WHEN the American Psychiatric Association drew up its list of disorders in 1952, it described homosexuality as a sociopathic personality disorder. Many therapists were far ahead of that formality: they were already trying to cure homosexual men and women and prevent homosexuality from taking hold in children.
Since the late 1800’s, psychiatrists, psychologists, endocrinologists, and others have investigated treatments for homosexuality. The vast majority of homosexual men and women never found themselves in a clinician’s office for treatment, of course, but those that did faced a bewildering array of therapies. The treatments reflected scientific theories of their time about the origins of homosexuality: some were laughable, while others were gruesome. Virtually every therapy has reported “successes,” namely men or women who have overcome homosexuality and grown into heterosexuality. Despite these self-reported successes, many of these therapies died alongside their inventors. Yet the history of therapeutic failure has not extinguished the debate altogether. Some therapists and religious counselors even now say they can help men and women redirect sexual attraction away from members of their own sex.
What follows here is a short tour of some therapists and their therapies that makes no claim to completeness. Its purpose is to show the range of treatments used in the name of eradicating homosexuality over the years. Readers will quickly notice that the vast majority of reports here deal with male homosexuality, a fact that reflects the emphasis in the professional literature. For those wanting to “treat” homosexuality, men and women should figure equally. In fact, however, that’s not the story the history tells.
1892. A United States neurologist, Graeme M. Hammond, recommends extensive bicycle riding as a treatment for homosexuality. He believed that homosexuality was rooted in nervous exhaustion and that bicycle exercise would restore health and heterosexuality.
1897. British psychologist Havelock Ellis expresses considerable skepticism about treatment for congenital homosexuality. He describes a treatment carried out by German therapist Albert von Schrenck-Notzing that involved up to 150 hypnosis sessions as well as consumption of large amounts of alcohol and subsequent visits to brothels. Ellis caustically notes that this “cure” usually ends in backsliding and sexually transmitted disease. “For my own part, I frankly confess that the remedy seems to me worse than the disease.” He acknowledged that homosexual men could be brought to have sex with women, but because that behavior did not extinguish homosexual interests, he called it little more than masturbation per vaginam. Not that he saw homosexuals as entirely normal. He said this when it came to homosexual men and women having children: “Nor is it possible to view with satisfaction the prospects of inverts begetting or bearing children. Often, no doubt, the children turn out fairly well, but for the most part they bear witness that they belong to a neurotic and failing stock. Sometimes, indeed, the tendency to sexual inversion in eccentric and neurotic families seems merely to be Nature’s merciful method of winding up a concern which, from her point of view, has ceased to be profitable.”
1899. Physician Denslow Lewis held that life itself is worthless without the attainment of a relationship with the opposite sex. He saw sex between women as “pernicious” and held out more hope for cure in the poor than in the wealthy. “The poor, hard-working girl is not addicted to this vice. The struggle for life exhausts her capabilities. The girl brought up in luxury develops a sexual hyperesthesia [excessive sensitivity to stimuli]that is fostered by the pleasures of modern society.” And the cure for these wretches? Lewis said that this hyperesthesia could be relieved by the application of cocaine solutions, saline cathartics, the surgical “liberation” of adherent clitorises, or even the administration of strychnine by hypodermic. He reported numerous successes, measured by reduction in “reflex excitability.” Some of these women, he said, went on to become wives and mothers. Two women did become wives and mothers, but they never enjoyed the sex act. Even more unfortunately, one of his patients went insane and ended her days in an asylum.
1920. Sigmund Freud’s writings about homosexuality span a broad range of his works across his long life. In 1920, he described the origins of homosexuality in a young woman sent to him by her parents. The girl herself was not distressed about her sexual interests. Freud said the possibility of changing the organization of sexuality was never easy: “In general, to undertake to convert a fully developed homosexual into a heterosexual does not offer much more prospect of success than the reverse, except that for good practical reasons the latter is never attempted.”
1929. Will castration cure homosexuality? An anonymous Swiss report about male and female prisoners who had been castrated to relieve some sexual abnormality showed that libido was diminished in more or less every case. Of eight cases of “perverse sexual practices,” a cure was secured in five. The authors conclude: “The operation is indicated in cases of persistent exhibitionism, rape, and homosexuality.”
