1953 Homosexuality included in DSM-I Critique from NIMH- no scientific basis 81 words clip - 4 minutes Evelyn Hooker research - 1957
When you assume homosexuality is a disorder, clearly you try to find ways to cure it. Which leads to such gems as this study. Annals of Bad Research: • Heath (1972) “Pleasure and brain activity in man: Deep and surface electroencephelographs during orgasm.” • Chair of Psychiatry & Neurology at Tulane through 1980 • Financed by CIA and US military • Experimented on prisoners and African-Americans, inducing schizophrenia On the surface, this looks like research meant to explore the difference in EEGs obtained during orgasms, one via masturbation, one via heterosexual intercourse. When you look further… The patient has severe epilepsy, is severely depressed with a history of suicide attempts, is multiply substance-addicted, and has been kicked out of the military… for being a homosexual. “...the patient was equipped with a three-button transistorized device... The three buttons... were attached to electrodes in the various deep [brain] sites, and the patient was free to stimulate any of these three sites as he chose... He was permitted to wear the device for 3 hours at a time: on one occasion he stimulated his septal region 1,200 times, on another occasion 1,500 times, and on a third occasion 900 times. He protested each time the unit was taken from him, pleading to self-stimulate just a few more times... the patient reported feelings of pleasure, alertness, and warmth (goodwill); he had feelings of sexual arousal and described a compulsion to masturbate.” Sounds great - let a depressed addict self-stimulate. What could possibly go wrong? (Rats will do this until they die.) BUT WAIT THERE’S MORE. “One aspect of the total treatment program for this patient was to explore the possibility of altering his sexual orientation through electrical stimulation of pleasure sites of the brain. As indicated in the history, his interests, contacts, and fantasies were exclusively homosexual; heterosexual activities were repugnant to him. A twenty-one-year-old female prostitute agreed, after being told the circumstances, to spend time with the patient in a specially prepared laborator.” (WHERE IS THE IRB? Oh wait, there wasn’t one.) “Later, the patient began active participation and achieved successful penetration, which culminated in a highly satisfactory orgiastic response, despite the milieu and the encumbrances of the lead wires to the electrodes.” Success!
Campaign to change the DSM 1972 APA convention - Dr. H Anonymous. Would only appear in an oversized suit, fright wig, and altered Nixon mask, with a voice distorting microphone. “I am a gay man and a psychiatrist.” A series of back-room meetings ensued leading to…. 1973 - Homosexuality removed as a disorder in and of itself. So everything’s better, right?
DSM III- 1980 ego-dystonic homosexuality (1) a persistent lack of heterosexual arousal, which the patient experienced as interfering with initiation or maintenance of wanted heterosexual relationships, and (2) persistent distress from a sustained pattern of unwanted homosexual arousal. Treatment for this diagnosis still focused on removing the homosexuality, rather than removing the dysstonia 1987, the diagnosis was FINALLY removed, but it was still implied in DSM-III-R under Sexual Disorders Not Otherwise Specified
The search for an answer to the “why” of sexual orientation continues. How on earth did this research get going? This has creepy overtones of the physiognomy studies done during the days of English colonialism to try to distinguish characteristics of “desirable” vs “undesirable” African tribes. The legacy of which is: 1) the Nazis’ program of eugenics against Jews and gypsies and etc., and 2) Rwandan genocide.
LeVay, a gay man himself: “As a teenager and young adult I accepted the Freudian line [on sexual orientation], according to which a young child&apos;s relations with his or her parents play a decisive role...it seemed to be borne out in my own family experience: I remembered my mother as having been very close and possessive, and my father as distant, even hostile...when I came to read Freud I was swept away by his eloquence and the sheer audacity of his theories. Later...I began to have serious doubts. First, as I got to know large numbers of gay men and lesbian women, it became harder and harder to see them, or myself, as the products of defective parenting; we just seemed too normal. Second, as I became trained in the methods of science I became more and more skeptical that there was anything scientific about Freud&apos;s ideas, even though he repeatedly asserted that they were so. And finally, discoveries were being made in the area of sexual biology that were pointing in all kinds of new and exciting directions; Freudianism, on the other hand, seemed to have become a fossilized immovable dogma.” So LeVay was trying to find an explanation other than “mothers make you gay.” That was nice of him! LeVey, 1991 - “Interstitial nuclei of the anterior hypothalmus” - tiny cell clusters in the brain. Measured 4 different groups, found no differences between gay men, straight men, and women in 3 of them. In the fourth (INAH 3), the region was twice as large in presumably hetero men than women (whose sexual orientation was not defined). It was also twice as large in hetero men than in gay men. “This finding suggests that INAH 3 is dimorphic with sexual orientation, at least in men, and suggests that sexual orientation has a biological substrate.” Of course to measure tiny regions of cells in the brain, you have to use dead people. And what were gay men dying of in the 80s? Also, when you measure brains of adults, you are measuring people who have already been having sex. So which is the chicken and which is the egg? Ultimately, the physio research has an underlying bias in its attempts to prove that gay men are “like” women and/or lesbians are “like” men. And at the end of the day, ring fingers and brain structures still fail to account for bisexuals… So what has science done for bi people lately?
“Bisexual Men Exist!” trumpets NY Times (August 2011). In 2005, a study from Northwestern said that “with respect to sexual arousal and attraction, it remains to be shown that male bisexuality exists.” This surprised many bisexual men and their partners. Standard “watch porn, measure arousal” studies. Northwestern repeated it this year (Cerny & Janssen) but recruited from “online venues specifically catering to bisexuals” and required that participants “have had sexual experiences with at least two people of each sex and a romantic relationship of at least three months with at least one person of each sex.” (Can you imagine a study of heterosexuals that excluded people who were virgins or who had only had casual sex? Because we all know you have no discernable sexual orientation until you have fallen in love and done the deed!) Thank goodness we can now confirm anecdotal sightings of bisexuals in the wild! One good thing: the study provides ammo against “it’s just a phase.”
Fortunately for bisexual women, their existence was confirmed in January in “Developmental Psychology.” Dr. Lisa Diamond, University of Utah - 10 year study of of women, showed a stable pattern of attraction to both sexes. They did show flexilibility in labels, some switching to “unlabled,” some to “heterosexual,” most of whom switched back to “bisexual” by the end of the 10 years. The label “lesbian” encompassed many who had sexual contact with men while none of those who self-labeled as heterosexual had female partners. “This provides further support for the notion that female sexuality is relatively fluid and that the distinction between lesbian and bisexual women is not a rigid one.” Of course, bisexuals continue to confound researchers who want to draw generalities, because they have confusingly different degrees of attraction to different sexes. And trans people mess up the binary model of attraction completely…
World Science Festival - “Impossible Predictions.” What gets done with this predictive research?
So by 1987, everything’s better right? OF COURSE IT IS. No wait, we can’t stop policing gender and sexual norms, so we have to shift the target! “Transsexualism” introduced as a disorder. • DSM IV- 1994, transsexualism changed to GID
Proposed changes to DSM-V GID to Gender Dysphoria Child and adult changes Increasing number of symptoms kids must have (6 out of 8), decreasing number adults must have (only 2 of 6) Still emphasizes individual impairment and distress as part of the diagnosed problem, instead of seeing the environment as impaired and the person as functional Transvestic Fetishism to Transvestic Disorder Controversy over the makeup of the committee developing these new categories - notorious “trans reparative therapy” practitioner appointed as the head/
Once again, with the diagnosis, comes treatment, and not always helpful treatment. When social norms are disguised as science, , the practices that come from science are practices that enforce and police social norms. “Bree” in “Transamerica” - “Isn’t it interesting, how a mental disorder can be cured with plastic surgery?” Lack of consensus in trans communities about whether the diagnosis should exist and a multiplicity of experiences of how the dx affects people.
For many religious people, this question is so salient because the answer to it reveals something about God’s intent. If God meant to create gay people then it’s OK, but if people choose to lead this sinful, broken lifestyle, then they should choose to stop. Despite “hard science’s” attempt to cast itself as neutral, value-free, and empirical, its 100+ year quest to “explain” homosexuality and gender variance has essentially been laid atop a strata of religiously-based discomfort with these “deviations” and an attempt to resolve the moral dilemma of “how should we treat these people - as beloved parts of creation, or as sinners?”
