User:MishMich/CV history

History

19th Century

Baron Albert von Schrenck-Notzing was a German physician and occultist. Historian Jonathan Katz writes that Schrenck-Notzing was the first person to attempt to treat homosexuality with hypnosis. His book Therapeutic Suggestion in Psychopathia Sexualis appeared in an American edition in English in 1895.

Jean-Martin Charcot, a French neurologist and professor of anatomical pathology, attempted in the 19th century to cure homosexuality through hypnosis. The failure of his attempts convinced him that homosexuality was inherited.

Methods used to treat homosexuality in the USA during the 19th century included "anaphrodisiac measures", surgical removal of the ovaries, castration, and hypnosis. Descriptions of such treatments were published in medical journals. In 1884 Dr. James G. Kiernan surveyed early writings on homosexuality, from America, Germany, and other countries. He described his treatment of a lesbian patient, stating that removing her homosexuality was out of the question, but that he had been able to help her keep it under control. F. E. Daniel proposed castration of gay men in 1893, while Dr. Henry Hulst proposed hypnosis as an alternative method, becoming the first American known to have supported this form of conversion therapy. Dr. John C. Quackenbos in 1899 reported on the use of hypnosis as a treatment for sexual perversion to the New Hampshire Medical Society. He stated that its success depended on the patient's desire to be cured. Quackenbos received publicity when the New York Times reported on his work.

In the UK, the Journal of Mental Science in 1896 published an article by sexologist Havelock Ellis and Dr E. S. Talbot about the attempted treatment of homosexuality in an American patient named Guy Olmstead through castration. Following the operation, which did not change his sexual orientation, Olmstead attempted to murder a man he had had a relationship with and was sent to an insane asylum. Ellis and Talbot suggested that the moral of the case was that, “The removal of the testicles, the apparently depressing effect of the operation, and the speedy occurrence of the crime after it, should suggest caution to the surgical psychiatrists who advocate the castration of inverts and sexual perverts generally“.

Europe: 20th Century to WW2

Krafft-Ebing was a German-Austrian psychiatrist and one of the founders of sexology; his Psychopathia Sexualis included autobiographies of people categorised as homosexual who did not wish to change their sexual orientation.. He argued that hypnotic suggestion would change homosexuality; he rejected castration as a cure, and against internment of gay people in asylums. In his view, physicians had a duty to provide such treatment if it was requested. Later editions of

Magnus Hirschfeld was a prominent figure in German homosexual emancipation up to the early 1930s, he treated thousands of people who were homosexual. Hirschfeld displayed an ambivalent attitude to homosexuality, believing that it might be caused by biological degeneracy (owing to alcoholism or syphilis) in some cases. He repeatedly compared homosexuality to deformities such as having a hare lip, regarding the main difference between these conditions as being that the former could not be corrected, while the latter could. In 1903 he published Der Urnische Mensch, arguing that the purpose of therapy should be to permit clients to accept their homosexuality, but he accepted that gay men had the right to try to change their sexual orientation if they wished and referred them to practitioners who claimed that they could help them with this. Hirschfeld believed that the psychonanlysitic failure to change homosexuality showed that it was biologically innate.

Freud (1856–1939) was skeptical of the possibility of therapeutic conversion.

Sigmund Freud was a physician and the founder of psychoanalysis. Freud's wrote on homosexuality between 1905 (Three Essays on the Theory of Sexuality) and 1922 (“Certain Neurotic Mechanisms in Jealousy, Paranoia, and Homosexuality“). Freud believed that people were bisexual, incorporating aspects of both sexes, anatomically, mentally and psychically; from this the concepts of heterosexuality and homosexuality developed.

Freud did not claim to have a complete explanation of homosexuality, believing it was caused by biological and psychological factors; he relied on Krafft-Ebing, Magnus Hirschfeld, and others for much of his information. he said that homosexuality could sometimes be removed through hypnotic suggestion, which while suggesting it may not be innate this did not convince him it was innate. He saw the causes of homosexuality as inhibiting normal sexual development, but this did not imply abnormality in other areas of life. Freud suggested that several distinct kinds of homosexuality might exist.

