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Does the APA consider hebephilia to be normal?

May 16, 2013 by 36 Comments

That question is being asked by Ray Blanchard in a letter to the editor (read entire letter here) of the Archives of Sexual Behavior. Blanchard is the former chair of the Paraphilias Subworkgroup of the APA’s DSM V Sexual and Gender Identity Disorders Workgroup. DSM stands for Diagnostic and Statistical Manual of the American Psychiatric Association. The new 5th edition is slated to be released any day now and has attracted much controversy for a variety of reasons.

Generally, there is no more controversial area of the DSM than the section on sexual disorders. Blanchard’s subworkgroup recommended including reference to hebephilia in the section on paraphilias in the new edition. Hebephilia is defined as primary sexual interest in children who are in early puberty (i.e., at Tanner Stages 2 and 3, often corresponding to development between ages 11 and 14). Blanchard begins his letter by noting that “on December 1, 2012, the American Psychiatric Association (APA) announced that its Board of Trustees (BOT) had voted to reject the changes to the diagnostic criteria for pedophilic disorder proposed by the Paraphilias Subworkgroup for DSM-5 and to retain the diagnostic criteria published in DSM-IV-TR [i.e., a sexual preference for prepubertal, i.e., Tanner Stage 1, children, nowadays about age 10 or younger].”

Blanchard believes the proposed change would have allowed more precise diagnosis and research of people who have sexual preferences for early pubescent children but not younger, pre-pubescent children or adults. However, for reasons that are not clear, the APA Board of Trustees did not accept the recommended changes.

The fact that the APA did not make this change raises questions. Blanchard asks if the APA wants to discourage research on hebephilia. Furthermore, Blanchard wonders if the current DSM allows for hebephilia to be diagnosed under the category “other specified paraphilic disorder.” In other words, can clinicians and researchers use the “other” category to give label to individuals with hebephilia.  Ultimately, according to Blanchard, the answers to these questions may provide insight into the APA’s stance on normal sexual preferences. He writes

It remains to be seen how the BOT [board of trustees] will respond to these questions when they start to arise in real-life settings, which they will. It seems to me that there are only two possibilities. If the BOT denies that it meant to assert that the sexual preference for children in early puberty is normal, then it has to allow the diagnosis of ‘other specified paraphilic disorder (hebephilia).’ If the BOT, or someone officially speaking on behalf of the BOT or the whole APA, states or testifies that the BOT intended to prohibit the diagnosis of ‘other specified paraphilic disorder (hebephilia),’ then that is tantamount to stating that the APA’s official position is that the sexual preference for early pubertal children is normal.

Elsewhere in his letter, Blanchard states that sexual preference for early pubertal children doesn’t “square with the average layperson’s concept of sexual normalcy and probably does not square with the average clinician’s either.” I agree and believe Blanchard raises some important issues which I hope the APA will address.

Note: On May 16, I asked the APA PR dept for comment on Blanchard’s letter. No response as of today (May 17). I will post anything I get.

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Based on Biased Reading of New Mortality Study, Paul Cameron Gives Sen. Portman Parenting Advice

April 24, 2013 by 13 Comments

In this month’s edition of the International Journal of Epidemiology, Morten Frisch and Jacob Simonsen reported a new study of mortality in Denmark. Paul Cameron wasted little time trotting out the study to give Senator Rob Portman advice on how to parent his gay son – tell him to get married to a woman. Apparently, any woman will do. After all, in the words of the song, what’s love got to do with it?

Cameron says he even went to Ohio to deliver his advice:

COLUMBUS, Ohio, April 24, 2013 /Christian Newswire/ – Dr. Paul Cameron, the first scientist to document the harms of secondhand smoke, went to Ohio’s capital to call upon U.S. Senator Rob Portman (R-OH) to reconsider his recently announced support for gay marriage. “Sen. Portman, gay marriage is hazardous to one’s health. For the sake of the son you love, urge him to marry a woman.”

