NotBornThatWay:NewScientificAnalysisQuestions

LGBTOrthodoxies

NotBornThatWay:NewScientificAnalysisQuestionsLGBT
Orthodoxies(4682)

Acomprehensivenewsurveyaboutsexualityandgender,
undertakenbyleadingmedicalexperts,concludesthatkeytheories
areunsupportedbyscientificevidence.

byJOANFRAWLEYDESMOND08/22/2016Comments(9)

'SexualityandGender,'anewreportbyDrs.LawrenceMayerPaulMcHugh,shedslightonkeypopulartheoriesaboutthis
subject,includingthebeliefthathomosexualpersonsare'bornthatway.'

WikimediaCommons

Agroundbreakingreportthatexaminesnearly200peerreviewedstudiesonsexualorientationandgender
identityconcludesthatsciencehasntconfirmedkeytheoriesaboutthesesubjects,includingthebeliefthat
homosexualsarebornthatway.
Anditrejectssurgicalandhormonalinterventionsforchildrenwhoidentifyastransgender,onthegrounds
thatthelargemajorityofsuchchildrenoutgrowidentitiesthatconflictwiththeirbiologicalsex.

Examiningresearchfromthebiological,psychological,andsocialsciences,thisreportshowsthatsomeof
themostfrequentlyheardclaimsaboutsexualityandgenderarenotsupportedbyscientificevidence,
readsanintroductorynotebyAdamKeiper,editorofTheNewAtlantis,aleadingjournalofscience,
technology,andethicsthatpublishedthereport,SexualityandGender.

ThereporthasaspecialfocusonthehigherratesofmentalhealthproblemsamongLGBTpopulations,
anditquestionsthescientificbasisoftrendsinthetreatmentofchildrenwhodonotidentifywiththeir
biologicalsex,saidKeiper.

Moreeffortiscalledfortoprovidethesepeoplewiththeunderstanding,care,andsupporttheyneedtolead
healthy,flourishinglives.

SexualityandGenderwaswrittenbyDr.LawrenceMayer,ascholarinresidenceintheDepartmentof
PsychiatryattheJohnsHopkinsUniversityandaprofessorofstatisticsandbiostatisticsatArizonaState
University,andDr.PaulMcHugh,aprofessorofpsychiatryandbehavioralsciencesattheJohnsHopkins
UniversitySchoolofMedicinewhoservedfor25yearsaspsychiatristinchiefattheJohnsHopkinsHospital.
ThestudywasreleasedonAug.22.

Thereportassertsthatscientificevidencedoesnotsupportthetheorythatgenderidentityisaninnate,
fixedpropertyofhumanbeingsthatisindependentofbiologicalsexthatapersonmightbeaman
trappedinawomansbodyorawomantrappedinamansbody.

Theauthorsalsoquestiontheadoptionofnewinterventionsforchildrenandteenswhodonotidentifywith
theirbiologicalsex.

Onlyaminorityofchildrenwhoexpressgenderatypicalthoughtsorbehaviorwillcontinuetodosointo
adolescenceoradulthood,thereportconcludes.

Thereisnoevidencethatallsuchchildrenshouldbeencouragedtobecometransgender,muchless
subjectedtohormonetreatmentsorsurgery.

Thereporttakesnopositiononrelatedpublicpolicydebatesandlegalquestionsregardingsamesex
marriageornewbathroomrulesfortransgenderstudents.Rather,theauthorsmakeclearthatpeople
whostrugglewitharangeofsexualityandgenderissuesneedthehigheststandardofcare,andtheycallfor
additionalresearchtoprovideasolidfoundationforeffectivetreatment.

Science,notPolitics
Inhisprefacetothereport,MayerpresentsSexualityandGenderasaworkofscience,notapolitical
manifesto.Anepidemiologisttrainedinpsychiatrywhohasbeenafulltimetenuredprofessorformorethan
40years,hehasheldappointmentsatPrinceton,theUniversityofPennsylvania,Stanford,ArizonaState
University,andJohnsHopkinsUniversityBloombergSchoolofPublicHealthandSchoolofMedicine,among
otherinstitutionsofhighereducation.

Mayerwasinspiredtocoauthorthereport,hesaid,afterinitialresearchstirredgraveconcernsaboutthe
LGBTcommunityspoormentalhealthoutcomes.
Idedicatemyworkonthisreport,first,totheLGBTcommunity,whichbearsadisproportionaterateof
mentalhealthproblemscomparedtothepopulationasawhole,wroteMayerinthestudyspreface.We
mustfindwaystorelievetheirsuffering.Amongthededications,hegivesspecialattentiontochildren
strugglingwiththeirsexualityandgender.

