Author: Warren Throckmorton

Recently, a fuss arose over a quote regarding HIV and young men who have sex with men (MSM) from Regina Griggs in a OneNewsNow article regarding youth and sexual identity. She said (in context):

Research shows that individuals often go through periods of gender and sexual confusion as they grow from children to teenagers to adults. Griggs wonders why, then, would schools opt to send children along a dangerous path. “Why are we allowing people to tell them, ‘Try it — you might like it?’ Over 70 percent of young kids 13- to 24-years-old, men having sex with men, are now HIV-positive,” Griggs notes. (see editor’s note)

Griggs here is describing prevalence, which is the total number of people in a population with a certain disease at a given time. However, this is clearly incorrect, as other bloggers have pointed out.
She may have been referring to a fact sheet at the CDC called HIV/AIDS Among Men Who Have Sex with Men when she was quoted by ONN.

In the United States, HIV infection and AIDS have had a tremendous effect on men who have sex with men (MSM). MSM accounted for 71% of all HIV infections among male adults and adolescents in 2005 (based on data from 33 states with long-term, confidential name-based HIV reporting), even though only about 5% to 7% of male adults and adolescents in the United States identify themselves as MSM.

The ONN editors recently added a note pointing out the 71% figure from the CDC fact sheet.
This simply says that men having sex with men accounted for 71% of infections among all males reporting infections in 2005. MSM was a large driver of infections reported in 2005. While this is a sobering statistic, it does not mean what Mrs. Griggs said it means.
I do not know what the actual prevalence of MSM aged 13-24 with HIV is but it would need to be over 800,000 cases in order for her statistic to be true. This does not seem possible.
I arrived at that number by looking US Census data for 2005 which pegged the number of males in the US between 15-24 at about 19.7 million. The CDC estimates 5-7% of this age group as being MSM which yields 1.2 million males. If 70% of this group was HIV positive, then that would mean Mrs. Griggs is claiming that about 840,000 young men have HIV. Of course, these numbers are estimates since I rounded figures and used the Census data starting with age 15 and not 13 as the CDC does.
According to the CDC fact sheet, there are not that many people living with AIDS at present:

At the end of 2005, an estimated 217,323 MSM (191,362 MSM and 25,961 MSM who inject drugs) were living with AIDS, representing 67% of male adults and adolescents living with AIDS and 52% of all people living with AIDS.

These numbers are staggering enough without exaggeration or misinterpretation. I commented here because many have asked about the validity of these numbers and the quote made me curious about the scope of the issue.

After posting the review of Bieber, I ran across a link to the following excerpt of a book by Michael Quinn which raises strong doubts about how poor father-son relationships could cause homosexuality.
He notes that fathers and sons in our culture have historically had “issues.”

For sixty years, various studies have demonstrated that a significant percentage, perhaps a majority, of American males have always felt estranged from the fathers who raised them. As early as 1928, Meyer F. Nimkoff found that 60 percent of the 1,336 males he studied (average age twenty-two) did not feel close enough to their fathers to confide in them, and the father-son relationship was distant in other significant ways. He concluded: “If sons withhold trust from their fathers, it appears they deny his leadership and limit association with him, also.”[3] Researchers have also noted that one-third to one-half of American teenage boys and adult men regard their fathers as “distant,” unaccepting, “cold or indifferent.” The psychiatrist Irving Bieber found that 37 percent of the heterosexual males he studied even said they “hated” their fathers, which was paralleled by a study that 21 percent of male heterosexuals at the University of Utah disliked their fathers.
As indirect evidence of this widespread father-son emotional dysfunction, studies of thousands of American adolescents since the 1930s have shown that only 5-22 percent of the young men “preferred” their fathers. In contrast, 34-76 percent of young men listed their mother as the preferred parent, even though the surveys also allowed sons to indicate equal preference or no preference. These statistics apply to young men in families without divorce. In addition, 82 percent of males in a 1978 study felt alienated from their fathers, while a 1985 study reported that only 8 percent of 500 male adolescents felt “loved” by their fathers.
Thus, claiming father-son emotional distance as the explanation for male homosexuality is similar to claiming that right-handedness causes homosexuality merely because most homosexuals are right-handed. The equation “abdicating fathers, homosexual sons” is a theory based on isolating homosexual experiences from human experiences generally. Typically, authors whose “reparative therapy of male homosexuality depends on “a failed relationship to father” do not acknowledge such well-known studies of father-son “failure” among American males generally. As the psychiatrist Richard Green, whose own research was originally based on the assumption of parental causation, has observed: “A gnawing question in these studies is what percent of heterosexuals answer all items [concerning father-son relationships] in the ‘homosexual direction’ and what percent of homosexuals answer all items in the ‘heterosexual direction’.” Because of such inconsistencies, Green returned to genetic or other biological determinants for homosexuality.

