Episode 122: The History of Sexual Orientation Conversion Therapy in the U.S.

As mentioned in my intro, you look at conversion therapy as something that’s really important for a certain segment of American Cultural History. What moment are we talking about? What’s going on? And how does this idea become important to a certain subset of people?

Yeah, I really begin the dissertation on 1940, even though there’s a period of conversion therapy history before that, and start in 1940, because there are psychoanalysts and psychiatrists who start to really think about the ways in which they can “cure” homosexuality from their patients. Around 1940 is when this practice starts to get a sizable patient population. And that patient population, often times, is conservative on issues of gender and sexuality and the family–being that they believe in strong patriarchal father, mom who should stay at home and raising children to perform what we would say is traditional gender roles.

So it’s 1940, just before the war, is this related to what today we would call the Religious Right? Or is that where it comes from?

Well, there are definitely religious elements to it, preceding what we would call the religious right, which really emerges in the 1970s as a cultural and political force. But even in 1940, you can start to see the religious influence that people feel when they want to pursue conversion therapy on their own. Often times, you’ll have interviews with patients in case studies and things like that, where people are identifying religious elements of their life that are important for pursuing and seeking out therapies.

So these are people who feel as though their personal belief system are incompatible with what they’ve come to understand as their sexual orientation?

Exactly. And you’re see references to the parts of the Bible like Sodom and Gomorrah, you know, put that part of Genesis that says that, you know, we had this ancient city that was smitten because of rampant homosexuality, although there are multiple interpretations of that story itself.

So as I mentioned, it’s 1940. It’s right before World War Two, how did the war and, and its aftermath impact this idea that this is something that people wanted to pursue?

The war had a great impact in one market way, which was it elevated the profession of psychiatry, and also psychology, and men’s form, and that psychiatry became its own medical division within the U.S. Army. You had a bunch of screening processes for soldiers, in which they were checking to see if soldiers, male and women were homosexual. So there was a screening process. But it was not very intense until towards the end of the war, at which point you had thousands of dismissals. They were called Blue discharges, because of the color of the paper, in which homosexuals or purported homosexuals were purged from the U.S. Military.

So I know from the interview I did with Lisa Moore about the post war era this was also a time when a number of young men and women sort of came to terms with their sexual orientation and, and after the war, didn’t want to go back to “normal” life. And this is where you see the the beginning of flourishings of what would be termed “gay ghettos,” and for example, San Francisco and New York. Did this create a movement away from the idea that sexual orientation can be changed or should be changed?

The creation of gay subcultures in places like San Francisco, Los Angeles, Chicago, New York definitely gave a greater acceptance for a community, in which people could feel a sense of belonging. But one of the more interesting parts of what I think my research is to show how some people came to what you described as gay ghettos, hoping for personal validation and satisfaction. But those cities, especially in New York, became the early centers of conversion therapy. It’s not the Bible Belt south, it’s really New York, New Haven, Boston, Chicago, where there is a large subset of people who have same sex desires. If they’re coming from elsewhere, they think that those same sex desires and their sense of self are going to be satisfied, but they’re going to be sometimes disappointed in what they find when they move. And places like New York are the centers of psychoanalytic training, there is a high per capita number of psychiatrists who can treat people. And there’s also a burgeoning community psychology movement, a large number of counseling centers, there’s lots of different venues for people who are really doubting or confused about their same sex desires to go and seek treatment.

So walk me through a little bit of what this treatment looks like. One of the things that I sort of left out of my introductory remarks is that the reason why conversion therapy is being banned is because the general consensus is that it can actually cause more harm to the patient the any benefits that may derived from such therapies. So, you know, we’re looking at the 1940s/1950s now, in this moment, what does one do, if one thinks, one is trying to change their orientation?

And this is one of the more confusing parts of the term conversion therapy is that it really is an umbrella term for a lot of different things. And it does depend on moment in time, and oftentimes place as well. In the 1940s, 1950s, 1960s, we’re talking about traditional talk therapy, not the Freudian sense, necessarily that you’re on a couch, and you never face your analysts. But there is definitely a face to face, oftentimes counseling session with a trained medical professional. These are people with M.D.s, who have done additional training and psychiatry, this is an intense amount of schooling that they’ve received. And oftentimes from the nation’s best schools, these are not kind of “Country Hicks,” who are only preaching.

