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Born That Way? Facts and Fiction About Homosexuality

A. Dean Byrd, Ph.D., MBA, MPH

In the world of the academy, homosexuality is an issue on which there is little genuine intellectual exchange these days. And it's this topic that FAIR has asked me to address. I should perhaps add to the introduction so that you can appreciate my perspective. You need to know that I am not much of an activist on this issue or any other issue. I direct a research organization, teach at the medical school, and manage to provide therapy for a unique population--men who are distressed by their unwanted homosexual attraction.

As I reflected on this patient population who I have treated for more than three decades, many of these men had religious backgrounds, although a substantial minority, perhaps as much as 40%, did not. For the single men who struggle with these unwanted attractions, the most frequent complaint was: "Gay relationships are not working for me. Would you help me explore my options?" For the men who were married, I frequently heard the following: "I love my family--my wife and children. I have these homosexual attractions, and I am only able to have a sexual relationship with my wife when I fantasize about having sex with a man. I have thought about becoming involved with a gay partner, but I want to honor my commitment to marriage and family. I really don't want the attractions. These homosexual feelings never really felt like a part of me or who I really am. Can you help me diminish the homosexual attractions and increase my sexual attractions for my wife?"

Many in the mental health professions would have me refuse to provide such psychological care to individuals even when such therapy is based on their request. They would have me say something like the following "a homosexual orientation is fixed and unmodifiable. I can only help you become more comfortable with your homosexual attractions."

I would like to begin with a little survey in which you can feel free to participate or not participate. How many of you agree with the following statements?

Homosexuality is basically biologically determined. Homosexuality is determined by factors other than biology. I really don't know what I believe about the cause of homosexuality. While it is unusual for me to use a video clip as the introduction to a lecture, I do have a short clip that highlights some of the issues that I want to discuss in my lecture this morning. [Video segment from ABC's 20/20 news magazine.]

Now, let me ask a rhetorical question. If we could repeat the above survey, would you change any of your answers? Is homosexuality innate and immutable? Or can a person with homosexual orientation make significant changes in the direction of becoming heterosexual? Are the official statements issued by the major national mental health associations which declare that there is no published evidence demonstrating that homosexuals can significantly alter their sexual orientation in fact accurate?

There is a considerable body of ideologically inspired "scholarship" which leans toward the notion that homosexuality is so strongly compelled by biological factors that it is indelibly ingrained in a person's core identity, and is therefore not amenable to change. Many of these articles, though well-written, do not reflect good science. In fact, the social advocacy of the articles would suggest a greater reliance on politics than on the scientific method.

There are basically three studies that led activists to trumpet the notion that homosexuality is biologically determined. These studies were conducted by Simon LeVay, Dean Hamer, and the team of Michael Bailey and Richard Pillard. Perhaps a brief review of these studies would lay a good foundation for my lecture today.1

At the time of his research, Simon LeVay was a biological scientist at the Salk Institute in San Diego. He conducted research on the brains of two groups of men: homosexual men and men who LeVay presumed were heterosexual. With a fairly small sample size (19 homosexual men and 16 presumed heterosexual men), LeVay conducted a post-mortem examination focusing on a particular cluster of cells in the hypothalamus known as the INAH-3. He reported that he had found "subtle but significant differences" between the brains of homosexual men and the heterosexual men. LeVay's research had a number of important limitations. He had very little information about the sexual histories of the research participants. Some of the subjects died of AIDS. Although there were differences between experimental and control groups, some presumed heterosexual men had small brain nuclei in the critical area, and some homosexual men had nuclei large enough to be within the normal heterosexual range. Activists proclaimed that the biological roots of homosexuality had been established. Listen to LeVay's interpretation of his research.

