NARTH article asking why homosexuality isn't a disorder.

This article by Kathleen Melonakos from the NARTH website was recently reprinted by Lifesite News.

While I think it is important to advocate for healthy sexual conduct, I do question the sources and some of the conclusions of this article. I did not check everything but a few things seem important to note.

First, the article quotes the discredited work of Paul Cameron and relies on his conclusions based on questionable assumptions. One popular response to his work notes the problems with sampling and inference in his articles.

Also, Ms. Melonakos says: As far as I know, there is no other group of people in the United States that dies of infectious diseases in their mid-forties except practicing homosexuals. The evidence for this statement is in a footnote that leads to the 1997 article by Hogg et al that has been widely reported. The finding often quoted that is generalized to homosexuals as a group is:

In a major Canadian centre, life expectancy at age 20 years for gay and bisexual men is 8 to 20 years less than for all men. If the same pattern of mortality were to continue, we estimate that nearly half of gay and bisexual men currently aged 20 years will not reach their 65th birthday.

Rarely do sources that cite the Hogg et al study or that simply assume a mid-40s life expectancy then cite the follow up letter from Hogg et al where the authors provide context for their research. It is important to read this letter to understand the significance of their findings. In this note, they state:

In contrast, if we were to repeat this analysis today the life expectancy of gay and bisexual men would be greatly improved. Deaths from HIV infection have declined dramatically in this population since 1996. As we have previously reported there has been a threefold decrease in mortality in Vancouver as well as in other parts of British Columbia.

and

It is essential to note that the life expectancy of any population is a descriptive and not a prescriptive mesaure. Death is a product of the way a person lives and what physical and environmental hazards he or she faces everyday. It cannot be attributed solely to their sexual orientation or any other ethnic or social factor. If estimates of an individual gay and bisexual man’s risk of death is truly needed for legal or other purposes, then people making these estimates should use the same actuarial tables that are used for all other males in that population. Gay and bisexual men are included in the construction of official population-based tables and therefore these tables for all males are the appropriate ones to be used.

Ms. Melonakos then notes the psychiatric criteria for viewing a syndrome as a diagnosis. The behavior or syndrome must cause subjective distress and/or negative social/life consequences. She asserts that homosexuality satisfies these criteria because many gays are unhappy with their sexual orientation and being gay is a “lethal addiction.” First, the DSM does include a diagnosis for those who are in distress over their sexual orientation (302.90). Second, the evidence is not clear that simply having same-sex attraction or taking on a gay identity requires one to pursue practices that do indeed lead to shortened life or disabling disease. I have previously addressed this issue relating to mental health morbidity.

In short, I do not believe the article makes the case for considering homosexual attraction per se to be a psychiatric disorder. Disordered sexuality of any sort (many partners, risky behavior, comcommitant drug usage, etc.) can be treated under several diagnostic headings, whether the person is gay, straight or bisexual.

More on this article. In it, Ms. Melonakos asks: “Can anyone refute that increased morbidity and mortality is an unavoidable result of male-with-male sex–not to mention the increased rates of alcoholism, drug abuse, depression, suicide and other maladies that so often accompany a homosexual lifestyle?[v] People with this whole cluster of behavior patterns are somehow “normal”?”

This is pretty easily refuted by observing people who engage in male-to-male sex but do not have these disorders. Even in studies showing an increased risk of the disorders cited here, the majority of people studied do not have them. Somewhat, and in some cases, very minor, elevated risk, yes, but “unavoidable” incidence? No. Research does not show that increased morbidity and mortality is an unavoidable result of male-with-male sex.

To better understand the issues in anal cancer, see this National Cancer Institute article. HPV (against which condoms do not protect well) seems to be the major culprit. Men and women who engage in anal sex are at risk as are those who have had other STDs. The 4000% number quoted in the NARTH article seems pretty amazing until you consider that anal cancer is about unheard of in the general population. So instead of less than 1 case per 100,000, the rate is 35 per 100,000 in men who engage in anal sex. The risk is substantially elevated but the cancer is pretty rare. Even though the incidence is rare, I do think health professionals should provide this information to patients and in schools as well.

