Homosexuality: Research Implications for Public Policy

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Edited by: John C. Gonsiorek & James D. Weinrich

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    Preface

    JohnC.Gonsiorek

    This volume began when two graduate students, dissatisfied with their disciplines' response to the public policy debates on homosexuality, decided to tackle the issue better than their more senior colleagues. They somehow succeeded. William Paul and James Weinrich, graduate students at Harvard in the mid-1970s, envisioned a pamphlet of one hundred pages or so, summarizing what science knew about homosexuality. As the project developed they involved me, then a graduate student in clinical psychology at the University of Minnesota, and Mary Hotvedt, in the process of completing her doctoral work in medical anthropology. As the four of us worked together, the scope enlarged and we became the Task Force on Sexual Orientation. It was clear that the project had become more than a pamphlet, and we began seeking sponsorship. The Society for the Psychological Study of Social Issues (SPSSI), Division 9 of the American Psychological Association, was the logical choice. SPSSI had developed and prospered since the 1930s as organized psychology's interface with social issues and public policy. Throughout SPSSI's history of careful objective analysis of social issues and courageous stands on their public policy implications, it has earned respect beyond the confines of academic psychology.

    SPSSI's response was most generous. Under the leadership of two of the society's presidents, Lawrence Wrightsman and June Tapp, we were provided programming time at the American Psychological Association from 1978 to 1981 with which to hone our ideas, financial support, encouragement, critical feedback, and perhaps most important, mentorship. John Gagnon, Evelyn Hooker, and John De Cecco served as able advisers to the Task Force.

    In 1982 the Task Force published its final report: Homosexuality: Social, Psychological, and Biological Issues (Sage Publications). Simultaneously, the mental health section of the Task Force report was published as a special issue of the journal American Behavioral Scientist in March 1982. The response to that first volume was positive. The Task Force disbanded, its mission successfully completed.

    The decade of the 1980s, however, saw an intensification and polarization, not a resolution, of the public policy debates about homosexuality. The emergence of the religious right wing in the United States and its use of homosexuality as a scare tactic produced levels of distortion about what science knew concerning homosexuality that surpassed anything in the 1970s. The fear and panic that accompanied the AIDS (acquired immune deficiency syndrome) epidemic further impaired reasonable debate about the public policy aspects of homosexuality. On a positive note, the first waves of new information about homosexuality in the 1960s and 1970s attracted the interest of scientists and scholars from all disciplines. The 1980s witnessed an unprecedented development of knowledge and theory concerning sexual orientation. The four editors of the original 1982 volume had hoped the information would remain current for some decades, but that the need for it would lessen after the public policy debates had been resolved. The opposite occurred. There was more new information about homosexuality than anyone anticipated, rendering the volume dated, and the public policy debates became more acrimonious, making the need for an updated and more focused volume acute.

    In 1987 William Paul and I began discussions with SPSSI to revise the volume for a paperback edition. William Paul's illness and eventual death from the complications of AIDS rendered him unable to participate in this revision. Jim Weinrich then took his place as coeditor. SPSSI, as before, provided the same catalytic environment of encouragement, critical feedback, and financial and technical support. This revision has also benefited from support and feedback from the Society for the Scientific Study of Lesbian and Gay Issues (Division 44 of the American Psychological Association), as well as from the Committee on Lesbian and Gay Concerns of the Board of Social and Ethical Responsibility of the American Psychological Association.

    A multiauthored coedited volume results from the efforts of many more people than appear on the authors' list. Some individuals' contributions were especially noteworthy. Leonard Bickman, the chair of SPSSI's Publication Committee, was generous with his time and feedback. Terry Hendricks of Sage Publications is any editor's dream of managing editor and publisher. All of our authors were selfless in donating their time, energy, and labor, but three of them, Greg Herek, Letitia Anne Peplau, and Charles Silverstein, took a particular interest in the volume as a whole and provided meticulous and considered feedback. Clinton Anderson, Linda Garnets, Terry Gock, and Doug Kimmel also provided crucial assistance by reviewing the entire manuscript.

    We dedicate this volume to our departed colleague, William Paul. We will long remember his ardent leadership of the Task Force on Sexual Orientation. We can think of no better memorial than to complete the project he twice spearheaded and attempt once again to provide a scientific base in understanding the public policy debates concerning homosexuality.

    Introduction

    JohnC.GonsiorekJamesD.Weinrich

    This volume attempts to summarize what science knows about homosexuality and its relevance for public policy. Those for whom a survey is adequate will find the most relevant literature covered. Those who require greater depth can utilize the volume as a guide to more extensive sources.

