Scotties Toy Box

May 20, 2012

Dr. Robert L. Spitzer, Noted Psychiatrist, Apologizes for Study on Gay ‘Cure’ –

Filed under: News — Scottie @ 15:30

Dr. Robert L. Spitzer, Noted Psychiatrist, Apologizes for Study on Gay ‘Cure’ –

Psychiatry Giant Sorry for Backing Gay ‘Cure’

Alex di Suvero for The New York Times

Dr. Robert L. Spitzer is a major architect of the modern classification of mental disorders.

Enlarge This Image
PRINCETON, N.J. — The simple fact was that he had done something wrong, and at the end of a long and revolutionary career it didn’t matter how often he’d been right, how powerful he once was, or what it would mean for his legacy.

Caleb Kenna for The New York Times

Wayne Besen, executive director of Truth Wins Out, a nonprofit group that fights antigay bias, in Burlington, Vt.

Readers’ Comments

Readers shared their thoughts on this article.

Dr. Robert L. Spitzer, considered by some to be the father of modern psychiatry, lay awake at 4 o’clock on a recent morning knowing he had to do the one thing that comes least naturally to him.

He pushed himself up and staggered into the dark. His desk seemed impossibly far away; Dr. Spitzer, who turns 80 next week, suffers from Parkinson’s disease and has trouble walking, sitting, even holding his head upright.

The word he sometimes uses to describe these limitations — pathetic — is the same one that for decades he wielded like an ax to strike down dumb ideas, empty theorizing and junk studies.

Now here he was at his computer, ready to recant a study he had done himself, a poorly conceived 2003 investigation that supported the use of so-called reparative therapy to “cure” homosexuality for people strongly motivated to change.

What to say? The issue of gay marriage was rocking national politics yet again. The California State Legislature was debating a bill to ban the therapy outright as being dangerous. A magazine writer who had been through the therapy as a teenager recently visited his house, to explain how miserably disorienting the experience was.

And he would later learn that a World Health Organization report, released on Thursday, calls the therapy “a serious threat to the health and well-being — even the lives — of affected people.”

Dr. Spitzer’s fingers jerked over the keys, unreliably, as if choking on the words. And then it was done: a short letter to be published this month, in the same journal where the original study appeared.

“I believe,” it concludes, “I owe the gay community an apology.”

Disturber of the Peace

The idea to study reparative therapy at all was pure Spitzer, say those who know him, an effort to stick a finger in the eye of an orthodoxy that he himself had helped establish.

In the late 1990s as today, the psychiatric establishment considered the therapy to be a nonstarter. Few therapists thought of homosexuality as a disorder.

It was not always so. Up into the 1970s, the field’s diagnostic manual classified homosexuality as an illness, calling it a “sociopathic personality disturbance.” Many therapists offered treatment, including Freudian analysts who dominated the field at the time.

Advocates for gay people objected furiously, and in 1970, one year after the landmark Stonewall protests to stop police raids at a New York bar, a team of gay rights protesters heckled a meeting of behavioral therapists in New York to discuss the topic. The meeting broke up, but not before a young Columbia University professor sat down with the protesters to hear their case.

“I’ve always been drawn to controversy, and what I was hearing made sense,” said Dr. Spitzer, in an interview at his Princeton home last week. “And I began to think, well, if it is a mental disorder, then what makes it one?”

He compared homosexuality with other conditions defined as disorders, like depressionand alcohol dependence, and saw immediately that the latter caused marked distress or impairment, while homosexuality often did not.

He also saw an opportunity to do something about it. Dr. Spitzer was then a junior member of on an American Psychiatric Association committee helping to rewrite the field’s diagnostic manual, and he promptly organized a symposium to discuss the place of homosexuality.

That kicked off a series of bitter debates, pitting Dr. Spitzer against a pair of influential senior psychiatrists who would not budge. In the end, the psychiatric association in 1973 sided with Dr. Spitzer, deciding to drop homosexuality from its manual and replace it with his alternative, “sexual orientation disturbance,” to identify people whose sexual orientation, gay or straight, caused them distress.

The arcane language notwithstanding, homosexuality was no longer a “disorder.” Dr. Spitzer achieved a civil rights breakthrough in record time.