But it is important to stress several limitations of the study. First the observations were made on adults who had already been sexually active for a number of years. To make a real compelling case, one would have to show that these neuroanatomical differences existed early in life preferably at birth. Without such data, there is always at least the theoretical possibility that the structural differences are actually the result of differences in sexual behavior perhaps the "use it or lose it" principle. Furthermore, even if the differences in the hypothalamus rise before birth, they might still come about from a variety of causes, including genetic differences, differences in stress exposure, and many others. It is possible that the development of the INAH-3 (and perhaps other brain regions) represent a 'final common path' in the determination of sexual orientation, a path to which innumerable factors may contribute.2

Quoting LeVay,

Another limitation arises because most of the gay men whose brains I studied died of complications of AIDS. Although I am confident that the small size of INAH-3 in these men was not an effect of the disease, there is always the possibility that gay men who died of AIDS are not representative of the entire population of gay men. For example, they might have a stronger preference for receptive anal intercourse, the major risk factor for acquiring HIV infection. Thus, if one wished, one could make an argument that structural differences in INAH-3 relate more to actual behavioral patterns of copulation than to sexual orientation as such. It will not be possible to settle this issue definitively until some method becomes available to measure the size of INAH-3 in living people who can be interviewed in detail about their sexuality.3

Further, LeVay summarized his research results in the following way:

It's important to stress what I didn't find. I did not prove that homosexuality was genetic, or find a genetic cause for being gay. I didn't show that gay men are born that way, the most common mistake people make in interpreting my work. Nor did I locate a gay center in the brain INAH-3 is less likely to be the sole gay nucleus of the brain than a part of a chain of nuclei engaged in men and women's sexual behavior...Since I looked at adult brains we don't know if the differences I found were there at birth, or if they appeared later.4

Commenting on the brain and sexual behavior, Dr. Mark Breedlove, a scientist as the University of California at Berkeley, demonstrated that sexual behavior can actually change brain structure. Referring to his research, Breedlove states, "These findings give us proof for what we theoretically know to be the case--that sexual experience can alter the structure of the brain, just as genes can alter it. It is possible that differences is sexual behavior cause (rather than are caused by) differences in the brain.5

Later, in his book Queer Science, LeVay offered additional clarification regarding biology and homosexuality:

Although there are significant differences between the attitudes of lesbians and gay men it is clear that both groups are far more inclined to consider their sexual orientation a biological given than is the general population....Should we take these assertions seriously? Not entirely, of course. No one even remembers being born, let alone being born gay or straight. When a gay man, for example, says he was born gay he generally means that he felt different from other boys at the earliest age he can remember. Sometimes the difference involved sexual feelings, but more commonly it involved some kind of gender nonconformist or sex atypical traits-disliking rough and tumble play for example, that were not explicitly sexual. These differences, which have been verified in a number of ways suggest that sexual orientation is influenced by factors operating very early in life, but these factors could still consist of environmental factors such as parental treatment in the early postnatal period.6

Finally, LeVay made an interesting observation about the emphasis on the biology of homosexuality. He noted, "...people who think that gays and lesbians are born that way are more likely to support gay rights."7

The next study was conducted by Michael Bailey and Richard Pillard who focused on identical twins, non-identical twins, non-adopted siblings and adopted siblings. In their sample, they had 56 sets of identical twins and 54 sets of non-identical twins. They found a 52% concordance rate for the identical twins which means that for every homosexual twin, the chances were about 50% that his twin would also be homosexual. For non-identical twins, the rate was about 22%, showing that about 1 in 5 twins who were homosexual had a homosexual brother also. For non-twin brothers, the concordance rate was 9.2%. Interesting enough, Bailey and Pillard found that the concordance rate in adopted brothers was 11.2%.

