Ideology-driven legislative initiatives are underway to ban therapeutic choice—“conversion therapy” being the provocative, pejorative and ill-defined colloquial term used as a jamming tactic—in the U.S. and internationally for people with undesired same-sex attraction or levels thereof. Carolyn Pela and Philip Sutton have delivered a very welcome contribution in the form of a stringent study answering criticisms levied against what is more properly termed SAFE-T (sexual attraction fluidity exploration in therapy), SOCE (sexual orientation change efforts) or change-allowing therapy. The foundational requirement for such therapy—and for talk-therapy of any kind for any patient complaint—is a willing, motivated and self-directed client. Involuntary therapy is failed therapy, no matter the problem.

Pela and Sutton’s “Sexual Attraction Fluidity and Well-being in Men: A Therapeutic Outcome Study” appears in the Journal of Human Sexuality.[1] It is described thusly, “Using a quasi-experimental, single-group, longitudinal, repeated measures design, the study evaluates the fluidity of opposite-sex attraction experiences (OSAE), same-sex attraction experiences (SSAE), sexual attraction identity (SAI), and well-being in 75 male adult psychotherapy clients.” The authors provide details on scales, questionnaires, metrics and methods, but the gist is this: “A linear mixed model was used to analyze the SSAE, OSAE, and SAI data obtained at baseline, 6 months, 12 months, 18 months, and 24 months, with results showing statistically significant fluidity of all three factors.”

The study specifically used Reintegrative Therapy™ as their method, described as “a specific combination of evidence-based, mainstream treatment interventions for trauma and addiction. RT includes the use of EMDR and mindful self-compassion, emphasizing client autonomy and self-determination and is supportive of SAFE-T.”

Their participants tended to be: “18–35 years old (52%), Roman Catholic (57%), religious (75% attended church once or more per week), and White (83%).” Also, 92% of participants desired to explore sexual attraction fluidity and claimed motivation of “either religious reasons (30%) or a desire to pursue a traditional marriage (37%).”

Results were impressive: “SSAE decreased, OSAE increased, and SAI moved toward heterosexual identity.” Data also “revealed a clinically and statistically significant improvement in well-being.” “Overall, the results of this study document that exploring sexual attraction fluidity in therapy can be effective, beneficial, and not harmful.”

Pela and Sutton boldly, and rightly, asserted, “It is no longer true that there is no scientific evidence concerning whether SAFE-T is helpful or harmful.” Furthermore, “…continued warnings by the American Psychological Association and other mental health associations against clients using SAFE-T are misinformed, unprofessional, and even unethical in terms of meeting the legitimate self-determination needs of clients. Similarly, the past failure of American Psychological Association to instruct those engaged in anti-SAFE-T legislation advocacy that research does not document that SAFE-T is harmful, and that all mainstream psychotherapy has a risk of harm, is no longer acceptable.” Simply put, “The present study shows, through a more rigorous research design, that persons with unwanted same-sex attraction may reasonably expect to benefit from—and not to be harmed by—their participation in SAFE-T.”

On a related note, as I blogged earlier this year,[2] Paul Sullins (2021) “in the strongest representative sample to date of sexual minority persons” reanalyzed the data used in a study claiming SOCE to be a pro-suicidal adverse childhood experience. Sullins concluded that, “By violating the principle of temporal precedence in scientific inference, i.e., that a cause cannot occur after an effect, Blosnich et al. reversed the correct conclusion in these data. Experiencing SOCE therapy does not encourage higher suicidality, as they claim; rather, experiencing higher suicidality appears to encourage recourse to SOCE, which in turn strongly reduces suicidality, particularly initial suicide attempts. Restrictions on SOCE deprive sexual minorities of an important resource for reducing suicidality, putting them at substantially increased suicide risk.”[3]

On another directly related theme, the popularly misrepresented American Psychological Association’s (APA) Task Force’s 2009 report “Appropriate Therapeutic Responses to Sexual Orientation”[4] (an update is soon to be released) made some interesting claims. For example (p. 43), “We found that nonaversive and modern approaches to SOCE since 1978 have not been rigorously evaluated.” This is a clear admission that modern change-allowing therapy has been “nonaversive” for more than 40 years. No electric shocks, no ice baths, no shaming or so forth. (Left unsaid is the fact that modern change-allowing therapists premised that aversive methods are unethical and ineffective. Odd that they would be slandered as purveyors of harm.) Under “Efficacy and Safety,” the report states, “We found few scientifically rigorous studies that could be used to answer the questions regarding safety, efficacy, benefit, and harm.” It also asserts (p.28), “We thus concluded that there is little in the way of credible evidence that could clarify whether SOCE does or does not work in changing same-sex sexual attractions.” To clarify, they left the jury out on the question of efficacy and safety, which is a far throw from concluding failure, harm and quackery, as so many falsely pronounce.