    The scholars who have contributed to this volume come from a variety of disciplines: social, clinical, and counseling psychology; law; psychiatry; social work; biology; nursing; and anthropology. This book does not attempt to address the complex range of concerns surrounding homosexuality as a social issue. Rather, it focuses on those issues that have been most central to current public policy debates about homosexuality. These include the nature and causes of sexual orientations; the reasons homosexuality is not a mental illness; the ethics of various mental health approaches to homosexuality; the effects of social and legal discrimination; newer biological and psychological understandings of homosexuality; homosexual people as couples and as parents; and the implications of the AIDS epidemic. The authors share a belief that scholarly explication of what science knows about these issues can clarify this controversial area in which discourse has typically been characterized by ignorance, distortion, and prejudice. The volume also shares a methodological perspective across many chapters, as a way to assist the reader to think critically about the material presented. In this manner, we hope to encourage readers to become discerning consumers of the scientific discourses on homosexuality, past, present, and future. The chapters are presented in a format accessible to the serious lay reader as well as professionals from various disciplines.

    The past 25 years have seen intense, generally unresolved, and at times acrimonious debate about the meaning of homosexuality and the place of homosexual individuals in our society. Scientific information is often cited by proponents of all viewpoints to justify their positions. Often, scientists and scholars have not spoken for themselves in these debates. Scientific and scholarly information abut homosexuality has been distorted and misused for political ends. Despite heterosexist bias having been thoroughly examined and critiqued (McDonald, 1981; Morin, 1977; Morin & Charles, 1981), it clearly persists.

    The authors in this volume are unusual in their willingness to enter this debate. Their task has been a challenging one: To sift through the most important aspects of scientific knowledge on their topic and apply this to public policy debates in a manner that is objective, yet clear and uncompromising, when science does have something to say about homosexuality. To most Americans, homosexual activities and people have been mysterious. Since the mid-1950s when Evelyn Hooker did her pioneering work on psychological adjustment in homosexuals, there has been a steady accumulation of scientific information about homosexuality. To serious scientists and scholars, homosexuality and homosexual individuals are no longer mysterious.

    Public policy debates about homosexuality include areas other than the biological and social sciences, such as moral values and religious concerns. This volume does not speak directly to those. We note, however, that proponents of all viewpoints have attempted to cloak themselves in the respectability of science. Not all religious and moral traditions are impervious to scientific understandings of human nature. For some traditions, science is important as a source of understanding, and we believe that this volume has much to offer those traditions that are receptive. We do not think it is too brash to say that those who call upon the biological, behavioral, or social sciences to support their points of view must seriously weigh the information contained in this volume if they are to retain credibility and integrity.

    Selection of topics for this volume presented a challenge. We have often had to remind ourselves that issues that are settled for scientists and scholars (e.g., whether homosexuality is a biological aberration or an illness) are not settled for the public. Our perception of which topics are most crucial for the knowledge base of a general audience guided selection. We have also had to make some difficult decisions abut which areas have sufficient literature to warrant a summary of research findings relevant to public policy. Space constraints have been a consideration, as one of the purposes of this volume is to be accessible and affordable. Not everyone will agree with our choices, but we believe we have covered most, though certainly not all, topics germane to public policy debates. If limitations of space (and therefore, cost of this book) were not a factor, our next most logical choices would have been racial, ethnic, and cross-cultural diversity in depth; historical understandings; expanded legal coverage; the status of gay and lesbian youth; sexual orientation over the life span; and exploration of the relationships between homophobia, sexism, racism, and economic exploitation.

    Like most scientific discourse, research on homosexuality has been filtered through societal biases. Among its other effects, this has meant that white, middle-class and above, adult, English-speaking males have been studied more than their numbers warrant. This situation showed some signs of improvement regarding women, who were more intensively studied in the 1970s and early 1980s than ever before. Ironically, the AIDS epidemic is again pushing research funding heavily in the direction of gay males to the exclusion of lesbians because of the vastly different HIV (human immunodeficiency virus) risk profiles of these two groups. (As a group, lesbians are probably at least risk based upon sexual orientation, while gay men are at greatest risk, based upon this variable.) The old sexist prejudices, though, have away of adapting themselves to new conditions, and much of the “new” male-oriented bias in research is simply that. Researchers have been considerably less sensitive to inclusion of nonadult and racial/ethnic minority populations in research, although a good deal of exciting work on identity development of this latter group is emerging. We have attempted to include information on women, non-middle-class samples, racial/ethnic minorities, and cultural diversity where it exists. We have been pleased to find this situation improved since we prepared the 1982 version of this book; we have been disappointed that so much distortion from equitable and representative sampling remains.

