Analysis of scientific data.

Source in English: Robert L. Kinney III - Homosexuality and scientific evidence: On suspect anecdotes, antiquated data, and broad generalizations.
The Linacre Quarterly 82 (4) 2015, 364 – 390
DOI: https://doi.org/10.1179/2050854915Y.0000000002
Group Translation Science for the truth/AT. Lysov, MD, Ph.D.

KEY FINDINGS: As a justification for the “normativeness” of homosexuality, it is argued that the “adaptation” and social functioning of homosexuals are comparable to heterosexual ones. However, it has been shown that “adaptation” and social functioning are not related to determining whether sexual deviations are mental disorders and lead to false negative conclusions. It is impossible to conclude that the mental state is not deviant, because such a state does not lead to impaired “adaptation”, stress or impaired social function, otherwise many mental disorders should be mistakenly designated as normal conditions. The conclusions cited in the literature quoted by proponents of the normativity of homosexuality are not a proven scientific fact, and questionable studies cannot be considered reliable sources.

INTRODUCTION

Shortly before this article was written, a Catholic nun [who wrote a critical article on homosexuality] was accused of using “suspicious stories, outdated data and broad generalizations to demonize gays and lesbians” (Funk 2014) For the same reason, another activist wrote that the nun deviated “into the field of sociology and anthropology”, which are “beyond her competence” (Gallbraith xnumx). It is not entirely clear what exactly was meant, but the reaction to the article raises several important questions. The charge of using outdated data and the deviation into an area outside anyone's purview involves two things. First, it implies that there is some evidence that is newer than the one presented by the nun on the topic of homosexuality. Second, it implies that there are credible experts who are more competent to speculate about homosexuality. The question also arises: what, in fact, say about homosexuality "not outdated", modern data? Also, what do the so-called authoritative experts say about homosexuality? A simple search on the Internet reveals that many of the so-called mental health experts claim that there is a significant body of scientific evidence to support their view that homosexuality is not a mental disorder. In this situation, it is necessary to carry out a review and analysis of supposedly scientific evidence that homosexuality is not a mental disorder.

Two groups that are generally referred to as “reputable and credible as experts in mental disorders in the United States of America” are the American Psychological Association (APA) and the American Psychiatric Association. Therefore, first I will give the position of these organizations regarding homosexuality, and then I will analyze the “scientific evidence” that they claim speak in favor of such a position.

I will show that there are significant flaws in the sources, which are presented as “scientific evidence” in support of the assertion that homosexuality is not a mental disorder. In particular, a significant portion of the literature presented as scientific evidence is not relevant to the topic of homosexuality and mental disorders. As a result of these shortcomings, the credibility of the American Psychiatric Association and APA, at least with regard to their statements regarding human sexuality, is being questioned.

AMERICAN PSYCHOLOGICAL ASSOCIATION AND AMERICAN PSYCHIOTRIC ASSOCIATION

I will start with a description of the APA and the American Psychiatric Association, and talk about their views on homosexuality. APA claims that it is:

“... the largest scientific and professional organization representing psychology in the United States. APA is the world's largest association of psychologists with about 130 000 researchers, educators, clinicians, consultants and students. ” (American Psychological Association 2014)

Her goal is “The contribution to the creation, communication and application of psychological knowledge in the public interest and to improving people's lives” (American Psychological Association 2014).

American Psychiatric Association (which also uses the acronym APA):

“... is the world's largest psychiatric organization. This is a medical specialized society representing a growing number of members, currently over 35 000 psychiatrists ... Its members work together to provide humane care and effective treatment for all people with mental disorders, including mental disorders and substance use disorders. APA is the voice and conscience of modern psychiatry ” (American Psychiatric Association 2014a).

The American Psychiatric Association publishes the Diagnostic and Statistical Manual of mental disorders ‑ DSM, which is:

“... a reference used by healthcare professionals in the United States and many countries around the world as authoritative mental health diagnosis guide. “DSM” contains a description, symptoms and other criteria for diagnosing mental disorders. It provides unity of communication for clinicians to communicate about their patients and establishes consistent and reliable diagnoses that can be used in the study of mental disorders. It provides unity of communication for researchers to explore criteria for potential future revisions and assist in the development of drugs and other interventions. ” (American Psychiatric Association 2014b, added selection).

The diagnostic and statistical guidelines for mental disorders are considered authoritative guidelines for diagnosing mental health conditions. It follows that those psychiatrists who make up the American Psychiatric Association, especially those who are involved in defining the content of “DSM,” are considered authorities and experts in the field of psychiatry (for people unfamiliar with the specifics of science, the study of psychology is different from the study of psychiatry, therefore there are two different professional organizations that study mental disorders - psychological and psychiatric).

The APA and American Psychiatric Association's attitudes towards homosexuality are outlined in at least two important documents. The first of these documents is the so-called. The Brief of Amici Curiae for APA¹provided during the US Supreme Court Lawrence v. Texas case, which led to the repeal of anti-sodomy laws. The second is an APA document entitled “Target Group Report on Appropriate Therapeutic Approaches to Sexual Orientation”². Authors in this report “Conducted a systematic review of peer-reviewed scientific literature on efforts to change sexual orientation” to provide “more specific recommendations to licensed mental health professionals, the public, and politicians” (Glassgold et al., 2009, 2) Both documents contain citations from materials that are presented as “evidence” to support the view that homosexuality is not a mental disorder. I will refer to the scientific evidence provided in the documents and I will analyze the sources presented as scientific evidence.

It should be noted that the “target group” that prepared the second document was led by Judith M. Glassgold, who is a lesbian psychologist. She sits on the board of Journal of Gay and Lesbian Psychotherapy and is the former chairman of the APA’s Gay and Lesbian Department (Nicolosi 2009) Other members of the task force were: Lee Bexted, Jack Drescher, Beverly Green, Robin Lyn Miller, Roger L. Worsington and Clinton W. Anderson. According to Joseph Nicolosi, Bexted, Drescher and Anderson are “gay,” Miller is “bisexual,” and Green is a lesbian (Nicolosi 2009) Therefore, before reading their opinion, the reader should take into account that APA representatives do not take a neutral position on this issue.

I will quote from these two documents. This will allow a wider disclosure of the position of the APA and the American Psychiatric Association.

POSITION OF TWO ORGANIZATIONS ON HOMOSEXUALISM

APA writes about homosexual attraction:

"... same-sex sexual attraction, behavior, and orientation are in themselves normal and positive variants of human sexuality - in other words, they do not indicate mental or developmental disorders." (Glassgold et al. 2009, 2).

They explain that by “normal” they mean “Both the absence of a mental disorder and the presence of a positive and healthy result of human development” (Glassgold et al., 2009, 11) APA Writers Consider These Statements “Backed by a significant empirical base” (Glassgold et al., 2009, 15).

The APA Expert Opinion document uses similar expressions:

"... decades of research and clinical experience have led all health organizations in this country to conclude that homosexuality is a normal form of human sexuality." (Brief of Amici Curiae 2003, 1).

Therefore, the main position of the APA and the American Psychiatric Association is that homosexuality is not a mental disorder, but rather a normal form of human sexuality, and they claim that their position is based on significant scientific evidence.

SIGMUND FREUD

Both documents continue with historical reviews of homosexuality and psychoanalysis. One paper begins by quoting Sigmund Freud, who suggested that homosexuality “Is not something shameful, vice, and degradation, it can not be classified as a disease, but is a variation of sexual function” (Freud, 1960, 21, 423 – 4) The authors note that Freud tried to change the sexual orientation of one woman, but, having not achieved success, "Freud concluded that attempts to change homosexual sexual orientation are probably unsuccessful." (Glassgold et al., 2009, 21).

It goes without saying that the letter written by [Freud] in the 1935 year is outdated or no longer relevant, depending on the choice of words. Freud's conclusion that the change in homosexual orientation "probably are unsuccessful "after just one attempt should be regarded as a" suspicious story. " Therefore, Freud's data in this case are insufficient; based on his letter, it is not possible to make a statement that homosexuality is a normal variant of a person’s sexual orientation. It should also be noted that the authors deliberately refrained from fully citing the views of Freud, who suggested that homosexuality is “a variation in sexual function caused by a particular halt in sexual development"(Herek 2012) Consciously avoiding this quote from Freud’s work is misleading. (In more detail about what Freud wrote about homosexuality, can be read in the work of Nicolosi).

