Integration in the study of homosexuality, GLBT issues, and sexual identity.

Yarhouse, Mark A.

This article examines integration in the areas of homosexuality, gay, lesbian, bisexual, and transgender (GLBT) issues, and sexual identity. It provides a brief account of where we have been as a field in our attempts to bring together a Christian worldview and the study of these issues. It then moves to a discussion of where we are going as a field, as well as the challenges and opportunities that exist for Christians interested in the integration of faith and the scientific study of homosexuality, GLBT concerns, and sexual identity.

There has been relatively little integration scholarship from Christian psychologists on the topics of homosexuality, gay, lesbian, bisexual, transgender (GLBT) issues, and sexual identity as, say, compared to theoretical integration or worldview integration. Even in the area of clinical integration, we have seen much less writing on GLBT issues and related themes as compared to protocols for addressing God image or forgiveness. Perhaps few Christian psychologists see it as an ideal career path, or perhaps it reflects to some extent the sense in which the broader mental health field may not see Christian perspectives as furthering our understanding of GLBT concerns. This perception was recently challenged somewhat when at least three evangelical Christians served as reviewers of the 2009 APA task force report on appropriate therapeutic responses to sexual orientation (APA, 2009). In any case, this area of scholarship continues to be one in which many challenges exist for integration. But there are opportunities, too, for engagement from a Christian perspective. In this article I explore some of the ways in which Christians have engaged the topics of homosexuality, GLBT issues, and sexual identity, as well as where I think we are heading in our integration discussions.

Integration on Homosexuality and Sexual Identity: Where Have We Been?

Ministry resources. It is noteworthy that most of what is available on homosexuality, GLBT issues, and sexual identity are not scholarly resources, nor are they empirical studies. Rather, they are books written from the perspective of people who claim that God has brought them out of homosexuality. I see these as primarily ministry resources, but I think they belong in the discussion of integration resources because they have historically dominated the landscape, perhaps as a result of the gap in the integration literature. The ex-gay movement has tended to send the message of hope for healing of homosexuality (and a change to hetero-sexuality). That message has been widely criticized by mainstream GLBT community and the stories of "ex-ex-gays" and vilified in the media and entertainment. The message of healing and heterosexuality from ex-gay ministries has been tempered to some degree in recent years, perhaps in response to criticisms by the main-stream GLBT community and research suggesting less frequent and less dramatic change in attraction or orientation for most who attempt such change (Jones & Yarhouse, 2007).

Scholarly review articles. Most of the scholarly integration materials on homosexuality, GLBT issues, and sexual identity have been review articles. The topics have included what causes homosexuality, whether homosexuality is a psychopathology, the mental health correlates to homosexuality or a GLBT identity, whether sexual orientation can change, critical reviews of the construct of homophobia and related themes, and so on (1) (e.g., Jones & Yarhouse, 2000).

We have also seen several integration books on human sexuality with a chapter dedicated to the topic of homosexuality from various disciplinary perspectives (e.g., Balswick & Balswick, 2008; McMinn, 2004; Smedes, 2004). Books by theologians have informed Christian integration, either by providing clarity as to biblical theology (e.g., Gagnon, 2001) or navigating different ways to respond to those who identify as GLBT (e.g., Grenz, 1998).

Part of the practical discussions on homosexuality, GLBT issues, and sexual identity have been the result of activist organizations that have drawn attention to religious and military institutions that they perceive as prejudiced against sexual minorities. For example, when Equality Ride (patterning themselves after the Freedom Riders of the civil rights movement) launched its campaign a few years ago, a pamphlet on Mel White's perspective on Scripture was available. Many Christian institutions contrasted White's theology with a critique provided by psychologist Stanton Jones. Both of these resources are readily available online and provide a contrast rarely seen in a brief and accessible format (see also, Via & Gagnon, 2003).

Original empirical research. When we look at original integration research, we see emphasis placed in a few areas, and I am going to briefly discuss three of those areas. The first is the level of compassion and love shown to sexual minorities and whether that can co-exist with a traditional Christian sexual ethic. This is the empirical study of the evangelical adage, Love the sinner but hate the sin, and Rodney Bassett and his team (2002) among others have studied this empirically in recent years.

Another area that has been studied empirically is whether sexual orientation can change (e.g., Jones & Yarhouse, 2007; Schaeffer, Nottebaum, Smith, Dech, & Krawczyk, 1999). The primary focus has been on the study of the impact of involvement in Christian ministries on sexual orientation, attractions, and identity.