The most fascinating question, however, is that if there is something in the genetic code that makes an individual homosexual, why did not all of the identical twins become homosexual since they have the exact same genetic endowment? Neil Whitehead provided some comparative data on twin studies. The concordance rate for identical twins on measures of extroversion is 50%, religiosity is 50%, divorce is 52%, racial prejudice and bigotry is 58%. From the Bailey and Pillard study one has to conclude that environmental influences play a strong role in the development of homosexuality.8

The third study, and perhaps the most sensationalized of the three studies since it emerged at the time of the controversy surrounding gays in the military during the Clinton era, was conducted by Hamer et al. Dean Hamer was a senior scientist at the National Cancer Institute. Hamer and his group attempted to link male homosexuality to a stretch of DNA located at the tip of the X chromosome, the chromosome that some men inherit from their mothers. In Hamer's study, he examined 40 pairs of non-identical gay brothers and asserted that 33 pairs--a number significantly higher than the 20 pairs that chance would dictate--had inherited the same X-linked genetic markers from their mothers.9

Criticism of Hamer's research came from a surprising source: George Risch, the scientist at Yale University School of Medicine who invented the method used by Hamer. Risch commented, "Hamer et al suggest that their results are consistent with X-linkage because maternal uncles have a higher rate of homosexual orientation than paternal uncles, and cousins related through a maternal aunt have a higher rate than other types of cousins. However, neither of these results are statistically significant."10

Commenting on his own research Hamer noted,

We knew genes were only part of the answer. We assumed the environment also played a role in sexual orientation, as it does in most, if not all behaviors... (Hamer & Copeland, 1994, p. 82). Homosexuality is not purely genetic...environment plays a role. There is not a single master gene that makes people gay...I don't think we will ever be able to predict who will be gay.11

Citing the failure of his research, Hamer further wrote, "The pedigree failed to produce what we originally hope to find: simple Mendelian inheritance. In fact, we never found a single family in which homosexuality was distributed in the obvious pattern that Mendel observed in his pea plants."12

What is more intriguing is that when Hamer's study was replicated by Rice et al with research that was more robust, the genetic markers were found to be nonsignificant. Rice et al concluded:

"It is unclear why our results are so discrepant from Hamer's original study. Because our study was larger than that of Hamer et al's, we certainly had adequate power to detect a genetic effect as large as reported in that study. Nonetheless, our data do not support the presence of a gene of large effect influencing sexual orientation at position XQ 28 .13

When asked by Anastasia Toufexis, a Time reporter, whether his theory ruled out social and psychological influences, Hamer's response was "Absolutely not, ...from twin studies we already know that half or more of the variability in sexual orientation is not inherited. Our studies try to pinpoint the genetic factors, not to negate the psychosocial factors."14

In summarizing the biological studies on homosexuality Byne and Parsons offer the following summary, "Recent studies postulate biologic factors as the primary basis for sexual orientation. However, there is no evidence at present to substantiate a biologic theory, just as there is no evidence to support any singular psychosocial explanation. While all behavior must have an ultimate biologic substrate, the appeal of current biologic explanations for sexual orientation may derive more from a dissatisfaction with the current status of psychosocial explanations than from a substantiating body of experimental data. Critical review shows the evidence favoring a biologic theory to be lacking. In alternative model, temperamental and personality traits interact with the familial and social milieus as the individual's sexuality emerges. Because such traits may be heritable or developmentally influenced by hormones, the model predicts an apparent non-zero heritability for homosexuality without requiring that either genes or hormones directly influence sexual orientation per se."15

Independently, Friedman and Downey noted that credible evidence is lacking for a biological model of homosexuality.16 They conclude that "human sexual orientation is complex and diversely experienced and that a biopsychosocial model best fits the current state of knowledge in the field."17

So what does all of this mean about biology and the genesis of homosexuality? Critical reviews of the studies attempting to link biology and homosexuality, and subsequent acknowledgments by the researchers themselves, yield only one conclusion: biology alone is insufficient to explain the development of homosexuality. Any reputable scientist, regardless of which side of the political debate he or she embraces, when asked whether homosexuality is nature or nurture, must answer "yes." What is fascinating is that more than 50 % of the scientists who report research in this area are self-identified as gay or lesbian. This is disproportionate to the 2-3% (The Kinsey myth that 10% of the population is homosexual has been thoroughly discredited) which is the current estimate of the number of homosexual men and women in the population.

