By Gregory Coles. Greg holds a PhD from Penn State, is a Senior Research Fellow at The Center, and is the author of Single, Gay, Christian, No Longer Strangers, and The Limits of My World.
Author and licensed psychologist Dr. Julia Sadusky recently published a short video explaining why she doesn’t do Reintegrative Therapy as a Catholic therapist. If you’re not familiar with Reintegrative Therapy, it’s a clinical approach which claims to bring about shifts in sexual orientation as a byproduct of trauma therapy. In their own words: “Reintegrative Therapy® is associated with statistically significant decreases in same-sex attractions, increases in heterosexual attractions, changes in sexual identity toward a heterosexual identity, and increases in psychological well-being (e.g., decreases in anxiety, depression, and suicidality).”[1]
I found Sadusky’s video quite compelling, and I recommend it to you. Of course, no one should be surprised that I feel this way. Several of Sadusky’s concerns align closely with what I’ve previously written about Reintegrative Therapy (here, here, and here). Also, she happens to be a voice I trust in this space.
Likewise unsurprisingly, some key voices connected to Reintegrative Therapy are less enthused by Sadusky’s video. Andrew Rodriguez, a certified Reintegrative Therapist, released a rebuttal video over two hours long. And Dr. Carolyn Pela, lead author on a study of Reintegrative Therapy criticized by both Sadusky and me, wrote a press release accusing Sadusky of “serious misrepresentations of my research.”
I don’t intend in this blog post to respond to every claim made by Sadusky’s critics. If you’re feeling highly curious (and highly motivated), I encourage you to go and read Pela’s study (coauthored by Philip Sutton), engage with Sadusky’s and my hesitations about the trustworthiness of the study, engage with Rodriguez’s and Pela’s responses to Sadusky, and then make your own conclusions. May the best reasoning persuade you!
My goal in writing here is to explore a few points of fascination as I’ve followed Rodriguez’s and Pela’s responses to Sadusky.
First, Rodriguez makes the striking claim that Pela and Sutton’s study wasn’t in fact a “two-year” study, and that it’s unfair to critique it as if it were a two-year study (and then raise questions about the low proportion of participants who remained involved for the entire two years). Here are his exact words:
It wasn’t a two-year study; it was a longitudinal study in that they would be assessed every six months during their therapy up until two years.
I was fascinated to hear this from Rodriguez, because Pela and Sutton themselves use the phrase “two-year study” within their study to explain why they took the approach they did.[2] Do they continue to think of their study as a two-year study? If so, what do they make of Rodriguez’s claim that it isn’t truly a two-year study?
If Pela and Sutton’s study is indeed a two-year study, I would have expected them to follow a majority of people for two years, sending follow-up assessments even after the group they call “early completers” ended therapy. This would have strengthened their claim that attraction changes persist over time. If the study isn’t a two-year study, I would have expected them to clarify this in their language. Either way, it’s hard to see how Sadusky is misrepresenting the study by critiquing it as a two-year study, since the study seems to regard itself as a two-year study.
Far more significantly, since Pela is concerned about serious misrepresentations of scholarly research, I read with great curiosity this section of her press release:
Dr. Sadusky also claimed, “we can’t say there is a causal shift” between a therapeutic intervention and sexual attraction changes. This contradicts emerging research. At least six recent studies across three continents—conducted by researchers with varying ideological perspectives—now suggest that sexual attractions can change as a byproduct of interventions. These studies include Allen et al. (2023), Bartels et al. (2018), Cornine (2013), Dickenson et al. (2021), Nicolosi and Szanduła (2024), and Pela and Sutton (2021).
Pela cites six studies as proof that Sadusky is incorrect—proof, apparently, that there is substantial evidence suggesting certain therapy interventions causally change the direction of people’s sexual attraction patterns (from gay to straight). And yet, at least three of the six studies Pela cites say nothing of the sort.[3]
Two of these studies—Allen et al. (2023) and Bartels et al. (2018)—describe using eye movement therapy to reduce the intensity of specific sexual fantasies. Neither study has anything to do with shifting the direction of broader attraction patterns (from gay to straight, or otherwise). In Bartels et al., for instance, 86% of the study’s participants identified as heterosexual. While these participants generally experienced diminished intensity in a specific sexual fantasy after therapy, the study never attempts to demonstrate that the participants were in any way less heterosexual after treatment.
A third study included in Pela’s list, Dickenson et al. (2021), uses neuroscience to observe how heterosexually identified women responded to sexual stimuli that was either consistent with their orientation (depicting men) or inconsistent with their orientation (depicting women). The study also explores the impact of mindfulness on participants’ sexual arousal. The authors conclude that “[s]exual orientation, rather than erotic flexibility, guides how women sexually respond to various genders.” Moreover, they argue that “attempting to change attentional processing only magnifies the effect of sexual orientation on women’s sexual processing.”
In other words, according to Dickenson et al., women’s spontaneous experiences of sexual arousal seem to be shaped by their broader pattern of sexual attraction (that is, their orientation). In fact, attempts to change the direction of their sexual attraction pattern may simply reinforce that sexual attraction pattern all the more.
The remaining three studies Pela mentions in her press release are a case report of a single client (Cornine [2013]), a study whose lead author is the founder of Reintegrative Therapy (Nicolosi and Szanduła [2024]), and the study critiqued by Sadusky on which Pela herself is lead author (Pela and Sutton [2021]).
I suspect the authors of these latter three studies are comfortable seeing their work marshalled in the way Pela marshals them—as evidence that certain therapy interventions causally change the direction of people’s sexual attraction patterns from gay to straight. But I struggle to imagine Allen et al., Bartels et al., or Dickenson et al. being comfortable with this representation of their work. What Pela implies these studies demonstrate is strikingly unlike what the studies themselves report.
If Pela is concerned about correcting serious misrepresentations, then, perhaps she’d like to begin by correcting her own misleading portrayal of these scholars’ work.
[1] This language comes from the Reintegrative Therapy website’s “Science” page: https://www.reintegrativetherapy.com/the-science/
[2] Specifically, in explaining their choice of a data analysis model, they argue that “[t]he repeated-measures ANOVA only functions well when missing data is not a problem (which is rare in a two-year study)” (p. 71). If Pela and Sutton did not in fact consider their study to be a two-year study, this would be an odd comment to make.
[3] Getting even deeper into the academic weeds: Notice Sadusky’s use of the words “causal shift.” When researchers want to show whether a therapeutic intervention is effective, they typically demonstrate causal shifts using a type of study called a randomized controlled trial (RCT). RCTs generally study two randomized groups: one group that receives the intervention being studied, and a second group (called the control group) that receives a previously established intervention or a placebo. For example, an RCT exploring whether there was a causal shift between a therapeutic intervention and a reduction in patterns of attraction to the same sex would randomly assign some same-sex attracted people to a therapeutic intervention (like Reintegrative Therapy) and others to a control group. Then, the research would report on the attraction pattern outcomes of each group. Of the six studies Pela cites, only one is an RCT. This doesn’t mean the other five studies are untrustworthy; it simply means we’d be unwise to claim them as evidence for the efficacy of a therapeutic intervention in creating “causal shifts.” As for the one study Pela cites which is an RCT—Nicolosi and Szandula (2024)—this study is looking at subjective reports of arousal related to a particular “unwanted sexually arousing memory,” not demonstrating categorical shifts in sexual attraction patterns more broadly.