Freud cautioned that his conclusions about homosexuality were based on a small number of potentially unrepresentative patients. His views ranged from homosexuality being a psychopathology to denying such a connection, and included a moderate position in which homosexuality is a feature of other pathological conditions and can generally be considered pathognomic but cannot be used for diagnostic specification. Freud often used the term "inversion" for homosexuality, rather than perversion, which was necessarily pathological in his view.

Freud‘s discussed female homosexuality in 1920 (“The Psychogenesis of a Case of Homosexuality in a Woman“). The father of a lesbian brought her to Freud in the hope that psychoanalysis would cure her. Freud was not convinced he could help her, and concluded that he was dealing with a case of biologically innate homosexuality, and eventually broke off the treatment, because of her hostility to men.

Freud was skeptical that psychoanalysis could change homosexuality because of biological factors, and he believed that attempts at changing homosexuality often failed because people didn't really want to change their sexual orientation, but pursued treatment because of social disapproval;

J. Vinchon and Sacha Nacht in 1929 published "Considerations sur la cure psychoanalytique d’une nevrose homosexuelle" in Revue francaise de psychoanalyse. This article divided gay people into three categories: those with glandular abnormalities, sexual perverts, and neurotics. Vinchon and Nacht believed that gay people in the second category (who were "comfortably settled in [their] vice") were incurable.

Sandor Ferenczi was an influential psychoanalyst. Native to Hungary, he wrote many of his works in German. Ferenczi denied the importance of inherited factors on homosexuality, claiming that it was caused by “excessively powerful heterosexuality (intolerable to the ego)“. Ferenczi tried to distinguish between several different types of homosexuality, basing his distinctions on an unspecified number of patients whose analyses had sometimes lasted for a short period and sometimes “a whole year and even longer.” Ferenczi hoped to cure some kinds of homosexuality completely, but was content in practice with reducing what he considered gay men‘s hostility to women, along with the urgency of their homosexual desires, and with helping them to become attracted to and potent with women. In his view, a gay man who was confused about his sexual identity and felt himself to be “a woman with the wish to be loved by a man” was not a promising candidate for cure. Ferenczi believed that complete cures of homosexuality might become possible in the future when psychoanalytic technique had been improved. Sandor Rado and Melanie Klein were pupils of Ferenczi.

German psychoanalysts who wrote about homosexuality included Felix Boehm. He accepted Freud’s earlier theory of homosexuality involving boys’ identification with their mothers and consequent narcissistic object choice. His major work was a four-part series on homosexuality published in the Internationale Zeitschrift fuer Psychoanalyse between 1920 and 1933. It attempted to present and illustrate the most up to date psychoanalytic thinking on homosexuality. In Boehm’s view, curing homosexuality meant making enjoyable heterosexual functioning possible rather than eliminating homosexual behavior. Boehm claimed to have cured gay people in the fourth part of his series on homosexuality, but presented as proof a case in which “the homosexuality never became conscious for the patient and had never expressed itself in manifest activity.” This patient does not appear to have been homosexual. Boehm claimed that manifest homosexuals regularly abandoned treatment out of hatred for their analysts just at the point when they were close to achieving heterosexual functioning. Boehm criticised Sadger’s Die Lehre von den Geschlechtsverwirrugen ... auf psychoanalytischer Grundlage for its brief analyses, many of which lasted only weeks or months.