The developmental biologist form Brown University, Dr. Anne Fausto-Sterling, a self-identified lesbian, offers some interesting insight. Referring to the "born that way" argument, she states:

It provides a legal argument that is, at this moment, actually having some sway in court. For me, it's a very shaky place. It's bad science and bad politics. It seems to me that the way we consider homosexuality in our culture is an ethical and a moral question.

When asked about how much of her thinking about change in sexuality comes from her own life, Fausto-Sterling responded,

My interest in gender issues preceded my own life changes. When I first got involved in feminism, I was married. The gender issues did to me what they did to lots of women in the 1970s: they infuriated me. My poor husband, who was a very decent guy, tried as hard as he could to be sympathetic. But he was shut out of what I was doing. The women's movement opened up the feminine in a way that was new to me, and so my involvement made possible my becoming a lesbian. My ex and I are still friends. It is true I call myself as lesbian now because that is the life I am living, and I think it is something you should own up to. At the moment I am in a happy relationship and I don't ever imagine changing. Still, I don't think loving a man is unimaginable.18

So if biology is insufficient to explain the development of homosexual attraction, what does the research say about the developmental or environmental factors?

I should preface this part of my lecture by stating that the homosexual population is not a homogenous population. There are likely different routes that lead to a homosexual attraction, a homosexual orientation or a homosexual identity. Not only do the processes appear to be different for men and women but a homosexual attraction does not necessarily lead to a homosexual orientation. And not all homosexually-oriented people claim a homosexual identity. Gender nonconformity is the single most common observable factor associated with homosexuality.19

Hamer concludes: "Most sissies grow to be homosexuals, and most gay men were sissies as children...despite the provocative and politically incorrect nature of that statement, it fits the evidence. In fact, it may be the most consistent, well-documented, and significant finding in the entire field of sexual orientation research and perhaps in all of human psychology."20

In Hamer's own study, he asked the following questions: "Did you consider yourself less masculine than other boys your age, or were you ever regarded as a sissy as a child?" The answer was yes for 68% of the gay men compared with 5% of the straight men. Another question, "Did you enjoy sports such as baseball and football as a child? Of the gay men, 8% said very much compared to 78% of heterosexual men said very much. The gay men recalled substantially more gender atypical behaviors than the heterosexual men."21

LeVay noted that "...gays and lesbians were more nonconformist than heterosexuals in the following gender-differentiated traits:"

Participation in rough and tumble play (RPT), competitive athletics, or aggression Toy and activity preference Imagined roles and careers (significant difference for men only) Cross-dressing Preference for same or opposite sex playmates Social reputation as a sissy or tomboy22 Friedman and Downey concluded that homosexual women were more likely than heterosexual women to report having been extreme tomboys as children.23 Saghir and Robbins reported that 70% of homosexual women recalled being "boy-like" in childhood compared to 16% of heterosexual women.24 The research data is extensive in correlating gender non-conformity and later self-identification as homosexual.

Another area where there has been substantial research is the area of sexual abuse. Schrier and Johnson concluded that:

homosexually-assaulted males identified themselves as subsequently homosexual seven times as often as the non-assaulted group. the mean age at which the molestation was reported was 18.2 with a range of 15 to 24. the age at the time of the molestation ranged from 4 to 16 with a mean age of 10. of an extension group, one half of the victims currently identified themselves as homosexual and often linked their homosexuality to their sexual victimization experiences.25 Friedman and Downey found that gay males are more likely than heterosexual males to become sexually active at a younger age (12.7 vs. 15.7).26 In clinical settings, homosexual men frequently report an early introduction to sexuality.

Tomeo et al conducted research with 942 non-clinical adults (97% of the men and women were participating in a gay-pride celebration).27 Gay men and lesbian women reported a significantly higher rate of childhood molestation than did a comparison group of heterosexual men and women. Forty-six per cent of the gay men in comparison to 7% of the heterosexual men reported homosexual molestation. Twenty-two per cent of the lesbian women in comparison to 1% of the heterosexual women reported homosexual molestation. So did the molestation contribute to the identification as gay or lesbian in adulthood? The question is particularly intriguing because 68% of the men and 38 % of the women did not identify as gay or lesbian until after the molestation.

