1. Indian J Physiol Pharmacol 2010; 54 (1) : 5–20REVIEW ARTICLEHOMOSEXUALITY : A DILEMMA IN DISCOURSE !K . K . G U L I A 1,2 * AND H. N. MALLICK2 1 2 National Brain Research Centre, Department of Physiology, NH-8, Nainwal Mode, and All India Institute of Medical Sciences, Manesar – 122 050 (Haryana) New Delhi – 110 029 ( Received on October 1, 2009 ) Abstract : Homosexuality has been in practice even prior to its recorded history. In the Indian cultural context, discourse on sexuality had never gained an agreeable consensus from any platform. However, in the recent past, efforts were made by governmental and nongovernmental organizations to bring sex-related issues to the masses after speculation on presumably the fast spread of AIDS (acquired immuno-deficiency syndrome) particularly through illegal homosexual activities. Nevertheless, strong cultural and religious ideologies discouraged any valid discussions on homosexuality. In light of the given scenario, the present essay aimed to highlight several aspects of homosexuality that include a brief history, biological basis, effect of nature versus nurture, evolutionary perspective and related issues concerning general well-being and health. Key words : homosexuality heterosexual AIDS INTRODUCTION homosexual was employed as part of a broader system for the classification of Homosexuality has been a feature of sexual types at a time when expressionshuman culture since its earliest history, such as same sex attraction disorder, anhowever, the term ‘homosexual’ was first inverse sexual orientation or even mentalcoined in 1869 by Karl-Maria Kertbeny to illness were applied indiscriminately.describe same-sex attraction and sexualbehavior in humans. Kertbeny had In general, homosexuality as a sexualanonymously published a pamphlet entitled orientation refers to an enduring pattern ofparagraph 143 of the Prussian Penal Code of or disposition to experience sexual,14 April 1851 and its reaffirmation as affectional, or romantic attractions primarilyparagraph 152 in the proposed Penal Code to people of the same sex. It also refers tofor the Norddeutscher Bund, an open and an individual’s sense of personal and socialprofessional correspondence to Royal identity based on those attractions, behaviorsPrussian Minister of Justice, in an attempt expressing them, and membership in ato oppose the anti-sodomy law (1). The term community of others who share them. It is * Corresponding Author : Kamalesh K. Gulia, National Brain Research Centre, NH-8, Nainwal Mode, Manesar – 122 050 (Haryana); Tel.: +91-124-2338922-26; Fax : +91-124-2338910/16; E-mail : email@example.com
2. 6 Gulia and Mallick Indian J Physiol Pharmacol 2010; 54(1)a condition in which one is attracted and in order to make a clear understanding ondrawn to his/her own gender, which is the biological basis of homosexuality. It isevidenced by the erotic and emotional believed that such scientific discourse shallinvolvement with members of his/ her own benefit the society, the judicial system andsex. There is a definite disinterest in the the policy maker at large in reaching to theemotional, sexual, and physical engagement roots of a genuine social cause in the currentwith members of the opposite sex. It is easily evolving egalitarian society.distinguished from other components of Historical perspectives of psychosexualsexuality including biological sex, gender concepts regarding homosexualityidentity (the psychological sense of beingmale or female), and the social gender role In most ancient cultures, religion and(adherence to cultural norms for feminine local laws had played a major role in guidingand masculine behavior). and advocating approval or disapproval of homosexuality in various contexts. In ancient Homosexuality has now emerged as an Greece, certain forms of erotic attraction anduninvited issue of polemics in the Indian sexual pleasure between males were acceptedsocial context. In general, the matters as part of the cultural norms, and therelating to sexuality were never encouraged socially significant form of close same-sexfor open discussion in the civil and sexual relations between adult men andgovernment networks. In the past, the adolescent boys was known as pederasty (2).prevalent legal provisions as well as cultural In cultures under Abrahamic religions, theand religious underpinnings were the major law and the church established sodomy as aguiding factors for condemnation of transgression against divine law or a crimehomosexuality at large. The biological against nature (cultures) with a provisionperspective was never taken into account, of severe punishment (3, 4). In some tribesand comprehensive psychoanalysis was in New Guinea, there is practice ofalmost overlooked at the time of formulation homosexuality wherein young boys (8–15of Indian by-laws on homosexuality in 1860 years) are inseminated by the adult male(Footnote 1). Nonetheless, since it pertains warriors (5). In Crete, every adolescent boyto an emerging concern of the public health has to undergo a homosexual relationshipdomain, it was thought appropriate to make as a rite of passage into manhood (5). Inan unbiased analysis of various aspects of these two instances, though homosexualityhomosexuality ranging from a brief history, is accepted but it appeared an enforced socialits causes - if innate or acquired, evolution, convention and is not a natural expression.the cross-cultural scenario, legal and health Hindu religious texts such as Rig Veda (1550perspectives. The objective of this essay is BC) elaborate on sexual practices, andto provide a comprehensive and critical sculptures of India’s ancient temples depictanalysis of available scientific information explicit homosexual acts. The ancient HinduFootnote 1 : Chapter XVI, Section 377 of the Indian Penal Code (Unnatural offences) was introduced during British rule of India to criminalize homosexual activity. It was drafted in 1860 by Lord Macaulay as a part of the colonial project of regulating and controlling the British- and Indian-origin subjects. It says ‘Whoever voluntarily has carnal intercourse against the order of nature with any man, woman or animal, shall be punished with imprisonment for life, or with imprisonment of either description for term which may extend to ten years, and shall also be liable to fine’.
