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Wednesday, August 31, 2016

"The Science Isn't Settled", While True, is a Very Shady Thing to Say

Stock photo of two scientists. Image source.
So here's a very misleading post on ADF's website: New Report Shows that Sexual Orientation and Gender Identity Claims Not Supported by Scientific Evidence. ADF (the Alliance Defending Freedom) is a Christian legal group that fights against LGBT rights and spreads lies that demonize LGBT people, you know, like Jesus would do. (They also advocate for other conservative Christian political positions, like "religious freedom" and "the sanctity of life.")

The post at that link is about a scientific study which, supposedly, tells us that claims made by LGBT advocates "are not actually supported by scientific evidence." Then there's a video introducing this new scientific report, where one of the authors says, "Science is never settled", which raises a huge red flag for me.

See, this is how Christian apologetics works. You take that openness to questioning and doubting- a necessary part of the scientific method- and use it to claim that, hey, maybe those mainstream scientists are wrong about EVERYTHING and we're right instead. ADF's audience is going to read "the science isn't settled" and think it means "hey, it's totally possible we can 'cure' gay people by praying for them enough! and being transgender isn't a real thing! and all the other ignorant claims we made in our efforts to deny LGBT people equal rights have a good chance of being true!"

I read the report. It says no such thing. Let me tell you what it really says.

Here's the link to the report. It's published in The New Atlantis, which, according to Wikipedia, is "a quarterly journal about the social, ethical, political, and policy dimensions of modern science and technology" published by "the social conservative advocacy group the Ethics and Public Policy Center." Okay, so it's got a conservative slant to it, but I read the report and I think it's very good. It summarizes a lot of studies about LGBT people, focusing on what exactly has been shown scientifically and what hasn't. It talks about areas where further research is needed, and flaws that some of the studies had.

And no, it does not say anything like what ADF's audience will think when they hear "the science is not settled." Let's take a look.

Part One is about sexual orientation. First the report talks about how the concept of sexual orientation is very difficult to define in a scientific sense. For science, you need a very very clear definition so you know exactly what you're talking about. Some studies on LGB people define sexual orientation in terms of people's attractions and fantasies. Some define it in terms of behavior- have you had any same-sex sexual partners in the past year? Some define it by self-identification- participants say whether they identify as gay, bisexual, heterosexual with occasional same-sex attractions, etc. When you compare the results of different studies, you have to make sure you know what definitions they were using.

Yes, I totally agree. Sexual orientation is difficult to define. When you listen to people telling the story of "how I figured out I was bisexual", for example, you'll find that each story is unique, and people often take a long time to figure out what label fits. There's no objective set of criteria everybody can easily measure themselves against. Terms like "gay", "bisexual", etc do have meanings, but in a scientific sense it's impossible to define them in a clear enough way that you can say exactly who is in and who is out.

I found this part in particular very interesting:
We can imagine, for example, a sixteen-year-old boy who becomes infatuated with a young man in his twenties, developing fantasies centered around the other’s body and build, or perhaps on some of his character traits or strengths. Perhaps one night at a party the two engage in physical intimacy, catalyzed by alcohol and by the general mood of the party. This young man then begins an anguished process of introspection and self-exploration aimed at finding the answer to the enigmatic question, “Does this mean I’m gay?”

Current research from the biological, psychological, and social sciences suggests that this question, at least as it is framed, makes little sense. As far as science can tell us, there is nothing “there” for this young man to discover — no fact of nature to uncover or to find buried within himself. What his fantasies, or his one-time liaison, “really mean” is subject to any number of interpretations: that he finds the male figure beautiful, that he was lonely and feeling rejected the night of the party and responded to his peer’s attentions and affections, that he was intoxicated and influenced by the loud music and strobe lights, that he does have a deep-seated sexual or romantic attraction to other men, and so on.
Asking the question "Does this mean I'm gay?" assumes that one's sexual orientation is an objective reality inside them that they must discover. I don't necessarily think that's true (and the writers of that report also question that assumption). The words we use- "gay", "bisexual", "asexual", etc- are an attempt to conceptualize the complex spectrum of sexuality in a way that we can easily classify and discuss. These words are the ones that our culture finds most useful at the present time, but they're not the only way to describe sexuality. When Matthew Vines talks about Romans 1, he says, "In the ancient world, homosexuality was widely considered, not to be a different sexual orientation or something inherent in a small minority of people, but to be an excess of lust or passion that anyone could be prone to if they let themselves go too much." Today, we see sexual orientation as a key part of a person's identity, but it's possible to use a different framework that sees it in a different way, and neither is necessarily right or wrong.

