User:Markworthen/sandbox/RTMH

IMPORTANT: This is a sandbox page to discuss edits and to reach consensus for the article Reparative Therapy of Male Homosexuality. Please see the article's Talk page if you wish to join the discussion. Please do not comment here as we want to keep the discussions in one place: Talk:Reparative Therapy of Male Homosexuality. Thank you.

Reparative Therapy of Male Homosexuality: A New Clinical Approach is a 1991 book about conversion therapy by the psychologist Joseph Nicolosi. Nicolosi, who draws on work by previous authors, maintains that the form of conversion therapy he promotes, "reparative therapy", does not remove all of a person's homosexual feelings, but can help men who do not wish to be homosexual to either become celibate or prepare for heterosexual marriage. He views male homosexuality as a developmental problem that often results from problems between father and son. The book was first published in the United States by Jason Aronson in 1991. The work, which advocates a therapeutic approach that departs from traditional psychoanalytic techniques, influenced the practice of conversion therapy.

Critics faulted Nicolosi's scholarship, and argued that he provided an inadequate discussion of biological influences on sexual orientation and incorrectly viewed homosexuality as pathological. The American Psychiatric Association opposes reparative therapy and similar treatments aimed at changing a patient's sexual orientation because homosexuality is not a mental disorder and there is no scientific evidence that reparative therapy achieves its stated goals.

Conversion therapy is a pseudoscience, and is banned in numerous jurisdictions. In 2019, following complaints, Reparative Therapy of Male Homosexuality was withdrawn from sale by Amazon.

Background
Nicolosi's theory has not received empirical support; that is, there is no scientific evidence that "reparative therapy" (conversion therapy) achieves its stated goals. In addition, there is some evidence that conversion therapy harms some men who have undergone the counseling. The scientific consensus is that conversion therapy is pseudoscientific. There is no reliable evidence that sexual orientation can be changed and medical and psychological associations and institutions warn that conversion therapy practices are ineffective and potentially harmful.

Medical, psychological, social science and government organizations in the United States and United Kingdom oppose the validity, efficacy, and ethics of "conversion therapy" or "reparative therapy", and sexual orientation change efforts (SOCE) generally. Based scientific, social, and ethical grounds, the following medical, psychological, counseling, social work, and government organizations oppose so-called "conversion therapy", "reparative therapy", and sexual orientation change efforts (SOCE) generally:



















Due to both evidence of harm and civil rights concerns, conversion therapy is illegal or restricted in an increasing number of jurisdictions.

Summary
Nicolosi discusses conversion therapy. He sees his contribution to its development as combining clinical research on the development of male gender identity, histories of family dynamics, and "the techniques of psychodynamic psychotherapy of male homosexuality". According to Nicolosi, the form of conversion therapy he advocates, "reparative therapy", does not remove all of a person's homosexual feelings, but can "strengthen masculine identification" and help men who do not wish to be homosexual to either become celibate or prepare for heterosexual marriage. He states that reparative therapy is partly based on object relations theory, and that its therapeutic goals include clarifying "the family dynamics that may have led to a man's homosexual condition" and making "peace with father".

Male homosexuality is seen by Nicolosi as "a developmental problem" that "often results from early problems between father and son". Nicolosi argues that the development of heterosexuality requires "the support and cooperation of both parents as the boy disidentifies from mother and identifies with father." In his view, problems in the relationship between father and son can result in the latter's "failure to internalize male gender-identity". He writes that a boy's failure to fully gender-identify leads to alienation from both the father and from male peers in childhood, resulting in an "eroticization of maleness", often associated with "alienation from the body" and "a deficit in sense of personal power", and that the homosexuality that results represents "the drive to repair the original gender-identity injury." According to Nicolosi, the relevant literature shows that genetic and hormonal factors do not "seem to play a predetermining role in homosexual development", but may be predisposing factors for some boys, making them more vulnerable to "gender-identity injury". Problems Nicolosi sees as associated with male homosexuality include "defensive detachment from other males" and sexual promiscuity; he argues that without the influence of women, male couples find it difficult to maintain monogamy, and that gay relationships are "inherently troubled by the limitations of sexual sameness", and thus are not equivalent to heterosexual relationships.

Nicolosi also discusses the work of Sigmund Freud, the founder of psychoanalysis, stating that Freud, like the psychiatrist Carl Jung and the psychotherapist Alfred Adler, viewed homosexuality as pathological. He maintains that the declassification of homosexuality as a mental disorder was the result of politics and the actions of gay rights campaigners rather than new research, and that it has discouraged "treatment and research". However, he also sees the change as being partly the result of the psychological profession's failure to identify with certainty the psychodynamic causes of homosexuality and its resulting failure to devise a treatment with an acceptable success rate. He suggests that psychoanalytic efforts at treating homosexuality may have failed because they mistakenly focused on homosexual men's assumed fear of females rather than their problems in relating to men; he credits the psychologist Elizabeth Moberly with correctly recognizing the importance of such "defensive detachment", which he sees as the major obstacle to therapeutic success. In agreement with Moberly, he criticizes the emotionally distant therapeutic approach characteristic of psychoanalysis, advocating personal involvement on the part of the therapist to meet the need of male patients for "intimate male connectedness".

Publication history
Reparative Therapy of Male Homosexuality: A New Clinical Approach was first published by Jason Aronson in 1991. The book was republished in 1997.

Reception
Reparative Therapy of Male Homosexuality influenced the practice of conversion therapy. The legal scholar Marie-Amélie George called the book "a standard text for reparative therapists", noting that it re-popularized ideas that had begun to be discarded following the declassification of homosexuality. Commentators have noted that the therapeutic approach it advocates departs from traditional psychoanalytic techniques. The psychiatrist Jeffrey Satinover, who credited Nicolosi with synthesizing and advancing prior research on conversion therapy, argued that these departures are consistent with what Freud predicted would be necessary, and were supported by the experience of many other therapists.

