The Board of Trustees of the American Psychiatric
Association removed homosexuality from the DSM in 1973 after reviewing
evidence that it was not a mental disorder. In 1987, ego-dystonic
homosexuality was not included in the DSM-IIIR after a similar review.
The American Psychiatric Association does not currently have
a formal position statement on treatments that attempt to change a person's
sexual orientation, also known as reparative or conversion therapy. There is
an APA 1997 Fact Sheet on Homosexual and Bisexual Issues, which states that
there is no published scientific evidence supporting the efficacy of
reparative therapy as a treatment to change one’s sexual orientation.
The potential risks of reparative therapy are great;
including depression, anxiety and self-destructive behavior, since therapist
alignment with societal prejudices against homosexuality may reinforce
self-hatred already experienced by the patient. Many patients who have
undergone reparative therapy relate that they were inaccurately told that
homosexuals are lonely, unhappy individuals who never achieve acceptance or
satisfaction. The possibility that the person might achieve happiness and
satisfying interpersonal relationships as a gay man or lesbian is not
presented, nor are alternative approaches to dealing with the effects of
societal stigmatization discussed. The American Psychiatric Association
recognizes that in the course of ongoing psychiatric treatment, there may be
appropriate clinical indications for attempting to change sexual behaviors.
Several major professional organizations, including the
American Psychological Association, the National Association of Social
Workers, and the American Academy of Pediatrics, have all made statements
against reparative therapy because of concerns for the harm caused to
patients. The American Psychiatric Association has already taken clear stands
against discrimination on the basis of sexual orientation.
Therefore, the American Psychiatric Association opposes any
psychiatric treatment, such as reparative or conversion therapy, which is
based upon the assumption that homosexuality per se is a mental
disorder or based upon the a priori assumption that the patient should
change his or her homosexual orientation.
(December 1998)