    This volume begins with an exploration of the difficulties in defining and measuring sexual orientation and contains a brief introduction to the current debates about the “nature” of sexual orientation. Biological understandings of sexual orientation are then pursued from a variety of perspectives, including evolutionary and hormonal. Not only do these chapters by Pillard and by Kirsch and Weinrich provide a grounding; the ideas they elucidate are among the most misused in public policy debates. Weinrich and Williams introduce cross-cultural information, which develops another level of understanding sexual orientation.

    Herek provides a thorough basis for understanding the social context of homosexuality as it affects both homosexual and nonhomosexual people. Rivera offers a similarly detailed review of the legal status of lesbian and gay citizens.

    Silverstein initiates a series of chapters on traditional mental health concerns: diagnosis and treatment. He offers a historical perspective, critiques the intrusion of political agendas into mental health practice, and then reviews biologically based treatment modalities. The review by Gonsiorek follows, outlining the empirical reasons why the illness model of homosexuality was discarded. Davison then analyzes the ethical reasons why attempts to change sexual orientation are problematic, while Haldeman reviews the empirical literature on attempts to change sexual orientation, with special emphasis on the newer religiously oriented “conversion” treatments. In a sense, much of this section is “old hat” to those knowledgeable about mental health and sexual orientation. It is covered in such depth because the public policy debates about homosexuality continue to be cluttered with the discredited and obsolete belief that homosexuality is an illness, almost a decade and a half after it was depathologized. Further, in recent years, there has been an increase in religiously oriented conversion therapies. We judged this area to be one of the most persistently confusing for a lay readership, and so gave it considerable emphasis. For the professional reader, we believe our extensive coverage will provide a sound methodological understanding of these issues.

    The next section samples what the newer lesbian and gay affirmative perspectives in psychology have to offer. Gonsiorek and Rudolph review identity development among lesbians and gay men, perhaps one of the issues most elaborated by this new perspective. The relationship of these ideas to racial/ethnic minority perspectives on identity development is briefly explored, and a proposed integration with self-psychology approaches is outlined. Peplau describes research on same-sex couples and places it in the context of understanding couples in general. Lesbians and gay men as parents may be one of the most common legal struggles pertaining to homosexuality today. Green and Bozett review what is known about homosexual people as parents.

    No book written in the 1990s about homosexuality would be complete without discussion of the AIDS epidemic. Yet, in this area, it was hardest to decide which topics were most relevant. Where does scientific research have something to say abut public policy and AIDS, specific to homosexuality? Topics we considered had a tendency to mushroom, encompassing broad public policy dilemmas relating to health care resources, delivery systems, and other areas not specific to homosexuality. After some deliberation, we concluded that HIV infection prevention raised the greatest number of public policy issues specific to homosexuality. Dejowski and colleagues examine the empirical basis for the most commonly used prevention tool in public health, partner notification. Gonsiorek and Shernoff discuss what is known about HIV infection prevention strategies in gay men in the context of what is generally known about health behavior change.

    A brief summary of the volume then follows. A master bibliography covers the entire volume, with one exception. The chapter on legal issues by Rivera retains its separate bibliography. A thorough bibliography is a useful tool for research and scholarship. The differences between legal and psychological citation systems are extensive. We decided it would be most useful for scholars in both areas to leave them separate.

    This book has a narrow, almost unidimensional focus: What does science know about homosexuality and what does this mean for public policy? This focus is both an asset and a liability. We believe we have provided a sound introductory text, and a guide to further exploration of the literature to the serious student, both lay and professional. We are also aware of our own frustration in resisting opportunities to expand into related areas. We have opted, for better or worse, to do a limited task, hopefully well. The deciding factor was the lack of a focused comprehensive treatment of this area, except for our earlier 1982 version, which is outdated in part, and less focused than this volume. We hope others will use this volume to push the limits of scientific understanding of sexual orientation beyond the parameters in which this volume is contained.

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    About the Authors

    Pearl Beck, Ph.D., is a research associate at the Rutgers University Institute for Health, Health Care Policy, and Aging Research. She is currently codirecting an evaluation of New Jersey's Respite Care Program. Previously, she directed an AIDS prevention intervention and research program and the evaluation of New Jersey's HIV Contact Notification Program. She received her doctorate in social psychology from the Graduate Center of the City University of New York. For the past 15 years, she has conducted research on a broad spectrum of public policy issues including AIDS, long-term care, and homelessness. Her major publications are in the area of aging and long-term care.