Alfred Kinsey

The APA Task Force document then refers to two books written by Alfred Kinsey in 1948 and 1953 (Sexual Behavior in the Human Male and Sexual Behavior in the Human Female):

“... at the same time that the pathologizing views on homosexuality in American psychiatry and psychology were standardized, evidence was accumulating that this stigmatizing view was poorly substantiated. The publication of “Sexual Behavior in the Human Male” and “Sexual Behavior in the Human Female” showed that homosexuality was more common than previously thought, indicating that such behavior is part of a continuum of sexual behavior and orientation. ” (Glassgold et al., 2009.

In this quotation, the key point is the attribution of homosexuality to the “normal continuum” of sexual behavior. In other words, the APA states the following based on Kinsey books:

1. It has been demonstrated that homosexuality is more common among people than previously thought;
2. Therefore, there is a normal distribution (or normal “continuum”) of sexual attraction to different sexes.

Kinsey's arguments (which are accepted by APA) are just as imperfect as the interpretation of what Freud said. “Continuum” is “a continuous sequence in which adjacent elements hardly differ from each other, although the extremes are very different” (New Oxford American Dictionary 2010, sv continuum) An example of a continuum is temperature readings - “hot” and “cold” are very different from each other, but it is difficult to distinguish between 100 ° F and 99 ° F. Kinsey explains his theory of continuums in nature:

“The world cannot be divided only into sheep and goats. Not all black and not all white. The basis of the taxonomy is that nature rarely deals with discrete categories. Only the human mind invents categories and tries to lay all the eggs in baskets. Wildlife is a continuum in all its aspects.. The sooner we understand this in relation to human sexual behavior, the sooner we can achieve a reasonable understanding of the realities of sex. ” (Kinsey and Pomeroy 1948, added selection).

Regarding homosexuality, Kinsey (like the authors of the APA) concludes that since some people are sexually attracted to their own sex, it automatically follows that there is a normal continuum of sex drive. In order to see the defectiveness of such argumentation definitions do not require a scientific degree. Normality of behavior is determined not simply by the observation of such behavior in society. This applies to all medical science.

To make it easier to understand the vulnerability of such an argument, I will cite an example of one very specific behavior that is observed among people. Some individuals have a strong desire to remove their own healthy parts of the body; among other individuals there is a desire to inflict scars on their body, while still others seek to harm themselves in other ways. All of these individuals are not suicides, they do not seek death, but simply want to remove their healthy limbs or cause damage to their body.

The condition in which a person feels the desire to get rid of a healthy part of the body is known in science as “apotemophilia”, “xenomelia”, or “body integrity disorder syndrome”. Apothemophilia is “The desire of a healthy person to amputate a limb that is healthy and fully functional” (Brugger, Lenggenhager and Giummarra 2013, 1) It was noted that “Most individuals with apotemophilia are men” that “Most want to amputate the leg”, although “A significant proportion of people with apothemophilia want to remove both legs” (Hilti et al., 2013, 319). In one study with 13 men, it was noted that all subjects with apotemophilia experienced «strong aspiration amputate legs " (Hilti et al., 2013, 324, selection added). Studies show that this condition develops in early childhood, and that it can be present even from the moment of birth (Blom, Hennekam and Denys 2012, 1). In other words, some people may be born with a desire or a persistent desire to remove a healthy limb. Also, in a study among 54 people, it was found that 64,8% of people with xenomyelia have higher education (Blom, Hennekam and Denys 2012, 2). One study showed that removing healthy limbs leads to “Impressive improvement in the quality of life” (Blom, Hennekam and Denys 2012.

So, to summarize: there is a mental state in which people “desire” and “seek” to remove their healthy limbs. This desire may be innate, or, in other words, people may be born with the desire to remove their healthy limbs. This “desire” and “aspiration” are the same as “inclination” or “preference”. “Desire” or “aspiration”, of course, is not directly equivalent to the commission of amputation (action), but preference, inclination, desire, and aspiration, as well as the act of removal itself are considered violations (Hiltiet al., 2013, 324)³.

Removing healthy limbs is pathological effect, and also the desire to remove healthy limbs is pathological desire or pathological tendency. A pathological desire develops in the form of thoughts, as in the case of most (if not all) desires. In many cases, the disorder has been present since childhood. Finally, people who fulfill their desire and remove a healthy limb feel better after amputation. In other words, those who act according to their impaired desire (pathological thoughts) and perform a pathological action to remove a healthy limb, experience an improvement in “quality of life” or experience a sense of pleasure after performing a pathological action. (The reader should note here a parallel between the pathological nature of apotemophilia and the pathological nature of homosexuality.)

The second example of a mental disorder that I mentioned above is the so-called. "Non-suicidal self-harm", or "auto-mutilation" (the desire to inflict injury, scars). David Klonsky noted that:

“Non-suicidal auto-mutation is defined as the deliberate destruction of the tissues of one’s own body (without suicidal goals) that are not regulated by social orders ... Common forms of auto-mutation include cutting and scratching, cauterizing, and interfering with wound healing. Other forms include carving words or characters on the skin, stitching body parts. ” (Klonsky 2007, 1039 – 40).

Klonsky and Muehlenkamp write that:

“Some may use self-harm as a means to excite or enjoy, similar to parachuting or bungee jumping. For example, the motives that some individuals use as auto-motives include “I want to get high”, “thought it would be fun” and “for the thrill”. For these reasons, auto-mutation can occur in a group of friends or peers. ” (Klonsky and Muehlenkamp 2007, 1050)

Similarly, Klonsky notes that

"... the prevalence of auto-mutation in the population is high and probably higher among adolescents and young people ... it has become apparent that automutation is observed even in non-clinical and highly functional population groups, such as high school students, college students and military personnel ... The growing prevalence of auto-mutation says clinicians are more likely than ever to encounter this behavior in their clinical practice. ” (Klonsky 2007, 1040, selection added).

The American Psychiatric Association notes that with non-suicidal auto-mutation, direct damage “Often the urge is preceded, and the damage itself is felt as pleasant, although the individual realizes that he or she is harming himself” (American Psychiatric Association 2013.

To summarize, non-suicidal self-harm is pathological effect preceded by pathological desire (or "Motivation") harm yourself. Those who injure themselves do it for the sake of "Pleasure". Some patients with the disorder "Highly functional" in the sense that they are able to live, work and act in society, at the same time they have this mental disorder. Finally, “The prevalence of auto-mutation is high and probably higher among adolescents and young people” (Klonsky 2007.

Now back to the original goal - to consider examples of apotemophilia and auto-mutation in the framework of the logic of APA and the American Psychiatric Association. The APA claims that Alfred Kinsey’s research findings have disproved homosexuality as a pathology. APA bases this statement on Kinsey’s research “Demonstrated that homosexuality was more common than previously thought, indicating that such behavior is part of a continuum of sexual behavior and orientation” (Glassgold et al., 2009.

Again, a shortened version of Kinsey's argument looks like this:

1. Among people, it has been demonstrated that homosexuality is more common than previously thought;
2. Therefore, there is a normal variation (or normal “continuum”) of sexual desire.

Replace homosexuality with examples of apotemophilia and auto-mutation, following the logic of Kinsey and APA, and then the argument will be as follows:

1. It has been observed that some individuals are tempted and eager to injure themselves and cut off healthy parts of their bodies;
2. In humans, it has been demonstrated that the urge to self-injure and cut off healthy body parts is more common than previously thought;
3. Hence, there is a normal variation of the urge to self-injure and cut off healthy body parts; there is a continuum of normal variation regarding attitudes toward self-harm.

Thus, we can see how illogical and inconsistent the arguments of Kinsey and APA are; the observation that behavior is more common than previously thought does not automatically lead to the conclusion that there is a normal continuum of such behavior. It could be concluded that each individual observed human behavior is simply one normal behavior in the “continuum” of human behavior; if the desire to hurt oneself or the desire to remove a healthy limb is shown to be more common than previously thought, then (by their logic) such behavior will be part of the usual continuum of behavior and the goals of self-harm.

At one end of the Kinsey spectrum there will be those who want to kill themselves, and at the other end of the spectrum there will be those who want the health and normal functioning of their body. Somewhere between them, according to Kinsey’s logic, there will be those who feel like cutting their own hands, and next to them there will be those who want to completely amputate these hands. This leads to the question: why all types of human behavior can not be considered normal variants of human behavior? Kinsey's market argument, if logically continued, completely eliminates any need for psychology or psychiatry; Kinsey wrote that "the living world is a continuum in all its aspects". If this were so, then there would be no such thing as a mental disorder (or physical disorder), and there would be no need for all of these associations and groups that diagnose and treat mental disorders. Attraction to the commission of serial crimes would, according to Kinsey's logic, be just one of the normal options in the continuum of attitude to human life.

Therefore, APA’s claim that Kinsey’s study is a “refutation” of homosexuality as a pathology is insufficient and erroneous. The data of the scientific literature does not support such a conclusion, and the conclusion itself is absurd. (In addition, it should be noted that along with illogical argumentation, most of Kinsey's research was discredited (Browder xnumx; see details myth of 10%).

