British Medical Journal: Reparative Therapies are “Pseudoscientific,” “Unethical.”

The tagline accompanying this April 2004 editorial in the British Medical Journal reads, “An ‘old’ problem with relevance today.” The “old” problem is the stigmatization of homosexuality by social custom and religious belief. The author, Marshall Forstein of the Harvard Medical School, offers one of the most eloquent, concise, and authoritative histories of research into homosexuality that I have read. It is well worth a read, and if you are gay, lesbian, bisexual, or transgendered, it is guaranteed to pick you up after the big let-down from the California Supreme Court on May 26 (re: Proposition 8).

Having recently had the Roman Catholic catechism quoted to me (“Homosexuality is objectively disordered”), the following passage from the BMJ editorial was especially meaningful:

In spite of every mental health and medical association in the U.S. stating unequivocally that there is no scientific evidence that homosexuality is a disorder, many religious organizations continue to declare homosexuality or homosexual behavior as sinful and immoral. This creates spiritual crises for many people who have grown up within anti-homosexual religious families and communities.

Meanwhile, the suicide rate among same-sex-oriented teens in the U.S. continues to be more than three times that of heterosexual teens. There is a clear and well-established connection between these suicides and the extremely toxic religious teachings about homosexuality that abound in our culture.

It is time for religious institutions to align their teachings with the overwhelming scientific consensus about homosexuality. Reparative therapies are not just pseudoscientific but unethical because of the potential dangers they pose, and religionists who support such therapies should be continually confronted with the ethical implications of their stance. The positive alternative to such therapies is gay-affirmative therapy, which helps sexual minorities accept their orientation as a variant of normal human behavior.


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15 Responses to “British Medical Journal: Reparative Therapies are “Pseudoscientific,” “Unethical.””

  1. Sophia Marsden Says:

    What if homosexual behavior really is sinful though? Whether the desire can be prevented or not.

  2. thebentangle Says:

    Sophia, I don’t personally believe in the concept of “sin,” and I don’t even believe that such a concept is necessary for a moral and ethical life. When I consider whether a behavior is moral, I ask myself, first of all, what the effects of that behavior are. If I cannot identify any ill effects (for myself or others), then I conclude that the behavior is okay. Homosexual relations between consenting adults have no ill effects unless they include other behaviors that are harmful.

    The danger in the “sinful” characterization is that it can be attached to behaviors simply on the basis of arbitrary religious teachings, while scientific research is ignored. Those who tell you that homosexual behavior is “sinful” will probably not tell you that eating shellfish is sinful or that wearing clothing of mixed fabric is sinful, or that speaking in church is sinful for women.

    Whenever someone declares something to be sinful, you have a right to challenge that person. Ask, “What is your basis for declaring it sinful?” If he or she quotes scripture to you, then ask, “But what about all the other things that the Bible says are sinful? Why are we unconcerned about those things?”

    Please feel free to comment again if you have any further thoughts about this.

  3. Sophia Marsden Says:

    But what if you are wrong, sin does exist, and there are behaviors that are objectively sinful and consequentialism is not the truth of morality?
    What if they say that “the fathers of the Church only ever speak about it in terms of it being a sin and aberration”?

    And… maybe women shouldn’t teach in church?

  4. thebentangle Says:

    Your questions suggest that you are making Pascal’s wager. The 17th century mathematician Blaise Pascal said that you’d better believe in God, because if you are right you will have eternal bliss, and if you are wrong, it won’t matter anyway. But if you don’t believe in God and you turn out to be wrong, then you’re damned for eternity.

    This is what I would call a “hook.” The “wager” hook is used by practitioners of particular religions to gain and hold adherents. The problem with this wager is that it is only one of a practically unlimited set of wagers that you might be asked to make by people professing hundreds of different beliefs about God and eternity. What if a Muslim were to pose this same question to you and suggest that it is in your interest to follow Islam? If you must decide between the Christian path to salvation and the Muslim one, the “wager” won’t help you much, because you could be damned for eternity if you place your bets on the wrong path to salvation.

    In any case, bet-hedging is rather cowardly, and, if there is a God, we might reasonably suppose that he has little respect for it.

    But all this talk about wagers is based on a very big assumption, and that is that belief is volitional, a matter of choice. I realized very early in my own life–around age 18–that belief was not something I could just “will” into being, or turn on and off like a spigot. But even more important was that I refused to be intimidated by the preachers’ talk of Hell. I knew even then that it was the ultimate threat and the ultimate bullying tactic, and I wasn’t buying it.

