“Do not be conformed to this world, but be transformed by the renewal of your mind….” Several implications for the struggler against same-sex attraction: first, when paired with teachings such as “do not love the word or the things in it,” it…must be a straightforward repudiation of the “gay” or “LGBT” identity, not merely the sexual behaviour itself — otherwise, how is one “fleeing sexual immorality”? … we need to restore Biblical language to the way we talk about lust and temptations: a person hates, fights, struggles, battles and aims to kill desires which “wage war against the soul.” A more Biblical self-identification for the struggler would therefore be “I battle these temptations,” rather than “I am gay”….

It goes without saying that the issue of homosexuality has become one of the most hotly debated topics in the biblically orthodox Reformed churches in the United States today. The advent of Revoice and the discussions at the recent Presbyterian Church in America (PCA) General Assembly have demonstrated substantial divisions, particularly regarding issues of self-identification and philosophy of ministry. A recent article by OPC minister Todd Bordow [1] highlighted some ways in which the two sides are in some sense “talking past” each other and offered suggestions to both groups for avoiding error and attempting to arrive at mutual understanding. One point struck me as important since it has been almost totally absent from recent discussion, that of the psychological dimension to same-sex attraction.

Homosexuality is such a complex issue precisely because of its multifaceted nature as a sin problem, psychological issue, and more recently also a political and cultural phenomenon. Those on the more conservative side of the debate have tended to focus mostly on the sin dimension and the necessity of repentance, while those espousing the more progressive view have voiced concern for the emotional impact on individuals, as well as evangelism in contemporary culture. However, it is important to bring to light another difference in perspective raised by Pastor Bordow, which in my view is driving some of the debate without being made explicit: the question of whether same-sex attraction is a psychological disorder, and if so, what repentance involves beyond the obvious abstention from the behaviour.

Historically, from Freud until the mid-70s it was assumed that homosexuality was a psychological disorder. The American Psychological Association changed its official stance on the issue in 1975 for political and cultural reasons, not due to any convincing new research. It has consistently been shown that homosexual attractions cannot be determined by genetic or biological factors alone, for example the identical twin studies which found that if one twin self-identifies as gay, only around one in nine siblings will also self-identify as gay. [2] Even the ultra-progressive APA statement (2009 [3]) admits that “no findings have emerged that permit scientists to conclude that sexual orientation is determined by any particular factor or factors.” There is much that we still do not understand about sexual attractions, and so long as unbiased research is hindered by the political vitriol and ideological entrenchment surrounding the issue, this is likely to remain the case for a while (though less ideologically motivated research is under way, e.g., [4] and [5]). At any rate, it is simply untrue that nothing is understood about the origins of same-sex attraction.

There is in fact a long history of psychological studies into homosexuality and the potential for changes in attractions going back to at least the late nineteenth century, with wide variation in quality, representativeness, and consistency with a biblical worldview (see [6] for an overview). The most enduring idea in the literature is that for at least some percentage of homosexuals, disturbances in parental and peer relationships during early childhood lead to same-sex attractions in adulthood. The most recent and substantial proponent of this view was the late Dr. Joseph Nicolosi Sr., whose book Shame and Attachment Loss [7] lays out this developmental model in great detail. Such therapeutic approaches to same-sex attraction have been much maligned in the media as well as among Christians of both conservative and progressive bent, but in my opinion are largely misunderstood due to a simple lack of reading. I am not convinced that most commentators who reject the theory outright have even bothered to read the primary texts on the matter, or if they have it has not been evident in their argumentation. (A notable exception is Transforming Homosexuality by Denny Burk and Heath Lambert. [8])

Dr. Robert Gagnon, the author of the most substantial scholarly Christian work on the biblical view of homosexual practice [9], provides clarification and engagement with Burk and Lambert in his presentation at the Evangelical Theological Society (ETS) 2015 [10]: “The goal… is bringing into harmony one’s birth sex with one’s self-understanding, whether or not attractions change.” Far from being described as a magic pill, counseling for individuals with unwanted homosexual attractions is presented by proponents as a challenging and hard road, with varying outcomes. As Christians, we are called to exercise discernment and allow the Scriptures to be the arbiter of truth and falsehood, our “sole rule of faith and life.” Biblical wisdom would dictate that a claim along the lines of “just do these simple three steps and your attractions will change”, or “if your attractions don’t change, you just don’t have enough faith”, are to be rejected as dangerous and contrary to Scripture. We must indeed be wary of the false prosperity gospel. Nevertheless, even a surface-level reading of the primary literature shows that these are not the claims being made.

The argument is rather that homosexuality stems in part from childhood experiences that center around gender identity formation, e.g., a boy feeling alienated from his masculinity or a girl from her femininity, and that the relations with parents of both sexes, siblings and peers can be contributing factors. Causation is not attributed to any single factor, instead several possibilities are mentioned, and every case is different: this model may not apply to those whose homosexual attractions result from sexual abuse, for instance. The claims are not universalizing, merely that in these therapists’ experience, this model has proven to be a helpful way to think about this phenomenon in many instances.

