Tuesday, 1 May 2012
Max Pemberton’s Telegraph article on ‘Gay cures’ is replete with unsupported assertions and misleading statements
Much of what he writes is quite sensible and he has won a number of journalistic awards.
His latest offering however, ‘There’s no such thing as a “gay cure”’, is a shoddy piece of polemic, replete with unsupported assertions and misleading statements, which does him no credit.
The article has already drawn strong criticism in online responses but I could not let it pass without comment myself.
Pemberton is openly gay and has already written against the ban on gay people donating blood in the UK, in support of gay adoption and about the impact of homophobic bullying. But on this occasion he makes a foray into the issue of therapies for unwanted same sex attraction.
His immediate target is the campaign by a Christian group called Anglican Mainstream to run an ad on the side of some London buses reading ‘Not gay! Post-gay, ex-gay and proud. Get over it!’ in response to a pro-gay rights campaign by the pressure group Stonewall.
The implication of Anglican Mainstream’s adverts was that some people can change their sexual orientation but their plan was blocked by the London mayor Boris Johnson after it had been signed off, approved and paid for.
Pemberton claims that the adverts are dangerous and motivated by prejudice, assertions I will return to later in another blog. But his primary objection to them is that they mislead people about the scientific facts.
Let’s allow him to explain it in his own words:
‘But amid all the furious debate about the adverts, one central fact was ignored. It’s not the prejudice I take issue with, but the quackery. The underlying suggestion was that it is possible to alter one’s sexual orientation. This moves the debate from the realms of theology and freedom of expression directly into the realm of psychology and scientific evidence. Here there is an extensive amount of empirical, objective research into the matter and it is refreshingly clear in this regard. Sexual orientation is an enduring, fundamental part of a person’s psychological make-up and is remarkably resistant to attempts to alter it. In fact, evidence suggests that attempts to change a person’s sexuality – or gay cure therapies” as they are sometimes known – are not just ineffective but dangerous.’
Pemberton gives no evidence whatsoever to support this view but simply makes an appeal to three authorities.
The Royal College of Psychiatrists, we are told, has said that ‘there is no sound scientific evidence that sexual orientation can be changed’ and that ‘so-called treatments of homosexuality create a setting in which prejudice and discrimination flourish’. The UK Council for Psychotherapy ‘utterly condemn(s) professionals who practise “reparative therapy” as sexuality is not a symptom which needs treating or correcting’. And the British Medical Association ‘condemns groups who claim they can change individuals’ sexual orientation’.
End of argument. Or is it?
Again Pemberton advances no evidence whatsoever to explain why these bodies have taken these views. Nor does he mention the fact that the dictum that sexual orientation is unchangeable is currently under attack from leading activists within the gay community itself.
Former Tory MP Matthew Parris and ‘Outrage’ leader Peter Tatchell are two striking examples recently highlighted on this blog who argue that sexual orientation is both changeable, and in some people at least, in part a matter of personal choice.
They are not alone in thinking this way.
The American Psychiatric Association (APA) has stated,‘some people believe that sexual orientation is innate and fixed; however, sexual orientation develops across a person's lifetime’. The APA also says that ‘for some the focus of sexual interest will shift at various points through the life span...’
A report from the Centre for Addiction and Mental Health similarly states, ‘For some people, sexual orientation is continuous and fixed throughout their lives. For others, sexual orientation may be fluid and change over time’.
Now if sexual orientation, in some at least, is changeable even without therapy, might it not be reasonable to assume that it could also be changed with therapy? And should not those who experience unwanted same sex attraction then have the right to explore whether they might receive professional help to see whether they might achieve a change in the strength and direction of their erotic feelings?
Surely this is not an unreasonable question to ask.
So is Pemberton justified in his bold assertions? And what does the evidence actually show?
Let me start by saying that I have some sympathy with Pemberton. I don't like the term 'gay cure' as it's a totally inappropriate term implying all or nothing, and also sickness.
Also, we need to recognise that there is significant potential for harm when inappropriately trained counsellors make unrealistic claims about what 'therapies' can achieve.
However, having conceded that, Pemberton has cherry-picked and misrepresented the evidence.
A recent CMF Publication, ‘Unwanted Same-Sex Attraction: Issues of pastoral and counselling support’, available on the CMF website, reviews the available evidence and is well worthy of study.
What do the authors conclude about so-called ‘therapies’ or ‘Sexual Orientation Change Efforts’ (SOCE)?
First they concede that there is currently no ‘high quality evidence’ in terms of randomised controlled trials (RCTs) to prove that these methods work. However they add that:
‘the generally accepted convention in evaluating under-researched and unproven counselling and psychotherapy approaches is that “absence of evidence is not evidence of absence”. In other words, the fact that there is no evidence of an effect is not evidence of no effect. .. We simply do not know whether they work or whether they do not work.’
However they do point to ‘lower quality evidence such as data from individual case studies (or outcomes in case series)’ and conclude:
‘The available data suggest that some individuals report benefit in the form of increased heterosexual interest and/or marked reduction in same-sex interest after participating in one of these approaches.’ (1,2)
So there is actually some evidence that SOCEs might work, just not high quality evidence. But neither is there high quality evidence to show that they don’t. So why does Pemberton not tell us that?
Then what about his claim that SOCEs cause harm? The authors argue that:
‘The current evidence about harm is mixed: some surveys(3) report significant numbers whereas in others the prevalence of harm is absent or negligible(2).’
However they add that:
‘no high quality RCT’s have been carried out in this area. Thus, assertions that SOCE cause harm rely upon anecdotal data, small case series and potentially biased surveys. In the absence of controlled experiments, we do not know whether, regardless of a particular therapy approach, these "harmful" experiences would have occurred anyway. More research is needed into the possible harmful side effects of different approaches.’
So there is low quality evidence pointing both ways and no RCTs have yet been carried out.
So in summary Pemberton argues that SOCEs don’t work because there is no high quality evidence to show that they do. He neglects to tell us however that this is because no RCTs have actually yet been carried out! He also neglects to tell us that there is there is some lower quality evidence to suggest that SOCEs might well help.
But then he argues that SOCEs cause harm when there is actually no high quality evidence to support this claim and the available low quality evidence points in both directions.
Well he can’t have it both ways. He cannot apply one evidence test in one instance (because it suits his private convictions) but neglect to use the same test when it doesn’t.
This is to employ a double standard and it is both misleading and dishonest.
Pemberton says that we should not ‘make claims that are not supported by science’. I agree.
But this is precisely what he has done. He has made a number of unsubstantiated statements which appear to be based more on ideology than evidence, and has appealed to authorities for support without putting forward the evidence or arguments which led them to these conclusions. He has then misrepresented the available evidence and applied a double standard in drawing conclusions.
This is at best lazy. But it is also misleading and possibly even deceitful.
As Pemberton himself warns, ‘Unlike questions of morality, in science, you can be proved wrong.’
1.Spitzer, R. ‘Can Some Gay Men and Lesbians Change Their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation’. Archives of Sexual Behavior 32, No. 5 (2003): 403-17.
2.Jones, Stanton L., and Mark A. Yarhouse. Ex-Gays?: A Longitudinal Study of Religiously Mediated Change in Sexual Orientation. Downers Grove, Ill.: IVP Academic, 2007.
3.Shidlo, A, and M Schroeder. ‘Changing Sexual Orientation: A Consumers’ Report’. Professional Psychology: Research and Practice 33 (2002): 249-59.