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Excerpted from "The Complex Interaction of Genes and Environment: A Model for Homosexuality" by Jeffrey Satinover,M.D.

It may be difficult to grasp how genes, environment, and other influences interrelate to one another, how a certain factor may "influence" an outcome but not cause it, and how faith enters in. The scenario below is condensed and hypothetical, but is drawn from the lives of actual people, illustrating how many different factors influence behavior.

Note that the following is just one of the many developmental pathways that can lead to homosexuality, but a common one. In reality, every person's "road" to sexual expression is individual, however many common lengths it may share with those of others.

(1) Our scenario starts with birth. The boy (for example) who one day may go on to struggle with homosexuality is born with certain features that are somewhat more common among homosexuals than in the population at large. Some of these traits might be inherited (genetic), while others might have been caused by the "intrauterine environment" (hormones). What this means is that a youngster without these traits will be somewhat less likely to become homosexual later than someone with them.

What are these traits? If we could identify them precisely, many of them would turn out to be gifts rather than "problems," for example a "sensitive" disposition, a strong creative drive, a keen aesthetic sense. Some of these, such as greater sensitivity, could be related to - or even the same as - physiological traits that also cause trouble, such as a greater-than-average anxiety response to any given stimulus.

No one knows with certainty just what these heritable characteristics are; at present we only have hints. Were we free to study homosexuality properly (uninfluenced by political agendas) we would certainly soon clarify these factors - just as we are doing in less contentious areas. In any case, there is absolutely no evidence whatsoever that the behavior "homosexuality" is itself directly inherited.

(2) From a very early age potentially heritable characteristics mark the boy as "different." He finds himself somewhat shy and uncomfortable with the typical "rough and tumble" of his peers. Perhaps he is more interested in art or in reading - simply because he's smart. But when he later thinks about his early life, he will find it difficult to separate out what in these early behavioral differences came from an inherited temperament and what from the next factor, namely:

(3) That for whatever reason, he recalls a painful "mismatch" between what he needed and longed for and what his father offered him. Perhaps most people would agree that his father was distinctly distant and ineffective; maybe it was just that his own needs were unique enough that his father, a decent man, could never quite find the right way to relate to him. Or perhaps his father really disliked and rejected his son's sensitivity. In any event, the absence of a happy, warm, and intimate closeness with his father led to the boy's pulling away in disappointment, "defensively detaching" in order to protect himself.

But sadly, this pulling away from his father, and from the "masculine" role model he needed, also left him even less able to relate to his male peers. We may contrast this to the boy whose loving father dies, for instance, but who is less vulnerable to later homosexuality. This is because the commonplace dynamic in the pre-homosexual boy is not merely the absence of a father - literally or psychologically - but the psychological defense of the boy against his repeatedly disappointing father. In fact, a youngster who does not form this defense (perhaps because of early-enough therapy, or because there is another important male figure in his life, or due to temperament) is much less likely to become homosexual.

Complementary dynamics involving the boy's mother are also likely to have played an important role. Because people tend to marry partners with "interlocking neuroses," the boy probably found himself in a problematic relationship with both parents.

For all these reasons, when as an adult he looked back on his childhood, the now-homosexual man recalls, "From the beginning I was always different. I never got along well with the boys my age and felt more comfortable around girls." This accurate memory makes his later homosexuality feel convincingly to him as though it was "preprogrammed" from the start.

(4) Although he has "defensively detached" from his father, the young boy still carries silently within him a terrible longing for the warmth, love, and encircling arms of the father he never did nor could have. Early on, he develops intense, nonsexual attachments to older boys he admires - but at a distance, repeating with them the same experience of longing and unavailability. When puberty sets in, sexual urges - which can attach themselves to any object, especially in males - rise to the surface and combine with his already intense need for masculine intimacy and warmth. He begins to develop homosexual crushes. Later he recalls, "My first sexual longings were directed not at girls but at boys. I was never interested in girls."

Psychotherapeutic intervention at this point and earlier can be successful in preventing the development of later homosexuality. Such intervention is aimed in part at helping the boy change his developing effeminate patterns (which derive from a "refusal" to identify with the rejected father), but more critically, it is aimed at teaching his father - if only he will learn - how to become appropriately involved with and related to his son.

(5) As he matures (especially in our culture where early, extramarital sexual experiences are sanctioned and even encouraged), the youngster, now a teen, begins to experiment with homosexual activity. Or alternatively his needs for same-sex closeness may already have been taken advantage of by an older boy or man, who preyed upon him sexually when he was still a child. (Recall the studies that demonstrate the high incidence of sexual abuse in the childhood histories of homosexual men.) Or oppositely, he may avoid such activities out of fear and shame in spite of his attraction to them. In any event, his now-sexualized longings cannot merely be denied, however much he may struggle against them. It would be cruel for us at this point to imply that these longings are a simple matter of "choice."

Indeed, he remembers having spent agonizing months and years trying to deny their existence altogether or pushing them away, to no avail. One can easily imagine how justifiably angry he will later be when someone casually and thoughtlessly accuses him of "choosing" to be homosexual. When he seeks help, he hears one of two messages, and both terrify him; either, "Homosexuals are bad people and you are a bad person for choosing to be homosexual. There is no place for you here and God is going to see to it that you suffer for being so bad;" or "Homosexuality is inborn and unchangeable. You were born that way. Forget about your fairytale picture of getting married and having children and living in a little house with a white picket fence. God made you who you are and he/she destined you for the gay life. Learn to enjoy it."

(6) At some point, he gives in to his deep longings for love and begins to have voluntary homosexual experiences. He finds - possibly to his horror - that these old, deep, painful longings are at least temporarily, and for the first time ever, assuaged.

