Lesbian, gay and bisexual (LGB) people are a lucrative ‘cash cow’ for many therapists as we have higher rates of mental health distress than the general population and present more frequently for mental health support. But I’m concerned less with the actions of a relatively small number of well-funded cranks trading on the fears and concerns of religiously conflicted conservative Judeo-Christians; what concerns me much more is that, when British mainstream therapists were asked if they had tried to help ‘confused’ or conflicted lesbians and gay men reduce their same-sex attraction, one in six said they had agreed to such contracts and four per cent had attempted to ‘cure’ homosexuality.¹

The therapists in this study were not acting from a belief that homosexuality is a sin but from a mixture of ignorance and ideas about freedom of choice and client autonomy. They have been severely let down by their training organisations, who pay scant attention to human sexuality, let alone to equipping practitioners to know how to respond ethically to clients who are deeply upset or confused about their sexual desires and feelings.

Reparative (or conversion) therapy (RT) is a multi-million dollar industry. Britain is increasingly seeing ‘missionary’ work here with some of the leading RT proponents from the US coming over to market the technique and train Christian ‘counsellors’. However, the edifice of RT is crumbling. In April this year Dr Robert Spitzer, the psychiatrist who was instrumental in getting the American Psychiatric Association to remove homosexuality from the Diagnostic and Statistical Manual of mental disorders, offered an apology and retracted his controversial and deeply flawed study that is often erroneously cited as evidence that RT works.²

Earlier this year, the President of Exodus International (the largest ‘Ex-Gay’ organisation in the world) renounced their position on being able to ‘cure’ homosexuality, saying that the promise of heterosexual re-orientation is an unsustainable myth.* And at the end of August, California state senators voted by 22 to 12 to ban children being subjected to RT, on grounds that they are unable to give informed consent. Parents who opposed the ban argued that it infringed their individual civil rights to treat (and beat) their children if they so wished.

All this undoubtedly represents some hard-won progress by LGB activists and supporters. But I feel the attention we’re giving to RT is a diversion; therapists in Britain need to own their lack of knowledge about and discomfort with working with people whose sexuality is different to their own. They are deflecting their responsibilities to provide culturally sensitive and informed care onto so-called religious zealots so they can feel comfortable that they are not like them. In fact, as Bartlett’s study shows, many non-religious therapists are smugly unaware of their negative impact on LGB clients or that, because their attitude is covert and insidious, its effects are potentially more harmful and harder for the client to resist.

Few therapy courses actively include content on working with LGB people in the core curriculum. I would like to see BACP taking a proactive stance by ensuring all BACP accredited courses prepare their students to a level of competence where they know how to respond to explicit requests to change sexual orientation and why such attempts are likely to fail. I’d also like colleagues who are already qualified to inform themselves about how to work with requests to change sexual orientation, either through training or reading the new guidelines from the British Psychological Society.³

By agreeing to help a client reduce their same-sex attraction, you are complicit in affirming the client’s view that homosexuality is wrong and that gay people can’t be happy and healthy. When both of you fail to get the results your client wants, the resulting depression, low self-esteem and feelings of hopelessness about their ability to function in a society that is oriented towards heterosexuality could lead the client to suicide or self harm. Because harm surely does result from attempts to redirect sexual orientation, whether that is through RT or through the interventions of well-meaning but incompetent counsellors.

Dominic Davies is Founder and Director of Pink Therapy and a fellow of BACP. Visit www.pinktherapy.com

* There is a very moving and heartfelt YouTube video of three former Exodus International leaders issuing a public apology for the harm they may have done in the misguided belief that they could change sexual orientation. See http://youtu.be/aDiYeJ_bsQo

1. Bartlett A, Smith G, King M. The response of mental health professionals to clients seeking help to change or redirect sexual orientation. BMC Psychiatry 2009; 9 (11). www.biomedcentral.com/1471-244X/9/11
2. Spitzer RL. Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation. Archives of Sexual Behavior 2003; 32 (5): 403–417. www.stolaf.edu/people/huff/classes/Psych130S2012/LabDocuments/Spitzer.pdf
3. British Psychological Society. Guidelines and literature review for psychologists working therapeutically with sexual and gender minority clients. Leicester: BPS, 2012. www.bps.org.uk/sites/default/files/images/rep_92.pdf