3. Indian J Physiol Pharmacol 2010; 54(1) Homosexuality : A Dilemma in Discourse! 7text Kama Sutra describes homosexuality inborn and therefore not immoral, that itmore vividly than any other ancient texts was not a disease, and that many(6). Nonetheless, the oldest text on code of homosexuals made outstanding contributionsconduct listed in the Manu Smriti has to society (10). He also disagreed thatprescribed restriction of homosexuality homosexuality could be cured or correctedthrough pu nishment (7, 8). by psychoanalysis. Freud’s basic theory of human sexuality was different from that of Within medicine and psychiatry, Ellis. He felt that all human beings werehomosexuality was not universally viewed as innately bisexual, and that they becomea disorder but a different view began to heterosexual or homosexual as a result ofpredominate judging such behavior as their experiences with parents and othersindicative of a person with a defined and (12). Nevertheless, Freud agreed with Ellisrelatively stable sexual orientation. Richard that a homosexual orientation should not bevon Kraft-Ebing elaborated the concept in viewed as a form of pathology. However, thehis book ‘Psychopathia Sexualis’ in the form later psychoanalysts did not follow this view.of a medico-forensic study in 1886 (9). British Sandor Rado (1940, 1949) rejected Freud’sphysician Havelock Ellis published similar assumption of inherent bisexuality, arguingviews in his influential book ‘Sexual that heterosexuality is inborn and thatInversion’ in 1897 that homosexuality was homosexuality is a phobic response tonot a disease or crime (10). These medical members of the other sex (13, 14). Othertexts were not widely accessible to the analysts later argued that homosexualitygeneral public thereby a Magnus Hirschfeld’s resulted from pathological familyScientific Humanitarium Committee was relationships during the oedipal periodconstituted that campaigned against anti- (around 4–5 years of age) (Footnote 2) andsodomy laws from 1897 to 1933 in Germany. claimed that they observed these patternsMagnus Hirschfeld was one of the pioneering in their homosexual patients (15). Charlessexologist who began his career in medicine Socarides (1968) speculated that the etiologybut was drawn to the study of human of homosexuality was pre-oedipal and,sexuality. Hirschfeld’s intention was to move therefore, even more pathological than hadhomosexuality from the arena of illness to a been suggested by earlier analysts (16).natural condition. His famous book ‘TheHomosexuality of Men and Women’ was Although psychoanalytic theories ofdesigned to provide a unified, comprehensive homosexuality have had considerabledescription of homosexuality which would influence in psychiatry, they have not beenclear heterosexuals of homophobic prejudice subjected to rigorous empirical testing.and allow homosexuals to accept themselves Instead, they have been based on analyst’sand stop feeling isolated (11). clinical observations of patients already known by them to be homosexual. The major Sigmund Freud and Havelock Ellis also flaw in these analytical procedures were,affirmed their viewpoints on homosexuality. first, double blind procedure was not usedEllis (1901) argued that homosexuality was in clinical psychoanalytic studies ofFootnote 2 : Oedipal period – In psychoanalysis, a stage in the psychosexual development of the child, characterized by erotic attachment to the parent of the opposite sex, repressed because of fear of the parent of same sex, usually occurring between the ages of 3 and 6 years.