“I wouldn’t say that Robert Spitzer became a household name among the broader gay movement, but the declassification of homosexuality was widely celebrated as a victory,” said Ronald Bayer of the Center for the History and Ethics of Public Health at Columbia. “ ‘Sick No More’ was a headline in some gay newspapers.”

Partly as a result, Dr. Spitzer took charge of the task of updating the diagnostic manual. Together with a colleague, Dr. Janet Williams, now his wife, he set to work. To an extent that is still not widely appreciated, his thinking about this one issue — homosexuality — drove a broader reconsideration of what mental illness is, of where to draw the line between normal and not.

The new manual, a 567-page doorstop released in 1980, became an unlikely best seller, here and abroad. It instantly set the standard for future psychiatry manuals, and elevated its principal architect, then nearing 50, to the pinnacle of his field.

He was the keeper of the book, part headmaster, part ambassador, and part ornery cleric, growling over the phone at scientists, journalists, or policy makers he thought were out of order. He took to the role as if born to it, colleagues say, helping to bring order to a historically chaotic corner of science.

But power was its own kind of confinement. Dr. Spitzer could still disturb the peace, all right, but no longer from the flanks, as a rebel. Now he was the establishment. And in the late 1990s, friends say, he remained restless as ever, eager to challenge common assumptions.

That’s when he ran into another group of protesters, at the psychiatric association’s annual meeting in 1999: self-described ex-gays. Like the homosexual protesters in 1973, they too were outraged that psychiatry was denying their experience — and any therapy that might help.

Reparative Therapy

Reparative therapy, sometimes called “sexual reorientation” or “conversion” therapy, is rooted in Freud’s idea that people are born bisexual and can move along a continuum from one end to the other. Some therapists never let go of the theory, and one of Dr. Spitzer’s main rivals in the 1973 debate, Dr. Charles W. Socarides, founded an organization called the National Association for Research and Therapy of Homosexuality, or Narth, in Southern California, to promote it.

By 1998, Narth had formed alliances with socially conservative advocacy groups and together they began an aggressive campaign, taking out full-page ads in major newspaper trumpeting success stories.

“People with a shared worldview basically came together and created their own set of experts to offer alternative policy views,” said Dr. Jack Drescher, a psychiatrist in New York and co-editor of “Ex-Gay Research: Analyzing the Spitzer Study and Its Relation to Science, Religion, Politics, and Culture.”

To Dr. Spitzer, the scientific question was at least worth asking: What was the effect of the therapy, if any? Previous studies had been biased and inconclusive. “People at the time did say to me, ‘Bob, you’re messing with your career, don’t do it,’ ” Dr. Spitzer said. “But I just didn’t feel vulnerable.”

He recruited 200 men and women, from the centers that were performing the therapy, including Exodus International, based in Florida, and Narth. He interviewed each in depth over the phone, asking about their sexual urges, feelings and behaviors before and after having the therapy, rating the answers on a scale.

He then compared the scores on this questionnaire, before and after therapy. “The majority of participants gave reports of change from a predominantly or exclusively homosexual orientation before therapy to a predominantly or exclusively heterosexual orientation in the past year,” his paper concluded.

The study — presented at a psychiatry meeting in 2001, before publication — immediately created a sensation, and ex-gay groups seized on it as solid evidence for their case. This was Dr. Spitzer, after all, the man who single-handedly removed homosexuality from the manual of mental disorders. No one could accuse him of bias.

But gay leaders accused him of betrayal, and they had their reasons.

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.

Several colleagues tried to stop the study in its tracks, and urged him not to publish it, Dr. Spitzer said.

Yet, heavily invested after all the work, he turned to a friend and former collaborator, Dr. Kenneth J. Zucker, psychologist in chief at the Center for Addiction and Mental Health in Toronto and editor of the Archives of Sexual Behavior, another influential journal.

“I knew Bob and the quality of his work, and I agreed to publish it,” Dr. Zucker said in an interview last week. The paper did not go through the usual peer-review process, in which unnamed experts critique a manuscript before publication. “But I told him I would do it only if I also published commentaries” of response from other scientists to accompany the study, Dr. Zucker said.

Those commentaries, with a few exceptions, were merciless. One cited the Nuremberg Code of ethics to denounce the study as not only flawed but morally wrong. “We fear the repercussions of this study, including an increase in suffering, prejudice, and discrimination,” concluded a group of 15 researchers at the New York State Psychiatric Institute, where Dr. Spitzer was affiliated.

