One of the most contentious issues in the contemporary cultural debate over homosexuality centers on whether sexual orientation is a fixed and immutable trait or whether it can be changed. On the one hand, agenda-driven gay activists have gained influence within the governing apparatus of mental health groups like the American Psychological Association and the American Psychiatric Association. These organizations then made politically correct denunciations of efforts by therapists and counselors to assist those with unwanted same-sex attractions. They claim – without real evidence – that these efforts don’t work and are harmful. On the other hand, thousands of former homosexuals proclaim their testimonies of change through the transforming love and power of Christ – declaring their right to steward their sexuality in ways consistent with their ethics and values.
In a landmark study released in 2007, Dr. Stanton L. Jones of Wheaton College and Dr. Mark A. Yarhouse of Regent University conducted the most thorough and rigorous examination to date of the question of sexual orientation change through religious-oriented programs. What follows is a summary and chapter synopses of their book, Ex-Gays? A Longitudinal Study of Religiously Mediated Change in Sexual Orientation.
Executive Summary:
Jones and Yarhouse studied 98 participants from 16 Exodus ministries around the U.S. Using a variety of assessments over a four-year period, they found that a significant number were able to change their sexual orientation from homosexual to heterosexual and that the group was not damaged by this process of attempted change.
Detailed Chapter Synopsis:
Chapter One – The Controversy
Jones and Yarhouse begin their book, Ex-Gays? A Longitudinal Study of Religiously Mediated Change in Sexual Orientation, by explaining what their study, The Exodus Project, set out to find:
- “Are the claims of a cluster of conservative religious ministries valid that homosexual orientation can be healed? In other words, is it ever possible for an individual who has a homosexual orientation to change that orientation via religious means?”
- “Is the attempt to change harmful as so many today claim?” (15)
The American Psychological Association claims that homosexuality is not changeable. The authors note that this is an absolute claim and that change from homosexuality by one person would falsify this claim (16, ff.).
This chapter describes the controversy and difficulty surrounding even contemplating such a study. The authors first note the shift in the scientific/psychological community from seeing homosexuality as a disorder to viewing it as immutable, with change from the orientation damaging to the individual (16). They go on to describe the view of many that science and religion are incompatible. Against this, the authors argue that science and religion can be in a constructive relationship (26-27).
At this juncture, Jones and Yarhouse also note the difficulty of defining and measuring sexual orientation and the disagreement between the essentialists, those who see homosexuals as “natural human kinds” and are at their essence gay or lesbian, and the constructionists, who believe that “sexual orientations are categories, not unlike the categories we use to describe political preferences” (29). Those who have same-sex attractions but do not want to be gay, usually for religious reasons, are often treated with scorn because of the current scientific climate – this despite anecdotal and other evidence of change for some (31-40). The authors view their study, which demonstrates that some people change their sexual orientation, as “an exercise of conversation between religion and science” which they hope will cause a re-examination of current scientific dogma (41).
Chapter Two – Understanding the Population
Because “mental health professionals are substantially less traditionally religious than the general population”, Jones and Yarhouse here try to give an understanding of “the conservative Christian community” (44). They explain traditional Christian thinking about the Bible, God, creation, the Fall, the nature and purposes of gender and sexuality, and salvation (45-55). Jones and Yarhouse affirm the high value Scripture places on marriage and sexuality and go on to explain the Biblical teaching about homosexual behavior (55-61). Fringe groups like Fred Phelps’ Westboro Baptist Church are contrasted with ministries that take a pastoral approach to homosexuality. The National Association for Research and Therapy of Homosexuality (NARTH) is also mentioned as a place where counselors, psychiatrists and others find a scientific perspective compatible with a Christian worldview (61-63). The final section of this chapter examines various groups – with various approaches – who offer help and support for those struggling with same-sex attractions: Exodus International, Courage (Roman Catholic), Homosexuals Anonymous and various independent ministries. Even within Exodus there is not a single approach, but a variety of tools and resources are offered by different ministries (63-72).