Cameron did say at least one thing that was true in his presser:

Cameron said, “Bad science is bipartisan…”

Proven by Cameron’s own press release, bad science is indeed everywhere.  And bad advice. One of the findings of the Frisch and Simonsen study is that mortality for same-sex married men is better than “unmarried, divorced and widowed men.” It is also important to note that the mortality rates for gay married men have improved since Frisch’s last study. Cameron doesn’t tell you that.

Cameron and Frisch tangled on this blog back in 2007 and 2008. Cameron made his mortality claims in a “study” presented before the Eastern Psychological Association and Frisch responded to him as a part of a nine-part series I did on gay mortality claims. Frisch’s first study on gay mortality was done in part to address Cameron’s spurious claims.

To understand more about Paul Cameron and his feelings about gays, read part 9 of the series. Disturbingly enlightening.

I have asked Morten for additional reactions and will have more reflections on the study in a coming post.

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The Scandal of the Evangelical Double Mind

January 29, 2013 by 54 Comments

In his 1995 book The Scandal of the Evangelical Mind, Mark Noll wrote, “The scandal of the evangelical mind is that there is not much of an evangelical mind.”

Recently, at Patheos, Eastern University professor Peter Enns updated Noll and added that “The real scandal of the Evangelical mind is that we are not allowed to use it.”

Today, I want to extend Enns and Noll and assert that the evangelical mind, such that it is, is double minded.

First, let me say that Enns makes an observation which sounds quite familiar to me:

Calling for Evangelical involvement in public academic discourse is useless if trained Evangelicals are legitimately afraid of what will happen to them if they do.

As a participant in the great sexual reorientation wars of the past decade and the current controversy over David Barton and American history, I can tell you that the culture war complex does not seek or accept well scholarship that does not support current culture war talking points.  For instance, after Thomas Nelson dropped Barton’s The Jefferson Lies, Wallbuilder’s number two man, Rick Green, compared Barton’s Christian critics to Hitler and Saul Alinsky. Green wrote:

Question: What do elitist professors have in common with Adolf Hitler & Saul Alinsky?

Answer: They masterfully use the powerful art of innuendo to falsely defame those with which they disagree.

That kind of thing is shocking but I am mostly numb to it after years of this give and take. However, I think most academics are a little skittish about such vitriol over doing what academics do.

Enns adds:

The scandal of the Evangelical mind is that degrees, books, papers, and other marks of prestige are valued–provided you come to predetermined conclusions.

Persistence pays off and real headway has been made in the sexuality arena, but I still see a blackout of sexual orientation research among Christian media. As I have documented, important studies of sexuality and gender have been reported in the popular press but haven’t risen to the level of newsworthiness in the Christian press. Even though evangelical scholars take these studies seriously, the consumers of culture war and Christian media probably won’t hear about them if the research implicates a biological origin for homosexuality.

On the American history front, many of the popular media sources have ignored the David Barton controversy (e.g,, I don’t think Christianity Today has touched the subject). Many popular radio hosts simply won’t allow another point of view on their programs.  I am very thankful that World Magazine has been the clear exception.

In 2011, Thomas Kidd pointed out that evangelicals are bosses at creating subcultures (e.g., Christian music, Christian television, Christian publishers). We also have our “experts.” Others (e.g., Stephens & Giberson in The Anointed: Evangelical Truth in a Secular Age) have pointed out that evangelical experts rarely have deep academic training in their chosen subject.

