Whether a change of sexual orientation (erotic target) is possible is a contentious issue, and this page addresses some of the evidence that sheds light on this topic.


A change in sexual orientation has been described in three contexts, one of which is denied by professional mental health organizations, such as the American Psychiatric Association (APA), and the remaining two contexts ignored by them. The three contexts are psychotherapy-based changes, adventitious changes and what can be loosely termed as spontaneous changes.

The APA denies that psychotherapy can change sexual orientation. Adventitious changes refer to unintentional changes in sexual orientation following treatment for a mental disorder (there is no attempt to change sexual orientation), and several such cases have been described in peer-reviewed journals.

Peer-reviewed journal articles have also described people who recall having experienced homosexual interests in adolescence or youth but no longer experience the same. There have also been documented examples of people with no history of same-sex sexual interest or homosexual contact, yet these individuals find themselves all of a sudden attracted to a same-sex person in adulthood. Such erotic target shifts can loosely be described as spontaneous though they are unlikely to be truly spontaneous given that such shifts usually occur after a change in life circumstances, and are best conceptualized as clustering with adventitious changes.

To show that a sexual orientation change is possible, one need only document one unambiguous example from contexts that the APA ignores and cannot deny, and there are plenty of such examples. Even within the realm of psychotherapy-based changes, there is some evidence for efficacy, but there is little to this effect that one will find in peer-reviewed journals, and this is more a result of the hostility of the gay lobby within the APA to the notion of sexual orientation change than to the academic merit of the issue.

On the other hand, proof that some change in sexual orientation is possible does not imply that change is always possible. A change, if any, takes a long time, often years. Complete remission of same-sex attraction and reorientation toward opposite-sex attraction is uncommon; a diminished drive to engage in homosexual sex is more common, allowing some to lead celibate lives without being tormented by sexual desires. In some cases, people will realize that they cannot change and will accept themselves for who they are. In other cases, people will realize that they cannot change and, unable to accept this, will experience great distress. Therefore, there are risks associated with undergoing reorientation therapy, and anyone seeking such psychotherapy does so at his own risk.

The APA makes much of the possible harm related to undertaking reorientation therapy, but ignores the fact that there are some people who will prefer death to living as a homosexual or continuing to experience same-sex attraction. In other words, some people simply cannot be made to accept their homosexuality. In light of evidence that some change is possible, especially in the context of adventitious changes, scientific research could shed light on what kind of people with unwanted same-sex attraction are more likely to change, what methods are likely to work for these individuals and how to find the best approach for a given individual, but one is not going to see such research anytime soon.

People who experience unwanted same-sex attraction may find some of the following resources helpful, and the lack of scientific credentials of the following resources is something that simply cannot be helped at the time of this writing, though NARTH has a lot of psychologists, physicians and other professionals on board. Evidence documenting the reality of sexual orientation change is mentioned below the resource list.

Some useful resources

Evidence that sexual orientation can change in some individuals

Professional psychiatry or psychology organizations typically dismiss reorientation therapy of homosexuality. But ex-gays and their therapists vouch that reorientation therapy works in several cases. Is there any basis for reorientation therapy?

Consider Fig. 1. Note that several individuals that behave bisexually in adolescence gravitate toward either exclusive homosexual behavior or exclusive heterosexual behavior as they grow older, and these individuals are more likely to gravitate toward exclusively heterosexual than exclusively homosexual behavior.

Bisexual and exclusive homosexual behaviors since puberty in a U.S. probability sample.
Fig. 1: Prevalence of bisexual (B) and exclusive homosexual (H) behaviors in a U.S. probability sample.1 F = female, M = male. Values are in percent of total sample.

In a representative sample of 34,706 Minnesota junior and senior high school students (grades 7 through 12), starting from grade 7, uncertainty toward sexual orientation and perceptions of bisexuality gradually gave way to heterosexual or homosexual identification, and in the process, there was a distinct trend toward heterosexual identification.2 Numerous other studies show that several individuals that behave homosexually in adolescence or youth stop doing so on their own.3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 These studies, including others,15, 16 show that most individuals that have ever behaved homosexually or have ever experienced same-sex attraction tend to be exclusively heterosexual or almost exclusively heterosexual in adulthood.