Edmund Bergler’s first contribution to the psychoanalytic theory of homosexuality was “Der Mammakomplex des Mannes“, an article co-authored with L. Eidelberg and published in the Internationale Zeitschrift fuer Psychoanalyse in 1933. It described a “breast complex“ found in both normal and pathological conditions, among which Eidelberg and Bergler included “a type of homosexuality.” The male child reacts violently to weaning, making unsuccessful attempts to inhibit his frustrated aggression that only heighten it. This causes ambivalent identifications, object choices, and narcissistic compensations. Cathexes are displaced from the breast onto the penis, and the infant substitutes urine for milk, attempting to make active what was once passive. He unsuccessfully tries to transfer hatred of the mother onto the father, but the Oedipus complex does not reach normal intensity because of the unresolved ambivalence of the oral period. The unstable organization achieve at the Oedipal period regresses to an earlier stage involving fixation on the oral mother, whose vagina is conflated with the infant‘s own cannibalistic mouth, transmuting it into the vagina dentata. This oral fixation lead to character traits such as spite and libido charged with aggression.

The Austrian-born psychoanalyst Melanie Klein moved to London in 1926. Her seminal book The Psycho-Analysis of Children, based on lectures given to the British Psychoanalytic Society in the 1920s, was published in 1932. Klein claimed that entry into the Oedipus Complex is based on mastery of primitive anxiety from the oral and anal stages. If these tasks are not performed properly, developments in the Oedipal stage will be unstable. Complete analysis of patients with such unstable developments would require uncovering these early concerns. The analysis of homosexuality required dealing with paranoid trends based on the oral stage. The Psycho-Analysis of Children ends with the analysis of Mr. B., a gay man. Klein claimed that he illustrated pathologies that enter into all forms of homosexuality: a gay man idealizes “the good penis” of his partner to ally the fear of attack he feels due to having projected his paranoid hatred onto the imagined “bad penis“ of his mother as an infant. She stated that Mr. B.’s homosexual behaviour diminished after he overcame his need to adore the “good penis” of an idealized man. This was made possible by his recovering his belief in the good mother and his ability to sexually gratify her with his good penis and plentiful semen.

In the 1930s, the rise to power of Nazism in Germany destroyed the gay rights movement. Hirschfeld was unable to return to Germany from a world tour because of growing political disorder in 1931 and 1932. He was obliged to move to France, where he made an unsuccessful attempt to establish a new sexological institute. Approximately fifty thousand people were convicted of homosexuality during Nazi rule, and roughly five thousand were sent to concentration camps, where most of them died. In 1944, the Danish endocrinologist Carl Vaernet carried out medical experiments on gay men at Buchenwald concentration camp. He implanted “artifical sex glands“ designed to release testosterone into at least ten gay men to attempt to change their sexual orientation. The experiments caused at least one man to die, but Vaernet claimed that some of them had been successful. These apparent changes in sexual orientation were probably the result of prisoners lying in attempts to be discharged from the camp. In 1945, Vaernet was arrested, but he managed to escape to Argentina.

United States: 20th Century to WW2

Surgical methods of treating homosexuality continued to be used in the 20th century. Psychoanalysis started to receive recognition in the United States in 1909, when Sigmund Freud delivered a series of lectures at Clark University in Massachusetts at the invitation of G. Stanley Hall.

Abraham Brill in 1913 wrote “The Conception of Homosexuality”, which he published in the Journal of the American Medical Association and read before the American Medical Association’s annual meeting, where it was criticised by several doctors. Brill declared that after long study he had slowly overcome his disgust for homosexuality. He denied that homosexuality was influenced by inherited factors or necessarily related to emotional disturbance. Brill observed that it was impossibile to use the term homosexuality diagnostically, since it could refer to several different entities. Brill asserted that the development of sexual attraction to the same sex was always related to narcissism, which he incorrectly defined as love for one‘s self. Brill criticised physical treatments for homosexuality such as bladder washing, rectal massage, and castration, along with hypnosis, but referred approvingly to Freud and Sadger's use of psychoanalysis, calling its results “very gratifying.“ Since Brill understood cure of homosexuality to mean restoring heterosexual potency, he claimed that he had cured his patients in several cases, even though many remained homosexual.

