Entries in the 'Professional issues' Category

Multiple factors involved in sexual orientation: New study

A new study released online with Archives of Sexual Behavior and via press release today propose a relatively small role for family attitudes in the direction of sexual attraction, with more of the explanation being factors not shared by siblings.

Society’s attitudes have little impact on choice of sexual partner

[PRESS RELEASE 16 June 2008] A unique new study from the Swedish medical university Karolinska Institute (KI) suggests that the attitude of families and the public have little impact on if adults decide to have sex with persons of the same or the opposite sex. Instead, hereditary factors and the individual’s unique experiences have the strongest influence on our choice of sexual partners.

The study is the largest in the world so far and was performed in collaboration with the Queen Mary University of London. More than 7,600 Swedish twins (men and women) aged 20-47 years responded to a 2005 - 2006 survey of health, behaviour, and sexuality. Seven percent of the twins had ever had a same-sex sexual partner.

“The results show, that familial and public attitudes might be less important for our sexual behaviour than previously suggested”, says Associate Professor Niklas Långström, one of the involved researchers. “Instead, genetic factors and the individual’s unique biological and social environments play the biggest role. Studies like this are needed to improve our basic understanding of sexuality and to inform the public debate.”

The conclusions apply equally well to why people only have sex with persons of the opposite sex as to why we have sex with same-sex partners. However, the conclusions are more difficult to transfer to countries where non-heterosexual behaviour remains prohibited.

Overall, the environment shared by twins (including familial and societal attitudes) explained 0-17% of the choice of sexual partner, genetic factors 18-39% and the unique environment 61-66%. The individual’s unique environment includes, for example, circumstances during pregnancy and childbirth, physical and psychological trauma (e.g., accidents, violence, and disease), peer groups, and sexual experiences.

Publication:
Niklas Långström, Qazi Rahman, Eva Carlström, Paul Lichtenstein, “Genetic and Environmental Effects on Same-sex Sexual Behaviour: A Population Study of Twins in Sweden.” Archives of Sexual Behaviour, 7 June 2008, doi 10.1007/s10508-008-9386-1

This is more evidence that different factors operate differently for different people. In discussing sexual orientation, it may be that individual narratives have validity for the individual but cannot be generalized widely. Where have I heard that before?

Another news item is circulating today with what appears to be a mix of new and old research on brain structure and sexual orientation.

UPDATE - There is indeed new research from Ivanka Savic’s team in the Proceedings of the National Academies of Science. The study, titled “PET and MRI show differences in cerebral asymmetry
and functional connectivity between homo- and heterosexual subjects” by Ivanka Savic and Per Lindstrom is not yet published but I have a copy and am reviewing it.

Abeo: Ex-gay in the UK?

The Irish Iris Robinson controversy appears to have quieted down somewhat. I noted last week that Northern Ireland’s “first lady” entered controversial waters by declaring homosexuality an abomination, with subsequent embellishments. Mrs. Robinson further recommended therapy for gays to change via a psychiatrist, Paul Miller, who advises Mrs. Robinson on health matters.

As noted in my initial post on this topic, I wrote to Paul Miller to ask him if he endorsed the bioenergetics techniques of Richard Cohen. This was a relevant question since Dr. Miller organized a training led by Mr. Cohen in November, 2007. Dr. Miller did not directly answer that question but instead referred me to the website of his organization - Abeo. What is Abeo?

ABEO is an umbrella organization, set up by Dr Paul Miller, of like-minded mental health professionals who want people to be all that they can be; so that they may experience deeper joy in their lives. Our tag-line, ‘joy through change’ captures the heart of this vision.

What does ABEO mean?
ABEO in Latin means, ‘to pass away’ or ‘to come to an end’, but in Nigerian it means ‘my arrival brings joy’. By taking this name we want to show that our mission is to show that all of us experience pain of different sorts, however, when faced with issues that bring pain into our lives we can be empowered to overcome them and experience joy through finding healthy adaptations to meet our core needs.

There is much emphasis on this site about meeting core needs, especially masculinity. There are pages on manhood and gender identity which look familiar to anyone conversant in reparative drive perspectives on same-sex attraction. On the Gender Identity page, links are provided to Jonah, NARTH, Mankind Project, New Warriors Training Adventure, Internation Healing Foundation (Richard Cohen), and People Can Change.

The approach to therapy is called “gender affirming therapy” and is designed to address same-sex attraction through enhanced masculinity. Abeo says:

Where a person experiences unwanted SSA we can provide expertise and therapy to help the person meet their core unmet needs in a way that allows them to resolve their SSA and so move towards a fuller expression of masculinity and a heterosexual expression of that gender identity.