    Frederick W. Bozett, RN, DNS, was a professor in the graduate program, College of Nursing, University of Oklahoma. He was editor of Gay and Lesbian Parents (1987), coeditor of Dimensions of Fatherhood (Sage, 1985), and editor of Homosexuality and the Family (1989). He published extensively in the area of fatherhood and gay fathers and was undertaking a longitudinal study of custodial gay father families, as well as studies of gay father-child relationships and gay grandfathers, at the time of his death in the fall of 1991.

    Stephen Crystal is Associate Professor of Social Work and Sociology, and Chair of the Division on Aging at the Institute for Health, Health Care Policy, and Aging Research at Rutgers University. He is the principal investigator of several studies relating to health services utilization and health status of persons with HIV infection. He has recently received an award from the National Center for Health Services Research to conduct a three-year survey of psychosocial, health care, and behavioral aspects of the illness. Previously, he served as chief of the Division of Health Care Sciences and was an assistant professor of community and family medicine at the University of California in San Diego. He also served as director of the Bureau of Management Systems, Planning, Research, and Evaluation for the City of New York Human Resources Administration. He received a Ph.D. in sociology from Harvard University in 1981.

    Gerald C. Davison is Professor of Psychology at the University of Southern California. He joined USC's psychology faculty in 1979 as director of Clinical Training and from 1984 to 1990 served as department chair. He is a Fellow of the American Psychological Association and of the American Psychological Society, and from 1973 to 1974 served as President of the Association for Advancement of Behavior Therapy. In 1988 he earned an award from the Committee on Lesbian and Gay Concerns of APA's Board of Social and Ethical Responsibility. His books include Abnormal Psychology, 5th ed. (1990), Case Studies in Abnormal Psychology, 3rd ed. (1991), Clinical Behavior Therapy (1976), and Readings in Abnormal Psychology (1989).

    Edmund F. Dejowski, J.D., Ph.D., is a senior research associate with the Institute for Health, Health Care Policy, and Aging Research at Rutgers University. In that capacity he serves as co-investigator and director of a study of respite care, and is an investigator in several AIDS studies. Previously, he served at the Institute as a postdoctoral trainee through the Rutgers-Princeton Program in Mental Health Research. Before coming to the Institute, he was a research scientist for the City of New York Human Resources Administration. In that capacity, he directed and was co-investigator for a four-year multistate investigation of adult protective services. He has also served as a clinical and community psychologist in New Jersey and in Maine.

    Lidia Dengelegi has an M.A. in psychology from New York University and a Ph.D. in social psychology from Temple University. She has worked at Beth Israel Medical Center in New York overseeing AIDS clinical trials and has conducted an assessment of the AIDS-related knowledge, attitudes, and behaviors of intravenous drug users in New York City. Presently she is a research associate at the Institute for Health, Health Care Policy, and Aging at Rutgers University, where she was the project director for the evaluation of New Jersey's HIV Notification Assistance Program.

    John C. Gonsiorek received his Ph.D. in clinical psychology in 1978 from the University of Minnesota. He is a Diplomate in Clinical Psychology of the American Board of Professional Psychology. He is currently Associate Director of Training at the Minnesota School of Professional Psychology and also has a private practice in Minneapolis. He has published extensively in the areas of psychotherapy with gay and lesbian individuals, professional ethics and boundaries, quality assurance in mental health, and other areas.

    G. Dorsey Green, Ph.D., is a psychologist in private practice in Seattle, Washington. She is the coauthor of Lesbian Couples (1988) and has written about and worked with lesbian and gay couples and parents over the last ten years. She also teaches and consults about gay and lesbian issues. She and four other Seattle psychologists are working on a research project that looks at social support systems of single, coupled, and parenting lesbians. She is currently involved in developing a community of 20 households to live on shared land near Seattle. The group is following the model of similar communities in Denmark and hopes to move to the new homes in early 1992.

    Douglas C. Haldeman, Ph.D., is a counseling psychologist in private practice in Seattle, Washington. He is active in educating other mental health professionals and the general public on issues relevant to sexual minorities, and serves on the assistant clinical faculty of the University of Washington. His special area of interest and expertise is the ethical and psychological implications of conversion therapy for gay men and lesbians.