Religiously-motivated groups have used psychological research in distorted ways to try to “prove” their homo-negative statements, much to scientists’ dismay.
J. Serovich - meta-analysis of reparative therapy literature What is the rigor of the studies supporitng the conclusions claimed by both sides of the debate? Limited participant info (repeatability?) No control groups No longitudinal follow-up Lack of theoretical rationale 61% didn’t report drop-out or return rates No clear measure of sexual orientation NO EMPIRICAL EVIDENCE that supports reparative therapy as an attempt to change SO Consequences: Depression Sucidal ideation/attempts Social & interpersonal harm Loss of social support Loss of spiritual harm Low self-esteem Difficulty sustaining relationships Sexual dysfunction
After the AAMFT statement came out in 2009, Dobson declined to renew his long-standing membership in AAMFT.
“My experience with GLBT people emphasized the importance of the social construction of meaning.” Other comments were more general, for example “I have noticed that much of the MFT literature and theoretical ideas work to create a ‘one size fits all’ approach to systems work.” Panelists offered critiques of the heterosexism of mainstream MFT literature and techniques, and its definitions of health and pathology. Some answers reflected a more global change in perspective, : “My experience has made me seek complications rather than simplifications.” Respondants agreed that they had learned to be accountable for ways in which they may perpetuate oppression via language, silence, and even their own identities. They identified a need for understanding the dynamics of privilege and power, so that therapy does not replicate social oppressions. Other effects of experience with GLBT issues: better connection with clients of all kinds, fewer clinical assumptions about sexuality and gender, and allowing space for a range of identities, therapeutic goals, and definitions of relationships and families (including “open relationships” and the definition of the word “marriage”). Respndants agreed that they were giving attention to alternate definitions of family in teaching/writing. Did NOT agree that they were attending to gender variance in training and research, or in clinical work - may indicate lack of support, lack of comfort, very minimal presence of out gender-variant people in the field. “I have come to believe that synthesizing queer theory with MFT allows for expanded definitions of healing, health, gender, and family for all clients, not just GLBT people.” “I challenge students to consider social pressures when using diagnostic terminology.” Respondants expressed concern about the degree to which QT and an LBGT perspective could ever be integrated with MFT, in part because of the field’s name and self-definition. Though increasing numbers of states that allow gay marriage may eventually shift this. The therapist-as-expert role also proved problematic for many respondants. On the other hand, postmodern and multicultural approaches were identified as good fits with these perspectives, and even general systems theory. The panel supported the statement “all MFT theories could be compatible with queer theory but underlying assumptions would need to be changed and altered.” Systems theory’s interest in outside resources, networks of support, dialogue and a support for both/and stances in couples and families, and the healing power of relationships were also seen as compatible. Though panelists agreed that over all an infusion of GLBT and queer perspectives would be a net gain for the field, they expressed concerns about a loss of critical numbers of therapists, particularly religiously-conservative therapists, faculty, and MFT programs. However they felt that more queer clients would seek help from MFTs if the field shed its heterosexist biases, and also agreed that even “traditional” families would benefit from more flexible, open definitions of “marriage” and “family.” They saw this change as one that would facilitate addressing gender issues with all clients, not just trans people. The field’s politics and fears of division were identified as clear barriers, as well as “fear of losing credibility or being seen as too liberal.” Changes in training, following best practices recommended by other professions and changes in law and popular opinion, were identified as supporting these changes. Do we need a “Rosetta Stone” to translate QT for the field (like Epston and White did with postmodernism, and feminist family therapists did with feminist theory?) We definitely need anxiety management as categories slip and slide! It appears that the most useful tool for change identified with the panel was the power of individual activism and persistence.
Sean Dorsey & Shawna Virago - trans couple in SF
San Fransciso State University - long term process and outcome research with diverse families of GLB (T?) kids.
