Reparative Therapy
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  Reparative Therapy of The Transgendered

 

Why this subject and what does it have to do with “policy”? When I first started looking into reparative therapy, it was because of the damage I had observed in the transgender community. This was centered on one individual, Jerry Leach, a self identified transsexual who has managed to suppress his desire/need to be Jennifer.

So why the concern if we have just one individual who is fighting his own battle? Jerry Leach is the person to whom Focus On The Family, a Christian organization started by Dr. James Dobson, sends those asking questions concerning transgender issues. I had not realized how much of a concern this was until I found out that two of the wives of transgendered individuals I know personally have talked with Jerry Leach and his wife Charlene. In both cases they were advised to divorce her husband. Fortunately, each have now come to an accommodation concerning her husband’s transgendered nature and are still married.

It is evident from research and from my own contact with transgendered individuals that both gender and sexual identification are not fixed, and that an individual’s self identification can, and will, change to greater or lesser degrees. The amount of that change is usually incremental and in most cases the original identification was based on the individual’s assumptions and lack of knowledge. A specific example is a female-to-male transsexual that identifies as a butch lesbian before he realizes that he is transgendered. In this example, the final identification is based on new/revelatory information and the original identification based on an incomplete understanding. Therefore, what I am discussing here is not change but the reason for and the method used to reach that change.

What you do not hear from those that espouse reparative therapy is that many transgendered individuals live happy and fulfilled lives, that it is not a mental illness, and that people that are transgendered can demonstrate perfectly normal mental health.

I will agree with Jerry Leach when he says of the christian (purposeful small c) church, “we have such a practiced art of shooting our wounded, rather than (Leach uses the word “redemptively”, I would not) addressing the real issues behind the behavior. It is much easier to condemn with harsh, unloving words.” (Leach J. Flight Toward Women. 2001)

Focus On The Family and the religious right have a huge impact on the Christian community, and as importantly, the politics and policies of this country. My more complete understanding is coming as a result of this effort to set right what I perceive as a serious situation.

I need to express that I am an evangelical Christian, and that I have tried to follow the prescribed course of action laid out in the book of Mathew; when you have a dispute with another Christian first go to them before seeking outside help. I e-mailed Jerry Leach and shared with him that I felt that what he was doing is counter to Christian principles and that I would be passing through his home town of Lexington, Kentucky on the way to a conference and would like to talk with him concerning this. I was refused, or more correctly, not responded to after a couple of exchanges of e-mail. (He wanted to charge $85 for a consultation.)    

In the opening of his book Leach says, “Since 1988 I have been given the opportunity to be a voice proclaiming freedom to those enslaved by sexual addiction, homosexuality, trans-gender confusion, and other forms of crippling emotional wounds”. (Leach, J. 2001)

I talked with Jerry Leach a couple of years ago concerning his web site and the problems I saw with it. Jerry does not site specific Bible verses condemning being transgendered in either his web site or in his book. However, attributed to him by others in October, 2004, are the use of Deuteronomy 22:5 “The woman shall not wear that which pertaineth unto a man, neither shall a man put on a woman's garment: for all that do so are abomination unto the LORD thy God” (KJV) and 1 Corinthians 6:9 “Know ye not that the unrighteous shall not inherit the kingdom of God? Be not deceived: neither fornicators, nor idolaters, nor adulterers, nor effeminate, nor abusers of themselves with mankind.” (KJV)

Going back to the Hebrew, the literal translation of Deuteronomy 22:5 is: “Never cause or force a warriors weapon to be used by a woman or weak person; neither dress warriors armor on a woman or weak person for to Yahweh, God of Host, disgusting is such that do so.” Note the word used in Hebrew tow` ebah, for “disgusting”, is the same one used for eating pork and shell fish.

This is born out by Jewish tradition and historical accounts. Jewish soldiers adopted women’s dress as a camouflage during military operations. Josephus, first-century historian, recorded this custom as part of the strategy of a band of soldiers led by John of Gishala:

“While they decked their hair, and put on women’s garments, and were besmeared with ointments: and that they might appear very comely, they had paint under their eyes, and imitated not only the or­naments, but also the busts of women . . . while their faces looked like the faces of women, they killed with their right hands; and when their gait was effeminate, they presently attacked men and became warriors . . . and drew their swords from under their finely dyed cloaks, and killed everybody whom they came upon.” (Whiston, 1777:242)

In Corinthians 6:9, the only word of concern is “effeminate,” which is used only in the KJV translation. The Greek word is malakoi which means soft, and has the sense of morally soft built on the usage of Jesus who, used the word to contrast John the Baptist with those that were rich. (Mathew 11:8 and Luke7:25).