Chapter Three – Rationale for the Study
Why study this issue? Jones and Yarhouse say that these are fascinating questions on four levels – empirically, theoretically, theologically and morally. From an empirical perspective, this issue should be studied because of the absolutist claims that change is impossible by much of the scientific community. Theoretically, the study of former homosexuals is fascinating because it opens up questions about sexual orientation and about “the array of change processes that may affect seemingly permanent and deep facets of human experience and character.” Theologically and morally, a study of ex-gays is relevant to our “theological conceptions of human persons” (73). The authors interest in this issue was piqued when they met people who “claimed to have been ‘healed by God’ of their homosexual orientation in favor of heterosexual experience (73).
Here, Jones and Yarhouse describe the stance within the psychological community toward change – including a recounting of Jones’ initial interest in doing this study in the early 1990s but encountering a lack of funding, and the media firestorm surrounding the Exodus ad campaign in the late-1990s promoting the idea that change is possible. At this point, Bob Davies, then-Executive Director of Exodus, found Jones’ original grant proposal and contacted him to see if he was still interested in studying religiously-mediated change of sexual orientation (74-77). The authors decided to study the issue of change within Exodus ministries, with the understanding that they would publish the results even if they were unfavorable to Exodus.
From here, the authors move to a brief survey of studies from the 1950s through the 1970s that document change in sexual orientation from same-sex to other-sex – the details of which are covered more fully in their previous book, Homosexuality: The Use of Scientific Research in the Church's Moral Debate (InterVarsity Press, 2000). Significantly, Jones and Yarhouse state that these earlier studies have flaws, especially by today’s research standards. At the same time, however, they note that “nearly every study ever conducted on change of orientation found some evidence of change” (78). Further, they report on more recent surveys by Houston MacIntosh, NARTH, and Shidlo and Schroeder – always mentioning the flaws and limitations of each survey (77-85). Then, they review change literature regarding religiously-mediated change, including studies by Pattison and Pattison, Schaefer, et al, and Dr. Robert Spitzer. Although these studies have limitations, they showed orientation change for many. Indeed, Spitzer received much criticism for even publishing his study, which again demonstrates the view of the psychological community (85-92).
Given the various limitations found in previous efforts to study change in sexual orientation, Jones and Yarhouse note that future studies on this subject would need the following in order to be more reliable:
1. Standard measures for sexual orientation, ideally with multiple measures;
2. A representative sample;
3. To be longitudinal in nature;
4. To be current, that is, not based on participants memories (92-94).
They also note that those who believe homosexuality is immutable – despite the preponderance of research evidence otherwise – have proceeded along two paths to this conclusion. In the first group are those who support a biological factor in homosexual orientation. In the second group are those who attack all the research on change and draw a conclusion that therefore change is impossible. They then demonstrate the illogical nature of these positions.
Finally, the authors deal with the assertion by both the American Psychiatric Association and the American Psychological Association that attempts to change are harmful. Significantly, neither group points to any documentation of actual harm. Given this, the primary hypothesis for Jones and Yarhouse is: “change of sexual orientation is impossible,” and as they note, “even one case of change will refute the absolute claim” (100). Their secondary hypothesis is “the attempt to change sexual orientation will create psychological distress for these individuals” (103). Despite the proliferation of research about lesbian, gay, bisexual, transgendered, and questioning issues, Jones and Yarhouse’ study is unique.
Chapter Four – Methodology for This Study
Jones and Yarhouse wanted do have the following core characteristics in their study:
1. Longitudinal, following participants over time;
2. Prospective, starting with those at the beginning of the change process (rather than retrospective or after the fact);
3. Representative sample;
4. Gather data directly (i.e., self-reporting, not therapist or group leader assessments of change);
5. Use standard measures;
6. Use multiple measures of (sexual orientation, change and harm);
7. Large sample size.
In short, this book is the first report on the Exodus Project, which interviewed participants from 16 different Exodus Member Ministries across the U.S. at different points in time in their change process. More specifically, this book gives data on the first three interviews – labeled respectively Time 1, Time 2, and Time 3. Presumably, another report will follow when the next three interviews are complete – Time 4, Time 5, and Time 6 (106-107).
Here, the authors answer the following possible objections to their study:
Q: “Why didn’t we implement a “true experiment” design using random treatment assignment to experimental and control conditions?”
A: 1. Pragmatically impossible;
2. The issue here is not whether change is faster in different groups, but does it happen at all;
3. Time constraints (Spitzer saw 2-5 year change period);
4. There was no credible comparison to Exodus;
5. The real-world nature of Exodus ministries would not condone putting people on a “no treatment” waiting list (108-112).