Now we come to the double-minded part. The experts (e.g., David Barton) create their niche by demeaning academic work, even by Christian scholars. Witness Barton’s defense of his work. As noted previously, his radio show co-host blasted us with comparisons to Hitler and Alinsky. With condescension, Barton blasted Coulter and me for being “academic elitists” and added

It is striking that the negative critiques of The Jefferson Lies revolve around the academic arrogance that says “Unless we tell you so, it just can’t be; we are the sole gatekeepers of historical truth.” But Governor Mike Huckabee, in speaking of my approach to history, stated: “In typical Barton style, every syllable is given scholarly research and backed up with source documents. Those who hate America and God’s Word won’t like it, but they won’t be able to discredit it.” Clearly, academics such as Throckmorton, Coulter, Jenkinson, Crawford, et. al., simply don’t like what the self-evident documentation actually proves.

Driving home the scandal of evangelical double-mindedness is this observation. On one hand, evangelicals spend lots of money to send their children to evangelical colleges, and they want those children to learn their lessons well. On the other hand, with donations to culture war  organizations, they prop up self-anointed experts who tell them that academic rigor, training, and skill are barriers to the real truth, hidden away by stuffy, arrogant professors. Want to know something about history (science, sexuality, etc.)? Then don’t call your child’s Christian college professor; call David Barton.

All of this should be deeply troubling to evangelicals. Actually, the kids are not alright; we are losing them in buckets. I have to say that I think one of the factors is the anti-intellectual stance of the organizations which say they represent us. By and large, these groups need to do an audit of the claims they make (scientific, historical, etc.) and allow Christian scholars of various views to weigh in. In addition, I think it would be helpful if the Christian media complex would report about research on hot scientific topics. And when they do, they need to go find academics who are doing the research and get comment from those Christian researchers and professors who understand the nuances of the topic.

I start with the premise that science is no threat to faith. If scientific work seems to conflict with tenets of my religion, I accept the tension until I understand things better. Extending that belief to history, I do not need the founders to be evangelicals in order to enjoy and defend American freedom for people of my faith, another faith, and no faith.

Loving God with all my mind doesn’t mean splitting it in two. If a study of science or history tells me something uncomfortable, I do not retool the science or history to make me comfortable. I walk by faith, live with the tension, and accept what is in front of my face.

 

 

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Matt Barber Invokes Jerry Sandusky to Mislead Public About SB 1172

January 5, 2013 by 47 Comments

I get it. Matt Barber thinks gays are disordered and he opposes CA SB 1172.

Agree with the bill or not, one should not exploit a tragedy in order to mislead people about what the bill says.

Barber says the bill prevents counselors from helping kids who have been sexually abused. He writes at WND:

The critical importance of stopping SB 1172 and similar legislation springing up elsewhere becomes especially clear when one considers that such sexual confusion is frequently caused by sexual molestation at the hands of homosexual pedophiles like Jerry Sandusky (hence the moniker: “Jerry Sandusky laws”).

First of all the general link between homosexuality and child abuse he attempts to make is spurious. The Tomeo study he refers to (Archives of Sexual Behavior determined in a 2001 study…) is not accurate and the second author has acknowledged this.  That study or any other one finding a correlation between abuse rates and orientation can tell us nothing about causation.  If Liberty Counsel makes that argument in court, I hope the court gives them a lesson in research methods.

Second, the new law does not prevent counselors from helping kids who have experienced such tragedy. Here is what the law says:

(o) Nothing in this act is intended to prevent a minor who is 12 years of age or older from consenting to any mental health treatment or counseling services, consistent with Section 124260 of the Health and Safety Code, other than sexual orientation change efforts as defined in this act.

Treatment for sexual abuse recovery is not prohibited.  One does not need to tell kids that they can change their sexual orientation by healing from sexual abuse in order to treat the effects of sexual abuse.

Furthermore,

(b) (1) “Sexual orientation change efforts” means any practices by mental health providers that seek to change an individual’s sexual orientation. This includes efforts to change behaviors or gender expressions, or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same sex.

(2) “Sexual orientation change efforts” does not include psychotherapies that: (A) provide acceptance, support, and understanding of clients or the facilitation of clients’ coping, social support, and identity exploration and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices; and (B) do not seek to change sexual orientation.

