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Sexual abuse and sexual orientation: A prospective study

Online now ahead of publication is a report from H. Wilson and C. Widom of a prospective study of the relationship between sexual abuse, physical abuse and neglect and sexual orientation in men and women. Published to subscribers January 7, 2009 on the Archives of Sexual Behavior website, the abstract provides a glimpse into the many findings reported here.

Existing cross-sectional research suggests associations between physical and sexual abuse in childhood and same-sex sexual orientation in adulthood. This study prospectively examined whether abuse and/or neglect in childhood were associated with increased likelihood of same-sex partnerships in adulthood. The sample included physically abused (N = 85), sexually abused (N = 72), and neglected (N = 429) children (ages 0-11) with documented cases during 1967-1971 who were matched with non-maltreated children (N = 415) and followed into adulthood. At approximately age 40, participants (483 women and 461 men) were asked about romantic cohabitation and sexual partners, in the context of in-person interviews covering a range of topics. Group (abuse/neglect versus control) differences were assessed with cross-tabulations and logistic regression. A total of 8% of the overall sample reported any same-sex relationship (cohabitation or sexual partners). Childhood physical abuse and neglect were not significantly associated with same-sex cohabitation or sexual partners. Individuals with documented histories of childhood sexual abuse were significantly more likely than controls to report ever having had same-sex sexual partners (OR = 2.81, 95% CI = 1.16-6.80, p = .05); however, only men with histories of childhood sexual abuse were significantly more likely than controls to report same-sex sexual partners (OR = 6.75, 95% CI = 1.53-29.86, p = .01). These prospective findings provide tentative evidence of a link between childhood sexual abuse and same-sex sexual partnerships among men, although further research is needed to explore this relationship and to examine potential underlying mechanisms.

Beyond the result reported above there is much of interest here. I want to describe some how sexuality was measured and then make some general observations. This study will get more than one post.

One of the weaknesses of research on sexual orientation and social factors has been the lack of long term prospective studies. Most research into abuse and sexual orientation is based on retrospective self-report. This study is a significant improvement in that the authors had documentation of childhood sexual and physical abuse and neglect regarding 908 children from juvenile and family courts in a midwestern metropolitan area. The cases were reported and processed between 1967 and 1971. The authors then interviewed as many of these individuals as possible and included interviews with a matched set of control participants. The control group was matched with the abuse group on age, sex, race/ethnicity, and approximate social class at the time of the abuse. The average age of participant reports for all cases was 6.3 years.

At follow up, when the participants were in their late 30s and early 40s, they were asked if they lived (at the time of the interview) with a person of the same sex in a sexual relationship, whether the person had ever cohabited in a same-sex relationship, had ever had a same-sex sexual partner and whether the person had such a partner with the past year. Attraction was not directly assessed which is an unfortunate aspect of the study. Primarily the authors were interested in sames-sex sexual behavior, which may or may not indicate enduring attractions.

Among males, 2.9% reported a same-sex partner within the last year and 6.4% saying they had such a partner at some time in the past. Percentages were similar for women (2.1% and 6.8% respectively). Similar differences were reported for cohabitation and any prior same-sex relationships. Nearly all participants reported sexual partners of both sexes. Only five men (1.3%) and one woman (.24%) reported exclusively same-sex relations. It is highly likely that some of these individuals would identify as straight but had engaged in same-sex relations at some point in their past.

The main significant finding was reported in the abstract: “men with histories of childhood sexual abuse were significantly more likely than controls to report same-sex sexual partners.” There was no relationship between child sexual abuse and sexual behavior for women. Also, “child physical abuse and neglect were not significantly associated with increased likelihood of same-sex cohabitation or sexual partnerships” (from paper, pg 7). While sexual abuse is associated with an increased likelihood of same-sex behavior, this is not a study that shows homosexuality is caused by sexual abuse. Also, the study does not indicate that sexual abuse leads to homosexuality. In the control group, 5.3% said they had engaged in same-sex relationships, whereas in the sexual abuse group, 27.3% did. More on this in the next post.

This study is a significant challenge to reparative drive theory. Reparative theory, on display recently on the Dr. Phil Show, proposes that gender disturbances are caused by a poor relationship with the same-sex parent. Although this study does not directly test a specific set of family dynamics, it is plausible based on reparative concepts to predict that abuse and neglect might be more frequent in homes where dad is uninvolved or hostile to the children. Dr. Nicolosi frequently says he has never met a gay man who had a good relationship with his father. One would expect a significant elevation in these circumstances but none shows up here. Regarding parenting and sexual orientation, Wilson and Widom write:

These results were consistent for men and women and support the conclusions of Bell et al (1981) that early parenting experiences, positive or negative, play little direct role in the development of sexual orientation. Among women, we also found no associations between childhood sexual abuse and same-sex relationships.

