Got interested in this book because of an article in the October 2007 issue of Mother Jones by Gary Greenberg, arguing that the use of a biological basis for homosexuality as a defense of its existence may be on shakier ground than previously assumed. It’s a very strange article, seemingly unbiased, but relying on the ex-gay, reparative therapy model as evidence that people can change sexual orientation, as well as scientific evidence that suggests sexual identity is more fluid than commonly believed. None of this is new, though: Kinsey’s Sexual Behaviour in the Human Male (1948), with its sliding scale from hetero to homosexuality, was based on this very idea. And many younger people seem to be comfortable defining themselves as bisexual rather than straight or gay. Greenberg says, ’... The political consensus that has emerged over the last century and a half [is] that sexual orientation is inborn and immutable, that efforts to change it are bound to fail, and that discrimination against gay people is therefore unjust. But as crucial as this consensus has been to the struggle for gay rights, it may not be as sound as some might wish. While scientists have found intriguing biological differences between gay and straight people, the evidence so far stops well short of proving that we are born with a sexual orientation that we will have for life. Even more important, some research shows that sexual orientation is more fluid than we have come to think, that people, especially women, can and do move across customary sexual orientation boundaries, that there are ex-straights as well as ex-gays. Much of this research has stayed below the radar of the culture warriors, but reparative therapists are hoping to use it to enter the scientific mainstream and advocate for what they call the right to self-determination in matters of sexual orientation.’ Not sure why Mother Jones published this. It’s a mixture of sense and nonsense. Reparative therapy has been discredited in North America for years. No one denies that human sexuality is fluid: people change over time, almost all gay people are ex-straights, if you wish to call them that, and there may very well be people who are ex-gays, but for the most part the ex-gay movement as exemplified by the religious right has been a spectacular failure, with its leaders being exposed having gay sex while preaching that they have been cured. I don’t think it’s likely that science is going to discover some marker for gayness in our genetic makeup. I have no idea if gayness is primarily a matter of biology or culture, nature or nurture. But I do know that many people feel profoundly that their orientation is exclusively gay and I don’t see why they can’t claim that that is a fact about them in the same manner as skin colour. Greenberger would have it that it is something more like religion, something we choose, and that we need to find another basis than a biological/scientific one to defend homosexuality. That may prove to be true, but until science proves unequivocally that there is or is not a biological basis for gayness and until there are more credible examples of gay people changing their orientation to straight than the ones offered by the religious ex-gay movement, I think we can safely continue to describe homosexuality as an inborn trait, for at least some of the population.
Bayer’s book is a fascinating account of the changes in thinking about homosexuality, from viewing it as a crime and sin to thinking of it as a illness, a process which has been described as its medicalization. After a brief survey of historical attitudes, he traces medical opinion from Freud, who had a humane approach though he thought of homosexuality as an arrestment of the development process; through Sandor Rado, who suggested homosexuality could be reversed (his disciple Charles Socarides, who died recently, was vehemently anti-homosexual); to Alfred Kinsey, who was the first to document the incidence of homosexuality in the lives of American men and to surprise everyone by positing a much higher occurence of gay sex than most believed; Evelyn Hooker, who was the first scientist to reject the orthodoxy that homosexuality was a sickness; Thomas Szasz, who went further and rejected the whole psychiatric enterprise; and, finally, to Judd Marmor, one of the first American psychiatrists to publicly challenge his profession’s assumption that homosexuality was an illness. Then Bayer traces the gay activism, from the relatively quiescent Mattachine Society to the confrontational Gay Liberation Front, which led to the removal of homosexuality from the American Psychiatric Association’s bible, the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM) in 1973, a decision that by no means reflected the views of all of the members of the organization and one that is still criticized as being motivated more by political considerations (the increasing pressure from gay activist groups) than by scientific evidence. It is a fascinating, complicated story.
One interesting sidenote is that Greenberg reports that Robert Spitzer, one of the psychiatrists instrumental in the deletion of homosexuality from the DSM (in spite of his initial misgivings) conducted a study reported in Archives of Sexual Behaviour in 2003 which ‘concluded that gay people could indeed change their sexual orientation’ and that Spitzer ‘also called for an end to the ban on research into reparative therapy …’ Stranger and stranger. God knows what happened to Spitzer since 1973. The other interesting thing to note is that if you google the title of Bayer’s book, the lunatic fundamentalist website www.traditionalvalues.org is the 3rd choice you are offered, well before many sites that simply provide info about the book. To me, that is disheartening and sad.
Of Ronald Bayer: ‘Ronald Bayer, Ph.D., is Professor at the Center for the History and Ethics of Public Health in the Department of Sociomedical Sciences at the Columbia University Mailman School of Public Health, where he has taught for 14 years. He has taken a leadership role in the HIV Center’s work on ethics since the Center’s beginnings and is now Co-Director of the Ethics, Policy, and Human Rights Core. Prior to coming to Columbia, he was at the Hastings Center, a research institute devoted to the study of ethical issues in medicine and the life sciences.
Dr. Bayer’s research has examined ethical and policy issues in public health, with a special focus on AIDS, tuberculosis, illicit drugs, and tobacco. His broader goal is to develop an ethics of public health. He is an elected member of the IOM [Institute of Medicine], serves on its Board on Health Promotion and Disease Prevention, and has served on IOM committees dealing with the social impact of AIDS, tuberculosis elimination, vaccine safety, smallpox vaccination, and the Ryan White Care Act. His articles on AIDS have appeared in the New England Journal of Medicine, the Journal of the American Medical Association, The Lancet, the American Journal of Public Health, and The Milbank Quarterly. His books include Homosexuality and American Psychiatry: The Politics of Diagnosis (1981), Private Acts, Social Consequences: AIDS and the Politics of Public Health (1989); AIDS in the Industrialized Democracies: Passions, Politics and Policies (1991, edited with David Kirp); Confronting Drug Policy: Illicit Drugs in a Free Society (1993, edited with Gerald Oppenheimer); and Blood Feuds: Blood, AIDS and the Politics of Medical Disaster (1999, edited with Eric Feldman); AIDS Doctors: Voices from the Epidemic, (2000, written with Gerald Oppenheimer and Mortal Secrets: Truth and Lies in the Age of AIDS (2003, written with Robert Klitzman) and Unfiltered: Conflicts over Tobacco Policy and Public Health (2004 Harvard University Press) (edited with Eric Feldman).’ (www.hivcenternyc.org)