The Bieber study: A review revisited

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?

Handicapping the APA abortion and mental health task force report

Last week, I reported the concerns of peace advocates, Consistent Life, about the upcoming American Psychological Association report regarding potential mental health consequences of abortion. In one of their letters to APA President Alan Kazdin, CL Executive Director, Bill Samuel, wrote:

It is accordingly with great concern we note APA has not taken sufficient care with a highly volatile issue, that of abortion. APA has held a position of abortion as being a civil right for women since 1969, and therefore has a clear political stand. Yet the Task Force on Mental Health and Abortion had no call for nominations; it was formed by Division 35, whose position is stronger and more focused than that of the national organization; and the final make-up of the task force had half the members as strong public advocates of the pro-choice view. Advocates of the view that abortion is violence to both unborn children and to women, which could balance such biases, are ominously absent. There are several well-qualified researchers who would have been pleased to serve on the panel, had the panel been selected with balance in mind.
Consider also that the report of this task force is scheduled to come out during an election year, 2008. The APA position is in accord with that of one of the major political parties, and in opposition to that of the other. When a prestigious organization puts out a report on a politically volatile issue at a time when political passions run particularly high, any imbalance on the task force will not pass unnoticed. Surely critics and observers will highlight the fact that members of such a task force were unbalanced in favor of those whose views matched the political position of the organization. The absence of those who could best challenge assumptions, provide alternative explanations, and offer differing interpretations of the same data will not be overlooked. We hope you will pause to reflect upon how partisan this will appear.

Dr. Kazdin wrote back to say that the APA report “must be grounded in the strongest, peer-reviewed science available…” This is of course the correct answer but I maintain that the Consistent Life people have raised valid points of concern. The task force report is to be released in August at the APA convention if approved by the Council of Representatives.
Beyond the appearance of bias, there is a more obvious indication of how the APA will report the research on abortion and mental health consequences. In the June 2008, APA Monitor, Rebecca Clay wrote an article on how the right wing misuses scientific research. In her article titled, “Science vs. ideology: Psychologists fight back against the misuse of research,” Clay interviews abortion researcher Nancy Adler regarding how anti-abortion psychologists are seeking legitimacy for their perspective by, shudder, doing research and reporting in peer-reviewed journals. Do you think the task force will see things much differently than Dr. Adler?

In other issue areas, special-interest groups have assumed the trappings of science to bolster ideology-driven claims. One example is so-called “post-abortion syndrome,” a scientific-sounding name for something most researchers say doesn’t exist. Nancy E. Adler, PhD, a professor of medical psychology at the University of California, San Francisco, is one of them. She has found that the rate of distress among women who’ve had abortions is the same as that of women who’ve given birth. Adler and other experts reviewed the literature in the late 1980s as part of an APA panel and found no evidence of a post-abortion syndrome. Even the anti-abortion Surgeon General C. Everett Koop, MD, refused to issue a report on abortion’s supposed psychological impact when President Ronald Reagan asked him to, citing the lack of evidence of harm.
Since then, says Adler, anti-abortion advocates have become more world-wise.
“They’re using scientific terminology,” she points out. They’re also gaining credibility by getting published in mainstream journals.
But such research often has methodological problems, Adler claims.
“Women are not randomly assigned to have abortions,” she points out. “Women who are having abortions are having them in the context of an unwanted pregnancy, which usually has some other very stressful aspects. Their partners may have left them. They may have been raped.”
In addition, says Adler, proponents of the syndrome don’t mention the base rate of depression and other psychological problems in society as a whole. And they always attribute such problems to abortion rather than any other possible causes.
A new APA Task Force on Mental Health and Abortion will examine such issues in a report later this year.

I think this is probably signals how the APA’s task force report will turn out. The good guys use good methods and the bad guys use the “trappings of science” and are being sneaky by “getting published in mainstream journals.” I guess the way to tell the good research from the bad is not the quality of peer-reviewed work but the ideology of the researcher. What I get from Clay’s article is this: When an APA-approved policy position is supported, it is science; otherwise, it is ideology.

San Jose/Evergreen Community College adjunct professor dismissed for discussion of homosexuality causes, sues college

On another post, a commenter (Dave G) brought up this case which has raised some eyebrows among academics. Here is the media version:

The controversy centers on an incident in June 2007, when Sheldon was asked by a student in a human heredity class about heredity’s impact on “homosexual behavior in males and females.” Among other references, Sheldon noted a German study demonstrating some link between maternal stress and homosexual behavior in males, according to the lawsuit.
After a student complained, college officials investigated and dismissed Sheldon, an adjunct professor at the school since January 2004. Court papers say the student expressed concern that Sheldon’s response was “offensive and unscientific.”
In the lawsuit and in a letter sent to the college district’s board of trustees, Sheldon, a veteran biology instructor, maintains she was simply providing students with an exchange on the “nature vs. nurture” aspect of sexual orientation. While acknowledging she was offering views that may have been controversial, Sheldon argues that it was relevant to the course work and part of important classroom dialogue.
“The textbook itself points out that the causes of homosexual behavior are a subject of debate in the scientific community,” said David Hacker, Sheldon’s lawyer. “This teacher did nothing more than explain this fact.”