BUT the important thing is, in modern US culture right now, sexual orientation is seen as a key part of a person's identity. That's the way it is in our culture, and it doesn't help anything when Christian groups like ADF come along and try to explain to LGB people why it's wrong to identify that way. This is who we are, this is the culture we live in, you can't change that. And in the context of this culture, it is literally violent to tell LGB people that it's wrong for them to see sexual orientation as part of their identity.

Here's my opinion on the definitions and labels: When you're trying to determine your own sexual orientation, it's helpful to think of it as an objective reality inside you that you can discover, or perhaps as a search for which label feels the best. In this situation, clear definitions like "gay means you are attracted exclusively to the same gender" are essential. But when it's somebody else's sexuality, you just have to accept the label they've chosen for themselves. In other words, "gay means a person who says they are gay"- though you might think they don't fit the objective "dictionary definition." It's their life, they've thought about it way more than you have.

The weakness of my point of view is you can imagine a hypothetical situation where somebody says "I'm a woman, I've only ever been attracted to men, I've only dated men, I only want to date men, I've never been attracted to women. And I'm gay." And then you're like, no, this person is not gay. But are you allowed to say someone is wrong about their own sexual orientation? If you say this person is wrong, then that means some policing of labels is okay- but where do you draw the line? Personally, I would say the chances of this hypothetical occurring are small enough that I'm willing to let such a person claim whatever label they want. Appointing ourselves as judges of others' labels is too tricky and morally questionable. (Readers, what do you think?)

But yeah, definitely not clear enough for scientific research purposes. Totally agree with the writers there. Even if we define "gay" as "people who claim they are gay" (a very clear-cut definition), people's understanding of terms like "gay" varies across cultures and time periods. It would be impossible to compare the results of different studies, or look for trends over time. You'd be unable to account for the variable of "in what circumstances do people choose to identify as gay?"

For science, the definitions aren't clear enough. But in terms of culture and social interactions, these words do have certain meanings and they are very important and useful.

The next part of the report talks about problems with the "born this way" theory. They cite a bunch of studies of identical twins where one or both was gay, bisexual, etc. This is pretty interesting stuff which, yes, we should definitely be researching. Their conclusion is that there is some evidence for a genetic cause behind same-sex attraction, but it can't account for everything, and there are other factors too. For example, there is correlation between child sexual abuse and identifying as LGB.

First of all, I'll say I'm not a fan of the whole "born this way" thing. The idea behind arguing that gay people are "born this way" seems to be "obviously being straight is better than being gay, but you have to let us be gay because we didn't have a choice, we were born this way, there's nothing we can do about it." This sort of argument can be helpful for conservative Christians who are just starting down the path to LGB acceptance- I mean real acceptance, not "hate the sin, love the sinner"- but it is absolutely not okay to stay there.

In my opinon, pro-gay advocates who insist on "born this way" are missing the point. When we talk about rights and equality and society-wide policies, it doesn't matter how people "become" gay or the reasons they want to pursue same-sex relationships. They should have the right to do that. "Born this way" and "it's not a choice" ideology is particularly bad for bisexual people. Bisexual people are able to experience attraction to people of an opposite gender; they do have a choice about which gender to pursue relationships with. Does that mean that, since it's possible for them to choose an opposite-gender partner, they have to? Are people only allowed to be in same-sex relationships if it's completely impossible for them to be attracted to an opposite gender? Only if "they don't have a choice"?

(Okay, I'm aware that I'm sort of conflating sexual orientation with behavior here. Sexual orientation is not a choice, behavior is. Still, I really don't think "it's not a choice, I was born this way" is a hill worth dying on, because it implies that if you did have a choice, it wouldn't be okay to choose certain orientations; they are inferior or morally questionable. Which is a belief rooted in LGB-hate.)

All right, back to that report from The New Atlantis. So it talks about studies with twins and studies about prenatal hormones (which test the "born this way" theory), and says there is evidence that sexual orientation is influenced by genes and prenatal hormones, but that can't account for all of it. Science doesn't support the idea that sexual orientation is already determined at birth.

Then there's the part about childhood abuse. There is a correlation between abuse and identifying as LGB (several studies are cited that show this correlation). The writers tell us there are (at least) 3 possible explanations for this correlation:
1. Abuse might contribute to the development of non-heterosexual orientation.

2. Children with (signs of future) non-heterosexual tendencies might attract abusers, placing them at elevated risk.

3. Certain factors might contribute to both childhood sexual abuse and non-heterosexual tendencies (for instance, a dysfunctional family or an alcoholic parent).
All right, as an ex-evangelical, I'm very very suspicious of arguments linking LGB identity to past trauma. But we have to talk about it- getting more facts can help us better understand and support LGB people. But we have to separate out the politics from the scientific facts.

