September 2, 2014

Happy 107th Birthday, Dr. Evelyn Hooker

Posted at 12:01 am (Pacific Time)

Today is the 107th anniversary of the birth of Dr. Evelyn Hooker, the psychologist who is widely credited with helping to establish that homosexuality is not inherently linked to mental illness.

Dr. Evelyn HookerIn the course of her remarkable life, Dr. Hooker surmounted many of the barriers faced by women who sought an academic career in the 20th century.

She was born Evelyn Gentry on September 2, 1907, to a poor farm family in North Platte, Nebraska. The sixth of nine children, she received her early education in one-room schoolhouses on the Nebraska prairie, followed by high school in Sterling, Colorado. She subsequently earned baccalaureate and master’s degrees at the University of Colorado.

She wanted to apply to the doctoral psychology program at Yale but her University of Colorado department chairman (himself a Yale graduate) refused to recommend a woman. Instead, she entered the graduate program at Johns Hopkins University, receiving her Ph.D. in 1932.

She taught at the Maryland College for Women and then at Whittier College. While at Whittier, she received a fellowship to study psychotherapy for a year in Germany. As Hitler was ascending to power, she resided with a Jewish family in Berlin. While in Europe, she also visited Russia shortly after Stalin’s purge of 1938. Those experiences in totalitarian states further deepened her interest in working for social justice and human rights.

Whittier fired Dr. Hooker and several of her colleagues for their liberal political beliefs. She was subsequently hired by UCLA as an adjunct faculty member. According to the department chairman, she was relegated to that status because the Psychology Department faculty (all but three of whom were men) were unwilling to appoint another woman to a tenure-track position.

In 1951, she married Edward Niles Hooker, a distinguished UCLA professor of English and the man she called her “true love.” He died suddenly in 1957, a loss that deeply pained her.

Dr. Hooker is best known for her psychological research in the 1950s and 1960s with gay men.

Her studies were innovative in several important respects. Rather than simply accepting the conventional wisdom that homosexuality is a pathology, she used the scientific method to test this assumption. And rather than studying homosexual psychiatric patients, she recruited a sample of gay men who were functioning normally in society.

For her best known study, published in 1957 in The Journal of Projective Techniques, she recruited 30 homosexual males and 30 heterosexual males through community organizations in the Los Angeles area. The two groups were matched for age, IQ, and education. None of the men were in therapy at the time of the study.

She administered three projective tests to the men — the Rorschach inkblot test, the Thematic Apperception Test (TAT), and the Make-A-Picture-Story (MAPS) Test). Then she asked outside experts to use the test data to rate each man’s mental health. Although today it seems like an obvious safeguard against bias, Dr. Hooker’s was the first published study to utilize raters who did not know the sexual orientation of the study participants.

Using the Rorschach data, two of the independent experts evaluated the men’s overall adjustment using a 5-point scale. They classified two-thirds of the heterosexuals and two-thirds of the homosexuals in the three highest categories of adjustment.

Hooker presented the judges with the 60 Rorschach protocols in random order and asked them to identify each man’s sexual orientation. Only six of the homosexual men and six of the heterosexual men were correctly identified by both judges. She later gave the judges another opportunity, this time presenting them with matched pairs of protocols, one from a homosexual man and one from a heterosexual. Only 12 of the 30 pairs elicited correct responses from both judges.

A third expert used the TAT and MAPS protocols to evaluate the men’s psychological adjustment. As with the Rorschach responses, the adjustment ratings of the homosexuals and heterosexuals did not differ significantly.

Dr. Hooker concluded from her data that homosexuality is not a clinical entity and that homosexuality is not inherently associated with psychopathology. Her findings have since been replicated by other investigators using a variety of research methods.

In retrospect, we can see that Dr. Hooker’s main hypothesis — that no group differences in psychological distress should exist between heterosexual and homosexual samples — actually applied too strict a test. We know today that some members of stigmatized groups manifest elevated rates of psychological distress — for example, because of the stress imposed on them by social ostracism, harassment, discrimination, and violence. Such correlations don’t mean that group membership is itself a pathology.

By documenting that well-adjusted homosexuals not only existed but in fact were numerous, Dr. Hooker’s research demonstrated that the illness model had no scientific basis. She helped to lay the foundation for the American Psychiatric Association’s 1973 decision to remove homosexuality from its Diagnostic & Statistical Manual of Mental Disorders, and for the American Psychological Association’s subsequent commitment to removing the stigma that has historically been attached to homosexuality.

Dr. Hooker died at her Santa Monica home on November 18, 1996. Her pioneering research and remarkable life were honored with awards from numerous professional organizations, including the American Psychological Association, and many advocacy and community groups.

* * * *

For more information, see the 1992 Oscar-nominated documentary, Changing Our Minds The Story of Dr. Evelyn Hooker.

A biographical sketch and a selected bibliography of Dr. Hooker’s publications can be found on my website.

