Warren Throckmorton, PhD

Sexual Orientation:
What do you think?
Mental health professional associations consider homosexuality to be a mental health disorder
ANSWER: False
 Most mental health professional organizations have adopted policies that do not treat homosexuality as a mental disorder.
 Distress concerning one’s sexual feelings, however, can be a legitimate reason to consult a counselor. The DSM-IV includes the diagnosis:
“302.9 Sexual Disorder Not Otherwise Specified” described as “Persistent and marked distress about sexual orientation” that may require counseling intervention.

 Homosexual behavior recorded from antiquity
 Concept of inborn homosexual orientation dates from 1860s
 Initially homosexuality thought to be a psychiatric illness needing a cure
 Removal of homosexuality from DSM beginning in 1973 brought treatment efforts into question

Sexual Orientation:
What do you think?
You can tell a person’s sexual orientation by the way he or she acts or talks
ANSWER: False
 While some people may go to extremes to let others know about their sexuality, most of the time you cannot tell anything about sexual feelings from how a person looks or acts.
 In fact, many students who are called “gay” or other names at school may not experience same sex attractions. This kind of stereotyping can be harmful.

Sexual Orientation:
What do you think?
A person is a homosexual if he or she has ever been sexually attracted to, or ever had sexual contact with someone of the same gender.
ANSWER: False
 Sexual attraction or behavior does not determine sexual identity.
 Confusion or uncertainty is common in adolescence
 Many individuals are not consistent across aspects of sexual orientation (erotic versus romantic attractions)
 Each individual must determine what his or her feelings or actions mean about sexual identity.

Sexual Orientation:
What do you think?
Scientists know with certainty how sexual orientation develops.
ANSWER: False
 Some scientists believe sexual attractions are primarily determined by genetics and/or prenatal factors
 Others believe that people mainly develop their sexual attractions throughout their life via a combination of life experiences and personal traits.
 No gay gene has been discovered
 Environmental circumstances have not been identified that always lead to same sex attractions for all people.
 Evidence exists to support both points of view, but there is not enough evidence to be conclusive about either viewpoint.

Sexual Orientation:
Biological factors
 LeVay found structural differences in the size of the hypothalamus of gay and straight men
(1991).
 Byne, et al (2001) failed to replicate LeVay’s findings and said “sexual orientation cannot be reliably predicted on the basis of INAH3 volume alone.”
 LeVay used HIV patients in study. HIV impacts brain negatively.

Sexual Orientation:
Biological Factors
LeVay said about his research:
 "It's important to stress what I didn't find. I did not prove that homosexuality is genetic, or find a genetic cause for being gay. I didn't show that gay men are born that way, the most common mistake people make in interpreting my work. Nor did I locate a gay center in the brain. ...Since I look at adult brains, we don't know if the differences I found were there at birth or if they appeared later.“
Nimmons, D. (1994). Sexual brain. Discover, 5, 3.

What about twin research?
 Pairwise concordance rates for male MZ twins have been reported at 11% (3 of 27 male twins) and 14% (3 of 22 female twins) in a 2000 study by Bailey et al (possible 0 – 50% heritability)
 Other personality traits with higher MZ concordances and similar heritabilities include: humility (58%), feelings about roller coasters
(50%) and attitudes toward reading books (55%)

Bailey et al, 2000
Twin research
 “Consistent with prior studies of siblings, we found that sexual orientation is familial. In contrast to most prior twin studies of sexual orientation, however, ours did not provide statistically significant support for the importance of genetic factors for that trait”
(p. 534). Quote from article.

 What about a gay gene?
 Research team led by Dean Hamer found a region on the sex chromosome linked to homosexuality (Xq28).
 Two efforts to replicate his work have failed.
 Newest study in this program claims to have located 3 regions, however none met criteria for significant linkage.
Mustanski, B.S., DuPree, M.G., Nievergelt, C.M., Bocklandt, S., Schork, N.J. & Hamer, D.H.
(2005). A genomewide scan of male sexual orientation. Human Genetics, 116 (4), 272-278.