4. 8 Gulia and Mallick Indian J Physiol Pharmacol 2010; 54(1)homosexuality therefore, the analyst’s homosexuality in parlance.theoretical orientations, expectations, andpersonal attitudes were likely to bias her or Evelyn Hooker obtained a grant from thehis observations (17). Another problem with National Institute of Mental Health to explorepsychoanalytic studies was that the examined the relationship between homosexuality andsubjects were only those homosexuals who psychological development and mentalwere already under psychiatric treatment or illness. The psychological tests weretherapy. Such patients either on their executed on both homosexuals andvolition or straying from cultural norms, heterosexuals to evaluate difference in theirhowever, are probably not representative of psychological adjustment. She recruited awell-adjusted individuals in the general sample of homosexual men who werepopulation. functioning normally in society rather than studying psychiatric patients. Both groups In the course of the 20th Century, were matched for age, intelligence quotienthomosexuality became a subject of and education level, and were then subjectedconsiderable study and debate in western to three psychological tests, the Rorschach,societies. It was predominantly viewed as a Thematic Apperception Test and the Make-disorder or mental illness. At that time A-Picture-Story Test. Experts were asked toemerged two major pioneering studies on rate men without giving prior knowledge ofhomosexuality carried out by Alfred Charles their sexual orientation. Blinded to eachKinsey (1930) and Evelyn Hooker (1957). A subject’s sexual orientation, two independentzoologist and taxonomist, Kinsey (Indiana Rorschach experts evaluated their overallUniversity, USA) conducted the research on adjustment using a 5-point scale. There werehuman sexuality to find out how many adults no significant differences between the twowere engaged in homosexual behavior. This cohorts in any of these tests (20, 21). Hookerempirical study of sexual behavior among concluded from her data that homosexualityAmerican adults revealed that a significant as a clinical entity did not exist and thatnumber of participants were homosexuals it was not inherently associated with(18, 19). In this study when people were psychopathology. She changed the landscapeasked directly if they had engaged in of this sexual behavior from one of pathologyhomosexual sexual relations, response of a to a normal type of sexual behavior in thelarge percent of the population was negative. minds of academicians.However, when asked if they had engagedin same-sex sexual relations, the percentage As a result of Hooker’s finding, theof positive responses nearly doubled. The American Psychiatric Association (APA)results of this study became the widely deleted homosexuality from its Diagnosticpopularized Kinsey Scale of Sexuality. This and Statistical Manual of Psychologicalscale rates all individuals on a spectrum of Disorders (DSM) in 1973 and released a publicsexuality, ranging from 100% heterosexual statement that homosexuality was not ato 100% homosexual. While establishing that mental disorder (22). The APA finally statedas many as 10% of adult males and 2–6% in 1994 that homosexuality is neither athe females reported having sexual relations mental illness nor a moral depravity. It iswith a same-sex partner, the impact of this the way a portion of the human populationstudy did little more than to adopt the term expresses their love and sexuality (23).
5. Indian J Physiol Pharmacol 2010; 54(1) Homosexuality : A Dilemma in Discourse! 9 Most psychoanalytic theories stress the neural circuits in these areas of brain attainrole of parental and family dynamics, not either of one of two opposite morphologicalthe society as a whole. Behaviorists believe patterns i.e. predominant male or femalethat some sexual and gender identification type. The SCN, a structure involved in thedifferences result from roles imposed by regulation of circadian rhythms andfamily and friends upon children, such as reproductive cycles, is elongated in femalesthe masculine and the feminine stereotypes. and more spherical in males (26). The meanHowever, there is no evidence, social or volume of the SDN-POA is 2.2 times largerbiological, to support that homosexual in males than in females and contained aboutchildren were raised differently from the twice as many cells (28). The function of thisheterosexual children. Besides, with sexually dimorphic area in humans is notreinforcement of gender identification norms, known, but presumably it is involved in theone would be led to logically deduce that all control of male sexual behavior. The volumethe stereotype reinforcement would serve to of the BNST is 2.5 times greater in malesensure a heterosexual behavior. than in females (27). Women have larger gray matter in the orbitofrontal cortexTheories on the cause of homosexuality : involving Brodmann’s areas 10, 11 and 25biological basis and temporomedial cortex (bilateral hippocampus and right amygdala), and To find out the putative role of nature their left basal insular cortex (24). Inor nurture, as a causative factor, a number contrast, men show a higher gray matterof studies were initiated to explore the concentration in the left entorhinal cortexbiological basis of homosexuality. Biological (Brodmann’s area 28), right ventral pallidum,theorists from time to time have supported dorsal left insular cortex and a region of thetheir contentions based on the anatomical, orbitofrontal cortex (Brodmann’s area 25).neuroendocrine evidences and genetic The gender differences in corpus callosumstudies. More recently, the neuroimaging are inconclusive (30-33). According to a fewtechniques are also employed to explore the reports, the males possessed a larger genuneural correlates of homosexuality. and the average thickness of corpus callosumAnatomical evidence was greater in the female splenium (30–32). These reports clearly describe prevalent In the central nervous system various structural differences between the sexes inareas that are involved in reproduction the brains of human and many vertebrateare sexually dimorphic. These areas include species. The following text attempts tothe medial preoptic area, the sexually examine if such difference also existsdimorphic nucleus of the preoptic area between homo- and heterosexual brain.