Same-sex attraction: science and philosophy
Homosexuality is not innate, immutable or without significant risk to medical, psychological and relational health.
We hear a lot from people who claim they are happy with their homosexual or lesbian orientation and want social recognition for it. But what of people who are unhappy with their attraction to others of the same sex? What help is available and on what scientific and ethical grounds is it based? We asked Dr Phillip Sutton, a licensed psychologist, therapist and counselor based in Indiana and Michigan in the US. He is also Editor of the Journal of Human Sexuality, a peer-reviewed scholarly publication of the National Association for Research and Therapy of Homosexuality (NARTH)
In the second part of a two-part email interview Dr Sutton describes his experience and methods of serving people with these issues.
MercatorNet: Many professionals, even professional groups, claim that sexual orientation is fixed and it is harmful to change it. What does the scientific research and empirical evidence actually tell us about this, to date?
Dr Sutton: Permit me to acknowledge that I am editor of the Journal of Human Sexuality, a peer-reviewed scholarly publication of the National Association for Research and Therapy of Homosexuality (NARTH). NARTH is a professional, scientific organization -- thankfully with a number of lay supporters -- which internationally promotes the rights of persons with unwanted same-sex attraction (SSA) to receive competent psychological care if they choose and the rights of qualified mental health professionals to offer such care. In addition, NARTH is committed to the ensuring the valid conduct of relevant clinical and scientific research and a fair reading, the responsible reporting, and accurate education of both professional and laypersons about what such research actually shows.
Homosexuality is not innate, immutable or without significant risk to medical, psychological and relational health. In 2009, NARTH published a review of over a century of experiential evidence, clinical reports, and research literature on professionally and other assisted change in persons' experience of homosexuality. NARTH's report, What Research Shows (WRS), documents that it is possible for both men and women to change from homosexuality to heterosexuality; that efforts to change are not generally harmful; and that homosexual men and women do indeed have greater risk factors for medical, psychological and relational pathology than do the general population.
A decade before WRS was published, Stanton Jones and Mark Yarhouse (Homosexuality: The Use of Scientific Research in the Church's Moral Debate, InterVarsity Press, 2000) reviewed the historical and then recent evidence for intentional change in unwanted homosexuality and concluded that there was sufficient evidence that, as a result of professional assistance, some people experienced one or more of the following: "reduced preoccupation with homosexual thoughts, reduced homosexual activity, reduced anxiety about heterosexual functioning, increased heterosexual activity, increased heterosexual fantasy, celibacy, heterosexual marriage and reports of [change of sexual orientation] from homosexual to heterosexual." (p.151)
Research reports even more recent than WRS have shown similar results. (Jones and Yarhouse, 2009: Ex Gays? An Extended Longitudinal Study of Attempted Religiously Mediated Change in Sexual Orientation; Elan Karten and Jay Wade, "Sexual orientation change efforts in men: A client perspective", The Journal of Men's Studies 18, 2010, 84-102). Also, there is a fair amount of both anecdotal and quality population-based research which shows that many persons diminish same-sex attractions and behaviors and increase opposite-sex attractions and behaviors, on their own, i.e., without professional assistance.
In 2008, the American Psychological Association (APA) finally -- and stealthily (i.e., without publicity or acknowledgement that it was "softening" its prior public views to the contrary) -- acknowledged the quite large body of clinical and scientific literature which shows that homosexuality is not 'innate'; that children, men and women are not simply "born that way"; and that psychological and social factors, as well as genetic and other biological factors (i.e. both nature and nurture) appear to influence the development of homosexuality.
A couple of month's after NARTH released What Research Shows, the long anticipated 2009 APA Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation was released. While in this report the APA claims that there is insufficient empirical evidence to show that sexual orientation itself may be changed through therapy or other (e.g. pastoral) means, the APA does acknowledge that sexual behaviour, attraction and orientation identity are "fluid," i.e., not fixed or immutable. Unfortunately, the Report warns potential consumers that "sexual orientation change efforts" (SOCE) may be harmful, yet also admits that "there are no scientifically rigorous studies of recent SOCE" which adequately document or provide an empirical basis for the APA's concern.
The 2009 APA report expresses views that supporters of NARTH's mission can accept. For example, the report formally promotes: 1) The rights of clients to determine their own direction of treatment, including "autonomous decision making and self-determination" and "the avoidance of and avoid coercive and involuntary treatments" (p. 76). 2) "Effective psychotherapy that increases a client's abilities to cope, understand, acknowledge, explore, and integrate sexual orientation concerns into a self-chosen life in which the client determines the ultimate manner in which he or she does or does not express sexual orientation"(p. 69). 3) Offering clients "interventions that emphasize acceptance, support, and recognition of [the clients'] important values and concerns" (p. 63). 4) "For individuals who experience distress with their sexual attractions and seek SOCE… [t]he following appear to be helpful to clients: • Finding social support and interacting with others in similar circumstances. • Experiencing understanding and recognition of the importance of religious beliefs and concerns. • Receiving empathy for their very difficult dilemmas and conflicts. And, • Being provided with affective and cognitive tools for identity exploration and development" (p. 61). 5) Respect for religious beliefs with regard to homosexuality must be respected (cf. p. 5, 19- 20, 51, 53, 56, 59, 64, 69, 70, 77-78, 82, 120), as well as the convictions of those who decide (apart from religious reasons) that their sexuality does not reflect their true self (cf. p. 18, 56, 68-69). And, 6) Offering "accurate… scientific and professional information about sexual orientation…in order to counteract bias that is based in lack of knowledge about sexual orientation." (p. 122)
NARTH does not agree with everything written in the APA report, which we havecritiqued elsewhere (summary version:http://www.narth.com/docs/apataskforcereportbroch.pdf). Sadly, I fear that much of what I and NARTH can agree with in the report may be only "lip service" by the APA. Time will tell. The professional ethics of all of the mental health professions in the U.S. support freedom of self-determination and also of religion. The challenge lies in ensuring that this is true in practice, not just in theory. Potential consumers of mental health services for any "presenting problem" are advised to ask a potential, new therapist the "tough questions" -- to ensure that one's deeply held values and lifestyle practices (including faith and religion) will be respected, if not understood, and that one's goals for therapy will be supported.
