"We are not to simply bandage the wounds of victims beneath the wheels of injustice,
we are to drive a spoke into the wheel itself." Dietrich Bonhoeffer, Letters and Papers from Prison (1943-1945)

Sexuality in Crisis - Where is the Science?

It is a strange world where people may choose their own gender but be banned from changing their  orientation. The UK Government has now commenced a consultation on banning change therapy.

Prof. Michael King, a key player in these sexuality debates, died in September 2021. He was a psychiatrist and epidemiologist in the Faculty of Brain Sciences at University College, London. His research interests included the role of religious beliefs in mental well-being, and the stress and stigma faced by homosexuals. A gay man himself and a professing Christian, he entered a civil partnership in 2006 and gay marriage in 2017.

As a Member of the Royal College of Psychiatrists (RCPsych), he chaired the College’s small “Special Interest Group” in Homosexuality. In that role, he oversaw the production of the College submissions to the Church of England’s Pilling Commission (2012) and the Home Office Consultation on Equal Civil Marriage (2012), as well as various RCPsych ‘Position Statements’ on sex and gender.  He also produced a briefing paper for members of the C of E’s General Synod before their 2017 debate, which supported Jayne Ozanne’s successful motion for the Church to call on the Government to ban “Conversion Therapy.” 

In King’s view, sexual orientation was not a choice. He believed its causes were biological in nature, determined by genetic factors and the early uterine environment. He was adamant that there was no good evidence to show that the nature of parenting or a history of early childhood abuse had any role in shaping sexual orientation. Once formed, orientation itself could not be changed. It was innate and to attempt to change it was both unethical and potentially harmful. This RCPsych dogma was a major argument in the case for legalising Gay Marriage.

King was highly influential. He brought into being a Memorandum of Understanding from the UK Council of Psychotherapists, calling for UK mental health bodies to prohibit their counsellors from practicing “Conversion Therapy”. The definition of such therapy has been an ongoing source of contention. More than 50 years ago, when homosexual acts were illegal, some appalling therapies were available and homosexuals were often coerced into using them. These included drug and electric shock aversion therapies, surgical lobotomies and even ‘therapeutic rape’. Since the 1970s, the only therapies used within the National Health Service have been conversational therapies, where skilled counsellors can explore their clients hopes and fears, and support them in fulfilling their chosen objectives.

I can only hope that I have accurately reflected his views on these matters, but I cannot be sure. In April 2013, my colleague Dermot O’Callaghan and I wrote on behalf of Core Issues Trust to Prof. Sue Bailey, the President of the Royal College of Psychiatrists, seeking clarification on numerous matters of concern. We claimed the College submission to the Government was founded on gay ideology rather than science, and was written by an author with undeclared interests, distorting science to achieve political ends. 

We concluded our letter by saying, “We do not want to misrepresent the College. We realise these matters have international implications and many doctors and therapists look to the College for guidance and leadership. We want to give you the opportunity to respond before we take matters further. We would be happy to meet with you to discuss these issues, if that would be helpful.”  She did not reply - at all.  

On 11th June 2013, we received a letter from the College Registrar, Dr Laurence Mynors-Wallis, saying, “I do not propose to enter into a discussion about sexuality.”  Was this ‘silencing’ of debate an early sign of our emerging ‘cancel culture’?

In 2015, we therefore took our grievances to the General Medical Council, claiming that the College had an ethical obligation to address serious matters of scientific dispute raised by their publications. The GMC replied on 21st May 2015, “It is unfortunate that the doctors have been unwilling to engage in discourse with you and we understand this may be frustrating. We appreciate that you are dissatisfied with the contents of the reports, in particular that they may have influenced policy making, but…the GMC is not the appropriate forum for dealing with these matters and we will not be taking any further action.”

So if we have misunderstood any of the RCPsych statements, it was not without a serious effort to gain clarification as to what they meant and what the science was that they were relying on.