* * * * *

Postscript. Although homosexuality has not been classified as a mental disorder in the United States for decades, the International Classification of Diseases (ICD) still lists several diagnoses related to homosexuality (although not homosexuality itself) as pathological. For example, “ego-dystonic” sexual orientation, which was removed from the DSM in the 1980s, remains in the ICD.

In preparation for the upcoming 11th edition of the ICD, the World Health Organization created a Working Group on the Classification of Sexual Disorders and Sexual Health to review these diagnoses. In a report released this summer, the Working Group, headed by Prof. Susan Cochran of UCLA, recommended that all of them be eliminated.

The Working Group’s recommendations will be reviewed by the ministers of health from more than 170 WHO countries, including Russia, Uganda, Nigeria, and other nations where sexual stigma is enshrined in law.

* * * * *

This entry is an expanded and updated version of a 2008 Beyond Homophobia post.

Copyright © 2014 by Gregory M. Herek. All rights reserved.

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June 26, 2008

Five Years Ago Today: Reflections on Lawrence v. Texas

Posted at 12:01 am (Pacific Time)

On June 26, 2003, the US Supreme Court issued its opinion in the Lawrence v. Texas case, ruling that state laws restricting adults’ rights to engage in private, consenting sexual behavior are unconstitutional.

Today, on the fifth anniversary of that historic decision, it seems appropriate to recall the events leading up to it and to consider what has happened since.

Consistent with this blog’s focus, I’ll emphasize the social science research data relevant to the case as presented to the Court in an amicus brief filed by the American Psychological Association (APA) and other professional organizations. I had the privilege of helping to write the APA’s briefs for Lawrence and the other cases mentioned below, all of which sought to inform the Court about current scientific knowledge related to homosexuality and sexual orientation.

Bowers v. Hardwick

Before discussing Lawrence, it’s important to recall the Court’s decision 17 years earlier in Bowers v. Hardwick.

Michael Hardwick was arrested in his Atlanta home after a police officer (who had been admitted to the home by a houseguest) peered through Hardwick’s partially open bedroom door and saw him engaging in oral sex with a male companion. Georgia had a sodomy law that, like the laws in many other states at the time, criminalized oral and anal sex between same-sex and different-sex partners alike.

With assistance from the American Civil Liberties Union, Hardwick brought a suit against the state Attorney General, Michael Bowers, challenging the law’s constitutionality. The case reached the US Supreme Court in its 1985–1986 term, and the APA filed an amicus brief jointly with the American Public Health Association.

That brief detailed the current state of scientific thinking and empirical research about homosexuality, explaining that the sexual conduct made illegal by the Georgia statute was common in both heterosexual and homosexual relationships, and was neither pathological nor harmful to the individual. Rather, the brief argued, such behaviors play a key role in maintaining intimate relationships, which in turn are important for the psychological well-being of heterosexual and homosexual individuals alike. The brief also explained that homosexuality is not a psychological disorder and it rebutted arguments by the Georgia Attorney General that the statute was an effective deterrent to the spread of AIDS.

By a 5–4 majority, the Court upheld the Georgia statute, declaring that states can legally regulate the private sexual behavior of consenting adults. This outcome was made all the more disappointing by later revelations that Justice Powell had initially sided with the justices who wanted to overturn the statute but then changed his vote. Justice Powell commented that he had never personally known any gay people. Ironically, several of his law clerks over the years had been gay but, out of concern for their careers, none had disclosed that fact to Justice Powell.

Three aspects of the majority opinion by Justice White and the concurring opinion by Chief Justice Burger are especially noteworthy.

  • First, the opinions framed the legal question very narrowly and addressed only homosexual conduct even though the Georgia statute made both heterosexual and homosexual sodomy illegal. As Justice White put it, “The issue presented is whether the Federal Constitution confers a fundamental right upon homosexuals to engage in sodomy and hence invalidates the laws of the many States that still make such conduct illegal and have done so for a very long time” (p. 190).
  • Second, both opinions found justification for their legal reasoning in religious and moral traditions. Justice White wrote that proscriptions against homosexual conduct “have ancient roots” (p. 194). Chief Justice Burger asserted that “To hold that the act of homosexual sodomy is somehow protected as a fundamental right would be to cast aside millennia of moral teaching” (p. 197).
  • Third, the opinions constructed same-sex sexuality as something very different from heterosexuality, declaring that it has no relationship to families. Justice White wrote, “No connection between family, marriage, or procreation on the one hand and homosexual activity on the other has been demonstrated, either by the Court of Appeals or by respondent” (p. 191). Elaborating further on this theme, he equated homosexual behavior with incest and heterosexual adultery, predicting that if the court were to decide that the Constitution protects the right to “voluntary sexual conduct between consenting adults, it would be difficult, except by fiat, to limit the claimed right to homosexual conduct while leaving exposed to prosecution adultery, incest, and other sexual crimes even though they are committed in the home” (p. 194).

The Bowers decision was a great blow to proponents of equality for sexual minorities. However, an opportunity to challenge it came surprisingly soon.

