Sunday, June 23, 2019

Conversion therapy is a toxic dead end for LGBT people - UPDATED

Every mainstream medical and counseling professional peer association agrees that conversion therapy is ineffective and potentially harmful.
Conversion therapy
Originally published on August 8, 2018.

Liberty Counsel, an anti-LGBT hate group, is spreading misinformation throughout the religious right echo chamber about the supposed effectiveness of conversion therapy.

Update: Hemant Mehta (Friendly Atheist) found out that the subject research article has been retracted by Linacre, the journal of the Catholic Medical Association. Mad Mat Staver is going to be even madder when he finds out. I have his real email address. I think that I will drop him a little note.

The existence of conversion therapy is — and always has been — a way for the religious right to claim that sexuality is a choice and is not immutable. They perpetuate the myth that sexuality they disapprove of is a mental disorder that can be cured.

Hate groups like Liberty Counsel spread falsehoods about conversion therapy to justify discrimination and to oppose nondiscrimination laws. Let us be clear that these groups wish to discriminate because they disapprove of LGBT people based on a literalist interpretation of very ancient texts.

According to Liberty Counsel:
A recent study, Effects of Therapy on Religious Men Who Have Unwanted Same-Sex Attraction, confirms the overwhelming effectiveness of people receiving counseling to reduce or eliminate their unwanted same-sex attractions, behaviors, or identity.
It is not recent, it is not really a study, it is published to the “journal” of the Catholic Medical Association and it proves only the determination of religious people to conform their world to scripture. It would not have survived peer review by any mainstream academic journal.

According to the article:
Over a six-week period (January 2011–February 2011), 197 surveys were filled out online, and completely, by 150 men and 8 women. For cultural and gender consistency, the survey sample was reduced to 125 male US residents. A few incomplete questionnaires were included if missing data would not affect calculations.
So much for the recency and the sample should be diverse; not consistent. More importantly, the lead author of the paper is Paul L. Santero. It just so happens that Santero wrote a book in 2011 with a very similar title: The Effects of Therapy on U.S. Men with Unwanted Same-sex Attraction. A vanity-published book has been retitled and reduced to a paper without the assistance of the lead author.

How do I know that the lead author was not responsible? If you look at the July, 2018 article, Santero is referred to only by his employer, Southern California Seminary in El Cajon, CA. However, Santero is not an employee of the seminary. He might have been in 2011 when he first authored his treatise but he is nowhere to be found. Santero is credited with  PhD. I have been unable to determine his field, when he supposedly received the degree and from where. The publisher of the article does not inform us. I suspect that they do not know.

Assuming that the seminary was Santero's employer at the time that he wrote his book (which is uncertain) then there is a strong probability that his PhD is not in a field related to sociology or counseling.

Since the Catholic Medical Association doesn't know what Santero's credentials are or where he is employed, they were unlikely to be in contact with him. This, in turn, suggests the absence of any meaningful peer review because the process ordinarily requires an interchange between the referees, the editor and the author. Moreover, the expertise of the author is an important factor in real peer review.

According to the article:
Corresponding Author:
Neil E. Whitehead, PhD, Whitehead Associates, Lower
Hutt, 5010 New Zealand.
Dr. Whitehead is a former and long time employee of the New Zealand government. He is well known for his literature reviews that are designed to demonstrate that gay people can be cured. He concedes small points to make himself look credible. While Whitehead has a PhD this is not his field. His doctorate is in biochemistry. Whitehead's usual venue (NARTH's as well) is The Journal of Human Sexuality. This is the home page of their website:

Crackpot central for anti-LGBT treatises
I can find no evidence that Dr. Whitehead has ever published any paper on human sexuality to a scholarly academic journal with rigorous peer review.

My theory is that Whitehead is responsible for the July submission of the subject article to the Catholic Medical Association which was distilled from Santero's 2011 book.

The third author is Dolores Ballesteros, PhD. Like Santero, the only information that we have is an association with Southern California Seminary. Like Santero, she is not listed as faculty or staff. Like Santero, we have no idea what her field is, from where she obtained her PhD or when.

