Soul Cycle: Atonement, and the Fruitless Search for Gender Redemption

Reminder: BROADview virtual hang for paid subscribers Sunday at 4:30 PM ET. We’ll discuss the podcast Atonement—or just come and chat, if you haven’t listened to it.

Photo by Steve DiMatteo on Unsplash

Atonement: The John Paulk Story is a new podcast about a gay man, sometimes a drag queen, who eventually became the poster boy for conversion therapy and the ex-gay movement. He married a woman who had been a lesbian, Anne Edward, with whom he had three sons, and went on to chair the far Christian right-funded Exodus International North America, which promoted coercive techniques to change homosexuality.

Spoiler alert: It didn’t work. But Paulk’s evangelizing was so effective that it helped create a cloud of false hope and resulting shame for thousands of gay people. Motivated to atone for the sin of homosexuality, Paulk is now on a quest to atone his for the sin of preaching conversion therapy.

It’s important to tell this story, in part because it can help us understand that sexuality—male sexuality in particular—isn’t particularly malleable.¹ There are some gay people who choose not to act on their proclivities, which is fine if that’s your thing—plenty of people have sexual urges that they don’t wish to act on (and in some cases, should not). But the kind of shame-based conversion therapy Paulk preached—that’s what many states eventually outlawed, and rightly so.

One problem with this podcast is that it uses an overly broad definition of conversion therapy, one that has clouded the attempt to reform youth gender medicine, and has put advocates of safeguarding children in the extremely uncomfortable position of having to defend practices subsumed by the label of conversion therapy. Having a discussion about why someone might want to remove body parts, or otherwise radically alter their appearances via cross-sex hormones, is now a sin.

“Conversion therapy really refers to any of several dangerous and discredited practices that are aimed at changing a person's sexual orientation or gender identity,” Casey Pick, senior director of Law and Policy at the Trevor Project, says on the podcast. Pick is a male who transitioned and identifies as a female, who explains that conversion therapy was once disseminated through physical forms—“aversion therapies, drugs, electroshock therapy, even in some cases lobotomies decades ago.” Now, Pick says, we see “talk based forms of conversion therapy” such as “reparative therapy, sexual orientation or gender identity change efforts, and gender exploratory therapy.”

Cue record scratch.

The first thing to know about “gender exploratory therapy” is that it is not a separate approach. There is no specific protocol or series of questions that make up a practice; it’s not a distinct discipline like CBT or psychoanalysis. The term appears to have been coined by Greek psychologist Anastassis Spiliadis, formerly of the UK’s disgraced GIDS clinic, in a 2018 paper. He describes how “therapist(s) could actively acknowledge and respect the young person’s gender identity and subjective experiences (without attempting to alter these) and at the same time invite them into an exploratory therapeutic or ‘assessment’ process, in order to better understand the meaning-making of their gender(ed) and broader selves.”

In other words, there was an approach between blanket affirmation of one’s self-conception—the “would you like fries with that” affirmative approach—and the coercive “normalizing” therapies of days of yore. This approach hadn’t been codified in any way, and still isn’t. It’s a loose term that generally means “do some therapy and explore why you might want to transition or explore your feelings about gender and whatever else is going on.” Actually, it just means therapy, but nobody really has a clear definition.

Even some academics defending gender-affirming care—itself a difficult term to define—have admitted: “I was unable to find any definition of what ‘gender exploratory therapy’ entails.”

WPATH’s SOC-8 says: “Non-specific terms for gender-related care are avoided (e.g., gender-affirming model, gender exploratory model) as these terms do not represent unified practices.”

SOC-7 doesn’t use the term, but notes: “Before any physical interventions are considered for adolescents, extensive exploration of psychological, family, and social issues should be undertaken, as outlined above. The duration of this exploration may vary considerably depending on the complexity of the situation.”

And:

“Mental health professionals should screen for these and other mental health concerns and incorporate the identified concerns into the overall treatment plan. These concerns can be significant sources of distress and, if left untreated, can complicate the process of gender identity exploration and resolution of gender dysphoria. Addressing these concerns can greatly facilitate the resolution of gender dysphoria, possible changes in gender role, the making of informed decisions about medical interventions, and improvements in quality of life.”

In other words: get some therapy before you transition. Explore gender, and everything else.

When Drs. Erica Anderson and Laura Edwards-Leeper published an op-ed in The Washington Post in 2021, decrying the dangerous excesses of the gender affirmation industry—while still arguing that some youth can and should transition safely—the subhed was: “Gender-exploratory therapy is a key step. Why aren’t therapists providing it?” They noted that doctors like Johanna Olson-Kennedy dismissed the need for therapy and assessment, because children knew who they were; she famously (or infamously) didn’t send diabetic kids to therapy before giving them insulin, she said, so why give them therapy before transition? “But comprehensive assessment and gender-exploratory therapy is the most critical part of the transition process,” Anderson and Edwards-Leeper wrote. Affirming instead of exploring was skipping that critical part.

