Thursday, May 25, 2006

What politics?

Reparative therapy is fascinating stuff. I've started reading Nicolosi's book on the subject, which from what I understand, is sort of the definitive text right now. He gives a pretty large set of references for prior work on the subject and the measured "successes" of past efforts. But, of course, those references and their supposed success cases have been criticized widely as not scientifically rigorous. This is understandable to me, but I find it a little amusing that there is now a propensity for people to go so far as to say reparative therapy has been shown to be unnecessary, ineffective, and harmful.

Unnecessary? I'll buy that. It surely depends on what one considers to be a necessity. If a person wants to live a happy and well-adjusted life as a gay man, no reparative therapy is necessary. But what I find interesting is that although the science is sketchy at best, there are many examples in the reparative therapy theory that have real and compelling applications in my life. I can identify dozens of experiences I've had consistent with "defensive detachment" and problems with masculine identity. (I can think of many inconsistencies too.) Pondering the lack of certain kinds of male companionship in my life helps me to realize that I can pursue those relationships through reparative therapy completely irrespective of the goal of sexual orientation change, and my life will be richer for it. In a word, although it's not necessary, it's desirable to me (and presumably anyone whose past abuse and disenfranchisement by male peers bothers them) even if no actual change in sexual orientation follows.

But what about those darned risks? Since reparative therapy has been "shown" to be harmful, surely it's a bad idea to go there. Well... I must reserve judgment as I'm not familiar with the primary data on the subject. However, it's not a closed case, and anyone claiming it is well understood and dangerous reads from a script I'm starting to become familiar with--the activist script. Nothing wrong with activism, as long as it doesn't masquerade as science. Even the APA says in their position that "To date, there are no scientifically rigorous outcome studies to determine either the actual efficacy or harm of 'reparative' treatments."

When reparative therapy was discussed in my medical curriculum, I asked the Planned Parenthood presenter for primary sources to support his claim that it is ineffective and harmful. He referred me to the APA's position statement. I pointed out that I was already familiar with the statement and that it actually says that reparative therapy has not been shown to be effective (not the same as 'shown to be ineffective') and that risks have been ignored or minimized by those who practice reparative therapy (not the same as 'shown to be harmful'), and that I was concerned that the material in our curriculum was more political than scientific in a way similar to that described by the APA statement. He questioned my motivations by asking why I was bringing politics into a discussion on healthcare.

Ummm... are you stupid? I'm not one to be thwarted by the ol' "you're making this political when any rational person can clearly see that I'm right even though the reference I use to back my claims actually CONTRADICTS my position."

Politics? What politics?

Okay, buddy, try pulling your head out and acknowledge that there is wide disagreement on this controversial subject. How can we talk about it if you seek to discredit my motives as "political" when I have merely asked for scientific references? The APA explicitly acknowledged the political nature of the debate. So sorry for asking for references from your one-sided and unannotated lecture.

No comments: