Homosexuality: A Psychiatrist's Response to LDS Social Services
National Affirmation Annual Conference, Portland, Oregon, 5 September 1998
By Jeffery R. Jensen, M.D.
September 5, 1998
Jeffery R. Jensen, M.D., originally presented this paper at the 1996 Sunstone Symposium. This text comes from his paper prepared at that time, which he re-presented to us on September 5, 1998, at the Affirmation National Conference in Portland, Oregon.
Listen to Dr. Jensen's Presentation at the Affirmation Conference (RealPlayer, 47:44 Min.).
About a year and a half ago I received a bootleg copy of the LDS Social
Services document "Understanding and Helping Individuals with Homosexual
Problems". I was intrigued and perplexed with the content and tone of the
document. It is unusual as a scientific document written to mental health
professionals in the 1990s for its unqualified and unjustified use of concepts
steeped more in the prejudices of Western tradition which date back to the
turn of the century than in modern social or psychological sciences. The
document's title spells out its primary, erroneous premise: that homosexuality
is, in fact, a mental health "problem." The LDS-SS document's thesis is that
homosexual orientation is a manifestation of a treatable disturbance in one's
gender identity which is caused by dysfunctional family relationships: "It is
in the three-way relationship between the parents and the child that the
homosexual's family background is commonly dysfunctional. Homosexuality is,
in part, a symptom of some type of relational deficit." In spite of the
numerous well-designed studies since the 1950s which have disproved this myth,
this fallacy forms the scientific cornerstone of the LDS-SS document. Even
more concerning, however, is the way that the LDS-SS document attempts to
justify—if not require—unethical professional behavior on the part of the
LDS Social Services psychotherapist who is treating homosexual persons. How
could the LDS-SS document have been conceived, published, and distributed in
1995 by the mental health division of the Church of Jesus Christ of Latter-day
Saints, an organization committed to the principles of honesty and integrity?
I will return to this question later.
Over the past year I have engaged in a comprehensive review of the mental
health literature on the subject of homosexuality. I reviewed literature form
the fields of psychiatry, psychoanalysis, psychology, and social psychology.
I have also read publications from a marginalized group of counselors who have
created a new field of "Christian" psychology (such as Nicolosi, 1991;
Moberly, 1983; Dallas, 1991; Consiglio, 1993; and others)—counselors who base
their psychology according to their interpretations of the Bible—a distinctly
nonpsychologic and nonscientific text. The results of my review are contained
in an—as yet— unpublished paper entitled: "Homosexuality: A Psychiatrist's
Response to LDS Social Services (1996)". Time constraints prevent me from
discussing even a tenth of the material from the original paper in this brief
Though the title of this paper indicates that my remarks will be directed to
LDS Social Services leadership and providers, my comments are meant to reach a
broader audience, addressing myths contained in the LDS-SS document which are
also widely accepted as facts by many people in Western cultures, particularly
those from Judeo-Christian backgrounds such as ours.
The Question of "Pathology"
History demonstrates that for psychoanalysis the answer as to whether
homosexual orientation is a form of mental illness preceded the question by
decades. Psychoanalysis had been writing about homosexuality and their
treatment efforts to eradicate homosexuality for over 50 years before
researchers such as Kinsey (1948, 1953), Hooker (1956, 1957, 1958), and Ford
and Beach (1951) began to ask whether homosexuality was a mental illness in
the first place. The question was especially important because by the 1950s
and the 1960s analysts had linked homosexuality with severe mental illnesses
such as schizophrenia, obsessional disorders and severe character pathologies;
disorders which simply are not present in the majority of homosexual people
but which have been used to butress our society's antihomosexual prejudices
and discriminatory practices.
A couple of points need to be made:
Additionally, all of the psychoanalytic studies on homosexuality used patients
who sought treatment for a variety of symptoms or who were brought to
treatment in mental hospitals or prisons. These subjects already had evidence
of poor adjustment irrespective of their sexual orientations. Before Evelyn
Hooker began her investigations using non-patient groups of homosexuals in the
1950s it had been assumed that the homosexuals in analytic treatment were
representative of all homosexuals. Such gross overgeneralizations are
misleading. An analogy would be going to a Ford dealership, noticing that all
the cars on the lot are Fords, then concluding that all cars are Fords.