Dr. Wilhelm Stekel, an Austrian, published his views on treatment of homosexuality, which he considered a disease, in the American Psychoanalytic Review in 1930. Stekel believed that “success was fairly certain“ in changing homosexuality through psychoanalysis provided that it was performed correctly and the patient wanted to be treated. In 1932, the Psychoanalytic Quarterly published a translation of Dr. Helene Deutsch's paper “On Female Homosexuality“. Deutsch reported her analysis of a lesbian, who did not become heterosexual as a result of treatment, but who managed to achieve a "positive libidinal relationship" with another woman. Deutsch indicated that she would have considered heterosexuality a better outcome.

Dr. La Forest Potter of New York City published Strange Loves: A Study in Sexual Abnormalities, which focused on homosexuality, in 1933, probably to exploit the interest in the subject generated by the American publication of Radclyffe Hall’s The Well of Loneliness and Blair Niles’s Strange Brother. He believed that homosexuality was caused by psychological and hormonal disturbances, and that it could be cured if the patient wanted to change. Potter advocated a mixture of psychoanalysis and hormone treatment. He believed that marriage might help to alter lesbianism in cases in which it was not hereditary. Potter described his treatment of two lesbians, stating that it was unsuccessful in one case but successful in the other. He stated that he had successfully cured a young man of homosexuality.

Dr. Louis W. Max reported to the American Psychological Association on September 6, 1935 that he had used electric shocks administered over several months to diminish what he called a homosexual fixation in a patient. This was the first documented attempt to use aversion therapy to alter homosexuality. He stated that low intensity shocks had no effect, but that higher intensities "definitely diminished the emotional value of the stimulus for days after each experimental period."

Edmund Bergler moved to the USA after vacating his post as psychoanalyst in Vienna in 1937. He published “Preliminary Phases of the Masculine Beating Fantasy“, a response to Freud‘s “A Child Is Being Beaten“, in Psychoanalytic Quarterly in 1938. Bergler claimed to have detected the early phase of a beating fantasy in boys. This phase began with the weaning shock, which mobilizes enormous sadistic rage against the breasts of the depriving phallic mother, which is an attempt at narcissistic restitution for the lost breasts of the mother. Due to guilt, this rage is transmuted into a masochistic fantasy of being beaten by the father, substituting the boy’s own buttocks for the mother’s breasts and idealizing the father out of hatred of the mother, thereby substituting a homosexual for a heterosexual bond. The paper shifted the important stage in the development of homosexual perversion back from the Oedipus complex to the oral stage, minimized the importance of object libido and emphasised more primitive narcissistic oral rage, and established that homosexual perversion could not be based on a primary homosexual attachment to the father, since there was always an earlier heterosexual attachment to the mother. The implication was that all outcomes of the Oedipus complex involving a passive homosexual stance toward the father are perverse.

Europe: 20th century, WW2 to 2000

Daniel Lagache in 1950 published “Homosexuality and Jealousy” in the International Journal of Psychoanalysis. It described the analysis of a gay man, illustrating the relation of active and passive forms of homosexuality and the defensive maneuvers that mediate between them. The patient shifted from homosexual to heterosexual interests, and experienced a stage of intense jealousy that Lagache regarded as both a sign of progress and a resistance. The heterosexual interest was a new defense against passive homosexuality, while active homosexuality had been his old defense. Passive homosexuality was intolerable to the patient because it was associated with castration, but it was deeply rooted in his psychology because “submission and obedience to the father [had] as their aim the right to take his place.”

Daughter of Sigmund Freud, Anna Freud became an influential psychoanalytic theorist in the UK after she left Austria in 1938 to escape the Nazis. Anna Freud reported the successful treatment of homosexuals as neurotics in a series of unpublished lectures. In 1949 she published “Some Clinical Remarks Concerning the Treatment of Cases of Male Homosexuality” in the International Journal of Psychoanalysis. In her view, it was important to pay attention to the interaction of passive and active homosexual fantasies and strivings, the original interplay of which prevented adequate identification with the father. The patient should be told that his choice of a passive partner allows him to enjoy a passive or receptive mode, while his choice of an active partner allows him to recapture his lost masculinity. She claimed that these interpretations would reactive repressed castration anxieties, and childhood narcissistic grandiosity and its complementary fear of dissolving into nothing during heterosexual intercourse would come with the renewal of heterosexual potency.

