By Gregory Coles. Greg is a Senior Research Fellow at The Center and is the author of Single, Gay, Christian and No Longer Strangers.
If you visit the website of the Reintegrative Therapy Association, you’ll see a triumphant announcement on their homepage declaring, “Landmark Study Shows Trauma Treatment Significantly Alters Sexual Attractions.” Dig deeper into the website, and you’ll find this elaboration:
We know from large-scale, longitudinal evidence that Reintegrative Therapy® is associated with statistically-significant[1] decreases in same-sex attractions, increases in heterosexual attractions, changes in sexual identity toward a heterosexual identity, and increases in psychological well-being (for example, decreases in anxiety, depression and suicidality).
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It's worth noting that Reintegrative Therapy is the brainchild of Dr. Joseph Nicolosi, Jr., whose father—Nicolosi, Sr.—was the founder of Reparative Therapy. Although the term “reparative therapy” has sometimes been used as a synonym for all forms of sexual orientation change efforts (or “conversion therapy”), Reparative Therapy refers specifically to Nicolosi, Sr.’s clinical approach, which claimed to “heal” same-sex orientation in men by addressing childhood wounds and traumas (specifically poor relationships with their fathers) in psychotherapy. [2]
In Reintegrative Therapy, the approach remains largely the same, though the claims are somewhat more muted. Instead of describing sexual orientation change as the goal of their therapy, they write that it is a “byproduct” of trauma treatment. They also incorporate the recent (and widely respected) trauma therapy technique EMDR, a physiological strategy for reprocessing past trauma through eye movement.
In one sense, there’s much to appreciate about Reintegrative Therapy. Helping people (of any sexual orientation) process past trauma and find healing from that trauma is always a good thing. And insofar as processing trauma happens to cause someone to experience their sexuality differently, I see no need to object to such a shift per se.[3] But of course, this returns us the inevitable question: how effective is Reintegrative Therapy in bringing about sexual orientation change? What is this large-scale, longitudinal evidence that connects Reintegrative Therapy to statistically significant decreases in same-sex attractions?
The evidence is described in an article titled “Sexual Attraction Fluidity and Well-Being in Men: A Therapeutic Outcome Study,” written by Carolyn Pela and Philip Sutton, published in the Journal of Human Sexuality in 2021. On its face, the research sounds impressive. It’s a two-year longitudinal study of 75 adult males, measuring their levels of same-sex attraction, opposite-sex attraction, and psychological well-being. At the end of the study, the researchers found that participants’ same-sex attraction had diminished, opposite-sex attraction had increased, and psychological well-being had increased.
There you have it: the therapy works! Problem solved! What’s not to love?
Quite a few things, actually. So many things that I’ll need another blog post to get to them all. But let’s start with the most obvious problem:
PUBLICATION VETTING
One reason we tend to trust scientific studies is that we believe they’ve been highly vetted during the peer review process, a process overseen by the academic journals where the studies are published. Any fool with a Ph.D. after their name can string together some words and throw them online for the world to read (for example, the blog post you are currently reading). But publishing in a credible journal means that other renowned experts have examined your data and your arguments, affirmed their credibility, and commended them to the broader academic field. The Journal of Human Sexuality sounds like this sort of credible publication: the kind of journal that would highly vet its publications.
Unfortunately, the name is more grandiose than the reality. The Journal of Human Sexuality is the publishing arm of the Alliance for Therapeutic Choice and Scientific Integrity (ATCSI), an organization whose mission includes “promoting a more complete truth… about the science of sexual orientation.” In their statement on sexual orientation change, dated 2012—nine years before Pela and Sutton’s purportedly “landmark” study—ATCSI declares that they are “committed to protecting the rights of clients with unwanted same-sex attractions to pursue change as well as the rights of clinicians to provide such psychological care.”
In other words, the people who published this study already knew which conclusions the study needed to reach. The Pela and Sutton study was published in The Journal of Human Sexuality not because (or, at least, not simply because) it was objectively good scientific work, but also because it matched the organization’s preexisting ideological commitments.[4]
This ideological alignment is especially notable given that ATCSI (and therefore the Journal of Human Sexuality) is funded by donations. They’re registered as a 501(c)(3) tax-exempt charity; the Journal’s homepage has a button that pleads “Help fund this vital Publication - CLICK TO DONATE.”[5]
When a journal is funded by donations given with a clear ideological motivation, we shouldn’t be surprised if that journal publishes articles that align neatly with the ideological motivations of its donors. Publishing what donors want to read is a time-honored strategy for financial solubility.
We should also consider the editorial board at the Journal of Human Sexuality. Their About page lists only one name among their editorial board of advisors: Philip M. Sutton, Ph.D.[6] If this name seems familiar to you, it’s because Dr. Sutton is the co-author of the study in question. It is, of course, possible to imagine an essay co-written by the sole member of a journal’s editorial board undergoing a rigorous vetting process before being published in that journal; but it does strain the imagination.[7]
All of this, of course, doesn’t address the contents of the study itself. For those details, I refer you to Part 2 of our miniseries, available here.
[1] A punctuational word to the wise: Words ending in “-ly” are not typically followed by hyphens in well-edited formal English.
[2] Nicolosi, Sr.’s 1993 book was titled Healing Homosexuality: Case Studies of Reparative Therapy.
[3] I am, however, deeply concerned about the ethics of working with gay clients whose reason for pursuing therapy is their desire to become straight, then implying to those clients that a change in their sexual orientation is a likely byproduct of therapy, and yet claiming that this therapy is not in fact an effort to change sexual orientation. It’s also worth asking whether a shift from same-sex orientation to opposite-sex orientation is experientially or spiritually advantageous. Since my thoughts on that latter topic are already available here and here, I won’t revisit them at present.
[4] Of course, no publication venue is without bias. The academic peer review process tends to be biased towards the preferential attitudes of the academy as a whole. But academic journals are formed around professional communities that develop biases organically over time; these journals also tend to have a dissenting minority within their community, by virtue of the breadth of most professions, and tend to experience gradual shifts in those biases over time in response to cultural shifts and new findings in the field. ATCSI, on the other hand, is specifically formed around an ideological position, and it simply draws people from any discipline who share that ideological position. It definitionally excludes an objecting minority as being outside of the journal’s "scholarly community" (in ways that a true scholarly community could never pull off, much as they might wish to at times). ATCSI’s self-definition renders impossible any meaningful shifts in response to new findings in the field. In some ways, the biases of an academic journal could be more insidious than ATCSI’s biases, because they are more hidden. At the same time, the biases of academic journals are also less egregious, because these journals do privilege (at least to some degree) the intellectual necessity of dissent.
[5] In case you don’t spend a lot of time reading academic journals: this is not a button typically found on credible journal websites.
[6] As of this writing, the website actually lists him as "Philp" rather than "Philip"
[7] Dr. Nicolosi Jr. has made the following clarifying statement about Dr. Sutton's editorial role: "Phil Sutton was not a peer reviewer for his own study. In a small field of academic study, it’s not unusual for an author who is also on a peer-review board to step down and allow others to do the peer-review work for them. This is the norm for all very specialized journals in all branches of science. That’s what happened with this article."