Selecting out of a population individuals who seem to share a common trait and
then stating that all members of the population also share that trait is
logically fallacious and yields meaningless and misleading data.
- Psychoanalysis, a theory and technique driven form of psychotherapy which originated with Sigmund Freud in the late nineteenth century, dominated early American psychiatry and psychology. Analytic theory has been the only source of psychological justification for labeling homosexuality as a mental illness. However, very few of the
components of analytic theory have found support in objective scientific
investigations. For instance, penis envy and castration anxiety, concepts
which were the starting place for the development of female psychology as well
as male homosexuality, have found no support when studied using objective
scientific methodology. Analytic concepts are interpretive principles more
closely associated with the subjective disciplines of philosophy and
literature than modern empirical scientific research. Due to its lack of a
scientific base, analysis has lost its influence in modern mental health.
Since it was assumed that homosexuals were mentally ill, no openly homosexual
persons were allowed to enter psychoanalytic training. Therefore, homosexual
persons had no voice in the formulation of psychoanalytic theory. The
evidence of this missing check and balance is clear as one reads the history
of psychoanalytic writings on homosexuality; the articles are full of angry,
hostile, sarcastic descriptions of homosexual patients and their problems with
an intolerable number of cheap jokes at the patient's expense. With
homosexuals disenfranchised from psychoanaylsis, psychoanalytic "experts" on
homosexuality exercised tyrannical control over their homosexual patients and
spurred hostile public opinion regarding homosexuality.
Beginning in the 1940s researchers finally began to question the
psychoanalytic assumptions regarding homosexuality. Well designed scientific
studies emerged—studies which removed researchers' biases from the assessment
tools. Without the researchers' distorting biases the studies conclusively
demonstrated that homosexuality was not associated with any mental illness.
To be sure, there are some homosexuals who also suffer from mental illness
just as there are some heterosexuals who also suffer form mental illness, but
there is no objective evidence which links homosexuality to any mental
disturbance any more than on can link heterosexual orientation to mental
Based on the numerous well designed, objective, and independently validated
studies discounting the pathology-position combined with the absence of any
scientifically sound evidence in favor of retaining homosexuality as a
diagnosable mental illness, the American Psychiatric Association removed
'homosexuality' from its official list of psychiatric disorders in 1973. All
of the mental health professions subsequently followed suit, including the
American Psychoanalytic Association which has begun accepting openly
homosexual women and men into its institutes.
Gender, Heterosexism, and Sexism
Evelyn Hooker found that there is no psychopathology linked to homosexual
orientation and that, in fact, there is as much psychological diversity among
homosexuals as among heterosexuals. Anyone, like Hooker, who has spent time
with homosexual persons finds such observations self-evident. that in 1958
Hooker's findings came as a surprise to many in the mental health professions
reveals the extent to which the mental health community relied on stereotypes
to form their opinions rather than interpersonal engagement as peers outside
of the consulting room. Recent surveys have shown that only one-third of
American adults personally know openly homosexual people. Studies have also
found lower degrees of antihomosexual bias in people who know openly
homosexual people on a personal basis. A Baltimore City Counselperson was
recently condemning homosexuals on a radio talk show. A caller asked him if
he personally knew any homosexuals and the Counselperson's response was an
indignant "NO, I DO NOT." The caller then invited the Counselperson to meet
and get to know him, his partner and a group of his gay and lesbian friends
since many of the things that the Counselperson had said about homosexuals
didn't apply to him or his friends at all. Much of the antihomosexual
rhetoric is produced by people who have no personal acquaintance with openly
homosexual persons; their rhetoric relies on stereotypes of homosexual
persons. Stereotyping a group of people who seem to share a common,
undesirable trait essentially reduces complex human beings into a caricature
which exaggerates perceived differences and minimizes similarities. William
Green points out: "A society does not simply discover its others, it
fabricates them, by selecting, isolating, and emphasizing an aspect of another
people's life, and making it symbolize their difference." Stereotyping is an
essential feature of interpersonal and institutional discrimination and the
basis of a society's prejudice.
Fernald reviewed the mounting literature on heterosexism, a social psychology
concept closely related to homophobia which is "...composed of the related
but independent dimensions of prejudice, stereotypes, and discrimination. In
the language of social-psychological behavior theory, heterosexist prejudice
refers to negative attitudes toward (i.e. dislike of) lesbians and gay men;
heterosexist prejudice stereotypes are widely shared and socially sanctioned
beliefs about gay men and lesbians that are used to justify anti-gay/lesbian
hostility; and heterosexist discrimination includes face-to-face overt
behaviors that distance, avoid, exclude, or physically violate lesbians and
Social psychology studies have shown that the factor most predictive of anti-
gay/lesbian bias is a rigid commitment to a traditional, Western culturally-
based male sex role which is based on Western stereotypes of "masculinity" and
"femininity". Several studies conducted with heterosexual subjects have
provided an image of the American heterosexist stereotype of a homosexual.
Homosexual men were perceived as being stereotypically "feminine" while
homosexual women were perceived as being stereotypically "masculine". Gay men
were perceived as less aggressive, less strong, poorer leaders, more clothes-
conscious, more gentle, more passive, and more theatrical, as well as less
calm, less dependable, less honest, and less religious, than heterosexual men.
Lesbians were perceived as more dominant, direct, forceful, strong, liberated,
and nonconforming than heterosexual women who were perceived as more
conservative and stable. To demonstrate the power of the stereotype,
Weissbach & Zagon presented a short video interview of a man to two groups of
heterosexual subjects. One group was told that the man in the video was a
homosexual. The subjects found the interviewee "weaker, more feminine, more
emotional, more submissive, and more conventional when he was labeled gay than
when he was not." The perceptions of the man varied dramatically depending on
whether the observer thought the man was gay or straight. Seeing the man
through the filter of some preconceived stereotype influenced significantly
the character traits ascribed to him by the research subjects. This is
Similarly, by officially presenting a derogatory stereotype of a homosexual
man and woman and the "dysfunctional families," the LDS-SS document is
contributing to the propagation of antihomosexual prejudice among LDS Social
Services mental health professionals who are ethically obligated by specific
professional ethics guidelines to eliminate prejudice from their clinical work
(see Am Psychol A, 1992, Principle B : Integrity, p. 1599 & Principle D:
Respect for People's Rights and Dignity, p. 1599; Block & Chodoff, 1991, p.
525; Am Psychiat Assoc, The Principles of Medical Ethics with Annotations
Especially Applicable to Psychiatry, 1995, Section 1, paragraphs 1 & 2).
We see another disturbing trend emerging through the social psychology
studies. Heterosexist stereotypes rely on sexist stereotypes. Western sexist
stereotypes of "masculinity" and "femininity" exaggerate cultural differences
between men and women—exaggerations which bias the distribution of power
toward men. The sexist "feminine" stereotype describes a woman as: a
follower, emotional, dependent, weak, submissive, passive, and creative , to
name but a few. These are the same features attributed to gay men. The
sexist "masculine" stereotype describes a man as: a leader, strong,
independent, aggressive, physical, less emotional, etc. These qualities are
attributed to lesbians. Thus, anti-gay/lesbian prejudice clearly is another
expression of sexist prejudice. Fernald concludes: "Lesbians and gay men, by
their very existence, challenge the sexist status quo. Because sexist
ideology depends on exaggerating the differences between women and men, and
explaining gender differences as natural and immutable, gay men and lesbians
threaten the foundation of sexism, whether consciously or not. .....Because
interpersonal heterosexist attitudes, beliefs, and behaviors, coupled with
institutional heterosexist rules and practices, reflect, create, and maintain
male dominance as well as heterosexual privilege, any strategies aimed at
reducing or eliminating heterosexism must also be concerned with reducing or
The LDS-SS document, in addition to statements by various general authorities
of the LDS Church has made traditional, Western culture-based gender role
conformity a central tenet of its antihomosexual rhetoric. In recent years
the LDS Church has moved away from its more blatant sexist positions (as
demonstrated in changes in the temple endowment ritual) but still insists upon
the sexist-based, Western cultural conceptualizations of "masculinity" and
"femininity" as universal and—sadly—eternal. It is upon those essentially
sexist grounds that the LDS-SS document and certain church leaders and members
have focused their anti-lesbian/gay rhetoric.