    If you are influenced by church fathers to the extent that you allow them to tell you what is right and what is wrong, then I can only hope that you will begin the long and difficult journey toward healthy skepticism. My own journey, which began nearly five decades ago, was never easy, but I have never regretted it.

  5. Sophia Marsden Says:

    Well… I do believe in God. Not just any God but a specific God.
    So for me it is not about bet hedging. I don’t think its my place to tell society what to do, society is predominantly non-Christian and in the end Christians are going to need to get used to the fact they are a minority and their values have not been hegemonic for decades now. That said, I think Christians should be able to try and live their lives the way they feel they ought, and if that means feeling guilty about …for the sake of argument, homosexual fantasies… well then, that’s what it means. We think there is such a thing as objective morality, a morality that includes ritual, idiomatic and iconic truths rather than just being a matter of obvious consequences. It’s a very different culture and worldview, and it is not based on the same methodology at all, but I think it has a right to exist within itself and to self-moderation.

  6. thebentangle Says:

    Well put, Sophia. I wish all Christians would adopt your very sensible approach. You seem genuinely respectful of other viewpoints, and, from what you have written, I cannot imagine you using your religion as a bludgeon against homosexuals who live their lives in self-affirmation and pride.

    Though I am an atheist, I am not a militant one, and I will not challenge anyone’s personal religious views without good reason. I can think of only two circumstances that prompt me to freely share my own skepticism about religion. The first is an open invitation to a frank discussion. The second is injustice perpetrated in the name of religion.

    Here is a quotation that I like. It is from “In the Name of Identity: Violence and the Need to Belong,” by Amin Maalouf.

    Traditions deserve to be respected only insofar as they are respectable—that is, exactly insofar as they themselves respect the fundamental rights of men and women.

    At present, many Christian churches are wantonly disseminating misinformation about homosexuality. That misinformation is causing a huge amount of suffering among gay and lesbian youth, whose suicide rate is much higher than that of heterosexual youth. When the Roman Catholic Church tells its youth that homosexuality is “objectively disordered,” they are creating a problem that has both sociological and psychological dimensions. First, they provide fodder for the bullies. Second, they instill self-loathing in the gay and lesbian youth.

    That this is happening in the way that I have described is simply beyond dispute. I have a short list of 15 medical journals that confirm and deplore this pattern.

    Dissemination of false information about homosexuality is simply unethical, and we must look honestly at its consequences. If we belong to churches that spread such information, then I believe we have a moral obligation to challenge them about it.

    It is not so easy to pull up the drawbridge and say, “Let secular society do as it pleases, and we will just retreat into our private beliefs.” I believe your impulse is noble, but the fact remains that certain Christian teachings have harmful—even disastrous—effects.

    Consider a hypothetical situation in which you have a child who self-identifies as gay. As a Christian mother who accepts your church’s teaching about homosexuality, you will have a very difficult decision to make. With your child’s best interests at heart, will you make that decision on the basis of sound science? Or will you bow to the official doctrine of your church? Your decision could change the entire course of your child’s life for better or for worse.

    Here is my short list of medical journals that have published studies on reparative therapies and on suicide rates among gay and lesbian youth:

    American Journal of Public Health
    Journal of Health Psychology
    BMJ (British Medical Journal)
    American Behavioral Scientist
    Clinical Child Psychology and Psychiatry
    Health Education Research
    Archives of Pediatrics & Adolescent Medicine
    Archives of General Psychiatry
    Transcultural Psychiatry
    Journal of Adolescent Research
    Canadian Journal of School Psychology
    New England Journal of Medicine
    Journal of Adolescent Research
    Pediatrics: Official Journal of the American Academy of Pediatrics (Web site:

  7. Sophia Marsden Says:

    If I ever have children and they turn out to be gay, I don’t think it should kill them to exercise self control and not have sex. Plenty of people over the ages have gone through life without having sex, and if they did have sex they could come to repentance. I will support them as best I can in their struggle but I would no more approve of it than I would approve of extramarital sex, idle speech or overeating.

    The thing is, a Christian life is not about minimising suffering, its not about having a particular lifestyle (birth, coming of age, marriage, family, death), it’s not even about being a good person. It is about reaching a state of profound humility in which ones total and utter dependence upon God is made manifest so completely that one literally becomes united with Him in surrender. All superficially unpleasant and negative life experiences can be very useful in bringing about that initial state of humility. Every loss is a gain. It is the broken and contrite heart that God will not scorn. It is the poor who are blessed and the rich who go away empty.

