Journal flags — but does not retract — decades-old paper on “correcting” gender identity

A psychology journal has expressed concern about a 46-year-old paper which described attempts to correct “deviant” gender identity in a 5-year-old boy using physical violence — the latest example of journals purging (or semi-purging) their pages of offensive studies. 

The 1974 article, “Behavioral treatment of deviant sex‐role behaviors in a male child,” appeared in the Journal of Applied Behavior Analysis. Its authors were O. Ivar Lovaas, a controversial psychologist, and George Rekers, who pushed now long-discredited conversion therapy and whose career flamed out spectacularly, as the journal’s editors note in an editorial published alongside the expression of concern:

Following a scandal regarding his travels with a hired male companion (Bailey, 2010; Bullock & Thorpe, 2010), the first author resigned from the anti-LGBTQ+ organization National Association for Research and Therapy of Homosexuality (NARTH), for which he had formerly served as officer and scientific advisor. His expertise and professional reputation were  discredited, eliminating his ability to testify in cases related to the civil liberties of the LGBTQ+ community as he had done in the past.

As for Lovaas, who died in 2010, his career was built in part on the now-discarded notion that “aversive” stimuli, such as slaps — often self-administered — could reverse undesirable (read: undesirable to others) behaviors. He was the founder of the Lovaas Institute, which describes him as: 

a world-renowned autism expert who has devoted his career to improving the lives of children with autism and their families.

His Lovaas Model of Applied Behavior Analysis [ABA] is based on 40 years of research and is backed by published studies showing half of children with autism who receive this intensive treatment become indistinguishable from other children on tests of cognitive and social skills by the time they completed first grade.

But Lovaas’s approach has been discredited. As the New York Times reported in 2014: 

The idea that autistic people could recover first took hold in 1987, after O. Ivar Lovaas, the pioneer of A.B.A., published a study in which he provided 19 autistic preschoolers with more than 40 hours a week of one-on-one A.B.A., using its highly structured regimen of prompts, rewards and punishments to reinforce certain behaviors and “extinguish” others. (An equal number of children, a control group, received 10 or fewer hours a week of A.B.A.) Lovaas claimed that nearly half the children receiving the more frequent treatment recovered; none in the control group did. His study was greeted with skepticism because of several methodological problems, including his low threshold for recovery — completing first grade in a “normal” classroom and displaying at least an average I.Q. The therapy itself was also criticized, because it relied, in part, on “aversives”: sharp noises, slaps and even electric shocks. By the 1990s, after a public outcry, Lovaas and most of his followers abandoned aversives.

The 1974 article — which has been cited 82 times, according to Clarivate Analytics’ Web of Science — related how: 

The mother was taught to reinforce masculine behaviors and to extinguish feminine behaviors using social reinforcement in the clinic and the father spanked the child at home based on the results of the a token reinforcement procedure in the home (i.e., a certain colored card indicated that there had been feminine behaviors at clinic and the child would be spanked).

The expression of concern states: 

This expression of concern is for the above article, published in print in 1974, and has been published by agreement between the journal Editor‐in‐Chief, the Society for the Experimental Analysis of Behavior (SEAB), and Wiley Periodicals, LLC. This expression of concern has been issued following concerns raised regarding the ethics of using reinforcement and punishment to reduce gender nonconforming behaviors. The Editor‐in‐Chief and SEAB conducted a thorough analysis of all available information and publications relevant to the article and subsequent uses of the article in alignment with the Committee on Publication Ethics (COPE) guidelines. The criteria for retraction are primarily based on clear and defensible evidence of scientific misconduct, falsification or fabrication of data, or clear ethics violation. By today’s standards and in light of our current scientific knowledge, the study would be considered unethical. However, the available evidence does not make it clear that the original study was unethical by the standards of that day. Therefore, the journal is instead issuing this expression of concern to readers. 

