Let’s have a SCIENCE-based debate about LGBT issues
So the nature of homosexuality and transsexualism is settled, incontrovertible, and beyond dispute? Yes, but only in newspapers, not in academia.
A landmark survey of decades of research by two eminent scholars working in the United States claims that many of these assertions are simply not supported by the weight of evidence in scholarly journals. The report was released today by The New Atlantis, a well-known journal of science, technology, and ethics based in Washington DC. The editors have organised what is probably the best single summary of the scientific evidence on LGBT issues published to date. (Click here for a PDF.)
“Sexual orientation and gender identity resist explanation by simple theories,” write psychiatrist Paul R. McHugh and epidemiologist Lawrence S. Mayer. “There is a large gap between the certainty with which beliefs are held about these matters and what a sober assessment of the science reveals. In the face of this complexity and uncertainty, we need to be humble about what we know and do not know.”
The two authors have impressive credentials. Mayer is a professor of statistics and biostatistics at Arizona State University and has held professorial appointments at eight universities, including Princeton, the University of Pennsylvania, and Stanford. McHugh was psychiatrist-in-chief at Johns Hopkins Hospital from 1975 to 2001 and served on a national bioethics commission during the Bush Administration.
What did they find?
The belief that sexual orientation is an innate, biologically fixed human property—that people are “born that way”—is not supported by scientific evidence. Headlines imply that sexual orientation is caused by genetics, hormones, brain structure. But these are too small or ambiguous to settle the issue. Furthermore, there are conceptual problems. There is no consensus on whether “sexual orientation” defined by attraction, behaviour, or identity.
Similarly, the belief that gender identity is an innate, fixed human property independent of biological sex—so that a person might be a “man trapped in a woman’s body” or “a woman trapped in a man’s body”—is not supported either. Again, there are conceptual problems. Gender theorists argue that gender is not who a person is, but what they do – which underpins Facebook’s decision to offer 56 different gender options. But this quickly becomes incoherent, with genders multiplying like snowflakes, each different, each inexplicable. They write:
“No degree of supporting a little boy in converting to be considered, by himself and others, to be a little girl makes him biologically a little girl. The scientific definition of biological sex is, for almost all human beings, clear, binary, and stable, reflecting an underlying biological reality that is not contradicted by exceptions to sex-typical behavior, and cannot be altered by surgery or social conditioning.”
It is becoming more and more common to encourage children who express gender-atypical thoughts or behaviour to seek puberty blockers, transitional hormone treatment and eventually surgery. This is “iniquitous”, writes Dr Mayer, in one of the rare moments of moralizing in the essay. “The notion that a two-year-old, having expressed thoughts or behaviors identified with the opposite sex, can be labeled for life as transgender has absolutely no support in science.” According to the DSM-5, the reference book for psychiatrists, “In natal [biological] males, persistence [of gender dysphoria] has ranged from 2.2% to 30%. In natal females, persistence has ranged from 12% to 50%.” In other words, some studies showed that at least 88 percent of girls recovered from their gender dysphoria and 98 percent of boys.
With that in mind, it seems reckless to encourage children to transition to a different gender. The mental and physical benefits of such treatment are, at best, modest, at the worst, they are lethal. A Swedish study in 2011 found that people who had “sex changes” were 4.9 times more likely to attempt suicide and 19.1 times more likely to die by suicide compared to controls. The researchers concluded that “Mortality from suicide was strikingly high among sex-reassigned persons.”
In one of the most interesting features of the study, Mayer and McHugh found that non-heterosexual and transgender people have much higher rates of mental health problems (anxiety, depression, suicide), as well as behavioral and social problems (substance abuse, intimate partner violence), than the general population. The quick riposte to this is that these dismal statistics are due to stigma and discrimination. While there may be some truth in this, they hardly account for the entire disparity.
The report contains a significant lesson for Australia, where politicians are debating whether to hold a plebiscite to settle the issue of same-sex marriage. A common argument against a plebiscite and for a simple vote in Federal Parliament is that debate would provoke severe psychological stress among gays and lesbians. What proof is there for such a theory? Very little.
Mayer and McHugh examined American research into the mental health of gays and lesbians in states where same-sex marriage was legal and states which had banned it. The data was inconclusive. One study found that “generalized anxiety disorder” appeared to rise in states which banned same-sex marriage – but, hilariously, drug abuse rose more in states which did not ban it. Another study found that LGBT activism during the election season was psychologically stressful, but the researchers acknowledged that this could have “simply reflected the typical feelings of advocates when they experience political defeat on an issue that they care passionately about.”