The stability of same-sex attraction is much lower in women than men.17 Consider a fairly representative example:18, 19

In a 3-interview assessment of homosexual/bisexual women over a period of 5 years, a fourth of the women stopped considering themselves homosexual or bisexual. Within this group, half acquired a heterosexual identity and the remaining gave up all identity labels. The group that had changed could not be distinguished from the unchanged group on the age at which they underwent sexual identity milestones, the factors that precipitated their questioning their sexuality, or their recollection of childhood “indicators” of same-sex sexuality. Women who had acquired a heterosexual identity had a smaller ratio of same-sex to opposite-sex attractions across the 5-year period, but their attractions did not change significantly. Only one woman described her previous sexual orientation identity as a phase; the rest emphasized changes in how they interpreted or acted on their attractions. Over just a 2-year period, half of this sample changed their sexual-minority identity more than once and a fourth of the lesbians had had sex with men.

A lower stability of same-sex attraction among women than men is consistent with an overrepresentation of women among individuals with borderline personality disorder.20, 21, 22, 23 These studies also reveal that nonheterosexuals are overrepresented among individuals with borderline personality disorder. Mental instability is the chief characteristic of borderline personality disorder.

Therefore, erotic targets change in some individuals on their own. In other words, erotic targets can change in some individuals. However, it may be argued that the examples we have considered are those of individuals with bisexual behaviors/interests and may not apply to individuals that are lifetime-exclusive homosexuals. This need not be true since homosexuals and bisexuals appear to belong to the same taxon.24 Indeed, one observes that most self-identified homosexuals pass through a bisexual phase in adolescence/youth (see Fig. 1 for example). Is there any iron-clad case of a lifetime-exclusive homosexual changing to a heterosexual?

A 23-year-old, left-handed, and lifetime-exclusive homosexual man sought treatment for extreme social phobia.25 After 4 weeks of phenelzine (antidepressant) treatment, he became more outgoing and also started getting interested in women. During the next 2 months, he began dating women exclusively, enjoyed heterosexual intercourse, lost interest in men, expressed a desire for a wife and family, and his sexual fantasies became entirely heterosexual. Note that the physician did not attempt to change this man to a heterosexual. Similarly, Porter described the remission of homosexual behavior in a patient that underwent treatment for stuttering.26 These two examples are not flukes:

  • Consider a man that had been transsexual and homosexual since early adolescence.27 At age 40, after his mother died, he became depressed and developed severe obsessive-compulsive disorder (OCD ). He refused treatment for transsexualism when he was referred for OCD two years later. His OCD and mood improved with self-exposure therapy, and simultaneously, his transsexualism and homosexuality remitted too. His depression and transsexualism came back 4 years later, and continued for the next 6 years even though his OCD did not come back.
  • Two case studies:28
    • Consider a young man with transsexualism who sought treatment for social phobia, panic attacks, and mild depression. Treatment with the antidepressant phenelzine not only cured the social phobia and panic attacks, but his transsexualism remitted, too. When he stopped taking phenelzine, his phobia and transsexualism came back. This pattern repeated itself as the patient experimented with taking the drug for a while and then stopping; finally, he decided to stick with the phenelzine treatment.
    • Consider a young man with exhibitionism, transvestic fetishism, and a desire to be a woman; he sought treatment for panic attacks and generalized anxiety. Phenelzine treatment caused his panic attacks to remit along with his exhibitionism and transvestic fetishism. When he stopped taking the drug a year later, all these symptoms came back. He went back on phenelzine treatment and achieved a remission of the same conditions again. Over the next 3 years, while on phenelzine treatment, he gravitated toward transsexualism, had sex-reassignment surgery, and went on to successfully live as a woman for at least the next 5 years, continuing to take phenelzine or his panic attacks would come back.
  • A male homosexual sought treatment for depression, irritability, and anger.29 Fluoxetine (antidepressant) treatment helped his symptoms and reduced his sexual desires, which was fine with him because he did not want to continue in the homosexual lifestyle. Eventually, his sexual dreams involved masturbation only, not sexual acts with another person. When he reduced his intake of fluoxetine, his homosexual thoughts and urges came back, and he promptly went back to the original dosage. At last follow up, fluoxetine treatment had suppressed homosexual desires in this man for 13 years.
  • A number of paraphilias or non-paraphilic sexual compulsion disorders can be diminished or even eliminated by antidepressants. 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42 This is possible because multiple mental disorders share common neural substrates, which also happens to be a reason why one often comes across a cluster of mental disorders in the same individual. Therefore, it is not surprising if unusual sexual behaviors sometimes remit after comorbid disorders improve with therapy or altered circumstances.