Q: “Why didn’t we use psychophysiological (biological) measurement of sexual orientation?”
A: 1. Impossible to do this sophisticated measurement with participants spread around the country;
2. Morally unacceptable given the Christian beliefs of the authors, the ministries, and the participants;
3. Responses can be suppressed/falsified by the participants and are not scientifically valid;
4. Physiological response is not an objective measure of psychological sexual desire (112-117).
Significantly, the researchers critique their own study and are confident that it meets most of their original goals (see above). They note, however, three areas where they are not completely satisfied:
- The study population is large, but not as large as they originally anticipated;
- The study is not fully prospective; the authors divided the population into Phase 1 subjects, who had entered the ministry within less than a year, and Phase 2 subjects, who had ministry involvement of 1-3 years);
- The sample is satisfactorily representative (not of the LGBT population, but of people seeking change through Christian ministries, and not of all individuals seeking help through Exodus, but of 16 ministries that cooperated and were geographically close to their research teams (117-127).
The study was funded by Exodus and began in 1999 with preliminary research. Interview teams were trained and conducted Time 1 interviews from 2000-2001. Time 2 assessments were from 2001-2003. All Time 3 assessments took place in 2003 (127-129).
Regarding research bias, the authors make clear that there are few neutral parties in the debate over homosexuality, and that most of the research comes from gay, lesbian and bisexual individuals. Dr. Jones’ told the Exodus Board at the very start of the project:
“Since it will be sponsored by Exodus and funded through Exodus contacts, the proposed study will be subject to severe criticism…the only possible counters to such criticisms are a clean and rigorous methodology and absolute intellectual and academic integrity… it is my unalterable intent as Principal Investigator to publish our findings regardless of what they are.” (italics theirs, 131)
They also note that the issue is not whether the authors are “interested” or “disinterested,” but whether the research is methodologically sound and honest. The final section of this chapter discusses some of the construction and administration of the research questionnaire (129-143).
Chapter 5 – The Sample
Jones and Yarhouse began with 98 subjects, 72 males and 26 females. The sample eroded from 98 participants at Time 1 to 85 at Time 2 to 73 at Time 3. This is a retention rate of 74.5%, which is excellent for a research project over this length of time. 57 of the participants were Phase 1 subjects (less than 1 year in Exodus ministries) and 41 where Phase 2 subjects (1-3 years involvement). The average age was 37.5, with the range from 21 to over 56. 64 of the subjects were never married.
Subjects were queried about their family of origin, education (they were a highly educated group), ethnicity (86 were white), previous therapy, religious affiliation and experience, and motivation for change. Participants were also asked about early sexual experiences, lifetime sexual partners, and sexual partners in the past 12 months. These were compared with a major study of sex in America by Laumann, et. al. (The Social Organization of Sexuality, University of Chicago Press, 1994 and an updated version, The Sexual Organization of the City, University of Chicago Press, 2004). The last section of the chapter gives a qualitative portrait of the subjects, with questions from interview transcripts about what brought them to Exodus, goals in the ministry process, intensity of motivation, beliefs about their religious faith, and beliefs about change (144-191).
Chapter 6 – Understanding and Measuring Sexual Orientation
Here the authors give an overview of some of the ways that our understanding of sexual orientation has changed over time and some of the difficulties of measuring sexual orientation. They also review common measures of sexuality and describe the specific instruments used in their study, which were chosen because they had a “substantive research base” (219):
1. Self description – both identity and orientation;
2. Kinsey (7 point scale from 0 = heterosexual to 6 = homosexual)
a. One-item rating – directionality of attraction
b. Two-item rating – above + behavior
c. Expanded Kinsey rating – above + infatuation + fantasy;
3. Shively and DeCecco rating
a. Sexual and emotional attraction to the same sex
b. Sexual and emotional attraction to the opposite sex
c. Expanded Shively and DeCecco rating
i. Intensity and frequency of attraction to the same sex
ii. Intensity and frequency of attraction to the opposite sex;
4. Klein Sexual Orientation Grid – (modified) sexual attraction , fantasies, emotional preference, and social preference;
5. Selfl assessment of sexual orientation (a self-administered questionnaire);
6. Yarhouse Sexual Orientation Thermometer (an experimental measure) – behavior, orientation, attraction, and fantasy (192-229)
Chapter 7 – Can Sexual Orientation Change? Report of the Quantitative Analysis
Three groups are reported on in this study at interview Times 1, 2, and 3:
- The first is the Whole Population. Here, the authors first compare Time 1 to Time 3 for the 73 who remained with the study, then Time 1 to Time 2 for the same 73, then Time 1 to Time 2 for the 85 who remained with the study at Time 2.