I was originally going to go through and pick out the verses Leach does use but decided it was a non-issue. What he says can be summed up simply:  with God’s help and faith, you can conquer your transgendered feelings (and, my note, something I feel that God does not have a problem with). From my own research I have found that historically we know that gender variance has been around as long as recorded history and there were those present that were intersexed and transgendered.

Reparative Therapy Theory

What is the underlying theory and what was its genesis?  This is the most important question because if the underlying theory is false, then what is done will not work and the potential for harm is great.  In fact, harm has indeed occurred. The first guide line for counseling is “First do no harm” (Hippocrates, Epidemics, 400 BCE Bk. I, Sect. XI).  The translation reads: "Declare the past, diagnose the present, foretell the future; practice these acts. As to diseases, make a habit of two things—to help, or at least to do no harm."  http://classics.mit.edu/Hippocrates/epidemics.html

The theory behind reparative therapy as it is used today appears to have started with psychoanalytic theorist Dr. Elizabeth R. Moberly and her 1979 book, Psychogenesis: The Early Development of Gender Identity. There are other sources discussing gender and sexual identity issues that predate her.  However, she seems to be the seminal source of the underlying theory. In the discussion concerning Moberly, I will be using extensive quotes as I feel it is important to keep information in exact context. I have kept the original spelling and grammar.

In the forward to her book she states “This study represents the fruit of seven years’ work in gender identity research. It is based solely on the existing psycho­analytic data available in this area, which I believe to have been insufficiently assessed hitherto. In making this extensive theoretical revision, my concern has been to provide a more thorough elucidation of the implications of these data, and to suggest a fresh perspective on their import”. (Moberly, 1983)  In other words, she did not do any research of her own and did not have any clinical experience. She simply did an extensive literature review of: among others Irving Bieber, C.W. Socarides, and Sigmund Freud (about a page in her bibliography for Freud, 32 citations); and came up with a major reinterpretation and distortion of their findings. The bibliography in her 110 page book is 20 pages of about 4 point type.

At this point, I need to say that all of the material I have looked at from the proponents of reparative therapy and references used are from an exceedingly narrow view point. I think this can be summed up by the hammer analogy. When you have a hammer, everything looks like a nail. In the many hundreds of pages I have read, there are no discussions of other view points other than to denigrate them with little, if any, scholarly support.  

Moberly continues, “In the discussion that follows, I consider both homosexuality and transsexualism from a psychodynamic point of view. Trans­sexualism has been one of the least explored areas of the human personality. The most prominent current hypothesis suggests that the male-to-female transsexual acquires a gender identity through a non-conflictual process of learning (Stoller, 1975). By contrast, I have suggested that transsexualism in both genders has a similar aetiology, and that the condition stems from unresolved childhood trauma Radical disidentification from the parent of the same sex results in a psychodynamic structure of same-sex ambivalence: there is a defensive detachment from the same-sex love-source and a reparative striving for a restored attachment. This same dynamic is involved in homo­sexuality, but in varying degree. At one extreme there is little to distinguish homosexuality from transsexualism, in that both are based on radical disidentification, whether or not this manifests itself in the form of an apparent cross-gender aware­ness. More commonly, homosexuality is marked by a lesser degree of same-sex ambivalence. However, the essential dynamic is the same in all cases, and thus the difference between these conditions is one of degree rather than of kind. The defensive detachment from the same-sex love-source implies that the process of same-sex identification is still to some extent incom­plete, whether radically or only partially so. On this under­standing, homosexuality itself becomes a problem of gender identity”. (Moberly 1983)

Let’s see if I can put together the bits and pieces of how Moberly came to the conclusions that she did. One of the sources quoted by Dr. Elizabeth Moberly and others in the book, and perhaps one of the sources that shaped her thinking, is Dr. Irving Bieber, a psychoanalytic therapist who wrote, “We have come to the conclusion that a constructive, supportive, warmly-related father precludes the possibility of a homosexual son ....” (Bieber, I. Homosexuality 1962), The Bieber sample consisted of 106 New York homosexual men (note: men only) in psychoanalytic therapy, collected in the early 1950’s.  All had serious mental problems: according to Bieber, 42% of character disorders, 29% of psychoneuroses, 27% suffered from schizophrenia, and the other 2% from other mental disorders. Concerning their sexual orientation, 91% wanted to hide it, and 60% wanted to be "cured".

