Science meets practice in determining effectiveness of sexual orientation change efforts.

Comments on the original article, "Guidelines for psychological practice with lesbian, gay, and bisexual clients," by the American Psychological Association (see record 2011-19419-001). Guideline 3 of the acknowledges the diversity of human sexual orientation and that "efforts to change sexual orientation have not been shown to be effective or safe" (p. 14). As noted in the Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation (APA, 2009), "Current criteria for effective treatments and interventions are specific in stating that to be considered effective, an intervention has consistent positive effects without serious harmful side effects [emphasis added]" (p. 26). The present authors note that half a century of scientific research on a variety of sexual orientation change efforts (SOCE) has not demonstrated their effectiveness according to the criteria of consistent positive effects and absence of serious harmful effects. Guideline 3 (APA, 2012) therefore urges psychologists to closely assess the motivations of clients who seek SOCE in the context of stigma and internalized prejudice about their non-heterosexual orientation. In addition, the guideline also recommends that psychologists obtain truthful, thorough, and thoughtful informed consent and that they focus on personal integration instead of sexual orientation change. The burden of proof has been on advocates of SOCE, and the present authors assert that it has not been met.