Treatments of homosexuality in Britain since the 1950s—an oral history: the experience of professionals
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7437.429.37984.496725.EE (Published 19 February 2004) Cite this as: BMJ 2004;328:429
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Editor
Rhona MacDonald is wrong to suggest in the
Editor's Choice column that only a bigot would believe that homosexuals
might benefit from psychiatric help.(1,2)
A recent paper by Professor Robert Spitzer(3)(who, incidentally, has
a long track record of supporting gay rights, and was instrumental in
getting homosexuality declassified as a psychiatric illness in the United
States in 1973) suggests that it is possible for some gay people to
reorientate themselves as a result of some form of "reparative therapy".
The study was of 200 self-selected individuals who had undergone therapy
at least 5 years previously. Structured interviews were used to assess
homosexual feelings and behaviour in the year before therapy and in the
year before the interview. The majority of participants gave reports of
change from a predominantly or exclusively homosexual orientation before
therapy to a predominantly or exclusively heterosexual orientation in the
year before interview. Professor Spitzer comments that, although he was
initially sceptical,in the course of the study he "became convinced of the
possibility of change in some gay men and lesbians". Most participants
reported finding the therapy helpful, and reported depression rates were
much lower at the time of interview than before therapy.
1.MacDonald R. Lessons from medicine's shameful past. BMJ
2004;328:Editor's choice.
2.King M,Smith G,Bartlett A. Treatment of homosexuality in Britain since
the 1950's - an oral history: the experience of professionals. BMJ
2004;328:429-432.
3.Spitzer RL. Can some gay men and lesbians change their sexual
orientation? 200 participants reporting a change from homosexual to
heterosexual orientation. Archives of Sexual Behaviour 2003;32(5):403-417.
Competing interests:
None declared
Competing interests: No competing interests
In their article, the authors reveal some of the personal views and
experiences
of medical and psychology professionals in the United Kingdom who
attempted to make homosexual men and women heterosexual in the 20th
century.
These experiences however must rank as relatively mild compared to
the
appalling events in South Africa Defence Force [SADF] during the
Apartheid
years, known as the Aversion Project.
There were horrifying revelations at the TRC. Over an 18 year period
900 men
and women were coerced into having sex change surgery after the crude
attempts at behaviour therapy failed.
This atrocity, which must rank as one of the worst abuses in
psychiatry since
World War 2, went on with the full conivance of the military authorities
who
regarded homosexuality as an intolerable defect that had to be weeded out
of
the conscript ranks. Victims were often handed in for treatment after they
had
confessed to the regimental chaplain.
Victims were discharged from the SADF with no support, in some cases
with
the surgical conversion incomplete. The psychiatrists who ran this system
have not been brought to justice and one is reported to have a prestigious
position in an overseas country.
The South African medical establishment has many sins [such as the
death of
Steve Biko] to answer for during the Apartheid years. The failure to act,
even
retrospectively about these psychiatric abuses is quite inexcusable.
Dr Robert Kaplan
[Kaplan R. The Aversion Project – Psychiatric abuses in the South
African
Defence Force during the Apartheid Era. South African Medical Journal
March
2001, 90-3;216-217.]
Competing interests:
None declared
Competing interests: No competing interests
Homosexuality was in the past, much like whistleblowing is today.
Psychiatrists are often guilty of judging behaviour - by normal or
abnormal. The judgement ruler is usually their own background, prejudices,
world view etc. That is my first criticism of some psychiatrists. There is
a world view that everyone is different and some people should be allowed
to be accepted without the stigma of a psychiatric diagnosis. It is
interesting though that the more judgmental doctors look upon behaviour
out of the ordinary to be a product of some form of personality disorder.
There was a judgment recently on the front page of the BMA news where
the privacy of doctors if judged as
"eccentric" should be grounds for an alert letter. Now judges seem to be
willing to make diagnosis of abnormality based on their own judgement.
This judgment shows that we have not really moved from a 16th century view
of "perceieved abnormal behaviour" judged very often as
" mental illness".
Homosexuality has a great deal of understanding in this day and age.
Other forms of behaviour eg campaigning etc within the medical profession
does not command that level of understanding. To campaign for better
healthcare these days is clearly according to the GMC a product of
abnormal behaviour although homosexuality is deemed acceptable.
I suspect it is time psychiatrists looked upon products of their own
prejudices before they take the time to judge an individualist within the
ICD 10 code.
Genetics exists for us to develop into individualists - not to remain
clone doctors moulded by a profession that remains stuck in the 19th
century :) or even further back!
Dr Rita Pal
Editor
www.nhs-exposed.com
Competing interests:
None declared
Competing interests: No competing interests
Dear Editor,
It was interesting to read the paper of King,Smith,and
Bartlett,Online First, Treatments of homosexuality in Britain since the
1950s--an oral history:the experience of professionals(BMJ
2004;0:379844967-0). My comment
1.It shows how legislation can affect the attitude of the public among
which are the professionals (the medical, and psychiatric staff).
2.It shows that although some professionals consider the treatments were
valid, many have doubts about efficacy and ethics.
3.I wonder whether we are dealing with one of the varities of sexual
behaviour,abnormal sexual behaviour, medical or psychological disorder?
4.The study reminds me of Insulin coma and frontal lobotomy for the
treatment of schizophrenia.
Thanking you,
Yours sincerely,
AK.Al-Sheikhli.
Competing interests:
None declared
Competing interests: No competing interests
Re: Reorientation is a possibility for some homosexuals
Re: Reorientation is a possibility for some homosexuals
Professor Spitzer's study, referred to by Dr Glendenning, has been
quoted by both critics and supporters of lesbian and gay people. It is
therefore helpful to hear Spitzer himself talking in an interview he gave
with Dr Raj Persaud on BBC Radio 4 recently. It can be heard at
http://www.bbc.co.uk/radio4/science/rams/allinthemind_20040203.ram
It's about 8 minutes, and ignore the first 2 minutes which are on a
different topic. In this Spitzer says he had difficulty in finding 200
volunteers who had apparently changed their sexuality and it took him 2
years to do so. He concludes it is a rare situation.The vast majority of
these volunteers came from religious organisations. His results showed
that only 14% of the group had completely eliminated their homosexual
feelings. He stresses that the survey was not a representative group and
his results are not generaliseable to the gay community. In a separate
article (in the Wall Street Journal) Spitzer has said he fully supports
human rights for gay and lesbian people.
I think that in view of the criticism of lesbian and gay people it is
not surprising that some of them wish to change. The viciousness of this
criticism may not be realised by people unfamiliar with some of the
published mainstream conservative religious writing. Spitzer's survey does
show that these religious critics are very influential, and bigotry is not
too strong a word for this. It is striking that in spite of such societal
pressures so few people do change their orientation to any significant
degree. Spitzer in his talk comments that his survey may have harmed more
people than it has helped. Primum non nocere. His findings do not alter
the fact that there are many lesbian and gay people, religious or not, who
do not wish to change, and would be incapable of changing. It should be
remembered that the General Medical Council requires that doctors must not
let their views about their patients' sexuality (or race, gender,
economic circumstances etc) prejudice the treatment they provide or
arrange ('Good Medical Practice', GMC 2001, p4).
Competing interests:
None declared
Competing interests: No competing interests