Healsodedicatedthereporttoscholarsdoingimpartialresearchontopicsofpubliccontroversy.Maythey
neverlosetheirwayinpoliticalhurricanes.

Thelatterdedicationunderscoresgrowingconcernsthatacademicresearcherscanbeinfluencedby
powerfulideologicalcurrentsthathavepavedthewayforthelegalizationofsamesexmarriage,anda
rangeofaccommodationsfortransgenderpeople.Andcriticsoftheseideologicalperspectivescontendthat
researchersfacepressuretosupporttheneworthodoxyonsexandgender,citingthecaseofMark
Regnerus,asociologistattheUniversityofTexasAustinwhowasthreatenedwiththelossofacademic
tenureafterhis2012peerreviewedstudyraisedquestionsaboutLGBTparenting.

TheauthorsofSexualityandGender,fortheirpart,willlikelyprovokecontroversyforchallengingnew
treatmentsforchildrenwhoidentifyastransgender,andfordisputingclaimsthatsamesexattractionhasa
stronggeneticbasis.

Infact,theauthorsaredeeplyskepticalaboutthewaysexualexperienceispresentedincontemporary
societyanduniversitygenderstudiescurricula.Theyurgereaderstobecautiousaboutadoptingoverly
simplistictheoriesaboutsamesexattractionandgenderidentity.

Popularunderstandingsofscientificfindingsoftenpresumedeterministiccausalitywhenthefindingsdonot
warrantthatpresumption,statesthereport.

SexualOrientation
Thus,whenaddressingquestionsaboutageneticbasisforsamesexorientation,theauthorsarecareful
todistinguishbetweenscientificevidenceanduntestedhypotheses.

Ontheonehand,theynotetheexistenceoflargestudiesofidenticaltwinsthatpointtosomeroleofgenetic
factorsinthedevelopmentofsexualorientation(whilenotingthattheconceptofsexualorientationisitself
scientificallyproblematic,becauseofitselasticdefinition).Atthesametime,theyciteotherfindingsthat
pointtothecomplexinterplayofotherfactorsthatstronglysuggestsexualorientationisnotpredetermined,
andtheynotethatstudiesoftwinsthatarereferencedbyactivistsasevidenceofthegeneticoriginofsexual
orientationdonotinfactsubstantiatesuchclaims.

SothequestionAregaypeoplebornthatway?requiresclarification.Thereisvirtuallynoevidencethat
anyone,gayorstraight,isbornthatwayifthatmeanstheirsexualorientationwasgeneticallydetermined,
thereportexplains.

Butthereissomeevidencefromthetwinstudiesthatcertaingeneticprofilesprobablyincreasethe
likelihoodthepersonlateridentifiesasgayorengagesinsamesexsexualbehavior.

Whatotherfactorscouldfostersamesexattraction?Theauthorsconsiderresearchpointingtoacausallink
betweennonheterosexualbehaviorinadultsandtheexperienceofchildhoodsexualabuseandbullyingby
peersaccordingtoa2011metaanalysisof37NorthAmericanstudies,nonheterosexualswere2.9times
morelikelytoreportsexualabuseaschildren,andnonheterosexualadolescentswere1.7timesmorelikely
tohavebeenattackedorthreatenedbytheirpeers.Buttheauthorssuggestthatfurtherstudyisneededto
clarifythisconnection.

Alongwithmanyotherfactors,socialcontextandvaluesclearlyplaysomerole,saytheauthors.For
example,researchershavefoundthatyoungpeoplewhoattendcollegeorwholiveinurbanareasaremuch
morelikelytoidentifyashomosexualthantheirpeerswhoresideinruralareasandthosewhodidnotattend
college.

Andtheauthorscautionagainstthecontemporarybeliefthatindividualswhohaveexperiencedsamesex
attractionsneedtoidentifyashavingagaysexualorientation,andneedtoexpresssuchanorientation
romanticallyandsexually.

[W]emayhavesomereasonstodoubtthecommonassumptionthatinordertolivehappyandflourishing
lives,wemustsomehowdiscoverthisinnatefactaboutourselvesthatwecallsexualityorsexualorientation,
andinvariablyexpressitthroughparticularpatternsofsexualbehaviororaparticularlifetrajectory,they
state.

