In a resolution adopted by the APA's governing council, and in an accompanying report, the association issued its most comprehensive repudiation of "reparative therapy" - a concept espoused by a small but persistent group of therapists, often allied with religious conservatives, who maintain gays can change.
No solid evidence exists that such change is likely, says the resolution, adopted by a 125-4 vote. The APA said some research suggests that efforts to produce change could be harmful, inducing depression and suicidal tendencies.
Instead of seeking such change, the APA urged therapists to consider multiple options - that could range from celibacy to switching churches - for helping clients live spiritually rewarding lives in instances where their sexual orientation and religious faith conflict.
The APA had criticized reparative therapy in the past, but a six-member task force added weight to this position by examining 83 studies on sexual orientation change conducted since 1960. Its report was endorsed by the APA's governing council in Toronto, where the 150,000-member association's annual meeting is being held this weekend.
The report breaks new ground in its detailed and nuanced assessment of how therapists should deal with gay clients struggling to remain loyal to a religious faith that disapproves of homosexuality.
Judith Glassgold, a Highland Park, New Jersey, psychologist who chaired the task force, said she hoped the document could help calm the polarized debate between religious conservatives who believe in the possibility of changing sexual orientation and the many mental health professionals who reject that option.
"Both sides have to educate themselves better," Glassgold said in an interview. "The religious psychotherapists have to open up their eyes to the potential positive aspects of being gay or lesbian. Secular therapists have to recognize that some people will choose their faith over their sexuality."
In dealing with gay clients from conservative faiths, says the report, therapists should be "very cautious" about suggesting treatments aimed at altering their same-sex attractions.
"Practitioners can assist clients through therapies that do not attempt to change sexual orientation, but rather involve acceptance, support and identity exploration and development without imposing a specific identity outcome," the report says.
"We have to challenge people to be creative," said Glassgold.
She suggested that devout clients could focus on overarching aspects of religion such as hope and forgiveness to transcend negative beliefs about homosexuality, and either remain part of their original faith within its limits - for example, by embracing celibacy - or find a faith that welcomes gays.
"There's no evidence to say that change therapies work, but these vulnerable people are tempted to try them, and when they don't work, they feel doubly terrified," Glassgold said. "You should be honest with people and say, 'This is not likely to change your sexual orientation, but we can help explore what options you have."'
One of the largest organizations promoting the possibility of changing sexual orientation is Exodus International, a network of ministries whose core message is "Freedom from homosexuality through the power of Jesus Christ."
Its president, Alan Chambers, describes himself as someone who "overcame unwanted same-sex attraction." He and other evangelicals met with APA representatives after the task force formed in 2007, and he expressed satisfaction with parts of the report that emerged.
"It's a positive step - simply respecting someone's faith is a huge leap in the right direction," Chambers said. "But I'd go further. Don't deny the possibility that someone's feelings might change."
An evangelical psychologist, Mark Yarhouse of Regent University, praised the APA report for urging a creative approach to gay clients' religious beliefs but - like Chambers - disagreed with its skepticism about changing sexual orientation.
Yarhouse and a colleague, Professor Stanton Jones of Wheaton College, will be releasing findings at the APA meeting Friday from their six-year study of people who went through Exodus programs. More than half of 61 subjects either converted to heterosexuality or "disidentified" with homosexuality while embracing chastity, their study said.
To Jones and Yarhouse, their findings prove change is possible for some people, and on average the attempt to change will not be harmful.
The APA task force took as a starting point the belief that homosexuality is a normal variant of human sexuality, not a disorder, and that it nonetheless remains stigmatized in ways that can have negative consequences.
The report said the subgroup of gays interested in changing their sexual orientation has evolved over the decades and now is comprised mostly of well-educated white men whose religion is an important part of their lives and who participate in conservative faiths that frown on homosexuality.
"Religious faith and psychology do not have to be seen as being opposed to each other," the report says, endorsing approaches "that integrate concepts from the psychology of religion and the modern psychology of sexual orientation."
Perry Halkitis, a New York University psychologist who chairs the APA committee dealing with gay and lesbian issues, praised the report for its balance.
"Anyone who makes decisions based on good science will be satisfied," he said. "As a clinician, you have to deal with the whole person, and for some people, faith is a very important aspect of who they are."
The report also addressed the issue of whether adolescents should be subjected to therapy aimed at altering their sexual orientation. Any such approach should "maximize self-determination" and be undertaken only with the youth's consent, the report said.
Wayne Besen, a gay-rights activist who has sought to discredit the so-called "ex-gay" movement, welcomed the APA findings.
"Ex-gay therapy is a profound travesty that has led to pointless tragedies, and we are pleased that the APA has addressed this psychological scourge," Besen said.