STANTON L. JONESStanton L. Jones is chair of the Department of Psychology, Wheaton College, and a licensed clinical psychologist. An expanded and fully referenced version of this essay, coauthored with Don Workman, will appear in The Journal of Psychology and Theology later this summer.
It has happened more than once—a friend has said casually, “Of course, the church’s historic stance on homosexuality is totally outmoded in light of what we now know about it.”
Neither the Christian tradition nor the Scriptures can be responsibly interpreted as approving of homosexual behavior. But many argue that recent scientific understandings put the church in a “new hermeneutical situation” where its traditional stance must be altered. But what are these new scientific understandings? As a psychologist, I would like to address what the behavioral and social sciences have to say to the church on three key questions: Is homosexuality a psychopathological condition? Is homosexual orientation caused by factors beyond a person’s voluntary control? Is change to heterosexuality possible for the homosexual?
Is Homosexuality Pathological?
Homosexuality was removed from the approved list of pathological psychiatric conditions by the American Psychiatric Association (APA) in 1974. Many take this to mean that homosexuality is no longer considered a psychopathology, a “mental illness.” But knowledge of the history and context of the APA’s action suggests that this simple answer will not work. The vote occurred at a time of tremendous social upheaval, at unprecedented speed, and under conditions of explicit threats from the gay-rights movement to disrupt APA conventions and research. While the deletion of homosexuality from the professionally authoritative Diagnostic and Statistical Manual of Mental Illness was in response to a majority vote of the APA, it appears that the majority of the APA membership continued to view homosexuality as pathological. Four years after the vote, a survey found 69 percent of psychiatrists believed that homosexuality “usually represents a pathological adaptation.”
Thus the question “Is homosexuality pathological?” is still alive. There is no absolute standard in this area, but four empirical criteria are often used to define abnormality: statistical infrequency, personal distress, maladaptiveness, and deviation from social norms.
As a lifelong, exclusive or near-exclusive orientation, homosexuality is not a common pattern, but neither is it rare. Kinsey found 4 percent of white males to be exclusively homosexual throughout their life and a total of 10 percent of white males to be mostly or exclusively homosexual during at least a three-year period between the ages of 16 and 55. Kinsey’s data are generally believed to overrepresent male homosexuality. Other estimates range from 1 percent to 4 percent for exclusive homosexual orientation among males. The incidence among females is commonly reported to be half that of males. (Less research exists on female homosexuality.)
While it is clear that contemporary research cannot be interpreted as saying that one out of ten persons in the general population is homosexual (a common assertion), quibbling about prevalence does not answer the psychopathology question: By what criterion can anyone judge homosexuality as normal at 10 percent and abnormal at 4 percent of the population? There exists no basis for deciding on pathology by mere statistical frequency.
Does homosexuality always and inherently involve personal distress? Most contemporary researchers conclude that homosexuals as a group are not more emotionally disturbed by current standards than are heterosexuals. Yet some researchers have conclusively documented higher rates of depression and loneliness, suicide attempts, and substance abuse in this population. Such elevated levels of distress among homosexuals (e.g., depression or suicidality) are often attributed to the interaction of homosexuals with a rejecting society, not to any discomfort produced by the orientation itself. These responses are likened to those of any persecuted or disenfranchised minority, and there is some validity to such an argument.
The question of the maladaptiveness of homosexuality is difficult, because one must ask about maladaptiveness according to some standard. Positively, homosexuality itself does not seem to prevent a person from being a productive and functional member of society. Negatively, the biological adaptiveness of homosexuality was once questioned on the basis that it does not contribute to the propagation of the species, but this view is not often voiced today, given current overpopulation fears. Relational stability may be relevant here: While it appears that lesbians show a capacity to form long-term monogamous relationships in a manner comparable to that of heterosexuals, male homosexuals as a group show a greatly reduced capacity for such relationships and a propensity for promiscuity. The famous Bell and Weinberg study found that only 10 percent of male homosexual respondents in a nonrandom but large sample could be classified as existing in couple relationships characterized as even “relatively monogamous” or “relatively less promiscuous.” In the same study, 28 percent of white homosexual males reported having had 1,000 or more homosexual partners in their lifetime, only 17 percent reported having had fewer than 50 partners, and 79 percent reported that more than half of their sexual partners were strangers. These figures from the mid-1970s have changed radically in the age of AIDS. But if one presupposes that the capacity to form stable monogamous erotic relationships is an essential adaptive capacity (which is not agreed upon by all), then real difficulties for male homosexuals emerge.