The FAP - extensive research on how families influence trajectory of LGBT youth – protective and risk-increasing factors – accepting is ideal, but the difference between ambivalent vs. rejecting is very steep – harm reduction Cross-cultural, cross-religious work with families providing them info Suggests that the most imprtant target question is “how can we help families move from outright rejection to a place of ambivalence, grudging tolerance, agreeing to disagree, etc.?” David Wohlsifer – discussant at AFTA - This research relates to resarch on neuroplasticity – the conclusion that we are “wired to connect” – we only grow in our brains in relationships (Mona ???, Dan Segal) – FAP research suggests a continuum of connection, acceptance – a continuum of oxytocin? Some is better than none? The yearning of youth for their parents – reinforces this view of the brain as relationally driven.
Parents managing children with non-trad gender roles – new strategies, new openness
Cheryl Kilodavis - wrote it based on experiences with her son (isn’t it interesting that trans acceptance seems to have jumped ahead in the “mainstream” to some degree? Anecdotally - religiously conservative students appear to have an easier time accepting and empathizing with trans people than with LGB people, although the Bible says men should not wear women’s clothes as well as appearing to condemn same-sex behavior…)
Queer theory in clinical practice Practice outside social and cultural definitions of what is healthy, desirable, and normal Challenge Western heteronormal ideals of family and relationships Queer as a sociology-cultural and political concept Sexuality as an individualized and individual idea rather than one shaped by culture and society Mechanisms of power and oppression in the lives of people History of pathologizing LGBT people/ medical model Traditional psychology has served to produce knowledge that reinforces heteronormativity and binary gender structures and oppress people who exist outside of those norms Most of us have been trained to embrace a practitioner-scientist model based on scientific &quot;evidence&quot; What is the role of science? Not writing to disregard research or evidence-based practices, rather critically examine who and how we study people and relationships and what are the ethics associated with those outcomes The quest to be normal, spiritually and religiously accepted What is the problem and for whom? (Butler & Byrne) What is queer is that which is subjugated in a relation to that which is dominant, not to accept, affirm, or tolerate what is &quot;different&quot; or alternative which others Don&apos;t impose heteronormative ideals onto clients life choices, affirm their choices For all clients, we are not choosing to other LGBT/ queer people, as we are all constrained by social rules and structures Multiple realities As therapists we are not politically neutral and have to be actively concerned with ethics and politics of power
Research suggests that knowing even one gay or lesbian person significantly increases your chance of supporting gay marriage. (Gallup poll, 2009) (Correlation vs. causation, but anyway.) Does familiarity increase empathy? Neuropsych could look at amygdala (fear structure) and brain functions that correlate with attunement to others. A kind of “exposure therapy” for homophobia? Old research (when? Who?) showing that men with highest homopobia scores show more physical arousal when they watch gay porn, yet they also deny any conscious awareness of this arousal. - Research into cognitive neuropsych of liberals vs. conservatives – larger amygdala (fear center) in conservatives, larger ACC in liberals (error detection, weighing competing choices, detecting nuance) - repeat this research with homophobic vs. homopositive adults? (of course, then what? I’ll leave that to the brain people…)
Of course without a dx, it’s hard to treat. Should we be talking about including “Gender Rigidity Disorder” in the DSM5? Bring back ego-dystonic sexual orientation disorder – but treating the homophobia, not the orientation? Homophobic Personality Disorder? E. Franklin Frazier, black social worker in the 20s, who identified patterns of delusional thinking among racists (persistent beliefs even in the face of contradictory facts), plus defense mechanisms, projections, and even hallucinations that supported their racism, was dismissed as the chair of the Atlanta University School of Social Work, and fled the city with a gun for protection. His work in this area has been largely ignored. Other black psychologists have tried to advocate for including a diagnosis in the DSM that describes racist delusions but have been excluded from the task force, which was justified by saying they had addressed diversity by including women (DSM-III revision). Racist Personality Disorder still hasn’t made it in.
