Can gay people become straight? Is human sexuality modifiable? Are we really still discussing this?

Yes, according to U.S. District Court Judge William Shubb, who ruled last week that three licensed psychotherapists have the right to practice therapy that attempts to change the sexual orientations of gay and lesbian minors.

In a culturally counterintuitive move, he ruled that First Amendment rights of mental health professionals who engage in "reparative" or "conversion" therapy outweigh concern that the practice poses a danger to their clients. This ruling, albeit temporary, adds a new plank to the debate over gay rights, traditional American liberties and what constitutes good therapy.

At the heart of the controversy over sexual behavior modification is the idea that same-sex attraction is not a permanent and inborn condition but rather an aberration that's often rooted in childhood trauma. As Erik Eckholm of The New York Times writes, "Homosexuality is caused, (conversion) therapists say, by a stifling of normal masculine development, often by distant fathers and overbearing mothers or by early sexual abuse."

Today, of course, providers of this persuasion tend to be outcast into the wilderness of the discredited. Most agree that those who once practiced masturbatory reconditioning and genital shock therapy have no place in modern psychology and psychiatry.

But what the Shubb ruling tried to do is carve out space for the non-crazies, the still controversial but credible practitioners who want to help patients who desire to do so to understand the nature of their sexual identity and expression within a larger religious framework. It's a framework that, in its fullest conception, contains psychological appreciation that is at once deeper, more supple and more holistic than the reductive sexual identity assumptions that anchor mere sexual therapy, be it one of conversion or acceptance. If a client asks for help, why would we tie the hands of a professional counselor to provide whatever help they can?

Therapists from this tradition accept that same-sex attraction is not merely a flip-the-switch choice but rather an individual-specific, complex issue that must acknowledge the mysterious interplay between nature and nurture. Because their faith dictates that adherents strive toward a particular sexual ethic - one that confines sexual relations to those between a husband and wife and requires celibacy in all other circumstances - they seek to help patients manage sexual impulses through "cognitive behavioral change."

Few of these therapists promise that gay and lesbian patients will emerge from their programs "straight." Rather, they seek to provide guidance, counsel and tools to help reframe desire, its nature and its ends. Such therapy exists to help clients understand the place of their sexuality in the broader conception of who they are.

For example, some Christian therapists might help a client who believes that they are made in the image of God explore what role sexuality ought to play in understanding their full identity: Is it everything, nothing or a piece of the greater whole? These conversations may lead a client to decide how dominant of a role sexual desire will play in their life. Others might counsel a client to abstain entirely from sexual relations. But in doing so, the therapist would seek to help the client find fulfillment, identity and purpose outside of romantic or sexual relationships. There is a long tradition of Christians - from priests to nuns to laypeople - who have chosen celibacy as a higher calling toward spiritual fulfillment.

Whether you like conversion therapy - or these particular outcomes - isn't the point. Protecting the religious rights of providers who help patients make sense of their sexuality in light of faith is fundamental. And these rights are under attack. Just last week, four gay men filed a civil suit in New Jersey against a prominent counseling group who provided a form of conversion therapy, charging it with deceptive practices under the state's Consumer Fraud Act. If other states follow California's initial ruling, restrictions on religious-based therapy could become the norm.

Gay activists deplore the existence of such options, claiming that it shames patients and represses their natural desires. Yet proponents of civil liberties support it, believing the greater threat is limiting a client's right or the religious therapist's ability to administer sound judgment in full integrity as she helps her client achieve his/her goals.

Conflicts like this are likely to keep the debate hot and fractured. Here are three big reasons the LGBTQ community may continue to oppose the rights of clients and religious-based therapists and why the religious community must persevere:

Allowing "conversion" therapy to go forward acknowledges that change is possible.

The roots of sexual attraction are hotly debated in both the scientific and psychiatric communities. No one has discovered a "gay gene," and neither has anyone proved that same-sex attraction can be credited solely to nature and not also nurture. Research and opinions on the matter are evolving.

Credible therapists do not claim that sexual-orientation change therapy turns people into ex-gay, happily married heterosexuals. Although some who participate in this type of therapy do not experience the full transformation they hoped for, others claim conversion therapy helped them achieve the results they sought.

Dr. Nicholas Cummings, a former president of the American Psychological Association, stated, "In my twenty years at Kaiser Permanente Health Maintenance Organization, 67 percent of the homosexuals who sought help from therapists for issues such as 'the transient nature of relationships, disgust or guilt feelings about promiscuity, fear of disease, (and) a wish to have a traditional family' experienced various levels of success obtaining their goals.

"In some cases ... individuals who initiated therapy not seeking to change their sexual orientation, actually did so through the process of working through other psychological issues," he said.

Everyone possesses attributes we'd like to change: behaviors, character qualities, temptation patterns. Therapy, of all kinds, can help us stare those down and create the life we desire to live. Some may learn to accept these attributes and even embrace their greater purpose, while others seek to minimize or eliminate that characteristic.

If someone is distressed over his or her sexuality, they deserve the opportunity to explore the distress in a safe, well-resourced space. It is up to the individual and the therapist to gauge how that process will best happen.

If altering sexual orientation is possible, the "born this way" ideology has to face a trickier reality.