UPDATE (12/19/06) – NARTH Board member Dave Pruden tells me that the NARTH Scientific Advisory Committee is reviewing this article for accuracy.

1/4/07 -This article has been pulled from both the NARTH and Lifesite News websites.

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  • Anonymous

    I am now very confused. NARTH has articles by you on its website and now this looks like you are contradicting NARTH.

    When so many studies say that homsoexuality is harmful why do you nitpick this article by NARTH?

  • Steve Boese

    Thanks for that analysis, Warren.

    Ms. Melonakos also seems content to link homosexuality and anal sex without considering lesbians, gays who don’t practice anal sex, or the practice of anal sex by heterosexuals.

  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    Anonymous – I think it is important to be accurate when advancing scientific arguments. If people who hold to a traditional view of sexuality misuse science then we cannot rightly criticize ideological opponents when they do this.

    This article has several inaccuracies that invalidate the basic argument. One may be opposed to homosexual practices without demonizing people. I believe this article uses research with poor and biased sampling in order to advance an ideology. Certainly you would not believe that the end justifies the means.

    I think I have met the author, and if I remember her correctly, I thought she was a well-intentioned person. I do think though that this area of research requires extra care to be accurate, thorough, up to date and to exercise discretion to avoid research that is poorly done even if it seems to support your point of view.

  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    Ms. Melonakos also seems content to link homosexuality and anal sex without considering lesbians, gays who don’t practice anal sex, or the practice of anal sex by heterosexuals.

    Steve – Spot on. Many people who engage in this discussion are reluctant to believe that straights engage in anal sex and are involved in aberrant sexual practices as well. This is an inconvenient awareness for them.

  • Michael Bussee

    If I am not mistaken, the preface to the DSM IV-TR contains some very specific language that you cannot consider something a disorder if the “subjective distress” is caused by social prejudice or discrimination. Of course, this wouldn’t make any difference to Nicolosi who dismissed this idea as “irrelevant.”

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  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    That is correct Michael. I do not think the source of such distress is irrelevant but I would not make social versus value based distress an either-or proposition. Clearly, values are socially embedded (I did not get a revelation directly from God. I learnt my religion from others) and so I cannot easily separate the two. However, as a therapist, I try to help a person determine what they believe apart from social dependency. Pro and con determinations repeatedly done are often helpful in getting at this.

  • Michael Bussee

    In terms of sorting out social pressure and value-driven issues, Here’s an actual case I dealt with this past year. Brian (not his real name) came to the AIDS project after recently being hospitalized for Pneumocystsis Pneumonia. He was quite underweight, exhausted, depressed and frightened. He had suspected he was HIV+ for some time — but had put off being tested until he landed in the hospital near death.

    He told me he was a born-again Christian and “hated himself for being gay”. Ge felt AIDS was “God’s punishment” and was very reluctant to take the life-saving meds he had been prescribed. He asked me to refer him to an “ex-gay” ministry if I knew of one. I did the following:

    (1) Told him I would only see him if he took his meds (he complied).

    (2) Told him that there was no good scientific evidence for ex-gay programs and that such programs might actually do harm.

    (3) Told him I, nevertheless, respected his right to choose.

    (4) Told him he must stop methaphetamine abuse and quit the “sex-for-sport” parties.

    (5) Told him we would deal with his desire to change his sexual orientation once his health was stablized.

    Over the next few months, Brian gained weight. He stopped meth abuse and started attending a gay-friendly 12 step program (his choice). His T-Cell count increased and his viral load became undetectable. He explored some of the roots of his sexual compulsivity. He decided to be celibate for a year “just to concentrate on getting stronger and healthier”.

    He looked up EXODUS on the internet, read my personal story and decided to “hold off” on trying to be straight “for now”. He started going to an affirming church (he felt “more welcome” there) and resumed composing beautiful choral music. He reaffirmed his faith in God. He’s still gay. He has formed some stable friendships. Still no desire for women, but definitely NOT disordered.

  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    Michael – With apparently the open door to pursue heterosexuality if he determines he values it.

  • http://www.drthrockmorton.com Warren Throckmorton

    Nice post mentioned in the above comment. Make no mistake Michael and I disagree about lots of stuff but I believe we both are committed to individual freedom of conscience.