1929. What are male homosexuals like? Physician John F. W. Meagher described them this way: “Indulgent male inverts like pleasant, artistic things, and nearly all of them are fond of music. They also like praise and admiration. They are poor whistlers. Their favorite color is green (red, complementary) whereas most individuals prefer blue or red.” Not everyone can be helped out of this condition. Congenital homosexuals are at a considerable disadvantage, as drugs and surgery are rarely helpful. But “acquired” homosexuality may be extinguished sometimes, depending on the strength of the desire of the person to change. Therapy should focus on gaining insight into one’s life, the development of heterosexual interests, self-control, and the avoidance of alcohol.
1940’s. In his 1985 account of the Third Reich, historian Geoffrey Cocks notes that the Nazis retained a Danish physician to test the cure of homosexuality through the implantation of sex glands, namely testicles.
1955. The British Medical Association issues a report on homosexuality and prostitution. They conclude that homosexuality is essentially a social problem, but an important one. They say an apparent increase in homosexuality is due to the weakening of personal responsibility and disregard for social and national welfare. According to this logic, it follows that the suppression of homosexuality “can be achieved by promoting in the minds, motives, and wills of these people a desire for clean and unselfish living.” As to treatment proper, the goal should be to help homosexual men and women refrain from overt acts which would bring them into conflict with the law. “It must be admitted with regret that some of the advice given to homosexuals in the name of treatment is often useless, simply defeatist, or grossly unethical.” Not all homosexuals need treatment, or are amenable to it. The report concludes by noting various kinds of treatment that may be useful: analytic psychotherapy, non-analytic therapies, group treatment, as well as possible physical and drug treatments.
1958. Psychoanalyst Clifford Allen reports a variety of cures through psychotherapy. Four people (men and women) were not “cured” outright, but he does say they were well on their way to normality. He says that these people reported attraction to the opposite sex and even held out hopes of marriage and children. He mentions other treatments: one man grew more body hair because of psychotherapy, another took methyl testosterone by mouth, and yet other men were turned from homosexuality by threats of beatings or encouragement to go to brothels. Allen concludes: “It is definitely not true that homosexuality is incurable.” Ideally, he says, every patient should be treated for an hour a day for five years.
1959. Cultural commentators and moralists hold out the prospect of treatment even while acknowledging that homosexuality may not be a disease, strictly speaking. For example, one Catholic moralist said: “The homosexual can become normal, and while we are aware that there is little available information regarding the treatment of homosexuals, everything is to be gained from this optimistic attitude that will soon transmit itself to the homosexual patient.”
1962. British psychologist I. Oswald injects a man with nausea-inducing drugs, repeatedly playing audiotapes of men engaging in sex and surrounding the man with glasses of urine. Eventually, the man experiences hallucinations. Here the goal was to “overdose” the man with homosexuality and unpleasant experiences so that he would turn to women for relief.
1962. Irving Bieber and colleagues publish a psychoanalytic perspective of male homosexuality, saying: “All psychoanalytic theories assume that adult homosexuality is psychopathologic and assign differing weights to constitutional and experiential determinants.” Even so, they also say male homosexuality is functionally the result of hidden and incapacitating fears of the opposite sex. The outcome? “Although this change may be more easily accomplished by some than by others, in our judgment a heterosexual shift is a possibility for all homosexuals who are strongly motivated to change.” Their study said that of 100 male homosexuals, one third had become exclusively heterosexual.
1964. R. J. McGuire and M. Vallance publish an article in the British Medical Journal describing the use of electroshock therapy for the treatment of homosexuality. The authors devise a small electroshock device that would be suitable for home use, so that people could shock themselves whenever they had unwanted sexual impulses.
1969. David Reuben publishes the wildly popular Everything You Always Wanted to Know About Sex but Were Afraid to Ask and describes homosexuality in dismal terms, rejecting the idea that homosexuality is inborn: “A lot of homosexuals … prefer to consider their problem the equivalent of a club foot or birthmark; just something to struggle through life with.” But that’s not all: “Homosexuals thrive on danger. It almost seems part of their sexual ritual.” Still, not all is lost because for “those who want to change there is a chance.” But how? “If a homosexual who wants to renounce homosexuality finds a psychiatrist who knows how to cure homosexuality, he has every chance of becoming a happy, well-adjusted heterosexual.”