Moberly states, “Defensive detachment is the core of reparative therapy theory, “Freud’s well-known hypothesis of a link between homosexuality and paranoia (the Schreber case, 1911) is examined in some detail. Paranoia is regarded as an extreme form of defensive detachment from a love source a detachment based on a pathological ‘mourning’ reaction to childhood trauma. The love-source may happen to be the parent of the same sex or, equally, the parent of the opposite sex. In the former case, the condition is that known as homosexual paranoia; in the latter, there is genuinely heterosexual paranoia. Freud’s hypothesis is con­sidered to be both verified and qualified. There is a significant link between homosexuality and paranoia, but not all paranoia is homosexual; and, just as importantly, not all homosexuality is paranoid”. (Moberly, 1983)

“Homosexuality and transsexualism alike imply a defect in the capacity for relating to the same sex - not the opposite sex, as is commonly assumed.” (Moberly, 1983)

“Gender identity and (homo)­sexuality are intrinsically linked, in that it is the defensive detachment from the same-sex love-source that blocks the fulfillment of identificatory love-needs. It is through a continuing and uninterrupted love-attachment to a parental figure of the same sex that the process of same-sex identification takes place”. (Moberly, 1983)

“An absence of a same-sex identificatory attachment since early childhood implies a state of radically incomplete growth in the adult personality. However, the potential for restoration is not absent. The very capacity for so-called ‘homosexual’ love marks the attempt to fulfill the hitherto unmet needs for same-sex love and identification. These needs as such are in no way abnormal, but their lack of fulfillment in the normal process of growth is, however, abnormal. The capacity for same-sex, i.e. ‘homosexual’, love marks an inherent reparative tendency, to­wards making up for normal growth that has been missing.” (Moberly, 1983)

Moberly moves away from the (Freudian) relationship with the mother and focuses on the defensive detachment and same sex ambivalence. This is based on the assumption that the youngster did not bond in some way with the same sex parent. Interesting to note that there is little reference to lesbians, bisexuals, and female to male transgendered individuals.

To sum this up, according to Moberly, and subsequently Nicolosi and Leach, the problem is defensive detachment from the same sex parent that is the problem and cause of both transgenderism and homosexuality. This is the underlying theory and basis for reparative therapy.

The extensive use of psychoanalysis in gay, lesbian, and transgender studies is very significant if you consider the ambiguities and uncertainties in the psychoanalytical assessment of sexuality and gender. Although Freud did not classify homosexuality as an illness, he did regard it as a "certain arrest of sexual development." (Freud. 1905), Assuming Freud's views on heterosexual causes, mainstream psychoanalysis has regarded homosexuality either as a sexual perversion not susceptible to psychoanalytical treatment or as a curable illness, with the assumption that the cure results in the patient's reorientation toward heterosexuality. The latter is not born out by research.

I find it interesting that the Christian right is so attached to Freudian concepts since he was as a nonbeliever who actively condemned religion. He considered it an obstacle to intelligence and maturity. These attacks took two directions psychological and historical. Freud attempted to look at the underlying psychological cause behind religion and tried to trace the religious ideas back to their historical genesis.  This came out in two books Totem and Taboo (Freud, 1913) and Moses and Monotheism (Freud, 1938).  One particular problem was that he relied not on Darwinian evolutionary theories, but instead on the erroneous ideas of Jean-Baptiste Lamarck (1744-1829) which were basically use and disuse.  Individuals lose characteristics they do not require and develop those which are useful. Inheritance of acquired traits, i.e. a swimmers son will have muscular legs.

In Three Essays (1905), we find the origin of the weak father theory. Freud claims that a decisive factor in all cases of homosexuality is "a phase of very intense but short-lived fixation to a woman, (usually their mother) is passed through, and that after leaving this behind, they identify themselves with a woman and take themselves as their sexual object". Freud does at this point indicate that only those presenting with extreme personal problems were analyzed. In a footnote Freud mentioned "the presence of both parents plays an important part. The absence of a strong father in childhood not infrequently favors the occurrence of inversion." I found this interesting because he perceived his own father as weak and ineffectual.  This is listed as just one of a number of possible, accidental, factors, and is not seen as being of great importance. Freud felt strongly that homosexuality is probably caused very early in childhood, as a different line (not perverse or degenerate) of sexual development. Note that Freud attributed most problems to a sexual causation.