- The second group is the Phase 1 group, those with less than 1 year’s involvement in Exodus ministry, so that there is clear description of those just starting religiously-mediated change and less chance of memory error. This group is probably more representative of those seeking change than the Phase 2 group, which has been in process longer (1-3 years) and is thus probably more committed to change.
- The third group is the Truly Gay subpopulation. This group had to have 3 scores of 5, 6, or 7 on the Klein scale of on a separate set of two Kinsey scales and one Klein scale. Since these scales included attraction, identity, and behavior, none of the sexually inexperienced participants were included in this group. (230-235)
Results: The authors report on all 6 measures listed above from chapter 6, using a number of graphs and charts (237-275). They also discuss the statistical significance and clinical meaningfulness of their results. Here is their conclusion:
“The general picture that emerges from our analyses of these data is that, on average, this population has experienced significant change away from homosexual orientation and toward heterosexual orientation. By empirically derived standards of effect size, the average movement away from homosexual orientation may be termed medium to large, and the average shift toward heterosexual orientation is small. This generalization is, of course, not true for every single test of every variable, but this is the clear trend in the data.” (italics added, 275)
Surprisingly, the population that saw the most significant change was the Truly Gay group. As the authors note, analysis of a whole group masks the change shown by specific individuals, which may be very dramatic. This, for an issue that is supposedly impervious to change.
Chapter 8 – Can Sexual Orientation Change? Report of the Qualitative (and Supporting Quantitative) Analysis
Jones and Yarhouse developed 6 final categories in their qualitative analysis of the data:
Success, Conversion = 15%
Success, Chastity = 23%
Continuing (in pursuing the change process) = 29%
Non-responses = 15%
Failure, Confused (given up on change, not gay-identified) = 4%
Failure, Gay Identity = 8%
Taping Failures = 5%
Given that the researchers classify 38% of the study participants as successful in their pursuit of change, clearly this is a favorable response for Exodus participants. Here, the results compare favorably with success rates for those dealing with other difficult issues, like depression. And even though the study is not about salvation, we note that the results point to a more favorable success rate than the one-in-four expectation that Jesus gives in the Parable of the Sower.
One participant who was labeled a “Success, Conversion” at the Time 3 questioning later wrote the authors and told them that he was now gay identified. The authors are continuing on with the study (Times 4, 5, and 6) and will report his change at that point.
The researchers go on to show how each (qualitative) group scored on the Kinsey, Shively and DeCecco, and Klein scales (quantitative analysis). They note that the success groups changed significantly in their sexual orientation – both away from homosexuality and toward heterosexuality (286-296). The final section of the chapter gives questions and answers from the narrative transcript for each group, including a section about what did or did not change for people (320-325). They also give examples of what the subjects reported to have helped them, including: participating in a group where they could discuss freely; group readings, worship, and journaling; individual counseling; teaching; and scripture and prayer (317-320).
Chapter 9 – Is the Attempt to Change Harmful?
Jones and Yarhouse frame their understanding of the predictions of the American Psychological and Psychiatric Associations as follows: “we should observe a decrement in emotional well-being as a result of involvement in the change process” (italics by the authors, 331). Jones and Yarhouse embedded several instruments in their interviews that measure psychological distress and emotional and spiritual maturity. They used the Review of the Symptom Check List-90-Revised, which measures psychological distress and gives results for a variety of symptoms in nine areas, such as hostility, anxiety, obsessive-compulsive, depression, and paranoid ideation. They compared the Exodus participants with a general population (non-mental health patients), and found them slightly higher than average, but lower than a population of mental health outpatients. And unlike what the mental health professions predict, all three population groups showed no increase in distress over time (343-344).
The authors also gave participants an assessment of well-being using the Spiritual Well Being Scales, which gave subscores for Religious Well-Being and Existential Well-Being. They found no evidence that Exodus ministries were detrimental to spiritual well-being (344-349).