1970. Psychologist John N. Marquis opines that sexual orientation can be reconditioned, no matter where it came from originally. He recommends intense masturbation to conventional homosexual fantasies and images, then suddenly shifting at the moment of orgasm to heterosexual fantasies and images. Marquis believed that sexual interests could be trained to heterosexuality by this means.
1973. The American Psychiatric Association rejects the classification of homosexuality as necessarily pathological. This decision does not settle the matter once and for all, as public health commentator Ronald Bayer has noted. The Association retains the category of “ego dystonic” homosexuality—a disorder if it is disruptive to the affected individual. The Association eventually threw out that diagnosis as well.
1974. Lee Birk reports findings about group therapy for homosexuals, concluding that men who remained in therapy for more than one and a half years experienced a partial shift to heterosexuality, with some making a nearly complete shift.
1975. Psychologist Albert Ellis notes that original Freudian views of homosexuality were fairly pessimistic about treatment, but that “Modern psychoanalysts, who increasingly subscribe to less Freudian positions, almost always take a more optimistic view of the treatment of homosexuals.” Successful treatment is possible, he says, if homosexuals can overcome their reluctance to admit their psychological disturbance. In any case, treatment will be difficult because homosexuals have low self-esteem, are exceptionally defensive, have low energy and find their days a drudgery, are generally incapable of enjoyment except through drugs and alcohol, are easily distressed, and create crisis after crisis for themselves. Ellis also notes that many homosexuals are in prison, not an environment that is conductive to successful change!
1975. Irving Bieber continues the psychoanalytic campaign against homosexuality, saying: “Repetitive sexual behavior in adult life between same sex members is always pathological. It is never normal. There is no such thing as homosexuality being a normal sexual variant.” He argues that therapy to undo that condition can only work if there’s sincere motivation, strong ego development, and some history of heterosexual desire or behavior.
1976. Psychologist Gerald C. Davison argues that psychologists should stop offering therapies for homosexuality, saying that the existence of these therapies contributes to wrongful social treatment of homosexual men and women.
1982. Edmund Bergler presses his case against homosexuality well into the 1980’s, describing male homosexuals as frightened fugitives from women, fleeing in their panic to another continent. Bergler denied that there was any biological basis for homosexuality, but treatment was essential because “the homosexual’s whole personality is neurotically sick.” Bergler said he had successfully concluded an analysis of more than 100 homosexuals, provided they met certain conditions at the start.
1983. Why treat homosexuality if you can prevent it in the first place? German hormone researcher Günther Dorner argues that it might be possible to prevent the birth of homosexual children by manipulating sex hormones during pregnancy.
1984. William H. Masters and Virginia Johnson say they don’t believe homosexuality is pathological but, even so, some people don’t want to be homosexual. They note that some men end up homosexual because they’re emotionally and socially stunted. Masters and Johnson use female “sexual surrogates” to help these men. In a non-threatening environment, the men learn how to approach, talk with, and have sex with women. Masters and Johnson note that that some men fail to respond heterosexually, but that’s because they decide they’re happy with being homosexual after all.
1991. Psychologist Joseph Nicolosi argues that homosexuality in males is the result of a psychological injury sustained in childhood at the hands of the father. He recommends training in the male gender role as a way to overcome sexual interest in males.
2000. The Catholic Medical Association issues a document, “Homosexuality and Hope,” which denies that there are homosexual people in the sense that homosexuality belongs to their very nature. This means that, with the proper guidance, there is always hope of overcoming homosexual interests and behavior.
2002. The American Psychological Association outlined disclosure standards for sexual orientation therapy, namely descriptions of what people seeking sexual orientation therapy may reasonably expect by way of success. Margaret Schneider and colleagues have argued that disclosure should include alternatives to therapy as well as accurate representations of whether or not the therapy can be expected to work.
2003. Psychologist Robert Spitzer reports that many homosexuals interviewed in a telephone study say they have, in fact, changed their sexual orientation over time and through a variety of interventions. He says the alternative explanation—that these respondents lied pervasively—is less credible than believing that the reported change did occur.
2004. Robert Perloff, a past president of the American Psychological Association, defends the right of psychologists and other therapists to offer sexual orientation therapy. He points to the right of clients to choose, saying some people are distressed by their homosexuality. In 2006, Gerald Koocher, another past president of the American Psychological Association, takes essentially the same position. The National Association for Research and Therapy of Homosexuality has publicized these comments widely (www.narth.org).