  • Michael Bussee

    It was a nice comment. I am curious, Warren, about what our many differences might be. It seems we agree on a lot. Aren’t we both Prebyterians? Seriously, what stuff? (By the way, thanks for your prayers. Also thank your students for me during my recent eye trouble. Much improved.)

  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    Maybe not lots of stuff, I don’t know but probably an email topic :)

    Very glad to hear about the improvement!

  • Michael Bussee

    What would be COOL would be to resume the discussion you hosted on “Common Ground” a few months back. It was a very lively, civil and productive conversation. Many folks posted thoughful and compassionate ideas. It was good to discuss — and not just take stands. (I, for one, can become passionate, rigid and frankly, unpleasant. I frequently embarass myself.)

    However, my deep feelings on the gay/exgay issue are based 50 years of experience as a gay man, over 35 years as a born-again Christian and over 30 years as a therapist.. My primary goal is to introduce people to Christ. My secondary goal is to help them bring their sexuality and sprituality into harmony.

    I take the position that the best way to do this is to help a person affirm their basic sexual orientation, not try to change it. But this may not be everyoone’s path. That’s when I really have to use my “therapist’s cap” and remind myself that it’s not about my “agenda.”

    I am there to help the client make better choices — for themselves.

    So, I believe that people of good will on both sides of the debate really DO want to find some balance — sound reasoning, strong ethics and a sense mutual respect. Let’s bring back “Common Ground”.

  • http://www.wthrockmorton.com Warren Throckmorton

    Michael – Good thought. I plan on taking some time off from blogging for the holidays and will announce a guest host soon. Perhaps that could be a good topic to kick that time off through the holidays and the new year.

  • http://www.wthrockmorton.com Warren Throckmorton

    Recently, Dave Pruden indicated that this article was to be pulled from the NARTH website while being reviewed. Last I looked, it was still up but I assume it is being reviewed since Dave said so.

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  • Kathy Barr

    Not only is the homosexual lifestyle risky to one’s physical health in terms of STDs, it is also risky in other ways. Physical abuse between partners is much more prevalent in the gay community; alcoholism and drug abuse rates also is common. Psychiatric disorders, including severe depression and suicidal ideation and attempts are also more commonly found in gays than in the heterosexual community, even in countries that accept the gay lifestyle.

  • Boo

    I’ll admit it is quite common for the gay community to have alcohol and drug abuse rates.

  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    Ms. Barr: Please follow the links in the post above, especially this one. You should note that NARTH pulled the article that this post references due to inaccuracies. Please provide references for the claims you make. Finally, please define the “homosexual lifestyle.” One of the reasons I review articles pertaining to sexuality is because lay people often do not have the ability to discern what is a proper interpretation of research and what is not.

  • http://www.conciant.com arthur mcbeth

    Of course, this wouldn’t make any difference to Nicolosi who dismissed this idea as “irrelevant.

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  • http://sgtdang.home.att.net Daniel Glenn

    “Ms. Melonakos then notes the psychiatric criteria for viewing a syndrome as a diagnosis. The behavior or syndrome must cause subjective distress and/or negative social/life consequences. She asserts that homosexuality satisfies these criteria because many gays are unhappy with their sexual orientation and being gay is a ‘lethal addiction.’”

    If this were true, than heterosexuality is also a psychiatric disorder. Some examples:

    1. HIV infections are the highest in the world in Africa among heterosexuals.

    2. Births out of wedlock and abortions are highest among heterosexuals (This is a loaded gun I’ll admit.) causing social stigma.

    3. The number of divorces in this country is a strong indicator that heterosexuals are dissatisfied with their ‘life-style of choice’, though divorce does not carry the social stigma it once did.

    4. Heterosexuals can be just as prone to additions as are gays and lesbians. It’s not called the Betty Ford (a heterosexual) Clinic without reason.

