About a year and a half ago I received a bootleg copy of the LDS
Social Services document Understanding and Helping Individuals
with Homosexual Problems (LDS-SS document, 1995). I was intrigued
and perplexed with the content and tone of the document. It is unusual
as a scientific document written to mental health professionals
in the 1990s for its unqualified and unjustified use of concepts
steeped more in the prejudices of Western tradition which date back
to the turn of the century than in modern social or psychological
sciences. The document's title spells out its primary, erroneous
premise: that homosexuality is, in fact, a mental health "problem."
The LDS-SS document's thesis is that homosexual orientation is a
manifestation of a treatable disturbance in one's gender identity
which is caused by dysfunctional family relationships: "It is in
the three-way relationship between the parents and the child that
the homosexual's family background is commonly dysfunctional. Homosexuality
is, in part, a symptom of some type of relational deficit" (LDS-SS,
p. 11). This fallacy forms the scientific cornerstone of the LDS-SS
document in spite of the numerous well-designed studies since the
1950s which disproved this myth (Bene, 1965; Siegelman, 1974; Saghir
& Robbins, 1970, 1971, 1973; Chang & Bloch, 1960; Clark, 1975; Hooker,
1957, 1965, 1969; Riess, 1980; and Thompson & McCandless, 1971).
Even more concerning, however, is the way that the LDS-SS document
attempts to justify -- if not require -- unethical professional
behavior on the part of the LDS Social Services psychotherapist
who is treating homosexual persons. How could the LDS-SS document
have been conceived, published, and distributed in 1995 by the mental
health division of the Church of Jesus Christ of Latter-day Saints
(LDS church), an organization committed to the principles of honesty
and integrity? I will return to this question later.
Over the past year I have engaged in a comprehensive review of
the mental health literature on the subject of homosexuality. I
reviewed literature from the fields of psychiatry, psychoanalysis,
psychology, and social psychology. I have also read publications
from a marginalized group of counselors who have created a new field
of "Christian" psychology (such as Nicolosi, 1991; Moberly, 1983;
Dallas, 1991; Consiglio, 1993; and others) -- counselors who base
their psychology according to their interpretations of the
Bible -- a distinctly nonpsychologic and nonscientific text. The
results of my review are contained in an -- as yet -- unpublished
paper entitled Homosexuality: A Psychiatrist's Response to LDS
Social Services (1996). Time constraints prevent me from discussing
even a tenth of the material from the original paper in this brief
Though the title of this paper indicates that my remarks will be
directed to LDS Social Services leadership and providers, my comments
are meant to reach a broader audience, addressing myths contained
in the LDS-SS document which are also widely accepted as facts by
many uninformed people in Western cultures, particularly those from
Judeo-Christian backgrounds such as ours.
The Question of "Pathology"
History demonstrates that for psychoanalysis the answer
as to whether homosexual orientation is a form of mental illness
preceded the question by decades. Psychoanalysts had been
writing about homosexuals and their treatment efforts to erradicate
homosexuality for over 50 years before researchers such as Kinsey
(1948, 1953), Hooker (1956, 1957, 1958), and Ford and Beach (1951)
began to ask whether homosexuality was a mental illness in the first
place. The question was especially important because by the 1950s
and 1960s analysts had linked homosexuality with severe mental illnesses
such as schizophrenia, obsessional disorders and severe character
pathologies (see Lewes, 1995; Bieber, 1962; Socarides, 1960); disorders
which simply are not present in the majority of homosexual people
but which have been used to butress our society's antihomosexual
prejudices and discriminatory practices.
A couple of points need to be made: 1) Psychoanalysis, a theory
and technique-driven form of psychotherapy which originated with
Sigmund Freud in the late nineteenth century, dominated early American
psychiatry and psychology. Analytic theory has been the only
source of psychological justification for labeling homosexuality
as a mental illness. However, very few of the components of analytic
theory have found support in objective scientific investigations.
For instance, penis envy and castration anxiety, concepts which
were the starting place for the development of female psychology
as well as male homosexuality, have found no support when studied
using objective scientific methodology. Analytic concepts are interpretive
principles more closely associated with the subjective disciplines
of philosophy and literature than modern empirical scientific research
(Fancher, 1995). Due to its lack of a scientific base, analysis
has lost its authoritative influence in modern mental health. 2)
Since it was assumed that homosexuals were mentally ill, no openly
homosexual persons were allowed to enter psychoanalytic training.
