Year: 2009

Gender issues debated on Dr. Phil Show today

Glenn Stanton from Focus on the Family and Joe Nicolosi square off with Dan Siegel and Michele Angello over how to raise gender variant kids today on the Dr. Phil Show. Check local listings for times in your area.
The problem with episodes like this is how polarized it is likely to be with these guests. One side will say gender variance is all environment (well, I hope Glenn doesn’t say that) and the other side will say gender variance is all inborn in every case.
UPDATE: Did anyone else view the show? It was not terribly helpful for the purpose stated which was to help parents who had gender variant children. I will have more to say about it later but the social conservatives offered the close mother-detached father theory of gender variance to open scorn – deserved scorn I might add. The segment was awkwardly edited so that comments were probably not really related to each other as the show was taped.
Thinking about the episode, I have decided not to say much more about it until I can find some video clips. If you didn’t see it, then my descriptions won’t help much. The extreme positions presented left me very frustrated, knowing that most cases of GID do not end up in gender reassignment but also knowing that parenting dynamics in GID situations are not that much unlike families that have no GID kids. Indeed, the woman on the Dr. Phil episode had two other children without gender identity issues. I reported here several months on a mother of twin boys, one with GID and one without any such issues.
Both sides did not address the data points which falsify their perspective. Phil McGraw asked Dr. Siegel why 85% of GID kids do not go on to request gender reassignment. Siegel answered by saying that was a good question and the science isn’t clear but never gave a plausible answer as to why puberty changed these kids in so many cases. On the other hand, Nicolosi is so committed to his theory that he glosses over the problems with parenting theory. As noted above, GID children are often found in families with siblings who are quite gender conforming. Parents report that they do the same things with the GID children as they do with their other children with vastly different results. Most parents with more than one child can relate to this. Kids respond differently to the same environment thus helping to shape different parent and child relationships. Parents cannot be faulted when a GID male hates his gender typical Christmas presents or out of the blue at age 4 says, I want to be a mom and have babies when I grow up. Even if the reparative proponent says we are not blaming the parents just pointing out the causes, the “explanation” fails to account for the fact that the other children in the family did not respond to the parents with gender confusion. Also, as in the case of Dr. Phil’s parent, the mother was not especially close to the son. The reparative proponent is left with a need to assert untestable hidden dynamics which must be true because no exceptions to the theory are allowed. This kind of response from Nicolosi was in clear view on this episode of Dr. Phil. If all you have is a hammer, everything must be a nail.
So both sides of the theoretical debate can be faulted for confirmation bias. Holding tightly to a theory of causation in the face of incomplete science can create a situation where the client in front of you becomes secondary to the felt need to verify the theory.
I soon will be meeting with a group of parents some of who (perhaps all, I am not clear on this as yet) have felt great hurt from the application of reparative drive theory to their children. It must be quite surreal to go to someone who everyone says is an expert only to have that person be so wrong in their guesses about your lives. I am quite sure that those who hold tightly to a theory underestimate the intense anger and frustration this creates in parents. At one point in the Dr. Phil show, Nicolosi criticized the GID mom for getting “emotional.” As Dr. Siegel pointed out, the woman had reason to be emotional. She was on national television talking about the greatest hurt of her life with people who were essentially blaming her for the trauma. I believe I would be upset as well.

Ted Haggard says sexuality labels "just don't work"

Ted Haggard could have been in my study last summer. Over 190 same-sex attracted men who are heterosexually married took my survey to describe their sexuality. Many of them said the same thing – that labels didn’t fully capture their experience.
Haggard told the Denver Post that labels don’t work. Read the rest at the link.
Haggard’s description is consistent with the results I found. I am still collecting data involving same-sex attracted women in straight marriages. Just a few points on the men:
-191 men completed the survey; referrals came from ex-gay ministries, bisexual groups, mixed orientation couple support groups and via this website.
-Regarding the labels issue, 33% of all respondents qualified their sexual orientation self-description because they felt the labels were not adequately descriptive.
-We found 6 groups of such men with different attaction patterns. Haggard may fit into the “spousosexual” group if his general attractions are for men, but he experiences attraction for his wife. We found 20% of the total group in that category.
-The smallest group was the “ex-gay” group. Just over 6% said they once were attracted to the same-sex primarily and are now primarily attracted to the opposite sex.
-The largest group (40%) were bisexual in their attraction patterns and about one-quarter of the men were primarily attracted to the same sex in the present.
There are many more interesting findings that I am saving for the paper on this research. It should be ready by the end of February for submission. Stay tuned…

