Sexual orientation

According to the American Psychological Association (APA), sexual orientation, biological sex, gender identity, and social sex, are the four elements which comprise human sexuality. Sexual orientation, as defined by the APA, is "distinguished by an enduring emotional, romantic, sexual or affectionate attraction to individuals of a particular gender." The three commonly recognized aspects of sexual orientation are heterosexuality (sexual attraction to peopleof the opposite gender), bisexuality (sexual attraction to people of both themale and female gender), and homosexuality (sexual attraction to members ofthe same gender). Sexual orientation differs from sexual behavior in that itinvolves an individual's feelings and perception of their own sexuality. On the other hand, sexual behavior--or the act of sex--may or may not express anindividual's feelings or self-concept.

The origins of sexual orientation have puzzled philosophers, theologians, andordinary people for thousands of years. In a few cultures, homosexuality hasbeen--and still is--regarded as a normal part of life. In some cultures, itwas even viewed as a gift from the gods. It seems that intolerance of homosexuality by the Christian church and society in general throughout Europe begansomewhere around the 12th century. Initially, homosexual relations were called "unnatural" and sinful. Ultimately, however, it also be came a crime in many societies. For example, the early American settlers instituted strong punishment for what was then called sodomy. Some colonies, such as New Haven, even applied the death penalty to both men and women found guilty of homosexualacts.

Sexual Orientation and Mental Health

In the late 1800s, western medicine and psychiatry turned its attention on homosexuality and virtually declared it a pathological disease. This shift to the status of a disease removed some of the "blame" from homosexual individuals because they were considered "sick" rather than so much illegal or immoral.This disease model remained the prevailing paradigm in studies of homosexuality throughout most of the 20th century. An exception to this concept was Richard von Kraft-Ebing who, in his Psychopathia Sexualis, called it a degenerative sickness. However, the psychoanalytic theories of Sigmund Freud and Havelock Ellis were less harsh. Ellis (1901) proposed individuals were born with their personal sexual orientation, therefore homosexuality couldbe neither a disease nor immoral. He also noted many homosexual individualshad made great contributions to society.

Freud, on the other hand, proposed that all individuals were born with bisexual tendencies, and that heterosexuality and homosexuality both arose from early childhood interactions with their parents and/or other individuals--that it developed either from the castration complex that supposedly resulted froma boy realizing his mother did not have a penis, or by the failure to break sexual bond with a smothering or domineering mother. In either case, Freud's initial ideas, which have not held up under scientific scrutiny, gave rise tothe idea that homosexuality could be cured by treatment. A 1935 letter from Freud to the mother of a homosexual in the United States reads:

"Homosexuality is assuredly no advantage, but it is nothing to be ashamed of,no vice, no degradation, it cannot be classified as an illness; we considerit to be a variation of the sexual function produced by a certain arrest of sexual development. Many highly respectable individuals of ancient and moderntimes have been homosexuals, several of the greatest men among them (Plato, Michelangelo, Leonardo da Vinci, etc.). It is a great injustice to persecute homosexuality as a crime, and cruelty too....

"If [your son] is unhappy, neurotic, torn by conflicts, inhibited in his social life, analysis may bring him harmony, peace of mind, full efficiency whether he remains a homosexual or gets changed...."

The behaviorist school argued that sexual orientation was a product of society and culture, but in a way more general than that proposed by Freud. According to behaviorist theory, if a boy was exposed to a homosexual role model, hemay be swayed toward becoming gay. A variation in this idea has it that bothheterosexual and homosexual orientation result from societal expectations. Unfortunately, this theory does not adequately explain how purely social factors could give rise to the propagation and survival of the human race.

In the 1940s, Sandor Rado rejected the Freudian theory of bisexuality at birth. He proposed that individuals are born heterosexual and become homosexual due to a "phobic response to members of the opposite sex." Then there were theories of pathological family relationships affecting children around the ageof four or five years old (called the oedipal period) and, in 1968, Charles Socarides decided sexual orientation was triggered during a much earlier stagecalled the pre-oedipal period, making homosexuality even more pathological.

These psychoanalytical theories were flawed, however, because analysts basedtheir conclusions on information gleaned from people they already knew were homosexual. This meant two things: One, the analysts' own sexual orientation and/or personal opinions and biases toward a particular sexual orientation skewed their studies and therefore their conclusions. Two, because patients werein psychoanalytic treatment, they were apparently having difficulty coping with or adjusting to their sexual orientation--the studies therefore excludedwell-adjusted homosexuals.

Many different studies have been conducted on sexual orientation since the mid-1900s. Alfred Kinsey, a zoologist, for example, conducted observational studies of the sex habits of American adults. He found that a "significant number" of the individuals in his studies admitted to homosexual activities afterthe age of 16 years, and that 10% of the males and from 2% to 6% of females in his study group were virtually exclusively homosexual between the ages of 16 and 55 years. These studies indicated that far more individuals engaged inhomosexual relationships than a few so-called "social misfits."

In 1951, other researchers found homosexuality to be "widespread among various nonhuman species and in a large number of human societies (64% of 76 societies in their sample). In the remaining societies, adult homosexual activity was reported to be totally absent, rare, or carried on only in secrecy."