(SDN-POA), the medial amygdala, thesuprachiasmatic nucleus (SCN), the Dick F. Swaab was the first to documentventromedial hypothalamic nucleus, the a difference in the anatomical structure of aventral region of the premammillary homosexual man’s brain based on hisnucleus, the accessory olfactory bulb, the bed noteworthy experiment reported in 1990. Anucleus of the accessory olfactory tract, the postmortem examination of homosexualbed nucleus of the stria terminalis (BNST) male brains revealed that a portion of theand a few regions in cortex (24–29). The hypothalamus of the brain was structurally
6. 10 Gulia and Mallick Indian J Physiol Pharmacol 2010; 54(1)different than a heterosexual brain (34). pseudohermaphroditism implying that maleLaura S. Alien found that the anterior homosexuals to have brains with the ‘matingcommissure was significantly larger in the centres’ of women in the body of men. Thehomosexual men than that of the neuroendocrine viewpoint in his basicheterosexuals (35). These two anatomical hypothesis was that the sexual orientationfindings became a standing ground for the is determined by the early levels (probablybiological argument on homosexuality. The prenatal) of androgen on relevant neuralsize difference would emerge due to sexual structures. If highly exposed to thesedifferentiation occurring during the prenatal androgens, the fetus becomes masculinized.period and not due to environmental factors. The adult female rats that received male- typical levels of androgens sufficiently early Simon LeVay (1991) focused on the in development exhibited male symptoms ofhypothalamus to test the biological substrate attraction. The same was true in the reverseof sexual orientation. LeVay did a post- when applied to the male subjects. Thus, themortem examination on human brains of female rat exposed to high levels of malepatients who had died from AIDS-related hormone exhibited high levels of aggressionillnesses. It is stated that these consisted of and sexual drive toward other females,19 declared homosexual men, 16 presumed eventually trying to mount the other femalesheterosexual men, and 6 presumed in an act of reproduction. All those maleheterosexual women. LeVay discovered that rats that received deficient levels of androgenwithin the hypothalamus, the third became submissive in matters of sexual driveinterstitial nucleus of the anterior and reproduction, and were willing to receivehypothalamus (INAH3) was smaller in the sexual act of the other male rat (38).homosexual men then in heterosexual men Dorner believed that the structure of the(36). It was concluded that the homosexual brain is built, step by step, into a female orand heterosexual men differ in the central a male pattern of sexual identity andneuronal mechanisms that control sexual behaviors. This happens through thebehavior, and that this difference in anatomy development of three centers: The sex centrewas no product of upbringing or environment, (controls typical male or femalebut rather prenatal cerebral development and characteristics), the mating centre (controlstructural differentiation. LeVay later stated sexual behavior), and the gender-role centerin his biography that the INAH3 may not be (controls behaviors such as aggression) thatthe only centre in the brain influencing the become fully expressed under the hormonalsexual behavior in men and women (37). influence of puberty. Swaab had drawnNeuroendocrine basis similar conclusions that the human gender identity and sexual orientation are Another line of investigation which programmed into our brain structures duringsupported the biological basis was the intrauterine period (39). Theseneuroendocrine studies. The study of Gunter investigators advocated the strong belief thatDorner, an East German scientist, has been social environment after birth has no majorused as reference to understand how the effect on gender identity or sexualbrain is patterned for gender during fetal orientation.development in rats. Dorner classifiedhomosexuality as a central nervous Dorner then tested his hypothesis in the
7. Indian J Physiol Pharmacol 2010; 54(1) Homosexuality : A Dilemma in Discourse! 11human population by closely examining the the development of each or any of thesehistory of the homosexuals who were born stages, there may be aberration in thebefore, during and after World War II. He gender patterning (for what our culturefound that significantly large numbers of defines as typical masculine or femininehomosexuals were born during the stressful characteristics and sexual expression). Whenwar and early post-war period than in the the plasma testosterone levels were assessedyears before and some time after the war. in homosexual women and age-matchedThe mothers of two-thirds of these heterosexual women in a study, it washomosexuals reported experience of severe found that though the levels overlappedto moderate maternal stress during their considerably, averaged concentration waspre-natal life with factors such as 38% higher in homosexual than inbereavement, bombings, rape or severe heterosexual subjects (46). However, theseanxiety. On the other hand, none of the results