Friday, 1 February 2013
Professor Michael King applies double standard to evidence on homosexual change therapies
A bisexual man wants to marry his girlfriend but is worried that his residual feelings of erotic attraction to other men might jeopardise the relationship. Should he be able to seek professional help?
Currently in Britain the answer is ‘no’ but these questions were at the very heart of a fascinating debate that took place in the House of Commons this week under the title ‘Sexual reorientation therapy: Freedom to change?’
The event was subtitled ‘Should people be able to change their sexual orientation?’ and was billed as being ‘a debate about the legitimacy and freedom to offer sexual reorientation when many professional bodies are banning such therapies’.
‘Change therapy’ is psychotherapy or cognitive therapy aimed helping people who wish to change the strength or direction of their sexual desires. These therapies are more correctly termed SOCEs (sexual orientation change efforts).
When a person’s sexual desires and values don’t match up they might seek professional help either to help them overcome guilt so that they can participate freely in same sex behaviour (gay affirmative therapy) or alternatively to deal with feelings of same sex attraction so that they can abstain (change therapy). But only the first kind of therapy is currently approved by professional bodies. Is this fair and justified? We were about to find out.
Dr Michael Davidson of CORE Issues (who is about to undergo a disciplinary procedure for using change therapy) and Canadian psychiatrist Dr Joseph Berger (who uses it regularly) were supporting change therapy.
Psychiatrist Professor Michael King (who is its most vehement UK critic) and gay rights campaigner Peter Tatchell were against it.
Although members of the mainstream press were present the debate has so far been reported only by Christian Concern, Pink News and Gay Star News.
Tatchell and King essentially argued that homosexual orientation was biologically caused and fixed, that change was impossible and that change therapies were damaging and unethical.
I have already blogged about Peter Tatchell’s inconsistent views on the causes of homosexuality and now turn my attention to Michael King.
Michael King (pictured) is professor of psychiatry at University College London (UCL) and is head of the UCL mental health sciences unit which specialises in ‘psychiatric epidemiology, molecular genetics, health services research and randomised trials of complex treatments in primary and secondary health care’.
He also chairs the Royal College of Psychiatrists' Gay, Lesbian and Bisexual Special Interest Group which has advised the College on its Social Inclusion Report and its submission to the Church of England Listening Exercise on Human Sexuality. King was lead author of this latter submission. His website www.treatmentshomosexuality.org.uk was set up in 2008 as a discussion forum but appears to have attracted little interest.
King’s views have been extraordinarily influential and his submission to the Church of England is widely quoted.
The British Association for Counselling & Psychotherapy (BACP) makes reference to it in its September 2012 statement of ethical practice and, according to the Guardian, has written to its 30,000 members saying that it is unethical for them to attempt to ‘convert’ gay people to being heterosexual.
The UK Council for Psychotherapy (UKCP), representing training organisations and over 7,500 individual therapists, has welcomed the BACP’s stance and in fact issued a similar statement in 2011.
The Pan American Health Organisation (PAHO) - a regional branch of the WHO - released a similar statement in May 2012 claiming that ‘therapies’ to change sexual orientation ‘lack medical justification and represent a serious threat to the health and well-being of affected people’.
King’s argument at the debate went as follows:
He first asked if homosexuality was a condition that needed treatment and said that it had been removed from the Diagnostic Screening Manual of mental health conditions (DSM III) in 1973 ending ‘millennia of prejudice, stigma and oppression’.
He then said that we did not know the cause of homosexuality (contrary to Tatchell’s ‘new’ view) but that it ‘had nothing to do with a person’s relationship to their father’.
He added that there was no evidence, in terms of randomised controlled trials, showing that change therapies worked and that all published studies purporting to show their effectiveness fell below this ‘gold standard’.
He concluded, on the basis of his first three points, that the use of change therapies was unethical.
He then turned to the question of whether those offering change therapy should be free to practise, and argued that all the relevant professional organisations (RCPsych, BACP and UKCP) had issued warnings about change therapies and did not accept them.
Finally he asked whether patients should be free to seek change therapy and said that this question was being raised in the context of a homophobic culture. People who wanted to reduce same sex desire should be able to pursue this but ‘did not need to rush to psychotherapists to do it’.
So in summary he argued that change therapies were ineffective, harmful, unethical and should not be allowed.
I was unable to get a question in to King during the plenary (I had used my one allowed question on Tatchell earlier!) so I asked King afterwards if there were randomised controlled trials which showed that change therapies were harmful or that showed gay affirmative therapies were effective.
He said there were not, but that there were cases studies and series of cases showing this.
I reminded him that there were also cases studies and series of cases showing that some change therapies were helpful for some people. He did not deny this (see CMF’s publication ‘Unwanted same Sex Attraction').
I then asked if he was applying a double standard by approving ‘gay affirmative’ therapies on the basis of case studies alone but barring change therapies (for which there were also supportive case studies) on the different basis that there were no randomised controlled trials supporting them.
He seemed unable to answer this question.
I then asked him if he was being less than fully transparent in his presentation of the evidence and less than even-handed in suggesting that change therapies should be banned whilst gay affirmative therapies supported. Again there was no real answer.
I then said to King that I actually agreed with him that some ‘change therapies’ were harmful and that some ‘therapists’ were not properly trained but that I could not see why people, like those whose case histories I outlined above, should not in a free society have access to professional accredited therapists who were in sympathy with their values.
I still fail to understand why change therapists are free to practise in the US and Canada under the auspices of their professional bodies but not in the UK. It seems to be primarily because of the actions of people like King.
Oh and one other thing. I was interested to listen in on King’s heated exchange with another questioner after the debate. Here he was turning from science to theology.
He said he was a ‘Christian’ and had been in a monogamous gay partnership for 30 years. He added that ‘Jesus said nothing about homosexuality’ and asked why God would have any objection to permanent monogamous gay partnerships. He said that he went to a ‘wonderfully inclusive church’ in Bayswater which welcomed him and that evangelical Christians were obsessed with sex.
I wondered if King's passionately held convictions about Christianity and his own life-style choices had had any influence on his reading and presentation of the evidence and why he had not declared any of these personal interests in his scientific writings on therapies for unwanted same sex attraction.
I also wondered why he and others were so determined to drive anyone offering change therapy from the public square.
Later that day I attended a fascinating talk which went through King’s submission to the Church of England in some detail arguing that he had misinterpreted and misrepresented the scientific papers he had quoted. King had been personally invited to attend this presentation but had opted not to.
I will return to that paper in more detail later.