This excellent study does not take sides on current legal and public policy controversies. But it does insist that debate needs to be informed by objective science, not partisan scholarship. It calls for more research on nearly 20 critical issues related to sexual orientation and gender identity. It’s a message that needs to be heard: too many lives are at stake.
Michael Cook is editor of MercatorNet.
This article appears in the NEW ATLANTIS JOURNAL
- about 12 hours ago — RT @EvanSparks Yes. @cnkeiper and @AdamKeiper reflected in @weeklystandard on what conservatives can appreciate in #HamiltonBway… https://t.co/ZijhGNfYFC
- about 12 hours ago — @AviWoolf @AriSchulman Yes indeed! (We’ve got a piece touching on similar themes in an upcoming issue—a nice complement.
This report presents a careful summary and an up-to-date explanation of research — from the biological, psychological, and social sciences — related to sexual orientation and gender identity. It is offered in the hope that such an exposition can contribute to our capacity as physicians, scientists, and citizens to address health issues faced by LGBT populations within our society.
Some key findings:
Part One: Sexual Orientation
● The understanding of sexual orientation as an innate, biologically fixed property of human beings — the idea that people are “born that way” — is not supported by scientific evidence.
● While there is evidence that biological factors such as genes and hormones are associated with sexual behaviors and attractions, there are no compelling causal biological explanations for human sexual orientation. While minor differences in the brain structures and brain activity between homosexual and heterosexual individuals have been identified by researchers, such neurobiological findings do not demonstrate whether these differences are innate or are the result of environmental and psychological factors.
● Longitudinal studies of adolescents suggest that sexual orientation may be quite fluid over the life course for some people, with one study estimating that as many as 80% of male adolescents who report same-sex attractions no longer do so as adults (although the extent to which this figure reflects actual changes in same-sex attractions and not just artifacts of the survey process has been contested by some researchers).
● Compared to heterosexuals, non-heterosexuals are about two to three times as likely to have experienced childhood sexual abuse.
Part Two: Sexuality, Mental Health Outcomes, and Social Stress
● Compared to the general population, non-heterosexual subpopulations are at an elevated risk for a variety of adverse health and mental health outcomes.
● Members of the non-heterosexual population are estimated to have about 1.5 times higher risk of experiencing anxiety disorders than members of the heterosexual population, as well as roughly double the risk of depression, 1.5 times the risk of substance abuse, and nearly 2.5 times the risk of suicide.
● Members of the transgender population are also at higher risk of a variety of mental health problems compared to members of the non-transgender population. Especially alarmingly, the rate of lifetime suicide attempts across all ages of transgender individuals is estimated at 41%, compared to under 5% in the overall U.S. population.
● There is evidence, albeit limited, that social stressors such as discrimination and stigma contribute to the elevated risk of poor mental health outcomes for non-heterosexual and transgender populations. More high-quality longitudinal studies are necessary for the “social stress model” to be a useful tool for understanding public health concerns.
Part Three: Gender Identity
● The hypothesis that gender identity is an innate, fixed property of human beings that is independent of biological sex — that a person might be “a man trapped in a woman’s body” or “a woman trapped in a man’s body” — is not supported by scientific evidence.
● According to a recent estimate, about 0.6% of U.S. adults identify as a gender that does not correspond to their biological sex.
● Studies comparing the brain structures of transgender and non-transgender individuals have demonstrated weak correlations between brain structure and cross-gender identification. These correlations do not provide any evidence for a neurobiological basis for cross-gender identification.
● Compared to the general population, adults who have undergone sex-reassignment surgery continue to have a higher risk of experiencing poor mental health outcomes. One study found that, compared to controls, sex-reassigned individuals were about 5 times more likely to attempt suicide and about 19 times more likely to die by suicide.
● Children are a special case when addressing transgender issues. Only a minority of children who experience cross-gender identification will continue to do so into adolescence or adulthood.
● There is little scientific evidence for the therapeutic value of interventions that delay puberty or modify the secondary sex characteristics of adolescents, although some children may have improved psychological well-being if they are encouraged and supported in their cross-gender identification. There is no evidence that all children who express gender-atypical thoughts or behavior should be encouraged to become transgender.