could not be replicated by othermothers of the heterosexual men in a control investigators (47).sample had been the victim of severe stress,and experienced only occasional moderate Interestingly, sexually-deviant behaviorstress. However, Schmidt and Clement (1995) occurs more frequently in males as malefailed to replicate Dorner’s finding that war- brains must undergo a more complexinduced stress in pregnant women caused a hormonal processing to change them fromdrop in fetal androgen levels which in turn the initial female brain pattern and so thereleads to the development of a homosexual is more chance for error. An extremeorientation (40, 41). They also found that example of this would be the so-calledeven in those cities that suffered the most accidents of nature wherein a femalesevere bombing during World War II, there patterned brain appears to reside in a bodywas no evidence of increased numbers of with external male genitalia and vice versa.homosexuals negating Dorner’s theory (41). GeneticsBut later, a few reports supported Dorner’shypothesis that stressed pregnant women The most preliminary approach, yet ahave a greater chance of giving birth to a powerful technique were to probe twinshomosexual daughter (42) or homosexual son to identify the mechanism underlying(43, 44). homosexuality employing the principles of genetics. To tease out the influences of Milton Diamond, an American scientist, genetic and environmental factors onhad a parallel line of thought to Dorner on psychological and behavioral traits,development of sexuality, but believed that comparison of the probability of homosexualityfour stages were involved: Stage 1 – basic between monozygotic (or identical) twinssexual patterning (passivity or (MZ), who possess exactly the same genesaggressiveness), Stage 2 – sexual identity as the co-twin, and dizygotic (or fraternal)(the gender mindset adoption), Stage 3 – twins (DZ), who are not closely relatedsexual object choice (similar to Dorner’s genetically to any normal sibling but roughlymating centre) and Stage 4 – control over half of their genes are the same, was done.sexual equipment (including the mechanism If there is a difference between theof orgasm) (45). Dorner and Diamond concordance rate for homosexuality in MZbelieved that if something goes wrong during and DZ, then this is strong evidence that
8. 12 Gulia and Mallick Indian J Physiol Pharmacol 2010; 54(1)there is some genetic component to the Hamer hypothesized that male homosexualityetiology of homosexuality. However, if the could stem from the maternal lineage, andconcordance rate in monozygotic twins is not the startling discovery of Xq28, led to his100%, then environmental factors must be findings being dubbed as the ‘gay gene study’.exerting some influence. The statistical probability of the 5 genetic markers on Xq28 to have matched randomly Franz J Kallman conducted the earliest was calculated to be 1/100,000, lending eventwin study in 1952 and reported a 100% more support to his findings.concordance between MZ twins, and only a12% concordance for DZ twins (48, 49). Later, it was asserted by SatinoverAlthough the theory was discredited with that no scientific evidence showed thatmethodological problems, it paved the homosexuality was directly inherited in theway for further studies. Michael J. Bailey way eye color is inherited as per Mendelianand Richard Pillard (1991) studied the Principles (54). His comment on the ‘gayhomosexuality between MZ, DZ twins, gene’ was that there is a genetic componentand non-related adopted brothers. They to homosexuality, but this component is justexamined how many of the sample a loose way of indicating genetic associationspopulation were homosexual and how many and linkages. Linkage and association dowere heterosexual. They found that 52% of not mean causation. There is no evidenceMZ twins, whereas 22% of DZ twins and only that proves that homosexuality is genetic5% of non-related adopted brothers were self- and none of the research so far lays suchidentified homosexuals (50). This experiment claim.was repeated and results were similarproving that the more closely genetically One of the most recent research showslinked a pair is, the more likely that both evidence of the genetic switch that can turnwill exhibit homosexual or heterosexual homosexuality on and off in fruit flies (55).tendencies. Later they also found occurrence Fruit fly (Drosophila melanogaster) is aof homosexuality among sisters in 48% of favorite research model in the geneticMZ twins of homosexual women, 16% of DZ studies. David E. Featherstone focused ontwins and 6% of adoptive sisters (51). a glial amino-acid transporter called genderblind, in which a mutation caused The role of genetics in male sexual male flies to court males with the sameorientation was further investigated by Dean probability as females (55). By manipulatingHamer in a pedigree and linkage analyses this gene, homosexuality in flies could beon 114 families of homosexual men (52). To altered. These investigators reported a non-investigate a maternal link, the family trees neuronal mechanism for modulation of theof declared homosexual men were examined. neuronal function in the brain as genderblindHe took DNA samples from forty homosexual is a glial transporter. There is a caveatmen, and genetically examined them to in the explanation and comparison ofexplore the possibility of homosexuality being homosexuality qualitatively across thean X-linked trait (female sex linked). It species. It is to be conjectured whether awas found that there was a remarkable part of such research findings can indeed beconcordance for 5 genetic markers on an arm extrapolated beyond flies as human behaviorof the X-Chromosome called Xq28 (53). is a lot more complex.
