Psychiatry giant sorry for backing gay ‘cure’

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Dr. Robert L. Spitzer

Courtesy of The New York Times

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.

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

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 depression and 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.”

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