The reason I feel this is of importance is that a theory is a framework that shapes the way you think about something. My experience in looking at theories is that they often become a lens that is looked through, and a theory that is antithetical to Christian thought warps the way that a perceived problem is examined. An objective examination looks at, not through.   

The insistence of the underlying cause being defensive detachment brings up an interesting dilemma. What happens when someone comes in and reports that there is no detachment from the same sex parent or molestation or…? In this case the repressed memory is sought. One TS friend of mine has story after story of encounters with a number of therapists who used repressed memory therapy techniques.

Repressed Memory Therapy

This appears in rather a hidden way through out Jerry Leache’s book. “Many of the most traumatic or significant childhood memories evade our conscious recall. The reason for that is that “no one completely understands the mental, emotional, and neurological process. But we do know that it requires a great deal of continuous emotional and spiritual energy to keep the memory in its hidden place. These denied problems go underwater and later reappear as certain kinds of (…) recurring cycles of spiritual defeat.” (Leach, 2001)

Richard Cohen who works with homosexuals uses therapy that he calls “inner child” work. This involves RMT (recovered memory therapy) to find painful memories that have made a person gay. Ex-gay leader Leanne Payne, au­thor of the Broken Image, is also a major advocate of memory heal­ing, (she is quoted in Jerry Leaches book). Cohen tells us he can recover traumatic memories from when the fetus is in the mothers’ womb. He refers to this as intrauterine experiences. (Cohen, 2000).

"False Memory Syndrome : 'An apparent recollection of something that one did not actually experience, especially sexual abuse during infancy or childhood, often arising from suggestion implanted during counseling or psychotherapy'." (Colman, A. 2001)

"...it is an unsettling fact that we can manufacture, wholesale and out of pure nothingness, whole events and pasts that never occurred. This fantastical creative ability of our minds may be treasured when it produces King Lear or War and Peace, but it can sometimes destroy lives and families when applied to ordinary, daily life." (Loftus, E. 2004).

 "...memories, by nature, are fluid and malleable, easily influenced by suggestion. People told they were abused eventually believe that they were, regardless of fact. The mind creates a visual picture of the abusive act. And if a person is surrounded by others who encourage her to draw out these pictures and details, this new memory can become even more vivid than an actual remembrance. To complicate things further, the brain starts creating emotional responses to these memories, which seem to validate the claims even more." (Meiser, 2004)

Recovered "memories" generally start as images found often after months of searching the client's past. Suggestive therapy techniques such as hypnosis, guided imagery, or simply the imagining of abusive events, and the use of images through drawing, are frequently used.  These images morph into what feel like genuine memories and appear to both the client and counselor to be a genuine recounting of traumatic events. These false memories often have their beginning in nightmares, horror movies, and most importantly the imagination. Virtually all memory researchers and therapists feel that there is no connection between images recovered using RMT and real events

Concerning the allegation that traumatic memories are repressed, is evidence from various researchers. One study found that children who witnessed the murder of one of their parents did not repress their memories. "Rather, they were preoccupied with the murder and were continually flooded with disturbing emotions."  (Malmquist, 1986)

In 1976, dozens of children were kidnapped in Chowchilla California under extremely frightening conditions. Children were kidnapped, placed in two vans, and driven for 100 miles. The vans were then buried in a quarry. The driver and two boys were able to dig their way out and get help. I remember the incident well as I was living in California at the time. A 1993 article revealed that none were found to have repressed memories of the event. (Safran, 1993)

Seventy-eight Holocaust survivors were interviewed four decades after the end of World War II. None had repressed their memories of experiences in the prison camps. All but one remembered forgotten details with simple prompting. (W.A. Wagenaar, & J. Groeneweg, 1990).

Paul Simpson stated: "As these case studies of actual victims show, none behave as repression theory predicts. In contrast, scientific research reveals that people remember, rather than repress, traumatic events."

APA Stop bad therapy RMT http://www.stopbadtherapy.com/main/apawelcome.shtml

Bogus Therapy

The minority of neo-Freudian psychoanalysts who practice "reparenting" or "reparative" theory typically do not publish accounts of their procedures, and the absence of scrutiny via impartial "peer review" or "clinical supervision" has led to tragic results. (McNamara, 1994)  In a familiar phrase, reparenting therapy is risky business, placing patients in highly suggestible, pseudo-childlike, relation to their therapist. (Loftus 1994)       

There are several common characteristics of bogus therapy. A number of specific examples related to specific content follow. I have included a more complete examination at the end of this paper as an appendix.