Lawrence v. Texas

In 1998, John Lawrence and Tyron Garner were arrested in Texas for having consensual sex in Lawrence’s bedroom. The Texas sodomy law was similar to Georgia’s in that it criminalized oral and anal sex. Unlike the Georgia statute, however, the Texas law applied only to conduct between people of the same sex. In a lengthy series of appeals, the lower courts refused to overturn the law, citing Bowers v. Hardwick as precedent. Lawrence and Garner finally appealed to the US Supreme Court, which heard the case in the spring of 2003.

For several reasons, legal experts believed it might be possible to overturn Bowers v. Hardwick at this time. Many states had eliminated their sodomy laws, either through the legislative process or because courts had found them to be in violation of the state constitution. Gay people had become much more openly integrated into American life, and public opinion surveys revealed widespread opposition to antigay discrimination. The membership of the Supreme Court had also changed since 1986, and the Court’s 1996 Romer v. Evans ruling suggested it was more receptive to gay issues than in the past. In addition, many legal scholars regarded the Bowers v. Hardwick opinion as not well reasoned and considered it an embarrassment to the Court.

The APA — joined by the American Psychiatric Association and the National Association of Social Workers — filed an amicus brief, one of more than two dozen such briefs submitted in the Lawrence case. As in Bowers v. Hardwick, the APA brief summarized the current state of scientific knowledge relevant to the case, citing an extensive list of empirical studies and literature reviews in support of its conclusions.

Although some aspects of the Lawrence brief were very similar to the earlier Bowers brief, a much larger body of scientific research on sexual orientation was available than had been the case 17 years earlier. In addition, consistent with the Texas statute, the Lawrence brief focused on research about homosexuality. It stressed three major conclusions from behavioral and social science research findings:

  • Homosexuality is a normal form of human sexuality. In connection with this point, the brief explained why and how sexual orientation is important to the individual; how sexual orientation develops, and the fact that most people do not perceive their sexual orientation to be a choice; and the mental health professions’ recognition that homosexuality is not a mental disorder.
  • Trying to legally suppress sexual intimacy among same-sex partners deprives gay men and lesbians of the opportunity to participate in fundamental aspects of human experience. In this regard, the brief discussed the importance to gay men and lesbians of sexual intimacy and committed relationships; the centrality of the specific behaviors proscribed by the Texas statute to sexual intimacy and, therefore, to the intimate relationships that are at the core of lesbian and gay families; the similarities between same-sex and heterosexual intimate relationships; and the ability of gay men and lesbians to be good parents.
  • Sodomy statutes — such as the Texas law — reinforce prejudice, discrimination, and violence against gay men and lesbians. Related to this point, the brief presented research findings on the discrimination, prejudice, and violence routinely encountered by gay people, and discussed how antisodomy statutes reinforce and help to perpetuate those enactments of sexual stigma.

Five years ago today, the Court declared the Texas law unconstitutional by a 6–3 majority, reversing Bowers v. Hardwick.

Justice Kennedy’s majority opinion was sweeping in its language and its recognition of the basic humanity of gay people. This is evident in his criticism of how the 1986 Court majority had approached Bowers v. Hardwick:

To say that the issue in Bowers was simply the right to engage in certain sexual conduct demeans the claim the individual put forward, just as it would demean a married couple were it to be said marriage is simply about the right to have sexual intercourse…. When sexuality finds overt expression in intimate conduct with another person, the conduct can be but one element in a personal bond that is more enduring. The liberty protected by the Constitution allows homosexual persons the right to make this choice (p. 567).

Justice Kennedy also noted that the continuance of Bowers as precedent “demeans the lives of homosexual persons” (p. 575), and asserted that “Bowers was not correct when it was decided, and it is not correct today” (p. 578). Near the end of the opinion, he wrote, “The petitioners are entitled to respect for their private lives. The State cannot demean their existence or control their destiny by making their private sexual conduct a crime” (p. 578).

These statements represented a dramatic break with the Bowers Court’s view of gay people.

What was the impact of the APA  briefs on the Court? In 1986, Justice Blackmun cited the APA brief in his impassioned dissent to Bowers v. Hardwick. Subsequently, in overturning their sodomy laws, some state courts relied on information from the APA amicus briefs submitted to them. The 2003 brief wasn’t explicitly cited in the written opinions for the Lawrence case, although some of Justice Kennedy’s recurring themes — his recognition of the humanity of gay men and lesbians, and the fact that sexuality is central to personal identity and intimate relationships — were repeatedly stressed in it.

Although we don’t know whether and to what extent the brief affected the Lawrence decision, what matters is that it was filed. As a joint effort by the largest mental health professional associations in the United States — whose memberships also include many of the country’s leading behavioral scientists — the brief illustrated just how far psychology and psychiatry have come in their understanding of human sexuality and their renunciation of sexual stigma.

The Marriage Equality Cases

The ink had barely dried on Justice Kennedy’s decision when questions began to be raised about its impact on marriage laws. Indeed, the justices directly addressed this question in their opinions, with Justice Scalia’s dissent interpreting the majority opinion as leading inevitably to marriage equality (an outcome not to his liking), and Justice Kennedy denying that such a conclusion was in any way inevitable. Justice O’Connor, who wrote a separate concurring opinion, made a point of separating the Lawrence decision from the marriage issue.