But you do have different moments in time where there’s different therapeutic interventions, the late 40s and early 50s, there are definitely cases of lobotomies being used. So, especially the ice pick variety of peeling back the eyelid and inserting a metal lance into the frontal lobe, which was thought to control a bunch of different impulses. And then also, in the 60s and 70s, you have increased records of electroshock therapy and then obviously, from the 70s on, there’s a lot more religious counseling, too. So it does definitely look different based on time and place. But the talk therapy element is consistent throughout. You have even within religious counseling, you have a lot people going to a trained medical professional and also a religious counselor.

So I guess one of the things that I should ask for clarification here: I think I, myself, and probably a lot of our listeners are assuming that there was a religious component from the beginning. But that doesn’t appear necessarily to have been the case?

It’s not as obvious as I think a lot of people would think it would be since conversion therapy, and the cultural imagination is so tied to the religious right today, who is talking a lot about religious liberty as a protection for it. You don’t see it in the same words, but there is always a religious component. And that’s I very much argue that and and a lot of that might be subsumed in different language. So if we go back to the early Cold War, there’s oftentimes talk about how the United States is a godly nation against the godless communists, you know, the Soviet Union, and part of upholding the godliness of the United States is raising heterosexual children. And how do you do that, unless you have modeling proper gender roles for your children, and things like that, and those are assumed to be Christian or emerging idea of Judeo-Christian ideas.

So moving forward a little bit. In 1973, the American Psychiatric Association removed homosexuality from its list of mental disorders. Does that change the calculus here somewhat?

Well, it didn’t. It didn’t in a lot of ways. So homosexuality from the early 50s had been in the American Psychiatric Association’s diagnosis, a diagnostic and statistical manual as some form of a mental illness. By the early 70s, it was a sexual deviance and it was listed alongside things like pedophilia. And, a bunch of different activists including Frank Kemeny, Barbara Gittings, and John Fryer had protested in some form or another at the annual meetings of the American Psychiatric Association. In 1973, they were able to remove homosexuality per se, from that list of sexual deviances and in its place almost immediately became a two different diagnostic categories.

The first one was ego-dystonic homosexuality. And, ego-dystonic just means if you don’t feel like you are having an ideal self, or you’re not realizing your ideal self image, you can have something changed and it’s justifiable to have that be treated. So, if you suffer from ego-dystonic homosexuality, you are uncomfortable with your same sex desires. And, that diagnostic category stayed in the DSM until 1987. More importantly is another category that kind of takes a bit of a time to become part of the DSM, and it’s still in, in some form, and that’s gender identity disorders.

So, in your introduction, you talked about sexual orientation change. A lot of people when they talk about conversion therapy have a very expansive understanding of it to include gender identity and gender expression. So in 1980, the American Psychiatric Association includes gender identity disorders in the DSM to address what they see as a problem of young boys and girls, especially not being able to fulfill traditional gender roles. And, they view that as a disorder of some sort that still is in the DSM as gender dysphoria. And, a lot of advocates to ban conversion therapy, say that it gives justification for what conversion therapists do.

So with this delisting of some types of homosexuality in the early 1970s. How does this alter the need, the sort of cultural need or the social need for conversion therapy and its advocates?

Well, it’s most important element is that it declassifies all forms of homosexuality as a mental illness. So it does recognize that there can be people who are highly functioning, who have same sex desires, who are not mentally ill. That is paradigm shifting in itself. And, you do have some of the largest proponents of, especially psychiatric care, protests this. You have people like Charles Socarides and Irving Bieber, who remain advocates of sexual orientation change therapies till their death, who want to challenge the decision to remove homosexuality from the DSM. And, what they do is they organize a petition campaign and they collect signatures, and they put it up to vote for the whole entire APA membership. And so there is a democratic governance that they exercise on their own, but they ultimately lose the vote by a sizable majority. If it was a presidential election, we would say it was a landslide. It’s closer than maybe a landslide in terms, but the APA membership does uphold what was an APA board decision to remove homosexuality per se, from the list of sexual deviances.

But, at the same time, they had initiated the political process for the next 30/40 years, you’ve had pro-conversion therapy people criticizing the vote as the only time in which American Medical Association has used democratic governance to decide what they think should be a scientific issue.

