Recently it was reported that the National Association for Research and Therapy of Homosexuality (NARTH) is rebranding itself to continue its work of bullying gay men and lesbians into "turning straight" -- an unethical and abusive form of therapy.
Therapy to change the sexual orientation of gay men and lesbians has been widely discredited. Practitioners of this "conversion therapy" or "reparative therapy," still advocated by some conservative religious groups, have claimed to be able to "cure" homosexual men. This is absolutely ridiculous. A person's sexual orientation cannot be changed. And in any case, homosexuality is not a pathological condition that needs to be changed.
The theory underlying reparative therapy is that men who "act homosexual" do so because they weren't fathered well. Once this "father hunger" is satisfied, their homosexuality will disappear and their innate heterosexuality will surface.
This is nonsense. However, it does contain a grain of truth.
I know that I am inviting controversy by claiming that some straight men seek sex with men, especially because I have found that "father hunger" can be a contributing factor. However, there is a world of difference between what I am claiming and what the reparative therapists claim (and what proponents of other discredited psychotherapies have claimed about changing sexual orientation).
The fundamental truth is that not all men who have sex with men are gay or bisexual. Some straight men have occasional "circumstantial" sex with men, which I don't believe is pathological. In other cases, straight men are drawn to compulsive sexual behaviors and fantasies that include men that need to be understood in the context of their personal histories and family-of-origin issues.
Therapy to help men who have sex with men isn't about the impossible task of changing their orientation; it's about helping them discover their orientation and their sexual preferences, feel positive about that discovery, and experience their sexuality without shame.
The Case of Paul
Consider "Paul" (a composite of many men I have seen over the years). He is a slim, attractive, 29-year-old white man who owns a landscaping company. He was referred to me by his therapist (with whom he was making no progress). He told me that eight months earlier, Julie, his fiancée, had discovered, by reading his emails, that he'd been having unprotected anal sex with men. When she confronted him, first he denied it, but soon he broke down and confessed.
Devastated and angry, she broke off their engagement. She was horrified at his duplicity and his keeping secrets and especially his putting her at risk for HIV and other sexually transmitted diseases.
Paul told me that he had loved Julie and felt that she was the woman for him. Even so, he hadn't told her about his homoerotic tendencies, nor had he confessed his suspicions that he might be bisexual. Then again, he thought every guy had some homoerotic thoughts that he probably kept private.
He told me that he was sexually aroused only by women, and that his masturbation fantasies were mostly about women. I asked him what the men who were occasionally included in his fantasies looked like, and he told me that they were faceless; even their physiques didn't matter to him. Paul also told me that when he had sexual fantasies about men, they were always "controlling" him and making him please them. His most common and peak erotic fantasies included being "hypnotized or drugged" by the man whose "spell" he was under.
He had arranged to meet guys via sexual websites, but he'd discovered that what he really wanted was to make an intimate connection with them through talk and nonsexual touch. He dreaded having the encounters turn sexual, which of course was what the men he met wanted. Meeting men was more erotic for him online and in his fantasies than it was in reality. He told me that he didn't enjoy sex with men as much as he did with women, but still he often allowed the men to penetrate him through unprotected anal intercourse without inquiring about their HIV status, even though he always went prepared with condoms. Not insisting on protection satisfied his fantasies of letting the men have full control over him.
Paul admitted to me that the men he'd met online had introduced him to crystal meth. He said the drug helped him enjoy the sex; he would have done the sex without it, but the drug heightened his enjoyment.
The first thing I told Paul was that he had to stop having sex with men while he was in treatment with me. He was endangering himself by having compulsive unprotected sex. I also insisted that he stop his experimentation with crystal meth.
He agreed, but added, laughing, "I can't believe I'm paying my gay shrink to tell me to stop having sex with men!"
Links With the Past
In subsequent sessions I asked Paul about sexual abuse, because it can lead to homosexual behaviors (not homosexual orientation), but he denied having been sexually abused as a child. However, he had been physically and psychologically abused. His father had been an alcoholic who had frequently hit and humiliated him. Because Paul hadn't been good at sports, his father had taunted him, calling him a "girly" man. To test his mettle as a fighter, his father had once initiated a fistfight that had left Paul bruised and bleeding. Paul had longed to have his father's love and acceptance but never knew how to get it. His mother had never intervened.
I consider sexual fantasies and erotic interests -- whether expressed in healthy or unhealthy ways -- as inseparable extensions of our core identity. They're clues to the past. Often they're unsuccessful attempts to resolve problems from childhood that have somehow entered into the erotic realm.
I began to see Paul's sexual contacts with men as an attempt to resolve his conflictual relationship with his father. As he attempted, unconsciously, to master the abuse and humiliation he had received as a child, he placed himself in sexual situations where he was at risk and felt humiliated all over again. The other man was intoxicated, just as his father had been. With the other man in control, Paul was "helpless."
Unfortunately, like so many attempts to master one's past by repeating it, this wasn't an effective strategy for healing. By placing him under the control of these drugged men, Paul's psyche was attempting to recreate his childhood relationship with his alcoholic father, but to have a different outcome. What Paul really wanted was for these men to hold him and affirm him and connect to him in an affectionate way. As some researchers in the field explain, "the fantasy thoughts are prompted by fear more than desire, by anxiety more than pleasure."
In other words, fantasies become a way of managing fear and anxiety. In Paul's case, his fantasies and sexual issues with men eroticized the pain that he'd suffered in childhood with his father. He was attempting to convert trauma into triumph. Unfortunately, the reality was that this behavior kept him feeling like a little boy, preventing him both from taking responsibility for his own life and from trying to actually resolve his issues with his parents.
In therapy Paul began to understand that he was "returning to the scene of the crime" for several reasons. He was not only angry at his father but "hungry" for the father he'd never had. He'd sought sex with men as a way of finding the nurturance and male acceptance that he hadn't received as a child. He tried to talk to his father about all the anger he'd accumulated since his childhood, but his father -- still an active drinker -- just laughed and called him weak.
Coming Out Straight
When our therapy work was finished, I asked Paul how he self-identified his sexual orientation in the light of all that we had discovered. He said that he believed he was heterosexual. He was consistently sexually and romantically attracted to women, and he wanted to be sexual and have emotional relationships with them. However, his straight orientation didn't mean that his interest in sexual behavior and fantasies with men had disappeared. He still enjoyed seeing and masturbating to gay-male pornography, and he continued to have infrequent encounters with men. He didn't identify as bisexual because he didn't desire other men. Instead, he saw himself as heterosexual with homoerotic interests. He no longer struggled with compulsions to be sexual with men, as so many gay men who are trying to fight their orientation do.
Paul realized that his underlying problem wasn't his interest in having sex with men. It was the secrecy and compulsivity (including not using protection) with which he had pursued this behavior. He felt bad about not being honest with his fiancée. He promised himself that if his relationship ended, all his future female partners would know about his sexual interest in men.
I train therapists who work with the population of men who have sex with men to follow their clients' leads. The work is as much about education as it is about psychotherapy. It's crucial to give each man information about homosexuality and the coming-out process, sexual abuse, out-of-control sexual behaviors, family-of-origin issues, and other issues that could contribute to the desire to have sex with males. However, as the work evolves, it's up to the client himself to decide what all of this means and, in particular, to self-identify his own orientation.
In my practice I sometimes have a male client who just wants once-in-a-while sex with men, and it means nothing more than that. In particular, it says nothing about his sexual orientation. As Freud said, "sometimes a cigar is just a cigar!"