Most judgments of the adaptiveness of homosexuality are made according to whether homosexuals achieve what theories of normal human development understand to be wholeness and health. For example, conventional psychodynamically oriented practitioners judge homosexuality as representing a fixation or regression in development. In this model, heterosexuality is presumed to be the natural endpoint of growth as a person; homosexuals do not reach that endpoint, and so their condition is judged maladaptive. Unfortunately, developmental models are always open to dispute—which is why the psychological and psychiatric communities have collectively retreated from using such models to make formal judgments about normalcy.
Finally, does homosexuality violate societal norms? Recent studies of public opinion show that about three-fourths of the general public view all instances of homosexual behavior as immoral. In the case of homosexuality, the mental health establishment seems to have committed itself to revising rather than reflecting the predominant majority public response—that is, to normalizing behavior clearly rejected by the public.
Determining whether or not homosexuality is inherently pathological is a difficult and unresolved task for behavioral scientists. Homosexuality is infrequent but not rare; it is not inevitably correlated with personal distress; judgments of its maladaptiveness are inconclusive; and it violates societal norms. This mixed scorecard reflects the confusion and disagreement in the field today about the pathological status of homosexuality.
I would not regard homosexuality to be a psychopathology in the same sense as schizophrenia or phobic disorders. But neither can it be viewed as a normal “lifestyle variation” on a par with being introverted versus extroverted. Christians typically believe that genital homosexual acts are immoral and that immorality is an abnormal (unintended by God) condition for humanity. It also seems undeniable that a Christian understanding of persons commits one to regarding heterosexuality as the optimal goal of human sexual and relational fulfillment.
Thus, homosexuality must be regarded as a problematic erotic orientation that contemporary social science can help us understand. One can take such a stand without regarding it as a psychopathology per se. Such a stance permits one to support the ordination of celibate persons of homosexual orientation who are otherwise suited and called to the ministry, in that homosexual orientation cannot be equated with diagnosing the individual as “neurotic” or “psychotic.” Further, designating a behavior as pathological is not necessary for that behavior to be viewed as sin. Idolatry, sorcery, pride, and greed are not recognized pathologies, but they are sins.
Does Homosexual Orientation Develop Involuntarily?
This question often reflects the presupposition that God would not declare as sinful proclivities that people had no part in establishing. The major hypothesized causes for homosexual orientation today focus on genetic, prenatal hormonal, and psychological factors.
Early identical-twin research into the causes for homosexuality suggested a strong genetic component, but these results have not been replicated. Today, it is generally concluded that there is some degree of genetic influence in the development of some homosexual persons, but the operative mechanisms are not direct.
The most powerful biological theory of causation today looks at prenatal hormones. Studies introducing abnormal hormone levels in pregnant animals have shown dramatic effects on sexual differentiation and erotic development in offspring. Hormone levels in human fetuses can unquestionably affect physical development, brain functioning, gender orientation, and adult behavior.
Does this suggest a prenatal hormonal cause of all or most homosexuality? While some theorists propose such a model, the evidence is either based on animal research that does not begin to approximate the complexities of the human situation or on correlational human research from which we cannot clearly adduce causation. A number of experts have concluded that prenatal influences may provide a “push” in the direction of homosexuality, but there is as yet no conclusive evidence that this push is powerful enough to be determinative. Further, there is no evidence that this push is present for all homosexuals. Many argue that psychological influences may result in a homosexual orientation without any predisposing prenatal influences.
Postnatal hormonal theories were once common, but the general consensus today is that there are no major differences in hormone levels between heterosexuals and homosexuals. In any case, all but the most extreme hormone variations have little impact on sexual interests and choices in humans.
Psychoanalytic theories of causation are well known. These assert that homosexuality is the result of serious disturbances of family dynamics during childhood. Psychoanalyst Irving Bieber developed the most familiar model: that homosexuality may result from a disturbance in parent-child relationships where a distant father frustrates a boy’s need to identify with his father, and a smothering and controlling mother blocks efforts at independent development and maturation. Bieber’s theory, based on clinical work and research with nearly 1,000 homosexuals, meets with varying responses in the mental-health community, ranging from outright dismissal to total acceptance. Others, including Christian analyst Elizabeth Moberly, offer different psychonalytic interpretations of homosexuality. While findings are intriguing, the general consensus is that psychoanalysts have not offered conclusive evidence for their theories.