Perhapsweoughtinsteadtoconsiderwhatsortsofbehaviorswhetherinthesexualrealmorelsewhere
tendtobeconducivetohealthandflourishing,andwhatkindsofbehaviorstendtoundermineahealthy
andflourishinglife.

MentalHealthProblems
Thisstrikingproposalintroducesthenextsectionofthereport,whichexaminesthedisturbinglyhighrateof
mentalhealthproblemsandsexualviolenceintheLGBTcommunity.

Forexample,41%oftransgenderindividualshaveattemptedsuicide,accordingtotheNationalTransgender
DiscriminationSurvey(NTDS),conductedbytheNationalGayandLesbianTaskForceandNationalCenter
forTransgenderEqualityandcitedinthereport.Incontrast,4.6%percentoftheoverallU.S.population
reportalifetimesuicideattempt.

Whatsbehindthisshockingdisparity?Someexpertshaveputforwardasocialstressmodeltoexplainthe
poormentalhealthoutcomesfortransgenderindividuals,andotherswhoexperiencediscrimination.

Thesocialstressmodelpositsthattheexperienceofstigmatizationinfamilyrelationships,school,andinthe
communityfostersdepression,anxietyandsuicidalthoughtsamongtransgenderindividualsandother
sexualminorities.

Federalandstategovernmentshaveenactedantidiscriminationstatutesandhatecrimelaws,inaneffortto
prohibitdiscriminationagainstthiscommunity,andsopromotepsychologicalwellbeing.

Theauthorsagreethatsocialstigmacaninflictdeepemotionalwounds,buttheyalsocallforwelldesigned
studiesthatcantestthesocialstresshypothesis.

Further,whilethesocialstressmodelisoftencitedtoexplainthepoormentalhealthoutcomes,thereport
arguesthatamorerobust,multifacetedapproachisneededtohelpthiscommunity.

Atthistime,themedicalandsocialstrategiesforhelpingnonheterosexualpopulationsintheUnitedStates
arequitelimited,andthismaybedueinparttotherelativelylimitedexplanationsforthepoormentalhealth
outcomesofferedbysocialscientistsandpsychologists.
GenderIdentityQuestions
Thereportalsoquestionsthescientificbasisforacademicgendertheoryorthodoxy,whichsharply
distinguishesbetweenthemalefemalebinaryofbiologicalsexandafluidrangeofgenderidentities.

Developmentsinfeministtheoryinthesecondhalfofthetwentiethcenturyfurthersolidifiedthepositionthat
genderissociallyconstructed,thereportnotes,citingsubsequentargumentsthatcallforthe
deconstructionofgenderroleswiththegoalofcreatingasociety,inwhichonessexualanatomyis
irrelevanttowhooneis,whatonedoes,andwithwhomonemakeslove.

Today,Facebookuserscanchoosefrom58genderoptionsfortheirprofiles,butthereportemphasizesthat
onlybiologicalsex,withitsreproductivefaculties,isafixedaspectofhumannature.

Thescientificdefinitionofbiologicalsexis,foralmostallhumanbeings,clear,binary,andstable,reflecting
anunderlyingbiologicalrealitythatisnotcontradictedbyexceptionstosextypicalbehavior,andcannotbe
alteredbysurgeryorsocialconditioning,readsthereport.

Bycontrast,genderidentityisasocialandpsychologicalconceptthatisnotwelldefined,andthereislittle
scientificevidencethatitisaninnate,fixedbiologicalproperty.

Factsabouthumanbiologyshouldnotbeforgottenintherushtoembracenewsocialgoals,warnthe
authors.

Toillustratetheirpoint,theyciteonehospitalspracticeofsurgicallyremovingthepoorlydevelopedgenitalia
ofmaleinfants,andgivingthemfemalegenitalia.Theparentsweredirectedtoraisetheboysasgirls,but
yearslater,whenresearchersfollowedupwiththefamilies,theydiscoveredthatmostofthesubjectsstill
identifiedasmale,despitewhattheyhadbeentold.

Whatisclearisthatbiologicalsexisnotaconceptthatcanbereducedto,orartificiallyassignedonthe
basisof,thetypeofexternalgenitalia,statesthereport.

Overall,theauthorsconclude,Inreviewingthescientificliterature,wefindthatalmostnothingiswell
understoodwhenweseekbiologicalexplanationsforwhatcausessomeindividualstostatethattheirgender
doesnotmatchtheirbiologicalsex....Yetdespitethescientificuncertainty,drasticinterventionsare
prescribedanddeliveredtopatientsidentifying,oridentified,astransgender.

