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ABSTRACT
Robert L. Spitzer, MD, recently published a report, “Can Some Gay Men and Lesbians Change Their Sexual Orientation?: 200 Subjects Reporting a Change from Homosexual to Heterosexual Orientation.” He recruited men and women who reported to once have had a predominantly homosexual orientation–which they felt conflicted about–and who claimed, due to some kind of “therapy,” to have sustained some change to a heterosexual orientation for at least five years. “Therapy” in this study included either seeing a mental health professional, attending an ex-gay or other religious support group, bibliotherapy, repeated meetings with a heterosexual role model, or, without any external support, changing one's relationship to God. Spitzer interviewed his participants by telephone, asking 114 closed-ended and some open-ended questions, which were answered in about 45 minutes.
Spitzer acknowledges that this approach has numerous limitations and discusses several of them in the paper. However, a careful methodological assessment of how Spitzer's study was conducted leads to the conclusion that its author's claims are not warranted. The major issue is how was change assessed, which is problematic because of the following combination of reasons: (1) reliance on self-report; (2) biased selection of the sample; (3) retrospective design of the study; (4) use of a telephone interview as the data collection method; (5) the way “harm” was operationalized; and (6) insufficient reporting of the findings. Even if the respondents' reports were valid, the changes observed are not as big as the title of the report suggests. The paper's discussion suggests what Spitzer could have done to do a better study, and then concludes with suggestions about what Spitzer should have done.