This study, along with the recent work from Andrew Francis casts more doubt on reparative drive theory as a general theory of same-sex attraction. In a future post, I want to address additional implications of this study, especially regarding the complex question of how sexual orientation may be related to sexual abuse. The pattern of findings in the Wilson and Widom study can be interpreted in several ways. More about that soon.

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  • Drowssap

    There was no relationship between child sexual abuse and sexual behavior for women.

    There goes that stereotype. To be honest I happened to put some credence in that one.

  • Lynn David

    Very interesting….. Do you think the fellows at NARTH, Focus on the Family, and in Exodus read the Archives of Sexual Behavior? And what of the article by Tanya Erzen in relation to their treatments?

    .

    .

    But what I really want to know, Warren, is if you’re going to comment on the Grov, Parsons, and Bimbi article.

  • Evan

    These results were consistent for men and women and support the conclusions of Bell et al (1981) that early parenting experiences, positive or negative, play little direct role in the development of sexual orientation.

    I haven’t seen the paper so I have to ask how was parenting quality assessed. Different experiences can imprint differently on different temperaments. Some boys are detached from their mothers very early, others never realise that they are still attached. Do they rate this as a positive or a negative in a questionnaire? Does parenting matter if some boys substitute an absent father with male peers influence?

    1st example: A boy is born in a family which already has another boy. The first born is jealous of the attention his parents pour on the newest member of the family. He grows angry and rejects both parents, socialising mostly with male peers from outside of the house. He rejects his younger brother and taunts him for being pampered by their parents. The first born boy grows up autonomous and is very successful in social networking and relationshipping. The second boy grows up anxious and attached to his mother, avoiding the social scene and developing depression. What does good or bad parenting means here and how could it be measured? Could questionnaires measure if their father was dominated by his wife and what effect would that have on the second boy’s upbringing? Could better parenting have helped the second boy develop better coping skills and avoid the pitfalls of a difficult temperament? On the last question — I think it could.

    2nd example: A family of three girls and one boy. Their father keeps very much to himself and doesn’t care much about the home environment and children’s upbringing. He has a very important and influential job which makes him a high income dad, but one who pays his way out of house duties. His son grows up overwhelmed by female presence and lack of any male support to confront them.

    Both first and second examples are about SSA-ed adult men who did not get into same-sex relationships. How they would have rated their parents is debatable, both during their childhood and now at adult age. I think parenting did play a role in their situations, but it’s uncertain if better parenting would have produced dramatically different outcomes or just slightly better in terms of adjustment, but not attractions.

    3rd example: A boy grows up in a house of many sisters and one older brother. He is sexually abused by his sister first, then by his mother, who is also his main caretaker. Being a very passive and contemplative kid, he is targeted by his older male cousin who forces him to have oral sex with him. Before puberty age, a male family friend “teaches” him how to have anal sex. He grows up addicted to homosexual sex, alcohol and anti-depressants. All his attempts at staying in one relationship fail, because of both partners’ interest in other partners. His family rejects him, even if they all live in a sexually very liberal country.

    Childhood abuse would indeed predict adult involvement in any same-sex relationship in the third case, but lack or presence of abuse, or positive/negative parenting rating would miss how all these children/adults were attached to their parents and how their attractions and peer socialising developed relative to that. I’m saying that abuse might tip a very delicate balance in the case of difficult temperaments, but all these particular cases might be affected by subtle dysfunctions in parental relationships that reflect on children’s development, whether or not children are aware of that and are able to rate them.

  • Marty

    I’ve often wondered — though I doubt we’ll ever see a study — how many of the ~4000 victims of the recent sex scandal in the catholic church will have been “turned out” into homosexuality?

    Which begs another question — how many victims never came forward at all, because — having been turned out as gay males — they ultimately didn’t consider their experiences “abusive” at all…

    • Drowssap

      It could be that sexual abuse makes some men gay. Or it could be that sexual abusers target boys who appear like they are about to turn out gay anyway.

      I wouldn’t be surprised if pedophile priests target effeminate boys who have a higher chance of being gay in the first place.

  • Eddy

    Due to the diversity within Exodus (Exodus is a loose-knit coalition of member agencies), you’ll find that Exodus acknowledges some validity in Reparative Therapy but I doubt you’d find more than a few who believe in its solitary theory of origin.

    The very real potential of childhood physical, verbal and/or sexual abuse leading a child into homosexual behavior and/or identity has always been recognized.

