Conversion therapy (also known as reparative therapy, reorientation therapy, or transformational therapy) has been generally understood to have as its chief goal the cessation or changing of individuals’ same-sex attraction and sexual behavior and the adoption of opposite-sex attraction and sexual behavior. Proponents and practitioners of conversion therapy base the rationale for such intervention on medical, moral, or religious traditions that regard homosexuality and homosexual behaviors as unnatural, psychopathological, or morally transgressive.
However, since the 1970s, mainstream mentalhealth组织(美国精神病学协会,美国心理学会)采用了疾病和政策,这些政策拒绝了同性恋个人在精神上仅仅因为其性取向而在精神上不健康的观念。从1950年代后期开始,伊芙琳·胡克(Evelyn Hooker)产生的科学研究清楚地表明,同性恋者的心理病理学频率没有比异性恋者更大,并且常见的心理诊断测试无法识别或有效歧视同性恋和异性恋者。
此外,美国精神病学协会,美国心理学协会,美国儿科学会,美国咨询协会和全国社会工作者协会都采用了反对转化疗法的专业职位,理由是其对同性恋的描述是异常的,它几乎是独有的专注于改变同性恋男人的同时忽略女同性恋妇女,缺乏科学支持,对这种干预措施的基本伦理以及医源性危险(抑郁症,焦虑和其他疾病)试图说服同性恋个人“他们是“不幸”的人,”或需要“治愈”。
What Is Conversion Therapy?
转化疗法包括一系列技术和方法;其中许多区别取决于从业者的基本哲学。转化疗法的早期心理技术集中在长期的古典心理分析上,试图揭露并为理论上的俄狄浦斯创伤提供了纠正的情感经历,被认为逮捕了性发展并引起了同性恋。其他方法利用了行为技术,试图通过将同性恋刺激与不愉快的经验(电动摇滚,焦虑,恶心)配对来调节同性恋者对同性活动的厌恶。一些方法采用语言疗法或咨询的形式,专注于与同性恋和教学相关的思想,感觉和行为。
Conversion therapy based upon religious traditions often relies on practitioners utilizing interpretations of religious doctrine or texts that forbid and condemn homosexuality; such practitioners seek to help homosexual individuals correct or cease sexual behavior that is found outside what is acceptable according to these doctrines. Such transformational ministries and “ex-gay” ministries (e.g., Exodus International) focus upon homosexuals’ inner turmoil as they attempt to reconcile their chosen religious or spiritual belief systems with their homosexuality.
许多转换疗法的支持者认为,如果同性恋认为他或她的性取向是不健康的,或者是反对个人持有的信念,并希望转变为异性恋(或至少停止同性性行为),则该人具有权利这种自决和寻求治疗以实现这一目标的权利。然而,对性认同发展的研究表明,由于社会异性恋以及对我们社会的抗异性恋和亲切性态度的灌输,这是同性恋者的正常身份发展的一部分,可以体验强烈的混乱,恐惧,怀疑,否认,否认,否认,否认,否认,污名,甚至在同性恋景点周围自我憎恨。如果“出来”(完全实现和接受同性恋的过程)会得到支持和积极的社会反应,那么身份发展的最初困难阶段就可以让位于健康的自我概念和作为同性恋的积极自我认同。
Does Conversion Therapy Work?
No program of peer-reviewed research published in mainstream scholarly journals shows that conversion therapy is effective. Those studies that have been conducted are often plagued by sampling problems that make drawing conclusions very difficult. For example, if an investigator examines the efficacy of conversion therapy with a sample of bisexual men (who have sex with persons of both the same and opposite sex), the ability of the men in this study to cease having sex with men for a period of time may be very different than would be found in a study where conversion therapy was provided to men who were strictly gay. As well, operationalization of what constitutes an “effective” outcome has been difficult. For example, the cessation of engagement in same-sex sexual relations is often considered a measure of “successful” conversion therapy; however, it is highly unlikely that behavioral cessation has also fundamentally changed the actual homosexual orientation of clients, who still emotionally and sexually desire same-sex persons and attitudinally think of themselves as homosexual. This latter state of affairs is anecdotally reported by “ex-gays” who have received conversion therapy. Many either have chosen to remain without sexual partners or have tried to forge heterosexual partnerships in an effort to resist their homosexual orientation and desires. Even though same-sex sexual relations have stopped, and heterosexual sexual relations begun, such “ex-gay” clients report still thinking of themselves as gay and desiring same-sex relations; they simply do not allow themselves to have them.
Most scholars have arrived at the consensus that although some homosexual or bisexual persons may be able to resist engaging in sex with same-sex partners, the alteration or transformation of homosexuality into heterosexuality is an extremely unlikely (and probably unhealthy) event and that an individual’s sexual orientation is a relatively stable characteristic.
想要成为异性恋的同性恋者呢?
Most mental health professionals accept the idea that it is the very rare individual who does not undergo some discomfort and period of adjustment upon the realization of being homosexual. Because values and models set heterosexuality as the norm in our society, and because these expectations are internalized, it is consequently difficult for persons finding themselves falling outside the norm to feel comfortable with possessing a nonmajority sexual orientation.
Many mainstream clinicians who encounter a gay or lesbian client who voices a desire to change his or her sexual orientation would first ensure that such a client is not simply in the midst of a typical phase of self-doubt and fear. In addition to these reactions arising from internalized homophobia, such clients may have also encountered highly critical or even hostile social reactions when sharing with others the fact they are homosexual, thereby heightening their concerns over their homosexuality. At a societal level, media messages and conversations about the erosion of gay rights, the push to make gay partnerships illegal and to deny gay partners health insurance, and reports of hate crimes (including murder) perpetrated against gay men and lesbian women would also add up to create a reasonable level of distress, anxiety, and confusion. Finally, as aforementioned, contextual and cultural variables (racial/ethnic, religious/spiritual, intrafamilial) would need to be assessed before arriving at a conclusion that the client is making an informed and healthy decision.
概括
Homosexuality and same-sex sexual attraction is not a mental illness, disorder, or pathology. Therefore, not only is the need for psychological treatment or counseling not supported or indicated, but self-reports from persons undergoing conversion therapies demonstrate that such treatments may bring harm to clients. No case can be built that justifies conversion therapy as judged by the ethical standards of major mental health organizations. Finally, there is no documented empirical research that demonstrates the efficacy or effectiveness of conversion therapy; in fact, almost all evidence of successful outcomes come from anecdotal or single source reports (e.g., therapist or client impressions) without corroborating or longitudinal evidence of stable and true change of sexual orientation or a healthy adjustment to a nonsexual lifestyle or a self-imposed heterosexual partnering.
参考:
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- Hooker,E。(1957)。男性公开同性恋的调整。投影技术杂志,第21卷,第18-31页。
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- Tozer, E., & Hayes, J. (2004). Why do individuals seek conversion therapy?: The role of religiosity, internalized homonegativity, and identity development. The Counseling Psychologist, 32, 716-774.
- Tozer,E。和McClanahan,M。(1999)。治疗紫色威胁:转化疗法和肯定替代方案的道德考虑。咨询心理学家,27,722-742。