Studying sexual orientation change : a methodological review of the Spitzer Study, "Can some gay men and lesbians change their sexual orientation?"

T. Sandfort

Robert L. Spitzer, MD recently published a report, "Can Some Gay Men andLesbians Change Their Sexual Orientation? 200 Subjects Reporting a Change from Homosexual to Heterosexual Orientation." He recruited men and women who reported to once have had a predominantly homosexual orientation "which they felt conflicted about" and who claimed, due to some kind of "therapy," to have sustained some change to a heterosexual orientation for at least five years. "Therapy" in this study included either seeing a mental health professional, attending an ex-gay or other religious support group, bibliotherapy, repeated meetings with a heterosexual role model, or, without any external support, changing one_s relationship to God. Spitzer interviewed his participants by telephone, asking 114 closed-ended and some open-ended questions, which were answered in about 45 minutes. Spitzer acknowledges that this approach has numerous limitations and discusses several of them in the paper. However, a careful methodological assessment of how Spitzer_s study was conducted leads to the conclusion that its author_s claims are not warranted. The major issue is how was change assessed, which is problematic because of the following combination of reasons: (1) reliance on self-report; (2) biased selection of the sample; (3) retrospective design of the study; (4) use of a telephone interview as the data collection method; (5) the way _harm_ was operationalized; and (6) insufficient reporting of the findings. Even if the respondents_ reports were valid, the changes observed are not as big as the title of the report suggests. The paper_s discussion suggests what Spitzer could have done to do a better study, and then concludes with suggestions about what Spitzer should have done.[Copies are available from: Haworth Document Delivery Center. The Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580, USA]