 They claim miraculous results beyond what can be explained by accepted scientific methods. Exaggerated claims of success are a red flag. This is from someone answering Jerry Leach’s e-mail:  “We have noted that 90% of those who have met with him for at least a two year period remain fully integrated and emotionally intact in their birth-gender roles.  Those who have worked with him for over 4 years ascribe to a 100% success rate; "success" being understood as the elimination of former desires to dress like or emulate the false feminine identity”.  E-mail from Counseline@aol.com 10/29/04 9:46:07 If I calculate correctly, with a weekly visit of one hour each at $85, this equals $17,680.  This excludes recommended group therapy. This is a cash cow, and Jerry Leach is one of the lower priced reparative therapists.

They are not receptive to being tested by scientific method involving double blind controls. All of the reporting of results that I have seen is of a subjective nature. Research relying on a subjective reporting by an individual, are notoriously biased. As an example, if there is a belief that behavior stems from the expression or repression of sexual motivations then all cases will be explained in those terms. The results will be a ‘pound to fit’ (square peg and round hole), the paradigm (I am using the hammer analogy again). Research methodology must be objective and subject to critical peer review in order to reduce the effect of subjective bias.  

Research

I can say after careful research that there does not appear to be much reliable unbiased research. There has been only a few studys of reparative therapy published in a reputable peer reviewed journals. The first article I found is15 pages long and the peer review over 50, note that this studied Gay men and Lesbians. This is the abstract from that article.

 

 

Archives of Sexual Behavior, Vol. 32, No. 5, October 2003, pp. 403–417 ( C ° 2003)

Can Some Gay Men and Lesbians Change Their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation

Robert L. Spitzer, M.D.2;3;4

“Position statements of the major mental health organizations in the United States state that there is no scientific evidence that a homosexual sexual orientation can be changed by psychotherapy, often referred to as “reparative therapy.” This study tested the hypothesis that some individuals whose sexual orientation is predominantly homosexual can, with some form of reparative therapy, become predominantly heterosexual. The participants were 200 self-selected individuals (143 males, 57 females) who reported at least some minimal change from homosexual to heterosexual orientation that lasted at least 5 years. They were interviewed by telephone, using a structured interview that assessed same sex attraction, fantasy, yearning, and overt homosexual behavior. On all measures, the year prior to the therapy was compared to the year before the interview. The majority of participants gave reports of change from a predominantly or exclusively homosexual orientation before therapy to a predominantly or exclusively heterosexual orientation in the past year. Reports of complete change were uncommon. Female participants reported significantly more change than did male participants. Either some gay men and lesbians, following reparative therapy, actually change their predominantly homosexual orientation to a predominantly heterosexual orientation or some gay men and women construct elaborate self-deceptive narratives (or even lie) in which they claim to have changed their sexual orientation, or both. For many reasons, it is concluded that the participants’ self-reports were, by-and-large, credible and that few elaborated self deceptive narratives or lied. Thus, there is evidence that change in sexual orientation following some form of reparative therapy does occur in some gay men and lesbians”.

Statement to HRC via e-mail: May 16 2001 concerning the aftermath from the article by Dr. Spitzer:  “I anticipated some misuse of the study results, but I did not an­ticipate that some of the media would say such ridiculous things as that the study raised the issue of homosexuality and choice. Of course, no one chooses to be homosexual and no one chooses to be heterosexual. I did anticipate, and in my presentation warn, that it would be a mistake to interpret the study as imply­ing that any highly motivated homosexual could change if they really were motivated to do so. I suspect that the vast majority of gay people—even if they wanted to—would be unable to make substantial changes in sexual attraction and fantasy and enjoy­ment of heterosexual functioning that many of my subjects re­ported. I also warned against the study results being used to justify pressuring gay people to enter therapy when they had no interest in doing so and I have already heard of many incidents where this has happened”.

Peer Commentary on Spitzer (2003) (a small portion of one, and one of many)

Can Sexual Orientation Change? A Long-Running Saga

John Bancroft, M.D.

Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Morrison Hall 313, Bloomington, Indiana 47405-2501;

e-mail: jbancrof@indiana.edu.

“First and foremost, the sample consists of men and women who principally sought treatment because of their religious beliefs and who were presenting themselves as evidence that such change was both possible and desirable for others (for 93%, religion was extremely or very important, and 78% had spoken in public about their “conversion,” in many cases in their churches). Assessment of change was entirely based on their recall of how things were before treatment. Given their powerful agenda of promoting such treatment, it would be surprising if they did not overestimate the amount of change. A similar problem exists with the evaluation of any treatment for which the patient has a vested interest in proving its worth.”