TheWelfareofChildren
Suchdrasticinterventionsareidentifiedasparticularlyproblematicinthecaseofsexreassignment
surgeriesandhormonalinterventionsinthecaseofchildren,sometimesasyoungastwoyearsold.

Thisisespeciallytroublingwhenthepatientsreceivingtheseinterventionsarechildrenwearedeeply
alarmedthatthesetherapies,treatments,andsurgeriesseemdisproportionatetotheseverityofthedistress
beingexperiencedbytheseyoungpeople,andareatanyrateprematuresincethemajorityofchildrenwho
identifyasthegenderoppositetheirbiologicalsexwillnotcontinuetodosoasadults.Moreover,thereisa
lackofreliablestudiesonthelongtermeffectsoftheseinterventions.Westronglyurgecautioninthis
regard.

Indeed,theconcernaboutthewelfareofchildrenwasidentifiedasthepreeminentpriorityofSexualityand
Gender,inMayersprefacetothescientificstudy.Aboveall,hewrote,Idedicateittochildrenstruggling
withtheirsexualityandgender.

SpeakingtotheRegisterAug.19,coauthorDr.PaulMcHughfurtheremphasizedthewelfareofchildrenas
aprimarymotivationforpublicationoftheSexualityandGenderreport.

Weareinaworldwhereeveryonesays,Wewantevidencebasedmedicinefortakinganantibiotic,said
McHugh,whoservedasoneoftheoriginalmembersoftheNationalReviewBoardfortheProtectionof
ChildrenandYoungPeoplethatwascreatedbytheU.S.bishopsin2002toaddressclergysexualabuseof
minors.Butwithoutevidencebasedmedicine,theywanttodoradicalthingstochildren,andweare
protesting.

Whiletheauthorsreservetheirsharpestcriticismfortherapeuticinterventionsthatinvolvechildrenwho
identifyastransgender,theyalsoquestionthevalueofsexreassignmentsurgeryforadults.Somestudies
reviewedbytheauthorsreportahighrateofsuicideattemptsevenafterthesurgeryhastakenplace.

Thescientificevidencesummarizedsuggestswetakeaskepticalviewtowardtheclaimthatsex
reassignmentproceduresprovidethehopedforbenefitsorresolvetheunderlyingissuesthatcontributeto
elevatedmentalhealthrisksamongthetransgenderpopulation,theauthorsstate.

Whileweworktostopmaltreatmentandmisunderstanding,weshouldalsoworktostudyandunderstand
whateverfactorsmaycontributetothehighratesofsuicideandotherpsychologicalandbehavioralhealth
problemsamongthetransgenderpopulation,andtothinkmoreclearlyaboutthetreatmentoptionsthatare
available.

WhatScienceActuallySays
Theauthorsmakeclearthatthereportdoesnotprovideanexhaustivereviewoftheirsubjectinallits
dimensions.

Scienceisbynomeanstheonlyavenueforunderstandingtheseastoundinglycomplex,multifacetedtopics
thereareothersourcesofwisdomandknowledgeincludingart,religion,philosophy,andlivedhuman
experience,theyacknowledge.

However,weofferthisoverviewofthescientificliteratureinthehopethatitcanprovideasharedframework
forintelligent,enlighteneddiscourseinpolitical,professional,andscientificexchangesandmayaddto
ourcapacityasconcernedcitizenstoalleviatesufferingandpromotehumanhealthandflourishing.

InhisremarkstotheRegister,McHughsuggestedthatwitnessclaimsthepersonaltestimonyof
individualswhoexperiencesamesexattractionorofotherswhodontidentitywiththeirbiologicalsex
havefueledmuchofthepublicdebateonsexualityandgenderissues.

McHughaffirmedthesubstantialvalueofpersonaltestimony.ButhealsobelievestheLGBTcommunityand
thegeneralpublicshouldbeawareofthebodyofknowledgeonthesubjectthathascomefromwell
designedscientificstudiesthattestvariousclaims.

Today,manyclaimsaboutsexualityandgenderarebeingmadewiththesuggestionthatsciencesupports
theseclaims,McHughsaid,notingattemptstoequategenderidentitywithraceandbiologicalsexin
governmentpolicies.

Wethinktheconversationneedstoincludewhatscienceactuallysays.
JoanFrawleyDesmondistheRegisterssenioreditor.