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An analysis of Dr. Spitzer's 2001 study into
whether adults can change their sexual orientation

Definitions and background

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Three critical terms and their definitions:

It is of paramount important to understand the precise meaning of terms related to therapy aimed at "changing" homosexuals. Different individuals and groups define terms in very different ways:

  • "Sexual orientation:" This describes an adult's or older adolescent's feelings of sexual attraction. It describes what a person is, not what they do sexually. Almost all therapists and human sexuality researchers accept that there are three sexual orientations:
    • Heterosexual -- a person is attracted only to members of the opposite gender.
    • Bisexual -- a person attracted to both men and women, although not necessarily to the same degree.
    • Homosexual -- a person attracted only to members of the same gender.

    However, a few disagree:
    • A minority suggests that asexuality -- a lack of feelings of sexual attraction -- should be considered a fourth sexual orientation.
    • Some therapists and researchers, including Dr. Spitzer, do not recognize bisexuality as an orientation.
    • A small number of socially and religiously conservative organizations follow the lead of Concerned Women for America and the Traditional Values Coalition. They have added to the list of three sexual orientation about 30 paraphilias (strong sexual urges or behaviors, sometimes criminal in nature) such as pedophilia, bestiality, sadism, exhibitionism, necrophilia, etc. Some commentators have suggested that this very unusual definition is a political maneuver to defeat hate-crimes and anti-discrimination legislation. If the definition of sexual orientation is expanded to include about 33 sexual orientations, then legislation intended to reduce gay bashing would also be seen to protect pedophiles.

    The National Association for Research & Therapy of Homosexuality (NARTH), a professional therapy group with a very small membership, and most religiously conservative denominations and para-church groups believe that homosexual orientation is a choice and can be changed with some effort. All other professional groups recognize that for an adult to change one's sexual orientation is extremely rare or even non-existent.

  • "Sexual behavior:" This describes what a person actually does sexually. There is general agreement that, with some effort, a person can be motivated to change their sexual behavior. For example:
    • A person can decide to become celibate and remain sexually inactive.
    • A bisexual can decide to pursue sexual relationships with only persons of one gender.

    A change in sexual behavior may occur even as their sexual orientation remains the same. For example, in the biblical passage at 1 Corinthians 6, Paul describes a pagan orgy in which a group of persons with a heterosexual orientation apparently engaged in sexual behavior with members of the same sex for a short time. They had a heterosexual orientation before the orgy and presumably had a heterosexual orientation after the orgy. But during the orgy they behaved like sexually active bisexuals.

  • "Homosexual:"
    • Some religious and social conservatives define "homosexual" and "homosexuality" in terms of behavior, not feelings of sexual attraction. Thus:
      • A person with a homosexual orientation who has decided to become celibate would be considered an ex-gay who has become heterosexual.
      • A person with a bisexual orientation who has decided to pursue relationships only with persons of the opposite gender would also be considered an ex-gay who has become a heterosexual.

      This appears to be the sources of "ex-gay" claims during reparative therapy and by transformation ministries.

    • Essentially all other groups define "homosexual" and "homosexuality" in terms of a person's sexual orientation, and consider that this is rarely changeable, if ever.

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Professional organizations and conversion therapy:

Various professional organizations, including the American Academy of Pediatrics, American Psychiatric Association, American Psychological Association, and the National Association of Social Workers have stated that an adult's sexual orientation cannot be changed by reparative therapy. 1,2

As noted above, a very small group disagrees: National Association for Research and Therapy of Homosexuality (NARTH). It was founded in 1992 as a "non-profit, educational organization dedicated to the research, therapy and prevention of homosexuality." It currently consists of "more than 1,000 mental-health professionals." -- fewer than 1% of the number of therapists who belong to either of the APA's. 3,4 NARTH strongly advocates the use of reparative therapy, believing it to be very effective and safe. They, alone among processional associations, regard homosexual behavior as a treatable mental disorder.