    (Whew! Remembered the notify button a split-second before I hit ‘submit’. )

    BTW: I think someone responded to me elsewhere that on their screen the ‘notify me/follow up box is just beneath ‘submit comment’. LOL. It is if you’re not drafting a blog comment. As you write your comment, the distance between ‘submit’ and ‘notify’ just keeps growing. For wordy me, ‘notify me’ is often below the bottom of my screen.

  • Mary

    I’d like to know how abuse is being defined. While I do not think (opinion) abuse causes SSA, I do think it contributes to the social/sexuality of a person and that unwinding the SSA bond can get be more complicated when that is present.

    • Pathia

      I would think any sort of abuse would make the unwinding of ANYTHING more difficult. It’s not like straight people aren’t really screwed up from it too.

  • Mary

    Needed to click the F/U button

  • http://www.patheos.com/blogs/warrenthrockmorton/2008/11/23/new-study-casts-doubt-on-older-brother-hypothesis-and-reparative-drive-theory/#comments carole

    Well said, Pathia:

    I would think any sort of abuse would make the unwinding of ANYTHING more difficult. It’s not like straight people aren’t really screwed up from it too.

    Another point: I am confused by the following passage from the findings of the study:

    Individuals with documented histories of childhood sexual abuse were significantly more likely than controls to report ever having had same-sex sexual partners (OR = 2.81, 95% CI = 1.16–6.80, p ? .05); however, only men with histories of childhood sexual abuse were significantly more likely than controls to report same-sex sexual partners

    The only difference between the two sentences beginning with the word “with” are in the use of the words “documented” and “ever.” Was the word intended to be stressed the word “only”?

    That is, do they mean that “only men with histories of childhood sexual abuse were significantly more likely than controls to report same-sex sexual partners”?

    • http://www.thesun.co.uk/sol/homepage/news/article2150173.ece?OTC-RSS&ATTR=News Evan

      Men, as opposed to women.

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

    Women were not significantly more likely so the distinction is men versus women. Sexual abuse relates in someway to the sexual behavior of men but apparently not for women as a group.

  • http://www.patheos.com/blogs/warrenthrockmorton/2008/11/23/new-study-casts-doubt-on-older-brother-hypothesis-and-reparative-drive-theory/#comments carole

    Got it. Thanks. The sentence could use an adverbial phrase qualifier, “only men, not women.”

  • Hob Bope

    Bell et al’s conclusions are worthless. They actually admitted at one point in their study that they had not shown that the classic distant father/close mother was not responsible for some cases of homosexuality, but by the end of their book they had strongly implied that they had shown exactly that. How can you take them seriously?

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

    @Hob Bope:

    Could you provide references for these statements? I believe you have oversimplified their work. Some of the variance was accounted for by various family factors but these factors were not the major ones.

    Given their sample size and the extent of the interviewing, it is not credible to say their conclusions are worthless.

  • Jayhuck

    …use and neglect were not significantly associated with increased likelihood of same-sex cohabitation or sexual partnerships” (from paper, pg 7). While sexual abuse is associated with an increased likelihood of same-sex behavior, this is not a study that shows homosexuality is caused by sexual abuse.

    Very interesting! :)

  • Hob Bope

    Warren,

    I was not referring to the quality of Bell et al’s data, but to the impressionistic way they interpreted it. There was at least one admission that the close mother stuff might well be relevant for some people, but near the end of the book they implied very strongly that such factors simply were not relevant at all, ever. That they did this goes to show the worthlessness of their reasoning.

    I will dig out page references if needed, but anyone who has read that study will know I’m right.

  • Hob Bope

    The part of Bell et al’s book that I find most objectionable is this, on page 192: “In short, to concerned parents we cannot recommend anything beyond the care, sympathy and devotion that good parents presumably lavish on all their children anyway.” (By “concerned parents”, they mean people who want to prevent their children becoming homosexual).

    Since Bell et al admitted that the classic Freudian theories about close mothers/distant fathers might be at least partially true, that was an irresponsible and dishonest claim. Nothing in their data justified it.

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

    @Hob Bope:

    Where is the admission of their “truth?” Bell et al acknowledged that for some, especially those in therapy, that these dynamics could play some role but as to being directly or solely causative as the modern day reparative therapists suggest, I do not believe you are reading them correctly. I have the book and will also consult it.

    Your dismissal of their findings leaves you where? It is one thing to say they were inconsistent in their presentation, it is another thing to say or provide evidence for the reparative drive theory. The two recent studies I have reported on here (Wilson & Widom and Francis) fail to provide evidence for theory-consistent predictions.

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  • Fg68at

    6.4% saying they had such a partner at some time in the past.

    No differentiation between teenager expirience and adult expirience?

  • Katie Cannon

    Wow, I just now have had time to really look through this blog. Very cool.

    I’ve never blogged before and don’t know how you see all the comments in a thread, any help would be much appreciated.