Dr. Spitzer in no way implied in the study that being gay was a choice, or that it was possible for anyone who wanted to change to do so in therapy. But that didn’t stop socially conservative groups from citing the paper in support of just those points, according to Wayne Besen, executive director of Truth Wins Out, a nonprofit group that fights antigay bias.

On one occasion, a politician in Finland held up the study in Parliament to argue against civil unions, according to Dr. Drescher.

“It needs to be said that when this study was misused for political purposes to say that gays should be cured — as it was, many times — Bob responded immediately, to correct misperceptions,” said Dr. Drescher, who is gay.

But Dr. Spitzer could not control how his study was interpreted by everyone, and he could not erase the biggest scientific flaw of them all, roundly attacked in many of the commentaries: Simply asking people whether they have changed is no evidence at all of real change. People lie, to themselves and others. They continually change their stories, to suit their needs and moods.

By almost any measure, in short, the study failed the test of scientific rigor that Dr. Spitzer himself was so instrumental in enforcing for so many years.

“As I read these commentaries, I knew this was a problem, a big problem, and one I couldn’t answer,” Dr. Spitzer said. “How do you know someone has really changed?”

Letting Go

It took 11 years for him to admit it publicly.

At first he clung to the idea that the study was exploratory, an attempt to prompt scientists to think twice about dismissing the therapy outright. Then he took refuge in the position that the study was focused less on the effectiveness of the therapy and more on how people engaging in it described changes in sexual orientation.

“Not a very interesting question,” he said. “But for a long time I thought maybe I wouldn’t have to face the bigger problem, about measuring change.”

After retiring in 2003, he remained active on many fronts, but the reparative study remained a staple of the culture wars and a personal regret that wouldn’t leave him be. The Parkinson’s symptoms have worsened in the past year, exhausting him mentally as well as physically, making it still harder to fight back pangs of remorse.

And one day in March, Dr. Spitzer entertained a visitor. Gabriel Arana, a journalist at the magazine The American Prospect, interviewed Dr. Spitzer about the reparative therapy study. This was not just any interview; Mr. Arana went through reparative therapy himself as a teenager, and his therapist had recruited the young man for Dr. Spitzer’s study (Mr. Arana did not participate).

“I asked him about all his critics, and he just came out and said, ‘I think they’re largely correct,’ ” said Mr. Arana, who wrote about his own experience last month. Mr. Arana said that reparative therapy ultimately delayed his self-acceptance as a gay man and induced thoughts of suicide. “But at the time I was recruited for the Spitzer study, I was referred as a success story. I would have said I was making progress.”

That did it. The study that seemed at the time a mere footnote to a large life was growing into a chapter. And it needed a proper ending — a strong correction, directly from its author, not a journalist or colleague.

A draft of the letter has already leaked online and has been reported.

“You know, it’s the only regret I have; the only professional one,” Dr. Spitzer said of the study, near the end of a long interview. “And I think, in the history of psychiatry, I don’t know that I’ve ever seen a scientist write a letter saying that the data were all there but were totally misinterpreted. Who admitted that and who apologized to his readers.”

He looked away and back again, his big eyes blurring with emotion. “That’s something, don’t you think?”

Gay judge nominee defeated by non-votes, ‘Rule 69’

Filed under: News — Scottie @ 15:28

Gay judge nominee defeated by non-votes, ‘Rule 69’.

Gay judge nominee defeated by non-votes, ‘Rule 69’

RICHMOND, Va. (AP) — It wasn’t the 31 conservatives in the Virginia House who voted no that denied Tracy Thorne-Begland’s bid to become the first openly gay judge elected to the bench in Virginia. It was those who abstained or didn’t vote that did him in.

Thorne-Begland, a frontline criminal prosecutor in Richmond, got 33 yes votes, mostly from Democrats and eight Republicans in a vote cast in the wee hours of Tuesday morning. Thirty-one voted no.

But 10 delegates invoked the House’s “Rule 69” to cast an abstention vote, and 26 did not vote at all. Each was just as deadly as any vote of no, allowing a legislator to help block a judicial appointment without the honest sting or accountability of just voting no.

In Virginia, judges must get affirmative votes of majorities in both the 100-member House and the 40-member Senate. So abstentions and non-votes have the same effect of denying a nominee a majority while leaving constituents to speculate on a legislator’s intent.