 Psychoanalytic writers suggest either a deficit in the relationships between same sex parent and child and/or a fear of the opposite sex parent
 Psychoanalytic studies suffer from small and unrepresentative samples
 Slightly higher prevalence of sexual abuse for gay men and lesbians.
 There are significant cultural and historical differences in the manifestation of sexual behavior

 Daryl Bem (1996) from Cornell University suggests a relationship between gender atypical temperament and same sex desire
 The difference experienced by gender atypical teens leads them to view same sex as the opposite sex. The difference becomes sexualized
 Bem’s theory has some empirical support. Bailey et al, 2000 found that gender nonconformity has a genetic component

 "It seems that theory building about the origins of any type of sexual orientation requires a multifactorial model--with biological, psychological and social factors exerting influences at different times and in different degrees." (P. 58)
 "What causes homosexuality? It is apparent that biological, psychological, and social factors interacting in complex and various ways, shape human sexual orientation." (P. 61)
Sexual Orientation and Psychoanalysis: Sexual Science and Clinical Practice (Richard
C. Friedman and Jennifer I. Downey: New York: Columbia University Press, 2002).

Sexual Orientation:
What do you think?
People choose to be attracted to the same or opposite sex.
ANSWER: False
 Although some do, most people who identify as gay, lesbian or bisexual say they do not consciously decide to be attracted to the same sex.
 Women describe a sense of choice more so than men
 However, engaging in sexual behavior and adopting a gay, lesbian or bisexual identity are decisions that often occur after a period of personal reflection.

 Distinguish between same sex attraction and a gay/lesbian identity
 Same sex attractions seems to arise spontaneously for many, seems adopted by others; probably a combination of nature and environmental factors, with the edge toward nonshared environmental factors
 Identity formation is much more deliberate and seems best considered as a chosen construct

Sexual Orientation:
What do you think?
No one has ever changed aspects of sexual orientation
ANSWER: False
 Many people report such changes, some with the help of counseling, some with the support of their religious beliefs and some spontaneously without any conscious attempt to change.
 Since sexual orientation cannot be tested in the laboratory or with a survey, there is no reliable method to say for sure other than the word of the persons involved
 Sexual orientation has been defined via behavior, attractions and identity or a combination of these aspects along a continuum

 "Despite our differing interpretations of his study, both
Dr. Spitzer and myself are of the opinion that there is a small group of people whose sexual orientation can change, sometimes even without any therapy. But neither of us believe that everyone's sexual orientation can change. To claim that everyone can change or that everyone should change is simply not true. To scientifically argue for that position in opposition to gay and lesbian civil rights is not only a misuse of Dr. Spitzer's study but a travesty of science itself."
 Jack Drescher, Chair of the American Psychiatric
Association's (APA) Committee on Gay, Lesbian and Bisexual Issues.
http://www.finnqueer.net/juttu.cgi?s=116_47_2

Counseling &
Sexual Orientation:
Research Issues
 Problems with measurement and definition of sexual orientation
 According to Gonsoriek, et al: sexual orientation is erotic and /or affectional disposition to the same and/or opposite sex
 We use the term sexual orientation to signify a cognitive identification and subjective emotional sense of oneself on a continuum of homosexual/bisexual/heterosexual identity.
This…allows for the possibility that sexual orientation may change over time. (Byne & Parsons)

Does sexual orientation change?
 Stokes, et al (1997) found that in a sample of behaviorally bisexual men, 33% shifted to exclusive homosexuality, 17% shifted to heterosexuality and half remained bisexual after one year.
 Kinnish et al (2005) found that women report more change in aspects of sexual orientation than men.
Two-thirds of the sample (n=762) had experienced some shift in at least one aspect of sexual orientation in their lives. 15% went from gay to either bisexual or straight. 36% changed entire categories (straight to gay or vice versa).

 Diamond (2003) found that 48% of a sample of 80 women changed their sexual identity label during between first assessment and last assessment (5 years).
 Twenty-seven percent of the sample changed their label to heterosexual or undefined from lesbian
 Histories of changers vs. non-changers did not differ
Was it a phase? Young women's relinquishment of lesbian/bisexual identities over a 5-year period. Journal of Personality and Social Psychology, 84, 352-364.