Less than six months after the Lawrence decision, the Massachusetts Supreme Judicial Court cited it in their ruling that prohibiting same-sex couples from marrying violated the state constitution. A few months later, Mayor Gavin Newsom directed the San Francisco County Assessor to issue marriage licenses to same-sex couples, and officials in a few other jurisdictions did likewise. Thus began a period of intense legal, political, and cultural focus on the issue of marriage equality.

In the past 4 years, several state courts have considered challenges to their marriage laws. The APA and other professional groups filed amicus briefs in those cases which summarized the social science research related to three major lines of argument:

  • In psychological terms, intimate same-sex relationships are not fundamentally different from different-sex relationships.
  • Gay and lesbian couples are currently raising children, and are just as capable as heterosexual couples in this regard.
  • Marriage confers a variety of tangible and intangible benefits that have important effects on psychological and physical health; because they cannot marry, same-sex couples are currently denied these benefits.

I’ve discussed the social science data supporting these arguments in previous posts to this blog.

To date, most of those laws have been upheld by state courts, although the New Jersey Supreme Court ruled that same-sex couples must be granted the same rights and responsibilities as different-sex married couples.

The important exception, of course, is California, whose Supreme Court ruled on May 15 that it is unconstitutional to deny marriage rights to Californians simply because they are gay.

That decision — which also declared that sexual orientation will now be considered a “suspect classification” and that laws and policies discriminating on the basis of sexual orientation will be subjected to strict judicial scrutiny — repeatedly cited the Lawrence v. Texas opinion. It also cited the APA amicus brief, as detailed in a previous post.

In the months ahead, Californians will debate whether or not the Court’s ruling should be undone by a constitutional amendment that has qualified for the November ballot. Meanwhile, a decision about Connecticut’s marriage law is expected from that state’s Supreme Court at any time, and an appeal is pending for an Iowa lower court judge’s opinion that the state’s ban on marriage rights for same-sex couples is unconstitutional.

*          *          *          *          *

Back in 1975, soon after the American Psychiatric Association removed homosexuality from its official roster of mental illnesses, the American Psychological Association (APA) adopted a resolution that not only endorsed the psychiatrists’ action, but also recognized psychologists’ responsibility to undo the harm their profession had historically done to sexual minorities. That resolution committed psychologists to “to take the lead in removing the stigma of mental illness that has long been associated with homosexual orientations.”

The APA’s amicus briefs in the Bowers, Lawrence, and related cases were translations of that resolution into concrete action.

Because current debates about law and policy concerning sexual orientation inevitably raise questions about the nature of intimate relationships, parenting, family dynamics, and the personal impact of sexual stigma — phenomena that have been extensively studied by behavioral and social scientists — psychologists and other behavioral scientists have an ongoing role to play in communicating our knowledge to policy makers, jurists, and the public.

By doing so, we will continue to fulfill our longstanding commitment to take the lead in removing the stigma historically attached to homosexuality and same-sex intimate relationships.

*          *          *          *          *

This essay is adapted from sections of a longer article titled “Confronting Sexual Stigma and Prejudice: Theory and Practice,” which was published in 2007 in the Journal of Social Issues, vol. 63, pp. 905-925. The original article is copyright © 2007 by Gregory M. Herek. Sources and bibliographic references can be found in the published article.

Copyright © 2008 by Gregory M. Herek. All rights reserved.

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May 19, 2008

Traditional Values Coalition Defers to Science

Posted at 9:00 am (Pacific Time)

The Traditional Values Coalition’s May 15th response to the California Supreme Court’s marriage equality ruling contained a big surprise.

I’m not referring to their view of the decision itself, which was predictably negative. TVC characterized it as a “stunning example of the ultimate tyranny of judicial activism” that “makes the voters’ will unconstitutional” and “effectively destroyed the sanctity of marriage defined as between only a man and a woman.”

No, the surprise was in their explanation of why they believe the California justices were wrong to rule that sexual orientation is a suspect classification under California law, a decision that means the California courts will now subject any laws and policies that discriminate against sexual minorities to “strict scrutiny,” the same standard that is used to evaluate the legality of gender and racial discrimination.

According to the TVC,

….This decision is also fundamentally wrong because homosexuality has never been declared by the American Psychiatric Association, the American Psychological Association, or the National Academy of Sciences as being completely genetic, nor does it fulfill the other requirements for minority-status classification. Therefore, it is still a behavior-based lifestyle choice that should not be given the equivalent of insular and discreet minority status.

Disregard the phrase about genetics. The question of whether or not sexual orientation is innate has long been a concern of the TVC’s leader, Rev. Lou Sheldon. The truly interesting subtext here is that the TVC now accepts scientific authority — including the two APAs — as the appropriate source for factual information about sexual orientation.