    Of course I would not want my child to despair, I struggle a lot with despair myself, it is very easy. But the answer to despair is not to scorn humility but to realise that God is in control, and loves more profoundly than is humanly conceivable, and who’s mercy is greater than any knowable value.

  8. thebentangle Says:

    In my humble opinion, the scenario that you described in your first paragraph would be a recipe for disaster in this day and age. First of all, it assumes a relation of near “ownership” of your child throughout the child’s life. Children simply do not accept such relations these days, and I believe you might drive a huge wedge between yourself and your child with such an assumption about your own exalted place in his or her life.

    I speak from experience. I am now 65 years old, and my mother is 90. I can easily imagine her saying, 66 years ago, the very same thing you’ve just said. I am currently half-way through writing a memoir about our relationship–a relationship that has come to grief time and time again over the issue of my sexuality and her presumption of a right to control it. Please, for the sake of any future child you may have, don’t go down the path that my mother took.

    Your child is a separate and distinct individual with certain inherent rights to self-expression and the pursuit of happiness. A mother who expects her son to remain celibate throughout his life is making an outrageous demand on him. A boy who accedes to such demands from his mother will remain in a state of dependency and infantilism. Is that what you want?

    To have had a child, you will have had sex. But you want to tell your child that he mustn’t have sex during his entire life?

    Indeed, the Christian life may not be about minimizing one’s own personal suffering in this life, but surely a Christian will want to minimize the suffering of others. If you bring a child into the world only to tell him that you expect him to accept any suffering that is prescribed by your faith, then you’d better be certain that his faith and yours are perfectly in synch. Otherwise, you can only be asking for trouble with a capital “T.”

    Your relationship with God is, of course, your business. But having a child opens up a whole new dimension of responsibility. As the father of a 21-year-old boy (now in college), I can only say, “Listen to your pediatrician, and please, please inform yourself about child psychology and development.”

  9. Sophia Marsden Says:

    If I were to have a child I would be responsible for him. That is exactly the problem. I would not expect to be able to control his behavior though. I would make my views known, but of course I cannot prevent him doing whatever he decides to do in the end.

    I hope that if I have children I will have an opportunity to bring them up away from mainstream western culture to be honest. Although I am not sure where I might go. But, at least in this stage of my life, I think it unlikely I will ever marry or have children (unfortunately I have had sex which I regret immensely, but I think I can avoid doing it again, it wasn’t particularly fun :p – certainly not worth the ensuing tears) to be honest so this is probably a non-issue for either of us.

    As for suffering of self and others. I think we as Christians are to want the highest good for others, that is union with God, even if it has to be at the expense of their suffering. At the same time its something that has to be freely sought, we are wrongheaded if we try and force it. Still, it seems the ultimate responsibility to try and raise a child to be steadfast in the faith, the most important thing a parent can do. Although I suppose in the end it is God who converts the heart and not parents.

  10. thebentangle Says:

    Getting away from mainstream Western culture without moving to the Middle East or one of the Asian countries might be a challenge. You may be thinking more along the lines of an enclave, however, rather than a separate country.

    I was struck by what you said in your third paragraph about the suffering of others. If I may paraphrase, you seem to be saying that Christians should want the highest good for others even when those others must suffer to achieve that highest good. But, you add, this suffering should be freely accepted, not imposed. I can certainly think of more than one scenario in which this principle might hold. If my brother is alcoholic, for example, I would naturally encourage him to take measures to end the addiction, even though I knew the cure would be painful. However, unless he was physically or emotionally harming someone else through his alcoholism, I would not seek to coerce him.

    This principle begins to break down, however, when it is applied to a behavior that is not harmful to anyone. Let’s assume that I am a heterosexual whose faith is orthodox Catholicism. If my brother is gay and living in a committed and loving relationship with another man, then my “concern” for him may become a serious irritant in our relationship. This is sad and unnecessary, but everyone has a right to their views.

    But what if we take this a step further? What if my brother lives in a town or a neighborhood where gays are not tolerated, where they are denied employment and housing and they are routinely attacked and beaten by thugs? What, then, is my stance as a devout heterosexual Catholic? Should I denounce those who discriminate against my brother or even injure him? Or should I assume that it is God’s will for my brother to suffer in such a way and that he will only be the better for it?

