Category: Research news

NARTH fact sheet: Female homosexual development, Part 2 – Child sexual abuse

In the first part of my review of the NARTH fact sheet on female homosexuality, I critiqued the empirical foundation of the NARTH theories about causation of female same-sex attraction.
In this post, I examine the statements regarding sexual abuse and causation. It may be surprising to some observers to read this:

Although sexual abuse does not directly cause same sex attraction, studies report male sexual abuse of lesbians as generally being twice as high as of heterosexual women, that is, on average, 50 percent of lesbian women report a history of sexual abuse. (26, 27) If family relational dynamics and gender nonconformity are already in place, sexual abuse can clench the direction of detachment, gender insecurity, and disidentification possibly leading to same sex attraction.

The article does not specify sexual abuse as a direct cause of same-sex attraction. However, the author does believe that being abused as a child can push a girl in that direction if she suffered detachment from her mom and was gender nonconforming as a child.
I checked the references offered by NARTH for the assertion that sexual abuse of lesbians by men are “twice as high as of heterosexual women” and that “50 percent of lesbian women report a history of sexual abuse.” I cannot find these statistics.
Reference 26 is to a survey of lesbians, gay men, and bisexuals and their siblings by Balsam, Rothblum, and Beauchaine in 2005 (see reference list at the end of the post). In this study, the authors used a convenience sample of same-sex attracted people and asked them to recruit a sibling to participate. They reported childhood sexual abuse (CSA) prevalences for straight (30.4%), lesbian (43.6%) and bisexual (47.6%) female participants. The effect size of these differences are very low, between 1-2%.
Reference 27 is to research reported in the Journal of Gay and Lesbian Social Services by Hughes and team in 2000. In this study, forty-one percent of lesbians reported CSA while among straight women the number was 24%.
The NARTH article adds:

Sexual abuse can be emotional, verbal, or physical. A girl who is sexually objectified though inappropriate sexual comments, denied age appropriate privacy or whose father has voyeuristic tendencies, has been sexually violated without ever being touched. (28, 29)

I do not contest that the paternal behaviors referenced here are inappropriate and potentially harmful. However, the references for these statements does not provide research support for the statements about CSA. One, (29) is not to a research study but to a book for a lay audience by Janette Howard and the other (28) is a 1991 research study by Peters and Cantrell which failed to discriminate lesbians and straight women via abuse variables.
There are some discouraging percentages in this literature but they apply to women overall, with a moderate elevation for lesbians. Here is what I found in a brief PsychLit search.
Table CSA
A look at the table demonstrates that most research finds a modest elevation for lesbians but does not demonstrate the 50% figure nor support for the conclusion that prevalences are twice as high for lesbians as straight women. Prevalences are sadly and unacceptably high for all women.
I fear that this fact sheet will become basis for inaccurate information spread by sexual identity and ex-gay ministries. Whatever the reason for the differences, it cannot be helpful to paint a false picture. Sexual abuse is a trauma that often requires therapeutic and spiritual intervention but whether it is involved in the origins of same-sex attractions continues to be an open question.
References:
Balsam, K.F.; Rothblum, E.D., & Beauchaine, T.P. (2005). Victimization over the life span: A comparison of lesbian, gay, bisexual, and heterosexual siblings. Journal of Consulting and Clinical Psychology. 73, 477-487.
Bradford, J., Ryan, C., & Rothblum, E.D. (1994). National lesbian health care survey: Implications for mental health care. Journal of Consulting and Clinical Psychology, 62, 228-242.
Briere, J., & Elliott, D. M. (2003). Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women. Child Abuse & Neglect. 27, 1205-1222.
Finkelhor, D., Hotaling, G., Lewis, I.A., & Smith, C. (1990). Sexual abuse in a national survey of adult men and women: Prevalence, characteristics, and risk factors. Child Abuse & Neglect. 14, 19-28.
Hughes, T.L., Haas, A.P., Razzano, L., Cassidy, R., & Matthews. A. (2000). Comparing lesbians and heterosexual women’s mental health: Results from a multi-site women’s health survey. Journal of Gay and Lesbian Social Services, 11 (1), 57-76
Peters, D. & Cantrell, P. (1991). Factors distinguishing samples of lesbian and heterosexual women. Journal of Homosexuality, 21, 1-15.
Vogeltanz, N.D., Wilsnack, S.C., Harris, T. R., Wilsnack, R.W., Wonderlich, S.A., & Kristjanson, A.F. (1999). Prevalence and risk factors for childhood sexual abuse in women: National survey findings. Child Abuse & Neglect. 23, 579-592.