The major issues of concern for us are now these:

1)   If orientation is biological and innate, why does the evidence from the studies of identical twins not support this? And why has extensive research (Ganna, A. et al 2019) now found no evidence for a ‘gay gene’?

2)   It is well known that it is common among adolescents to experience a temporary, emotional or physical attraction to members of their own sex. If this happened to, say 50% of teenagers, it seems that only 1-2% develop a settled homosexual orientation.

3)  There has been a growing body of evidence that many adults are attracted to both sexes (as shown in the recent Ipsos MORI Poll, Jan 2021). Does this “sexual fluidity”, especially common among those aged under 25 yrs, not mean that such adolescents have a real choice? The RCPsych ‘Position Statement’ of April 2014 stated, “There is no evidence to impute any kind of choice into the origins of sexual orientation…There is no sound scientific evidence that sexual orientation can be changed.”

4) Does that not also mean there is no sound scientific evidence that orientation cannot be changed?

5)  Over the past generation, there has been increasing recognition that brain development is “plastic”, meaning that its nerve pathways and connections are not fixed but can change and develop, even into old age. Learning to play a musical instrument, speak a new language, and develop new skills are very much easier in early adult life but can even be achieved after retirement. Such things do not happen overnight but occur with practice and perseverance over a passage of time. Why has there been no public discussion about the role of neuro-plasticity in retraining and redirecting sexual responsiveness? Would Cognitive Behavioural Therapy not help?

6) In exploring the stories of homosexual people, the experience of feeling emotionally distant from  their same-sex parent is very common.  This lack of same-sex affection, affirmation and role-modelling from parents appears to find compensation in same-sex relationships. This is reported in celebrity biographies (eg. Elton John and Freddie Mercury) but also in every-day stories of those who want help to leave gay culture and behaviour. (See the recently published 44 testimonies in the important new book “X-OUT LOUD”, pub. Core Issues Trust 2021).

7) Sexual behaviours can be very addictive, pornography being a common example. Change can occur, but clients may need considerable on-going support and encouragement. As addicts know only too well, the possibility of relapse is a constant reality and any talk of ‘cure’ is inappropriate. I once asked a psychiatrist for advice as to what he thought was the prognosis for an abuser who was a ‘spanker’. He replied memorably, “In my clinical experience, once a spanker - always a spanker.” Certainly paedophilia can be very resistant to treatment, but aren’t these practices better understood to be addictive behaviours rather than innate dispositions?

8) King himself documented the increased psychological distress experienced by lesbians and gay men, including their drug and alcohol abuse, and self-harm, compared to heterosexuals (BJP 2003), but was deaf to the cries of those who wanted help to move away from gay culture.

9) Is transgender dysphoria acquired or is it innate? This has now become a major social issue.

The RCPsych Winter 2019 Newsletter, “The Psychiatric Eye”, published an interview with Prof. King. The final question from Dr. Sachin Shah was, “What areas are most important for future research?”  King replied:

“One of the key things I would do is understand the natural history of discontent with gender, or feelings that your gender identity is at odds with that assigned at birth. That would be very important. The other important thing is to understand much more about sexual orientation. It’s quite obvious that it is much more of a spectrum than we’ve hitherto thought. What appears to be coming from most recent studies with young people is that there’s a certain flow and flux along a spectrum. It’s much more likely that sexuality is on a spectrum, as most things in nature are. It would be really helpful to understand that more. To understand that many people have sexual responsiveness to the same or other sex, and it doesn’t classify them as being a certain type of person for their lives.”

Our questions, published in our book, “Beyond Critique - The Misuse of Science by UK Professional Mental Health Bodies” (Core Issues Trust, 2013) were clearly appropriate. The refusal of RCPsych to even discuss these issues was a major dereliction of duty on their part. The GMC was incapable of seeing the importance of intervening. Now, in the light of King’s astonishing volte-face, is the Church of England and the British Government still of a mind to join the international campaign to ban Counselling Therapy, and in so doing ban freedom of speech, freedom of belief and freedom of choice?

        Dr. Peter May,  MRCGP.      31.10.21

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