The journal also published a lengthy editorial by Linda A. LeBlanc, its editor-in-chief, about the history of the article and decries the harm it has caused to not only members of the LGBTQ+ community but to the reputation of her field: 

Every behavior analyst reading JABA should be aware that individuals may have encountered a mistaken impression of our field based on their exposure to the Rekers and Lovaas (1974) paper. Those individuals might think of our field as solely linked to autism and be unaware that applied behavior analysis has created and is still creating positive impacts in areas from disease prevention (LeBlanc et al., 2020; Lombard et al., 1991) and safety (Lehman & Geller, 1990; Maxfield et al., 2019) to treatment of substance abuse and unemployment (Silverman et al., 2008; Silverman et al., 2019).

She also notes that the purported therapy did not work as its proponents suggested — and that he took his own life as an adult:

While the suicide cannot be causally linked to participation in the study decades earlier, it is clear from the family’s report that the experience of participating in this study was very negatively impactful for them. This harm, regrettably, cannot be undone and the fact that this study was conducted and published in a different societal context cannot be erased.

But LeBlanc argues unsatisfyingly against retraction of the paper, for which, she writes “the evidential criteria were not met”. Except that they were. As LeBlanc notes: 

By today’s standards and in light of our current scientific knowledge, the study would be considered unethical and would not be published in JABA. However, the available evidence does not make it clear that the original study was unethical by the standards of that day. 

By that logic, the journal could keep on its books a how-to guide on tooth extraction by Martin Hellinger. Psychology seems to have less of a problem with moral relativism in research than some critics think it should. 

Arthur Caplan, a medical ethicist at New York University, told us he had “never seen such a ‘historically oriented’ disclosure.” He continued:

I doubt you can retract all unethical studies from the literature.  But, I find it troubling that this note says the study was not wrong by the standards of the day.

I think many would have found punishing this behavior wrong by the standards of the day so I am not persuaded this note is accurate.

We emailed LeBlanc through her consulting company but have yet to receive a response. 

Update, 2200 UTC, 10/22/20: LeBlanc discusses the decision to issue an expression of concern, rather than a retraction, on the journal’s podcast.

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17 thoughts on “Journal flags — but does not retract — decades-old paper on “correcting” gender identity”

  1. ‘gender identity’ is a vague term that has been tossed about in popular discourse.

    The RW headline is:

    Journal flags — but does not retract — decades-old paper on “correcting” gender identity

    But the study is not about correcting ‘identity’ (whatever that could mean), it is about correcting *behavior*:

    This study demonstrated reinforcement control over pronounced feminine behaviors in a male child who had been psychologically evaluated as manifesting “childhood cross‐gender identity”.

    and in the EOC:

    ‘They investigated the use of reinforcement and punishment to target non‐gender‐conforming behaviors of a 5‐year‐old male child.’

      1. That may be true but it would really depend on how “identity” was being used and it generally isn’t used precisely. The quotes make it clear this is about “behavior” and the headline has made an inference that this about ‘identity’.

        1. I’ve spend decades researching this history, first for my class I taught at the Harvey Milk Institute in the late ’90s, then for my essays on the Science of Changing Sex, as I researched that science history for my upcoming book of the same name.

          Dr. Stoller and Green believed that they were treating pre-transsexual children, whose gender identity was as “female” / “feminine”… and that they could and should find ways to change that.

          1. I’e read a lot about this too. You don’t need to read past the name of the journal or the title of the paper, the claims are explicitly about “behavior”.

            Can you find a claim about ‘identity’ in the paper?

          2. In fact, I cannot find ‘gender identity’ in the expression of concern. I am flummoxed as to why RW has misrepresented what the paper and the expression of concern are about.

