Book Review: The Straight Line

BookReviewLogoWhat makes a person heterosexual? Can heterosexuality be measured in the body? In the brain? Is it discerned and practiced through sexual acts? Emotional attachments? Self-reported desires? Can it be chosen or is it innate? In modern Western culture most individuals are presumed to be heterosexual until they convince us otherwise through acts or affiliations; once the world understands an individual to be homosexual (in the hetero/homosexual landscape bisexuality is routinely elided) — once that individual has crossed “the straight line” into gay or lesbian identity — can that individual return? In The Straight Line: How the Fringe Science of Ex-Gay Therapy Reoriented Sexuality (University of Minnesota Press, 2015) sociologist Tom Waidzunas (Temple University) explores these questions through the lens of ex-gay reorientation therapy status and practices in the United States.

thestraightlineToday, reorientation therapies — a collection of practices that seek to shift a person’s sexual orientation from homosexual toward heterosexual — exist on the fringes of established scientific communities, broadly understood to be both ineffective and often also harmful to patients. Yet seventy years ago, in the postwar period, reorientation therapies were considered to be a cornerstone of treatment for those experiencing homosexual desires or engaging in homosexual acts. How, then, did a collection of practices once considered standard practice get pushed to the edges (if not off the edge) of legitimate scientific understanding? And, perhaps more importantly, how did the journey of reorientation therapy from the center to the margins of psychiatric care in the United States change how Americans understand the nature of human sexuality?

Waidzunas sets out to answer this question using a blend of sociological, historical, and queer theoretical methods. Drawing on archival research and interviews with key figures, he traces how the political agitation of gay-affirmative and anti-gay social movements struggled within and around the mental health professions succeeded over the course of half a century in redrawing the boundaries of accepted scientific knowledge. In response to the reorientation community’s belief that sexual orientation can be changed, gay-affirmative therapists and activists have increasingly relied on notions of fixity: the notion that one’s body carries an innate true orientation that can be measured and remains stable throughout one’s life even as personal identity and community affiliation may change. While effective in marginalizing reorientation practices hostile to homosexual desires, the notion of a fixed sexual orientation is scientifically fraught (how to measure it?) and problematically cis male-centered (most assertions of sexual fixity are rooted in studies involving penises and porn). Ultimately — without discounting the harms done to individuals in ex-gay therapy —  The Straight Line challenges gay-affirming readers to re-examine their assumptions that the demise of reorientation science is an untempered win for LGBT rights. Across four thematic and roughly chronological chapters, Waidzunas traces the rise and fall of the “reorientation regime” in the U.S., with a fifth chapter coda at the end that touches on reorientation’s enduring global relevance. Chapter one surveys reorientation techniques used between the end of World War Two and the early 1970s, when scientific and religious authorities were in general agreement that reorientation was both possible for and beneficial to those experiencing same-sex desires. Chapter two considers the rise of gay-affirmative therapy practices using the career of Dr. Robert Spitzer as a focal point. Influential in the psychiatric community’s decision to demedicalize homosexuality in the eary 1970s, Spitzer later drew the ire of the LGBT community when he conducted research in the 1990s on the efficacy of ex-gay therapeutic practices. Chapter three considers the influence of ex-ex-gay testimonies in further marginalizing reorientation therapy, and chapter four shows how the American Psychological Association’s opposition to reorientation therapy (as crystallized in a 2009 position statement) confirmed the new scientific orthodoxy of sexual orientation fixity. Chapter five, an intriguing if somewhat awkwardly-appended chapter, uses anti-gay sentiment Uganda as a case study in understanding how notions of anti-gay sexual reorientation continue to have currency globally even as they have become marginalized science in the United States. While bringing an international dimension to the narrative, the fifth chapter introduces us to a topic that could be a book in its own right and thus stands somewhat apart from the preceding narrative.

At times, The Straight Line drags through some of the organizational politics of professional committees, fallings-out between colleagues, interim reports, and position statements. Yet all of these details have a purpose: documenting how the boundary work of drawing “the straight line” between homosexual and heterosexual humanity has been a continual, politically-engaged process. The Straight Line is a valuable contribution to our understanding of how scientific knowledge is produced through the interaction between scientific communities and social movements or interest groups. As historians of science have long understood, scientific truths are established serially through both the accumulation of research data and the interpretation of that data through the subjective understanding of scientists and the general public — both inflected, as they are, with expectations and desires privileging certain outcomes over others. Waidzunas takes what is a material win for LGBT human rights — forcing or pressuring individuals to reject same-sex desires is now considered malpractice by the psychiatric community — and troubles the victory lap. How comfortable or complacent should we be with an understanding of human sexuality that privileges on phallocentric markers of arousal over the self-reported desires of individuals? Waidzunas seems to feel we should question the utility of such a narrow and convoluted understanding of human sexual experience.

As others have before him, Waidzunas points out that immutability need not be a precondition for civil rights or human dignity. “A person could change religion in theory,” he points out, “yet that person’s religion might constitute such a deep part of her sense of self that if the state required the person to change, it would be a violation of her human dignity” (252). A similar framing of sexual desires and affiliations, he goes on to argue, “would sidestep the coercive politics of fixity, while still granting rights to people who experience their sexualities as fixed” (252). Such an approach also opens up possibilities for inclusive sexuality education for young people, who might then be taught that “they may or may not experience a variation in their sexual desires and even their gender identification across a wide spectrum, and that in the end, sexuality and gender are mysterious but should be treated with respect” (251).

The Straight Line is a dense read that will be most rewarding to those readers who have some familiarity with the history of LGBT activism and its interaction with the American psychiatric establishment since the 1940s and also the history of religious debate over human sexual ethics that has played such an outsized role in keeping reorientation therapies alive since the demedicalization of homosexuality. Highly recommended for those scholars with an interest in the history and culture of human sexuality as it intersects with the histories and cultures of science, medicine, religion, and political activism.

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