Many of the aforementioned studies that have successfully diminished or eliminated paraphilias have used antidepressants belonging to the class of drugs known as selective serotonin reuptake inhibitors (SSRIs). There is plenty of evidence of serotonergic disturbances in the mental illnesses that are more frequent among individuals with paraphilias and also homosexuals/bisexuals (examples) and the sexuality section of this site offers a lot of evidence that nonheterosexual individuals are overrepresented among individuals with paraphilic and non-paraphilic sexual compulsion disorders. Interestingly, bulimics benefit from anti-depressants even if they are not depressed.43 Therefore, homosexual or bisexual interests could possibly be diminished or sometimes eliminated by pharmacological therapy, even in the absence of psychiatric morbidity.

Clearly, it is possible for some homosexuals or bisexuals to be reoriented toward heterosexuality. However, only one of the examples that we have considered above is that of a nonheterosexual changing to a heterosexual via psychotherapy. How successful is psychotherapy at such reorientation?

In 2001, Dr. Robert Spitzer announced that based on his interviewing several ex-gays, he was convinced that some homosexuals can change to heterosexuals.44, 45, 46 He argued that a number of ex-gays are able to achieve good heterosexual function and not be bothered by homosexual desires after reorientation therapy. Dr. Spitzer's argument is noteworthy because he is an atheist and a psychiatrist who played a significant role in removing homosexuality from the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. Some of his critics have argued that Dr. Spitzer did not have a representative sample of individuals seeking remission of homosexual interests. However, Dr. Spitzer wasn't investigating what proportion of homosexuals can change to heterosexuals; rather, he was attempting to find out if any change is possible via psychotherapy.

On the other hand, at the time of this writing, valid evidence that supports a sexual orientation change in terms of a physiological response (penile or vaginal ) to erotic stimuli has been lacking.47 For instance, in 4 studies of aversive therapy attempting to change homosexual men into heterosexual men, 17% of the men who displayed a penile response indicative of predominant homosexuality before therapy showed a penile response indicative of predominant heterosexuality after therapy.48 However, in a study of male homosexuals demonstrating a penile response indicative of predominant homosexuality, 20% could produce a penile response indicative of predominant heterosexuality when requested.49 Therefore, the results of the aversive therapy treatments do not offer unambiguous evidence for a change in sexual orientation.

Based on comprehensive interviews by Spitzer and also plenty of evidence discussed by NARTH, one can say with high confidence that some homosexuals can change to heterosexuals via psychotherapy. NARTH subscribes to psychoanalytic ideas and believes that homosexuality is a developmental disorder. Psychoanalytic therapy to reorient homosexuals toward heterosexuality is also known as reparative therapy. I have argued against psychoanalytic ideas in my book and also that homosexuality is not a mental disorder; yet this does not mean that NARTH is unable to reorient some homosexuals. The key factors in the reorientation of some nonheterosexuals seem to be an improvement in psychiatric morbidity or change in circumstances, as noted above; such changes can be brought about by a psychoanalytic therapist even if he is mistaken about the etiology of homosexuality.

I do not have data as to the proportion of homosexuals that can change to heterosexuals via psychotherapy alone, but I would guess this to be a small proportion of homosexuals. It would be interesting to find out what proportion of lifetime-exclusive homosexuals can change to heterosexuals via psychotherapy alone.

A diminished urge to engage in homosexual behavior is also possible via psychotherapy. For instance, imaginal desensitization without traumatic imagery or aversive physical stimuli has helped several male homosexuals with compulsive sexual behaviors to reduce the compulsion they feel toward sexual activity, even though no attempt has been made to change sexual orientation.50


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