Therefore, homosexual persons had no voice in the formulation of
psychoanalytic theory. The evidence of this missing check and balance
is clear as one reads the history of psychoanalytic writings on
homosexuality (see Lewes, 1995); the articles are full of angry,
hostile, sarcastic descriptions of homosexual patients and their
problems with an intolerable number of cheap jokes at the patients'
expense. Some analysts have gone so far as to justify and endorse
violence against homosexual men and women (Silverberg, 1938). With
homosexuals disenfranchised from psychoanalysis, psychoanalytic
"experts" on homosexuality exercised tyrannical control over their
homosexual patients and spurred hostile public opinion regarding
homosexuality (for examples see Bergler, 1956 & 1959).
Additionally, all of the psychoanalytic studies on homosexuality
used patients who sought treatment for a variety of symptoms or
who were brought to treatment in mental hospitals or prisons. These
subjects already had evidence of poor adjustment irrespective of
their sexual orientations. Before Evelyn Hooker began her investigations
using non-patient groups of homosexuals in the 1950s (Hooker,
1957 & 1958) it had been assumed that the homosexuals in analytic
treatment were representative of all homosexuals. Such gross
overgeneralizations are misleading. An analogy would be going to
a Ford dealership, noticing that all the cars on the lot are Fords,
then concluding that all cars are Fords. Selecting out of a population
individuals who seem to share a common trait and then stating that
all members of the population also share that trait is logically
fallacious and yields meaningless and misleading data.
Beginning in the 1940s researchers finally began to question the
psychoanalytic assumptions regarding homosexuality (see Kinsey,
1948 & 1953; Hooker, 1957, 1958, 1959, 1965 & 1968; Ford & Beach,
1951). Well designed scientific studies emerged -- studies which
removed researchers' biases from the assessment tools. Without the
researchers' distorting biases the studies conclusively demonstrated
that homosexuality was not associated with any mental illness. To
be sure, there are some homosexuals who also suffer from
mental illness just as there are some heterosexuals who also suffer
from mental illness, but there is no objective evidence that links
homosexuality to any mental disturbance any more than one can link
heterosexual orientation to mental illness.
Based on the numerous well designed, objective, and independently
validated studies discounting the pathology-position combined with
the absence of any scientifically sound evidence in favor of retaining
homosexuality as a diagnosable mental illness, the American Psychiatric
Association removed 'homosexuality' from its official list of psychiatric
disorders in 1973. All of the mental health professions subsequently
followed suit, including the American Psychoanalytic Association
which has begun accepting openly homosexual women and men into its
Gender, Heterosexism and Sexism
Evelyn Hooker (1958, 1959, 1969) found that there is no psychopathology
linked to homosexual orientation and that, in fact, there is as
much psychological diversity among homosexuals as among heterosexuals.
Anyone, like Hooker, who has spent time with homosexual persons
finds such observations self-evident. That in 1958 Hooker's findings
came as a surprise to many in the mental health professions reveals
the extent to which the mental health community relied on stereotypes
to form their opinions rather than interpersonal engagement as peers
outside of the consulting room. Recent surveys have shown that only
one-third of American adults personally know openly homosexual people
(Herek, G.M., & Capitanio, J.P., in press; Herek, G.M., & Glunt,
E.K., 1993). Studies have also found lower degrees of antihomosexual
bias in people who know openly homosexual people on a personal basis
(Herek, 1996). A Baltimore City Counselperson was recently condemning
homosexuals on a radio talk show. A caller asked him if he personally
knew any homosexuals and the Counselperson's response was an indignant
"No, I do not." The caller then invited the Counselperson to meet
and get to know him, his partner and a group of his gay and lesbian
friends since many of the things that the Counselperson had said
about homosexuals didn't apply to him or his friends at all. Much
of the antihomosexual rhetoric is produced by people who have no
personal acquaintance with openly homosexual persons; their rhetoric
relies on stereotypes of homosexual persons. Stereotyping a group
of people who seem to share a common, undesirable trait essentially
reduces complex human beings into a caricature which exaggerates
perceived differences and minimizes similarities. William Green
(quoted in Pagels, 1995, p. xix) points out: "A society does not
simply discover its others, it fabricates them, by selecting, isolating,
and emphasizing an aspect of another people's life, and making it
symbolize their difference" (see also Volkan, 1994). Stereotyping
is an essential feature of interpersonal and institutional discrimination
and the basis of a society's prejudice.
