Tag Archives: sexual identity

The APA on identity therapy and conversion therapy


[Let me wade into something that tends to fire up lots of feelings and lead to controversy. And let me ask all to be civil. Civility seems to be the first thing that disappears when we discuss matters near and dear to our hearts. But let us be different and listen to each other rather than talk at or past each other. As James tells us, let us be quick to listen and slow to speak.]

In recent days media outlets have picked up the story of the American Psychological Association’s release of a report and declaration of their official stance on reparative or conversion therapies for individuals seeking to change their sexual orientation. You can read their press release and find their 100 page research review here. Being a member of the organization, knowing a few of the players in the research side of things, and knowing how easy it is to get caught up in debate and miss some of the finer points, I thought I might make a few comments that may not make it to the public eye.

1. Researchers are beginning to distinguish between sexual identity and orientation. This is a good thing. I dare say that the public lags far behind on this matter. Separating these two different aspects of sexuality allows for individuals to consider and interpret their sexual feelings in accord with their beliefs and NOT as how either the minority or majority of the world tells them to define themselves. This is akin to biracial people determining how they want to self-identify rather than be forced to say they are black or white.  Consider the following quote by one of the players (whom  I don’t know),

The distinction between orientation and identity (or attraction and identity as we often describe it here) is key, in my view, in order for us to understand the experience of those who say they have changed while at the same time experiencing same-sex attraction….I hope we can agree that sexual attraction patterns may be one thing while meaning making aspects may lead two people with the same attraction pattern to identity in disparate ways. (emphasis mine; from http://www.crosswalk.com/blogs/EWThrockmorton/11607271/)

If I understand the relationship between identity and orientation, it would seem that one forms identity from a variety of “data” which leads to an orientation. This is true outside of sexual identity. A number of factors come together for a person to see themself in a particular way (this may include biology, family, life experiences, key “flashbulb” moments, etc) and in cementing that particular identity they develop an orientation towards the world. SO, this may explain why trying to change orientation has little positive effect. Until the person reviews, explores, and reconsiders their identity (something that happens in nearly every counselee I’ve ever worked with) and begins to practice another way of seeing self, not much is going to change in attraction and orientation. Further, what may change is one’s sense of importance (and therefore meaning) of various parts of themself. When my clients explore their identity, it is rare they come to understand that they were completely mis-perceiving their feelings or experiences. Rather, they begin to see those experiences and feelings from a different vantage point.  

2. Change. What constitutes change is still up in the air. Ask a depressed person if they have changed even if they are only 50% less depressed and they will say likely say yes. Ask someone else and they may say “no,  I’m still depressed.” In the realm of sexual orientation, however, many see orientation as all/nothing. All same sex or all opposite sex orientation. Many will tell you this is just not their particular experience. So, IF someone wanted to change their direction of sexual attraction, what standard would they use to determine if change had taken place? Would 50% change be good? Who would decide this?

There is another analogous scenario in psychology. Should psychologists provide weight loss treatment? Given that an extremely large portion of those who lose weight gain it back and more, many have felt it unethical for a psychologist to offer weight loss therapies when they know that success is extremely low. So, how long do you need to keep the weight off to make a treatment worthwhile? How much do you need to lose? Who decides?

My gut feel is that the APA is not accurate in saying that there isn’t evidence that individuals can change. There is some evidence. Not complete change, but let us not deny what is there. Neither are they accurate about their reporting of harm. Harm reports are difficult to objectify. The best research will show you that some are harmed and some are not. Instead of assuming harm, let us evaluate more closely how some are harmed and how some are helped. Just as one might do with the weight loss scenario.  

3.  APA makes an attempt to make room for the work of helping one to find congruence between faith commitments and sexual feelings. This is also a good thing. Now, just how a psychologist does this matters greatly. Does he or she evangelize here? By that I mean (a) encourage a client to choose a different faith or change it to fit one’s sexual feelings, or (b) encourage a client to deny feelings and deny the suffering one might have by choosing not to act on a desire? My personal opininon is that option c (stay neutral) does not exist and is not possible. So, where does that leave us? Informing clients of our personal positions and yet not attempting to force individuals into our view of the situation. In other words, truthful but humble without being demanding.   

This is a divisive topic. Do individuals seeking to change their sexual orientation have the right to try to do so with the help of psychologists? Is change possible? Desirable? Damaging? And of course in trying to answer these questions you have a number of players on each side–each reading the “evidence” the way they would like to see it. You have those who have personal experiences in one direction or another. You have those with political or philosophical agendas. And, on top of that, you have media players interested in creating controversy where they can. I observed this last one myself where a local talk show host did his level best to create differences between two parties that weren’t disagreeing with each other as much he wanted them to.

So, what do you make of the difference between identity and orientation? Is it meaningful? How do we speak of change? Can we admit that it happens for some and not for others no matter our personal opinion whether change is good or not? And finally, can we avoid the “what if…” tendency in our conversations so that we deal with what is happening and not what we fear might happen?

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Filed under APA, Christianity, counseling science, ethics, homosexuality, Psychology, sexual identity, sexuality, Uncategorized

What makes you feel like a ______ (man/woman)?


In a weak moment last week when I couldn’t take NPR or news radio I surfed the local radio stations in my car. Here are two phrases I heard in the span of 5 minutes. I have no idea who the artists are nor am I all that interested…

“Man, I feel like a woman.”
“I’m yo man…” (but something about needing to get down at her place because he had a girl at home)”

Suffice it to say I’m not going back anytime soon to the music on the radio. But, I will admit it got me thinking about how we know what feelings are quintessentially male or female. In the first song the woman feels like a woman because she has the power of attraction but does her own thing. In the second song, I assume the male singer feels like a man because he can sexually please a woman all night long.