A conservative defense of sex research

During the Saddleback Civil Forum, if Rick Warren had asked the candidates about funding sex research, it might have gone like this.
Warren: What is your position on researching sex?
McCain: (with resolve and without hesitation) – Missionary!
Obama – Uh, well, it depends on how you define “sex” and “research.” Scientifically and politically, it is above my pay grade to determine what my position is in that arena.
Pure fiction, of course. I doubt sex research will come up in this year’s election. However, the topic has become a concern to some politicians. According to an ABC News report, “Sex, massages and taxpayer dollars,” some legislators are bothered by some NIH grants to universities to study sexuality. Some of Michael Bailey’s work aroused more than curiosity. To wit:

A few years ago, NIH gave a $147,000 grant to a Northwestern University psychology professor who was paying women to view pornography while a device measured their sexual responses.
That study didn’t go over too well in the halls of Congress.
Arizona Rep. Jeff Flake was among 20 Republicans to sign a letter to NIH’s director asking for an explanation for why taxpayer money was going for such a study. They called it “a bizarre spending decision.”
Today, Flake believes Congress has failed to properly oversee NIH and its spending.
“It’s Congress’ job to set guidelines for how NIH and other agencies spend taxpayer money and then exercise oversight to ensure that those guidelines are being followed. “However, over the last several years, Congress has neglected its oversight function,” Flake’s office told ABC News. “It’s difficult for Congress to criticize NIH for wasteful grants when Congress itself is earmarking billions of dollars every year on similarly wasteful pet projects.”

I have to disagree with Rep. Flake and his colleagues. As a social conservative, I am very interested in research which helps us better understand how sexuality works. Regarding sex research, I think Guggenheim Fellow Alice Dreger raises a valuable point when she argues:

What about the studies that look into things like which kind of pornography stimulates women versus men? Useless and prurient? I don’t think so. I know this sort of research horrifies conservatives, but they should really wake up to the fact that research into sexual stimulation can actually help promote family life by helping married couples understand how to have satisfying sex lives within the context of monogamy. (Is it better that a guy cheat on his wife with a prostitute, or better that he learn a vibrator and some massage might make his wife a lot more receptive? I vote for the latter.)

Of course, an unexciting sex life does not force anyone into seeking prostitutes, but I think Dr. Dreger’s argument should be taken seriously. Counselors know that otherwise solid couples, yes even very religious couples, are not exempt from sexual questions and concerns. Better that counselors are armed with good science on sexuality than the latest issue of Cosmo. Reading the Song of Solomon, while quite, uh, interesting, might not be enough to help overcome issues which would benefit from basic information. Lay people might be surprised that research is needed to better understand sex and attraction, but such science is important for reasons that might not seem apparent.
In my work, I have found the research coming out of the Bailey lab to be very helpful. His research informs my work with people on a regular basis. I often consult with heterosexually married, same-sex attracted men who wish to maintain their marriage. Bailey’s (and other researchers’) brain research, for instance, provides significant insight into how the brain responds to sexual cues. This is valuable information for those who seek insight into why they respond as they do. And many of them use this information to pursue their values and beliefs to avoid sex with men and enhance their marital adjustment with their wives.
I guess the bottom line for me is that funding sex research doesn’t mean advocating an anything-goes stance toward sex. Studies done solely for prurient interests should be questioned, but basic science of sexual attraction and arousal can have positive, and even conservative, applications.

Narth fact sheet: Female homosexual development

Narth recently released a fact sheet that is relevant to some information I posted regarding reparative therapy research.
The paper has some bright spots but overall reverts to the same reparative drive theoretical formulation for which NARTH is known. On the NARTH website, Dean Byrd praises the APA for taking a more nuanced perspective toward causation and same-sex attraction, but in this paper, NARTH does not follow the APA’s lead.
The paper begins by attempting to make a case for sexual fluidity by quoting mainstream researchers. I suspect researchers such as Michael Bailey, Ken Zucker, and Lisa Diamond will be uncomfortable with how their work is integrated in this piece. The unnamed NARTH author then suggests that the reason research supporting developmental causes is minimized today is due to bias against these findings. For some reason, Rogers Wright is quoted in this context. However, Rogers is referring to psychotherapy and not research on causal factors. Regarding the research on environmental factors, the paper says:

There is, in fact, a wealth of older research identifying many common developmental, temperamental and family patterns connected to homosexuality. This research has never been scientifically refuted.