In 1990, a report was published on previously unpublished military studies conducted by physicians during World War II. One of these military studies concluded that "overt homosexuality occurs in a heterogeneous group of individuals ... that there was no evidence to support the common belief that homosexuality is uniformly correlated with specific personality traits ... and that, based on evidence in service records, homosexuals were no better or worse thanother soldiers and that many performed well in various military jobs, including combat."

One of the first, and perhaps the most famous studies opposing the idea thathomosexuality (in and of itself) is psychopathic was by psychologist Evelyn Hooker. In her 1957 study, Hooker compared the psychological adjustment of both heterosexual and homosexual individuals, studied homosexual men who were not in psychotherapy and functioning well in society, and employed a rating scale in which she had experts evaluate the adjustment of men without prior knowledge of their sexual orientation. Hooker's study concluded that "homosexuality as a clinical entity does not exist, and that homosexuality is not inherently associated with pathology." Although some studies published since that time refute Hooker's findings, those studies appear to be methodologically flawed. Other studies, including one by Freedman in 1971 that studied homosexualand heterosexual women, reached a similar conclusion to that of Hooker.

These more scientific and unbiased studies, as well as changing societal andcultural attitudes toward homosexuality, resulted in the removal of homosexuality by the American Psychiatric Association from their Diagnostic and Statistical Manual of Mental Disorders (DSM). Their new diagnostic reference, entitled "ego-dystonic homosexuality" included in the DSM III edition in 1980, was removed from the 1986 revision of that reference manual, and the onlyreference to homosexuality was placed under "Sexual Disorders Not OtherwiseSpecified." The APA quickly followed this action, and both associations continue to work toward eliminating the negative stigma associated with homosexualorientation.

Indications of Genetic Influence in Sexual Orientation

The traditional attitude toward homosexuality in this country, therefore, hasbeen that homosexuality is a lifestyle that an individual chooses, and not something influenced by genes. With the ever-increasing interest in genetics,there is a growing segment of research probing its role in the determinationof sexual orientation. Some studies seem to indicate genetic influence, whileothers do not. However, familial studies--particularly those of monozygotic(MZ) (identical) twins--consistently show 50% of MZ twins have the same sexual orientation. Two major approaches to genetic studies are, 1) neuroendocrinestudies:

  • Findings suggest that "homosexual men and heterosexual womenhave neural sexual orientation centers that are similar to each other and different from those of heterosexual men and homosexual women, respectively; and that
  • "Differentiation of these structures depends on early (probably prenatal) androgen action."

and 2) behavioral genetics:

  • All but one such study (1986) found the rate of homosexuality between brothers is about 9% higher than for heterosexualcontrols, and that homosexual women appear to have a slightly larger incidence of homosexual sisters than heterosexual controls.
  • All but one large study (1993) suggest that gay men tend to have more gay brothers than theydo gay sisters, while for gay women the opposite trend is true. These findings not only indicate familial genetic influences but that males and females appear to be influenced differently.
  • Twin studies also indicate environmental influences in sexual orientation. Approximately 50% or higher of homosexual probands have a heterosexual twin. In studies of both female and male MZ discordant (one homosexual/one heterosexual) twins, both twins report experiences different from the other during early childhood.

Molecular Genetics

In 1993, Dr. Dean Hamer and his colleagues at the National Institutes of Health published the results of a study on the genetic origins of sexual orientation in the magazine Science. Hamer et al. reported that at least one subtype of sexual orientation, male homosexuality, appeared to be geneticallyinfluenced, and that it might be linked to a set of five DNA sequences located on the Xq28 region of the X chromosome, which is passed down by mothers totheir offspring. Their study concluded that gay brothers tend to share theseXq28 sequences, which suggested a genetic origin for homosexuality passed through the female line. Hamer later cited twin and family studies as evidence that female sexual orientation is as likely to be inherited as male sexual orientation, but he felt it unlikely that the same version of Xq28 associated with male sexuality would be responsible for female homosexuality (lesbianism)in light of there being relatively few observations of families with large proportions of both gay men and women. Hamer's findings generated considerableinterest, not the least because sexual orientation is at the center of fiercedebates involving politics, the law, religion, ethics, and the very meaningof human behavior. The Pentagon was interested because of the potential effect the results might have on legislation about gays in the military. Observershave also pointed out that Supreme Court decisions could be influenced if itdoes indeed turn out that homosexuality is an immutable human characteristic. And there would also be ethical, medical, and economic issues to deal withif it turns out that there is indeed a gay gene.