K. S. FORD AND FRANK A. BEACH

Another source that has been put forward as scientific evidence that homosexuality is not a mental disorder is a study by C. S. Ford and Frank A. Beach. The APA wrote:

“CS Ford and Beach (1951) showed that same-sex behavior and homosexuality are present in a wide range of animal species and human cultures. This discovery showed that there was nothing unnatural in same-sex behavior or homosexual orientation."(Glassgold et al., 2009.

The quote is taken from a book called Patterns of Sexual Behavior. It was written in 1951, and in it, after studying anthropological data, the authors suggested that homosexual activity was permissible in 49 from 76 human cultures (Gentile and Miller, 2009, 576). Ford and Beach also “indicated that among primates both males and females participate in homosexual activity” (Gentile and Miller, 2009) Thus, APA authors believe that since two researchers in 1951 discovered that homosexuality is observed in some people and animals, it follows that there is nothing unnatural in homosexuality (the definition of “nothing unnatural” seems to mean that homosexuality is the "norm"). The essence of this argument can be expressed as follows:

1. Any action or behavior observed in a wide range of animal species and human cultures suggests that there is nothing unnatural in such behavior or action;
2. Same-sex behavior and homosexuality have been observed in a wide range of animal species and human cultures;
3. Consequently, there is nothing unnatural in same-sex behavior or homosexual orientation.

In this case, we are again dealing with an “obsolete source” (1951 study of the year), which also draws an absurd conclusion. Observation of any behavior both among people and among animals is not a sufficient condition for determining that there is nothing unnatural for such behavior (unless the APA comes up with any other meaning for the word “natural” to accept this term) . In other words, there are many actions or behaviors that humans and animals do, but this does not always lead to the conclusion that "There is nothing unnatural»In such actions and behavior. For example, cannibalism has been shown to be widespread in human cultures and among animals (Petrinovich 2000.

[Twenty years later, Beach admitted that he did not know a single true example of males or females in the animal world who prefer a homosexual partner: “There are males who sit on other males, but without intromissi or climax. You can also observe a cage between females ... but to call it homosexuality in the human concept is an interpretation, and interpretations are tricky ... It is very doubtful that the cage itself can be called sexual ... " (Karlen 1971, 399) —  approx. per.]

Applying cannibalism behavior to the logic used by the APA will result in the following argument:

1. Any action or behavior observed in a wide range of animal species and human cultures suggests that there is nothing unnatural in such behavior or action;
2. Eating individuals of their own species was observed in a wide range of animal species and human cultures;
3. Consequently, there is nothing unnatural in eating individuals of their own species.

However, do you not think that there is definitely something "unnatural" in cannibalism? We can come to this conclusion on the basis of just common sense (without being an anthropologist, sociologist, psychologist or biologist). Thus, the use by the APAs of the erroneous conclusion of Ford and Beach as “evidence” that homosexuality is not a mental disorder is outdated and insufficient. Again, the scientific literature does not confirm their conclusions, and the conclusion itself is absurd; their argument is not a scientific argument. (This example could also be used to illustrate the absurd logic of Kinsey and APA: there would be veganism at one end of the “normal continuum of food orientation” and cannibalism at the other).

Evelyn Hooker and Others on “Adaptability”

The following argument by the authors of the APA target group is a reference to the publication of Evelyn Hooker:

“The study of psychologist Evelyn Hooker subjected the idea of ​​homosexuality as a mental disorder to a scientific test. Hooker studied a non-clinical sample of homosexual men and compared them to a matched sample of heterosexual men. Hooker found, among other things, from the results of three tests (thematic apperceptive test, Tell the story by pictures test and Rorschach test) that homosexual men were comparable to a heterosexual group by level of adaptability. It is amazing that the experts who studied the Rorschach protocols could not distinguish between the protocols of the homosexual group and the heterosexual group, which led to a glaring contradiction with the dominant understanding of homosexuality and projective assessment methods at that time. ” (Glassgold et al., 2009, 22, selection added).

APA Expert Opinion also refers to Hooker as "Thorough research":

“... in one of the first careful Research into Mental Health in Homosexuals Dr. Evelyn Hooker used a battery of standard psychological tests to study homosexual and heterosexual men who were matched on age, IQ, and education... From her data, she concluded that homosexuality is not inherently associated with psychopathology and that “homosexuality does not exist as a clinical condition.” (Brief of Amici Curiae 2003, 10 – 11, selection added)

So, in 1957, Evelyn Hooker compared men who claimed to be homosexual to men who claimed to be heterosexual. She studied subjects using three psychological tests: a thematic apperceptive test, a “Tell a story from pictures” test, and a Rorschach test. Hooker concluded that “homosexuality as a clinical condition does not exist” (Brief of Amici Curiae 2003, 11).

A thorough analysis and criticism of the Hooker study is beyond the scope of this article, but several points should be noted.

The most important aspects of any research are: (1) the measured parameter (English: “outcome”; end point), and (2) whether it is possible to derive the target conclusion by measuring this parameter.

Another important aspect of the study is whether the measurements are correct. Hooker's study looked at the "adjustment" of homosexuals and heterosexuals as a measurable parameter. Hooker stated that the fitness measured in homosexuals and heterosexuals was similar. It does not, however, offer a definition for the term "adaptability". For now, the reader should be mindful of the term “adaptability,” which I will come back to later. It should be noted here that many other works have critically described methodological errors in Hooker's study (two works that deal with methodological errors in Hooker's research are given in the references section - these are Schumm (2012) и Cameron and Cameron (2012)) In this article, I will dwell on the parameter that Hooker used as scientific evidence in favor of the statement about the "normality" of homosexuality: adaptability.

I focused on this parameter, because in the 2014 year, “adaptability” is still the parameter referenced by the main associations as scientific evidence, in favor of the assertion that homosexuality is “a normal variation of a person’s sexual orientation”.

After citing the study of Evelyn Hooker as scientific evidence, the authors of the APA task force stated:

“In the Armon study among homosexual women, similar results [with data from Evelyn Hooker] were obtained .... In the following years after studies by Hooker and Armon, the number of studies on sexuality and sexual orientation grew. Two important events marked a dramatic change in the study of homosexuality. First, following the example of Hooker, more and more researchers began to conduct research on non-clinical groups of homosexual men and women. Previous studies mainly included participants who were distressed or imprisoned. Secondly, quantitative methods for assessing the human personality (for example, the Eysenck personality test, Cattell questionnaire, and the Minnesota test) were developed and were a huge psychometric improvement over previous methods, such as, for example, the Rorschach test. Studies conducted with these newly developed assessment methods have shown that homosexual men and women were essentially similar to heterosexual men and women in terms of adaptation and functioning. ”(Glassgold et al., 2009, 23, selection added).

This last line, which I emphasized, is extremely important; "newly developed methods"Compared"adaptation”And the ability to function in a society between homosexuals and heterosexuals, that is, they used comparison to substantiate the view that homosexuality is not a disorder. It should be noted here that “adaptation” was used interchangeably with “adaptability” (Jahoda xnumx, 60 – 63, Seaton in Lopez 2009, 796 – 199). Consequently, APA again implies that since homosexual men and women are “essentially similar” to men and women in the process of adaptation and social functioning, this necessarily suggests that homosexuality is not a mental disorder. This is the same argument proposed by Evelyn Hooker, who reinforced her conclusion that homosexuality is not a pathology with data indicating a similarity between homosexuals and heterosexuals in “adaptability”.

A review by John C. Gonsiorek entitled "Empirical Basis for the Demise of the Illness Model of Homosexuality" is also cited by APA and the American Psychiatric Association as evidence that homosexuality is not a disorder (Glassgold et al., 2009, 23; Brief of Amici Curiae 2003, 11). In this article, Gonsiorek makes several statements similar to those of Evelyn Hooker. Gonsiorek indicated that

“... a psychiatric diagnosis is an adequate method, but its application to homosexuality is erroneous and incorrect, since there is no empirical justification for this. In other words, diagnosing homosexuality as a disease is a bad scientific approach. Therefore, regardless of whether the credibility of the diagnostic action is accepted or rejected in psychiatry, there is no reason to consider homosexuality as a disease or as an indicator of a psychological disorder ”system. (Gonsiorek, 1991.

Gonsiorek accuses those who support the claim that homosexuality is a disorder of using a "bad scientific approach." In addition, Gonsiorek suggests that “The only relevant question is whether there are any well-adapted homosexuals” (Gonsiorek 1991, 119 – 20) and

“... to the question whether homosexuality is per se or not pathological and associated with a psychological disorder, it is easy to answer .... studies of different groups have consistently shown that there is no difference in psychological adaptation between homosexuals and heterosexuals. Therefore, even if other studies show that some homosexuals have impairments, it cannot be argued that sexual orientation and psychological adaptation alone are interconnected. ”. (Gonsiorek, 1991, 123 – 24, highlighted)

So, in Gonsiorek's work, “adaptability” is used as a measured parameter. Again, the scientific evidence cited by Gonsiorek, stating that “homosexuality is the norm”, is based on a measurement of the “adaptability” of homosexuals. Gonsiorek implies that if sexual orientation is “associated” with psychological adjustment, then we can assume that homosexuals are people with a mental disorder. If, however, there is no difference in the adaptability of heterosexuals and homosexuals, then (according to Gonsiorek) homosexuality is not a mental disorder. His argument is almost identical to Evelyn Hooker's argument, which was as follows:

1. There are no measurable differences in psychological adaptability between homosexuals and heterosexuals;
2. Therefore, homosexuality is not a mental disorder.

APA's Expert Opinion in Lawrence v. Texas also cites the Gonsiorek review as scientific evidence supporting the claim that “Homosexuality is not associated with psychopathology or social maladaptation” (Brief of Amici Curiae 2003, 11). The APA Expert Opinion mentions several more references to scientific evidence supporting this claim. One of the articles mentioned is the 1978 review study of the year, which also considers adaptability "and" concludes that the results so far obtained have not demonstrated that the homosexual individual is less psychologically adapted than his heterosexual counterpart "(Hart et al., 1978, 604). The American Psychiatric Association and APA also cited studies by Gonsiorek and Hooker as scientific evidence in their resume for the recent US v. Windsor (Brief of Amici Curiae 2013, 8). Consequently, once again, measures of “adaptability” were used to support the claim that homosexuality is not a mental disorder. Therefore, we must find out what exactly is meant by “adaptability”, since this is the basis for most “scientific evidence” that claims that homosexuality is not a mental disorder.

“ADAPTABILITY” IN PSYCHOLOGY

I noted above that “adaptability” is a term that has been used interchangeably with “adaptation”. Marie Jahoda wrote in 1958 (one year after the publication of Evelyn Hooker's study) that

“The term“ adaptability ”is actually used more often than adaptation, especially in the popular literature on mental health, but often ambiguously, which creates ambiguity: should adaptability be understood as a passive acceptance of any life situation (that is, as a state satisfying situational needs) or as a synonym adaptation "system. (Jahoda xnumx.

The Hooker study and the Gonsiorek survey are striking examples of the ambiguous use of the term “adaptability”. No author defines this term exactly, but Gonsiorek alludes to what he means by this term when he refers to many studies published between the 1960 and 1975 years (the full text of which is difficult to obtain due to the fact that they were published before the introduction of digital archiving):

“A number of researchers have used the Adjective Check List (“ ACL ”) test. Chang and Block, using this test, did not find differences in the total adaptability between homosexual and heterosexual men. Evans, using the same test, found that homosexuals showed more problems with self-perception than heterosexual men, but that only a small proportion of homosexuals can be considered poorly fit. Thompson, McCandless, and Strickland used the ACL to study psychological adaptability both men and women - homosexuals and heterosexuals, concluding that sexual orientation is not associated with individual adaptability. Hassell and Smith used the ACL to compare homosexual and heterosexual women and found a mixed picture of the differences, but in the normal range, based on this we can assume that in the homosexual sample adaptability was worse. " (Gonsiorek, 1991, 130, selection added).

Thus, according to Gonsiorek, at least one of the indicators of its adaptability is “self-perception”. Lester D. Crow, in a book published in the same time period as the studies reviewed by Gonsiorek, notes that

“Complete, healthy adaptability can be achieved when an individual exhibits certain characteristics. He recognizes himself as an individual, both similar and different from other people. He is confident in himself, but with a realistic awareness of his strengths and weaknesses. At the same time, he can evaluate the strengths and weaknesses of others and adjust his attitude to them in terms of positive values ​​... A well-adapted person feels safe in his understanding of his ability to bring his relationship to an effective level. His self-confidence and a sense of personal security help him to guide his activities in such a way that they are aimed at constantly examining the well-being of himself and others. He is able to adequately solve the more or less serious problems that he faces day by day. Finally, a person who has achieved successful adaptability is gradually developing a philosophy of life and a system of values ​​that serve him well in various fields of practice - study or work, as well as relations with all people with whom he comes in contact, younger or older. ” (Crow xnumx, 20 – 21).

A later source in The Encyclopedia of Positive Psychology notes that

“In psychological research, adaptability refers to both achieving the result and the process ... Psychological adaptability is a popular measure of assessing results in psychological research, and measures such as self-esteem or lack of stress, anxiety, or depression are often used as indicators of adaptation. Researchers can also measure a person’s level of adaptability or well-being in response to some kind of stressful event, such as divorce or lack of deviant behavior, such as alcohol or drug use. ” (Seaton in Lopez 2009, 796 – 7).

Both the excerpt from the 1967 book of the year and the later quotation from the encyclopedia correspond to the definitions from the studies mentioned by Gonsiorek. Gonsiorek cites numerous studies in which

“Significant differences were found between homosexual, heterosexual and bisexual groups, but not to the level that psychopathology could offer. Methods were used to measure the level of depression, self-esteem, relationship problems and problems in sexual life. ” (Gonsiorek, 1991.

Obviously, the “adaptability” of an individual is determined (at least in part) by measuring “depression, self-esteem, problems in relationships and problems in sexual life”, stress and anxiety. Then, it is assumed that a person who does not suffer from stress or depression, has a high or normal self-esteem, can maintain a relationship and sexual life, will be considered “fit” or “well fit”. Gonsiorek claims that since homosexuals are similar to heterosexuals in terms of depression, self-esteem, relationship problems and problems in their sexual lives, it automatically follows that homosexuality is not a disorder, because, as Gonsiorek notes: “The general conclusion is clear: these studies overwhelmingly suggest that homosexuality as such is not related to psychopathology or psychological adaptability” (Gonsiorek, 1991, 115 – 36). Here is a simplified Gonsiorek argument:

1. There are no measurable differences in depression, self-esteem, relationship problems and problems in sexual life between homosexual people and heterosexuals;
2. Therefore, homosexuality is not a psychological disorder.

Like the conclusion of Evelyn Hooker, the conclusion of Gonsiorek does not necessarily follow from the data that, in his opinion, supports him. There are many mental disorders that do not lead to a person experiencing anxiety and depression or have low self-esteem; in other words, “adaptability” is not an appropriate measure of determination to determine the psychological normality of each process of thinking and behavior that is associated with these mental processes. Depression, self-esteem, “imbalance of relations”, “sexual dissonance”, suffering and the ability to act in society are not related to every mental disorder; that is, not all psychological disorders lead to a violation of "adaptability". This idea is mentioned in The Encyclopedia of Positive Psychology. It notes that measuring self-esteem and happiness to determine adaptability is problematic.

These are subjective measurements, as the author notes,

“... that are subject to social desirability. An individual may not be aware and, therefore, may not be able to report his or her violation or mental illness. Similarly, people with severe mental illnesses may nevertheless report that they are happy and content with their lives. Finally, subjective well-being necessarily depends on the specific situation. ” (Seaton in Lopez 2009.

To demonstrate this, consider some examples. Some pedophiles claim that they do not experience any problems with their “intense sexual interest” in children, and can fully function in society. The American Psychiatric Association indicates for pedophilia that:

“... if individuals also report that their sexual attraction to children causes psychosocial difficulties, then they can be diagnosed with pedophilic disorder. However, if they report a lack of guilt, shame or anxiety about such an attraction and are not functionally limited by their paraphilic impulses (according to self-report, objective assessment, or both) ... then these people have pedophilic sexual orientation, but not pedophilic disorder ". (American Psychiatric Association 2013, 698, selection added).

In addition, people who suffer from apotemophilia and auto-mutation can fully function in society; it was previously noted that such behavior is observed in “high-performance populations, such as high school students, college students and military personnel” (Klonsky 2007, 1040). They can function in society, just as adults with “intense sexual interest” in children can function in society and not suffer from stress. Some anorexicics may “remain active in social and professional functioning” (American Psychiatric Association 2013, 343), and the continued use of non-nutritious, non-food substances (such as plastic) "is rarely the only cause of impaired social functioning"; APA does not mention that depression, low self-esteem, or problems in relationships or sexual life is a condition for diagnosing a mental disorder in which people eat non-nutritious, non-food substances in order to enjoy themselves (this deviation is known as peak syndrome) (American Psychiatric Association 2013, 330 -1).

The American Psychiatric Association also mentions that Tourette’s syndrome (one of the tick disorders) can occur without functional consequences (and therefore without any relation to “adaptability” measures). They write that “Many people with moderate to severe ticks have no problems functioning, and they may not even know that they have ticks” (American Psychiatric Association 2013, 84). Tick ​​disorders are disorders that manifest as involuntary uncontrolled actions (American Psychiatric Association 2013, 82) (that is, patients claim that they do not intentionally make quick, recurrent, irregular movements or utter sounds and words (often obscene), other patients may generally claim that they were “born that way”). According to the DSM ‑ 5 handbook, stress or impaired social functioning are not required in order to be diagnosed with Tourette’s syndrome, and therefore this is another example of a mental disorder in which adaptability measures are not relevant. This is a disorder in which adaptability cannot be used as scientific evidence of whether Tourette’s disorder is not a mental disorder.

Finally, a mental disorder unrelated to “adaptability” is delusional disorder. Persons with delusional disorder have false beliefs that

“... are based on a false perception of external reality, which is firmly held, despite the fact that such perception is rejected by other people, and on the fact that there is irrefutable and obvious evidence to the contrary.” (American Psychiatric Association 2013, 819)

The American Psychiatric Association notes that “with the exception of the direct influence of delirium or its consequences, the functioning of the individual does not noticeably deteriorate, and behavior is not strange” (American Psychiatric Association 2013, 90). In addition, “the common characteristic of individuals with delusional disorder is the apparent normality of their behavior and appearance when they do not act according to their delusional ideas” (American Psychiatric Association 2013, 93).

Individuals with delusional disorder do not appear to show signs of "impaired fitness"; apart from their immediate delusional ideas, they seem normal. Thus, delusional disorder is a prime example of a mental disorder that is not associated with measures of adaptation; fitness has nothing to do with delusional disorder. It can be said that homosexuals, although their behavior is a manifestation of a mental disorder, "appear normal" in other aspects of their life, such as social functioning and other areas of life where maladjustment may occur. Consequently, there are many mental disorders in which the measurement of fitness has nothing to do with mental disorder. This is a serious flaw in the literature used as scientific evidence to support the conclusion that homosexuality is not a mental disorder.

This is an important conclusion, although I am not the first to mention the problem of diagnosing mental disorders through the prism of assessing stress, social functioning or parameters, which are included in the terms “adaptability” and “adaptation”. This issue was discussed in an article by Robert L. Spitzer and Jerome C. Wakefield on the diagnosis of psychiatric abnormalities based on a clinically evident disorder or impaired social functioning (the article was written as a criticism of the older version of the Diagnostic and Statistical Manual, but the critical arguments apply to my discussion) .

Spitzer and Wakefield noted that in psychiatry, some mental disorders are not correctly identified due to the fact that

“[In psychiatry] it is a practice to determine that a condition is pathological, based on an assessment of whether this condition causes stress or impairment in social or individual functioning. In all other areas of medicine, the condition is considered pathological if there are signs of biological dysfunction in the body. Separately, neither stress nor impaired social functioning are sufficient to establish the majority of medical diagnoses, although both of these factors often accompany severe forms of the disorder. For example, the diagnosis of pneumonia, cardiac abnormalities, cancer, or numerous other physical disorders can be made even in the absence of subjective stress and even with successful functioning in all social aspects."(Spitzer and Wakefield, 1999.

Another disease that can be diagnosed without stress or impaired social function, which should be mentioned here, is HIV / AIDS. HIV has a long latent period, and many people for a long time do not even know that they are HIV-infected. By some estimates, 240 000 people do not know that they have HIV (CDC 2014).

Spitzer and Wakefield imply that a disorder can often be present even if the individual is functioning well in society or has high rates of “adaptability”. In some cases, the practice of assessing stress and social functioning leads to “false negative” results in which the individual has a mental disorder, but such a disorder is not diagnosed as a violation (Spitzer and Wakefield, 1999, 1856). Spitzer and Wakefield give many examples of mental conditions in which a false-negative assessment is possible if only the level of social functioning or the presence of stress is used as diagnostic criteria. They noted that

“Often there are cases of individuals who have lost control over the use of drugs and as a result experience various disorders (including health risks). However, such individuals are not stressed and can successfully fulfill a public role. Consider, for example, the case of a successful stockbroker who was addicted to cocaine to an extent that threatened his physical health, but who did not experience stress and whose social functions were not impaired. If the “DSM – IV” criteria is not applied to this case, then the condition of drug dependence is correctly diagnosed in such an individual. Applying the “DSM – IV” criteria, the condition of this individual is not a disorder ” (Spitzer and Wakefield, 1999.

Spitzer and Wakefield give other examples of mental disorders that will not be diagnosed as a disorder if we consider only the presence of stress and the level of social functioning; among them are some paraphilia, Tourette’s syndrome and sexual dysfunctions (Spitzer and Wakefield, 1999, 1860 – 1).

Others investigated the discussion by Spitzer and Wakefield, noting that the definition of mental disorder, which is based on a measurement of adaptability (“having stress or impaired social functioning”), is circular, namely:

“Spitzer and Wakefield (1999) were some of the most well-known critics of the eligibility criterion, calling its introduction to“ DSM – IV ”“ strictly conceptual ”(p. 1857) rather than empirical. The fuzziness and subjectivity of this criterion are considered especially problematic and lead to vicious circle situations as applied to the definition: the disorder is determined in the presence of clinically significant stress or impaired functioning, which themselves are a disorder significant enough to be considered a disorder ... The use of the adaptability criterion does not coincide with the general medicine paradigm according to which stress or functional impairment is usually not required for diagnosis. Indeed, many asymptomatic conditions in medicine are diagnosed as pathologies based on pathophysiological data or in the presence of an increased risk (for example, early malignant tumors or HIV infection, arterial hypertension). To assume that such disorders do not exist until they cause stress or disability would be unthinkable. ” (Narrow and Kuhl in Regier 2011, 152 – 3, 147 – 62)

The above quote refers to “DSM – IV,” but the lack of the criterion of “stress or disruption in social functioning” is still used to argue that homosexuality is not a mental disorder. Moreover, as the quote rightly points out, the definition of a mental disorder that is based on “stress or a disturbance in social functioning” as a criterion is circular. Vicious circle definitions are logical errors; they are meaningless. The approach to the definition of “mental disorder”, according to which the American Psychiatric Association and APA base their claim on homosexuality, is based on the criterion of “stress or impairment in social functioning”. Thus, the statement about homosexuality as a norm is based on a meaningless (and outdated) definition.

Dr. Irving Bieber, “One of the key participants in the historical debate, culminating in the 1973 decision to exclude homosexuality from the directory of psychiatric disorders” (NARTH Institute), admitted this error in the argument (the same issue was considered in the article Socarides (Xnumx), 165, below). Bieber identified the problematic criteria of the American Psychiatric Association for the diagnosis of sexual disorders. In a summary of Bieber's article, it is noted that

“... The [American] Psychiatric Association has pointed out the excellent professional performance and good social adaptation of many homosexuals as evidence of the normality of homosexuality. But the mere presence of these factors does not exclude the presence of psychopathology. Psychopathology is not always accompanied by adaptability problems; therefore, to identify a psychological disorder, these criteria are actually inadequate. ” (NARTH Institute nd)

Robert L. Spitzer, a psychiatrist who participated in the exclusion of homosexuality from the directory of psychiatric disorders, quickly realized the inappropriateness of measuring “adaptability” in diagnosing mental disorders. Ronald Bayer in his work summarized the events associated with the decision of the American Psychiatric Association (1973), noting that

“... during the decision to exclude homosexuality from the list of excursions, Spitzer formulated such a limited definition of mental disorders that was based on two points: (1) that behavior was recognized as a mental disorder, such behavior should be regularly accompanied by subjective stress and / or“ some general worsening social performance or functioning. ” (2) According to Spitzer, with the exception of homosexuality and some other sexual abnormalities, all the other diagnoses in DSM – II met a similar definition of disorders. ” (Bayer, 1981.

However, as Bayer notes, “during the year even he [Spitzer] was forced to admit“ the inadequacy of his own arguments ”(Bayer, 1981, 133). In other words, Spitzer acknowledged the inappropriateness of assessing the level of “stress,” “social functioning,” or “adaptability” to determine mental disorder, as was shown in his later article cited above (Spitzer and Wakefield, 1999).

Obviously, at least some of the mental disorders officially included in the DSM handbook do not cause problems with “adaptability” or social functioning. Individuals who cut themselves with razor blades for pleasure, as well as those who have intense sexual interest and sexual fantasies about children, clearly have mental abnormalities; anorexics and individuals who eat plastic are officially considered people with mental disabilities according to the DSM ‑ 5, and individuals with delusional disorder are also officially considered mentally ill. However, many of the above pedophiles, automutilants, or anorexics seem normal and "do not experience any problems in social functioning." In other words, many people who are not mentally normal can function in society and do not show signs or symptoms of “impaired adaptability”. Other mental disorders appear to have latent periods or periods of remission, during which patients are able to function in society and seem clearly normal.

People with homosexual tendencies, people with delusional disorder, pedophiles, auto-mummers, eaters of plastic and anorexic, can function normally in society (again, at least for a certain period of time), they do not always show signs of “impaired adaptability” . Psychological adaptability is not related to certain mental disorders; that is, studies that consider measures of “adaptability” as a measurable parameter are inadequate to determine the normality of psychological processes of thinking and the behavior associated with them. Consequently, (obsolete) studies that have used psychological adaptability as a measurable parameter have flaws, and their data are insufficient to prove that homosexuality is not a mental disorder. It follows that the statement by APA and the American Psychiatric Association that homosexuality is not a mental disorder is not supported by the data to which they refer. The evidence they cite is not relevant to their conclusion. This is an absurd conclusion drawn from irrelevant sources. (Moreover, with regard to conclusions not arising from the results: Gonsiorek's assertion that there is no difference between homosexuals and heterosexuals in terms of depression and self-esteem also turns out to be untrue in itself. It has been shown that homosexual individuals are more marked higher than heterosexuals, the risk of severe depression, anxiety and suicide, (Bailey 1999; Collingwood xnumx; Fergusson et al., 1999; Herrell et al., 1999; Phelan et al., 2009; Sandfort et al. Xnumx). It should be noted that these statistics are often used to infer that discrimination is the cause of such differences in stress, anxiety and suicidality. But this is another conclusion that does not necessarily follow from the premise. In other words, it is impossible to make an unambiguous conclusion that depression, etc., are a consequence of stigma, and not a pathological manifestation of the condition. This must be scientifically proven. Perhaps both are true: depression, etc., are pathological, and homosexual individuals are not perceived as normal, which, in turn, further increases the stress of such individuals.

“ADAPTABILITY” AND SEXUAL DEVIATIONS

Next, I want to consider the consequences of using only measures of “adaptability” and social functioning to determine whether sexual behavior and the thought processes associated with it are a deviation. By the way, it should be said that this approach is selective and does not apply to all psychosexual disorders. One wonders why APA and the American Psychiatric Association consider only “adaptability” and measures of social functioning to judge some forms of behavior (for example, pedophilia or homosexuality), but not for others? For example, why do these organizations not consider other aspects of paraphilia (sexual perversions) that clearly indicate their pathological nature? Why is the condition in which a person masturbates to an orgasm, fantasizing about causing psychological or physical suffering to another person (sexual sadism), not considered a pathological deviation, but the condition in which a person has delusional disorder is considered a pathology?

There are people who are sure that insects or worms live under their skin, although a clinical examination clearly shows that they are not infected with any parasites; such people are diagnosed with delusional disorder. On the other hand, there are men who believe that they are women, although a clinical examination clearly indicates the opposite - and, nevertheless, these men are not diagnosed with delusional disorder. Individuals with other types of sexual paraphilia showed the same rates of adaptation and adaptability as homosexuals. Exhibitionists are individuals with strong motives to show their genitals to other people who are not expecting this in order to experience sexual arousal (American Psychiatric Association 2013, 689). One source notes that

“Half to two-thirds of exhibitionists enter into normal marriage, achieving satisfactory rates of marital and sexual adaptability. Intelligence, educational level and professional interests do not distinguish them from the general population ... Blair and Lanyon noted that in most studies it was found that exhibitionists suffered from feelings of inferiority and considered themselves timid, socially non-integrated and had problems expressed in social hostility. In other studies, however, it was found that exhibitionists do not have noticeable changes in terms of the functioning of the individual ”. (Adams et al., 2004, added selection).

A satisfactory level of social functioning in combination with deviant forms of sexual desire can also be observed among sadomasochists. Sexual sadism, as I mentioned earlier, is “Intense sexual arousal from the physical or psychological suffering of another person, which manifests itself in fantasies, urges, or behavior” (American Psychiatric Association 2013, 695); sexual masochism is “Recurrent and intense sexual arousal from experiencing an act of humiliation, beating, immobilization or any other form of suffering that manifests itself in fantasies, impulses or behavior"(American Psychiatric Association 2013, 694). A study in Finland found that sadomasochists are “well-adapted” socially (Sandnabba et al., 1999, 273). The authors noted that 61% of sadomasochists surveyed “Occupied a leading position in the workplace, and 60,6% were active in public activities, for example, they were members of local school boards” (Sandnabba et al., 1999.

Thus, both sadomasochists and exhibitionists do not necessarily have problems with social functioning and disruption (again, the terms that were included in the umbrella term “adaptability”). Some authors noted that the “defining features” of all sexual deviations (also known as paraphilia) “can be limited by the individual’s sexual behavior and cause minimal deterioration in other areas of psychosocial functioning” (Adams et al., 2004)).

“At present, there are no universal and objective criteria for assessing the adaptive involvement of sexual behavior and practice. With the exception of sexual murder, no form of sexual behavior is universally considered dysfunctional ... The rationale for excluding homosexuality from the category of sexual deviations seems to be the lack of evidence that homosexuality itself is a dysfunction. However, it is curious that the same logical line of reasoning did not apply to other deviations, such as fetishism and consensus sadomasochism. “We agree with Laws and O'Donohue that these conditions are not inherently pathological, and their inclusion in this category reflects inconsistencies in the classification.” (Adams et al., 2004)

Consequently, the authors suggest that the only form of sexual behavior that is “universally considered dysfunctional” (and therefore universally considered a mental disorder) is sexual killing. They came to this conclusion, implying that any sexual behavior and related thought processes that do not cause deterioration in social functioning or “adaptability” measures are not a sexual deviation. As I explained above, such logic is erroneous, and leads to erroneous conclusions. It is obvious that not all sexual deviations are normal, but that some psychiatrists and psychologists have misled society by referring to irrelevant measures to assess the mental state as evidence that the condition is normal. (I am not saying that this was done intentionally. Sincere mistakes could also have been made.)

The catastrophic consequences of such an approach, in which the only way to determine whether a sexual drive (behavior) is a deviation or a norm, are using irrelevant measures of assessing “adaptability” and social functioning, are observed in discussions in the DSM ‑ 5 handbook on sexual sadism and pedophilia .

The American Psychiatric Association no longer considers sexual sadism a deviation. The American Psychiatric Association writes:

“Individuals who openly admit to having an intense sexual interest in the physical or psychological suffering of others are called “admitting individuals.” If these individuals also report psychosocial difficulties due to their sexual interest, then they may be diagnosed with sadistic sexual disorder. In contrast, if "confessed individuals" state that their sadistic urges do not cause them feelings of fear, guilt or shame, obsessions, or interfere with their ability to perform other functions, and their self-esteem and psychiatric or legal history indicate that that they do not realize their impulses, then such individuals should have a sadistic sexual interest, but such individuals will not meet the criteria for sexual sadism disorder. " (American Psychiatric Association 2013, 696, original selection)

Consequently, the American Psychiatric Association does not consider that in itself “Sexual attraction to physical or psychological suffering” the other person is a mental disorder. In other words, sexual attraction and fantasies occur in the form of thoughts, that is, the thoughts of a person who thinks about the physical and psychological harm to another person in order to stimulate himself to orgasm, the American Psychiatric Association is not considered pathological.

It should be noted that the American Psychiatric Association also does not consider pedophilia in itself as a mental disorder. Having similarly indicated that the pedophile can reveal the presence of “intense sexual interest in children,” they write:

“If individuals indicate that their sexual attraction to children causes psychosocial difficulties, they may be diagnosed with pedophilic disorder. However, if these individuals report a lack of guilt, shame, or anxiety about these motives, and they are not functionally limited by their paraphilic impulses (according to self-report, objective assessment, or both), and their self-report and legal history show that they never acted according to their impulses, then these people have a pedophilic sexual orientation, but not a pedophilic disorder ” (American Psychiatric Association 2013.

Again, sexual fantasies and “intense sexual attraction” occur in the form of thought, which is why the 54-year-old man who has an “intense sexual interest” in children, constantly reflecting on sex with children to stimulate himself to orgasm, according to the American Psychiatric Association, has no deviations. Irving Bieber made the same observation in the 1980's, which can be read in the summary of his work:

“Is a happy and well-adapted pedophile“ normal ”? According to Dr. Bieber ... psychopathology can be ego-syntonic - not cause deterioration, and social effectiveness (that is, the ability to maintain positive social relations and efficiently perform work) can coexist with psychopathology, in some cases even psychotic in nature ”system. (NARTH Institute nd).

It is very disturbing that sadistic or pedophilic motives may be deemed not to meet the criteria for a mental disorder. Michael Woodworth et al. Drew attention to the fact that

“... sexual fantasy is defined as almost any psychic stimulus that causes an individual's sexual arousal. The content of sexual fantasies varies greatly between individuals and is believed to be highly dependent on internal and external stimuli, such as what people see, hear and experience directly. ” (Woodworth et al., 2013.

Sexual fantasies are mental images or thoughts that lead to arousal, and these fantasies are used to stimulate orgasm during masturbation. The content of sexual fantasies depends on what people see, hear and experience directly. Thus, it is not surprising to assume that the pedophile, in the neighborhood with whom the children live, will have sexual fantasies with these children; it will also not be surprising to assume that a sadist fantasizes about causing psychological or physical suffering to his neighbor. However, if a sadist or pedophile does not experience discomfort or impaired social functioning (again, these terms are included in the "umbrella term" "adaptability") or if they do not realize their sexual fantasies, then they are not considered to have mental deviations. Sexual fantasies or thoughts about having sexual intercourse with an 10-year-old child in the mind of an 54-year-old pedophile or fantasies or thoughts of a sadist fantasizing about causing psychological or physical suffering to his neighbor are not considered pathological if they are not stressed, impaired, or do not cause social functioning harm to others.

Such an approach is arbitrary, on the basis of a mistaken assumption, an absurd conclusion is given that any thought process that does not cause a violation of adaptability is not a mental disorder. You will see that APA and the American Psychiatric Association have dug themselves a deep hole with a similar approach to identifying sexual disorders. It seems that they have already normalized any sexual deviations and practices in which there is a “consent” of those who participate in such practices. To be consistent with the similar logic used to normalize homosexuality, they must normalize all other forms of sexual behavior that stimulate orgasm that do not cause a deterioration in “adaptability” or do not lead to impaired social functioning. It is worth noting that according to this logic, even sexual behavior in which another person is harmed is not considered a deviation - if the individual agrees. Sadomasochism is a behavior in which one or another individual is stimulated to orgasm by causing or receiving suffering, and, as I said above, this behavior is considered normal by the American Psychiatric Association.

Some might call this article a “shaky argument,” but that would be a misunderstanding of what I’m trying to convey: The American Psychiatric Association has already normalized all orgasmic-stimulating behaviors, except those that cause “adjustment” problems (stress, etc.) problems in social functioning, harm to health or the risk of causing such harm to another person. In the latter case - "harm or risk of harm" - an asterisk is needed, because this criterion allows exceptions: if mutual consent is obtained, then orgasm-stimulating behavior is allowed, even leading to harm to health. This is expressed in the normalization of sadomasochism, and this explains why pedophile organizations so insist on lowering the age of consent (LaBarbera 2011).

Thus, the accusation that this article makes shaky arguments is unfounded: all of these mental disorders have already been normalized by the American Psychiatric Association. It is alarming that the authority of the organization normalizes any behavior that leads to orgasm, if consent is obtained for such behavior; that normalization is the result of a misconception that “any stimulating orgasm behavior and related mental processes that do not lead to problems with adaptability or social functioning are not a mental disorder.” This is insufficient argumentation. Although at least one more article is required to fully disclose the principle of determining what constitutes a mental and sexual disorder, I will try to summarize some criteria. It was shown above that modern “mainstream” psychology and psychiatry arbitrarily determine that any sexual behavior (with the exception of sexual murder) is not a mental disorder. I have already mentioned that many mental disorders are associated with the nonphysiological use of one's own body - apotemophilia, auto-mutation, peak and anorexia nervosa. Other mental disorders can also be mentioned here.

Physical disorders are often diagnosed by measuring the functioning of organs or systems of the body. Any doctor or specialist who claims that there is no such thing as the functioning of the heart, lungs, eyes, ears or other systems of the organs of the body would be called, at best, a careless ignoramus, if not a criminal in a dressing gown, from whom you must immediately take a medical diploma. Thus, physical disorders are somewhat easier to diagnose than mental disorders, because physical parameters are more accessible for objective measurement: blood pressure, heart rate and respiratory rate, etc. These measurements can be used to determine the state of health or disorder. certain organs and organ systems. So, in the field of medicine, the basic principle is that there are normal function of organs and systems. This is the fundamental and fundamental principle of medicine that must be recognized by any practitioner, otherwise they have nothing to do with medicine (they will be reduced to "medicine according to Alfred Kinsey", in which every organ of the body will simply have a normal continuum of functionality).

Orgasm-related organs have been (arbitrarily) excluded from this fundamental principle of medicine. Mainstream authors seem to arbitrarily ignore the fact that the genitals also have a proper rate of physical functioning.

The mental normativeness of sexual behavior can be (at least partially) determined by the physical normativeness of sexual behavior. Thus, in relation to men who have sex with men, physical trauma caused by genital-anal friction is a physical violation; sexual anal contact almost always leads to physical disturbances in the anorectal region of the receptive participant (and, possibly, in the area of ​​the penis of the active participant):

“Anus’s optimal health requires the integrity of the skin, which acts as a primary defense against invasive pathogens of infections ... A decrease in the protective functions of the mucous complex of the rectum is observed in various diseases transmitted through sexual anal contact. The mucous membrane is damaged during anal intercourse.and pathogens easily penetrate directly into crypts and columnar cells ... The mechanics of anoreceptive intercourse, in comparison with vaginal intercourse, are based on an almost complete violation of the cellular and mucous protective functions of the anus and rectum ” (Whitlow in Beck xnumx, 295 – 6, selection added).

It seems to me that the information presented in the previous quote is a proven solid scientific fact; It seems to me that a researcher, medical practitioner, psychiatrist or psychologist who denies this fact would at best be called a careless ignoramus, if not a criminal in a dressing gown who should immediately take a medical diploma.

Thus, one of the criteria for whether sexual behavior is normal or deviant may be whether it causes physical harm. It seems obvious that sexual anal contact is a physical disturbance, causing physical harm. Since many men who have sex with men want to perform these physically deviant actions, therefore, the desire to participate in such actions is deviant. Since desires arise at the “mental” or “mental” level, it follows that such homosexual desires are a mental deviation.

Further, the human body contains various types of fluids. These fluids are "physical", they have physical functions within normal limits (again, this is just a physiological given - fluids in the human body have certain proper functions). Saliva, blood plasma, interstitial fluid, lacrimal fluid - have proper functions. For example, one of the functions of blood plasma is to transfer blood cells and nutrients to all parts of the body.

Sperm is one of the fluids of the male body, and therefore (unless a selective approach to the field of medicine is applied), sperm also has proper physical functions (or several proper functions). Sperm, as a rule, contains many cells, known as sperm, and these cells have the proper purpose where they should be transported - to the cervical region of a woman. Thus, the physically ordered sexual intercourse of a man would be one in which the sperm would physically function properly. Therefore, another criterion for normal sexual behavior is the condition in which the sperm functions properly, sperm are delivered to the cervix.

(Some may argue that some men may have azoospermia / aspermia (lack of sperm in the semen), so they may claim that the normal function of sperm is not to deliver sperm to the woman’s cervix, or they may state that, according to to my argument, individuals with aspermia can release their ejaculate wherever they wish. However, azoospermia / aspermia is an exception to the norm and is the result of either a “profound violation of the process of sperm formation (special matogeneza) due to the pathology of the testes ... or, more commonly, genital tract obstruction (eg due to a vasectomy, gonorrhea or Chlamydia infection) "(Martin 2010, 68, sv azoospermia). In the body of healthy males, sperm are produced, while males with medical impairments may have conditions in which it is impossible to measure the amount of sperm in the semen. If there are objective normal functions of any parts of the body, then a violation or absence of one part of the body does not necessarily lead to a change in the function of another part of the body. Such a statement would be similar to the statement that the normal function of blood plasma is not to deliver red blood cells and nutrients throughout the body, as some people have anemia.)

It is also very obvious that the body has a system of “pleasure and pain” (which can also be called a “system of reward and punishment”). This system of pleasure and pain, like all other systems and organs of the body, has a proper function. Its main function is to act as a sender of a signal to the body. The pleasure and pain system tells the body what is “good” for it and what is “bad” for it. The system of pleasure and pain, in a sense, regulates human behavior. Eating, excretion of urine and feces, sleep - these are forms of ordinary human behavior that include some degree of pleasure as a motivator. Pain, on the other hand, is either an indicator of physically deviant human behavior, or a violation of the organ of the body. Pain associated with touching a hot plate prevents it from touching the burn and getting burned, while painful urination often indicates a problem with the organ (bladder, prostate, or urethra).

