Pilling Report Reviewed No 7: Unscientific obfuscation

Report ignores important evidence that sexual orientation change therapy is increasingly discredited

Moving on through Part 2 of the Pilling Report we come to one entitled

Arguments about science

The first subsection here is the question, ‘Are human beings sexually dimorphic?’ The working group received presentations from Dr John Hare and Dr Susannah Cornwall (her surname is spelt incorrectly here in the pdf version of the Report I am using), who have both written on the theological implications of people with intersex conditions. However, no conclusions to this important question are offered at this point. This might be due to the structure of the Report, which postpones reflection until later, but I am not aware that it ever returns to it, and the question is left hanging, unless we are meant to draw our own conclusion from the reference (paragraph 197) to intersex conditions affecting ‘a small minority of people’.

It is true that relatively small numbers of people are affected by the specific intersex conditions noted in that paragraph, but, to quote my collaborator, Michelle O’Brien, who has written extensively in this field, ‘The numbers concerned are usually influenced by the person’s definition of what is genuinely intersex; …. The broader view places estimates as high as 2% of the population; the narrow view is that intersex is very rare.  Many people do not know that they are intersex, as this was kept from people for many years.’

Paragraph 198, the only detailed reference in the Report to transsexual people, claims that, ‘Unlike people with intersex conditions, their bodies are unambiguously either male or female’. Although generally true this is not always the case. For example, during gender reassignment surgery a gonad of the opposite gender is sometimes discovered in the body of someone who was assumed to be of ‘unambiguous’ gender. However, the Report is not simply inadequate in its discussion of intersex and transgender people, but in what it has to say about the subject of gender more generally, which is a serious weakness.

Paragraphs 199 & 200 address the question, ‘Is sexual attraction fixed and immutable’ to which the answer appears to be, ‘for some people it is, but not for all.’ The ‘causes of homosexuality’ comes next. It’s interesting to note – to quote a parallel example – that in the care of transgender people, aetiology is now considered largely irrelevant and the emphasis is on dealing with the reality rather than how it came about. The sources quoted by the Report emphasise that the causes of homosexuality are multi-factorial, which is also the case with transsexualism, and, as the Report accepts (paragraph 204), so is most human behaviour and experience.

The next three questions are, frankly, embarrassing. I had assumed that the working group had been exposed to sufficient evidence from their meetings with lesbian and gay people to convince them that the answer to the first question – ‘Is homosexuality harmful or is harm the result of social prejudice?’ – must be the latter, but no: ‘a causative link between social prejudice and health issues among gay and lesbian people is neither proven nor ruled out by the evidence.’ What evidence? The Core Issues Trust’s quibbles over three papers cited by the Royal College of Psychiatrists quoted in this section? A visit to the PACE website tells a very different and harrowing tale:

‘There are some problems that LGBT people face, such as discrimination, intolerance and harassment that may increase their risk of suicide. This is especially true for young people. One study found that young lesbian, gay and bisexual people were more than three times as likely as their straight peers to report having seriously considered suicide in the last year, while another found that nearly have of young transgender people had seriously considered suicide.’


And to imply that ‘homosexual orientation “and all it entails cuts against a fundamental, gender-based given of the human condition, thus causing distress”’ (paragraph 208), in a Report that gives such limited consideration to gender is almost laughable. What if the notion of a ‘fundamental, gender based given’ to human nature is itself a social construction that is part of the problem, as many feminists would argue?

The second question as to ‘the durability and stability of same sex relationships’ introduces the old stereotype that gay relationships are short-lived, accompanied by the now familiar disagreement from the Core Issues Trust about the papers submitted by the Royal College of Psychiatrists. On this limited basis, the working group concludes that there is an ‘absence of compelling evidence one way or another’ and so adopts ‘a neutral stance.’ I’m sure that Changing Attitude, England would be only too glad to introduce the working group to lesbian and gay couples whose relationships have lasted decades, but that might be confusing for them, as it would question the notion that the homosexual person is strange and other, whereas ‘the evidence’ is that some people, gay or straight, maintain monogamous, life-long relationships, and others do not: simple really.

The third question, ‘are sexual orientation change efforts [SOCE] effective or do they do harm’, masks, as the Report admits, ‘a more fundamental divergence of opinion over whether seeking to reduce or overcome same sex attraction is a legitimate activity.’ The Royal College of Psychiatrists is in no doubt ‘That this can be deeply damaging … and … there is no evidence that such change is possible (paragraph 215). This should be conclusive, but no, we are told that the effectiveness of such therapy remains uncertain because of the lack of ‘randomized, controlled trials’, and that in their absence we have to rely on such studies as exist and on ‘anecdotal evidence’.

The Report seems to have forgotten what it informed us, at paragraph 49, that one of the biggest US players, ‘Exodus International – dedicated to helping people overcome same sex attraction has decided that their activities caused harm and ceased that aspect of their ministry.’ UK based group Courage has also done the same. These examples are significant evidence that SOCE is increasingly discredited as an effective therapy. This is not to say that some individuals are not helped by it, but they are a tiny minority.

It’s worth recalling, as the section ends, that its subject was meant to be scientific arguments about homosexuality, though the scientific evidence seems incredibly thin. An assessment of its significance is promised in Part 3, which I will come to … eventually.

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