    This whole conundrum becomes even more interesting when we consider the religious roots of the violent and discriminatory behaviors directed against my brother. The connection between religious teaching and homophobic acting-out is well-established, and conservative religions are strangely silent about this point.

    The question is: How much discrimination or even thuggery against gay people should a Christian tolerate in the name of the victims’ own highest good? At what point is it a Christian’s duty to speak out for the victim?

  11. Sophia Marsden Says:

    Well, one should never condone anyone being horrible to others. If people are being thugs, you should disapprove of that as much and as openly as you would of any other bad behavior.

    Middle East or Asia? Haha, I had thought Africa was my best bet, although it largely depends where in Africa (or Asia were I to go there). Diverse continents.

    As a Christian I believe all sin is harmful, likewise, I do not think the “none of my business” approach to someone’s alcoholism, even when it harms no-one but themselves is right. In that sense I think individualism has gone to far. I might not intervene if I thought intervention was futile, but the fact that someone doesn’t harm anyone but themselves is no reason to ignore or condone their activity. Our society has made an idol of the atomised individual and of individual choice. I don’t really buy into that, we are a social and an interdependent species.

  12. thebentangle Says:

    The alcoholic who is quietly and harmlessly drinking himself into an early grave needs our compassionate encouragement to seek help. Coercive intervention is probably not possible except in extreme cases—e.g., when the pancreas has begun to fail. Nor should it necessarily be. The state, which is the only entity that could conduct a coercive intervention, will not engage in that level of policing because the public simply does not want it. People want the freedom to overeat, to smoke, to self-medicate with alcohol, and to engage in high-risk sports activities.

    One of the problems with coercive state interventions is that we all have our little vices and addictions. It has recently been observed that teenagers are becoming “addicted” to video games, text messaging, and the like. All the signs of addiction are there—inability to study, to work, and to relate to other people in a meaningful way. Two weeks ago, I listened to a psychologist describing college students who had come to her for treatment. They were failing all their courses because they could not put away the video games.

    One of my purposes in creating this blogsite is to dispel the notion that there is anything inherently problematic about homosexuality. Homosexuality is not like alcoholism or video-game addiction, and it is not like over-eating or smoking. It is simply a variant of normal human affectional and sexual behavior. Sex itself, however, may become an addiction for anyone, whether straight or gay. When it does, then what needs addressing is the addiction, not the underlying sexual orientation.

    The position of the Roman Catholic Church, among others, is simply wrong, misguided, and harmful. It is harmful like smoking and alcoholism are harmful. It creates social and psychological problems that lead to bullying and suicides.

    The retreat into private faith (faith in church teaching and tradition) is not acceptable when it ignores the suffering caused by misguided faith-based teachings. Traditions deserve our respect when they are respectable and when they cause no harm. Unquestioning submission to toxic teachings can have tragic consequences for everyone.

  13. Sophia Marsden Says:

    The thing is your position that there is no such thing as sin is no more provable than mine that there is such a thing. Your saying that “The retreat into private faith (faith in church teaching and tradition) is not acceptable when it ignores the suffering caused by misguided faith-based teachings.” only works if you can be sure that nothing non-physical is real.

  14. thebentangle Says:

    Ah! I had a feeling that sentence might give you pause. What I said earlier was that I don’t believe in the concept of sin. However, I do understand the concept, because I was raised as a Baptist. Furthermore, I can easily identify behaviors that you would regard as “sinful.”

    I might regard some of these behaviors as immoral for one reason or another, and I prefer the term “immoral” to “sinful” because there is ample evidence that we as a species have a moral sense and that it has a biological basis that can be studied objectively. “Sinful” is not a scientific term; it is based in certain faith traditions and varies according to the tradition that uses it. It can be extremely arbitrary, as anyone familiar with the Mosaic code knows full well, and the variations are especially notable across major world faith traditions, e.g., going from Christian to Islamic fundamentalism.

    In other words, your definition of “sinful” depends entirely on your particular confession: Catholic? Baptist? Muslim? In the Middle East, where I lived for 11 years, eating pork and drinking alcohol are sinful, as is any day-time eating during the month of Ramadan. Southern Baptists believe that dancing and alcohol consumption are sinful, but Catholics do not. Neither Catholics nor Baptists regard eating pork as sinful. And we could go on and on. What you regard as sinful depends on your perspective.