Sexual Orientation:
What to teach in school?
All people who attempt to change aspects of sexual orientation experience depression and suicide attempts.
ANSWER: False
 Some people have reported feeling harmed by their efforts to change sexuality
 Some people have reported feeling helped by them

Counseling &
Sexual Identity Therapy:
Is it harmful?
 In a sample of 202 people recruited from dissatisfied clients of change therapy, Shidlo and
Schroeder found 87% felt harmed and 13% felt helped.
 It took five years to find 176 people who said they had felt harmed.
 Problems plague all research in this area:
Sampling, definitions and measurements of sexual orientation and change cloud the meaning of the results

Counseling &
Sexual Identity Therapy:
Is it harmful?
 In my reviews of the literature (1998) and (2002),
I found evidence of modification of sexual feelings, behavior, fantasies and identity
 Spitzer (2003) reported 66% of men and 44% of women experienced heterosexual functioning after orientation efforts. Many women had not married but were not bothered by same sex attractions.
 43% of men and 47% of women reported depression pre-therapy and 1% of men and 4% post-therapy

Sexual Orientation:
What to teach in school?
Disagreements over homosexuality are always based in fear and homophobia or religious prejudice.
ANSWER: False
 Disagreement with certain forms of sexual behavior is not bigotry.
 Disagreement does not prevent a person from feeling and showing respect

10% of the general population identifies as gay, lesbian or bisexual.
ANSWER: False
 The most authoritative survey (National Health and Social
Life Survey) puts the percentage of those who declare themselves to be gay, lesbian or bisexual at just over 2% of the general population in the United States.
 A recent census survey in Canada found 1.7% of the general population identified as gay, lesbian or bisexual.
 Determining an actual number is complicated by problems defining these terms and by the fact that some people are reluctant to admit their sexual feelings to those doing surveys

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 www.drthrockmorton.com/schools.ppt

Simon LeVay commented:
A person's sexual orientation is not necessarily a fixed, life-long attribute. Sexual orientation can change: for example a woman may be attracted to men for many years, and have a happy marriage and children during that time, and then become aware of samesex attraction in her thirties, forties, or later. This does not mean that she was repressing her homosexuality during that early period. To argue that she was really homosexual all the time would be to change the definition of sexual orientation into something murky and inaccessible. (1995)

Animal Models of Sexual Orientation:
 Gay sheep study – Oregon researchers found levels of testosterone and hypothalamus size of male preferring rams between ewes and female preferring rams (2004)
 Finch study – Baby birds raised without fathers more likely to attempt mating with other males
(2000)
 Which, if any, animal model should we use? Do sheep date?
 Role of environment and biology has not been clarified or explained

 Bailey, J.M., Dunne, M.P. & Martin, N.G. (2000). Genetic and environmental influences on sexual orientation and its correlates in an Australian twin sample. Journal of
Personality and Social Psychology, 78, 524-536.

Bem, D.J. (1996). Exotic becomes erotic: A developmental theory of sexual orientation.
Psychological Review, 103 , 320-335.

Broido, E.M. (2000). Constructing identity: The nature and meaning of lesbian, gay and bisexual identities. In the Handbook of Counseling and Psychotherapy with Lesbian, Gay and Bisexual Clients , Eds, Washington, DC: American Psychological Association.

Byne, W. & Parsons, R. (1993). Human sexual orientation: The biologic theories reappraised. Archives Gen. Psychiatry 228, 229-243.
 Diamond, L. (2003). Was it a phase? Young women's relinquishment of lesbian/bisexual identities over a 5-year period. Journal of Personality and Social Psychology , 84 , 352-
364.
 Friedman, R. (1988). Male homosexuality.
New Haven: Yale University Press.
 Garnets, L.D. (2002). Sexual orientations in perspective. Cultural Diversity and Ethnic
Minority Psychology, 8 (2), 115-129.
 Laumann., E.O., Gagnon, J.H., Michael, R.T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States . Chicago: University of
Chicago Press.

Mondimore, F. M. (1996). A natural history of homosexuality. Baltimore: Johns Hopkins
Press.

 Nimmons, D. (1994). Sexual brain. Discover, 5, 3.
 Schidlo, A., & Schroeder, M. (2002). Changing sexual orientation: A consumers’ report. Professional Psychology: Research and Practice,
33, 249-259.
 Spitzer, R.L. (2003). Can some gay men and lesbians change their sexual orientation? 200 participants reporting a change from homosexual to heterosexual orientation . Archives of Sexual Behavior,
32 , 403-417.
 Stein, E. (1999). Mismeasure of desire: The science, theory and ethics of sexual orientation. Oxford: Oxford University Press.
 Throckmorton, W. (1998). Efforts to modify sexual orientation: A review of the outcome literature and ethical issues. Journal of Mental Health
Counseling , 20, 283-304.
 Yarhouse, M. A., & Throckmorton, W. (2002). Ethical issues in attempts to ban reorientation therapies. Psychotherapy:
Theory/Research/Practice/Training, 39, 66-75