Beyond this, they also used a Faith Maturity Scale to assess the study group, and found “no evidence for damage or decrement in this population.”
Finally, since participants who embraced their gay identity would be seen by the psychological community as healthier and those who continue to seek change as unhealthy (remarkably, at Time 3, “59 of 73, or 81% were still committed to the change attempt” 353), the authors factored out those who stopped seeking change to see how damaged the Exodus participants were. Again, they write, “we find no evidence of movement in a harmful direction as a result of Exodus involvement” (emphasis theirs, 354).
But were dropouts damaged? Here, the authors had insufficient data, but stated that the “data reported in this chapter does not appear to support the hypothesis that it is the change process, in and of itself, that produces clinical distress and psychological harm” (359).
And what about anecdotal evidence of harm (e.g., the web site of pro-gay religious activist group Soulforce features stories of suicide by those who could not reconcile being gay and Christian, 359)? The authors write that while we must be sensitive to such stories, they have less evidentiary value than empirical evidence. Anecdotes of harm should also be counterbalanced by counter-anecdotes from many who claim to be helped by the change process and by many who say that gay feelings and behavior brought them despair, which was compounded when they were told there was no way to change. And, as Jones and Yarhouse write, “the reality is that members of the gay community experience elevated risk for suicide and for many other types of psychological distress compared to the general population” (361). While some attribute this to homophobia and heterosexism, there is no conclusive proof for this. The authors argue compellingly that men and women should be free to weigh the risks and benefits of Exodus support groups and make their own choices (361-362).
Chapter 10 — Conclusion
Here, Jones and Yarhouse give a review of The Exodus Project (364-372). Significantly, they articulate what they did not find in their study:
1. “We did not find that everyone (or anyone) can change.”
2. They did not find unequivocal change from totally homosexual to totally heterosexual (orientation is more complex than this);
3. The findings do not refute anecdotal reports by some that they tried and could not change (and visa versa);
4. The study was of religiously-mediated change, not of professional interventions;
5. A scientific study does not “prove” God’s intervention in the participant’s lives;
6. The real changes are not shown as permanent by this study;
7. The study did not document what methods were effective in producing change;
8. The authors do not find predictors within individuals for success or failure;
9. Although they found that on average participants did not experience increased distress of harm, that does not mean specific individuals were not harmed (372-376).
Given this, what are the implications for this study? In short, more research is needed. Beyond this, “these results suggest the importance of respecting the autonomy and right of self-determination of individuals who, because of their personal values, religious or not, desire to seek change of their sexual orientation as well as of those who desire to affirm and consolidate their sexual orientation” (377).
Finally, Jones and Yarhouse discuss the arguments that will be used to dismiss this study:
1. The study may be dismissed because of “raw cynicism and incredulity” by those in the psychological community (382);
2. The results may be rejected because the researchers are seen as biased. The authors argue that they should not be excluded from discussion because they are Christians, just as LGBT researchers are not dismissed out of hand because of their perspective (383);
3. Those dismissing the study may point to methodology, which the authors explained and justified in detail in chapter 6 (383-385);
4. The self-reporting of the participants may cause some to dismiss the research, even though self-reporting is the basis for much research (385);
5. Individuals who were studied may emerge to repudiate their change, although the opposite could happen, as well (386);
6. Critics may point out that chastity is not success – although from a Christian perspective, chastity can be seen as a huge achievement (386-387).
Jones and Yarhouse conclude the book with their study’s results: change happened for some men and women through Exodus ministries and the process did not damage them.
Ex-Gays?
A Longitudinal Study of Religiously Mediated Change in Sexual Orientation
By Stanton L. Jones and Mark A Yarhouse
InterVarsity Press, Downers Grove, IL, 2007
For Further Study
Stanton L. Jones and Mark A. Yarhouse, Homosexuality: The Use of Scientific Research in the Church’s Moral Debate, InterVarsity Press, Downer’s Grove, IL, 2000.
Jeffrey Satinover, Homosexuality and the Politics of Truth, Baker Book House, Grand Rapids, MI, 1996.
Rogers H. Wright and Nicolas A. Cummings, editors, Destructive Trends in Mental Health: The Well-Intentioned Path to Harm, Routledge, New York, 2005.