Abeo also offers training to mental health professionals, which presumably included the Cohen visit to Northern Ireland. About the training, Abeo says:

ABEO also provides training to those professionals working in the area of unwanted SSA. Through links with NARTH, JONAH, the International Healing Foundation and a number of international experts we are seeking to spread evidence based skills that will help professionals working in this area.

Given the aspiration of teaching “evidence based skills,” the links provided are puzzling. Where is the evidence that the kinds of masculinity-building interventions promoted by these organizations “resolve” SSA toward a “heterosexual expression?” As we have noted, MKP in the US has been through all of that with many manly gay warriors happy to dispute these claims.

Another aspect of this story that is interesting to me is that I expected this site to be more Christian-based given Iris Robinson’s strong words of a referral. MKP and NWTA certainly do not point their participants to Christianity as a means of manly identity. The UK Scouting Association issued an advisory warning scouting groups not to rent camps to the MKP. In the US, the ex-gay organizations can be divided into those who seem to be faith-based and those that are based in the men’s movement. If that division is real in the UK, it seems clear from a review of Abeo that the men’s movement ex-gay wing got a major plug from the first lady.

Counsellorlicense.com - Just add another letter “l”

I noted recently that the counselorlicense.com site removed the links to get a pastoral counseling certificate. However, now I see that the folks from Phoenix State University have gone British and added an “l” to the old URL yielding counsellorlicense.com.

Same testimonials, same spare bedroom…

A new blog for New Directions

Wendy Gritter’s New Direction ministry has started a blog called, Bridging the Gap. The blog may have the sound of a Bridges Across the Divide but aims for a more relational tone.

Go by and give Wendy a shout, eh?

Counselorlicense.com: An update

Last week, I posted a link to a website purporting to offer a pastoral counseling certificate which would allow the recipient to circumvent state licensing laws.

Counselorlicense,com1

The image above is what it looked like prior to the post. Click on the link to see it now. Replacing the testimonials about making money doing counseling is a rambling essay called “What is a pastoral counselor?” There are no links to send in money, no glowing reports of life change via getting a certificate from Phoenix State University. However, if you go to the PSU site, you still can become certified in a variety of fields from gunsmithing to gemology, and still including pastoral counseling.

I have received a couple of emails back from the registrant (mail@tomhalstead.com). One said Tom Halstead had “passed away.” I hope that is not true but if there really is a Tom Halstead out there, someone is changing up your websites…

Gender identity disorder research: Q & A with Kenneth Zucker

As a follow up to the recent broadcasts by NPR and several posts regarding gender identity, here is a Q & A involving J. Michael Bailey and Ken Zucker recently posted on the SEXNET email list. Dr. Zucker is the Head of the Gender Identity Service, Child, Youth, and Family Program and Psychologist-in-Chief at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada. Dr. Zucker is the chair of the newly appointed Sexual and Gender Identity Disorders working group for the 5th edition of American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-V). Dr. Bailey is Professor of Psychology at Northwestern University, prolific sexual orientation researcher and moderator of the SEXNET list. As the NPR article noted, Dr. Zucker has extensive clinical and research experience with persons who experience gender dysphoria. This interview was conducted by Dr. Michael Bailey via email and has been slightly edited for posting here. Both Drs. Bailey and Zucker have reviewed and approved it.

Bailey: Both NPR shows used the phrase “a girl trapped in men’s bodies.” How common is this concern over body image?

Zucker: I would say that, in general, there has not been a lot of good empirical research on body image issues in pre-pubertal children with GID. In adolescence, the Dutch group has reported clear evidence of body image dissatisfaction as one finds in adults. One of my PhD students has a dissertation that should be defended later this year in which we studied body image in boys with GID compared to clinical and community controls. We did detect significant body image differences among the three groups: body image in general and in relation to gender-specific anatomic dysphoria. The boys with GID had a poorer body image in general and, of course, with regard to gender-specific anatomic dysphoria. It is only a first pass at this issue and I will report on this down the road after the dissertation is defended.

Bailey: The case on the second NPR show is of a child (natal boy) who had extreme temper tantrums when not allowed to engage in feminine behaviors. Is this common in the kids you see, or is there something unusual about these kids?

Zucker: This is not uncommon. Some parents will report that if they try to limit cross-dressing that this can be very distressing for the boys. Some parents describe it as “he needs his fix.”

Bailey: You are more familiar than anyone else I know with the difference between the British and Dutch treatment centers that yielded the findings that only 20% of the British kids but 100% of the Dutch kids pursued sex reassignment eventually. Did the Dutch center focus on older children (who were less likely to change their minds)? To the extent that the samples were comparable, it is a shocking difference in outcome.