Quinn proposes that a son who is different in the gender sense might actually pull away from dad and not the other way around.

Another fallacy involves attaching great significance to the finding of many studies that homosexual men are “more likely” to describe their fathers as “distant, hostile, or rejecting” than heterosexual sons are. Such a pattern is unsurprising in a culture that has negative judgments about homosexuality. In other words, since both heterosexual and homosexual American males report unsatisfactory relationships with their fathers, the higher incidence of strain between homosexual sons and their fathers is more likely a result of the sons’ “homosexual tendencies” rather than the cause

A reader sent along a link to a review of the psychoanalytic study of homosexuality headed by Irving Bieber and reported in 1962. Titled Homosexuality: A Psychoanalytical Study of Male Homosexuals, the nine-year study of 106 gay men summarized the reports of psychoanalysts about their patients but did not interview the patients directly.
The pdf of the the review by George Carter, MD is here. Since it is brief, I am going to post it and then comment.

Homosexuality—A Psychoanalytic Study of Male Homosexuals
Irving Bieber et al.
New York, Basic Books, Inc., 1962,358 pp.
A statistical comparison from questionnaires submitted not to their patients, but to a group of
psychoanalytic psychotherapists, gives much interesting information about 106 overtly homosexual male patients, as compared with 100 not overtly homosexual male patients (controls). Most of the study patients were seen once (13%), twice (50%), or three times (31%) a week for periods varying from months to years. The group included patients with character disorders, neurotics, and schizophrenics The questionnaires intensively covered wide areas of development and functioning including relationships between parents,. patient and mother, patient and father, patient and siblings; sexual development and current, functioning; choice of homosexual partner; relation to women; latent homosexuality, etc. The emphasis is on conscious present and past attitudes, experiences, and behavior of the subjects, and does not explore the therapist’s dynamic understanding of the material. It is notable that 74% of the therapists either did reply (55%) to, or answered simply “no” (22%) to the question: “Did the analyst feel the questionnaire explored the fundamental dynamics of the patient?” It is also difficult to evaluate the statistics at times. For example, the authors base some of their theoretical conclusions on the fact that they find ‘latent homosexuality” less frequently (in their controls) than is ordinarily reported in psychoanalytic literature. But the data collection method may not be psychoanalytic, since it is not clear that the reporting analysts asked their patients to free-associate! It is difficult to evaluate the results.
Nonetheless, the study does point up some interesting issues. It suggests most strongly that overt homosexuality is especially apt to occur among those exposed to certain constellations of early family relationships, including what the authors call a close-binding, intimate mother and a distant or detached father. There are many other interesting inferences, especially about prognosis and treatment. However, the authors’ stated basic theoretical conclusion that homosexuality is the result of hidden, but incapacitating fears of the opposite sex seems over-simplified and over-determined, since they started with this as a working assumption, but found direct evidence for it, as I understand it, in only about 70% of the studied group and in at least one-third of the nonhomosexual controls.
GEORGE H. CARTER, M.D.

One observation I had not noticed before relates to the evaluation of the survey by the analysts involved:

It is notable that 74% of the therapists either did reply (55%) to, or answered simply “no” (22%) to the question: “Did the analyst feel the questionnaire explored the fundamental dynamics of the patient?”