The Foundation of Individual Rights in Education has taken on the issue and has a lengthy description of the case as well.
A biology professor, P.Z. Myers, who describes himself as a “godless liberal,” blogs about this at Pharyngula (H/t Brady). He casts a somewhat skeptical eye on the complaint and makes some good points in the process. He provides links to relevant documents for those interested.
Coincidentally, this past week, I was researching for my book by reading Lisa Diamond’s new book Sexual Fluidity. By the way, this is an excellent book with a wonderful description of her research. On page 39, the maternal stress hypothesis is mentioned:

Another line of research on the neuroendocrine theory concerns male children born to mothers who were exposed to extremely high levels of stress during pregnancy. Animal research has found that such experiences can affect sexual differentiation in utero through a delay of the testosterone surge that influences brain masculinization.

Here she cites two studies, one led by Michael Bailey and the other by Lee Ellis, along with a review of biological studies with Brian Mustanski as the first author. Professor Sheldon was citing Dorner’s work on hormones and brain differentiation. However, I suspect when this goes to trial, page 39 of Diamond’s book might also be presented in the court room.
Given what I have read regarding this situation, I like Sheldon’s chances in court. Professors present controversial material about subjects daily. Some (much?) of that material we do not agree with but present to help students become aware of the field as it is.

Mankind Project clarifies stance on reparative therapy

Within the last day or so, Mankind Project members received an email from Executive Director, Carl Griesser with an alert to a new feature on the MKP website.

…the next time you visit www.MKP.org you will find a rainbow flag with the word Friendly superimposed as a navigation button linked directly to a slightly modified version of the reparative therapy statement. The Executive Committee and our IT Team believe this is an effective way of indicating our welcoming attitude to all men, while making the statement easily accessible to the public.

Click on the link and you will find the following article titled Sexual Orientation & the Mankind Project:

· The ManKind Project creates trainings and circles in which men are invited to discover their deepest truths.
· We welcome men of all sexual orientations: gay, straight, and bisexual, as well as those who identify as having unwanted same sex attraction, to do their own work as they define it, to respect the identity and value of others, and to take responsibility for the impact their words and behaviors have on others.
· We support each man in pursuing his path to deeper authenticity. We do not provide therapy nor endorse any particular therapy, including reparative therapy. Any group or organization that states or implies otherwise does so without our permission.
· We do not, and will not, attempt to change a man’s sexual orientation.
· We stand firm in support of gay and bisexual men. We support men who believe that homosexuality is a normal part of the spectrum of human sexuality and of mature masculinity.
· We will not tolerate proselytizing for any religion or belief and do not tolerate discrimination on our trainings or in our communities. We support our training and community leaders in identifying and challenging discriminatory language and behavior.

I provided a link to this statement in a previous post. Essentially, some reparative therapy clients/therapists were recommending the New Warriors Training Adventure to same-sex attracted men as a means of enhancing their sense of masculinity. Reparative therapists believe male same-sex attraction derives from a sense of distrust of men and a disconnection from natural masculinity. Via the reparative drive, he sexualizes his desire for masculine closeness and seeks homosexual relationships. Get a man feeling all masculine and his SSA disappears. Perhaps one of the clearest statements of this hypothesis and the proposed remedy is David Pickup’s the Workout program.
Mr. Pickup recommends the New Warriors Training Adventure and notes on his website that he serves as training coordinator of the Los Angeles branch of the Mankind Project. This is the branch which hosted Joseph Nicolosi, Narth co-founder and father of reparative therapy, at a training session in 2005. This session was quite controversial and eventually led to the MKP statement.
The email to MKPers provided this rationale for the new rainbow link:

Men,
As many of you are aware, the Project Council approved a Position Statement on Reparative Therapy in February 2007. Based on initial text prepared by Jim Mitchell, I prepared a statement which was then revised by a group of gay, bi, and straight men, and men who identify as having Unwanted Same Sex Attraction (USSA). We decided that it was necessary to take this stand because many men were being referred to the NWTA by reparative therapists and groups who had little or no experience with MKP (as well as by some reparative therapists and USSA men who had been through the training.) It was our intention to clarify for ourselves and for these men what they can expect if they attend our trainings. I sent the statement to the reparative therapists and groups I knew about, and have continued to do so when I learn of others. I asked organizations which implied on their websites that MKP offered or supported reparative therapy to remove such statements and any links to our website. Some complied with the request, though not all.

I got a chuckle out of this sentence: “It was our intention to clarify for ourselves and for these men what they can expect if they attend our trainings” since the MKP is so secretive about what men can expect. In any case, I believe it is valuable for MKP to indicate to men that they do not adhere to the masculinity enhancement model of reparative therapy for men who might be encouraged by reparative organizations/practitioners to seek NWTA for that purpose.

Insure.com in gay lifespan dispute

Boxturtlebulletin is reporting a Cameron citing of some interest. Insure.com has an article on the company website which accepts the lifespan estimates of the Camerons.
We have covered this matter here in depth (e.g. here). To make it easier to follow that nine-part series, I have put it into one article – “Only the gay die young? An exchange between Warren Throckmorton, Morten Frisch, Paul Cameron and Kirk Cameron regarding the lifespan of homosexuals.” All of the posts are included with commentary regarding the arguments presented in that exchange.
As I look at the Insure.com article and the CEO response, I am puzzled why the company has not removed it from the website. I do not believe the Camerons made their case in that article. Also, the one other team which reports a more traditional methodology, Hogg et al, later made it clear that their estimates would be much more positive if current data were used. The author, Joe White, omits that information from his article.
Mr. White quotes the Cameron’s Eastern Psychological Association presentation but does not link to it. It is no longer on the Christian Newswire website but is stored here on the Lifesitenews website. The Cameron’s EPA report is extensively critiqued in my article above by Danish epidemiologist, Morten Frisch and me.