Fernald (1995) reviewed the mounting literature on heterosexism,
a social psychology concept closely related to homophobia
which is "... composed of the related but independent dimensions
of prejudice, stereotypes, and discrimination. In the language of
social- psychological behavior theory, heterosexist prejudice refers
to negative attitudes toward (i.e., dislike of) lesbians and gay
men; heterosexist stereotypes are widely shared and socially sanctioned
beliefs about gay men and lesbians that are used to justify anti-gay/lesbian
hostility; and heterosexist discrimination includes face-to-face
overt behaviors that distance, avoid, exclude, or physically violate
lesbians and gay men" (p. 82).
Social psychology studies (Thompson, Grisanti, & Peck, 1985; Dunbar,
Brown, & Amoroso, 1973) have shown that the factor most predictive
of anti-gay/lesbian bias is a rigid commitment to a traditional,
Western culturally-based male sex role which is the basis of Western
stereotypes of "masculinity" and "femininity." Several studies (Taylor,
1983; Simmons, 1965; Steffensmeier & Steffensmeier, 1974; Rooney
& Gibbons, 1966; and Jenks, 1988) conducted with heterosexual subjects
have provided an image of the American heterosexist stereotype of
a homosexual. Homosexual men were perceived as being stereotypically
"feminine" while homosexual women were perceived as being stereotypically
"masculine." (See Herek 1984, 1986b; Levitt & Klassen, 1974; Staats,
1978; and Eliason, Donelan, & Randall, 1992.) Gay men were perceived
as less aggressive, less strong, poorer leaders, more clothes-conscious,
more gentle, more passive, and more theatrical, as well as less
calm, less dependable, less honest, and less religious, than heterosexual
men (Gurwitz and Marcus, 1978). Lesbians were perceived as more
dominant, direct, forceful, strong, liberated, and nonconforming
than heterosexual women who were perceived as more conservative
and stable (Gross, et al., 1980). To demonstrate the power of the
stereotype, Weissbach & Zagon (1975) presented a short video interview
of a man to two groups of heterosexual subjects. One group was told
that the man in the video was a homosexual. The subjects found the
interviewee "weaker, more feminine, more emotional, more submissive,
and more conventional when he was labeled gay than when he was not"
(Fernald, 1995, p. 92). The perceptions of the man varied dramatically
depending on whether the observer thought the man was gay or straight.
Seeing the man through the filter of some preconceived stereotype
influenced significantly the character traits ascribed to him by
the research subjects. This is prejudice.
Similarly, by officially presenting a derogatory stereotype of
a homosexual man and woman and their "dysfunctional families," the
LDS-SS document is contributing to the propagation of antihomosexual
prejudice among LDS Social Services mental health professionals
who are ethically obligated by specific professional ethics guidelines
to eliminate prejudice from their clinical work (see Am Psychol
A, 1992, Principle B: Integrity, p. 1599 & Principle D: Respect
for People's Rights and Dignity, p. 1599; Block & Chodoff, 1991,
p. 525; Am Psychiat Assoc, The Principles of Medical Ethics with
Annotations Especially Applicable to Psychiatry, 1995, Section 1,
paragraphs 1 & 2).
We see another disturbing trend emerging through the social psychology
studies. Heterosexist stereotypes rely on sexist stereotypes. Western
sexist stereotypes of "masculinity" and "femininity" exaggerate
cultural differences between men and women -- exaggerations which
bias the distribution of power toward men. The sexist "feminine"
stereotype describes a woman as: a follower, emotional, dependent,
weak, submissive, passive, and creative, to name but a few. These
are the same features attributed to gay men. The sexist "masculine"
stereotype describes a man as: a leader, strong, independent, aggressive,
physical, less emotional, etc. These qualities are attributed to
lesbians. Thus, anti-gay/lesbian prejudice clearly is another expression
of sexist prejudice. Fernald (1995) concludes: "[L]esbians and gay
men, by their very existence, challenge the sexist status quo. Because
sexist ideology depends on exaggerating the differences between
women and men, and explaining gender differences as natural and
immutable, gay men and lesbians threaten the foundation of sexism,
whether consciously or not. ... Because interpersonal heterosexist
attitudes, beliefs, and behaviors, coupled with institutional heterosexist
rules and practices, reflect, create, and maintain male dominance
as well as heterosexual privilege, any strategies aimed at reducing
or eliminating heterosexism must also be concerned with reducing
or eliminating sexism" (pp. 108, 110).
