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). Currently almost all evidence addressing the contested question whether SOCE is effective or safe consists 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). From 45% to 69% 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.

Sexual orientation change efforts: Health associations, sexual identity labeling, and reports of change by engagement status.

“…If these participants are considered to have perceived some degree of increase in other-sex sexual attraction during SOCE and we subtract 14 participants who endorsed both categories so as to only count them once, then a maximum 21% (159/757) of participants who ended SOCE may have experienced such change. Hence, the range for sufficient development of other-sex sexual attraction during SOCE would be approximately 11% to 21%, with the low-end figure roughly equivalent to some studies on change (e.g., S. L. Jones & Yarhouse, 2011) and the high-end statistic comparable to other studies (e.g., Sullins et al, 2021). If participants still pursuing SOCE who reported developing enough other-sex sexual attractions to make other-sex sexual activity enjoyable are combined with those who reported this among the Ended SOCE participants, then, as noted earlier, 16% (173/1083) of our participants indicated such change.…”

“…Hence, the range for sufficient development of other-sex sexual attraction during SOCE would be approximately 11% to 21%, with the low-end figure roughly equivalent to some studies on change (e.g., S. L. Jones & Yarhouse, 2011) and the high-end statistic comparable to other studies (e.g., Sullins et al, 2021). If participants still pursuing SOCE who reported developing enough other-sex sexual attractions to make other-sex sexual activity enjoyable are combined with those who reported this among the Ended SOCE participants, then, as noted earlier, 16% (173/1083) of our participants indicated such change.…”

Difficulties With Methodology in Social Science Research With Controversial Issues Regarding Human Sexuality

“…The study had a number of commendable aspects, but it also featured room for improvement. First, there was considerable opportunity to create multi-item measurement scales from many of the study’s questions, but results for some of those possible scales were not reported in Sullins, Rosik, and Santero (2021). Second, those providing SOCE need, if possible, help in understanding how pre-existing conditions for their clients may influence SOCE outcomes with respect to apparent sexual orientation changes as well as their evaluation of SOCE helpfulness.…”

“…Such answers were missing. Another important question unanswered by Sullins, Rosik, and Santero (2021) is whether men for whom SOCE led to stronger levels of homosexuality will report more or less satisfaction with their SOCE experience. Would men who became more homosexually oriented over time reject their SOCE experience and/or report high levels of dissatisfaction?…”

“…Did congruence between sexual orientation attraction and identity before SOCE predict SOCE outcomes? These types of questions remained unanswered from the results presented in Sullins, Rosik, and Santero (2021), but some of these questions have been the focus of a recent report (Schumm, 2022).…”