Since the publication of his article, Hamer has stated that nature and nurture probably work together to determine sexual orientation. Using the analogy of the personal computer, Hamer says that sexual orientation could be the product of both genes and environment, in much the same way that the software ina computer is a mixture of what is installed in the factory and what the useradds later. It is significant, however, that the results of a 1995 study byDr. George Rice of the University of Western Ontario have cast doubts on someof Hamer's findings. Specifically, Rice et al. failed to find a gene of large effect that influences sexual orientation, although they did not rule out the existence of such a gene elsewhere in the human genome. To this extent, the results of Rice et al. are not inconsistent with earlier studies in families and twins suggesting that sexual orientation is at least partially linked to genetics. Also in 1995, Hu et al. successfully replicated Hamer's study, finding that similarity of sexual orientation between brothers could be tracedto the Xq28 gene marker. ("Not only did gay brothers tend to share the markers, but gay-straight pairs tended not to share the markers.") However, a 1997study by Bailey et al. failed to replicate Hamer's findings. The Xq28 linkagetheory remains to be confirmed.

Profile of Genetics in Human Handedness and Human Sexual Orientation

This profile, developed in the 1997 book entitled A Separate Creation: TheSearch for the Biological Origins of Sexual Orientation by Chandler Burr, outlines similarities/differences between inherited trains of left-handedness and homosexuality (referred to as minority orientations). Some categoriesstudied, and the results, include:

  • Do either left-handedness or homosexuality correlate with race, geography, culture, or mental/physical pathology? The answer in all instances was no.
  • The male/female ratio for left-handedness was 30% higher in men than women; however, the homosexual orientation ratio was 100% higher in men.
  • Age of first behavioral appearanceof minority orientation was around two years in both instances.
  • Neither orientation is chosen.
  • In both instances, external expression canbe altered while interior orientation cannot.
  • Both traits run in families.
  • "Maternal effect" in both traits implies the X-chromosome linkage.
  • In both traits, minority orientation shows little to no correlation to orientation of adoptive parents, strongly indicating genetic influences.
  • Minority orientation rates are higher for both traits in families where one or more member shows the trait.
  • MZ twins are more likely toshare the minority orientation in both instances; concordance rate (both twins sharing the minority orientation) is 1.5 times higher for left-handedness and 10 times higher for homosexual orientation than control groups.

The subject of genetic influence on sexual orientation is still, of course, ahighly controversial issue, one that is far from settled at this time.

Homosexuality and Child Molestation

The psychology department and the University of California-Davis reviewed several empirical studies on this subject. They conclude that gay men are no more likely than heterosexual men to be child molesters. (Few women are child molesters--their role in child abuse cases is primarily one of accomplice, of "assisting a male perpetrator in producing victims; or an adult woman seducinga young male.") It appears that child molestation is a function of arrestedsexual development, which is not determined by sexual orientation.

One controversial study published in Psychological Reports by Paul Cameron in 1985 concluded that at least one-third of sexual abuse of children was by homosexuals, and that bisexuals and/or homosexuals are more likely to sexually molest children than heterosexuals. However, careful analysis of his report by other experts determined that his study was seriously flawed in several ways. For example, while he stated that homosexual teachers were 90 timesmore likely to sexually assault a pupil, he simply assumed male-male molestation to be homosexual without ever determining the usual sexual orientation of the perpetrator.

In a study that produced entirely contradicting results, Dr. Carole Jenny reviewed 352 medical charts of child abuse victims seen at either the child abuse clinic or emergency room in a Denver, Colorado children's hospital during a12-month period from 1991 to 1992. Her research revealed that, in the 269 cases in which the abuser was identified, only two cases involved a homosexual(gay or lesbian) perpetrator--which was less than 1% of all cases treated.

Earlier studies by Groth and Birnbaum (1978) and Groth, Hobson, &Gary (1982) classify child molesters as "either fixated or regressed. Fixated offenders never developed an adult sexual orientation of any sort, whereas regressedmolesters have done so. Thus, regressed molesters can be adult homosexuals,heterosexuals, or bisexuals. But it is meaningless to speak of fixated molesters in these terms--they are attracted to children, not to men or women."

Can Sexual Orientation Be Changed?

This, too, remains a controversial subject. Many therapeutic techniques haveclaimed success in this arena; however, other opinions suggest the change ismerely in behavior and not in actual orientation. Also, in some instances where conversion techniques claim success, the individual was labeled homosexualwhen they were, in fact, bisexual, and already highly desirous of leading purely heterosexual relationships. It also appears that many attempts to changesexual orientation simply cause the individual to suppress their homosexualfeelings and needs, ultimately denying them the ability to respond sexually at all. Some techniques include "exposing the individual to electric shocks ornausea-producing drugs while showing them pictures of same-sex nudes."

The official website of the American Psychiatric Association states that: "There is no published scientific evidence supporting the efficacy of 'reparative therapy' as a treatment to change one's sexual orientation. A similar statement from the APA included the remarks that "research findings suggest that efforts to 'repair' homosexuals are nothing more than social prejudice garbedin psychological accoutrements." Further, in 1997, the APA passed a resolution by a large majority affirming homosexuality is not a disorder. In 1998, theAmerican Psychiatric Association endorsed their position that: "The potential risks of 'reparative therapy' are great, including depression, anxiety, andself-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by thepatient" and that "the Association opposes any psychiatric treatment, such as'reparative' or 'conversion' therapy which is based upon the assumption thathomosexuality per se is a mental disorder or based upon a prior assumption that the patient should change his/her homosexual orientation."

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