Other psychological theories focus on the role of learning, suggesting that early sexual and other emotional experiences shape erotic orientation. For example, a boy with troubled family relationships and a pre-existing tendency toward effeminate behavior may be more likely to experience his early erotic experiences in a homosexual fashion, begin to define himself as homosexual, and may subsequently choose homosexual interactions even when heterosexual options are available. Conclusive evidence for these theories is also lacking.
Two final lines of evidence suggest that the causes of homosexuality are not exclusively biological. First, though homosexual behavior occurs often in the animal kingdom, it most often occurs in interactions between dominant and subordinate animals, when other-sex mating partners are unavailable, or under stresses such as crowding. Stable, lifelong homosexual orientation in animals is quite unusual.
Second, homosexual behavior occurs to some extent in all known human cultures, but the form it takes varies, suggesting that the meaning attributed to homosexual behavior in the culture is a prominent influence on the behavior itself. In other cultures, homosexual behavior seems to occur for two main reasons: lack of available other-sex partners or as part of a culturally defined ritual. The concept of homosexual orientation as a stable, lifelong pattern does not seem to exist in all societies, and it is rare in preindustrial societies.
Is homosexuality developed involuntarily? This divergent phenomenon appears to be the product of a host of factors, with causes and facilitating influences varying from person to person. Psychological, familial, and cultural influences may be most important. It appears that homosexuality can develop without genetic or hormonal factors, but generally it does not develop without learning and socialization.
The scientific literature often seems to assume that humans are buffeted about by external and internal mechanisms. Such a view of human passivity seems sub-Christian, but a Christian view of persons cannot deny that biological and social forces influence our lives. A Christian view would suggest that we respond to these influences with subtle or obvious responsible acts of our own, adding our own choices to the host of influences that shape our personalities. We may fail to see the impact of our choices because the decisions that shape our lives are often not grand, climactic ones, but small cumulative ones that result in our being kind or cruel, envious or thankful, idolatrous or godly. We cannot, on the basis of scientific evidence, rule out some human accountability for our problematic sexual orientations.
It is possible, on the other hand, that some individuals are the helpless victims of powerful influences that shape their orientation in its original form, particularly in the vulnerable period of childhood. God unquestionably allows some of his children to bear the brunt of powerful external events for which they are not responsible. But in the case of homosexual orientation, we would need to affirm the individual’s responsibility for acting on that preference. By analogy, an adult child of an alcoholic may have biological and psychological predispositions to respond positively to alcohol, but he or she must face the responsibility of choosing whether or not to indulge that predisposition. Focusing on why we are the way we are cannot eliminate the question: “How should I act given what and who I am?”
Can Homosexuals Become Heterosexuals?
A textbook I began using this year says unequivocally that psychotherapy for homosexuality “has been ineffective.” This is an erroneous conclusion. Change is possible for some. Every study of conversion (from homosexual to heterosexual) reports some successes, ranging from 33 percent to 60 percent. In a curious non sequitur, however, opponents of such therapies use the modest cure rates to argue that no cure is possible.
But change is difficult. It does not follow from a simple willingness to change or some straightforward set of procedures. Change is most likely when the counselee is young, highly motivated, has functioned successfully as a heterosexual, does not manifest gender-identity confusion, and has been involved in minimal homosexual behavior. Change of homosexual orientation may sometimes be impossible by any natural means.
A number of Christian groups claim that change is impossible and seek to have Christians accept monogamous homosexuality. But there are also a growing number of Christian ministries attempting to help homosexuals change. These latter groups offer a variety of approaches, but generally they concur that change is a difficult and painful process of renouncing sinful practices and attitudes, and reaching out to grasp God’s promise of help. These groups suggest that struggling with homosexual attraction is a lifelong task, but that the person who takes on that struggle can expect gradual change. Some aim at change to heterosexuality; others seek merely to replace compulsive homosexual passions and behavior with an experience of fulfilled chaste singleness. Unfortunately, these groups have not systematically documented their success rates. At this date there is only minimal scientific evidence that change is possible through these means—although there is dramatic anecdotal evidence.
Have recent developments in the behavioral sciences put the church in a “new hermeneutical situation” in which it must revise its understanding of Scripture and tradition?
While we know much more about homosexuality than ever before, we have not learned anything that mandates a radical overhaul of the historic stance. What we have learned should increase our compassion and pastoral effectiveness.
It should also end harsh, simplistic, and judgmental condemnation toward homosexual persons. Homosexual sins are not a special category meriting our hatred and disgust. To live out the call of the gospel properly, we must faithfully regard as sin all that God himself condemns; we must also embody the character of Christ, who loved sinners and gave his life for them. By his stripes, we must all be healed.
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