9. Indian J Physiol Pharmacol 2010; 54(1) Homosexuality : A Dilemma in Discourse! 13Neuroimaging studies evoked sexual arousal (61, 62). However, heterosexual men showed activation in the There is evidence to suggest that the bilateral lingual gyrus, right hippocampus,brains of homosexual men function and right parahippocampal gyrus, areas notdifferently than the brains of heterosexual activated in homosexual men. In anothermen (56-59). The studies comparing the report, it was shown that in the homosexualhomosexual, heterosexual men and women men and heterosexual women volumes of thehave indicated that homosexual men are cerebral hemispheres were symmetricalmore like women in their intellectual whereas in homosexual women andfunctions and different than heterosexual heterosexual men there was a rightwardmen (56-59). They have superior verbal cerebral asymmetry (63). Sex-differentiatedabilities compared to heterosexual men (57, functional connections are shown in60). More recently, neuroimaging techniques amygdala at rest. In man, the connectionshave been used to facilitate our were mainly from right amygdala targetingunderstanding in the neural mechanism of to sensorimotor cortex, striatum, andsexual orientation in homosexuals (61–67). pulvinar, whereas in women these are moreEven till now, phallometry (Footnote 3) was pronounced in left amygdala and project toconsidered gold standard in assessment of subgenual cortex and hypothalamus. Butsexual orientation (68), but this measurement homosexual subjects showed sex-atypicalhad been criticized because of its amygdala connections (63).intrusiveness and limited reliability (69). Thefunctional magnetic resonance imaging Cerebral responses to putative(fMRI) is a non-invasive technique in which pheromones and objects of sexual attractionthe differential spatial activation of the brain were also found to differ between homo- andis revealed by a change in blood oxygen level- heterosexual subjects (64, 65). Men exhibitdependent signals. Various sexual arousal much higher levels of genital and subjectiveparadigms are used to predict the difference arousal to sexual stimuli containing theirin neural circuits involved in homo and preferred sex than they do to stimuliheterosexual brain (61–67). Positron containing only the nonpreferred sex.emission tomography (PET) imaging involves Apparently heterosexual men are notinjection of a radioactive tracer (a biological stimulated by a male scent which suggestsmolecule which carries a positron emitting that pheromones contribute to determiningisotope). Within minutes, the molecule our behavior in relation to our sexualaccumulates in an area of the body for which orientation (64). Homosexual women, asit has an affinity and the emitted positrons compared to heterosexual women, reactedare detected. PET imaging is used to evaluate in a sex atypical, almost reciprocal way tothe functional connectivity in the brain (63). pheromones (65). It is known that men showThe results from these imaging modalities category-specific genital and self-reportedshow activations of right cingulate cortex, specific sexual arousals in response to visualthe left angular gyrus, left caudate nucleus, sexual stimuli, and their greatest sexualand right pallidum in homosexual men, but arousal is to the categories of people withnot in heterosexual men during visually whom they preferred to have sex.Footnote 3 : Phallometry or penile plethysmograph is a method for assessing sexual arousal/interest among men.
10. 14 Gulia and Mallick Indian J Physiol Pharmacol 2010; 54(1)Comparisons of activation to preferred sexual stimulus. One line of thought suggests thatstimuli, nonpreferred sexual stimuli revealed a male/female dichotomy in behavior developslarge networks correlated with sexual with age and this development might bearousal, spanning multiple cortical and under the influence of very differentsubcortical areas as both homosexual and learning experiences as sexual experiencesheterosexual men exhibited category-specific are experiences that are likely to changearousal in brain activity (66). Within the brain profoundly (70). So there is still aamygdala, greater preference-related strong possibility that any real differencesactivation was observed in homosexual men, demonstrated between adult homosexual andbut it is unclear whether this is a cause or heterosexual brains related to sexuala consequence of their sexuality. functioning could result due to learning and experience. It is known that sexually arousing visualstimuli activates the human reward system It is an interesting observation that theand triggers sexual behavior. Ponseti used homosexual men have an increasedpictures of either male or female genitals prevalence of non-right-handedness and theydisplaying signs of sexual arousal as a sexual exhibited atypical patterns of hemisphericstimuli instead of sexually arousing pictures functional asymmetry. Non-right-handednessof a person to avoid confounding brain in men is associated with increased size ofactivation related to neuronal processing of the corpus callosum, particularly of thefaces, gestures or social interactions (67). isthmus, which is the posterior region of theThe fMRI during visual processing of sexual callosal body connecting parietotemporalcore stimuli pinpointed a neuronal correlate cortical regions (71). These results indicateof sexual preference in humans as stimuli that callosal anatomy and laterality for motorlacked any additional contextual information. functions are dissociated in homosexual men.The ventral striatum and the centromedian Another study indicates that the auditorythalamus showed a stronger neuronal systems of homosexual and bisexual females,response to preferred relative to non- and the brain structures responsible for theirpreferred stimuli. Likewise, the ventral sexual orientation