The citations for this statement are a 10 year old paper by Mark Yarhouse and a 15 year old book by Goldberg. Yarhouse and I were making a case for reorientation therapies broadly speaking several years ago. However, our model now calls for a cautious and realistic assessment of the literature on change and causal factors. Our sexual identity therapy framework is based, in part, on the observation that we do not know what causes sexual orientation in any general sense, nor do we know what, if any, factors might lead to fluidity. Our model stresses value congruence rather than change in orientation.
In fact, “the older research” has been addressed as inadequate to explain the complexity of sexual orientation (e.g, Bell, Weinberg & Hammersmith, 1981; see this post about Fisher and Greenberg’s review of psychoanalytic literature, and this post as well). In the context of the NARTH claim, I would like to ask anyone to produce the three best studies which support the “common developmental, temperamental and family patterns connected to homosexuality.” I am serious about this. Preferably I would like proponents to post them in a comment for discussion but these references may also be emailed to me.
Based on this lead, I expected the author to make a case that the observation of sexual fluidity for some meant that therapy could be helpful in promoting change of orientation. However, the paper did not quite come to that conclusion, saying

The concept of sexual fluidity, defined as the spontaneous evolution or transformation of one’s sexual preferences, is different from the concept of changeability involving intentional effort directed towards altering or changing one’s sexual preferences. As mentioned, many researchers attest to the reality of female sexual fluidity. This does not directly translate into proof that any woman can easily change or alter her same sex attraction. It does however confirm that sexual feeling and behaviors are not absolutely immutable or unchangeable. The degree to which a woman can or will experience change will be uniquely determined based on her history and motivation to do so.

While I appreciate the distinction between spontaneous fluidity and intentional attempts to change, I do not think significant evidence has established that motivation is a catalytic component for such fluidity. Certainly some women testify that they sought change and experienced it but others sought change and did not. We do not know that change is determined by “history and motivation.” This sentence almost sounds like change is related to motivation in some dose-dependent manner – the more motivation, the more the change. This can be a very frustrating and defeating message for people who are quite motivated and yet continue to experience same-sex attraction.
The paper then indicates via quote from George Rekers that gender nonconformity and a feeling of being different is associated with adult homosexuality. This is the same data Bem appeals to in crafting his erotic becomes exotic (EBE) theory. Although less so for females than males, these are true observations. In 1995, Bailey and Zucker summarized the research on gender nonconformity and adult sexual orientation this way:

As our analyses demonstrated for both men and women, research has firmly established that homosexual subjects recall substantially more cross-sex-typed behavior in childhood than do heterosexual subjects. By rough criteria, effect sizes were large for both men and women. Indeed, they were among the largest effect sizes ever reported in the realm of sex-dimorphic behaviors.

However, instead of stopping there, the NARTH paper leaves research and goes to theory and clinical anecdote by suggesting:

Typical in the history of women with same sex attraction are failures of attachment with the mother resulting in disidentification (rejection as role model).

The research cited does not suggest that gender nonconformity leads to failures of attachment, but the lay reader might not catch the shift from data to theory. The NARTH paper cites no studies which demonstrate higher levels of attachment failures, nor higher levels of disidentification with mother. The reference is to a speech given by NARTH Board Member, Janelle Hallman at a NARTH conference.
Then Elizabeth Moberly’s theories are referenced as evidence. Dr. Moberly, who was not a clinician nor did research on sexual orientation, proposed the basic reparative drive theory which holds:

…that the homosexual-whether man or woman has suffered from some deficit in the relationship with the parent of the same-sex: and that there is a corresponding drive to make good this deficit-through the medium of same sex or “homosexual” relationships.”

The NARTH paper also claims poor fathering, marital distress and sexual abuse play a role in lesbian development. Feminist researchers are quoted out of context to make a point about the need for positive attachments among women. However, the reader is not informed that no research has linked poor mother-daughter attachments to later lesbian development
In a second part of this critique, I will take the sexual abuse statistics separately. Let me say now that I reviewed the studies referenced, and I cannot determine how the NARTH author arrived at a statistic of 50% of lesbians, on average, have been sexually abused. One must take into account representative sampling when offering such data. I am looking for something more recent but one 1994 study using a representative sample of lesbians found that 21% of lesbians reported sexual abuse as a child.
The NARTH paper concludes this way:

Women who deal with same sex attraction, possess a history of disindentification with their mothers, and therefore with their femininity. This leads to a longing for connection with the feminine that becomes sexualized in adolescence or adulthood. Without a secure attachment to mother, she fails to identify with mother as a female role model losing the opportunity to develop trust and a healthy gender identity. Because of an empty or distorted view of her feminine self she has an inability to connect in a healthy way with other girls. Her sexual development is arrested.

It is possible that the NARTH author believes that since the paper mentions biological, psychological and social factors in the same paper that a “bio-psycho-social model of causation” is being advanced. However, a review of the paper finds no such model where these factors are integrated with research support.
Despite the use of some research studies in this paper, the conclusion leaves data and moves to the reparative drive theory first articulated by Elizabeth Moberly. Back in March, I posted about Dean Byrd’s review of the APA paper on sexual orientation. Then I wondered

…when NARTH would make an APA-like statement about theorized environmental factors such as child abuse and same-sex parenting deficits. What if NARTH acknowledged “what most scientists have long known: that a bio-psycho-social model of causation best fits the data?” Wouldn’t there be a need for a statement cautioning readers of their materials that evidence for parenting playing a large or determining role is meager? Paralleling Dr. Byrd’s assessment of the APA pamphlet, shouldn’t NARTH say with italics, “There is no homogenic family. There is no simple familial pathway to homosexuality.”