IF ONE CONSIDERS homosexuality as pathological or disordered, it follows as a matter of medical logic that one should look for treatments and cures. Yet even as the number of people who interpret homosexuality this way diminishes, some people remain interested in shedding their homosexuality. Some people express unhappiness about their homosexuality because it conflicts with their religious values or idealized self-image. Also, some parents don’t like the sexual identity they see emerging in their adolescent children. All these people look to therapists for help, who in turn look to the science of their time for tools. So long as change remains even theoretically possible, the prospect of sexual re-orientation remains on the table. Today some wonder whether genetics will succeed where other ventures have failed.
Even as the moral debate about the ethics of therapy continues, it is important to remember that most homosexual men and women have never looked for help in changing their sexual orientation, not even when psychiatry labeled homosexuality a sociopathic personality disturbance. In fact, the market for sexual orientation therapy almost certainly shrinks in direct proportion to social acceptance of gay and lesbian adults and adolescents. It would probably shrink even further if all therapists and religious counselors who offer therapy for homosexuality were honest with their clients about the likely outcomes. One thing is certain for all ventures in sexual reorientation therapy: it has failed vastly more times than it has ever succeeded, and future research is unlikely to change that fact.
Allen, Clifford. “Homosexuality: Its Nature, Causation and Treatment,” in Charles Berg, Clifford Allen, eds., The Problem of Homosexuality. Citadel Press, 1958.
Anonymous. “Results of Castration in Sexual Abnormalities.” The Urologic and Cutaneous Review, 1929 (33).
Bayer, Ronald. Homosexuality and American Psychiatry. Princeton University Press, 1987.
Bergler, Edmund. Counterfeit-Sex, 2nd ed. Grune & Stratton, 1982.
Bieber, Irving. “Male Homosexuality” (video recording). Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, 1975.
Birk, Lee. “Group Psychotherapy for Men who are Homosexual.” Journal of Sex and Marital Therapy, 1974 (1).
Catholic Medical Association, “Homosexuality and Hope,” 2000, at: www.cathmed.org/publications/homosexuality.htm
Cocks, Geoffrey. Psychotherapy in the Third Reich. Oxford University Press, 1985.
Dorner, Günther. “Neuroendocrine predisposition for homosexuality” (letter to the editor). Archives of Sexual Behavior, 1983 (12).
Davison, Gerald C. “Homosexuality: The Ethical Challenge.” Journal of Consulting and Clinical Psychology, 1976 (44).
Ellis, H. and J. Addington Symonds. Sexual Inversion. Arno, 1897.
Freud, Sigmund, “Psychogenesis of a Case of Homosexuality in a Woman.” Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. XVIII. Hogarth, 1955.
Hammond, Graeme M. “The Bicycle Treatment in the Treatment of Nervous Diseases.” Journal of Nervous and Mental Disease, 1892 (19).
Lewis, Denslow. “The Gynecologic Consideration of the Sexual Act” (orig. presented and published in 1900). Journal of the American Medical Association, 1983 (250) 2.
Marquis, J. N., “Orgasmic Reconditioning: Changing Sexual Object Choice through Controlling Masturbation Fantasies.” Journal of Behavior Therapy and Experimental Psychiatry, 1970 (1).
McGuire, R. J. and M. Vallance. “Aversion Therapy by Electric Shock.” British Medical Journal, 1964 (Jan. 18).
Meagher, John F. W., “Homosexuality: Its Psychobiological and Psychopathological Significance.” The Urologic and Cutaneous Review, 1929 (33).
Nicolosi, Joseph. The Reparative Therapy of Male Homosexuality: A New Clinical Approach. Jason Aronson, 1991.
Oswald, I. “Induction of Illusory and Hallucinatory Voices with Consideration of Behaviour Therapy.” Journal of Mental Science, 1962 (108).
Schneider, Margaret; Laura S. Brown; Judith M. Glasgold. “Implementing the Resolution on Appropriate Therapeutic Responses to Sexual Orientation: A Guide for the Perplexed.” Professional Psychology: Research and Practice, 2002 (33).
Special Committee of the Council of the British Medical Association. Homosexuality and Prostitution, 1955.
Spitzer, Robert L. “Can Some Gay Men and Lesbians Change their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation.” Archives of Sexual Behavior, 2003 (32).