Last week I commented on sexual identity formation in little kids. It spawned a large number of comments, both on and off topic. Hesitantly, I will make another post on the topic of sexual identity–this time from a brochure published by my own clinical association.
The American Psychological Association (APA) has a pamphlet on sexual orientation and homosexuality designed to aid understanding and reduce prejudice. My friend, John Freeman, gave me this to me and pointed out an interesting line which we’ll look at in a moment. But first, let me summarize the pamphlet
Sexual orientation, according to the APA is
“an enduring pattern of emotional, romantic, and/or sexual attractions to men, women, or both sexes. Sexual orientation also refers to a person’s sense of identity based on those attractions, related behaviors, and membership in a community of others who share those attractions.”
Right away it is clear they don’t really distinguish between attraction and identity and orientation and identity. You see the simple equation: attraction=orientation/identity. This is where Yarhouse’s studies with individuals within a gay affirming church give ample concrete evidence that such an equation is simplistic and mischaracterizes a set of complex issues. The reality is that one may recognize an attractional pull without it forming a private or public identity.
The APA document continues with the following,
“According to current scientific and professional understanding, the core attractions that form the basis for adult sexual orientation typically emerge between middle childhood and early adolescence.”
Again we see the attractions = orientation. This fits with the popular identity development theory that one moves from discomfort with to pride in attractions and accepts orientation as a given. Interpretive assumptions are given short shrift here.
Now to the good stuff. The brochure asks the question: What causes a person to have a particular sexual orientation? And here is their answer,
There is no consensus among scientists about the exact reasons that an individual develops a heterosexual, bisexual, gay, or lesbian orientation. Although much research has examined the possible genetic, hormonal, developmental, social, and cultural influences on sexual orientation, no findings have emerged that permit scientist to conclude that sexual orientation is determined by any particular factor or factors. Many think that nature and nurture both play complex roles; most people experience little or no sense of choice about their sexual orientation.
This is an interesting paragraph. The APA rightly recognizes that no one factor is likely to determine later orientation. In fact, we’re not really at a point where we can say one factor is X% of the equation. There is no equation yet. It doesn’t mean we won’t have a better sense of it in the future, but as of yet, the problem is not merely a biological process. So, this opens the door to choice and manipulation of one’s orientation unless one subscribes to behavioral naturalism–something most of us would not accept in other areas of life. Obviously no one is suggesting that sexual orientation is as transitory as a passing fancy. And yet the APA recognizes that even when folks don’t experience themselves choosing orientation, there is an interpretative and choice element however subtle and slow the process.
At this point the brochure turns to the problem of discrimination and its impact on gay and lesbian people. No matter your beliefs about homosexuality, you ought to recognize that there is great stigma and mistreatment for those so identified (and also for those who may not fit stereotyped roles but do not have a gay identity). Then the brochure covers the question of mental disorder.
Is homosexuality a mental health disorder? No says the APA and I agree based on the definition of mental illness where it has to cause distress. Not all with a gay identity are distressed, period. This really isn’t the issue.
The brochure goes on but I will mention only one last section. They discuss the validity of therapy intended to change orientation. They state there is, “no scientifically adequate research to show that therapy aimed at changing sexual orientation is safe or effective.” First, this sentence is full of highly charged words whose meaning can be debated: adequate…safe…effective. What constitutes adequate? Safe? Effective? There is some data that is not merely anecdotal suggesting that change is possible and not unsafe (see Yarhouse and Jones’ Ex-Gays(IVP). Now, their data isn’t as strong as it could be, isn’t overwhelmingly positive, but neither can it be denied as an anecdote. On the flip side, there isn’t any adequately scientific data suggestive that change therapies are unsafe and ineffective. Both sides of the research agenda have the same set of weaknesses that one would expect in researching this particular population (i.e., convenience samples).
I agree with the APA that we therapist must respect and person’s right to self-determination. But the APA violates this very principle by disrespecting those who have carefully thought about change. It is a paternalistic stretch to say that every person who wishes to change orientation only does so because of biases or because of a fundamentalist upbringing. The APA wants to be sensitive to a client’s “race, culture, ethnicity, age, gender, gender identity, sexual orientation, religion…” as long as their religion doesn’t guide them to see sexuality in a different light.
All in all, the APA takes a complex set of factors and ends up with, “It just is, so be nice!” I’m all for reducing mistreatment and violations of constitutional rights. But, I expect my scientific organization to spend my dues in a more balanced manner–faithfully representing what is true, whether attractive or not.
Musings on Faith and Psychology 