Thorne-Begland fell 18 votes short of the 51 House votes he needed. In just 15 minutes, the House voted on 41 nominees, and Thorne-Begland was the only one whose confirmation failed. The other 40 were approved with 77 votes or more.

To hear his opponents tell it, the vote had nothing to do with sexual orientation.

“It’s unfortunate that members on both sides of the aisle focused on lifestyle — being a gay,” said Del. Christopher Stolle, R-Virginia Beach, a physician and, like Thorne-Begland, a former Navy officer. “That wasn’t it at all.”

Thorne-Begland’s confirmation ran into turbulence a few days before the vote when the socially conservative Family Foundation emailed alerts on May 11 to legislators and followers that an openly gay man had been nominated for the Richmond General District Court.

Thorne-Begland had spoken out for gay rights, the statement warned: “The question is, will his personal agenda take precedent over Virginia law and the Constitution?”

General district courts in Virginia spend their days adjudicating traffic tickets and misdemeanors, not pondering the weighty constitutional dilemmas of our time.

Del. Bob Marshall, the Prince William Republican who wrote Virginia’s constitutional ban on gay marriage and unsuccessfully sponsored legislation this year that would have accorded embryos the same legal standing as a person, took up the group’s cause.

Marshall, currying conservative support in his longshot GOP Senate primary bid against former Gov. George Allen next month, said Thorne-Begland’s life itself — living with his partner in Richmond and raising twins — “would be a contradiction to the constitution you swear to uphold and defend.”

Republicans were not in lockstep against Thorne-Begland. Del. Manoli Loupassi, a Richmond Republican and private lawyer who has known and practiced against the prosecutor in court for years, urged support for Thorne-Begland not only on the House floor but in the closed confines of the House GOP Caucus.

Loupassi and seven other Republicans voted for Thorne-Begland.

Stolle was among 10 delegates to invoke Rule 69, a House protocol that allows a member who has “an immediate and personal interest” in a matter up for a vote to avoid an ethical conflict by voting neither yes or no.

Thorne-Begland’s vote, taken at 1:13 a.m. Tuesday, presented no such conflicts to any legislator. Only three other abstention votes were cast for the other 40 nominees combined.

Del. Joe May of Loudoun said the practice of voting to abstain became the preferred means for expressing opposition to judicial candidates about a dozen years ago under former House Speaker S. Vance Wilkins.

“Voting for judges is different from voting for ordinary legislation,” May said. “Over the years, Rule 69 became a way to make a statement instead of voting no. In the end, the thing that matters is whether they have 51 votes or not.”

Other House members avoided voting altogether. Of the 26 members who did not vote on the Thorne-Begland nomination, eight had voted for the previous nominee just 23 seconds earlier, and would be back in their seats voting on the next nominee just 23 seconds after the roll closed on the Thorne-Begland vote. Seventeen delegates had left the Capitol and missed the entire judicial vote.

“That’s just a way to effectively vote no,” Del. Todd Gilbert, R-Shenandoah, said of the lone judgeship vote he missed.

Thorne-Begland had been a Navy pilot when he disclosed his sexuality on national television, speaking out against the “Don’t Ask, Don’t Tell” policy President Bill Clinton had just imposed. If the Navy was furious, it didn’t show it: Thorne-Begland received an honorable discharge.

May, Stolle and other military veteran delegates contended in Associated Press interviews last week that their votes were swayed by Thorne-Begland’s decision to go public against the policy. The policy was repealed last September, allowing gays to serve openly.

That, they said, was a direct affront to required standards of military behavior that forbid active-duty soldiers, sailors, Marines and airmen from speaking out on political and social issues of the day.

Del. Steve Landes, R-Augusta, said he knew Thorne-Begland was gay and considered voting for him until he learned that he had spoken out while in the military.

“Judges have to make judgment calls. In this case, the gentleman did not show good judgment. He took an oath and he violated it,” he said.

Landes voted to abstain.

WALTONSUN: RON HART: Gay marriage and politics: Strange bedfellows

Filed under: News — Scottie @ 12:49

Maybe this will work better. Still having trouble posting like I normally do with the iPad Sent from my iPad

A funny, smart essay.

Filed under: opinion — Scottie @ 12:46

Really puts it in line.    Good article, but some what ” tongue in cheek “. So watch out for the humor.   Hugs

Blog at

%d bloggers like this: