Peter May surveys the role of ideology in the debate over homosexuality.

In January 2013, a retired engineer published a remarkable paper. He examined in detail the 2007 submission by the Royal College of Psychiatrists to the Church of England's Listening Exercise on Human Sexuality and their almost identical submission to the Pilling Commission in 2012. Rarely, when doctors read medical papers do they examine all the footnotes, but Dermot O'Callaghan did.

The origins of homosexuality

He noticed that the College had made a significant alteration to their original report. The first said, 'It would appear that sexual orientation is biological in nature, determined by a complex interplay of genetic factors and the early uterine environment.' The second version however, says that it is 'determined by genetic factors and/or the early uterine environment'. While the first version implied that genetic and hormonal influences work together in this, the second version logically allows that orientation could be caused entirely by genes or entirely by hormones. Conversely, it may have nothing to do with genes or nothing to do with hormones. The College thereby admits that there is no compelling evidence to say it is genetic or hormonal. Where then is the evidence that orientation is biological in nature?

Regrettably, the College ignores twin studies, a major research field for two decades. An important study published in 2000 (1) showed that among male identical twins, where one was gay, there was an 89% chance that his co-twin was not. As they shared essentially identical genes and intrauterine environments, this implies the importance of later postnatal, non-biological causes, such as life events or choices, in determining sexual orientation.

Certainly, genes do not dictate behaviour. Alcoholics, for instance, can resist their genetically influenced cravings. These studies also show that the common analogy with skin colour is demonstrably false.

The College claims, 'There is no substantive evidence to support the suggestion that the nature of parenting or early childhood experiences play any role in the formation of a person's fundamental heterosexual or homosexual orientation.'

Yet in 2006, a major Danish study reported, 'population-based, prospective evidence that childhood family experiences are important determinants of heterosexual and homosexual marriage decisions in adulthood.' (2) The College appears to have locked itself into a 'born gay' ideology by ignoring the evidence to the contrary. Its argument that causation is 'biological' has led to the widespread belief that LGB people are being 'true to their nature' in homosexual behaviour.

The psychological and social wellbeing of LGB people

The College claims that 'discrimination in society... means...that some LGB people experience a greater than expected prevalence of mental health and substance misuse problems'.

It tells us that the first civil partnerships were in Denmark (1989) but doesn't mention a study carried out in that 'undiscriminating' society. Over a twelve year period, the incidence of suicide for homosexual men in civil partnerships was found to be eight times that of heterosexual men in marriages. (3)

To support its contention that increased mental illness is mainly due to discrimination and social rejection, the College cites three papers, which do not actually support that view. One stated, 'the precise causal mechanism at this point remains unknown. Therefore studies are needed...to evaluate the relative salience of social stigmatisation and lifestyle factors...'. (4)

The second paper was by Prof Michael King, (5) the lead author of the College submissions. While the College says that 'discrimination in society...means that some LGB people experience a greater than expected prevalence of mental health and substance misuse problems', his academic paper goes on to state, 'Conversely, gay men and lesbians may have lifestyles that make them vulnerable to psychological disorder.' Why does King not admit this in his submissions to the Church?

The third paper goes further: 'many people will conclude that widespread prejudice against homosexual people causes them to be unhappy or mentally ill. [This view] would be premature however and should be discouraged. In fact a number of potential interpretations need to be considered...'. (6) While none of their referenced papers actually supports the College viewpoint, this paper specifically cautions against it.

Reparative therapy

The College submission addresses the issue of reparative therapy, shortly to come before Parliament. A Private Members' Motion to regulate psychotherapy includes a highly illiberal clause outlawing psychotherapy for people who want help in reducing unwanted same-sex desires. This may be to safeguard their marriages, protect the wellbeing of their children, or because they believe that homosexual acts are wrong or such desires are socially uncomfortable. Several matters require comment.

First, there is an underlying assumption being made that a person's sexual orientation is fixed and it would be harmful to try and change it. However, there is considerable evidence that, for some, sexual orientation is fluid, and can change over the course of life, with or without therapy. This is particularly well documented among young people (7) and among women. (8) (9) Furthermore, it is now recognised that more people are bisexual than homosexual, their orientation being essentially fluid. (10)

Second, evidence of harm harks back to 50 years ago, when electric shock and drug therapies were being used to 'cure' homosexual behaviour. This has nothing to do with modern psychotherapeutic methods aimed at changing or ameliorating intrusive desires. The College says one study 'showed...considerable harm', (11) but that research was retrospective, did not use any measures of harm and was unable to show a causal relationship between therapy and harm.

Third, the College, which claims to believe strongly in evidence-based treatment, ignores very good evidence of psychotherapeutic benefits. The best study available today concludes, 'the findings...appear to contradict the commonly expressed view that sexual orientation is not changeable and that the attempt to change is highly likely to result in harm.' (12)

Another study is said by the College to have claimed change 'in 13% of LGB people, most of whom could be regarded as bisexual at the outset'. In fact, that study actually claimed that the majority of participants experienced change from predominantly or exclusively homosexual orientation. (13) This is seriously misreported by the College.

Finally, the UK Council for Psychotherapy has been repeatedly asked to provide evidence for their claim that such treatment is harmful – but none has been offered.

Outcome

These findings were published in a booklet (14) and sent to Prof Sue Bailey, President of the Royal College of Psychiatrists on 11 April 2013, with a letter inviting the College to do one of three things: to withdraw, amend or publicly re-affirm their submission to the Church in the light of these findings. She has taken a fourth option: she has not replied!

The booklet was also sent to Sir Joseph Pilling, Chairman of the Church of England's Working Group on Human Sexuality, suggesting that he, on behalf of the Church, might engage directly with the College on these scientific matters. In his Report (15) he has commented unfavourably on the College's use of science but does not appear to have taken up any of these issues with them.

The past year has seen an international revolution in public and political thinking about homosexuality. Gay Marriage has been approved by Parliament and the Pilling Commission has reported to the Church. Yet the College has refused to address any of these fundamental issues, which undermine the advice they have given.

Now we are faced with a debate in Parliament as to whether people with unwanted same-sex desires have any right in law to seek counselling to change or ameliorate those desires. Prof Michael King has said, 'It is anachronistic even to have these debates. Society has moved on from this issue.'

But moved on from what – the science? Given its provisional nature, science itself can move on.

But if you move on from the objectivity of science, what do you move towards? Only to a fantasy world, where all truth is subjective, malleable, prejudiced and relative. It is a world where all truths appear to be tolerated, until a bullying intolerant Bill, like the current one, comes before Parliament.

What is the science that undergirds our understanding of homosexuality? And who are its custodians? For the past 40 years, psychiatrists have not recognised homosexuality as being a mental illness, so it is no longer their business. Yet when Church and State wish to address the subject, the Royal College of Psychiatrists is the only Royal College to offer submissions – and their views are influential all over the world. Ironically, it has taken an engineer to expose fundamental flaws in the ideological 'science' they have put forward.

Christians have a mandate from Christ to love and care for all people, including those who struggle with their sexuality. Would Jesus refuse help to a man troubled by unwanted same-sex desires, which threaten his marriage and the security of his children?

We also have a mandate to be passionate and honest about truth and to strive to teach it accurately. All truth belongs to God, and all untruths deny him. We must insist that love and truth are essential values in public discourse.

Peter May is a retired GP in Southampton.