What a refreshing departure from the Christian Right’s frequent attempts to distort and subvert the findings of scientific research!

Since the TVC would surely never do anything so intellectually dishonest as to selectively cite only the research findings that are consistent with their own ideological position, I guess we can now expect them to echo other assertions by the APAs that are based on scientific research about sexual orientation and sexual minorities.

Here are some good candidates for immediate TVC endorsement.

  • “[T]here is no scientific evidence that parenting effectiveness is related to parental sexual orientation: lesbian and gay parents are as likely as heterosexual parents to provide supportive and healthy environments for their children.”
  • “[R]esearch has shown that the adjustment, development, and psychological well-being of children is unrelated to parental sexual orientation and that the children of lesbian and gay parents are as likely as those of heterosexual parents to flourish.”
  • And in its Resolution on Sexual Orientation & Marriage that same year, the APA found that “psychological research on relationships and couples provides no evidence to justify discrimination against same-sex couples.”
  • For its part, the American Psychiatric Association has concluded that “altering sexual orientation is not an appropriate goal of psychiatric treatment.” Moreover, “the American Psychiatric Association opposes any psychiatric treatment, such as ‘reparative’ or ‘conversion’ therapy, which is based upon the assumption that homosexuality per se is a mental disorder, or based upon a prior assumption that the patient should change his/her homosexual orientation.”

While we await the TVC’s embrace of these and other APA declarations, a clarification is in order concerning their criticism of the California Court decision.

It’s true that the amicus brief filed by two APAs, the California Psychological Association, and the National Association of Social Workers and its California chapter correctly noted that scientific research has not determined the origins of sexual orientation. This was stated in Footnote 60 of the brief:

Although much research has examined the possible genetic, hormonal, developmental, social, and cultural influences on sexual orientation, no findings have emerged that permit scientists to conclude that sexual orientation — heterosexuality, homosexuality, or bisexuality — is determined by any particular factor or factors. The evaluation of amici is that, although some of this research may be promising in facilitating greater understanding of the development of sexual orientation, it does not permit a conclusion based in sound science at the present time as to the cause or causes of sexual orientation, whether homosexual, bisexual, or heterosexual. [bibliographic references omitted]

And here’s the text of the paragraph in the body of the brief where that footnote appeared:

As noted [above], homosexuality is neither an illness nor a disability, and the mental health professions do not regard a homosexual orientation as harmful, undesirable, or requiring intervention or prevention. Currently, there is no scientific consensus about the specific factors that cause an individual to become heterosexual, homosexual, or bisexual — including possible biological, psychological, or social effects of the parents’ sexual orientation.[60] However, the available evidence indicates that the vast majority of lesbian and gay adults were raised by heterosexual parents and the vast majority of children raised by lesbian and gay parents eventually grow up to be heterosexual.

Although the TVC correctly characterized the two APAs’ statement in the brief, the question of origins became irrelevant to sexual orientation’s status as a suspect classification under California law as of last Thursday’s ruling. I’m not a legal expert, but I think the California Supreme Court decision explains this pretty clearly in several passages. Here’s what the majority opinion said on pp. 96-98 (with legal case citations and quotations omitted and some punctuation modified).

First, the justices stated their opinion about the status of sexual orientation:

[W]e conclude that sexual orientation should be viewed as a suspect classification for purposes of the California Constitution’s equal protection clause and that statutes that treat persons differently because of their sexual orientation should be subjected to strict scrutiny under this constitutional provision.

Next, they summarized the lower court’s rationale for not using strict scrutiny:

In addressing this issue, the majority in the Court of Appeal stated: “For a statutory classification to be considered ‘suspect’ for equal protection purposes, generally three requirements must be met. The defining characteristic must (1) be based upon an immutable trait; (2) bear no relation to [a person's] ability to perform or contribute to society; and (3) be associated with a stigma of inferiority and second class citizenship, manifested by the group’s history of legal and social disabilities. While the latter two requirements would seem to be readily satisfied in the case of gays and lesbians, the first is more controversial.” Concluding that “whether sexual orientation is immutable presents a factual question” as to which an adequate record had not been presented in the trial court, the Court of Appeal ultimately held that “[l]acking guidance from our Supreme Court or decisions from our sister Courts of Appeal,” the court would review the marriage statutes under the rational basis, rather than the strict scrutiny, standard.

Then the justices provided the very guidance that the Court of Appeal said it lacked. They explained why strict scrutiny is to be used in cases involving sexual orientation discrimination:

Past California cases fully support the Court of Appeal’s conclusion that sexual orientation is a characteristic (1) that bears no relation to a person’s ability to perform or contribute to society, and (2) that is associated with a stigma of inferiority and second-class citizenship, manifested by the group’s history of legal and social disabilities.

We disagree, however, with the Court of Appeal’s conclusion that it is appropriate to reject sexual orientation as a suspect classification, in applying the California Constitution’s equal protection clause, on the ground that there is a question as to whether this characteristic is or is not “immutable.” …[I]mmutability is not invariably required in order for a characteristic to be considered a suspect classification for equal protection purposes.