It does a great disservice to Christian counselors who work in this area to suggest that they are all quacks, simply because they acknowledge the possibility of change, and the idea that gender identity might be connected to same-sex attractions. This is especially true if one has not put in the minimal reading effort to ascertain their actual position, or spoken with Christians who received this therapy, for that matter.

The recent banning of testimonial books by Anne Paulk [11], Joe Dallas [12] and Alan Medinger [13] by Amazon, including Nicolosi’s work itself, is indicative of an attempt to suppress the voices of those who have been helped by this approach. It appears that the large contingent of Christians who are more optimistic about change in attractions, for example the Restored Hope Network [14], have been largely ignored in the Reformed world, perhaps due to the charismatic background of many of their board members – but this surely does not permit their views to be dismissed without basic engagement, nor imply that their biblical argumentation is automatically suspect. This is not to mention other groups such as the Alliance for Therapeutic Choice [15] or Core Issues Trust [16], whose proposals at least ought to be debated. Dr. Gagnon’s article in particular makes several interesting points that seem to be relevant to the debate, but do not appear to have been widely discussed or acknowledged in the broader NAPARC conversation.

The claim that traumatic relational experiences with parents and peers in early childhood contribute to the development of homosexuality is still theoretical, and we certainly ought to be cautious about attributing direct causation, particularly since this is an area of limited reliable research. However, as a recent Ph.D. graduate in a scientific field, I have been surprised and disappointed by the number of times I have heard pastors and others make sweeping empirical claims based solely on anecdotal evidence. A basic understanding of statistical inference should make one aware of sample bias: phrases like “everyone I’ve dealt with who experiences X…;” “I don’t know anyone with problem Y who…;” and the like, are effectively being used as statistical claims about the properties of a population, without being subject to appropriate testing.

This is especially problematic when we do not acknowledge potential factors contributing to the sample: for instance, we could hypothesise that the cultural and political contexts of pastors in rural Texas and urban California would affect the likelihood of them encountering individuals predisposed either towards or against “gay culture” — a hypothesis that itself would need to be tested. I am not arguing that anecdotal evidence is worthless or inadmissible, particularly when the speaker has years of experience in a given area — simply that such evidence should not be taken to establish facts about a population, until the necessary research has been done. Indeed, if we were to weigh anecdotal evidence alone, Dr. Nicolosi’s clinical opinion should be given the greatest weight, since he dealt with hundreds of men with unwanted homosexual attractions as his day job for over four decades: nonetheless, this does not in itself prove the theory.

What, then, is the appropriate attitude to therapy? This seems to me to be a situation where we must exercise “Christian prudence, according to the general rules of the Word, which are always to be observed.” Aside from the obvious need to reject the prosperity gospel, the main question is one of the individual therapist’s worldview: minimally, do they share the biblical view of the fallenness of man, of the Christian sexual ethic and of God’s good design for male and female in marriage?

A good counselor will neither promise complete removal of attractions, nor deny the possibility of them changing, but focus instead on healing the hurts and pain in the person’s life, which can be very deep. With a theologically sound therapist, dealing with childhood traumas head-on can be healing and beneficial regardless of any difference in frequency of temptations: this is especially true in instances of past sexual abuse or severe emotional abuse.

The therapy advanced in Dr. Nicolosi’s work is entirely talk-based and largely similar to counseling interventions for issues such as other sexual addictions or alcoholism, with a similar range of outcomes. I do not agree with everything in Dr. Nicolosi’s book — for instance, his Roman Catholic background led to a truncated doctrine of sin in some ways, and I would wish to be more explicitly skeptical of Freud — but that does not mean his work is not very informative and of potential help when used with discernment.

Pastor Bordow’s distinction between the psychological issue and lust is timely: lustful thoughts are to be mortified, plain and simple, and as John Owen taught, “be killing sin or it will be killing you.” On the other hand, although same-sex attractions are disordered and far from morally neutral (as Romans 1 affirms), in the case of unwanted attractions they are not consciously chosen, and in the true Christian a kind of “thorn in the flesh.” I am concerned about the limitations of comparing these attractions to other mental issues, since we are presupposing too much in the absence of solid evidence — this also applies to the extremes on the scale of optimism or pessimism regarding the extent of change. Moreover, if homosexual attractions are comorbid with depression and even suicidality in many cases (as seems to be true from the psychological literature [17] [18]), we should also be careful about assuming that the self-reported pessimism of some strugglers regarding their own change potential represents the absolute truth of the matter. Nevertheless, Christians are not promised removal of thorns in this life, only in the next; we therefore need to show compassion and understanding in the present, while not compromising the call to repentance and faith.

