Gay "conversion therapy", which claims to help men overcome unwanted same-sex attractions but has been widely attacked as unscientific and harmful, is facing its first tests in the courtroom.
In New Jersey on Tuesday, four gay men who tried the therapy filed a civil suit against a prominent counselling group, charging it with deceptive practices under the US state's Consumer Fraud Act.
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Four gay men are suing US organisation Jonah for fraud, accusing the therapy group for selling "conversion therapy" with false promises to make them straight.
The former clients said they were emotionally scarred by false promises of inner transformation and humiliating techniques that included stripping naked in front of the counsellor and beating effigies of their mothers. They paid thousands in fees over time, they said, only to be told that the lack of change in their sexual feelings was their own fault.
In California, ex-gay therapists have gone to court to argue for the other side. They are seeking to block a new state law, signed by Governor Jerry Brown in September and celebrated as a milestone by advocates for gay rights, that bans conversion therapies for minors.
In Sacramento on Friday, a federal judge will hear the first of two legal challenges brought by conservative law groups alleging that the ban is an unconstitutional infringement on speech, religion and privacy.
Since the 1970s, when mainstream US mental-health associations stopped branding homosexuality as a disorder, a small network of renegade therapists, conservative religious leaders and self-identified "life coaches" has continued to argue that it is not inborn, but an aberration rooted in childhood trauma. Homosexuality is caused, these therapists say, by a stifling of normal masculine development, often by distant fathers and overbearing mothers or by early sexual abuse.
An ex-gay industry of "reparative therapy" clinics and men's weekend retreats has drawn in thousands of teenagers and adults who hope to rid themselves of homosexual urges, whether because of religious beliefs or family pressures.
But leading scientific and medical groups say the theories are unfounded and that there is no evidence that core sexual urges can be changed. They also warn that the therapy can, in the words of the American Psychiatric Association, cause "depression, anxiety and self-destructive behaviour" and "reinforce self-hatred already experienced by the patient".
Those conclusions will be at the centre of the coming legal fights in the state and federal courts.
In the spotlight in New Jersey are a counselling centre called Jews Offering New Alternatives for Healing, or Jonah, along with its co-founder, Arthur Goldberg, and an affiliated "life coach", Alan Downing.
Goldberg helped found Jonah in 1999, after he finished serving a prison sentence and probation for financial fraud he committed in the 1980s. The group describes itself as "dedicated to educating the worldwide Jewish community about the social, cultural and emotional factors that lead to same-sex attractions", and says it "works directly with those struggling with unwanted same-sex attractions", including non-Jews.
While many Orthodox Jews consider homosexual relations to be a violation of divine law, Goldberg's group has no official standing within Judaism, and many Jews accept homosexuality.
The notion that your parents caused this is a horrible lie. They ask you to blame your mother for being loving and wonderful.
Neither Goldberg nor Downing is licensed as a therapist, so they are not subject to censure by professional associations.
The Southern Poverty Law Centre, a rights group based in Montgomery, Alabama, is bringing the suit on behalf of four former patients along with two of their mothers, who say that they not only paid thousands of dollars for useless therapy for their sons, but that they also paid for more counselling to undo the damage.
"The defendants peddled anti-gay pseudo-science, defaming gay people as loathsome and deranged," said Sam Wolfe, a lawyer with the group.
The suit, filed in Superior Court in Hudson County, calls for monetary compensation and for a shutdown of Jonah.
Goldberg and Downing did not respond to telephone and email requests for comment.
One former client in the suit, Michael Ferguson, 30, who is now a doctoral candidate in neuroscience at the University of Utah, sought help from Jonah in 2008. He tried to battle his homosexuality, he said, when he was a practising Mormon who believed that only those in a heterosexual marriage could achieve eternal bliss.
Ferguson attended a retreat called Journey Into Manhood, where he shared what he called his "dark secret" with 40 other men. To be accepted among men who were also struggling with homosexuality was euphoric, he said, but that temporary high was not the promised first step toward becoming a heterosexual.
After months of $US100 therapy sessions with Downing at Jonah's Jersey City offices, and after suffering from depression that led him simultaneously to see a licensed psychotherapist elsewhere, Ferguson said he realised that he was not changing.
"It becomes fraudulent, even cruel," he said in an interview. "To say that if you really want to change you could — that's an awful thing to tell somebody."
"I was encouraged to develop anger and rage toward my parents," he added. "The notion that your parents caused this is a horrible lie. They ask you to blame your mother for being loving and wonderful."
Another former client in the suit, Chaim Levin, 23, grew up in an Orthodox Jewish community in Brooklyn where, he said, being gay seemed unthinkable.
Referred to Jonah by a rabbi when he was 18, Levin began attending weekend retreats at $US650 each. For a year and a half he had weekly private sessions with Downing as well as weekly group sessions. He quit, he said, after Downing had him remove his clothes and touch himself, saying it would help him reconnect with his masculinity. Goldberg has defended Downing's methods as sometimes appropriate for men dealing with body image problems.
But Levin called the episode "degrading and humiliating".
Levin said that he was sexually abused by a relative between the ages of six and 10 and that Goldberg and Downing blamed his homosexual attractions on the abuse.
"Saying the abuse made you gay is terrible," Levin said. "Once I accepted that I was gay, I was able to focus on more serious problem of a history of sex abuse."
The New York Times