).…”