With any scientific paper, the credibility is first determined by the credibility of the outlet, the rigor of peer review (if any) and the credentials of the authors. This is a fail on all counts. But there is more as we discover how participants were recruited:
Ex-gay ministry groups and affiliated private therapists throughout the United States that worked with individuals who wanted help with their unwanted same-sex attraction were contacted. These contact people asked individuals over eighteen years old who had either been through or were currently in therapy for their same-sex attraction and whether they might be interested in taking the survey.
This is not even a convenience sample. Convenience sampling is a non-probability sampling technique where subjects are selected because of their convenient accessibility and proximity to the researcher. In this case, participants were selected for their accessibility and proximity to the recruiter who had a vested interest in the outcome of the study. There is no way that this methodology would survive scholarly peer review.

There is more.

This has the appearance of a cohort study which is a form of longitudinal study. However, a cohort study has similarly situated participants with a common time frame. In other words: Recipients of conversion therapy who began the process during [limited date span]. Santero's subjects are merely limited to adults. Some might have just started while others might have been in counseling for years. Moreover, in a longitudinal study, participants are observed over a long period of time; years and even decades. This was a one-shot web survey.

There is much more but I would point out that they used the same online questionnaire to determine the mental health of the participants to depict whether conversion therapy was harmful. People cannot appreciate their own mental health. Some self-assessment is possible but that would require a study questionnaire designed by disinterested mental health professionals. To document changes in mental health would require questioning over time.

Furthermore, they conclude that conversion therapy is harmless without any evaluation of mental health prior to conversion therapy and, because the cohort lacks a common date span, there is no understanding of how mental health changed even if it had been measured over time.

In other words, progress cannot be measured without an evaluation at a fixed starting point and there is none. There was no evaluation prior to counseling and there is no predetermined starting point because of the lack of a real cohort. In a word, this is bullshit.

Image from Southern California Seminary website
Santero, then in the employ of a very conservative Christian seminary, predetermined the outcome of this enterprise before he typed a word of his book. He made sure that he would achieve that result.

With that in mind, let us return to the polemic of Liberty Counsel:
Liberty Counsel has filed several lawsuits challenging laws banning counsel that might change or reduce unwanted same-sex attractions, behavior or identity. One filed suit is against the City of Tampa for its adoption of an ordinance that prohibits licensed counselors from providing and clients from receiving counsel to reduce or eliminate unwanted same-sex attractions, behaviors, or identity. The ordinance imposes significant monetary fines on counselors who provide such counseling. Liberty Counsel represents Robert Vazzo, LMFT, David Pickup, LMFT, and their minor clients and their parents.
Of course Liberty Counsel is doing this because there is a veritable tide of people desiring conversion therapy. I said, at the outset, that conversion therapy is all about discrimination; excusing it and opposing nondiscrimination laws. In the Tampa matter, Liberty Counsel filed a 200 page complaint. Since December there are 106 docket entries. This has generated thousands of pages of briefs, motions and responses.

Unfortunately in 1993 (Daubert v. Merrell Dow Pharmaceuticals) the Supreme Court made it the job of federal judges to act as gatekeepers. Individuals with little scientific training are required to sift out real science from junk science. In this case, however, the scientific consensus should mean something but it is up to lawyers to properly present the facts about qualifications, methodology and peer review.

After noting other similar cases that Liberty Counsel is involved in, they conclude:
"This recent study by Santero, Whitehead and Ballesteros again confirms that people struggling with unwanted same-sex attractions, behaviors or identity benefit significantly from professional counseling," said Mat Staver, Founder and Chairman of Liberty Counsel. "Every person should have access to the counsel of their choice. No government has the authority to prohibit a form of counseling simply because it does not like the religious or moral beliefs of a particular counselor or client," said Staver.
“Recent study?” When research by qualified scientists is published to a mainstream scholarly journal with rigorous peer review, it is worthy of consideration. All else is junk science. There is nothing other than junk science in support of conversion therapy. Liberty Counsel is willing to compromise the wellbeing of individuals in order to advance discrimination against those same individuals.

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