Perhaps I can provide you with a more personal glimpse about the potential role of sexual abuse in the development of sexual confusion through the eyes of the Olympic Diver, Greg Louganis. At sixteen he was propositioned by an Olympic judge: "The whole thing was surreal...but did divers actually sleep with a judge to get a higher score ?"28

The experience having sex with an older man was confusing to Louganis. Listen to the description of the experience.

He put his arms around me and kissed me. I really liked being held, and I was thrilled that this guy found me attractive. I thought that over time I'd feel less ashamed about what I was doing, but it only got worse. The age difference bothered me more, and he couldn't exactly be a part of my life. I felt stupid telling him what I was doing at school and I couldn't introduce him to any of my classmates. I hate the separation and the secrecy, but I kept going back for the affection, the holding, the cuddling-more than the sex. I was starved for affection, and he was happy to give it to me. It upset me that he was so much older, not because I felt molested or anything. I had been more than a willing partner, but the difference in our ages made the experience even more shameful.29 I looked forward to my furtive meetings with the older man from the beach, but he wasn't someone I could really talk to.30 At some point he told me he was concerned about seeing me because I was under eighteen. Apparently, he'd been jailed in the past for picking up minors.31

Another area where there has been considerable research is peer abuse. As boys, many homosexual men report name-calling, feeling rejected, being excluded by their peers. Daryl Bem, who is an activist theorist from Cornell, offers an interesting theory of how homosexuality develops. His theory is referred to as EBE or the Exotic Becomes the Erotic. His theory is that boys feel attraction for those who were different from them. The theory basically proposes that biological variables, such as genes, prenatal hormones, and brain neuroanatomy, do not code for sexual orientation per se but for childhood temperament that influences a child's preference for sex-typical or sex-atypical activities and peers. These preferences lead children to feel differently from same-sex peers-to perceive themselves as dissimilar, unfamiliar, and exotic. This, in turn, produces heightened nonspecific autonomic arousal that subsequently gets sexualized or eroticized in that same class of dissimilar peers: exotic becomes erotic.32 In essence, temperamentally sensitive boys sexualize that with which they are not familiar. Psychiatrist Richard Fitzgibbons has done significant work in this area.33 His conclusions strongly support the role of peer abuse as a factor in the development of gender confusion and later, homosexuality.

A final area of developmental factors is associated with family relationships. In homosexual men there appears to be a disconnect between them and their fathers as well as an overconnect with them and their mothers. The psychoanalytic literature seems to hold true in many case where there is a perception of the father being distant, uninvolved and unapproving. Many clinicians report that fathers have a difficult time connecting with their gender atypical sons. Bell, Weinstein and Hammersmith34 and Rekers35 concluded that the relationship of the child to the father may be more critically predictive of outcome than any other aspects of the relationship with the mother. In Bell, Weinstein & Hammersmith's study they found that 72% of the homosexual men recalled feeling very little or not at all like their fathers.36

So what does all of this mean? Regarding homosexuality, there are simply no variables that are by themselves, totally predictive. What we know is that the probable genesis of homosexuality lies in a combination of temperament and environmental factors such as sexual abuse and peer abuse along with familial factors.

Leaving aside this etiologic discussion, the next question is homosexuality immutable? Is it fixed, or is it fluid and amenable to change? There is a fairly good body of research that demonstrates that homosexuality is more fluid than fixed.37

Throckmorton's research suggests that some kind of changes occurred for many who now identify as ex-gay.38 A study by Lisa Diamond, a professor at the University of Utah, concluded that sexual identity is far from fixed in women who are not exclusively heterosexual.39 Kenneth Zucker, renowned Canadian researcher, acknowledging the lack of evidence for the biologic theory of homosexuality, offers an interesting observation. Referring to those on both sides of the debate, the politically and ideologically conservative and "rightest" as well as the politically and ideologically liberal and "leftist," he noted that both sides agree that homosexual orientation is "more fluid than fixed." "At times," Zucker noted, "there really is something to the expression that science and politics make strange bedfellows."40 My own research published in peer reviewed journals also supports this fluidity.