Barber also falsely says:

[The law] would have forced counselors to violate their oath to “do no harm,” compelling them to advise sexually confused children to adopt a “gay identity” they reject.

The law does not require a counselor to advise any clients, sexual confused or otherwise, to adopt a gay identity. The law simply says that counselors may help clients explore their their identity but does not prescribe an outcome. This law does not prevent clients from deciding they are gay or not gay. It simply prevents therapists from applying interventions that are explicitly designed to changed their sexual orientation.

It seems obvious that Barber’s objection here is based on the fact that he doesn’t understand the proper role of a counselor. Counselors don’t tell clients what identities they should adopt. Such paternalistic approaches would probably put a counselor at risk for a disciplinary action even without SB 1172.

I am not sure the law will pass constitutional muster and will depend in part on how the court rules on the professional-client speech issues. For this post, the merits of the law are not the point. Rather, an accurate description is at issue. Furthermore, exploiting one of the most heinous cases of our time is irresponsible.

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I Have Updated My Post on Generalizing Research on One Type of Therapy to Another Type of Therapy – UPDATED

January 2, 2013 by 22 Comments

UPDATE 2: Yes, I changed my title to exclude reference to horse therapy. Read why here.

UPDATE: There is now a dispute over the facts reported in this story. On the Cowboy Church website, this alert was published. Bell appears to be saying that he never talked to the media about EAP and homosexuality. I wrote to Rev. Bell and he wrote back taking me to task for referring to the HuffPo story without talking to him first. He has declined thus far to disclose whether or not he has any views on horse therapy for gays. If he informs me of his perspective, I will report it here.

As for the post, I think the basic argument stands.Substitute any outlandish sounding therapy for horse therapy and the point is still valid. Reparative therapists often use data that are not directly relevant to what they do.

——-

 

If you read about the reparative therapy wars, you have probably come across the Virginia pastor who has been quoted as advocating Equine Assisted Psychotherapy (EAP) for homosexuality.

Raymond Bell is the pastor of the Cowboy Church of Virginia and promoter of horse therapy as a sexual orientation change effort, according to Gay Star News.

Gay Star News quotes Bell as follows “because of rape, abandonment, lacking a male role model, abuse and having low self-esteem.” This seems like the standard reparative therapy line. Bell now contests these reports, although has not clarified what he does believe.

As far as I can tell there is no proof for these claims. And in this, horse obscure therapies have something in common with other forms of reparative therapy. If pressed, perhaps purveyors of strange therapies would do what other reparative therapists do – point to studies that claim to document change. However, the problem for Bell and for other reparative therapists is that the studies they point to rarely have anything to do with what they do.

Most of the early studies of sexual orientation change featured behavioral techniques such as aversive therapy. As far as can be determined, none of the current crop of reparative therapists use these techniques. Some of the early studies rely on psychoanalytic treatment but these are mostly case studies or reports from psychoanalysts who were practicing traditional psychoanalysis. Current reparative therapists use pillow beating and screaming, orange therapy, body therapy and other fringe techniques that have not been evaluated for most uses, let alone their use to support sexual orientation change efforts.

Thus, when reparative therapists point to studies of change, ask them what methods were used in those studies. The chances are extremely likely that the techniques used in those studies are not what today’s reparative therapists use.  The fact is that what is today being defended in courts in CA and NJ has not been evaluated for use in changing sexual orientation. Some techniques (catharsis) have been evaluated for other purposes and found to be counterproductive. And at least one technique commonly referenced by Joseph Nicolosi (Affect Focused Therapy) has been rejected as a technique for reorientation by one of the developers of the approach (Diane Fosha).

To sum up, reparative therapists tell us that 70-100 years of research prove that change is possible. Then they defend what they do and say research supports them. So if Raymond Bell ever says horse therapy people who advocate unusual therapies work because research proves that change is possible, they will be using the same rhetorical device as is being used by their professionally trained colleagues.

 

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