are partially masculinizedpremotor cortex which is a key structure by exposure to high levels of androgensfor imitative (mirror neurons) and tool- prenatally. The click-evoked otoacousticrelated (canonical neurons) actions showed emmisions (CEOAEs) are echo-likea bilateral sexual preference-specific waveforms emitted by normal-hearingactivation. It was suggested that viewing cochleas in response to a brief transientsexually aroused genitals of the preferred sound. The CEOAEs are stronger in femalessex triggers action representations of sexual than in males. Homosexual and bisexualbehavior. The neuronal response of the females were intermediate to those ofventral striatum, centromedian thalamus heterosexual male and females. Noand ventral premotor cortex to preferred differences were observed betweensexual stimuli was consistent across all homosexual and heterosexual males (72).groups. This invariant response pattern in Homosexuality among animals :core regions of the human reward and motor an evolutionary perspectivesystem represent a functional endophenotypefor sexual orientation independent of the The homosexual behavior has beengender of the observer and gender of the observed in many animal species. The study
11. Indian J Physiol Pharmacol 2010; 54(1) Homosexuality : A Dilemma in Discourse! 15of homosexual activity in diverse species acquisition mechanism that males canmay elucidate the evolutionary origins of employ if they are unsuccessful at competingsuch behavior. The use of the term for, or attracting, female reproductive‘homosexuality’ in the context of animals partners. Another theory suggests thatrequires drawing a distinct line between homosexual behavior in animals serves ansocial interactions alone and sexual adaptive socio-sexual function by which same-interactions. The strong cultural implication sex mounting is a ritualized gesture thatlaid in this term among the human society individuals used to communicate theirwould be least relevant for other species. dominant relationship and those behaviorsThe cognitive component in animal sexuality which are sexual in form (75). Homosexualand motivating factors are least understood. behavior in males preserves sexual function,In animals, sexual behavior is defined as enabling an animal to maintain itscourtship displays or sexual solicitations, reproductive fitness, providing a beneficialmounting, and any interaction involving stimulation for continued production ofgenital contact between one animal and seminal fluid and interest in sexual activity.another. Bruce Bagemihl (1999) characterized The wild koalas, which are mostly solitary,sexual behaviors that include courtship, seem to be strictly heterosexual and their homosexual activity was certainly enhancedaffection, interactions involving mounting in captivity (76). Bonobos, our nearest kin,and genital contact, pair bonding and exhibit homosexuality (77). The homosexualparenting activities (73). Thus, homosexuality bonding system in bonobos represent thein animals conforms to exhibition of highest frequency of homosexuality knowncopulation, genital stimulation, mating in any species. Japanese macaques (knowngames, and sexual display behavior between as snow monkey), lions, penguins and manyindividuals of same sex. other species are shown to display Animals which engage in sexual homosexuality (73, 78, 79). Homosexualityinteractions with members of then- own sex among some species appears to be far moreare obviously not in immediate pursuit of common in captivity than in the wild.reproductive goals (conception). This Captivity may bring out homosexualviewpoint highlights paradox for the behaviors in part because of a scarcityDarwinian Theory as homosexual behavior of opposite-sex mates. Prevalence ofmight not conform to procreation role of homosexual alliance in same-sex settingsnature (74). Sexual selection is one theory such as prisons, military camps, hostels andthat explains a process of differential sports teams is a reflection of ‘situationalreproduction as males vary in their ability homosexuality’. It is also hypothesized thatto acquire female mates as reproductive exclusive male homosexuality has apartners. Mate acquisition competition could catastrophic effect on reproduction (80).be intra-sexually occurring intra-sexually Sexual impulses like any evolved phenomenaamong males for females and encompasses may be subverted for other purposes (81).physical fights and threats as well as Other related issuesritualized displays of courtship aimed atattracting females or inter-sexually involving Medico-legal viewpoint : international statusfemales selecting the most attractive malecompetitor. More recently, sexual coercion The APA removed homosexuality fromhas been proposed as an additional mate the DSM in 1973, and later declared that it
12. 16 Gulia and Mallick Indian J Physiol Pharmacol 2010; 54(1)was not a disorder. Subsequently, a new Medico-legal viewpoint : indian provisionsdiagnosis, ego-dystonic homosexuality, was In India, section 377 of the Indian Penalcreated for the DSM’s third edition in 1980. Code (Chapter XVI) was introduced inEgo-dystonic homosexuality was indicated by legislation during British rule to criminalizea persistent lack of heterosexual arousal, homosexual activity. It is commonly referredwhich the person experienced as interfering the ‘Anti-sodomy Law’ (84). After almost 149with initiation or maintenance of wanted years of the formulation of Section 377, theheterosexual relationships, and distress from Delhi High Court gave a historical verdicta sustained pattern of unwanted homosexual for decriminalization of homosexuality on 2ndarousal. In 1986, this diagnosis was removed July 2009 (85). Apparently, the ambit ofentirely from the DSM. The only vestige of section 377 as the anti-sodomy act is theego-dystonic homosexuality in the