The LDS-SS document, in addition to statements by various general
authorities of the LDS Church (see Oaks, 1995), have made traditional,
Western-culture based gender-role conformity a central tenet of
their antihomosexual rhetoric. In recent years the LDS Church has
moved away from its more blatant sexist positions (as demonstrated
in changes in the temple endowment ritual) but still insists upon
the sexist-based, Western cultural conceptualizations of "masculinity"
and "femininity" as universal and -- sadly -- eternal. It is upon
those essentially sexist grounds that the LDS-SS document and certain
church leaders and members have focused their anti-lesbian/gay rhetoric.
That various elements of sexism are institutionalized in the LDS
Church, as well as other organizations whose leadership and power
are assigned based first on gender, is beyond speculation
and speaks more to the historical social contexts during which such
institutions arose than to purposeful discriminatory bias. However,
that a social prejudice wasn't obvious at one point in time confers
no authority to maintain it once it has been identified as such.
The more appropriate role for LDS Social Services, as the mental
health branch of the LDS Church, is persistent efforts at educating
church members and leaders, local as well as general, as to the
detrimental effects on individuals and the institution itself of
perpetuating sexist and heterosexist stereotypes in the service
of maintaining the illusion of social order based on heterosexual
Sexual Reorientation Therapies
Psychotherapies attempting to change homosexual orientation to
heterosexual orientation have been attempted for many years. Even
with highly motivated people the results are less than encouraging.
Most sexual reorientation studies report less than 30 percent of
homosexual subjects achieve a heterosexual outcome, and over half
of those who experience some change in their sexual orientation
were bisexual at the beginning of treatment (See Haldeman, 1994;
James, 1978). Anecdotes on sexual reorientation, particularly those
published by the "Christian" reorientation therapists such as Nicolosi,
Moberly, and Dallas, are so heavily influenced by researcher biases,
flaws in design, sampling techniques and outcome measurement that,
according to Haldeman's comprehensive review of treatment outcomes,
"no consistency emerges from the extant database which suggest that
sexual orientation is amenable to redirection or significant influence
from psychological intervention" (Haldeman, 1994, p. 224). In some
people homosexual behavior, like heterosexual behavior, can
be restrained for periods of time but there is no evidence that
core sexual orientation can be modified through psychotherapeutic
There are several other serious flaws with the sexual reorientation
studies. None of the studies compared outcomes with control groups
of subjects who accepted their homosexuality. Studies exist which
have demonstrated more favorable therapeutic outcomes in homosexual
people who successfully integrate their homosexuality into their
private and social identities (for example, see Weinberg & Williams,
1974). Additionally, not a single sexual reorientation study addressed
the psychological (or spiritual) damage that occurs in the majority
of subjects who fail to achieve a change in sexual orientation.
Sexual reorientation therapies attempt to treat a disorder which
doesn't exist using unethical therapeutic techniques which don't
work while simply ignoring the damage they do to the majority of
people who fail to change -- people who are judged by the
failing therapist to be resistant, morally corrupt, unrepentant,
or simply weak.
In their review of statements on homosexuality made by various
general authorities of the LDS church, Bingham and Potts (1993)
The Church has supported efforts of the LDS Social Services
and other consulting professionals to research the issues and
to offer a reparative therapy approach which assumes that homosexual
behavior can be changed. (p.14)
By "the Church" I suspect that Bingham and Potts are referring
to a small number of general church leaders who have been unusually
outspoken in voicing their sexist and heterosexist biases as if
they were doctrine and -- perhaps worse -- as if they were science.