Here's the problem. In their attempts to argue that same-sex attraction is a problem that can be cured with prayer and therapy, evangelicals really like the theory that says people become gay because they were sexually abused or didn't receive the correct amount of affection from their mother or father. This is how we get reparative therapy- which is abusive and doesn't work. This is how we get good parents blaming themselves for ruining their kid by not loving them the correct amount. And really, when Christians make the argument that non-heterosexual orientations are the result of abuse, what they're really saying is "see, it's a problem that should be fixed- not a normal part of someone's identity, not a minority demographic that deserves full equal rights." It's not an attempt to actually understand LGB people better, to learn what their needs are and how best to help them- no, it's an excuse to argue against their rights.

And when you have this kind of situation, where people are debating about reparative therapy and whether gay people can become straight, it's easy to see why the pro-gay side would latch on to "born this way, can't change it, it's not a choice" and the anti-gay side would take "it's caused by abuse, it's not normal or healthy, they need therapy to cure them." But let's try to get away from that. Let's first establish that it's NOT OKAY to tell someone that their sexual orientation- their identity- is wrong and they need to change. That is abusive and violent, and it's not possible to force someone to change, or for people to change their own attractions by "praying hard" or whatever other method you try.

If we start with "your sexual orientation is valid and no one's going to force you to change", then we can honestly research the causes without fearing the political implications that may result. Like I said, in terms of the law and equal rights, it doesn't matter why people are gay or bi or whatever orientation. They all deserve 100% equal rights. No question about that. Maybe it is true that childhood abuse can be a factor that sometimes contributes to developing a non-heterosexual orientation. We don't have to be afraid of that truth. (And keep in mind, even if there is a correlation, it's definitely NOT true that all LGB people experienced abuse. In the studies cited, the percentages are all over the place, but most of them reported that under 50% of LGB people experienced abuse. Still higher than the rate among heterosexuals, but nothing like the idea, common in reparative therapy, that there MUST HAVE BEEN some traumatic event that CAUSED someone to become LGB.)

Next, Part Two of the report. It's about health issues for LGBT people. They are at a much much higher risk for depression, anxiety, suicide, and related mental health issues (with trans people at an even higher risk than LGB people). There are even some studies that showed a higher risk of drug abuse, physical health problems, and intimate partner violence for LGBT people. The writers of the report say it's very very important to understand the causes of these problems because they're really serious. Especially the research on suicide.

The report says the most commonly accepted explanation is the "social stress model." "This model posits that discrimination, stigmatization, and other similar stresses contribute to poor mental health outcomes among sexual minorities. An implication of the social stress model is that reducing these stresses would ameliorate the mental health problems experienced by sexual minorities." They talk about studies on hate crimes, discrimination in the workplace which results in lower salaries for gay men (though non-heterosexual women have higher average salaries than heterosexual women, maybe because they are less likely to interrupt their careers to have children?), and the stress that comes from hiding an aspect of one's identity.

There are studies that show stress, anxiety, trauma, and other mental health effects of these problems. But the question is, is there evidence that societal prejudice is the main reason for poor mental health in the LGBT community? In my opinion, it's impossible to test this. You would need some kind of control group which consisted of LGBT people who lived in a society with absolutely no anti-LGBT discrimination or stigma. Ha. Yeah, that society doesn't exist.

But the report did mention a few studies on LGBT people in states that passed laws banning workplace discrimination on the basis of sexual orientation, and laws that defined marriage as one-man-one-woman. There was some correlation between LGBT mental health and the passing of such laws- but it was only a few studies, and one used convenience sampling which probably biased the results by selecting LGBT people who had strong feelings about politics. Not enough evidence yet to really say that "social stress" is the main reason for mental health problems. (And in my opinion, passing laws is important, but there are other factors that have a far bigger effect. Experiencing rejection from family/friends/random strangers is much more likely to cause trauma/stress/depression than abstract laws which may or may not actually affect your life.)

In other words, there haven't been any scientific studies that show societal stigma and discrimination account for most of the mental health risks that LGBT people face. (As I said, I don't see how you really could create a study to show that.) I think it's probably true though. (Anecdotally, you can find a lot of stories from LGBT people about how their lives got so much better when they found people who truly accepted them.) I also think the writers' own biases come out in the way they keep emphasizing how there's not enough research to make a good case for the social stress model. Everything they say is true, but to a conservative Christian audience, the implications are very shady. It's too easy to take their statements and spin them as "science hasn't proven the social stress model, but our evil, godless society keeps talking like it has, don't believe them and their claims about how we need to be more accepting and have equal rights. Probably we should do what anti-LGBT politicians say instead."