Still wondering.

Did Barack Obama vote to withhold treatment to infants surviving abortion?

This question continues to dog the Obama campaign and now the National Right to Life organization has amassed documentation regarding the claim and the Obama response.
Rather than reproduce it all here, I am going to post the link and comment more a bit later.
Click here to read the NRTL news release.
The Weekly Standard has some reporting on this issue as well.
Jill Stanek, the Illinois nurse who blew the whistle on infants left to die has ongoing coverage of this controversy.
The New York Sun has an article clarifying the issue even more. It seems Obama is now saying that the Illinois bill might have impacted Illinois law but that he would have voted for the federal version since there was no federal abortion law.

Indeed, Mr. Obama appeared to misstate his position in the CBN interview on Saturday when he said the federal version he supported “was not the bill that was presented at the state level.”
His campaign yesterday acknowledged that he had voted against an identical bill in the state Senate, and a spokesman, Hari Sevugan, said the senator and other lawmakers had concerns that even as worded, the legislation could have undermined existing Illinois abortion law. Those concerns did not exist for the federal bill, because there is no federal abortion law.

However, he is a prime supporter of the Freedom of Choice Act which would become federal law. Does that mean he would support the repeal of the federal Born Alive Act?

Norwegian study finds abortion-depression link

A relatively recent study from Norway finds a link between abortion and subsequent depression. Titled, Abortion and depression: A population-based longitudinal study of young women, the research was conducted by Willy Pedersen and published in the 2008 Scandinavian Journal of Public Health, volume 36, pages 424–428. Here is the abstract:

Induced abortion is an experience shared by a large number of women in Norway, but we know little about the likely social or mental health-related implications of undergoing induced abortion. International studies suggest an increased risk of adverse outcomes such as depression, but many studies are weakened by poor design. One particular problem is the lack of control for confounding factors likely to increase the risk of both abortion and depression. The aim of the study was to investigate whether induced abortion was a risk factor for subsequent depression.
Methods: A representative sample of women from the normal population (n5768) was monitored between the ages of 15 and 27 years. Questions covered depression, induced abortion and childbirth, as well as sociodemographic variables, family relationships and a number of individual characteristics, such as schooling and occupational history and conduct problems. Results: Young women who reported having had an abortion in their twenties were more likely to score above the cut-off point for depression (odds ratio (OR) 3.5; 95% confidence interval (CI) 2.0–6.1). Controlling for third variables reduced the association, but it remained significant (OR 2.9; 95% CI 1.7–5.6). There was no association between teenage abortion and subsequent depression.
Conclusions: Young adult women who undergo induced abortion may be at increased risk for subsequent depression.

This was a longitudinal study with very high response rates at all response times over the course of the effort (from 97% at time one to 82% at time four). The research team used questions about depression from the Symptom Checklist-90 (SCL-90), a well-accepted mental health measure.
Dr. Pedersen further describes the strengths of this study and notes other recent work which found a link between abortion and mental health.

This study is robust in several respects. The response rate is high, respondents were observed over a considerable length of time, and measures of the key variables are well validated. We have also controlled for a large number of other factors pertaining to the lives of the women that are likely to affect whether a pregnancy is brought to term or aborted, and the likelihood that depression will set in at a later date. Nonetheless, the sample’s abortion rate does indicate either underreporting or a slight non-response bias. The sample is, moreover, relatively small, making the abortion and childbirth groups small as well. The study would have benefited from a larger sample.
Studies in this area present an inconsistent picture. Most identify abortion as a mental health risk factor, but they typically have selected samples, poor response rates and/or inadequate control for
other aspects of the women’s lives that could affect future risk of depression. The most robust study was conducted in New Zealand [4,8]. This study found that abortion seemed to be a risk factor for poor mental health, including the likelihood of depression.
Reactions to abortion are, one may assume, strongly coloured by the local sociocultural climate. A sense of guilt, loss and lower self-esteem are assumed to mediate between an induced abortion and later onset of depression [21]. New Zealand’s abortion laws are much more stringent than Norway’s [8], and this in itself could possibly increase the risk of social stigmatization and negative sentiment regarding abortion. It is therefore worth noting that such reactions are also experienced by many Norwegian women following an abortion. In light of this finding, women who terminate a pregnancy would probably benefit from postabortion counselling.

Next week, the APA Mental Health and Abortion Task Force report is slated to be considered by the APA Council of Representatives. If that report adopts the findings of this and the New Zealand research reports noted in the Pedersen article, it would represent a departure from prior APA positions. Stay tuned…