Perhaps the most significant study completed to date was conducted by Robert L. Spitzer. Against tremendous protest and politics of intimidation, the study was published in the prestigious Archives of Sexual Behavior. Ironically enough, Spitzer was the psychiatrist who led the charge to remove homosexuality as a disorder from the psychiatric manual in 1973. Spitzer is a self identified secular humanist atheist Jew who has been consistent in his support of gay rights. Briefly, Spitzer conducted a study of 200 people who reported that they had changed from homosexual to heterosexual. Spitzer found that 66% of the men and 44% of the women who had participated in therapy to change their homosexual orientation had arrived at what he called "good heterosexual functioning." Additionally, 89% of the men and 95% of the women reported that they were bothered slightly or not at all, by unwanted homosexual feelings. In Spitzer's own words: "Like most psychiatrists I thought that homosexual behavior could be resisted, but sexual orientation could not be changed. I now believe that's untrue-some people can and do change." Spitzer concluded that the changes occurred not just in behavior but in core features of sexual orientation.41

In a commentary published last year, Dr. Scott Hershberger, a scientist from the University of California at Long Beach, a long time supporter of gay rights and a self-identified essentialist (a individual who believes that homosexuality is biologically determined), reviewed the Spitzer research. Instead of just commenting on the Spitzer research, he elected to conduct a Guttman Scalability analysis. Basically, this is a mathematical test used to determine whether or not the reported changes occur in a cumulative, orderly fashion. His conclusion, "The orderly, law-like pattern of changes in homosexual behavior, homosexual self-identification, and homosexual attraction and fantasy observed in Spitzer's study is strong evidence that reparative therapy can assist individuals in changing their homosexual orientation to a heterosexual orientation. Now it is up to those skeptical of reparative therapy to provide comparably strong evidence to support their position. In my opinion, they have yet to do so."42

While it is beyond the scope of this lecture to talk about the theory and methods that are helpful in diminishing homosexual attractions, perhaps I can offer a very simple statement with which most therapists in this area would agree. The basic theory is that social and emotional variables affect gender identity which in turn determines sexual orientation. The work of the therapist is to help individuals understand their gender development. Subsequently such individuals are able to make choices that are consistent with their value system. The focus of treatment is to help individuals fully develop their masculine or feminine gender identity.

It is interesting that there has even been questions as to whether or not an individual should have the right to seek treatment to diminish unwanted homosexual attractions. The alleged justification for disallowing therapy is that such individuals seek help because of society's pressure or because of "internalized homophobia." From a clinical perspective, the choice to seek treatment can be a rational, self-directed goal, as should be the case with patients from any population group.

I would like to begin closing by citing the conclusions of 4 activists on the fluidity of homosexuality and therapy to diminish homosexual attraction.

Camille Paglia:

Homosexuality is not normal. On the contrary it is a challenge to the norm...Nature exists whether academics like it or not. And in nature, procreation is the single relentless rule. That is the norm...Our sexual bodies were designed for reproduction...No one is born gay. The idea is ridiculous...homosexuality is an adaptation, not an inborn trait.