More recent research has been on sexual identity development and synthesis. This study follows main-stream GLBT research on milestone events in sexual identity development among those who identify as GLBT but contrasts that with the milestone events among Christians who do not identify with a GLBT identity (e.g., Yarhouse & Tan, 2004; Yarhouse, Tan & Pawlowski, 2005. This research has been applied and extended to those in mixed orientation marriages--marriages in which one partner is a sexual minority and the other partner is heterosexual--by focusing on milestone events and other variables of interest, such as forgiveness and covenantal values (e.g., Yarhouse, Kays, Poma, Atkinson, & Ripley, 2011). It has also been applied to the experiences of sexual minorities on Christian college campuses in terms of both identity development and campus climate (e.g., Dean, Stratton, Yarhouse & Lastoria, 2011; Yarhouse, Stratton, Dean & Brooke, 2009).

Role integration. Role integration refers to the issues Christians face when adopting a role--often a public role in the field of psychology--that places them in a unique position with respect to balancing their own values with the expectations for a specific role and in light of fiduciary responsibilities to the public (Hathaway, 2010). We are seeing more conflicts between Christian students and clinicians and GLBT concerns in training and practice. These conflicts have been salient in the field of counseling with a few high-profile legal cases having to do with the conflict between personally held religious beliefs and training programs, as well as religious beliefs and scope of practice in specific settings, such as Employee Assistance Programs. To date, the rulings seem to be about the rights of training programs to expect students to adhere to their training program and policies and undue hardship for clients who need access to clinicians where such conflicts will not impede the offer of counseling.

The way Christians have approached role integration in the areas of homosexuality, GLBT issues, and sexual identity may have contributed at least in part to the current polarization. This brings us to our last current theme in integration: applied/clinical integration.

Clinical practice/applied clinical integration. The primary way Christians have been portrayed as responding to sexual orientation has been through sexual reorientation therapy. Some Christians have likely been drawn to this approach in response to clients' stated requests for such services and in light of past research suggesting that such approaches may be beneficial. The concern with the assumptions that underlay reorientation therapy as related to a Christian worldview is that it can conflate sanctification and heterosexuality. We can run the risk of assuming that for a person to grow in Christ they must become straight. The challenge comes when not all (or most) people experience as significant of shift as they would have liked--and they wonder what it means to grow in Christ as a sexual minority, with so few models for how to do that without claiming change to heterosexuality.

The primary model that is advocated is gay affirmative therapy, a broad posture with respect to GLB issues more so than a model of therapy. Gay affirmative therapy is perhaps most problematic when the trajectory collides with that of a client trajectory that is moving in a different direction altogether.

We have seen several third-way models of therapy proposed in the past few years. These are not all Christian integration models but rather are attempts to find alternatives to both reorientation therapy and gay affirmative therapy. Some within the American Psychological Association (APA) have also noticed these third-way models. For example, the APA (2009) Task Force report on appropriate therapeutic responses to sexual orientation background document encouraged a client-centered, identity-focused approach to working with sexual minorities. The report referred to this approach as affirmative rather than gay affirmative therapy. This client-affirmative approach is defined by the task force as follows:

  We define an affirmative approach as supportive of clients' identity
  development without a priori treatment goals for how clients identify
  or express their sexual orientations. Thus, a multiculturally
  competent affirmative approach aspires to understand the diverse
  personal and cultural influences on clients and enables clients to
  determine (a) the ultimate goals for their identity process; (b) the
  behavioral expression of their sexual orientation; (c) their public
  and private social roles; (d) their gender roles, identities, and
  expression; (e) the sex and gender of their partner; and (f) the
forms of their relationships. (p. 14)

One such client-affirmative model that I have helped develop is Sexual Identity Therapy (www.sit-framework.com), an approach to sexual identity concerns that is client-centered and identity-focused (rather than orientation-focused). It is implicitly integrative to the extent that it provides Christians in the field with a model that may be a better fit in light of their own values surrounding same-sex sexuality than, say, a gay affirmative approach.

I have discussed some places where we have been in the integration discussion around homosexuality and sexual identity. Now, let's turn our attention to where we are going.

Integration on Homosexuality and Sexual Identity: Where Are We Going?

The future of integrative work with homosexuality, GLBT issues, and sexual identity is fairly wide-open. There is much that can be done in this area, primarily because so few Christians in the field of psychology have engaged the topic in a public way--in their writing, research, and scholarship. In the space that follows, I discuss multicultural competence, role integration, theological reflection, and clinical practice.