Yet using a term to describe this process made it seem as if it existed separately from standard therapeutic practices, and allowed critics to lump it in to conversion therapy.

And that’s why a podcast about one of the most scandalous gay conversion therapy organizations, and its still-very-gay lead advocate, was misled into including it.

Atonement itself admits that conversion therapy is a “nebulous” term, and that “it’s not based in science, medicine, or fact.” They call it “pseudo psychology.”

Well, the same can be said of gender-affirming care. It’s rooted in the assumption that intervening with kids before puberty would help them “pass” as the opposite sex, and lead to fewer mental health problems in adults—since the adult population was plagued with them. The evidence that it works is generally so low-quality that we can’t determine whether it does, and the risks are so high that several European countries have scaled back on these interventions, to the point where they’re hardly ever done. In places where medicine was elevated above politics, and where partisanship didn’t interfere, reform was possible—precluding the need for atonement.

Here in the US, we’re not so lucky. We keep sinning and atoning, in an endless cycle, rather than evolving and reforming. I’m no stranger to this cycle. After I wrote an op-ed in 2017 for The New York Times, about people assuming my masculine daughter was trans, I was name-called and threatened—my first taste of cancellation—and went on a quest to understand what my fellow liberals thought I’d gotten wrong. I wrote an entire book accepting those critiques, because I had neither the support nor the data to push back on them, to realize that those proselytizing the affirmation-or-death narrative weren’t actually liberal. They were authoritarian.

What I was doing, to some extent, was atoning for my op-ed in writing that book, Tomboy. Now, I have to atone for how I wrote it, because I allowed my own voice to be altered by that of the “sensitivity readers” I hired at my own expense, to obscure what I felt to be the truth.

For some people, gender transition is a never-ending quest, because no one can actually change sex, you’re never done, you never arrive at the end point. Similarly, redemption remains always slightly out of reach, because there is no way to undo the past. We may find ourselves traveling to dark places to find it, growing ever more radical in the hopes of cleansing our souls, because it is still about us.

As an example of this endless question see the 2020 “Letter of Apology to LGBTQ+ Communities” from the APA’s Society for Psychoanalysis and Psychoanalytic Psychology, known as Division 39. It promised to atone for “adopting theories that discriminate against, pathologize, and marginalize gay men, lesbians, bisexual, queer, asexual, intersex, transgender, gender expansive, and gender queer people, whether those individuals are clients, students, therapists, researchers, educators.”

Their listserv would henceforth be monitored, they wrote, so posts wouldn’t “pierce” the most vulnerable and marginalized among them, and members would “engage in examining one’s own privilege and standing up for the dignity of LGBTQ+ folks.” It prohibited “speech that is injurious to LGBTQ+ members.”

There is, of course, much to regret in psychology and medicine’s history—just as there is within any field, which starts off with one set of facts and assumptions and eventually, hopefully, ingests others and evolves. These fields have been guilty of racism, sexism, and homophobia, mostly because those worldviews were entirely acceptable when they began, and with whom they began. It was kosher within those circles to accuse women of hysteria or chemically castrate gays or unwittingly infect black men with syphilis and then use them as a control group, denying them medical care. Until it wasn’t—thanks to activism, whistleblowers, and cultural shifts.

Change is good. Evolution: necessary. But atonement—that’s a more troubling pursuit. Atonement is the search to clean’s one’s soul by way of repairing damage, but requires looking backward, and doesn’t always involve charting a new path forward.

Some in the gender rabbit hole arrived because of grief, which eventually curdled into vengeance—an understandable chemical reaction to the endless gaslighting of so-called liberal institutions, medical associations, and once-trusted professionals. But some of us are motivated by atonement—the stinging sensation that we were complicit in the institutionalization and sacralization of gender identity, and thus must now pursue not just a remedy but redemption.

But sometimes, pursuing redemption can get in the way of reform. Thus, in ten to twenty years—and that’s if we’re lucky—we’ll see another letter like that from the APA Division 39, apologizing for the era of gender affirmation, for the censorship, for the insistence on a singular, ideological approach, rather than an evidence-based one. Someday, those who advocated against gender-exploratory therapy may find themselves once again attempting to atone.

And someday, this recent podcast about atonement may need to do some atoning, too.

1. For further discussion: Paulk’s ex-wife, Anne, continues to preach the ex-gay way. Many sexologists believe that women’s sexuality is more malleable than men’s, which may partially account for why she continues to be “converted.”