  • http://sgtdang.home.att.net Daniel Glenn

    “Comment by Kathy Barr

    December 26, 2006 @ 12:39 pm

    Not only is the homosexual lifestyle risky to one’s physical health in terms of STDs, it is also risky in other ways. Physical abuse between partners is much more prevalent in the gay community; alcoholism and drug abuse rates also is common. Psychiatric disorders, including severe depression and suicidal ideation and attempts are also more commonly found in gays than in the heterosexual community, even in countries that accept the gay lifestyle.”

    Not only is the heteroexual lifestyle risky to one’s physical health in terms of STDs (new HIV infections are highest in the world in Africa among heterosexuals), it is also risky in other ways. Physical (and mental) abuse between partners is much more prevalent in the straight community resulting in massive divorce rates; alcoholism and drug abuse rates also is common (They don’t call it the Betty Ford [a straight woman] Clinic for nothing.). Psychiatric disorders, including severe depression and suicidal ideation and attempts are also more commonly found in gays than in the heterosexual community, even in countries that accept the gay lifestyle, but is that a result of a sick ‘lifestyle’ or the symptom of growing-up in a sick society that constantly rejects you and debates your self-worth as a person?

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  • John Smith

    Ms. Melonakos’ reasoning may be flawed, but I think the basic questions – Why isn’t homosexuality a disorder? What’s the evidence to prove that homosexuality is not a disorder? Were the reasons for removing homosexuality as a mental disorder good ones in 1973? -are all very valid questions.

    The inaccuracies you point out are fertile grounds for future research. Is there a higher death/morbidity/substance abuse/physical abuse rate among homosexuals than heterosexuals? I think such research could be very beneficial and should be encouraged- regardless of ideology.

  • http://www.boxturtlebulletin.com Timothy Kincaid

    John Smith

    Interestingly, the Geographers from Kansas State University just released a study which looked at the Seven Deadly Sins from a geographic perspective. This was mostly just a fun detailed analysis of a frivolous concept. But they did provide one graph that is telling.

    Lust was calculated by compiling the number of sexually transmitted diseases — HIV, AIDS, syphilis, chlamydia and gonorrhea — reported per capita.

    And looking at the Spatial Distribution graph of “lust” (sexually transmitted disease per capita), we see that those areas that have the highest concentration of gay population are not where STDs are the worst. In fact, none of the top ten cities are known to have much of a gay population at all.

  • http://www.boxturtlebulletin.com Timothy Kincaid

    correction: the Chicago area is on the list at number 8 and Chicago does have a sizable gay population. But Lula, MS does not.

  • http://www.boxturtlebulletin.com Timothy Kincaid

    Ugh… Misread the chart. It wasn’t “top ten”. It was just a comparison of casino cities. The comments about the charts, however, hold.

  • Mary

    Not documented gays. If they are vice cities then we can assume prostitution? What is the life expectancy of prostitutes? Does anyone know? Does anyone care?

  • http://www.boxturtlebulletin.com Timothy Kincaid

    Mary,

    Actually I got distracted with the cities. They were only included to compare between themselves and not as an example of “the worst”.

    To get my point you have to look at the nation as a whole. STDs per capita were the worst in the South and not really all that evident in, say, San Francisco or LA or NYC or South Beach – the areas where all those sinful diseased homos live.

    If, as Mile McPherson (Carry Prejean’s pastor) says, gays are 23 times more likely to have STDs, then we would expect the areas where they are most congregated to show up as “hot spots” rather than the Missouri or South Carolina.

  • http://www.boxturtlebulletin.com Timothy Kincaid

    Which is not to say that gays don’t get more STD’s.

    For all I know, they may. But certainly not in rations that anti-gays claim or in any way that justifies calling homosexuality a disorder.

  • David Blakeslee

    @ Timothy Kincaid,

    This is a curious research article…gluttony is not a problem in the US according to this chart?

    I am having trouble accessing the detailed information you cite.

    Aren’t STD’s highly correlated with being granted “leave” from bootcamp training? That could explain Biloxi…

    So many variables uncontrolled, how can this be used to support anyone’s argument?

    The issue is the incidence per sexual orientation controlling for age.

  • Jayhuck

    You know, when a disease occurs more often in another minority, or when a particular minority suffers in general from something more than another does, or even the majority – we never use this fact to suggest that the minority is inherently disordered – this seems like a no-brainer.

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