The American Academy of Pediatrics, American Counseling Association, American Association of School Administrators, American Federation of Teachers, American Psychological Association, American School Health Association, Interfaith Alliance Foundation, National Association of School Psychologists, National Association of Social Workers, and National Education Association formed the "Just the Facts Coalition." In 1999, they developed and endorsed "Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel." It includes a number of quotations from major professional organizations expressing concern about reparative therapy and other methods of attempting to change an individual's sexual orientation. One example is the American Academy of Pediatrics, which stated:

"Therapy directed specifically at changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation." 5

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Background of Dr. Spitzer's study:

Dr. Robert Spitzer is a Professor of Psychiatry at Columbia University. During his three decades of psychiatric research, he has specialized in the topic of human sexual orientation. In 1973, he was one of the members of the American Psychiatric Association (APA) who was instrumental in removing homosexuality from their list of mental illnesses. The APA was the first major mental-health agency to do so. Others followed rapidly.

For their annual conference in 2000-MAY, the American Psychiatric Association had scheduled a panel discussion to debate whether there is any hard evidence that an adult's sexual orientation can be altered through reparative therapy.  Dr. Robert Spitzer was scheduled to be the moderator. Two psychiatrists withdrew from the panel, stating that the topic is too politically charged to permit a scientific discussion. The debate was then cancelled. According to the APA:

"The doctors who were to debate on the topic decided there was not enough scientific information to have a proper debate. They felt that any debate would turn into a political debate and not a true scientific debate. While there is information on reorientation therapy, there have been no controlled research studies." 6

Dr. Spitzer said:

"I think we ought to be able to talk about anything in a dispassionate way."  Referring to the speakers who dropped out, he said, "I think they felt that to even debate it was to legitimize the topic and they felt that since the groups that they regard as their enemy were kind of salivating over having the debate, they didn't want it."

Exodus International, a Fundamentalist Christian group who tries to help gays and lesbians change their sexual behavior, protested the cancellation. Their national board chairman, John Paulk of Colorado Springs, CO, said: "I'm here as one representative for a virtually unseen but sizable population. I once lived as a gay man, but now I'm heterosexual, something the American Psychiatric Association says does not exist." 7 It is notable that he did not say that he was once gay; he said that he "lived as a gay man." We have a hunch that he has had a bisexual orientation during all of his adult life, engaging first in homosexual behavior, and more recently in heterosexual behavior. [Palk may not actually be an ex-gay; he was spotted in "Mr. P's," a gay bar in Washington DC some months later.] 8

At the time of the proposed debate, Dr. Spitzer suspected that an adult's sexual orientation is fixed. He said: "There is no documentary evidence showing someone's sexual preference can be changed by therapy. "

Author's note: The term "sexual preference" is normally only meaningful when used to refer to persons with a bisexual orientation -- adults who are attracted to both men and women. Bisexuals are often attracted to one gender more that the other. They can thus be described as having a gender "preference" in their relationships. The vast majority of adults have either a heterosexual or homosexual orientation. They are attracted to only one gender, and thus cannot accurately be said to have a "preference."  Dr. Spitzer appears to have used the term here in place of the more generally used term "sexual orientation." 

He continued:

"There is only anecdotal evidence, mostly from the therapists themselves, claiming that what they do works. That's not very scientific. On the other hand, there's no scientific evidence to show that this is impossible...It hasn't been studied."

Before the scheduled debate, Dr. Spitzer had decided to conduct a study of "ex-gays" and "ex-lesbians,"  These are individuals who:

bulletHad once identified themselves as homosexuals.
bulletHad attempted to change their sexual orientation by:
bulleteither engaging in reparative therapy with a therapist, or
bulletthrough spiritual counseling from a conservative Christian transformational ministry.
bulletNow consider themselves to be heterosexual.

All or almost all of the people referred to Dr. Spitzer's study are evangelical Christians.


The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. "Answers to your questions about sexual orientation and homosexuality," American Psychological Association, at: 
  2. Doug Nave, "Organizations of US Mental Health Professionals are unanimous," at:
  3. The National Association for Research and Therapy of Homosexuality (NARTH) has a home page at:
  4. As of 2001-JAN, NARTH can be reached at: 16633 Ventura Boulevard, Suite 1340, Encino, CA 91436-1801. Phone: (818) 789-4440. Fax: (805) 373-5084
  5. "Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel," at:
  6. APA response copied from a reader's Email
  7. Psychiatrists cancel gay debate," Associated Press, 2000-MAY-18, at:
  8. Joel Lawson, "Ex-gay leader confronted in gay bar," Southern Voice, 2000-SEP-21, at:

Copyright © 2002 to 2010 by Ontario Consultants on Religious Tolerance
Originally written: 2002-FEB-16
Latest update and review: 2010-JUN-09
Author: B.A. Robinson

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