And the justices noted a parallel that must have been particularly interesting to the TVC:

California cases establish that a person’s religion is a suspect classification for equal protection purposes… and one’s religion, of course, is not immutable but is a matter over which an individual has control. Because a person’s sexual orientation is so integral an aspect of one’s identity, it is not appropriate to require a person to repudiate or change his or her sexual orientation in order to avoid discriminatory treatment.

Thus, although the TVC is correct (in my opinion) to defer to scientific authority concerning the current state of knowledge about sexual orientation’s origins, they are wrong in arguing that sexual orientation must be “completely genetic” in order to be a suspect classification under California law, and that it doesn’t “fulfill the other requirements for minority-status classification.” The California Supreme Court — whose ruling on such issues is the last word — has said otherwise.

Presumably, the TVC will soon correct this factual inaccuracy about California law on its website and in its public statements.

I’ll be watching for that, just as I’ll be eagerly waiting for the TVC to revise its past statements about sexual minorities so they are consistent with mainstream scientific opinion.

But maybe I won’t hold my breath.

Copyright © 2008 by Gregory M. Herek. All rights reserved.

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December 13, 2007

AIDS and Quarantine: Looking Backward

Posted at 4:08 am (Pacific Time)

Quarantine: Enforced isolation or restriction of free movement imposed to prevent the spread of contagious disease. (American Heritage Dictionary of the English Language, 4th edition).

Last Saturday, the Associated Press revealed Republican presidential candidate Mike Huckabee’s responses to questions about AIDS and homosexuality during his 1992 campaign for the US Senate. On the topic of AIDS, Mr. Huckabee stated:

If the federal government is truly serious about doing something with the AIDS virus, we need to take steps that would isolate the carriers of this plague…. It is difficult to understand the public policy towards AIDS. It is the first time in the history of civilization in which the carriers of a genuine plague have not been isolated from the general population, and in which this deadly disease for which there is no cure is being treated as a civil rights issue instead of the true health crisis it represents.

According to a Sunday AP story, Huckabee stands by his 1992 statement.

“I still believe this today,” he said in a broadcast interview, that “we were acting more out of political correctness” in responding to the AIDS crisis. “I don’t run from it, I don’t recant it,” he said of his position in 1992. Yet he said he would state his view differently in retrospect.

When Huckabee expressed his opinion in 1992, scientific research had identified the human immunodeficiency virus as the cause of AIDS and it was well understood that, unlike many other communicable diseases, HIV could not be transmitted through casual social contact.

That message had been strongly reinforced the previous year when Los Angeles Lakers superstar Earvin “Magic” Johnson publicly disclosed his HIV infection. Indeed, in its November 18, 1991 issue that featured Johnson on the cover, Sports Illustrated included a special “For Kids Only” page that tried to explain the news to readers 12 and younger. Roughly half of that article stressed that HIV isn’t spread through casual social contact. After listing the many ways in which AIDS isn’t contracted, it summarized the message:

The truth is, AIDS is a disease that’s hard for young kids to get. It’s almost impossible for any kid to get AIDS from doing everyday things such as going to school. (p. 46)

There was no credible medical or public health argument in support of quarantining people with AIDS in 1992. Rejecting calls for quarantine and similar punitive measures wasn’t a matter of being “politically correct.” Rather, it was based on sound evidence about the nature of HIV.

Nevertheless, a substantial minority of the US public shared Huckabee’s view. In a 1991 national telephone survey that I conducted with funding from the National Institute of Mental Health, 34% of US adults agreed with the statement, “People with AIDS should be legally separated from others to protect the public health.” (By 1999, only 12% of survey respondents expressed such sentiments.)

What was behind this support for quarantine? For some people, it reflected an unfounded belief that AIDS could be easily transmitted. Their support for quarantine was part of a general fear of contact with HIV-positive individuals.

Such misapprehensions and fears are still around. A 2006 Kaiser Family Foundation national survey found that more than one third of Americans still didn’t know that HIV isn’t spread through kissing, and nearly one fourth didn’t know it can’t be spread by sharing a drinking glass. More than one fifth of the Kaiser survey respondents said they would be uncomfortable about having a coworker who is HIV-infected, and 30% of parents in the sample expressed discomfort at the prospect of their child having a teacher who is HIV-positive.

For others, however, support for quarantine was less about fear of HIV infection than it was about using the AIDS epidemic as an opportunity to express their preexisting prejudices against lesbians and gay men. In analyses of survey data from the latter half of the 1990s with my UCD colleague, Professor John Capitanio, I found that most heterosexuals continued to associate AIDS primarily with homosexuality or bisexuality, and this association was correlated with higher levels of sexual prejudice. In addition, although everyone who contracted AIDS sexually was blamed to some extent for becoming infected, gay and bisexual men were blamed more than heterosexual men and women. Moreover, sexual prejudice was correlated with both misconceptions about HIV transmission and discomfort with HIV-infected people.