But the APA Task Force report nonetheless made conclusions. Dr. Stanton Jones observed (2012), “they then had the chutzpah to warmly recommend gay affirming therapy while explicitly acknowledging that it lacked the very empirical validation required of SOCE.”^[5] Pela and Sutton (2021) similarly observed that the APA “critiques existing research as inadequate for providing clear, empirical support for sexual attraction fluidity exploration in therapy (SAFE-T), saying that the research includes “biased sampling techniques, inaccurate classification of subjects, assessments based solely upon self-reports, and poor or nonexistent outcome measures” (American Psychological Association, 2012, p. 14). Paradoxically, they use similar research to support their opposition to SAFE-T.”[6] Call the APA position chutzpah or paradox, it is scientifically unmerited and suggests ideological imperative.

This year an APA webinar on LGBTQ+ state legislative advocacy offered “suggested talking points” opposing therapy for unwanted same-sex attraction, which I addressed and rebutted in a prior blog.[7] For a more concise presentation of “Evidence Opposing Therapy Bans,” suitable to guide letters to legislators, click here.[8]

In 2013 I wrote, “The categorical (all-or-none) versus the continuum view of change are at war. The former, held by many SOCE critics, view any recurrence of same-sex attraction or arousal as both a disproof and invalidation of therapy. But change occurs along a spectrum, not as an all-or-none result, and this holds true for nearly any form of therapy.”^[9] The APA position presumes a simplistic “affirmation” versus “conversion” false dichotomy. The study by Pela and Sutton and that by Sullins provide solid evidence calling into question the APA position against SAFE-T/change-allowing therapy, as well as legislative efforts to ban therapeutic choice for undesired or over-powered same-sex attraction. The tables are turning.

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[1] Pela, C., & Sutton, P. (2021). Sexual Attraction Fluidity and Well-being in Men: A Therapeutic Outcome Study. Journal of Human Sexuality, Vol. 12.

[2] “SOCE Reduces Suicidality in a New Study,” CMDA The Point, June 24, 2021. https://cmda.org/soce-reduces-suicidality-in-a-new-study/

[3] Paul Sullins, SEXUAL ORIENTATION CHANGE EFFORTS (SOCE) REDUCE SUICIDE: CORRECTING A FALSE RESEARCH NARRATIVE, Pre-print researchgate.net, March 2021,https://www.researchgate.net/publication/350124048_SEXUAL_ORIENTATION_CHANGE_EFFORTS_SOCE_REDUCE_SUICIDE_CORRECTING_A_FALSE_RESEARCH_NARRATIVE?enrichId=rgreq-610bacc159836fbb103f4eefce465664-XXX&enrichSource=Y292ZXJQYWdlOzM1MDEyNDA0ODtBUzoxMDAyNDI4NDcyMjMzOTg2QDE2MTYwMDg5ODA0NDc%3D&el=1_x_2&_esc=publicationCoverPdf

[4] American Psychological Association, Task Force on Appropriate Therapeutic Responses to Sexual Orientation. (2009). Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation. Retrieved from http://www. apa.org/pi/lgbc/publications/therapeutic-resp.html

^[5] S. Jones, “Same-Sex Science: The social sciences cannot settle the moral status of homosexuality,” First Things, Feb. 2012.

[6] Pela, C., & Sutton, P. (2021). Sexual Attraction Fluidity and Well-being in Men: A Therapeutic Outcome Study. Journal of Human Sexuality, Vol. 12.

[7] “Therapy Bans, APA Talking Points, and Counseling Choice,” CMDA The Point, Feb. 25, 20121. https://cmda.org/therapy-bans-apa-talking-points-and-counseling-choice/

[8] Andre Van Mol, “Evidence Opposing Therapy Bans,” CMDA The Point, August 26, 2021. https://cmda.org/evidence-opposing-therapy-bans/

^[9] NARTH Statement on Sexual Orientation Change. January 25, 2012.