Reparative journalism

Reporter sinks a controversial paper on “ex-gay” therapy

It’s not often that a journalist convinces a prominent scientist to recant a controversial study that he has tenaciously defended for 11 years, but that’s just what Gabriel Arana did last month.

While working on an article for The American Prospect about his experience undergoing so-called sexual reorientation, or reparative therapy, as a teenager in the late 1990s, Arana interviewed Dr. Robert Spitzer, who authored a controversial 2001 research paper, which concluded that the therapy worked for some people.

Spitzer, then a professor of psychiatry at Columbia University, had interviewed 200 patients who claimed the therapy had led to a shift toward heterosexual orientation.

The journal Archives of Sexual Behavior published Spitzer’s paper along with more then two-dozen commentaries from his peers, however, who criticized him for relying on patients referred by groups that condemned homosexuality and for uncritically accepting patients’ assertions that they’d changed, among other faults. As a recent front-page article in The New York Times reported:

The study had serious problems. It was based on what people remembered feeling years before — an often fuzzy record. It included some ex-gay advocates, who were politically active. And it did not test any particular therapy; only half of the participants engaged with a therapist at all, while the others worked with pastoral counselors, or in independent Bible study.

Nonetheless, Spitzer stuck to his guns for more than a decade, until Arana showed up at his door earlier this spring. In the course of their interview, Arana told Spitzer that in 2001, his reorientation therapist had asked him to participate in Spitzer’s study. But Arana never called. Had he, Arana added, he would have told Spitzer that he, too, was making progress, even though he wasn’t.

The revelation pushed Spitzer over the edge. When Arana asked about the criticisms of his paper, Spitzer finally admitted that they were “largely correct.”

“What impressed me was how he said that had he called in, he would’ve told me he was making improvement, when in fact he was not,” Spitzer said in an interview with CJR. “It made me think about what I didn’t want to think about, which was my decision to accept the credibility of my subjects’ answers.”

Spitzer saw that those answers were inherently unreliable and unverifiable, and the conversation convinced him to follow through on a letter he’d been thinking about writing to Archives of Sexual Behavior formally disavowing his research.

“Once I knew he [Arana] was going to write about my misgivings, I decided that I had an obligation to explain my feelings myself and not only through him,” he said.

The journal will publish the letter soon, according to Spitzer, but Truth Wins Out, a non-profit organization that “fights anti-gay religious extremism,” posted a leaked draft in late April, a couple of weeks after Arana’s article appeared in the Prospect. In it, Spitzer credited the reporter and apologized to the gay community for “making unproven claims of the efficacy of reparative therapy.”

E.J. Graff, one of Arana’s colleagues at the Prospect, who writes about human rights and discrimination issues, posted the draft as well. “Ask the right questions,” she wrote in the headline, “and you can change the world.”

Indeed, Arana’s work is a wonderful, albeit rare, example of the corrective power of courageous journalism. His article has set off a wave of high-profile coverage, including the front-page Times article cited above, which was published on May 19. On Monday, NPR’s Talk of the Nation invited Spitzer, Arana, and Benedict Carey, the author of the Times piece, to discuss the repudiation of the 2001 study.

“I didn’t go with the expectation of confronting [Spitzer],” Arana explained, adding that he “was a bit taken aback” when Spitzer conceded that his study was fatally flawed.

Unfortunately, coverage of reparative therapy was not always as critical as it could have been. In his article for the Prospect, Arana noted that in 1998, the year he started therapy, national newspapers published an ad campaign sponsored by conservative religious organizations asserting that the technique worked. According to Arana:

With few voices to challenge the testimonials, reporters transmitted them as revelation. Newsweek ran a sympathetic cover story on change therapy, and national and regional papers published ex-gays’ accounts.

By the time Spitzer’s paper was published three years later, the coverage had improved, but many problems remained. An article from The Associated Press quoted a variety of critics, for example, but featured a sensational lede that referred to the analysis as “an explosive new study.” It also failed to report that at the same meeting of the American Psychiatric Association where Spitzer was presenting his paper, some his peers were presenting research which found that reparative therapy was ineffective and could even cause “significant harm” to patients.

Articles in The New York Times, The Washington Post, and the San Francisco Chronicle were more comprehensive and critical, but a news roundup at the time by the group Fairness & Accuracy in Reporting (FAIR) concluded that, on balance, journalists played up controversy at the expense of credibility.

Even Spitzer, who had led the charge for removing homosexuality from the list of disorders in psychiatry’s principal diagnostic manual in 1973, complained about the coverage. In an op-ed for The Wall Street Journal (unavailable online), he wrote:

My study concluded with an important caveat: that it should not be used to justify a denial of civil rights to homosexuals, or as support for coercive treatment. I did not conclude that all gays should try to change, or even that they would be better off if they did. However, to my horror, some of the media reported the study as an attempt to show that homosexuality is a choice, and that substantial change is possible for any homosexual who decides to make the effort.

Now Spitzer has come to believe that reparative therapy shouldn’t be used at all, but that hasn’t quelled problematic coverage. William Saletan, a science reporter for Slate, argued that Spitzer’s disavowal of his paper doesn’t mean reparative therapy should be “eradicated.” According to his post:

Experience and research suggest it’s extremely unlikely that you can change your sexual orientation, and you’re better off accepting who you are. But what’s true for you may not be true for someone closer to the margins of homosexuality. Tempting as it is to politicize Spitzer’s apology and dismiss the malleability of sexual orientation, resist that urge. Morally and therapeutically, it’s better to treat people as individuals.

Saletan is generally a good reporter, but his logic is hard to accept in light of the World Health Organization’s statement on May 17 that, “Services that purport to ‘cure’ people with non-heterosexual sexual orientation lack medical justification and represent a serious threat to the health and well-being of affected people…”

In his article for the Prospect, Arana wrote that his failed reorientation program almost drove him to suicide, and Spitzer said that while he still thinks people’s sexual orientations can change over time, “there are dangers to reparative therapy that are quite clear and noticeable.”

Moreover, Spitzer added, “There is really no such thing as reparative therapy. Reparative therapy is any therapy that has the goal of making somebody straight, but there are no specific techniques or approach that defines what reparative therapy is.”

Spitzer appreciates the coverage of his conversion, calling the articles by Arana and The New York Times “terrific.” As Arana reported, “Now 80 and retired, he was afraid that the 2001 study would tarnish his legacy and perhaps hurt others.” But he may never have done it without a push, and now Arana, who didn’t respond to a request for comment, has a legacy that he can be proud of, too. Call it reparative journalism.

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Curtis Brainard writes on science and environment reporting. Follow him on Twitter @cbrainard. Tags: , , , ,