Zucker: I don’t think the British group has published their data yet. But, yes, the Dutch group data are on adolescents and I think that the British group is talking about clients first seen in childhood, not adolescents. The Dutch group now has a paper that is close to being “in press” on their first follow-up of GID children and then followed up later. The GID persistence rate for their boys was about 20% and the persistence rate for girls was 50%. Their persistence rate for boys appears to be similar to what I have summarized for the boys seen in my clinic (Zucker, 2005), but higher than the 12% rate for girls that we published earlier this year (Drummond et al., 2008). The Dutch group speculates that their girls were, at initial presentation, more extreme in their cross-gender behavior than the girls that we reported on, but that will require more careful analysis.

Bailey: The NPR show, and some people on it, kept implying that some of these kids are “really” transgender, and others are not. I suspect you don’t agree with this way of thinking about it, although you recognize that some kids are more likely to become transgender adolescents and adults than other kids are. Can you remind us which factors are associated with persistence of GID from childhood?

Zucker: I don’t think we know yet. Two possible candidates are age at initial evaluation (later age associated with greater persistence rates) and quantitative metrics of cross-gender behavior in childhood.

By persistence rate, Dr. Zucker is referring to the percentage of GID children who are still GID at a later assessment. In the Dutch group, as well as in Dr. Zucker’s research sample, most boys who want to be girls in childhood, end up as men who do not want to be women. For women in the Dutch sample, half remain GID. I think the assessments of low persistence of GID provide some helpful information to parents who wonder about puberty delay and behavioral interventions with their GID children.

Thanks to Drs. Bailey and Zucker for permission to post this conversation.

Mankind Project of Houston settles wrongful death lawsuit; some mental health oversight required

Some months ago, I reported extensively on the Mankind Project with attention to their signature program, the New Warriors Training Adventure. My interest in MKP and NWTA was provoked by a Houston Press article detailing the suicide of Michael Scinto. Mr. Scinto had attended a NWTA and reported distress thereafter. His parents Kathy and Ralph Scinto believed his death was linked to his experiences on that weekend and filed a wrongful death lawsuit on behalf of his estate in August, 2007.

In April, 2008, the case went to mediation and was settled. Although the parties to the dispute have signed a confidentiality agreement, the terms of the settlement are available for review on the Harris County, Texas District Court e-docs website. You will need to register (name, email address), verify your email and then change your password but the process is free. Once registered, search the name Scinto as Plaintiff and you will find all documents related to the case.

The terms of the settlement are found in a 20 page, May 20 document titled, Defendant’s Motion to Enforce Settlement Agreement. The Scintos and their attorney won $75,000 split roughly three ways. Furthermore, MKP of Houston is required to make some changes in procedure. The changes involves screening of applicants, disclosure of activities and means to exit the weekend. Anyone who registers can preview all of the court documents for no cost. I summarize the highlights here:

-MKP of Houston agreed to have its pre-New Warrior Training Adventure Adventure questionnaire reviewed by a licensed mental health professional for recommendations about how it can be improved. However, the MKPH board must approve changes before they can be implemented.

-Each application for the NWTA must be screened by a mental health professional who has personal knowledge of the weekend. The screener shall determine whether the applicant shall be accepted or not with the decision written on the application.

-The following changes will be made within 30 days of a required MKP of Houston Board review of the website:
1. Change the website to provide adequate information from which potential applicants can make an informed decision about whether to attend the NWTA.
2. The website shall disclose that a mental health professional will screen applications to determine suitability for participation.
3. The website will need to disclose that people who wish to leave the NWTA are free to do so.
4. Applicants will be told that the NWTA may involve optional nudity and certain elements of Native American traditions.

-MKPH agrees to develop a written protocol which will allow any participant to leave NWTA safely with MKPH assistance. Participants requesting to leave shall be allowed to do so immediately unless the action would result in further risk of harm. Once a request is made, the participant is not required to do any other activities unless the participant changes his mind.

As far as I can tell, this settlement is only applicable to MKP of Houston with no requirement that MKP elsewhere implement any of these points. Given the lawsuit involved a wrongful death charge as well as claims of performing psychotherapy without a license, I would say these changes are minimal, but important. I think they are valuable and provide recognition that some form of oversight, minimal though it is, is important. While I suspect that MKP of Houston will have no problem getting a mental health professional to perform this screening function, I would recommend any mental health professional performing this duty check first with his/her liability insurance carrier to make sure such a
review is covered activity.