We’ve also alluded to the rise of the religious right from the late 1960s onward, and of course, we know that it coming into the 1980s there’s a resurgence with the rise of the Moral Majority. Does this become a marriage of convenience or one cause being picked up by another because there does definitely seem to be a relationship or support for conversion therapy among that demographic?

Yeah, I mean, there are people like James Dobson, who is a trained psychologist at the University of Southern California, who are very much on board with what it looks like to raise children the “right way,” in order to be proper, young men, proper young women who have heterosexual desires. And, he’s writing tons of books in the 70s, talking about disciplining children in the right way. And there’s always a hint of conversion therapy in there, and it’s not necessarily may be going to a therapist, but it is preventative. In that if as long as you raise your kids the right way, they won’t be gay. So that in itself is a very underexamined element of conversion therapy. Is the child rearing elements that are oftentimes in self help books? Especially self help books for parents who might be confused, when young Jimmy puts on high heels for the first time kind of thing. And, Dobson is a huge member of the religious right, he very much takes over for Jerry Falwell, and especially in the 1990s. But Jerry Falwell, you will see mailers and stuff talking about the evil gay agenda, destroying the American family, and how therapy is extraordinarily important too.

Another person who’s part of the religious right is Anita Bryant, who led a campaign in Miami to overturn anti-discrimination protections for gay men, lesbians, and bisexuals in that political campaign successful, as along with a bunch of others around the country. And, she has her own ministry and although she is not very sophisticated with her therapeutic interventions. You know, a lot of ways the “pray the gay away” label comes from somebody like Anita Bryant, who doesn’t think that you need to know much psychology because God will just intervene. She’s very, very prominent within this movement and raises the public profile of maybe the pastoral counselor religious side, to upgrade our height that would not have been there without her assistance.

I want to ask about how you were able to do your research on this topic?

Well, that’s an interesting question. And, in a lot of ways it involved lots of archival research, and I think it will be surprising to most people where my first grant, external grant came from. It’s actually the Southern Baptist Commission was the first outside organization that gave me money and they were the second archive that I went to in Nashville, and they opened up their archives. And, the Southern Baptists, from the 70s into the early 2000s, were large proponents of sexual orientation change therapies and gender identity therapies and very much engaged in what we would now call the culture wars, issuing a not only press releases, but in their newsletters talking about the organizations that you could go to, in case if you had what they were called “unwanted same sex attractions.”

And, it was really that archival research from, especially the Southern Baptists, and a bunch of other organizations that got the later part, especially religious history part really grounded at first. But, I knew that it was much more complex than that. I knew that there were some sources that had not been seen before, because these are also medical records oftentimes. So, if we could flash back again, we’re talking about those M.D.s who did all that psychiatric training, their patient records are protected by federal and oftentimes state law. And, so I did have to request certain waivers from families oftentimes. And, I was able to see handwritten notes and case histories that archivists told me no one else had had seen.

And, you met some of the people you write about?

I have met some of the people I write about. Even before I did archival research, I started going to meetings of these therapists. The first two years is pretty easy being based in Austin, they were meeting in Dallas, so I was able to just take a Megabus up and stay a couple nights, and really talk to them about their worldview and what they had experienced. And that early point in time, I didn’t know the full scope of where my work would go. But, I knew that as somebody who has many more gay and lesbian friends than I have religious right friends, it was really important to be able to discuss what they have experienced in their lifetime, and get their point of view on things.

I know talking to you about this at various points, I’m not sure I would have been able to maintain the professional neutrality that I think you were able to do. So, kudos to you for that.

With the fact that the practice is now being banned in so many areas, some might say that this is an idea whose time has come to be done away with, but it seems to me like there’s still quite active and a number of people who think that this is something that people still want and need.

Yeah, I think it definitely is much more active and thriving than most people would recognize. And, it’s thriving in places that are large metropolitan areas. And then, you know, kind of the the back countries of the bible belt too. You know, you have practices in places like Fresno and Sacramento and Dallas, and you do have even practices in Minnesota and Massachusetts. And, there is always seemingly a need, because conservative Americans, especially conservative, religious Americans are throughout the whole entire country. And so it’s not necessarily a practice that you can relegate to a part of the country that you’re not from in order to exoticize it. So, but at the same time, there is the striving movement in order to ban its use on minors. So, the 17 states that have passed laws, all those laws are on minors. There is a little bit of pushback as to what adults should be able to pursue on their own.