    “Sin” is also unstable diachronically. You can find a number of significant shifts in its meaning when you compare the Old Testament to the New. Jesus himself subverts Old Testament law in the Sermon on the Mount when he offers an alternative to the retributive ethics of an “eye for an eye.” Nowadays, too, everyone ignores Paul’s injunction to women not to speak in church. (“Women should be silent in the churches,…for it is shameful for a woman to speak in church.” –I Corinthians 14:34-36) (And, BTW, you thought the verb was “teach,” but it is actually much more restrictive than that; it is “speak.”)

    I would think that Paul’s injunction about speaking would pose a problem for a Christian woman. Even if your church does not forbid you to speak while you are on the premises, the Bible declares that doing so is shameful (sinful). You may, of course, disregard that Biblical teaching because it is not enforced by your Church, but what does that say about your faith and where you are placing it?

    I’m not trying to confuse you, but only to suggest that faith is not as stable and reassuring as the church fathers would like you to believe. It is easy to talk about submission, but the real question is, “Submission to what and to whom?” To the word of God, to the church fathers, or to one’s own experience of God?

    There is also the vexing issue of extent. What are the limits of your faith? Would you sacrifice your son, as Abraham was prepared to do, if you thought God expected it of you? Would you become a martyr? I assume that you have tremendous faith in science if you consult doctors, fly in airplanes, cross suspension bridges, and go up in tall buildings. But consider for a moment what you would do in the place of the man in the following anecdote:

    While walking through the woods, a man suddenly falls into an abandoned mine shaft. On his way down, he catches hold of a tree root. Hanging there, he calls up, “Is anybody up there?” Suddenly, there is a roll of thunder and a blinding light shines down into the shaft. A voice says, “I am the Lord your God. Trust me, let go of the tree root, and I will save you.” The man thinks for a moment, and then he shouts back, “Is there anybody else up there?”

    Finally, your last sentence, about the retreat into faith, raises a question that is sort of moot. Of course, I cannot deny the possibility of non-material essences. However, such essences are by definition unverifiable, so I don’t waste my time trying to figure out what they might be. There is simply an infinite number of possibilities for non-material essences (Zeus, Thor, the tooth fairy, etc.), and the only way for me to “buy into” any particular one of them is for me to fall under the influence of a person or institution that is promoting it. As a student of anthropology and history, I am all too aware of our species’ capacity for magical and delusional thinking—and on a massive institutional scale, as we can observe. Humans are veritable machines for churning out delusions of all shapes and sizes, and our belief in them can be fierce and unwavering.

    I would rather focus my energies on what is observable and verifiable in the here and now, while working to promote justice and prosperity in the real world.

  15. Sophia Marsden Says:

    The implication though is that you want to prevent other people from being allowed to raise their children according to their worldview. This is much more than just not personally taking an interest in it, not focusing your energies as it were.

    But, I was raised by pagans. I spent my teen years as variously a marxist a (dabbling) nihlistic “magician” (though I may cringe at the thought) and a “I ❤ the enlightenment"ist (dunno what the word for that is). I have over that time heard about many different varieties of Christianity. I know there are many types. I think that Apostolic Succession can be validly claimed by at least three Churches though (the Orthodox, the Chalcedonian Orthodox and the Catholic Church), and I think on that basis those Churches do have special authority (although only within the bounds of tradition). Which of those actually is *the* Church …I am not decided on. It is a matter of great anguish for me. The only thing that can satisfy me is God, and "you cannot have God for a Father without the Church for a Mother", yet… which Church is the Church?

    I don't think laypeople should really be speaking in church anyway :p so since women cannot be ordained, its not that much of a change. If the church has become lax on that point that is a problem, but its a problem of laxity not the changing nature of sin. If protestants have thrown half of christendom away that is again a problem of their losing the treasures passed down from the apostles, not of the changing nature of religious truth.

    Sin… also… is not immorality. Sin is seperation from God, to miss the mark, to seek temporal goods rather than the eternal good which is God. Immorality is a much more earthly concept than sin. Sin is likewise not a legalistic thing, it's not so much about specific rules, although there are rules and it is good to follow them, but about the love of God. In that sense, if I know that God has commanded women not to speak in church, then it is good for me to be silent there, out of love for God. But say I was silent for the purpose of looking holy, or I was silent when the priest expected me to talk to him (after all the Priest is an icon of Christ, that is just as important to respond to as the words of St. Paul! We are also supposed to be obedient to priests) or something then… its not easy to work out the correct thing to do, but so long as ones eyes are fixed on God and not on earthly goods, then one cannot sin.

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