It must be acknowledged that -- like all approaches to psychological care for any issue -- many who attempt to use professional care to facilitate their process of changing their experience(s) of SSA do not achieve their initially stated or desired goals, and that for those who do, this process is commonly long, hard, and uncomfortable, with many setbacks and "slips" along this healing and growth journey. While apparently not strictly necessary to achieve such changes, people of religious faith have found that seeking a professional who truly supports -- if not shares -- his or her values is important for resolving not only unwanted SSA but also psycho-social difficulty.
Everyone, including the professional, comes to the issue of homosexuality with their own philosophical or ideological or religious convictions about it. What, briefly, are yours?
Let me begin by stating that I am unabashedly a practicing and devout Catholic who is loyal to the Church's teaching about faith and morals. That said, I have found that both my own and others' clinical experience and the clinical and research literature, as a whole support what I privately and the Church publicly believe and propose about the issue of homosexuality -- and the value of chastity or sexual purity/integrity for all human beings. I consider that a ninth beatitude would be appropriate: "Blessed are the chaste (those with sexual purity or integrity), for they will know the peace and joy that comes with sexual self control in the service of authentic love (charity, agape).
My professional views are consistent with the natural law, i.e., the understanding of what constitutes healthy, humane behaviors; which actions do and do not allow and foster authentic human flourishing. Same-sex attraction or SSA needs to be understood in the context of what is healthy, mature sexuality and what is not. I believe that all unchaste behaviors -- including fornication, contraception, adultery, masturbation, pornography, coerced, and prostitution, as well as explicitly homosexual behaviors -- are both a cause and effect of immature sexuality. Often, especially if they are compulsive or addictive, all of such behaviors also may be self-defeating attempts to resolve or at least "self-medicate" one or more emotional or psychological problems.
In spite of claims that relationships based on gratifying SSA are a natural and normal variant of human sexual expression, a growing body of evidence clearly reveals otherwise. Those engaging in SSA behaviours have significant, alarmingrisks of harm to their medical, mental and relational health compared with those who don't. These risks include a myriad of medical problems and diseases directly related to homosexual practices; AIDS and STD's; substance abuse; suicidal ideation and attempts; psychological and psychiatric concerns, including depression, anxiety, paranoia, personality and eating disorders; and same-sex relationship violence.
These are not just concerns for adults. The concerns of parents, family members and friends of teenagers whose sexual behaviors and/or attractions leave them at risk for such harms are understandable and scientifically and clinically justified. An adolescent's desire to prevent or cease experiencing these serious health problems or risks is sufficient reason for him or her to seek and receive competent psychological care to minimize or resolve the desires, behaviors and lifestyles associated with such increased risks.
Finally, I think that recent social and political efforts to allow for same-sex "marriage," adoption, etc., ignore not only the natural law, but also good science. Permit me to quote from the abstract of a paper by Dean Byrd in the most recently published volume of the Journal of Human Sexuality: "All family forms are not equally as helpful or healthful for children. More than two decades of research demonstrates that children do better in a home with a married mother and father. Children in this one family form navigate the developmental stages more easily, are more solid in their gender identities, perform better in academic tasks, have fewer emotional disorders and become better functioning adults. This conclusion clearly makes a strong case that gender-linked differences in child-rearing are protective for children. Men and women do indeed contribute differently to the healthy development of children."
By contrast, recent reports claiming that children raised by two lesbians fare as well or better than those raised by their own married mother and father, actually have shown that being raised by two lesbians results in an increased incidence of non-heterosexual identity and behaviors for these children. Other critiques also highlight the poor quality of such research.
With all of the media-stoked debate and activism about whose definition of marriage and family will stand, I'm mindful that the good-enough marriage and family based on lifelong, faithful and fruitful marriage between a man and a woman who conceive and raise their own children as a fruit of their conjugal love is the "gold standard" for how the vast majority of human persons were meant to live out their lives as sexual beings.
Dr Phillip Sutton, is a licensed psychologist, therapist and counselor based in Indiana and Michigan in the US. He is also Editor of the Journal of Human Sexuality, a peer-reviewed scholarly publication of the National Association for Research and Therapy of Homosexuality (NARTH)
Further reading of Dr Sutton's work:
Who Am I? Psychological Issues in Gender Identity and Same-Sex Attraction. In H. Watt (Ed.), Fertility & Gender: Issues in Reproductive and Sexual Ethics (Oxford: Anscombe Centre, 2011).
Cretella, Michelle, M.D. & Sutton, Philip, Ph.D. Health Risks: Fisting and Other Homosexual Practices. (2010).
Report of symposium at the American Psychological Association's 2009 convention in Toronto, Canada, 2009, entitled: Sexual Orientation and Faith Tradition: A Test of the Leona Tyler Principle.
Want to read more articles by Philip Sutton? Click on the links below
- Same-sex attraction: a therapist's view | 18 April 2011