Multicultural competence. The mental health field currently locates GLBT issues under the larger umbrella of the multicultural movement. The multicultural movement emphasizes understanding and appreciating clients' unique differences. For the APA, this includes differences related to age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status. The differences in these and other areas inform case conceptualization and treatment planning (APA, 2009). The reader will note that religion is also a part of diversity discussions, although it is perhaps not as well developed as some of the other areas of diversity.

So one of the challenges for the Christian is how competence is defined and measured and whether those definitions and measurements will capture the wide array of experiences among sexual minorities, especially those for whom a religious identity is more salient than a modern sexual identity label. Another challenge will be whether there will be room in the field for Christians whose beliefs and values do not support an implicit gay-affirmative posture that may be imposed on them by external authorities.

While I do see important improvements in how religion is being engaged in the past 10 years by the broader field of psychology, Christians are going to need to continue to be involved in these discussions at many different levels. Their entry into these discussions will likely be predicated on their appreciation for multicultural competence.

Role integration. The topic of multicultural competence is related to role integration. Some Christians manage the felt conflict with multiculturalism by seeing their capacity to function as a psychologist in a predetermined role as reflecting role integration as I discussed above (Hathaway, 2010). This understanding has been helpful to many Christians in explaining how they function in various capacities based upon their broader commitments to the public good. However, other Christians may experience role integration as a kind of "functional perspectivalism" insofar as they may feel that they compartmentalize their faith in order to meet the demands of their specific role as a psychologist. I suspect this will continue to be a point of tension for Christians, and there will be a demand for sophisticated models for the practical outworking of these approaches to integration.

Theological reflection and integration. Few Christians in psychology are trained sufficiently in theology to really grapple with theological material in a sophisticated way. I suspect that this leads us to either take our cues from Christian scholars whose training is in theology (e.g., Gagnon, 2001) or from the broader culture, where this issue has been settled in a gay-affirmative manner. It may also lead some to turn to theology that reflects that of the mainstream GLBT community (e.g., Myers & Scanzoni, 2005), as such theology seems to be a better "fit" with the broader ethos of secular psychology and may be the result of a more perspectival approach to GLBT issues in which theology and psychology are less in a dialogue and are more two different perspectives on the same topic.

The practical challenges may occur in integration training programs and other Christian colleges and universities as students and faculty alike may be revisiting their assumptions about homosexuality and GLBT issues while in settings that are clearly conservative in their sexual ethics and policies. I envision increased tension in attempts to avoid conflict within the field of psychology, particularly with governing bodies and issues of accreditation but also in finding ways to reflect Christian values of love and mutual respect in the context of having behavioral standards that are framed by the GLBT mainstream as unloving, biased, and harmful. I see here the potential for greater divisions as some Christians will respond to the pressures within the governing bodies of our organizations to resolve these tensions by moving away from traditional Christian sexual ethics in light of professional expectations and the values that implicitly undergird them. Others will likely polarize against the perceived liberalization on this topic in a way that reflects the more conservative Christian community and the messages therein that make the task of integration difficult to begin with.

Clinical practice. Christians will gain greater credibility through applied integration to the extent that we continue to develop protocols that can be supported through empirical study. The question of whether sexual orientation can change and whether there is a significant risk of harm in attempting change are important considerations for some people. Those who attempt to answer these questions empirically will need to produce well-designed studies. Also, as more third-way models emerge--approaches that are client-centered and identity-focused, it will be important to provide research support for them as well. At this point there are no well-designed outcome studies of reorientation therapy, gay affirmative therapy, or third-way models of therapy.

Third-way narratives. We are beginning to see narratives of Christians who essentially do not engage in same-sex behavior or identify with the gay community but they acknowledge same-sex attractions and have come to terms with that reality rather than attempting to change to heterosexuality (e.g., Hill, 2011). It will be interesting to see if there will be a sustained narrative of these experiences that might find a place alongside the narratives of healing and reorientation, as I suspect that these counter-narratives (to the dominant gay narrative) will be important for many Christian sexual minorities who do not experience heterosexuality on the other side of therapy or ministry.

Conclusion

There is certainly ample opportunity for integration in the areas of homosexuality, GLBT issues, and sexual identity. A need exists for Christians to engage this topic in ways that reflect the best of what science and historic Christianity have to offer.

References

American Psychological Association (2009). Report of the APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation. Retrieved from http://www.apa.org/pi/lgbt/resources/therapeutic-response.pdf.

Balswick, J. K., & Balswick, J. 0. (2008). Authentic human sexuality: An integrated Christian approach (2nd ed.). Downers Grove, IL: InterVarsity Press.