  2. In defense of the journal’s decision, the point is not that no one would have found the study unethical at the time. Some certainly would have, and did so in print. The point is that there were no institutional standards in place at the time of publication. The year the paper was published was the same year the National Research Act was enacted to develop ethical guidelines for research with human subjects. This eventually led to the 1978 publication of the Belmont Report that to this day provides the framework for IRBs. Prior to 1974, there were no *institutional* guidelines for ethical research, and so to deem studies from that era as unethical implies that one is using present-day standards to evaluate the research. Retracting the paper would imply that the authors were deliberately and knowingly engaged in misconduct at the time, a conclusion that goes well beyond the available facts. I think the editors made the right call here, by strongly denouncing the research but not retracting the paper, they made the case that the paper would not pass ethical muster today without falling into the trap of revisionist history.

  3. You misspelled “Rekers.”

    You claim that Linda A. LeBlanc argued that harm was done to the “LGBTQ+ community” and then presented a block quote which makes no reference to “LGBTQ+.” Nor do you make any effort to explain what the above study would have to do with “LGBTQ+” since that artificial, political “community” hadn’t been invented in 1974, and the study itself is concerned with gender nonconformity, not homosexuality, bisexuality, or transgenderism..

    You imply that LeBlanc was asserting a link b/t the study and a suicide many years later, when her quote makes clear that no connection can be so drawn.

    You need to retract this post. Further, there is nothing unethical about studying methods to resolve gender nonconforming behavior. LGB youth and straight youth would benefit enormously if these efforts were expanded.

    1. We’ve fixed the spelling of Rekers’ name, thanks for bringing that to our attention.

      Our summary in the lead-up to the block quote is correct. LeBlanc refers to LGBTQ+ seven times in the editorial to which we link, including this passage:

      The second evident harm is that this study has been and may still be being inappropriately
      used as evidence for the effectiveness of conversion therapy (i.e., aversive conditioning of same-
      sex stimuli to reverse sexual preference) resulting in continued harm to the LGBTQ+ community.

      The editorial is available here.

      1. Also worth noting that the Editor’s Note uses ‘sexual preference’. This term was mysteriously and famously attacked in a political forum and had the definition changed almost instantly in a dictionary (with multiple editorials quickly popping up to support the idea):

        The usage here confirms that the term is a banal synonym for ‘sexual orientation’.

    2. Wow! Talk about revisionist history! LGBT folk didn’t exist or have a community in 1974? You do know that the both the Mattachine Society and The Daughters of Billitus were active at the time, not to mention actively publishing. Oh… and that Stonewall was in 1969, that the Compton Cafeteria Riot (transfolk) happened in 1966? That in 1974, the Ericsson Education Foundation was actively monitoring and supporting research into ethical treatment of transsexuals?

    3. Thomas Elkins – it sounds like you’re suggesting that children would benefit from the expansion of efforts that promote the use of behavioral technology (in this case of the current study corporeal punishment) to decrease gender-atypical behavior. Note that there are shifts in what is typical across cultures and time. On what basis to you argue for this? Where is the evidence that this would be helpful?

  4. I spent the morning reading the paper. They say more than once that at the start the boy was wearing a dress, a wig and had his nails painted but never ask the parents why, if they didn’t want him wearing that, did they buy it for him? He has no job, he’s not buying his own wigs. I didn’t allow my daughter to paint her nails at that age. Buying dolls for him and then hitting him for playing with them seriously twisted.
    The mother’s biggest praises of the results were that now his hair is messed up and his clothes aren’t coordinated! And as if that weren’t enough successes he now goes camping with someone they call rough-neck Kenny from next door! No wonder his hair is messed up now. I bet they never caught any fish while camping. The adults are crazier than the kid.

  5. I think with the comments in this article, RW are moving (again) quite far into activism. I would prefer RW to be a website/blog reporting about retractions of scientific papers rather than actively pursuing individual cases based on personal positions.

  6. When I started Uni in 1977, at Orientation Week, the various university clubs and societies had stalls set-up across the union square to attract new members from the fresher intake. One of the largest of these was that of the University Gay Society.

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