Anna Freud in 1951 published “Clinical Observations on the Treatment of Male Homosexuality” in Psychoanalytic Quarterly and “Homosexuality” in the American Psychoanalytic Association Bulletin. These articles insisted on the attainment of full object-love of the opposite sex as a requirement for cure of homosexuality. In 1951 she gave a lecture about treatment of homosexuality which was criticised by Edmund Bergler, who emphasised the oral fears of patients and minimized the importance of the phallic castration fears she had discussed. Anna Freud asked a journalist not to quotes her father's doubts in his earlier letter to the mother of a homosexual, “…nowadays we can cure many more homosexuals than was thought possible in the beginning. The other reason is that readers may take this as a confirmation that all analysis can do is to convice patients that their defects or ‘immoralities‘ do not matter and that they should be happy with them. That would be unfortunate.”

The British government in 1952 subjected Alan Turing to hormonal treatment after he was arrested on a charge of gross indecency. The treatments took the form of oestrogen injections, which were effectively chemical castration. Turing became overweight and developed breasts as a side-effect of the treatment, then became depressed and eventually killed himself.

During the 1960s and 1970s, the endocrinologist Gunter Dorner, who was influenced by Eugen Steinach through his teacher Walter Hohlweg, performed experiments on rats designed to alter their sexual behavior. He reported that the destruction of the ventromedial nucleus in apparently homosexual rats caused them to become heterosexual. Dorner suggested that homosexuality in humans was caused by hormonal factors and should be cured or prevented. In 1962, Fritz Roeder, a neurosurgeon at the University of Gottingen, destroyed the ventromedial nucleus of of a 52 year old man who was in prison for having sex with numerous boys between the ages of 12 and 14. He volunteered for the operation as an alternative to castration. It reduced his homosexual feelings but did not cause him to develop heterosexual feelings. Nearly forty other men were later subjected to the same operation. The men the operations were performed on were all in prison or hospitals for the criminally insane. Some of them were heterosexual rapists, while others were labelled homosexual pedophiles, although most of their offences were committed with post-pubertal youths. The operations usually caused reduction in sexual desire, with obesity as a common side-effect. Some of the operations were performed by Roeder and others by a different group of German scientists lead by Gert Dieckmann and R. Hassler. The Dieckmann and Hassler group acknowledged that Dorner’s work had provided scientific background for their surgery. Roeder claimed in 1970 that he had changed the sexual orientation of his patients from pedophilic to heterosexual.

Dorner suggested in his 1976 book Hormones and Brain Differentiation that homosexuality might be cured through brain surgery. He criticised the use of castration and steroids to change human sexual orientation, stating that they could only alter the strength of sexual attraction, not its direction. The German Society for Sex Research criticised Dorner‘s research on scientific and moral grounds in 1982.

Hans Eysenck was born in Berlin, Germany, but moved to England as a young man in the 1930s because of his opposition to the Nazi party. He was notable as being one of the three most influential psychiatrists of the 20th Century and helped develop behavioural therapy. He advocated using Electroconvulsive Therapy to treat homosexuals, as well as aversion therapy, and claimed half were cured. On November 2nd 1972 Peter Tatchell of the UK Gay Liberation Front invaded a closed meeting where Eysenck was speaking, Tatchel disputed that 50% of those treated were cured, questioned whether what happened was cure, and asked about the other 50%. Eysenk conceded that the success rate was not high, but "dismissed concerns about the pain and danger involved as a fuss over nothing. 'Aversion therapy is', he said, 'just like a visit to the dentist'".

Many gay people chose Jacques Lacan, the French psychoanalyst, because he did not attempt to convert them to heterosexuality.