The work has been criticized on numerous grounds. The neuroscientist Simon LeVay criticized Nicolosi for viewing homosexuality as pathological. The psychiatrist Jack Drescher wrote that Nicolosi valued "social conformity above the needs of the individual", a view he criticized as "authoritarian". He maintained that Nicolosi favored "formulaic" interpretations of his clients. The clinical social worker Chuck Bright compared Nicolosi's views to those of the psychoanalyst Charles Socarides, criticizing both. The psychiatrist Richard C. Friedman criticized Nicolosi for making generalizations about gay people based on clinical samples. In 2000, the American Psychiatric Association (APA), in a statement published in The American Journal of Psychiatry, reaffirmed its opposition to treatments, including reparative therapy, which assume that a patient should change his or her homosexual orientation, noting that they are based on theories that conflict with its position that homosexuality is not a mental disorder. It referred to Nicolosi as a practitioner of reparative therapy who had "openly integrated older psychoanalytic theories that pathologize homosexuality with traditional religious beliefs condemning homosexuality".

Reparative Therapy of Male Homosexuality received a positive review from the psychologist I. Reed Payne in Issues in Religion and Psychotherapy, a mixed review from the sex researcher James D. Weinrich in the Journal of Sex Research, and a negative review from Friedman in the Archives of Sexual Behavior.

Payne endorsed Nicolosi's view that the idea that homosexuality is innate and unchangeable is mistaken. He believed that the book benefited from Nicolosi's clinical experience and credited him with clearly presenting his views on the diagnosis and treatment of homosexuality, as well as helping to explain its development. However, he noted that critics of Nicolosi's work would object to the limited attention given to biological influences on homosexuality, and that Nicolosi could not answer all the questions his work raised.

Weinrich credited Nicolosi with being the first author of a book offering therapy to homosexual men who wish to change their sexual orientation to admit that such change is not possible. He also credited him with acknowledging that his theory about the cause of male homosexuality is not applicable to all homosexual patients. However, while he considered the idea that "defensive detachment" is a cause of homosexuality applicable to some gay men, he criticized Nicolosi for concluding that homosexuality must be pathological if it develops in the way he proposed. He also criticized Nicolosi for failing to discuss how his religious beliefs might have affected his views on homosexuality, providing an inadequate discussion of biological influences on sexual orientation that ignored relevant evidence, and for stereotyping gay men and describing gay relationships only in negative terms. He concluded that Nicolosi's views on homosexuals were based on a biased sample, and questioned the quality of Nicolosi's scholarship as well as his proposals for therapy.

Friedman wrote that the book had scholarly limitations. He considered Nicolosi incorrect to claim that the declassification of homosexuality as a mental disorder had discouraged research. He also faulted his discussion of "the psychobiology of sexual orientation" and maintained that his understanding of gay people was "severely compromised by his personal negative belief system about homosexuality." Though he agreed that some mental health professionals had adopted a political stance on homosexuality, he regarded Nicolosi as being equally as biased as the gay rights activists he criticized. He argued that the book's quality was undermined by the fact that Nicolosi was not trained as a psychoanalyst.

Gwen Aviles of NBC News reported in July 2019 that Amazon had withdrawn Nicolosi's books, which she described as "some of the most well-known works about conversion therapy", from sale following a campaign by gay rights activists. Amazon's decision received criticism from some commentators. In The American Conservative, the journalist Rod Dreher decried it as a step toward censorship. He noted that Amazon continued to sell other books that were controversial or could be considered dangerous or unscientific. In The Daily Signal, Joseph Nicolosi Jr. defended his father's books, and said that one man credited Reparative Therapy of Male Homosexuality with saving his marriage. On Townhall, Robert Knight described Amazon's decision to stop selling Nicolosi's books as a form of censorship. Daniel Newhauser of Vice News reported that a group of Republican members of the United States House of Representatives was campaigning to reverse Amazon's decision, which they considered a form of censorship.

However, other commentators supported Amazon's decision. Brad Polumbo of the Washington Examiner observed that Nicolosi's books, as well as books by authors who considered themselves ex-gay, were controversial. While he considered the criticism that Amazon's decision to stop selling them had received understandable, he nevertheless believed the decision correct, describing Nicolosi's work as "harmful pseudoscience". He noted that Reparative Therapy of Male Homosexuality was still available from its publisher. In a Newsweek article, journalist Kashmira Gander interviewed physician Natasha Bhuyan, who voiced her support for Amazon's decision to stop selling Nicolosi's books, noting that the books involve approaches rejected by every mainstream medical organization, including the American Medical Association, the American Academy of Family Physicians, and the American Psychological Association. Daniel Reynolds reported in The Advocate in February 2019 that the gay writer Damian Barr had criticized Amazon for selling the books, arguing that they were discredited and harmful. Aviles dismissed conversion therapy as "pseudoscientific".

Kelly Burke of Australia's Seven News reported that despite the withdrawal from sale of the books by Amazon in the United States, they "remained available on Amazon's Australian site until 7NEWS.com.au approached the company for comment, after which they were hastily removed." Burke added that Reparative Therapy of Male Homosexuality continued to be available from Dymocks. Jordan Hirst of QNews reported that, following Amazon's decision to stop selling Nicolosi's books, gay rights organization Equality Australia was "petitioning Australian retailers to follow suit." Hirst noted that Reparative Therapy of Male Homosexuality was still available for sale from booksellers such as Dymocks.