Spitzer used a sample that was far from unbiased, 43% came from the ex-gay ministries and 23% were referred from NARTH, an anti gay organization. Many of the individuals depend on the antigay movement for their livelihoods.

Other studies

I have just (as of December 3, 2004) found a number of other studies and I will include in an appendix a summery of one which is also biased in the pro homosexual side but appears to be better done. It shows a “change” in only eight of 202 participants in the study and six of those are Conversion counselors.

American Psychiatric Association position statement, December 1998

 The potential risks of “reparative therapy” are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient.

APA Reiterates Position On Reparative Therapies

In 2000 APA expanded its 1998 position on therapies, often called reparative or conversion therapies, which claim they can successfully transform homosexuals into heterosexuals. The policy makes the following points and recommendations:

• APA affirms its 1973 position that homosexuality per se is not a mental disorder. Recent publicized efforts to repathologize homosexuality by claiming that it can be cured are often guided not by rigorous scientific or psychiatric research, but sometimes by religious and political forces opposed to full civil rights for gay men and lesbians. APA should respond quickly and appropriately as a scientific organization when claims that homosexuality is a curable illness are made by political or religious groups.

• As a general principle, a therapist should not determine the goal of treatment either coercively or through subtle influence. Psychotherapeutic modalities to convert or "repair" homosexuality are based on developmental theories whose scientific validity is questionable. Furthermore, anecdotal reports of "cures" are counterbalanced by anecdotal claims of psychological harm. . . .Until there is rigorous research available, APA recommends that ethical practitioners refrain from attempts to change individuals’ sexual orientation, keeping in mind the medical dictum to first, do no harm.

• The "reparative" therapy literature uses theories that make it difficult to formulate scientific selection criteria for [reparative therapists’] treatment modality. This literature not only ignores the impact of social stigma motivating efforts to cure homosexuality; it actively stigmatizes homosexuality as well. "Reparative" therapy literature also tends to overstate the treatment’s accomplishments while neglecting potential risks. APA encourages and supports research in the NIMH and the academic research community to further determine "reparative" therapy’s risks and benefits. http://pn.psychiatryonline.org/cgi/content/full/36/13/34-c

One of the overriding concerns that I have is related to those who come to reparative therapists for help. The majority are Christians who come out of religious concerns, in many cases severely wounded by the church. They come because they are in distress and convinced there is something sinful about what they are.  Jerry Leach’s experience is based on those that have presented to him with a serious concern, or those who are very angry with him. I would feel from what I have seen in his writing that he has little experience with those that are well adjusted transgendered individuals.

Potential harm

Families of origin can be damaged as all of the blame falls on them for poor parenting. This is hugely exacerbated by the use of repressed memory techniques.  Some Christian transgendered individuals feel a huge sense of failure when they can not reach what they are told God wants of them. Failure has lead to marriage dissolutions, self damage, and suicide.

If gender were truly changeable other than in perception, I think we would have seen examples of it by now. There is so much pain, so many tears, so many unkept promises often extracted under threat.  I have heard firsthand accounts of exorcisms and driving out of demons, and wives that have, at the advice of the Leaches, withdrawn their love and divorced their loved ones.  One common result of failure is that it convinces the client that their gender is not changeable and can lead to self acceptance and a comfort with who they are.

Social Analysis

The perceptions that being transgendered is other than a normal variation in gender is a culture problem, and has no basis as being other than such. This is based on cross cultural studies and is unfortunately a combination of factors starting with in many cases Christian missionaries. Many aboriginal groups valued their gender/sexually variant members.

  Until very recently little research has been conducted concerning those that are transgendered and that is just starting to change. One of the difficulties has been the fact that most are deeply in the closet and as such there is no way to know the number of transgendered individuals in the population.  Historically it is between five and ten percent of the population. In a research project that I started, I asked the question “Do you know of any one else in your family that is transgendered?” The answer at this point is 14% yes and 37.8% unknown.

 

 

R32 are there any other transgendered people in your family?

 

 

 

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

yes

20

1.3

14.0

14.0

no

65

4.2

45.5

59.4

unknown/don't know

54

3.5

37.8

97.2

99.00

4

.3

2.8

100.0

Total

143

9.2

100.0

 

 

The distribution is through out all population groups and there is according to the latest UK statistics a 1:1 ratio of those that are female to male and male to female. The female to male may be unaware of their transgender status.