    Also, I see Warren has an interest in “mixed orientation” couples. That applies to me, to the extent I’m straight and my sig. other id’s as straight but has a long history of sex with men, continues to have fantasies of sex with men, watches gay porn, but is straight id’d LOL. What a trip.

    Katie

  • Katie Cannon

    I have no idea how to follow the order of comments, but now that I have had time to read more about the participants, and especially Warren, and especially his what he says about the I Exist video, I think I have a fully understanding of where this blog is coming from.

    In my experience with interacting with 100s of either bisexually identified men or straight men who have sex with men, only an extremely small minority find they are completely free of all homosexual fantasy. And it seems to me that it would be within this population that the likelihood of seeing complete change would be more likely.

    Among the straight identified men who feel highly motivated on a conscious level, the numbers of still quite small. More men find that they simply learn to live with their homosexual fantasies in a more peaceful manner and not allow them to through their identities into question, and thus not to act upon them in what feels to them to be an obsessive/compulsive way.

    But again, not many seem free of homosexual fantasies. And given my personal situation, I’ve searched high and low for more hopeful statistics.

    Still, as Spitzer suggests, even if the numbers are small, the therapeutic community needs to be more open to self-determination.

    (But don’t you think this is beginning to happen? It seems to me that both sides of the extreme are coming more towards the middle.)

    Change of any sort takes high motivation, and there’s a lot to be gained in having an ambivalent sexuality.

    Warren, do you support both gay affirmative therapy as well as helping those who would like to lead a more coherent heterosexual life?

    Katie

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

    Katie – It is hard to follow comments on some of the threads due to some changes made by WordPress along the way.

    THe short answer is yes I support a full range of therapeutic stances. The longer answer is here: http://www.sexualidentity.blogspot.com. This is the website for the Sexual Identity Therapy Framework. I am in a rush now but will have more to say later. I wanted to get that link in a comment for now.

  • Katie Cannon

    Warren,

    Thanks.

    What is the APA doing with the effects of sexual abuse? How do they view a man who says he’s romantically, aesthetically, emotionally, attracted to women, but nevertheless has sex with men — often because they really like anal sex and really big penises?

    Do they consider this an “orientation”? Would this fall under “reparative therapy?”

    It’s been very difficult to find a therapist who either 1) views all homosexuality as a developmental delay, or 2) assumes that such a guy just needs to come out of the homosexual closet and embrace his true nature.

    Katie

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  • Richard Anderson,MD

    I am a retired psychiatrist who used to treat victims of childhood sexual abuse,many of whom had dissociative idenity disorder(DID, formally multiple personalit disorder.) A number of them had homosexual alters but “the person” was hetorsexual. Thus this might explain why 8% reported any history of same sex relatioships. An unpublished study done years ago in Baltimore showed a high percentage of children removed from foster care and placed in a temporary shelter had DID,and I suspect when they grew up many would have same sex partners at some time in there life but not be gay.

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  • Semyon

    Dr. Throckmorton:

    With this post being so old (January 2009), I don’t know if you’re still reviewing reader comments but hopefully you are. Here’s my comment/question:

    With the Boy Scouts having just decided to allow openly gay individuals to join, I’ve been researching this issue and came across this article.

    Having read through this post twice, being careful to note what FRC and Drs. Stall and Valdiserri said, I do not see how the FRC mischaracterized the Stall/Valdiserri study. In its commentary on the research, the FRC did not definitively attribute to homosexuality to childhood sexual abuse but stated that such abuse may lead to many outcomes, including confusion with respect to “…sexual orientation and gender identity.”

    Further, I’d like to note that in their reply (at least that reported in the post here – I will read the full reply, which you linked), neither Stall nor Valdiserri took issue with the FRC’s summary of their research, stating that FRC had misquoted or misstated the published text.

    Can you please offer some clarification, if there’s an actual distinction between what the FRC wrote and what the study authors said in reply?

    The reason I’m asking is because I’m sure you’ve met and talked with Dr. Nicholas Cummings, a former APA President, and I suspect you’re aware of the paper that he and two other former APA Presidents (Drs. Bonnie Strickland and Frank Farley) presented at the APA Convention in 2006.

    Entitled “The APA and Psychology Need Reform,” it documents a repressive environment within the APA, whereby the organization discourages any studies that depict homosexuality unfavorably and that (either directly or indirectly) tends to ostracize researchers, who performed the studies.

    Consequently, I’m suspicious that Stall and Valdiserri’s response was entirely motivated out of a desire to clarify their study and what it means. I also suspect that much, if not most of their response was a desire to distance themselves from groups that either the APA or powerful organizations that seek to mainstream homosexuality deem politically incorrect.