    Gregory M. Herek, Ph.D., is an associate research psychologist at the University of California at Davis. A noted authority on the social psychology of prejudice and violence against lesbians and gay men, he has published numerous scholarly articles on these and related topics. He is past chairperson of the Committee on Lesbian and Gay Concerns of the American Psychological Association (APA), and a member of the APA Task Force on AIDS. His advocacy work has included testifying on behalf of the APA for congressional hearings on antigay violence, public speaking about prejudice against lesbians and gay men, and numerous appearances on national and local media.

    John A.W. Kirsch, Ph.D., is Professor of Zoology and Director of the University of Wisconsin Zoological Museum in Madison, where he teaches a gay studies course in addition to introductory biology, taxonomy, and several graduate seminars. His chief interest is in the phylogeny of marsupials, another group of misunderstood mammals, using biochemical techniques to establish relationships—work that involves him in frequent trips to the southern hemisphere. He has published nearly 100 papers, book chapters, and reviews, including several on the biology of homosexuality.

    Letitia Anne Peplau is Professor of Social Psychology and Acting Co-Director of the Center for the Study of Women at the University of California, Los Angeles. She received her doctorate in social psychology from Harvard University in 1973. Her research interests include gender, close relationships (both homosexual and heterosexual), and loneliness. She has published, with others, numerous journal articles and several books including Social Psychology, 7th Ed., Close Relationships, and Loneliness: A Sourcebook of Current Theory, Research, and Therapy. She is currently a member of the Task Force on Bias in Psychotherapy with Lesbians and Gay Men of the Committee on Lesbian and Gay Concerns of the American Psychological Association.

    Richard C. Pillard, M.D., is Professor of Psychiatry at Boston University School of Medicine, Medical Director of the Solomon Carter Fuller Mental Health Center, and cofounder of Boston's Homophile Community Health Service. He has done research into the psychopharmacology of psychoactive drugs, and on whether homosexuality runs in families. He was the first publicly identified gay psychiatrist in the United States.

    Rhonda R. Rivera is Professor of Law, The Ohio State University College of Law. She received an M.P.A. in 1960 from Syracuse University and a J.D. from Wayne State University College of Law. She wrote the germinal work on sexual orientation law in 1979, Our straight-laced judges: The legal position of homosexual persons in the United States, (30 Hastings Law Journal 799). In the ten years following, she has updated that work with three more major law review articles. She is the cofounder of the Gay/Lesbian Legal Issues Section of the American Association of Law Schools and a practicing attorney.

    James R. Rudolph received his Ph.D. in counseling psychology from Lehigh University in 1988. He is currently Clinical Director at Carver County Mental Health Center, Waconia, Minnesota. He is also an adjunct assistant professor of psychology at St. Mary's College Graduate Center in Minneapolis, where he teaches coursework on psychological assessment. He has written on counselors' attitudes toward homosexuality and is planning future writing projects integrating self-psychology and affirmative gay/lesbian psychotherapy.

    Michael Shernoff, CSW, ACSW, is founder and codirector of Chelsea Psychotherapy Associates in Manhattan. He also serves as adjunct faculty to the Department of Education at Gay Men's Health Crisis. He is former cochairperson of the AIDS Task Force of the Society for the Scientific Study of Sex.

    Charles Silverstein is a psychologist in private practice in New York City. He was the founding editor of the Journal of Homosexuality and the founding director of both Identity House and the Institute for Human Identity. He is editor of Gays, Lesbians and Their Therapists: Studies in

    Psychotherapy. His previous published works include A Family Matter: A Parents' Guide to Homosexuality, Man to Man: Gay Couples in America, and, with Edmund White, The Joy of Gay Sex. He is a Fellow of the American Psychological Association and a consultant to the New York University AIDS project.

    James D. Weinrich, Ph.D., is Assistant Research Psychobiologist in the Department of Psychiatry at the University of California, San Diego, where he is Center Manager of the HIV Neurobehavioral Research Center. Author of Sexual Landscapes: Why We Are What We Are, Why We Love Whom We Love, he has written and lectured extensively on matters of sex, gender, and evolutionary biology. In 1987 he and Richard C. Pillard shared an award from the Society for the Scientific Study of Sex for the best paper published that year in the Journal of Sex Research.

    Walter L. Williams, Ph.D., is Associate Professor of Anthropology and the Study of Women and Men in Society at the University of Southern California. He has published books about interethnic relations, most notably The Spirit and the Flesh: Sexual Diversity in American Indian Culture (1986). In 1987–1988, he was a Fulbright Scholar in Indonesia, which resulted in his most recent book, Javanese Lives: Women and Men in Modern Indonesian Society (1991). He is Director of Postgraduate Studies at the Institute for the Study of Human Resources in Los Angeles.


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