Genetics and environment: Interaction in a different key

In previous posts, I wrote about PANDAS, the streptococcus related autoimmune disorder which involves obsessions, compulsions and perhaps more broad anxiety and movement problems. Discussion has been vigorous about the role of pathogens in creating mood and mental health issues.
Genetics as an influence is another biological factor often considered as a causal factor in mental health and behavior. Today, Brain Blogger discusses the influence of genetics and depression in a post with the provocative title, “Stressed by his short allele.” Brain Blogger is an interesting read in that he attempts to bring neurological research to a lay audience in a magazine format.
Regarding depression, stress and genetics, BB writes:

Individual differences in the genetic makeup of the serotonin system have been shown to increase one’s vulnerability to depression, anxiety and other psychiatric conditions, particularly if individuals are exposed to stressful events in their lives. Studies are showing that certain people (those that have the short allele of the serotonin transporter gene) have a greater biological reactivity to stressful events, including a larger hormonal response to stress and a greater brain reactivity to threat. In other words, both the hormonal and brain systems (amygdala) involved in fear and anxiety are more active in response to stress in those individuals who have a certain genetic makeup (short allele). This genetic difference may also account for individual differences in personality; those people who have a short allele for the serotonin transporter have been suggested to exhibit more “anxious” personality traits. This means our differences in gene function may bias our brains and our personalities to create a tendency to be more “negative,” “anxious” or reactive to stress.

Bringing together the PANDAS research with the observations regarding short serotonin gene alleles, one can envision several scenarios. A child with a stubby allele gets strep throat. This child is unfortunate in that the antibodies created to seek and destroy the strep bacteria find and bind with dopamine receptors in the basal ganglia. At that point, the cells designed to kill strep bacteria which are supposed to be hooked up with strep antibodies find this unholy alliance of strep antibody and dopamine receptors and launch their holy war of immunity. Dopamine cells fall in friendly fire thus sending the dopamine-serotonin balance into disarray. This child, being completely unaware of this of course, begins to feel nervous and irritable (mood change). This creates stress in the family and parents who may also have stubby alleles get stressed too. As BB notes, the short-allele brain already primed to be more reactive in the event of stress (the illness itself, the mood change and reaction of parents and sibs) goes into full fledged alert, generating lots of chemicals which basically provide that child with thoughts suggesting something is wrong here (anxiety and depression).
We can also imagine a child with a full sized allele going through the same thing. When the dopamine-serotonin balance is disrupted via an autoimmune disorder, one may see the typical rapid onset of PANDAS symptoms but these will likely not turn into a chronic problem. Furthermore, it is possible that the symptoms will be less intense or that the child will be more easily soothed with even modest parental inputs, thus preventing an escalation of panic.
Active readers will probably imagine a few hundred more scenarios.
I recently spoke with Susan Swedo at the NIMH who provided invaluable information regarding PANDAS. She agreed with me that we are at the beginning of this line of research and thinking. There is no doubt that psychological trauma is stressful and thus impacts mental health. However, the mechanisms of extended impact may be much different than psychodynamic theorists imagine.
The more of this kind of information we can get to patients the better in my view. It is helpful for people to understand the tricks their brain is playing on them when they get the intuition that they must engage in a compulsive action in order to relieve anxiety. Or when everything is really going well and they constantly fear the worst. Our active, monitoring minds play tricks on us and we are learning more about how those tricks are constructed in part via pathogens in the environment interacting with a genetically prepared host.

Mankind Project says report inaccurate, offers no corrections

Last week, I reported that the Mankind Project Houston has not kept the terms which were a part of settling a wrongful death lawsuit brought by the parents of Michael Scinto. Scinto killed himself after a New Warriors Training Adventure. In an online article Friday, the Houston Press confirmed with Mrs. Scinto that she was unaware of any effort to comply with the court settlement.
Prior to that post, I wrote the Mankind Project of Houston to ask if I missed something on their website or if they plan to comply in the future. Friday afternoon, an unnamed person from MKP-H wrote back to refer me to their legal counsel “regarding your inaccurate assumptions against MKP on your blog.”
However, the emailer offered no examples of anything inaccurate. In fact, I didn’t assume anything. I reported what the court order said (a copy of which was retrieved from the Harris County court website) and what their website says.
If MKP-H has evidence that either of those sources are incorrect, then it should be a simple matter to produce it.