The debate among scholars and gay activists and religious/political activists about the appropriateness and efficacy of conversion therapy has left out a number of individuals for whom neither gay-affirmative nor conversion therapy may be indicated. The present discussion, through the use of case material, offers considerations for the practitioner who seeks to assist same-sex attracted male clients in the integration of their conflicting religious and sexual selves. Issues of attachment, social and family considerations, religious and spiritual factors, and developing familiarity with the gay community are considered. Ethical considerations of treatment are discussed.