United States: 20th Century, WW2 to 2000

thumb|Charles W. Socarides, M.D. During the three decades between Freud's death in 1939 and the Stonewall riots in 1969, conversion therapy received approval from most of the psychiatric establishment in the United States. Sandor Rado in 1940 criticized Freud's theory of innate bisexuality in his article "A Critical Examination of the Concept of Bisexuality". Rado concluded that pursuing the genital organs of the opposite sex is the standard form of achieving genital stimulation and that the main cause of homosexuality is anxiety, although he granted that "constitutional factors may have an influence on morbid sex developments." Rado‘s article appears to have been partly motivated by the desire to combat homosexuality.

Bergler was the most important psychoanalytic theorist of homosexuality in the 1950s. He was vociferous in his opposition to Alfred Kinsey, who argued that homosexuality was normal human variation. Bergler argued that Kinsey's statistical research overestimated the incidence of homosexuality because it was conducted in cities where perversion thrived. Bergler based his theories partly on analysis of the novels of literary figures known to be gay. Kinsey's work, and its reception, led Bergler to develop his own theories for treatment, which were essentially to 'blame the victim'.

Bergler claimed that if gay people wanted to change, and the right therapeutic approach was taken, then they could be cured in 90% of cases. Bergler used confrontational therapy in which gay people were punished in order to make them aware of their masochism. Bergler openly violated professional ethics to achieve this, breaking patient confidentiality in discussing the cases of patients with other patients, bullying them, calling them liars and telling them they were worthless. He insisted that gay people could be cured, and that if they believed they should be accepted, they were asking for punishment, which confirmed their pathological immaturity. Bergler initially blamed those who mistreated gay people, because it provided a rationale for the masochistic view of the world; but, from the 1950s, and following the emergence of gay rights organisations, he began to blame homosexuals for their own oppression. Bergler confronted Kinsey because Kinsey thwarted the possibility of cure by presenting homosexuality as an acceptable way of life, which was the basis of the homosexual rights activism of the time. Bergler popularised his views on homosexuality and its cure in the USA in the 1950's using magazine articles and books aimed at non-specialists.

In 1951, the mother who wrote to Freud asking him to treat her son sent Freud's response to the American Journal of Psychiatry, in which it was published. The 1952 first edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-I) classified homosexuality as a mental disorder.

The practice of aversion therapy was influenced by "Treatment of Male Homosexuality through Conditioning", an article published by the Czech doctors J. Srnec and Kurt Freund in the International Journal of Sexology in 1953. Srnec and Freund‘s procedure, conducted in Czechoslovakia, involved giving patients coffee or tea mixed with emetine, then subcutaneous injections with a mixture of substances, before showing them pictures of nude men while the drugs made them vomit. Patients were next shown pictures of women after being injected with testosterone. This was repeated between five to ten times per patient. Srnec and Freund stated that of twenty five men who were subjected to this procedure, ten “achieved predominant heterosexuality at practically full sexual activity.” They expressed the hope that the method they described could eventually be replaced by something more effective.

The homosexuality as sickness theory started to come under criticism in the 1950s. Evelyn Hooker in 1957 pulished “The Adjustment of the Male Overt Homosexual”, which found that "homosexuals were not inherently abnormal and that there was no difference between homosexual and heterosexual men in terms of pathology." This paper subsequently became influential.

Irving Bieber and his colleagues in 1962 published Homosexuality: A Psychoanalytic Study of Male Homosexuals, which concluded that "although this change may be more easily accomplished by some than by others, in our judgment a heterosexual shift is a possibility for all homosexuals who are strongly motivated to change." The same year, Albert Ellis published Reason and Emotion in Psychotherapy, which claimed that "fixed homosexuals in our society are almost invariably neurotic or psychotic:... therefore, no so-called normal group of homosexuals is to be found anywhere." Ellis published his main work on homosexuality, Homosexuality: Its Causes and Cure, in 1965."

Psychologist Martin E.P. Seligman reported in 1966 that using aversion therapy to change sexual orientation "worked surprisingly well," with up to 50% of men subjected to such therapy not acting on their homosexual urges. These results produced "a great burst of enthusiasm about changing homosexuality [that] swept over the therapeutic community". The findings were later shown to be flawed: most of the treated men who stopped having sex with men were actually bisexual. Among men who were primarily gay, aversion therapy was far less successful.