Effects of trauma on the brain – physical and emotional – short and long-term. Relevant to bullying, family physical/emotional abuse of queer kids. Trauma and the brain – neuro research tells us that the brain works exceptionally well to focus on cues for attention (inhibit other inputs), and then strongly reinforce that focus to create long-term learning (locks it in). Great when you’re trying to evolve in the forests and grasslands and spread your DNA more effectively. Terrible when you’re trying to survive in school where you’re being bullied at every turn, even when you go home and turn on your computer. Trauma seems to reduce brain size, increase cortisol, and suppress posterior cingulate – a brain area that confirms where in space your body is. You literally become detached from your physical existence. It impacts the prefrontal cortex, which regulates our ability to self-relate and self-observe, and the relationship between right and left hemispheres which can affect speech and expression. If your expression is impaired, you can’t reflect on yourself, and you feel detached from the real world, is it any surprise if you consider suicide? Teicher, 2011 - Bullying can leave an indelible imprint on a teen’s brain at a time when it is still growing and developing. Being ostracized by one’s peers, it seems, can throw adolescent hormones even further out of whack, lead to reduced connectivity in the brain, and even sabotage the growth of new neurons. These neurological scars, it turns out, closely resemble those borne by children who are physically and sexually abused in early childhood. Neuroscientists now know that the human brain continues to grow and change long after the first few years of life. By revealing the internal physiological damage that bullying can do, researchers are recasting it not as merely an unfortunate rite of passage but as a serious form of childhood trauma. hose who reported having been mistreated by their peers had observable abnormalities in a part of the brain known as the corpus callosum — a thick bundle of fibers that connects the right and left hemispheres of the brain, and which is vital in visual processing, memory, and more. The neurons in their corpus callosums had less myelin, a coating that speeds communication between the cells — vital in an organ like the brain where milliseconds matter. Kids who had been bullied reported more symptoms of depression, anxiety, and other psychiatric disorders than the kids who hadn’t. Vaillancourt, 2008 - bullied boys have higher cortisol, bullied girls have lower - possibly a sign of such chronic stress that the body has stopped over-producing? Bullied kids perform worse on verbal memory tests, possibly a sign of damage in hippocampus.
EFT and trauma - Trauma’s natural antidote is being able to turn to someone and have them literally hold and soothe you. A huge part of the brain is devoted to reading and interpreting others’ behavior – the brain is a social organ. A loving environment is a natural healing device. Working with US Army, VA hospitals, post-deployment protocol. It’s also being used with the NY City fire department. Attachment changes the threat’s meaning as it’s being coded, when it’s being laid down in the brain. It seems to re-direct the focus on the threat cue – “look over here!” “If you can reach for someone else when the dragon is coming for you, the relationship gets stronger. If you reach and they’re not there, the dragon seems worse.” - SJ It would seem an excellent fit for working with families of GLBTQ youth, to provide a “cushion” against bullying, but would need study to see if it’s effective.
Fine, “Delusions of Gender” - The neurobio effects of gender difference – being exposed to sexist tropes affects performance. “Looping effects” (Ian Hacking) (you create the category but the category creates you). What is relevant about this for GLB and Trans people, and exposure to rigid gender norms, homophobia, etc.? Being told who you are, how you should be, what you should NOT be, how defective you are if you don’t measure up, etc.
David Eagleman - “Incognito: The Secret Lives of the Brain” Secret-keeping – research showing it creates stress response effects of being in the closet? (does this explain homophobes?) For those who manage identity and are partly in, partly out depending on context, (e.g. those with religious families) how can their stress be mitigated? What makes some resilient to this stress?
Do anti-prejudice messages increase prejudice? Telling people how to think – in this case, telling people to not be prejudiced, rather than allowing them the opportunity to determine their own values – is an approach that often boomerangs. This comes from cognitive psych research showing that directly contradicting a strongly-held belief actually makes the belief stronger, no matter how odd or unsupported the belief is. According to co-author Lisa Legault, Ph.D., ”Controlling prejudice reduction practices are tempting because they are quick and easy to implement. They tell people how they should think and behave and stress the negative consequences of failing to think and behave in desirable ways.” Conservative vs. liberal neuropsych and thinking styles - liberals tend to do more compare/contrast of facts, have stronger activity in areas that evaluate nuance. Conservatives have larger amygdalas (fear center, but also empathy) and tend to react with emotion first when their beliefs are challenged because they strongly identify with their beliefs. (Amodio 2007, Kanai et al. 2011) What messages are effective? The “bipolar brain” - prejudice and acceptance can co-exist. Goes back to the secret-keeping research - if your brain is “keeping a secret from itself,” what effect does that have? How can we get at this conflict, particularly when strong messages disputing a belief you hold deeply will tend to entrench you further in that belief?