"The Church," which has no authority in professional, scientific
matters, has declared homosexuality a curable mental illness and
has required LDS Social Services to agree. Because such biases have
been recognized as incompatible with the ethical practice of mental
health, all of the mental health professions have included specific
warnings against these biases in their ethics guidelines (see Am
Psychol A, 1992, Principle B: Integrity, p. 1599 & Principle D:
Respect for People's Rights and Dignity, p. 1599; Block & Chodoff,
1991, p. 525; Am Psychiat Assoc, The Principles of Medical Ethics
with Annotations Especially Applicable to Psychiatry, 1995, Section
1, paragraphs 1 & 2). In order for LDS Social Services "to offer
a reparative therapy approach which assumes that homosexual behavior
can be changed," they had to leave the mainstream of the mental
health professions and shop around for anyone whose own prejudices
match those of "the Church" no matter how unjustified, antiquated,
unscientific, ineffective, harmful and unethical their beliefs and
practices may be. This unfortunate collusion has compromised the
scientific integrity of LDS Social Services and -- by extension
-- the LDS church; a retreated, closed, propagandistic and anxiety-maintained
position which is untenable for a people whose prominent motto is
"the glory of God is intelligence."
We may ask: If a majority of people in a society agree that certain
groups of people are undesirable, why should we fight against such
an attitude? There are a number of reasons why we should fight against
socially sanctioned hate and discrimination, not the least among
them being the example of one Gallilean Jew who dined with publicans,
associated closely with women, defended and befriended prostitutes,
and ministered to Samaritans -- hated, demeaned, subserviant or
simply ignored out-groups of the culture of his day, for which he
was derided and chastised even by his closest associates and disciples.
It is he whom we recognize as The Judge. It is his example we seek
to emulate -- including his manner of judging (or, as he has wisely
commanded, not-judging -- withholding the impulse to judge and condemn
one's fellow human beings -- the remedy for prejudice and
a corrective for pride). I make this point to demonstrate that the
LDS Church (or its members) discriminating against any group of
people according to stereotypes and prejudices is incompatible with
core LDS beliefs. Indeed, we are obligated morally to weed-out of
society and the church lies which perpetuate attitudes and actions
of hate. LDS Social Services should be at the forefront of this
struggle, using insights gathered from the mental health and social
sciences to help "perfect the Saints" by eliminating such individually
and collectively corrupting falsehoods rather than distort knowledge
and facts to justify oppressive standards and norms.
There are several tasks which need to be accomplished by LDS Social
As a matter of personal and professional integrity, firmly commit
to the principles of ethics established by the mental health professions
to which LDS Social Services providers belong.
Any mental health professional whose personal feelings or biases
toward a patient or class of people cannot be contained is obligated
ethically to seek out supervision or consultation or refrain from
treating such people.
Carefully read (or read again) the abundant scientific literature
on homosexuality even if it seems to contradict one's personal biases.
Critically assess all literature according to the objective standards
accepted by the scientific committees of the various mental health
Be willing to reevaluate one's own biases and prejudices. This
is an opportunity for personal and professional growth.
As an obligation to one's society, use insights gained through
one's professional and personal development to combat social prejudices
Do not make the mistake of denying any church leader his humanity.
Psychology has taught us that we all have conflicts, fears
and unfounded biases -- conscious or otherwise -- which influence
our thoughts and behavior; it is not fair to church leaders to assume
that they do not. They, too, are in need of growth experiences.
Refrain from utilizing stereotypes in clinical and personal endeavors.
Each personal and professional encounter with another human being
is a chance to learn and share on equal grounds with someone as
complex and deserving of respect as oneself. Emmerson said: "The
sign of a true scholar is that in every man there is something wherein
I may learn of him. In that, I am his pupil." This humble approach
to one's clinical work and interpersonal engagements can only better
oneself as a clinician and as a human being.
Since only one-third of Americans know an openly homosexual man
or woman, an important way to challenge one's own culturally-sanctioned
heterosexist prejudices is to associate with openly homosexual persons
on equal social footing rather than as a leader, therapist, or otherwise
social judge. Stereotypes lose their validity when confronted with
the whole reality of another human being.
This list of suggestions is a starting place. Prejudice, hate
and discrimination against people whom we don't know and don't understand
prevents mutually beneficial interactions. There is much we can
learn about our common humanity if we can get past the tendency
to reject those who think, feel, love or believe differently or
who come to represent aspects of ourselves which we may wish to
banish. Christ taught that God is love. Let us recommit to honoring
this principle in our personal and professional endeavors.
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