What seems to be the major social values conflict is largely a lack of understanding, “unfamiliarity breeds contempt,” and most folks do not have contact with those who are transgendered, that they know of. The religious right has assumed it is a sin issue.

Economic Analysis

There are many very qualified individuals that have been marginalized due to wide spread employment discrimination. There was little or no legal protection from being fired because you are transgendered. Title VII has been used recently in Smith v. Salem Ohio, a decision for the plaintiff a fireman who transitioned on the job. This precedent-setting case has far reaching consequences

Too many transitioning transsexuals end up as sex workers for a lack of any other method of finding a job that pays a living wage or any job at all. This is exacerbated by the fact that many drop out of high school due to bullying and have few job skills. I have heard from shelter workers that many runaway/throwaway kids are transgendered.

I feel I can safely say that bullying is a universal. Bullying is proven to decrease learning and many drop out of school, hence earning ability as an adult is lessened  They will contribute less to society and pay less taxes.

Antidiscrimination legislation is necessary. Those firms who already have made efforts at nondiscrimination have reaped rewards in a loyal and able work force. The experience of companies who have an open and accepting policy has been positive with benefits in decreased tension in sexual and race relations. There is greater openness in other areas. 

Political Analysis

The major stakeholders regarding this issue are transgendered and intersexed individuals, insurance companies, the religious right and those charged with enforcing the law. The transgender groups are in the process of becoming a political force, often in cooperation with gay and lesbian groups. Opposition comes primarily from the religious right and sometimes the insurance industry. All of the efforts politically are to my knowledge coming from within the transgender and to a lesser extent, gay, lesbian, and bisexual communities. The one lobbying effort is under the National Center for Transgender Equality. There are other groups that are active.  Tri-Ess and IFGE come to mind.   

Conclusion

The change in cultural attitude from tolerance to intolerance has interested me for some time, for it was not always so. The desire to repress gender identity is a result of a cultural introject often reinforced by the religious. A desire to change gender identification is fostered in some individuals.

The relationship between client and therapist is second only to the desire of the client for change in effective therapy. The lack of evidence other than anecdotal of long term change is there fore very significant. I know of those that have seen counselors using reparative therapy techniques with no success and with great harm.

Many of those having claimed success in reparative therapy have a financial stake in that claim (Spitzer, 2003) and (Shidlo, & Schroder, 2002) by being employed in the practice of conversion therapy or having spoken publicly in support of it.

 The major psychiatric/counseling organizations have condemned reparative therapy including the APA, ACA and NASW.

The political and policy implications are far reaching because if being transgendered can be “cured”, there is no need for antidiscrimination or hate crimes legislation. The human cost is, for the most, part hidden and staggering.   

Those engaged in conversion/reparative therapy have only through good science and research to prove that their “product” works and is not harmful to gain acceptance. That there is no such evidence is a hallmark of bogus therapy. Anecdotal evidence gives example after example of harm caused by those engaged in conversion/reparative therapy. It will probably be necessary for those who have been the victims to file lawsuits against those who engage in this practice to bring oversight and change.   

 

 

 

 

 

 

 

 

 

 

 

References

Bieber I. (1962) Homosexuality: A Psychoanalytic Study, New York: Basic Books,

Cohen, R. (2000). Coming Out Straight: Understanding and Healing Homosexuality.                                                     Winchester, VA: Oakhill Press.

Colman, A. (2001) "A Dictionary of Psychology," Oxford University Press, (2001).

Moberly E, R. (1983)  Psychogenesis The Early Development of Gender Identity:          Routledge & Kegan Paul

Leach J. (2001). Flight Toward Woman (self published) Reality Resources Publications  previously published under the title Cowboys Don’t Cross-dress

Loftus, E., (1994)The myth of repressed memory : false memories and allegations of sexual abuse. St. Martin's Press,.

McNamara, E. 1994 Breakdown : sex, suicide, and the Harvard psychiatrist Pocket Books, 1994

Nicolosi, J. Reparative Therapy of Male Homosexuality. Jason Aronson Inc 1991

Note the publisher publishes psychotherapy books and is Jewish

Freud,S. All references to Freud here are from the Standard Edition of the Complete Psychological Works of Sigmund Freud, edited by James Strachey and Anna Freud, Hogarth Press Ltd, London, 1957

Loftus, E. The Memory Wars. Science & Spirit magazine, 2004-JAN/FEB

Malmquist, C.P. Children Who Witness Parental Murder: Post-traumatic Aspects. Journal of American Academy of Child Psychiatry, 25 (1986),

C. Safran, Dangerous Obsession: The Truth About Repressed Memories. McCalls, 1993-JUN),

Meiser, R. The lost years long removed from the therapy that broke their families,     anguished parents mourn the children who walked away. Cleveland Scene (Ohio) 2004-AUG-4.