A person with “congenital insensitivity to pain with anhidrosis (CIPA)” cannot feel pain, and therefore it can be said that the pain system is impaired (using common non-medical terms). This system does not send the right signals to the brain to regulate the body's behavior. The pleasure system may also be impaired, this is observed in people with “agovesia” who do not feel the taste of food.

Orgasm is a special type of pleasure. It has been compared with the effects of drugs such as opiates (heroin) (Pfaus xnumx, 1517). Orgasm, however, is achieved normally in people who have normally functioning genitals. Some (apparently including the American Psychiatric Association) hold that orgasm is a type of pleasure that is good in itself, regardless of the circumstances conducive to orgasm.

Again, another article is needed to state all the shortcomings of such a statement.

However, in short, if the authorities in the field of medicine are consistent (and not selective), they must recognize that the pleasure associated with orgasm serves as a signal or message to the brain that something good has happened to the body. This "something good" associated with orgasm is the stimulation of the penis until sperm ejection in the cervix. Any other type of orgasmic stimulation (for example, any type of masturbation — be it self-stimulation, same-sex contact, or mutual masturbation with the opposite sex — is an abuse of the pleasure system. Abuse of the pleasure system during masturbation (and in all same-sex orgasm-stimulating actions) may be better explained by the example of other bodily pleasures.If it was possible at the touch of a button to cause a feeling of "satiety" associated with food, then constant pressing of such a button would be an abuse of s pleasure system. The pleasure system will send "false" wrong signals to the brain. The pleasure system will in some sense "lie" to the body. If the body felt the pleasure associated with a good night's rest, but really would not rest at all; or pleasure from urination or defecation, without actual urination or defecation, in the end, serious physical disturbances will occur in the body.

Thus, another criterion for determining whether sexual behavior is normal or deviant is to determine whether sexual behavior leads to disturbances in the functioning of the pleasure system or pain in the body.

Finally, it goes without saying that consent (correspondingly achieving the required age of consent) is a criterion that must be associated with the definition of healthy from impaired "sexual orientation".

CONCLUSIONS

The American Psychiatric Association and APA cite the above studies as scientific evidence that homosexuality is a normal variant of a person’s sexual orientation. APA noted that homosexuality as such does not imply a deterioration in thinking, stability, reliability and overall social and professional potential. In addition, APA calls on all mental health professionals to take the initiative to address the stigma of mental illness that has long been linked to homosexuality (Glassgold et al., 2009, 23 – 24).

The APA Expert Opinion repeats the same statement, as a justification for this statement it refers to the aforementioned literature, which addresses “adaptability” and social functioning (Brief of Amici Curiae 2003, 11). However, adaptability and social functioning have not been shown to be relevant to determining whether sexual deviations are mental disorders. As a result, scientific studies that examined only measures of adaptability and social functioning lead to erroneous conclusions and show “false negative” results, as noted by Spitzer, Wakefield, Bieber and others. Unfortunately, catastrophically erroneous reasoning served as the basis for the alleged “Scrupulous and convincing evidence”which hides the assertion that homosexuality is not a mental deviation.

It is impossible to conclude that certain human behavior is normal simply because it is more prevalent than previously thought (according to Alfred Kinsey), otherwise all forms of human behavior, including serial murder, should be considered the norm. It is impossible to conclude that there is "nothing unnatural" about certain behavior simply because it is observed in both humans and animals (according to C.S. Ford and Frank A. Beach), otherwise cannibalism should be considered natural. Most importantly, it is impossible to conclude that a mental state is not deviant, because such a state does not result in impaired adjustment, stress, or impairment of social function (according to Evelyn Hooker, John C. Gonsiorek, APA, American Psychiatric Association and others), Otherwise, many mental disorders must be mistakenly labeled as normal. The conclusions cited in the literature cited by supporters of the normativity of homosexuality are not proven scientific fact, and dubious studies cannot be considered reliable sources.

APA and the American Psychiatric Association may have accidentally made catastrophic logical errors in selecting literature, which they cite as evidence to support the claim that homosexuality (and other sexual deviations) is not a mental disorder; this scenario is quite possible. Nevertheless, one should not be naive and ignore the opportunities that exist for powerful organizations to carry out propaganda science. There are serious discrepancies in the logical conclusions, as well as arbitrary application of the criteria and principles by those who are considered "authorities" in the field of psychiatry and psychology. The analysis of literature carried out in this article, which is referred to as “rigorous” and “convincing” empirical evidence, reveals its main shortcomings - irrelevance, absurdity, and obsolescence. Thus, the credibility of the APA and the American Psychiatric Association regarding the definition of sexual dysfunction is being called into question. Ultimately, suspicious stories and outdated data they are really used in debates on the topic of homosexuality, but authoritative organizations do not hesitate to apply this technique.

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¹ In the Anglo-Saxon legal system, there is an institution of “friends of the court” (amici curiae) - it refers to independent individuals assisting in the trial, offering their expert opinion relevant to the case, while the “friends of the court” themselves are not actually parties to business.

² Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation.

³ The American Psychiatric Association does not consider apotemophilia a violation; DSM-5 states: “Apotemophilia (not a violation according to“ DSM-5 ”) involves the desire to remove a limb in order to correct the discrepancy between the sensation of one’s own body and his or her actual anatomy. American Psychiatric Association 2014b, p. 246-7).

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ADDITIONAL INFORMATION

• Wright RH, Cummings NAeds. Destructive Trends in Mental Health: The Well ‑ Intentioned Path to Harm. New York and Hove: Routledge; Xnumx
• Satinover JF. The Trojan Couch: How the Major Mental Health Guilds Subverted Medical Diagnostics, Scientific Research and Jurisprudence to Undermine the Institution of Marriage, paper presented at the NARTH Conference November 12, 2005.
• Wright RH, Cummings NA, eds. Destructive Trends in Mental Health: The Well-Intentioned Path to Harm. New York and Hove: Routledge; Xnumx 
• Satinover JF. The Trojan Couch: How the Major Mental Health Guilds Subverted Medical Diagnostics, Scientific Research and Jurisprudence to Undermine the Institution of Marriage, paper presented at the NARTH Conference November 12, 2005. 
• Satinover JF. Neither Scientific nor Democratic. Linacre Quarterly. Volume 66 | Number 2; 1999: 80 - 89. https://doi.org/10.1080/20508549.1999.11877541 
• Socarides CW. Sexual Politics and Scientific Logic: The Issue of Homosexuality. The Journal of Psychohistory; Spring 1992; 19, 3; 307 - 329. http://psycnet.apa.org/record/1992-31040-001 
• Satinover JF. Homosexuality and the Politics of Truth. Baker Books, 1998. 
• Ruse A. Fake Science: Exposing the Left's Skewed Statistics, Fuzzy Facts, and Dodgy Data. Regnery Publishing, 2017. 
• van den Aardweg G. Male Homosexuality and the Neuroticism Factor: An Analysis of Research Outcomes. Dynamic Psychotherapy; 1985: 79: 79. http://psycnet.apa.org/record/1986-17173-001 
• Fergusson DM, Horwood LJ, Beautrais AL. Is Sexual Orientation Related to Mental Health Problems and Suicidality in Young People? Arch Gen Psychiatry. 1999; 56 (10): 876-880. https://doi.org/10.1001/archpsyc.56.10.876 
• Herrell R, et al. Sexual Orientation and Suicidality: A Co-Twin Control Study in Adult Men. Arch Gen Psychiatry. 1999; 56 (10): 867-874. https://doi.org/10.1001/archpsyc.56.10.867 
• Cameron P, Cameron K. Re-examining Evelyn Hooker: Setting the record straight with comments on Schumm's (2012) reanalysis. Marriage and Family Review. 2012; 48: 491 – 523. https://doi.org/10.1080/01494929.2012.700867 
• Schumm WR. Re-examining a landmark research study: A teaching editorial. Marriage and Family Review. 2012; 8: 465 – 89. https://doi.org/10.1080/01494929.2012.677388
  
• Cameron P, Cameron K, Landess T. Errors by the American Psychiatric Association, the American Psychological Association, and the National Educational, Association in representing homosexuality in amicus briefs about Amendment 2 to the US Supreme Court. Psychol Rep. 1996 Oct; 79 (2): 383-404. https://doi.org/10.2466/pr0.1996.79.2.383

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Open letter "On the need to return to domestic scientific and clinical practice the definition of the norm of sexual desire"