A pertinent passage is Romans 12.2: “Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect” (ESV). This has several implications for the struggler against same-sex attraction: first, when paired with teachings such as “do not love the word or the things in it” (1 John 2.15-17), it seems to me that there must be a straightforward repudiation of the “gay” or “LGBT” identity, not merely the sexual behaviour itself — otherwise, how is one “fleeing sexual immorality” (1 Cor. 6.18)? This means we need to restore Biblical language to the way we talk about lust and temptations: a person hates, fights, struggles, battles and aims to kill desires which “wage war against the soul” (1 Peter 2.11). A more Biblical self-identification for the struggler would therefore be “I battle these temptations,” rather than “I am gay,” since as Pastor Bordow rightly notes the latter will only cause confusion to outsiders and could even (wrongly or not) be interpreted as a denial of “male and female He created them” (Genesis 1.27).

Second, all Christians are commanded to “be transformed by the renewal of your mind”: this implies a radical change, not merely behaviour modification. It means that our whole way of thinking that comes from the “old man,” the “flesh” and its corrupt desires, must fall away and be replaced with new desires. Repentance of course does not mean “feel bad if your unwanted attractions don’t go away,” but it does involve increasingly seeing the goodness and beauty of God’s design for the sexes, and putting aside all hindrances to obedience (Hebrews 12.1). Thank God, that His Holy Spirit accomplishes this change in us, because we are incapable of giving ourselves new hearts! This is a comforting truth for the Christian, that our sanctification is also ultimately in God’s hands — that the God who justifies us also predestines us to be conformed to the image of Christ (Romans 8.29).

Finally, part of discerning “what is good and acceptable and perfect” means loving God’s law (think of Psalm 119) in the presence of Jesus, who perfectly fulfilled that law. We must be people who love what God loves and hate what God hates, whether we struggle more with loving His just law, or loving His mercy to sinners.

Much more can be said and has already been said on this complex issue, but the neglect of even discussing the psychological dimension is perplexing, and possibly in part due to ignorance of the relevant literature. Whatever one position one takes regarding the role of counseling, it is evident that denials of any possibility of attractions changing are contradicted by both Scripture and anecdotal experience, while the prosperity gospel approach of “just have more faith” is likewise precluded by God’s Word. A full picture of the likelihood of changes in sexual attractions over time, and the relation of such changes to therapeutic interventions — at least beyond anecdotal reporting or highly politically biased studies — remains to be seen. Therefore, it seems to me that a moderate position, recognizing a helpful role for counseling for those who wish to seek it, without unrealistic promises, is the most prudent option.

Daniel Galbraith is a recent Ph.D. graduate of Stanford University. He is a member of a PCA church in the San Francisco Bay Area.

References

[1] https://www.theaquilareport.com/revoice-the-pca-and-a-way-forward/

[2] Bailey, J.M., Dunne, M.P., & Martin, N.G. (2000). Genetic and environmental influences on sexual orientation and its correlates in an Australian twin sample. Journal of Personality and Social Psychology, 78 (3), 524-36.

[3] APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation. (2009). Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation. Washington, DC: American Psychological Association.

[4] Journal of Human Sexuality, vols. 1-9, available at https://www.therapeuticchoice.com/journal-of-human-sexuality

[5] Mayer, L.S. and McHugh, P.R. (2016). Special Report on Sexuality and Gender: Findings from the Biological, Psychological and Social Sciences. The New Atlantis, 50, Available at https://www.thenewatlantis.com/publications/number-50-fall-2016

[6] Phelan, James E. (2013). Successful Outcomes of Sexual Orientation Change Efforts: An Annotated Bibliography. Charleston, SC: Practical Application Publications.

[7] Nicolosi, Joseph J. Sr. (2009). Shame and Attachment Loss: The Practical Work of Reparative Therapy. Westmont, IL: IVP Academic.

[8] Burk, Denny and Lambert, Heath. (2015). Transforming Homosexuality. Phillipsburg, NJ: P&R Publishing.

[9] Gagnon, Robert J. (2001). The Bible and Homosexual Practice: Texts and Hermeneutics. Nashville, TN: Abingdon Press.

[10] Robert J. Gagnon, “Are Christianity and Reparative Therapy compatible?”, available at https://www.josephnicolosi.com/collection/robert-a-j-gagnon

[11] Paulk, Anne. (2003). Restoring Sexual Identity: Hope for Women Who Struggle with Same-Sex Attraction. Eugene, OR: Harvest House Publishers.

[12] Dallas, Joe. (2003). Desires in Conflict: Hope for Men Who Struggle with Sexual Identity. Eugene, OR: Harvest House Publishers.

[13] Medinger, Alan. (2000). Growth into Manhood: Resuming the Journey. Colorado Springs, CO: WaterBrook Press.

[14] https://www.restoredhopenetwork.org/

[15] https://www.therapeuticchoice.com/

[16] https://www.core-issues.org/

[17] Sandfort, T. G. M., de Graaf, R., Bijl, R. V., & Schnabel, P. (2001). Same-sex behavior and psychiatric disorders. Archives of General Psychiatry, 58, 85-91.

[18] de Graaf, R., Sandfort, T. G. M., & ten Have, M. (2006). Suicidality and sexual orientation: Differences between men and women in a general population-based sample from the Netherlands. Archives of Sexual Behavior, 35, 253-262.