Any Catholic physician who is breathing and conscious in America knows well the pressure to comply with viewpoints and practices on sexuality and gender that violate Catholic faith and conscience. But as rapidly as professional pressure escalates, scientific support for such perspectives continues to crumble. Assumptions that same-sex sexuality or transgender identity is inborn, unchangeable, and invariably normal are not holding up, suggesting psychiatric treatment for underlying causes may reasonably be expected to lead to decrease or change in these experiences as a by-product of therapy for some individuals.
Researchers who recently completed the largest gene study to date have stated they are now confident there is no single “gay gene” and that one will never be found. A group of 20 scientists from universities and research institutes in the UK, the US, the Netherlands, Australia, Sweden and Denmark and the 23andMe Research Team analyzed existing information from nearly half a million research participants. The researchers studied millions of DNA markers across these individuals’ genomes to find markers that were associated with self-reported same-sex sexual behavior.[i] Their study is “the first to include enough people to be able to link specific genetic variants and same-sex sexual behavior with demonstrable statistical confidence.”[ii]
The researchers found that many genes may individually contribute a very negligible influence toward same-sex behavior, but the genes are not necessarily about sex. Many genes they found to be associated with same-sex behavior correlate with personality traits or psychiatric disorders, including loneliness, openness to experience, risk-taking behavior (smoking and cannabis use), depression, schizophrenia, and, especially for women, bipolar disorder and cannabis use. More research is needed to understand how these genes may interact with experiences in the environment. The researchers found one marker associated with male pattern balding, suggesting that sex hormone regulation may be involved in the biology of same-sex sexual behavior, and another gene related to “mis-smelling.” Olfaction has been found to be important for sexual attraction, although more research is needed to understand if it affects behavior.[iii] Even if all genes that correlated with same-sex behavior are identified in an individual, they do not predict that same-sex sexual behavior will occur. Environment and life experiences make the largest contribution to same-sex behavior, the researchers said.[iv]
The APA Handbook of Sexuality and Psychology, on which the American Psychological Association conferred its “imprimatur” and which it declared “authoritative,”[v], states, “Biological explanations, however, do not entirely explain sexual orientation. Psychoanalytic contingencies are evident as main effects or in interaction with biological factors.”[vi] In addition, the handbook notes that childhood sexual abuse has “associative or potentially causal links” to having same-sex partners for some, though not all.[vii] It based this conclusion on research that includes a 30-year, prospective, longitudinal, case-control study of documented cases of childhood sexual abuse.[viii]
The APA Handbook says,[ix] and abundant rigorous research has established,[x] that same-sex attraction, behavior, romantic partnerships, and identity all change through life experience. Thus we know that some people can change.
Transgender identity is also likely caused by a complex mixture of biological influences and experiences in the environment, according to ten professional organizations, including the American Psychiatric Association in the DSM-5,[xi] the American Psychological Association in the APA Handbook of Sexuality and Psychology,[xii] the American Academy of Pediatricians in its policy statement,[xiii] and the Endocrine Society and the society’s six co-sponsoring organizations in the Endocrine Society guideline for altering bodies to appear more like the opposite sex.[xiv] In support of this view, research so far on identical twins reveals that, if one identical twin lives as the opposite sex, the other usually does not,[xv] indicating it is likely that, as in the case of same-sex behavior, gender-sex discordance develops somewhat from biological influences and largely from experiences in the environment.
Nearly all these same professional organizations say gender dysphoria overwhelmingly desists, or changes, by late adolescence or adulthood.[xvi] Most of these organizations also caution that affirming children to live as the opposite sex stops this natural resolution.[xvii] The American Academy of Pediatricians is an outlier when it denies high desistance rates and advocates for affirming children as another sex at early ages.[xviii] The AAP has aligned itself with a political advocacy organization, the Human Rights Campaign,[xix] and its guideline has been strongly criticized by prominent experts.[xx] [xxi]
The World Professional Association for Transgender Health (WPATH) says gender dysphoria may be “secondary to or better accounted for by other diagnoses.”[xxii] Causes of discordant gender identity may be pathological. New research points toward this being the case for the majority of gender non-conforming adolescents. A study of the electronic medical records of an entire cohort of 8.8 million Kaiser-Permanente members in Georgia, northern California, and southern California over an eight-year period found that the majority of gender non-conforming adolescents (ages 10-17) experienced far higher rates of psychiatric disorders, psychiatric hospitalizations, self-harm, and suicidal ideation compared to gender-conforming peers in the six months leading up to first evidence of gender non-conformity.[xxiii] This may be the first study that provides records that enable us to know that other psychiatric disorders came first, before first evidence of gender non-conformity, showing that psychiatric disorders may well be causal factors. Gender non-conformity could not cause psychiatric disorders and suicidality that precede it, but psychiatric disorders could lead to rejecting one’s body and adopting an alternate identity. These adolescents need psychiatric treatment, not medical procedures that harm their bodies and health.[xxiv]
In summary, same-sex attraction feelings and behaviors and gender-sex discordance are caused somewhat by biological influences and mostly by life experiences, may have pathological causes, and may change through life experience — as is normal for feelings, behaviors, perceptions, traits, and tendencies therapists help people change every day. There is no reason that therapy to change same-sex or gender discordant experiences should be any less safe or effective than any other therapy. It is reasonable to expect that treating underlying trauma and psychiatric disorders — by using evidence-based trauma treatments and well-established practices used by therapists around the world — may as a by-product lead to diminished or resolved unwanted same-sex or gender-sex discordant experiences.