What makes us male or female? (No, I’m not talking genetics here.) Sometimes we look at behaviors and interests. Sometimes we look at attitudes or attraction to the opposite sex. But most of the time I think we look at how others perceive us. If they treat us the way we think our gender should be treated (or, is commonly treated even if we don’t like it), then we feel like our gender. When we are invisible to others, treated differently (or so we perceive) based on our interests, behaviors, body type, etc. then we may feel that we are not like most of our gender.

Why is this important to consider? I have clients who have wondered about their orientation due to their feeling different than most of their friends of the same gender.

The simple answer is to assume that God makes a diverse group of males and females and that we ought not interpret our differences as having that much meaning. Of course, we rarely find the simple answer helpful. So what are we to do when we do not feel like others of our gender? Is this a big issue out there or just something we counselors see?

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Filed under christian counseling, christian psychology, Cultural Anthropology, Identity, Psychology, sexual identity, sexuality

children, sexual identity, and counseling


“All Things Considered” on NPR ran a two day story on children and gender identity. Two days ago, they ran a story on two families with toddler to preschool boys who are attracted to girl-oriented toys, colors–one of whom sees himself as a girl, changing his name from Jonah to Jona as he entered school. His parents now refer to him as their daughter. Yesterday, they ran a story about a prepubescent boy wanting to take hormones to delay or stop puberty. You can click here to read or hear the stories and additional content on their site.

What makes this fascinating is the two psychologists interviewed. The first, Dr. Ken Zucker, sees the problem as gender identity confusion, something to be modified. The second psychologist, Dr. Diane Ehrensaft, sees it as something biological and fixed and then the job is to help the child and parents transition to transgender. Dr. Zucker rejects that idea and likens the acceptance/transition approach to that of accepting that a Black child wants to be thought of as white (I wonder if he would also liken it to accepting a psychotic child’s hallucinations were real). His response sounds behavioral in that the boy has his dolls and dresses removed and play with boy type toys is reinforced. Dr. Ehrensaft opposes this as controlling and suggests the best treatment is to go with the flow and allow the child to express him/her self as they see fit:

Ehrensaft, however, does not use that label [gender identity]. She describes children like Bradley and Jonah as transgender. And, unlike Zucker, she does not think parents should try to modify their child’s behavior. In fact, when Pam and Joel came to see her, she discouraged them from putting Jonah into any kind of therapy at all. Pam says because Ehrensaft does not see transgenderism itself as a dysfunction, the therapist didn’t think Pam and Joel should try to cure Jonah.

“She made it really clear that, you know, if Jonah’s not depressed, or anxious, or having anything go on that she would need to really be in therapy for, then don’t put a kid in therapy until they need it,” Pam says.

Ehrensaft did eventually encourage Joel and Pam to allow Jonah to live as a little girl. By the time he was 5, Jonah had made it very clear to his parents that he wanted to wear girl clothes full time — that he wanted to be known as a girl.

While I disagree with his approach, I would humbly suggest that Zucker’s diagnostic view is more accurate. Children may go through fixations and personality response types that do not carry into adulthood. To treat even an entrenched viewpoint of a small child as fixed is unethical. A child simply does not fully understand themselves and the world yet. We do not accept our children’s fears of monsters as normal, we do not accept our children’s hitting to get their way. Why? We know they are not old enough to understand. We empathize but correct.

This is not like trying to make a left handed child be right-handed, to force feed peas when the child gags. Our identities may be rooted in biology, they are not fixed. Zucker rightly accuses some of being essentialists–a form of biological reductionism. Even the APA does not do that when it comes to personality. A child cannot be given a personality disorder until 18 because we know that personality is flexible even when shaped and rooted in early years.

However, Zucker seems harsh in that his treatment is to remove all girl playtoys. While I would not want a child of one gender to accept and believe they are the opposite gender, I would want they and the parents to expand their view of gender. If a boy likes pink, silky things, dolls, etc. so what? There is nothing essentially male about trucks. My wife as a child was a cowboy. She’d be more likely to have six shooters than a doll. Thankfully, her family didn’t make it an issue (which may be the cause of some folks’ gender identity confusion). 

Of course, a family will want to draw some lines, such as saying no to referring to oneself as the opposite sex. “No, God made you a boy, but he gave you interests in soft things…” Instead of wearing dresses which in our culture isn’t the norm, the boy might be able to enjoy softer materials.

It would seem that some, in the interest of helping everyone self-actualize, lose their ability to think critically about child development. This is not unlike the misguided notion that all bad behaviors are about low self esteem and so we should only praise. In fact, many have too much esteem of self and so abuse others.

ADDED: Check out this link for a local Philly news article on the subject of a transgendered 9 year old and see that they spoke to the ever controversial Paul McHugh from Johns Hopkins.

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Filed under Cultural Anthropology, Identity, News and politics, parenting, Psychology

Considering sexual identity


Tonight I’m talking to a large group of teens at Monmouth Chinese Christian Church in NJ on the topic of sexual identity. Unlike a good sermon, I have four points: Is sexual identity important? Does God have anything to say about it? How does it get formed and deformed? What can we do to protect our identity and desire.

Should be fun. I’m going to start them out with this question: What words, ideas, images, characteristics, etc. come to mind when you complete the sentence, “A man is…” or “A woman is…”

We all have images and words and ideas that pop into our heads. We have an image of a “manly” man and a “womanly” woman. I want the audience to think for a bit about where those images come from.

What images pop into your head? How do these effect your own evaluation of your manhood or womanhood? Where did that script come from?

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Filed under Identity, sexual identity, sexuality