Is the gay identity so fragile that it cannot bear the thought that some people may not wish to be gay? Sexuality is highly fluid, and reversals are theoretically possible. However, habit is refractory, once sensory pathways have been blazed and deepened by repetition-a phenomenon obvious with obesity, smoking, alcoholism or drug addiction--helping gays to learn how to function heterosexually, if they wish is a perfectly worthy aim. We should be honest enough to consider whether or not homosexuality may not indeed, be a pausing at the prepubescent stage where children band together by gender....Current gay cant insists that homosexuality is not a choice; that no one would choose to be gay in a homophobic society. But there is an element of choice in all behavior, sexual or otherwise. It takes an effort to deal with the opposite sex; it is safer with your own kind. The issue is one of challenge versus comfort.43

Douglas Haldeman:

A corollary issue for many is a sense of religious or spiritual identity that is sometimes as deeply felt as is sexual orientation. For some it is easier, and less emotionally disruptive, to contemplate changing sexual orientation, than to disengage from a religious way of life that is seen as completely central to the individual's sense of self and purpose...

However we may view this choice or the psychological underpinnings thereof, do we have the right to deny such an individual treatment that may help him adapt in the way he has decided is right for him? I would say that we do not.44

Simon LeVay:

First, science itself cannot render judgments about human worth or about what constitutes normality or disease. These are value judgments that individuals must make for themselves, while possibly taking scientific finding into account. Second, I believe that we should as far as possible, respect people's personal autonomy, even if it includes what I would call misguided desires such as the desire to change one's sexual orientation.45

Dean Hamer:

...biology is amoral; it offers no help in distinguishing between right and wrong. Only people, guided by their values and beliefs can decide what is moral and what is not.46

It's intriguing that the researchers whose studies have been used to perpetrate the myth that homosexuality is innate and immutable are speaking out. Friedman and Downey, psychiatric researchers at Columbia University who are very supportive of gay rights, provide a strong response to the argument that homosexuality is somehow fixed and unchangeable. Listen to their strongly worded conclusion, "At clinical conferences one often hears...that homosexual orientation is fixed and unmodifiable. Neither assertion is true... The assertion that homosexuality is genetic is so reductionistic that it must be dismissed out of hand as a general principle of psychology."47

Robert Perloff, former president of the American Psychological Association, became uncharacteristically angry with activist attempts to ban therapy for homosexuality. He condemned the APA's narrow politicism. Of re-orientation therapy with homosexuals, he said, "It is considered unethical...That's all wrong. First the data are not fully in yet. Second, if the client wants to change, listen to the client. Third, you are barring research.48

In my view, homosexuality is an issue of ethics and morality. Science--good science--can add a dimension to the discussion. However, I am in full agreement with the activists noted above--individuals who experience unwanted homosexual attractions have a right to treatment aimed at diminishing those attractions. Whether or not others agree with that choice is not as important as respecting the right to make those choices.

Tolerance is a two way street. A confounding of politics, psychology and therapeutics has occurred because of anti-gay bias in some cases and gay activism in other cases. This co-mingling of facts and fiction by anti or pro homosexual political groups-both of which claim to have science on their side does little to help. Accusations of homophobia or heterophobia serve to diminish dialogue, not to encourage dialogue. Patient self-determination, the cornerstone of all the mental health professions, must rise above the political debate. Contrary to the prevailing climate, the data on homosexuality is far from complete, but there is much that we know.

Ethicality would suggest that the suppression of data and discouragement of further scientific research should not be tolerated. It is well within the purview of science to study issues such as the change from homosexuality. The well-intentioned caretakers or our national organizations slide down a slippery slope when advocating what amounts to a virtual censorship of scientific investigation of politically unpopular views. Fortunately, that is changing. Within the last year, I have had nine master's or doctoral students from prominent universities throughout the country contact me for assistance with thesis or dissertation topics. Science progresses by asking interesting questions, not by avoiding questions whose answers might not be helpful in achieving a political agenda.

Being supportive of the basic civil rights of self-identified gays and lesbians does not require a belief in the false notion that homosexuality is invariably fixed in all people. It is not. As a final note, I personally repudiate any uncivility, religious or otherwise, toward self-identified gays or lesbians. At the same time, suppression of research and the intimidation of scientists must not be tolerated. Under no circumstances should science be pre-empted by activism. No one benefits when that occurs.