Laura Haynes, Ph.D. is a retired psychologist who reviews research, writes and speaks internationally on sexuality and gender as they relate to therapy, law and global policy. She has testified before legislative committee hearings in several states in the U.S., trained therapists from 25 nations, and addressed U.N. dignitaries and high-level government officials. Dr. Haynes will present on this topic at the CMA Annual Educational Conference on September 26, 2020.
[i] https://geneticsexbehavior.info/wp-content/uploads/2019/08/ganna190830.pdf
[ii] https://geneticsexbehavior.info/what-we-found
[iii] https://geneticsexbehavior.info/wp-content/uploads/2019/08/ganna190830.pdf
[iv] https://geneticsexbehavior.info/what-we-found/
[v] Vandenboss, G. (2014), Series Preface, in Tolman, D., & Diamond, L., Co-Editors-in-Chief (2014) APA Handbook of Sexuality and Psychology, vol. 1, p. xvi [1:xvi], Washington D.C.: American Psychological Association, https://www.apa.org/pubs/books/4311512, Passages quoted or cited throughout this paper from the APA Handbook of Sexuality and Psychology may be found online here: https://docs.wixstatic.com/ugd/ec16e9_396244b80efc4a6f9c27b4653a974132.pdf, p. 1
[vi] Rosario & Shrimshaw, 2014, in APA Handbook, vol. 1, p. 583.
[vii] Mustanski, Kuper, and Geene, in APA Handbook, vol. 1, pp. 609-610.
[viii] https://pubmed.ncbi.nlm.nih.gov/19130206-does-physical-abuse-sexual-abuse-or-neglect-in-childhood-increase-the-likelihood-of-same-sex-sexual-relationships-and-cohabitation-a-prospective-30-year-follow-up/
[ix]Diamond, vol. 1, p. 363; Rosario & Schrimshaw, vol. 1,p. 562; Mustanski, Kuper, & Green, vol. 1, p. 619, in APA Handbook (2014).
[x] https://pubmed.ncbi.nlm.nih.gov/26986464-scrutinizing-immutability-research-on-sexual-orientation-and-us-legal-advocacy-for-sexual-minorities/ p. 7, Table1. For rebuttal on therapy that is open to change, http://www.learntolove.co.za/images/Quiet-Death-of-Sexual-Orientation-Immutability.pdf
[xi] DSM-5, p. 457.
[xii] Bockting (2014) in APA Handbook, vol. 1, pp. 743-744, 750, and see
https://docs.wixstatic.com/ugd/ec16e9_396244b80efc4a6f9c27b4653a974132.pdf , p. 6.
[xiii] https://pediatrics.aappublications.org/content/pediatrics/142/4/e20182162.full.pdf p. 4
[xiv] https://academic.oup.com/jcem p. 6, also p. 7
[xv] https://www.tandfonline.com/doi/abs/10.1080/15532739.2013.750222 . It appears that the figure of 20% identical twin concordance in the abstract should be corrected to 28% by calculations from Table 5, p. 28.
[xvi] DSM-5, p. 455; APA Handbook, op cit and see https://docs.wixstatic.com/ugd/ec16e9_396244b80efc4a6f9c27b4653a974132.pdf , p. 6; https://academic.oup.com/jcem, p. 11.
[xvii] APA Handbook, op cit, and see https://docs.wixstatic.com/ugd/ec16e9_396244b80efc4a6f9c27b4653a974132.pdf , p. 6; https://academic.oup.com/jcem/article/102/11/3869/4157558, op cit.
[xviii] https://pediatrics.aappublications.org/content/pediatrics/142/4/e20182162.full.pdf, p. 4
[xix] https://assets2.hrc.org/files/documents/SupportingCaringforTransChildren.pdf
[xx] https://www.tandfonline.com/doi/full/10.1080/0092623X.2019.1698481
[xxi] https://www.tandfonline.com/doi/abs/10.1080/15532739.2018.1468293, https://www.researchgate.net/publication/333516085_Debate_Different_strokes_for_different_folks
[xxii] https://www.wpath.org/media/cms/Documents/SOC%20v7/Standards%20of%20Care_V7%20Full%20Book_English.pdf
[xxiii] https://pediatrics.aappublications.org/content/pediatrics/141/5/e20173845.full.pdf
[xxiv] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885, https://pubmed.ncbi.nlm.nih.gov/30476120-letter-to-the-editor-endocrine-treatment-of-gender-dysphoricgender-incongruent-persons-an-endocrine-society-clinical-practice-guideline/