Although he may also therefore feel intense conflict, he cannot help admit that the relief is immense. This temporary feeling of comfort is so profound - going well beyond the simple sexual pleasure that anyone feels in a less fraught situation - that the experience is powerfully reinforced. However much he may struggle, he finds himself powerfully driven to repeat the experience. And the more he does, the more it is reinforced and the more likely it is he will repeat it yet again, though often with a sense of diminishing returns.

(7) He also discovers that, as for anyone, sexual orgasm is a powerful reliever of distress of all sorts. By engaging in homosexual activities he has already crossed one of the most critical and strongly enforced boundaries of sexual taboo. It is now easy for him to cross other taboo boundaries as well, especially the significantly less severe taboo pertaining to promiscuity. Soon homosexual activity becomes the central organizing factor in his life as he slowly acquires the habit of turning to it regularly - not just because of his original need for fatherly warmth of love, but to relieve anxiety of any sort.

(8) In time, his life becomes even more distressing than for most. Some of this is in fact, as activists claim, because all-too-often he experiences from others a cold lack of sympathy or even open hostility. The only people who seem really to accept him are other gays, and so he forms an even stronger bond with them as a "community." But it is not true, as activists claim, that these are the only or even the major stresses. Much distress is caused simply by his way of life - for example, the medical consequences, AIDS being just one of many (if also the worst). He also lives with the guilt and shame that he inevitably feels over his compulsive, promiscuous behavior; and too over the knowledge that he cannot relate effectively to the opposite sex and is less likely to have a family (a psychological loss for which political campaigns for homosexual marriage, adoption, and inheritance rights can never adequately compensate).

However much activists try to normalize for him these patterns of behavior and the losses they cause, and however expedient it may be for political purposes to hide them from the public-at-large, unless he shuts down huge areas of his emotional life he simply cannot honestly look at himself in this situation and feel content.

And no one - not even a genuine, dyed-in-the-wool, sexually insecure "homophobe" - is nearly so hard on him as he is on himself. Furthermore, the self-condemning messages that he struggles with on a daily basis are in fact only reinforced by the bitter self-derogating wit of the very gay culture he has embraced. The activists around him keep saying that it is all caused by the "internalized homophobia" of the surrounding culture, but he knows that it is not.

The stresses of "being gay" lead to more, not less, homosexual behavior. This principle, perhaps surprising to the layman (at least to the layman who has not himself gotten caught up in some pattern, of whatever type) is typical of the compulsive or addictive cycle of self-destructive behavior; wracking guilt, shame, and self-condemnation only causes it to increase. It is not surprising that people therefore turn to denial to rid themselves of these feelings, and he does too. He tells himself, "It is not a problem, therefore there is no reason for me to feel so bad about it."

(9) After wrestling with such guilt and shame for so many years, the boy, now an adult, comes to believe, quite understandably - and because of his denial, needs to believe - "I can't change anyway because the condition is unchangeable." If even for a moment he considers otherwise, immediately arises the painful query, "Then why haven't I...?" and with it returns all the shame and guilt.

Thus, by the time the boy becomes a man, he has pieced together this point of view: "I was always different, always an outsider. I developed crushes on boys from as long as I can remember and the first time I fell in love it was with a boy, not a girl. I had no real interest in members of the opposite sex. Oh, I tried all right - desperately. But my sexual experiences with girls were nothing special. But the first time I had homosexual sex it just 'felt right.' So it makes perfect sense to me that homosexuality is genetic. I've tried to change - God knows how long I struggled - and I just can't. That's because it's not changeable. Finally, I stopped struggling and just accepted myself the way I am."

(10) Social attitudes toward homosexuality will play a role in making it more or less likely that the man will adopt an "inborn and unchangeable" perspective, and at what point in his development. It is obvious that a widely shared and propagated worldview that normalizes homosexuality will increase the likelihood of his adopting such beliefs, and at an earlier age. But it is perhaps less obvious - it follows from what we have discussed above - that ridicule, rejection, and harshly punitive condemnation of him as a person will be just as likely (if not more likely) to drive him into the same position.

(11) If he maintains his desire for a traditional family life, the man may continue to struggle against his "second nature." Depending on whom he meets, he may remain trapped between straight condemnation and gay activism, both in secular institutions and in religious ones. The most important message he needs to hear is that "healing is possible."

(12) If he enters the path to healing, he will find that the road is long and difficult - but extraordinarily fulfilling. The course to full restoration of heterosexuality typically lasts longer than the average American marriage - which should be understood as an index of how broken all relationships are today.

From the secular therapies he will come to understand what the true nature of his longings are, that they are not really about sex, and that he is not defined by his sexual appetites. In such a setting, he will very possibly learn how to turn aright to other men to gain from them a genuine, nonsexualized masculine comradeship and intimacy; and how to relate aright to woman, as friend, lover, life's companion, and, God willing, mother of his children.

Of course the old wounds will not simply disappear, and later in times of great distress the old paths of escape will beckon. But the claim that this means he is therefore "really" a homosexual and unchanged is a lie. For as he lives a new life of ever-growing honesty, and cultivates genuine intimacy with the woman of his heart, the new patterns will grow ever stronger and the old ones engraved in the synapses of his brain ever weaker.

In time, knowing that they really have little to do with sex, he will even come to respect and put to good use what faint stirrings remain of the old urges. They will be for him a kind of storm-warning, a signal that something is out of order in his house, that some old pattern of longing and rejection and defense is being activated. And he will find that no sooner does he set his house in order that indeed the old urges once again abate. In his relations to others - as friend, husband, professional - he will now have a special gift. What was once a curse will have become a blessing, to himself and to others.

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