If most participants in the study did not believe the instrument captured the essence of the patient how can any conclusions be drawn from the results? There are numerous problems with this research as a study of causation, but this is another serious blow to the validity of the approach Bieber used.
The Bieber study is often cited as a foundation for reparative drive theory. Bieber, like modern day reparative therapists, believed that a “constructive, supportive, warmly related father precludes the possibility of a homosexual son; he acts as a neutralizing, protective agent should the mother make seductive or close-binding attempts.” As the reviewer above pointed out, Bieber went into the study believing that a fear of women as a reaction to a too close mother, was at the root of male homosexuality. He believed that the father could bring the boy out of this problematic attachment, if he was “warmly related.”
The reviewer hints at but does not elaborate on the confirmation bias at work here. Bieber believed homosexuality was the result of a certain set of family forces and found what he expected to find. As Carter points out, the patterns were not universal and existed in the heterosexual controls as well.
However, despite the problems with validity, no follow up, no direct questioning of patients, etc., Bieber made a conclusion which continues to have influence in the modern ex-gay movement. The concept of the father’s intervening role with the overinvolved mother can be seen in the masculinity enhancement approach to reparative therapy. If you make a man more trusting of men (as dad should have done), then you give a man the courage to distance himself from mother (women). Once distant from mother (women) and in the world of the father (men), he loses his fear of being engulfed by mother (women) and finds them appealing. I think the appeal of the New Warriors Training Adventure comes from this view of masculinity. The Mankind Project view is that women have prevented men from being initiated into manhood. Only a man can initiate a man. So since by (reparative) definition, SSA men are fearful of mother (women), the need is to initiate them in the world of men (father) by other men (pretend fathers). What I have never heard addressed by reparative advocates is why these family constellations mark both same-sex and opposite-sex attracted men. If this set of factors was determinative in some general way for all same-sex attracted men, then why do we see SSA men who do not have these backgrounds and OSA men with them?

In addition to my work in sexual identity issues, I am quite interested in policy relating to the psychological reactions of women who have had abortions.
I have observed over the past several years that women who associate their abortion with mental health distress have approached the American Psychological Association with their concerns and stories. I blogged about an effort like this in 2007. Briefly, the letter sent by advocacy group, Silent No More, offered to put APA researchers in touch with women who had adverse reactions and asked for a meeting with the APA to discuss means of helping women with post-abortion problems. Georgette informed me that 600 women signed the letter. However, Georgette’s group received no response from the APA.
Another group, Lumina: Hope and Healing After Abortion, led by Theresa Bonopartis, sent a letter to each member of the Mental Health and Abortion Task Force requesting the opportunity to provide information about post-abortion reactions. She also received no response.
Contrast the reaction of the APA to women who believe abortion has triggered harm with the APA reaction to clients who report harm as a result of participation in reparative therapy and/or ex-gay ministries. The APAs (both the psychiatric and psychological groups) have been quite responsive to them, crafting advisories and almost banning reparative therapy in advance of publications systematically demonstrating harm. The major study of adverse reactions by Ariel Shidlo and Michael Shroeder took 5 years to solicit nearly 200 reports of various types of harm. In addition to this study, groups representing glbt people have met with and requested assistance from the APA to oppose reparative therapies.
Before I go on, I need to say that I am in favor of the APA taking seriously client concerns regarding reparative therapy and ex-gay ministries. I have been a persistent critic of reparative approaches as a general response to same-sex attraction. Further, I have consistently acknowledged that harm has been done by various methods to attempt sexual reorientation. The APA should vigorously pursue concerns about client welfare which are presented by clients and their advocates. Due respect should be shown to those who seek such services and ministries, but nonetheless, reports of adverse reactions should be addressed and investigated.
Having noted the appropriateness of the professional groups to attend to reports of adverse psychological reactions, I ask why the APA has not responded to the reports of adverse psychological reactions to abortion? These reports are common and compelling. Many more studies have found adverse reactions associated with abortion than have found such negative reactions to reparative therapy. I recognize that abortion is a much more common procedure than is reparative therapy but this fact should prompt an energetic response. In this context and speaking about APA conclusions about abortion and adverse reactions, I want to quote again a provocative question (see letter #2) from Bill Samuel, President of Consistent Life to APA president Alan Kazdin:

Is there any other phenomenon where the conclusion is based on those who do not have problems rather than on the therapeutic needs of those who do?

I might be misinformed, and in fact have an email in to the APA to check this, but I can find no indication that the APA has met with or responded directly to groups representing women who experienced adverse psychological reactions they attribute to abortion.
Now for some discussion. Am I missing something here? Is there something so different about these adverse reactions that could explain the differential response? At this point, I am thinking out loud…

The Tennesee church shooter, James Adkisson, sounds like many other mass killers in this article from the Knoxville News-Sentinel. In the USA Today, the note he left was described as “irrational.”
In reading the Sentinel article, you get the sad picture of a person who was in need of mental health treatment but did not get it. His ex-wife attended this church which may have been a motive in the shooting.