This linkage of AIDS-related stigma and sexual prejudice highlights the relevance of Mr. Huckabee’s 1992 survey response on the topic of homosexuality:

I feel homosexuality is an aberrant, unnatural, and sinful lifestyle, and we now know it can pose a dangerous public health risk.

I can’t say whether Mr. Huckabee’s support for taking unnecessary punitive measures against people with AIDS was fueled by his negative attitudes toward homosexuality. However, sexual prejudice apparently has led many Americans to respond in a similar manner.

The fact that Mr. Huckabee is standing by his 1992 comments is disturbing in light of the continuing danger that HIV poses to gay and bisexual men in the United States. HIV infections appear to be increasing among young sexual minority men, the generation too young to have experienced the ravages of the epidemic during the 1980s and 1990s. Those men have reached sexual maturity during an era when homosexuality remains stigmatized, federal law explicitly delegitimizes same-sex relationships, and HIV researchers are advised to delete words pertaining to gay men and homosexuality from the abstracts and titles of their federal grant applications if they hope to be funded.

This situation recently led to a call for a new commitment to combating the spread of HIV among men who are gay, bisexual, or involved in sexual contact with other men (MSM). Writing in the Journal of the American Medical Association, three prominent AIDS researchers stressed the urgent need for leadership from public health officials and within the sexual minority community. Among other actions, they stressed the need to:

… call for the end of stigma toward MSM, which may mitigate the internalization of homophobia leading to sexual risk behavior. This need is particularly critical within racial and ethnic minority MSM communities that bear the stigma of homosexuality along with the discrimination faced by these minorities. Political leadership is also needed to advocate for legal domestic partnerships as a way to promote stable, longer-term MSM relationships. (Jaffe et al., 2007, p. 2413)

Unfortunately, even with such leadership, the prospects for a renewed commitment to implementing effective programs to stop the spread of HIV are bleak as long as serious contenders for national office still believe that quarantining people with HIV was a reasonable idea in 1992.

# # # # #

For the Associated Press article about Mr. Huckabee’s 1992 questionnaire responses, see A. DeMillo. (2007, December 8). Huckabee wanted to isolate AIDS patients. San Francisco Chronicle.

For the JAMA editorial, see H. W. Jaffe, R.O. Valdiserri, & K.M. De Cock. (2007). The reemerging HIV/AIDS epidemic in men who have sex with men. Journal of the American Medical Association, 298, 2412-2414.

For more discussion of research on the link between sexual prejudice and HIV-related stigma, see G. M. Herek & J. P. Capitanio. (1999). AIDS stigma and sexual prejudice. American Behavioral Scientist, 42, 1130-1147.

Copyright © 2007 by Gregory M. Herek. All rights reserved.

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September 25, 2007

The Iran-Cameron Connection

Posted at 4:01 pm (Pacific Time)

Q: What does the president of Iran have in common with certain antigay activists in the United States?
A: Both maintain that homosexuals don’t really exist.

Yesterday, when Iranian President Mahmoud Ahmadinejad denied the existence of homosexuals in his country, the audience at Columbia University responded with laughter and derision.

Asked about the persecution of homosexuals in Iran, Ahmadinejad answered:

“In Iran, we don’t have homosexuals, like in your country. We don’t have that in our country. In Iran, we do not have this phenomenon. I don’t know who’s told you that we have it.”

The policies of Ahmadinejad’s own government would appear to contradict his statement. As documented by HOMAN (the US-based Iranian Gay, Lesbian, Bisexual and Transgender Organization) and the Iranian Queer Organization (IRQO), Iranian law severely punishes men and women who engage in homosexual behavior. The punishment for male-male sex involving penetration is death. In 2005, two gay teenage boys were hanged after admitting to having sex with each other.

The public response to Ahmadinejad’s assertion has been similar to that of the Columbia audience. To most Americans, the idea that there are no homosexuals in Iran or any other country simply isn’t plausible.

But at least a few individuals apparently agree with the Iranian president, except for one detail: They would take issue with his assertion that there are homosexuals in the United States.

The Cameron Connection

Purveyors of junk science on the topic of sexual orientation increasingly seem to be denying that anyone is really gay or lesbian.

An example of this sentiment can be found in the guidelines that antigay activist Paul Cameron and his collaborators are developing on their new Web vehicle for reporting the results of their “research.”

As Jim Burroway reported on the Box Turtle Bulletin website, Cameron et al. recently announced that they’re creating their own on-line vanity press which presumably will feature papers that even Psychological Reports won’t publish. (They apparently also hope to reverse their cash flow; instead of paying Psychological Reports for publishing their papers, they say they’ll charge contributors upwards of $500 to publish an article on their own website.)

The content of the website has been changing, but a version I accessed on September 23 listed some rules for terminology:

“…[A]uthors should avoid terms such as ‘gay,’ homosexual,’ heterosexual,’ or ‘bisexual,’ as they are diagnostic and/or political, implying ‘something’ beyond the empirical facts. Describing those who engage in SS [same-sex sexual behavior], or who don’t engage in SS but desire to, as ‘homosexuals,’ ‘bisexuals,’ etc. also implies ‘something beyond the empirical reality’ of what individuals do and should be avoided….”