The only way we can create second-order change is to learn how to have meta-conversations about our research and our work. We have to learn how to QUEER, or call into question, the fundamental assumptions which permeate the conversation when it comes to studying sexual orientation and gender. Queer theory: A theoretical analysis which questions the existence of categories, particularly sexual identity and gender categories, and critiques the way in which these categories may exclude as much as they include. As opposed to: GLBTQ identity: A political, social-justice analysis that advocates for greater inclusion of the experiences, contributions, and needs of gay, lesbian, bisexual, transgendered, and otherwise queer people in academic and public discourse, social services, public policy, etc.
See handout on queer research questions
AAMFT 2011 Queer Science: History & Research Implications on Families
History & Research Implications on
Sheila M. Addison, Ph.D., LMFT
Kristen E. Benson, Ph.D., LMFT, CFLE
North Dakota State University
Annual Meeting of the American Association for Marriage and Family
Therapy, September 22-25, 2011, Fort Worth TX
• What are we doing here?
• What are you hoping to get out of today?
• Information from today’s presentation will be posted at
http://www.drsheilaaddison.com by the end of the conference
1. gain a historical perspective on clinical research
about homosexuality, gender variance and
2. increase critical thinking skills about the design
and application of research to the study of
sexuality and gender.
3. explore the implications of LGBT research on
clients and families.
4. generate ideas for how to develop research on
LGBT individuals and families.
“The Many Faces of Human Sexuality”
Source: World Science Festival
Baby, were you born that way?
• What have you heard causes a gay, lesbian, or
• What have you heard causes transgender gender
History of Queer Science
QuickTime™ and a
are needed to see this picture.
Source: World Science Festival
History of Queer Science
• “This is why it has always been dangerous
to rest the claim for LGBT equality on the
argument that homosexuality is genetic or
biological. It may well be, but what if it
were proven not to be so? Would that now
mean that it would be ethical to
discriminate against LGBT folks, simply
because it wasn’t something encoded in
their biology, and perhaps was something
over which they had more “control?”
History of Queer Science
Source: “Diagnosing Difference”
From time to time AAMFT receives questions about
a practice known as reparative or conversion
therapy, which is aimed at changing a person’s
sexual orientation. As stated in previous AAMFT
policy, the association does not consider
homosexuality a disorder that requires treatment,
and as such, we see no basis for such therapy.
AAMFT expects its members to practice based on
the best research and clinical evidence available.
- Board of Directors, March 2009
Queering the field
Addison - unpublished dissertation (2007) -
Delphi study of LGBT and QT informed
• “How have these knowledges informed your
teaching, research, and practice?”
• “What would the field be like if it were similarly
• “What would the field gain or lose?”
• “What stands in the way of or facilitates such
Queering the field
Trans people and their partners’ perceptions of CFTS: They think they
could be helpful, but they just don’t “get it.”
Where could we go from here?
“What is the
problem, and for
whom? - Butler &
Where could we go from here?
Do not know
Do not support
Q: 1) Do you personally know someone gay?
2) Do you support gay marriage?
Reading research queerly
Queer theory: Foucault, Butler, Halberstam, etc.
Recommended: “Queer Theory, Gender Theory” - Riki Wilchins
“Queer is by definition whatever is at odds with the normal, the legitimate, the dominant.
There is nothing in particular to which it necessarily refers. It is an identity without an essence” -
• Questioning binararies
• Interrogating assumptions (“truth statements”)
• Exploding categories (making them “slippery”)
• Identify, confront, and embrace the anxiety this creates
“At the margins, science no longer asks, but tells.” - Wilchins
Reading research queerly
What questions can we ask in order to “queer”
research that we encounter?
How will a “queered” perspective inform our research?
How will this perspective inform our clinical work with
couples and families?