Bassett, R. L., Baldwin, D., Tammaro, J., Mackmer, D., Mundig, C., Wareing, A., & Tschorke, D. (2002). Reconsidering intrinsic religion as a source of Universal compassion. Journal of Psychology and Theology, 30, 131-143.

Dean, J B., Stratton, S. P., Yarhouse, M.A., & Lastoria, M. D. (2011). Same-sex attraction. In M. D. Lastoria (Ed.), Sexuality, religiosity, behaviors, attitudes: A look at religiosity, sexual attitudes and sexual behaviors of Christian college students (pp. 56-69). Houghton College, Houghton, NY: Association for Christians in Student Development.

Gagnon, R. (2001). The Bible and homosexual practice. Abingdon.

Grenz, S. (1998). Welcoming but not affirming. Westminster John Knox Press.

Hathaway, W. L. (2010). Faithful skepticism/curious faith. In G. Moriarty (Ed.), Integrating faith and psychology: Twelve psychologists tell their stories (pp. 209-229). Downers Grove, IL: "InterVarsity Press.

Hill, W. (2011). Washed and waiting. Grand Rapids, MI: Zondervan.

Jones, S. L., & Yarhouse, M. A. (2007). Ex-gays? A longitudinal study of religiously mediated change in sexual orientation. Downers Grove, IL: InterVarsity Press.

Jones, S. L., & Yarhouse, M. A. (2000). Homosexuality: The Use of Scientific Research in the Church's Moral Debate. Downers Grove, IL: InterVarsity Press.

McMinn, L. (2004). Sexuality and holy longing: Embracing intimacy in a broken world. San Francisco: Jossey-Bass.

Myers, D. G., & Scanzoni, L. D. (2005). What God has joined together? A Christian case for gay marriage. New York, NY: Harper Collins.

Schaeffer, K. W., Nottebaum, L., Smith, P., Dech, K., & Krawczyk, J. (1999). Religiously-motivated sexual orientation change: A follow-up study. journal of Psychology and Theology, 27, 329-337.

Smedes, L. (2004). Sex for Christians: The limits and liberties of sexual living (2nd ed.). Grand Rapids, MI: Eerdmans.

Via, D. 0., & Gagnon, R. A. J. (2003). Homosexuality and the Bible: Two views. Minneapolis, MN: Fortress Press.

Yarhouse, M.A., Kays, J. L., Poma, H., Atkinson, A., & Ripley, J. (2011). Characteristics of mixed orientation couples: An empirical study. Edification, 4 (2), 41-56.

Yarhouse, M. A., Stratton, S. P., Dean, J. B., & Brooke, H. L. (2009). Listening to sexual minorities on Christian college campuses. journal of Psychology and Theology, 37(2), 96-113.

Yarhouse, M. A., & Tan, E. S. N. (2004). Sexual identity synthesis: Attributions, Meaning-Making, and the Search for Congruence. Lanham, MD: University Press of America.

Yarhouse, M. A. & Tan, E. S. N., & Pawlowski, L. M. (2005). Sexual Identity Development and Synthesis Among LGB-Identified and LGB Dis-Identified Persons. Journal of Psychology and Theology, 33 (1), 3-16.

(1.) Several review articles have also appeared in various special issues in the integration journals. For example, the Journal of Psychology and Theology had a two-part special issue on sexuality in 2002 that dealt with many topics, including homosexuality and sexual identity. The Journal of Psychology and Christianity dedicated a special issue to the topic of sexual identity in 2002 (as well as an earlier special issue on the topic of homosexuality that was published in 1996). Christian Scholars' Review also had a special issue on homosexuality published in 1997 chat covered a range of integration themes. The new journal, Edification, recently published a special issue on the topic as well.

Correspondence can be sent to Mark A. Yarhouse, Psy.D., Professor of Psychology & Endowed Chair, Director, Institute for the Study of Sexual Identity, School of Psychology and Counseling, Regent University, CRB 161, 1000 Regent University Drive, Virginia Beach, VA 23464, email: markyar@regent.edu.

Mark A. Yarhouse

Regent University

Author Information

YARHOUSE, MARK, A. Tide: Licensed clinical psychologist in Virginia, as well as Professor of Psychology and the Hughes Endowed Chair at Regent University in Virginia Beach. Dr. Yarhouse is Director of the Institute for the Study of Sexual Identity (www.sexualidentityinstitute.org). Degree: PhD. Areas of specialization: human sexuality, sexual identity, ethics, and applied clinical integration.