By September 25, the language rules were softened a bit but were still consistent with the previous version:

“With the understanding that persons who engage in same-sex sexual behavior are often called ‘homosexuals,’ ‘gays,’ ‘lesbians,’ and the like, it is preferred that the terms MSM (males who have sex with males), FSF (females who have sex with females) be used….”

Perhaps the shift toward a less categorical ban on on words like “homosexual” came after Cameron looked through his own published papers, e.g., a 2006 report titled Children of Homosexuals and Transsexuals Are More Apt To Be Homosexual. Nevertheless, the message is pretty clear: Sexual behavior corresponds to an empirical fact, but being gay or lesbian doesn’t.

What’s the point of this exercise? Why deny the existence of homosexuals?

The Law and Policy Connection

I don’t pretend to know President Ahmadinejad’s motivation for his statement at Columbia. But American homosexuality-deniers appear to be trying to create a rationale for antigay laws and policies.

This rationale is built on (at least) two components: (1) There’s no such thing as “a homosexual,” therefore, sexual minorities don’t constitute a minority group that is subjected to unfair discrimination and hence don’t need legal protection. (2) People who call themselves “homosexual” (or gay or lesbian or bisexual) can and should become heterosexual.

These arguments were presented, for example, in a legal declaration that Jeffrey Satinover submitted in the original San Francisco Superior Court case concerning the marriages of same-sex couples performed at San Francisco City Hall in 2004. He asserted:

“Homosexual or bisexual identification… spontaneously and dramatically declines to the largest degree over the course of the lifespan, especially in the adolescent years when sexual identity is most mutable and impressionable and subject to outside influence from peers, popular culture, formal education and the standards set by figures of influence as well as by the nature of actual sexual activity. Thus, to the largest degree, homosexual identification is a self-reinforcing, hence culturally-dependent phenomenon…”

“Homosexuality, once in the process of developing, can be altered. It can be more readily altered when mutually reinforcing effects of the environment (cultural, demographic variables — the “messages” sent by society) and the wishes of the individual are in accord. It is more difficult to alter if an individual decides to change course after having gone farther down a pathway that involves extensive repetition, but not necessarily impossible. For those who do not desire it… the best way to insure that this option remains viable is to create an environment that does not reinforce it in the first place.”

Translation:

  1. There’s really no such thing as “a homosexual.” Impressionable young people who engage in same-sex behavior end up believing they’re “gay” or “bisexual” because they’ve been influenced or duped by popular culture, but most of them grow out of it.
  2. People who want to stop being homosexual can and should do so, and the best way for society to assist them is to make sure that the culture is as hostile to sexual minorities as possible. (As quoted on the NARTH website, Satinover believes that “homosexuality — like narcissism — is best viewed as a spiritual and moral illness.”)

Responding To The Arguments

These attempts by antigay activists to argue sexual minorities out of existence seem better suited to the imaginary worlds created by George Orwell and Lewis Carroll than to the contemporary United States. Unfortunately for them, their wish to create new meanings for words — or to completely abolish the concepts to which the words refer — doesn’t change reality.

In fact, most people in the United States experience their sexual orientation as a fundamental component of their identity. Most gay, lesbian, and bisexual people (and probably most heterosexuals) feel they couldn’t change their sexual orientation if they wanted to. And most don’t wish to change.

This isn’t to say that culture exerts no influence on how people experience their sexuality and form identities based on it. Indeed, historical and anthropological studies over the last several decades have documented the central role that culture plays in shaping such experiences and identities. They have also illuminated how the meanings attached to sexual behavior have changed over the course of history. However, the arguments presented by Satinover et al. ignore the fact that identities shaped by cultural forces are “real” — whether they reflect sexual orientation, religion, ethnicity, or some other characteristic.

Nor am I arguing that no one’s sexual orientation changes over the course of their life. Many gay and lesbian people report that they once considered themselves heterosexual. However, claims that a particular “therapy” or “treatment” can alter a person’s sexual orientation have no scientific support. And there are solid grounds for questioning the safety and ethics of such interventions.

What, then, is the appropriate response to the arguments put forth by the American homosexual-deniers?

The Columbia University audience’s reaction to President Ahmadinejad’s statement strikes me as a good start. They booed and laughed.

* * * * *

For more information about the situation of sexual minorities in Iran, check the websites of HOMAN, the IRQO (formerly the Persian Gay and Lesbian Organization, or PGLO), the International Lesbian and Gay Association, the International Gay and Lesbian Human Rights Commission, and Human Rights Watch.

Journalist Doug Ireland has written about the persecution of Iranian sexual minorities in his blog and in articles for various publications, including In These Times.

In January of 2007, the IRQO sponsored an all-day symposium at the University of Toronto on systematic violations of human rights in Iran, including the rights of sexual minorities.

Copyright © 2007 by Gregory M. Herek. All rights reserved.

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