Then Part Three is about gender identity. First, definitions. Biological sex is clearly defined by what type of reproductive organs you have (except in the case of intersex people- we'll talk about them in a minute). But what is gender? It's much more difficult to define. The report describes several cases where a certain gender identity was forced on a child. First, David Reimer, who was biologically male but raised as a girl after a botched circumcision. Yeah, gender doesn't work that way- "he self-identified as a boy, and eventually, at the age of 14, his psychiatrist recommended to his parents that they tell him the truth. David then began the difficult process of reversing the hormonal and surgical interventions that had been performed to feminize his body. But he continued to be tormented by his childhood ordeal, and took his own life in 2004, at the age of 38." They also mention intersex children and children with deformed genitals being assigned male or female (usually female), and how sometimes the child identifies as a different gender than what was assigned. In other words, gender is something internal- you can't just take a biological male and tell them they're a girl and expect everything to go just fine. Gender identity isn't something that can be completely controlled by socialization and environment.

Next, they talk about gender dysphoria. "According to the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gender dysphoria is marked by 'incongruence between one’s experienced/expressed gender and assigned gender,' as well as 'clinically significant distress or impairment in social, occupational, or other important areas of functioning.'" They say there are still many questions about dysphoria that require researching. I agree, let's research them.

Sometimes being transgender is described as "a boy mind in a girl body" but studies of the brains of trans people haven't really shown that that's the case. Some studies have found similarities between trans people's brain structure and the brains of cis people of the gender they identify with, but the report tells us that most of these studies were too small, or that it's not clear if the brain structure caused the gender identity or vice versa, or the correlation isn't strong enough to actual make useful predictions.

In other words, gender identity is hard to define in a scientific sense, and there is no biological indicator that's been found that can tell us if a person is transgender or not. We don't know what causes it. (But I'm sure some very shady Christians will spin this and pretend it means there's no evidence that trans people exist, or something ridiculous like that.)

Next they talk about treatment for people who identify as transgender. They discuss studies that looked at children and at adults. Some have shown there is improvement in quality of life after transitioning. Several studies compared trans people who had gone through sex reassignment surgery to a control group of cis people, and found that the trans subjects had a lower quality of life and more mental health problems- including a scary high risk of suicide. The weakness of these studies is that they didn't have a control group of trans people who wanted surgery but didn't get it. (Ideally, as far as science is concerned, you would assign surgery randomly among your trans test subjects.) So based on the results, it's impossible to say whether they would have been better off with or without the surgery. The studies weren't designed to measure that.

Their conclusion is that not enough studies have been done to show that transitioning is a good way to treat gender dysphoria. Again, I think that, while it might be technically true, this is a very shady thing to say. You have conservative Christians who, no matter what the evidence says, no matter how many people are hurt by their bigoted theology, will insist that "the bible says" trans people don't exist [note: the bible doesn't say that]. They're so sure that transitioning is always a bad idea that goes against "God's design" or some crap like that. They would be happy to read this report and declare "see? the science isn't settled! this means we're totally right to fight against trans people's rights and spread dehumanizing lies about them!" (To be clear: the report says gender dysphoria definitely does exist. The question is whether there is enough scientific research on how best to treat it.)

(Zinnia Jones, a trans woman, has talked about scientific studies that show transitioning improves trans people's lives. Yeah go read her post, she knows way more than I do about this.)

I agree that we need information on gender identity and how to know if transition is a good idea. For children who identify as a gender opposite their assigned sex, is it typically a "phase" they "grow out of"? Is it helpful for them to take medications that delay puberty? How often do people regret their decision after they transition? BUT. THE MOST IMPORTANT THING is we have to ask these questions from a position of "we need to give people good information so they can make the choice that's right for them." NOT "God says that being trans is a sin, let's try to find evidence that it's bad so we can convince people not to transition."

In the conclusion to their report, the writers say it's "especially troubling" when children are advised to transition. Is it true that doctors and scientists are advising this so recklessly? To me, it feels like an example of the writers' bias coming through. I really hope no one's being pressured into identifying as transgender. At the same time, no one should think that it's "erring on the side of caution" to not let children transition until they reach adulthood. Going through puberty for the wrong gender is horrible, from what I hear.

This report cited a ton of studies and made good points about how sexual orientation is very hard to define in a scientific sense, and how the "born this way" theory can't fully account for sexual orientation or gender identity. They also talk about the alarming rate of mental health problems among LGBT people, and about how the causes need to be better understood in order to help them, but their claim that there's not enough evidence for the social stress model can very easily be used as a weapon by people who definitely do NOT want to help LGBT people. They also had insightful things to say about how gender identity is hard to define yet it definitely is a real thing separate from biological sex, but again, it is way too easy for their conservative Christian audience to use this report to claim transition doesn't work and being trans isn't even a real thing. The report itself says no such thing, but I am very alarmed at the way ADF summarized it by saying "the science isn't settled" and that claims about sexual orientation and gender identity "are not actually supported by scientific evidence."

Oh, come on. Nothing in this report suggests that the work ADF does fighting against LGBT equality is in any way helpful. There are questions that science does not have answers to, but we know enough to say "oppose LGBT rights" is definitely not the answer.

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