revised only legal measure to safeguard and protectDSM-III occurred under “Sexual Disorders the dignity of the unprivileged section ofNot Otherwise Specified”, which included society in the Indian context where childrenpersistent and marked distress about one’s and members of weaker section are highlysexual orientation. At this juncture, another vulnerable to sexual exploitation.widely used listing of mental disorders – theWorld Health Organization’s International Hidden health hazards associatedClassification of Diseases 9th edition (ICD-9) with homosexualitystill included homosexuality as a diagnosis Homosexuality has been illegal underand it was only in 1992 that WHO removed Indian law and the prevalent cultural normshomosexuality from the ICD-10 (23). obliged the men or women to marry the members of opposite sex only. Thus, a The American Bar Association in 1974 majority of homosexuals are not only marriedapproved decriminalization of consensual to heterosexual partners but also continueadult homosexual acts. During the 1980s and to retain their homosexual alliances in secret1990s, most developed nations enacted (86). One serious ramification has beenlaws decriminalizing homosexual behavior exposure of the innocent partner to diseasesand prohibiting discrimination against like AIDS and other venereal diseases if thehomosexuals in employment, housing, and homosexual spouse continues to haveservices. In South Asia, Middle East and multiple sexual links. Though there are noAfrican countries, homosexuality is still documented records on consequences of theseillegal carrying punishment by life marriages, it is likely that when aimprisonment to the death penalty. homosexual person is obliged to hide his/ her sexuality and forced to marry under It is reported that quality of life among various social and family pressures, there ishomosexuals were high in cultures with high probability of conjugal conflicts leadingaccepting attitude towards homosexuality to upsurge in secondary psychiatric disorders.than in culture with restricted attitudes (82).A group of Human Rights experts launched The general robust belief is that marriageYogyakarta principles on the application of is in no way comparable to alliance betweenHuman Rights Law in relation to Sexual homosexuals. In some countries there isorientation and Gender rights in 2007 (83). provision of marriage between same-sex
13. Indian J Physiol Pharmacol 2010; 54(1) Homosexuality : A Dilemma in Discourse! 17couple whereas in few others there is the sexual function produced by a certainprovision of a civil union with partial rights arrest of sexual development. Many highlyof marriage (87). respectable individuals of ancient and modern times have been homosexuals, several ofDeterrents to perception of homosexuality the greatest men among them (Plato, The age-old cultural and religious Michelangelo, Leonardo da Vinci, etc.). It isendorsements have consistently advocated a great injustice to persecute homosexualitythat homosexuality is wrong both in principle as a crime, and cruelty too....” (92).and on ethical grounds, since it pertains to Future trends :an unnatural act without any valid outcome.Moreover, the bowdlerization of any issue Homosexuality has been viewedpertaining to sexuality, scientific or social, differently in various cultures. Thein the public has only worsened the situation psychosexual concepts related to it hadby letting all kinds of misconceptions to undergone enormous transformations in lastspread at the cost of human dignity and century from a state of mental illness/health. Even the very idea of sex education disorder to a natural condition. The biologicalis generally ill-perceived in the conservative evidence indicates that the human gendersocial framework. identity and sexual orientations are programmed into the brain during the Another major concern comes from the intrauterine period and there is geneticprevailing law that prevented homosexuals component to homosexuality. A few studiesto come forward to test for HIV/AIDS. indicate that learning experiences duringAccording to estimate of National AIDS various stages of development can alsoControl Organization, NACO, there are 2.5 influence sexuality. Homosexuality is a moremillion male homosexuals in India (88). It is complex issue in human as compared toestimated that the number of exclusively or animals, and the role of nature versuspredominately homosexual men in India may nurture is yet under scanner of scientificbe over 50 millions but accurate data is investigation. All the studies anddifficult to gather due to the legal barrier evolutionary theories till date individually(89). Recent reports in India indicate high did provide useful information to someHIV prevalence among homosexual men (90, aspects of homosexuality but a more91). The prime fear among the policy makers comprehensive and integrated researchis that legalization of homosexuality might approach is desired to understand theresult in increase in number of AIDS cases. roots of homosexuality in longitudinal studies.However, there is another angle to it, i.e. if ACKNOWLEDGEMENTSthe legalization provides for a mandatoryregistration of homosexual’s, then the The authors greatly thank Prof. V.homosexual alliance would not only be safe Mohan Kumar (Sree Chitra Tirunaland would also guard against the spread of Institute of Medical Sciences & Technology,AIDS in a major way. Freud had stated that Thiruvananthapuram (Kerala) and“Homosexuality is assuredly no advantage, Dr. Subbulakshmi Natarajan, National Brainbut it is nothing to be ashamed of, no vice, Research Centre, Manesar (Haryana) forno degradation, it cannot be classified as an their critical evaluation and helpfulillness; we consider it to be a variation of suggestions to this review.
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