Charles Socarides’s first book, The Overt Homosexual, was published in 1968. Socarides regarded homosexuality as an illness arising from a conflict between the id and the ego usually arising from an early age in "a female-dominated environment wherein the father was absent, weak, detached or sadistic". He credited the earlier work of Irving Bieber with clarifying progress in therapeutic knowledge and effectivenes.

The Stonewall Inn

There was a riot in 1969 at the Stonewall Bar in New York after a police raid. The Stonewall riot acquired symbolic significance for the gay rights movement and came to be seen as the opening of a new phase in the struggle for gay liberation. Following these events, conversion therapy came under increasing attack. Activism against conversion therapy increasingly focused on the DSM's designation of homosexuality as a psychopathology.

Lawrence Hatterer in 1970 published Changing Homosexuality in the Male, which advocated a therapy based on simplified psychoanalytic ideas and behavior modification techniques. 1970 also saw the publication of Arthur Janov's The Primal Scream, which claimed that homosexuality was a neurosis that could be cured by a therapy that used screaming and other methods in attempts to release repressed pain. The Gay Liberation Front invaded Janov's office in West Hollywood, and had a "scream-in" to protest his anti-gay writings. Janov's therapy later became widely influential.

In 1973, after years of criticism from gay activists and bitter dispute among psychiatrists, the American Psychiatric Association removed homosexuality as a mental disorder from the Diagnostic and Statistical Manual of Mental Disorders. Supporters of the change used evidence from researchers such as Alfred Kinsey and Evelyn Hooker. Psychiatrst Robert Spitzer, a member of the APA's Committee on Nomenclature, played an important role in the events that lead to this decision. Critics argued that it was a result of pressure from gay activists, and demanded a referendum among voting members of the Association. The referendum was held in 1974 and the APA’s decision was upheld by a 58% majority.

Exodus International, a Christian organization that promotes "the message of freedom from homosexuality through the power of Jesus Christ", was founded in 1976. It does not conduct clincal treatment but does provide referrals to professional therapists.

Robert Kronemeyer in 1980 published Overcoming Homosexuality. Influenced by the work of Wilhelm Reich, Kronemeyer claimed that homosexuality could be cured by a method he called "Syntonic Therapy." Kronemeyer criticised some earlier methods of changing homosexuality, including lobotomy, electroshock treatment, and Aesthetic Realism.

Research psychologist Elizabeth Moberly in 1983 published Homosexuality: A New Christian Ethic, which tried to understand homosexuality through a combination of psychological theory and theology. It used the term reparative drive to refer to male homosexuality, interpreting men's sexual desires for other men as attempts to compensate for a lacked connection between father and son during childhood. Moberly denied the importance of over-dominant mothers as a cause of homosexuality and encouraged same-sex bonding with both mentors and peers as a way of stopping same-sex attraction.

The APA removed ego-dystonic homosexuality from the DSM-IV in 1987 and opposes the diagnosis of either homosexuality or ego-dystonic homosexuality as any type of disorder.

Joseph Nicolosi began playing an important role in the development of conversion therapy in the early 1990s, publishing his first book Reparative Therapy of Male Homosexuality in 1991. In 1992, Joseph Nicolosi, Charles Socarides, and Benjamin Kaufman founded the National Association for Research & Treatment of Homosexuality (NARTH), a mental health organization that opposes the mainstream medical view of homosexuality and aims to "make effective psychological therapy available to all homosexual men and women who seek change."

During the 1990s, new research into the biological basis of homosexuality raised the possibility that science might develop a method of changing sexual orientation through gene therapy or brain surgery. Several gay writers discussed this issue, including scientists Dean Hamer and Simon LeVay, and journalist Chandler Burr. Hamer opposed the use of such methods under any circumstances, but LeVay and Burr argued that gay people should be free to use them if they were ever developed.