Spitzer, R. Archives of Sexual Behavior, Vol. 32, No. 5, October 2003, pp. 403–417 ( C ° 2003)

Shidlo, A. & Schroeder, M. Professional Psychology: Research and Practice 2002, Vol. 33, No. 3, 249–259

Whiston, W. (1777) translated, The New Complete Works of Josephus, Kregel Publ, (1999),

Wagenaar, W. & Groeneweg, J. The Memory of Concentration Camp Survivors, Applied Cognitive Psychology, 4 (1990).


 

Appendix 

There are many other therapies and therapists which prey on the hope and desperation of their clients. They are easy to spot because they tend to have common characteristics (Beyerstein, 1997).

1. They claim miraculous results beyond what can be explained by accepted scientific methods.

2. They claim to be effective with a wide variety of unrelated mental and emotional disorders.

3. They are usually loosely associated with some scientific or pseudo scientific principle, such as Eisenberg’s uncertainty principle, or Chaos Theory, or Chi, although the exact nature of the connection or causation is either incorrect or remains a mystery.

4. They can only be effective when administered by adherents to the approach.

5. In order to become an adherent you most often must obtain expensive training which can only be offered by a chosen few.

6. They are not receptive to being tested by scientific method involving double blind controls. In fact, sometimes they claim to be beyond scientific scrutiny because they are supernatural.

Do some of these therapies seem to work, some of the time, with some people? Yes. So what, you may ask, is wrong with these so called "miracle cures" if patients believe they have been helped by them, and in some cases, actually demonstrate improvement? I would offer the following list of reasons, which is by no means exhaustive:

1. The failure to diagnose a real medical, emotional, or mental disorder could lead to serious complications which could otherwise have been avoided.

2. Some therapies rely on hypnosis or regression techniques which have not only been shown to be unreliable, but have been shown to cause deterioration of the clients’ condition. Some of these therapies result in client abuse: emotional, physical, and/or sexual.

3. When these therapies don’t work the therapist often blames the client or the client’s family, not the therapy. In addition, the client becomes disillusioned with therapy in general and may not seek help elsewhere.

4. Therapists who adhere to some of these therapies may begin to believe their own potency and cease to consider alternative treatments or referrals.

5. A loss of the public trust and a further tarnishing of the professional image of counseling.

6. And finally, where it is starting to really hurt, use of unsubstantiated therapies is resulting in law suits against the therapists. In fact, my mental health insurance specifies in bold letters that it will no longer cover anyone who uses hypnosis or regression therapy to uncover repressed memories of sexual abuse.

So what’s an ethical counselor to do? Trust your instincts. If a therapy seems to be too good to be true, it probably is. We must be skeptical, but not cynical. We can be cautious yet open to new treatment techniques. In order to provide the best treatment to your clients consider these steps:

1. Work within your scope of practice or professional boundaries. If clients present problems you have not been trained to deal with refer them to a more qualified professional. For Guidance Officers this often presents difficulties, particularly in country areas where there may not be other professionals to refer your clients.

2. Inform you clients of their rights and tell them what to expect in treatment. If you are working with minors you should convey this information to their parents.

3. Write out treatment plans. Because you know what you are doing you should be able to write it down and you should not be ashamed to show it to your clients or other professionals. If you can’t write it down, or as one family therapist once told me, "I can’t tell you what I’m going to do until I do it, I just get a feeling and go with it," then my advice is to go into acting or politics.

4. Consult with colleagues and other professionals on a regular basis. The notion of your family physician, or for that matter your auto mechanic, never consulting others is positively frightening, yet we sometimes operate this way.

5. Keep up with the professional literature. Read professional journals. Join professional associations. Go to professional conferences and workshops, and don’t believe everything the presenter tells you.

6. Evaluate your work and allow your clients to evaluate you. If you are effective you have little to fear.

7. And finally, do not lose faith in yourself or in counseling. It is slow, it is emotionally draining, but it works.

Beyerstein, B. L. (1997, September/October). Why bogus therapies seem to work. Skeptical Inquirer, 29-34.

http://cmhs.utoledo.edu/mritchie/Courses/cmhs7530/unit_16/crazy_therapies.htm

 

 

 

Last modified: 12/24/13