Notes

1 Simon LeVay, "A difference in hypothalamic structure between heterosexual and homosexual men," Science 253 (1991), 1034-1037; Dean Hamer, et. al., "A linkage between DNA markers on the X chromosome and male sexual orientation," Science 261 (July 1993), 321-326; J. Michael Bailey and Richard C. Pillard, "A genetic study of male sexual orientation," Archives of General Psychiatry 48 (1991), 1089-1096.
2 Simon LeVay, Queer Science. (Cambridge, Massachusetts: MIT Press, 1996), 143-145.
3 Ibid.
4 D. Nimmons, "Sex and the brain," Discover (March 1994), 64-71.
5 M. Breedlove, "Sex on the brain," Nature 389 (1997), 801.
6 LeVay, Queer Science, 6.
7 Ibid., 282.
8 Neil Whitehead and B. Whitehead, My Genes Made Me Do It! A Scientific Look at Sexual Orientation (Lafayette, Louisiana: Huntington House Publishers, 1999).
9 Dean Hamer, et. al., "A linkage between DNA markers on the X chromosome and male sexual orientation."
10 N. Risch, E. Squires-Wheller, and B.J. Keen, "Male sexual orientation and genetic evidence," Nature 262 (1993), 2063-2064.
11 N. Mitchell, "Genetics, sexuality, linked study says," Standard Examiner (April 30, 1995).
12 Dean Hamer and P. Copeland, The Science of Desire (New York: Simon and Schuster, 1994), 104.
13 G.A. Rice, C. Anderson, N. Risch, and G. Ebers, "Male homosexuality: Absence of linkage to microsatellite markers at XQ28," Science 284 (1999), 665-667.
14 Anastasia Toufexis, "New evidence of a gay gene," Time 146 (November 13, 1995), 43.
15 W. Byne and B. Parsons, "Human sexual orientation: The biologic theories reapprised," Archives of General Psychiatry 50 (1993), 229.
16 R.C. Friedman, and J.I. Downey, "Neurobiology and sexual orientation: Current relationships," Journal of Neuropsychiatry 5 (1993), 131-153.
17 R.C. Friedman and J.I. Downey, Sexual Orientation and Psychoanalysis: Sexual Science and Clinical Practice (New York: Columbia University Press, 2002), 131.
18 C. Dreifus, "Exploring what makes us male or female," New York Times Science Section (January 2, 2001).
19 Handbook of Child and Adolescent Sexual Problems, edited by G.A. Rekers (New York: Simon & Schuster, 1995); Hamer and Copeland, The Science of Desire.
20 Hamer and Copeland, The Science of Desire, 166.
21 Ibid., 167.
22 LeVay, Queer Science, 98.
23 Friedman and Downey, Sexual Orientation and Psychoanalysis: Sexual Science and Clinical Practice.
24 M.T. Saghir and E. Robins, Male and Female Homosexuality (Baltimore: Williams and Wilkins, 1973).
25 D. Schrier and R.L. Johnson, "Sexual victimization of boys: an ongoing study of an adolescent medicine clinic population," Journal of the National Medical Association 80:11 (1988), 1189-1193.
26 R.C. Friedman and J.I. Downey, "Homosexuality," New England Journal of Medicine 331 (1994), 923.
27 M.E. Tomeo, et. al., "Comparative data of childhood and adolescence molestation in Heterosexual and Homosexual persons," Archives of Sexual Behavior 30:5 (2001), 535-541.
28 Greg Louganis and E. Marcus, Breaking the Surface (New York: Random House, 1995), 16.
29 Ibid., 76.
30 Ibid., 89.
31 Ibid., 79.
32 Daryl J. Bem, "Exotic becomes erotic: A developmental theory of sexual orientation," Psychological Review 103 (1996), 320-335.
33 Richard Fitzgibbons, "The power of peer rejection," NARTH Bulletin (August 1997).
34 A.P. Bell, M.S. Weinberg, and S.K. Hammersmith, Sexual Preference: Its Development in Men and Women (Bloomington, Indiana: Indiana University Press, 1981).
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