Europe: 21st Century

Following the increased visibility of the gay community during the AIDS epidemic of the late 1980s and the declassification of homosexuality as a mental disorder in the ICD-10, non-pathological models of homosexuality became mainstream. Nevertheless, Robert L. Spitzer‘s study of sexual orientation change, conducted in 2001, quickly attracted attention in Germany. German opponents of civil unions used the study to support their view that the relationships of gay men and lesbians should not be legally recognized. The Suddeutsche Zeitung on May 15, 2001 published an interview with Hartmut Bosinski, the Head of the Department of Sexual Medicine at the University of Kiel and a supporter of civil unions. Bosinski criticised the Spitzer study. Civil unions were passed into law on July 17, 2002 despite the controversy. In 2008, Bundestag, the parliament of Germany, ruled that homosexuality does not require therapy and cannot be changed through therapy. It also stated that conversion therapy has harmed gay people and is dangerous.

Peel, Clarke and Drescher wrote in 2007 that only one organisation in the UK could be identified with conversion therapy, a religious organisation called The Freedom Trust (part of the US-based Exodus International): "whereas a number of organisations in the US (both religious and scientific/psychological) promote conversion therapy, there is only one in the UK of which we are aware". The paper reported that practitioners who did provide these sorts of treatments between the 1950s and 1970's now view homosexuality as healthy, and the evidence suggests that 'conversion therapy' is a historical rather than a contemporary phenomenon in the UK, where treatment for homosexuality has always been less common than in the USA.

In 2007, the Royal College of Psychiatrists, the main professional organization of psychiatrists in the United Kingdom, issued a report stating that: "Evidence shows that LGB people are open to seeking help for mental health problems. However, they may be misunderstood by therapists who regard their homosexuality as the root cause of any presenting problem such as depression or anxiety. Unfortunately, therapists who behave in this way are likely to cause considerable distress. A small minority of therapists will even go so far as to attempt to change their client's sexual orientation. This can be deeply damaging. Although there is now a number of therapists and organisation in the USA and in the UK that claim that therapy can help homosexuals to become heterosexual, there is no evidence that such change is possible."

In 2009, a research survey into mental health practitioners in the UK concluded "A significant minority of mental health professionals are attempting to help lesbian, gay and bisexual clients to become heterosexual. Given lack of evidence for the efficacy of such treatments, this is likely to be unwise or even harmful." Scientific American reported on this: "One in 25 British psychiatrists and psychologists say they would be willing to help homosexual and bisexual patients try to convert to heterosexuality, even though there is no compelling scientific evidence a person can willfully become straight", and explained that 17% of those surveyed said they had tried to help reduce or suppress homosexual feelings, and 4% said they would try to help homosexual people convert to heterosexuality in the future.

United States: 21st Century

United States Surgeon General David Satcher in 2001 issued a report stating that "there is no valid scientific evidence that sexual orientation can be changed". The same year, Robert Spitzer's study on sexual orientation change caused controversy and attracted media attention.

The American Psychoanalytic Association (APsaA) spoke against NARTH in 2004, stating "that organization does not adhere to our policy of nondiscrimination and ... their activities are demeaning to our members who are gay and lesbian." In 2006, Focus on the Family and several other organizations announced that they would protest the American Psychological Association's convention in New Orleans. Mike Haley, the director of gender issues for Focus on the Family, commented that, "The APA's views on issues such as the immutability of homosexuality have caused real harm to real people and patients." The same year, a survey of members of the American Psychological Association rated reparative therapy as "certainly discredited", though the authors warn that the results should be interpreted carefully as an initial step, not a final word.

The American Psychological Association in 2007 convened a task force to evaluate its policies regarding reparative therapy; ex-gay organizations expressed concerns about the lack of representation of pro-reparative-therapy perspectives on the task force, while alleging that anti-reparative-therapy perspectives were amply represented.

In 2008, the organizers of an APA panel on the relationship between religion and homosexuality canceled the event after gay activists objected that "conversion therapists and their supporters on the religious right use these appearances as a public relations event to try and legitimize what they do."