Gay or Straight: Can You Really Change?

IMAGE At age 20, David did not want to deal with the fact that he might have a problem. Although he was getting married in a few hours, he had spent the previous night having sex with his best man. David pulled himself together and went through with the marriage ceremony. For 25 years he slept only with women. He fathered 2 sons and eventually left his wife for another woman. When that affair ended, David, now 48, finally told his family and friends that he was gay."I desperately wanted not to be gay," David now freely admits, "so I had convinced myself that I wasn't." However, when his last relationship with a woman broke up, David realized that he had no desire to date other women. He also realized that he did not want to be alone for the rest of his life. "I realized," he says, "that I had to sit myself down and deal with my sexuality."At the time, David felt he had only two choices: he could admit that he was gay and live the rest of his life as a homosexual or he could kill himself. "I wanted to live, not die," he said. "Given that choice, I had nothing to lose."

Understanding Sexuality

The transformation in David's life underscores the issue of whether sexual orientation is a choice or a predisposition—a topic that invokes passionate debate among healthcare professionals and religious adherents.The American Psychological Association defines sexual orientation as an emotional, romantic, sexual, or attraction to men, women, or both. However, sexual orientation is different from sexual behavior. Sexual orientation is merely an innate attraction. Sexuality is a range of attractions and behaviors. Some may label themselves, while others may not.Although it is unclear how orientation comes about, evidence shows that it starts to appear between middle childhood and early adolescence. The orientation will dictate attraction, but this does not mean that people will express their sexual orientation in their behaviors. Behaviors may be heavily influenced by pressure from families, relationships, or general society. In other words, it is possible to be attracted to the same sex without acting on it. This is how some people live a fully heterosexual life for years before embracing a homosexual relationship.

To Change or Not to Change

In 1973, The Board of Trustees for the American Psychiatric Association voted to remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders and thus formally declassified it as a mental illness. If it is not a mental illness, then can it be changed? That is the crux of the debate. A sizable group of religious leaders, as well as a number of mental health professionals, advocate that reparative therapy, also known as conversion therapy, can change a person's sexual orientation from homosexual to heterosexual. Another group of mental health professionals, educators, and public officials—the National Association for Research and Therapy of Homosexuality (NARTH)—also assert that homosexuality can be treated by addressing unwanted homosexual feelings. The American Psychiatric Association (APA), on the other hand, expresses concern that these therapies do not work. APA points to the lack of evidence, and further points out that these therapies can be harmful by reinforcing stereotypes. Negative attitudes about homosexuality contribute to discrimination and family rejection, which put people at risk for suicide or depression.The concerns over conversion (or reparative) therapy were so strong that some states have or are considering banning the practice. California became the first state to ban conversion therapy practices on minors. As of 2013, no mental health provider will be able to provide services to change behavior in people with romantic attractions or feelings to others of the same sex. However, conversion therapy bans continuously undergo legal changes. Many decisions go through appeal processes, which may result in a reversed decisions.No matter what side you take, there are ways to help you or a family member to cope with the challenges ahead.

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