That various elements of sexism are institutionalized in the LDS Church, as
well as other organizations whose leadership and power are assigned based
first on gender, is beyond speculation and speaks more to the historical
social contexts during which such institutions arose than to purposeful
discriminatory bias. However, that a social prejudice wasn't obvious at one
point in time confers no authority to maintain it once it has been identified
as such. The more appropriate role for LDS Social Services, as the mental
health branch of the LDS Church, is persistent efforts at educating church
members and leaders, local as well as general, as to the detrimental effects
on individuals and the institution itself of perpetuating sexist and
heterosexist stereotypes in the service of maintaining the illusion of social
order based on heterosexual male rule.
Sexual Reorientation Therapies
Psychotherapies attempting to change homosexual orientation to heterosexual
orientation have been attempted for many years. Even with highly motivated
people the results are less than encouraging. Most sexual reorientation
studies report less than 30 percent of homosexual subjects achieve a
heterosexual outcome, and over half of those who experience some change in
their sexual orientation were bisexual at the beginning of treatment.
Anecdotes on sexual reorientation, particularly those published by the
"Christian" reorientation therapists such as Nicolosi, Moberly, and Dallas,
are so heavily influenced by flaws in design, sampling techniques and out come
measurement that, according to Haldeman's comprehensive review of treatment
outcomes "no consistency emerges for the extant database which suggest that
sexual orientation is amenable to redirection or significant influence from
psychological intervention". In some people homosexual behavior, like
heterosexual behavior, can be restrained for periods of time but there is no
evidence that core sexual orientation can be modified through
There are several other serious flaws with the sexual reorientation studies.
None of the studies compared outcomes with control groups of subjects who
accepted their homosexuality. Studies exist which have demonstrated more
favorable therapeutic outcomes in homosexual people who successfully integrate
their homosexuality into their private and social identities. Additionally,
not a single sexual reorientation study addressed the psychological or
spiritual damage that occurs in the majority of subjects who fail to achieve a
change in sexual orientation. Sexual reorientation therapies attempt to treat
a disorder which doesn't exist using unethical therapeutic techniques which
don't work while simply ignoring the damage they do to the majority of people
who fail to change—people who are judged by the failing therapist to be
resistant, morally corrupt, unrepentant, or simply weak.
In their review of statements on homosexuality made by various general
authorities of the LDS Church, Bingham and Potts approvingly noted: "The
church has supported efforts of the LDS Social Services and other consulting
professionals to research the issues and to offer a reparative therapy
approach which assumes that homosexual behavior can be changed."
By "the church" I suspect that Bingham and Potts are referring to a small
number of general church leaders who have been unusually outspoken in voicing
their sexist and heterosexist biases as if they were doctrine and —perhaps
worse—as if they were science. "The Church," which has no authority in
professional, scientific matters, has declared homosexuality a mental illness
and has required LDS Social Services to agree. Because such biases have been
recognized as incompatible with the ethical practice of mental health, all of
the mental health professions have included specific warnings against these
biases in their ethics guidelines. In order for LDS Social Services "to offer
a reparative therapy approach which assumes that homosexual behavior can be
changed," they had to leave the mainstream of the mental health professions
and shop around for anyone whose own prejudices match those of "the church" no
matter how unjustified, antiquated, unscientific, ineffective, harmful and
unethical their beliefs and practices may be. This unfortunate collusion has
compromised the scientific integrity of LDS Social Services and—by
extension—the LDS Church; a retreated, closed, propagandistic and anxiety-
maintained position which is untenable for a people whose prominent motto is
"the glory of God is intelligence."
We may ask: If a majority of people in a society agree that certain groups of
people are undesirable, why should we fight against such an attitude? There
are a number of reasons why we should fight against socially sanctioned hate
and discrimination, not the least among them being the example of one
Gallilean Jew who dined with publicans, associated closely with women,
defended and befriended prostitutes, and ministered to Samaritans—hated,
demeaned, subservient or simply ignored out-groups of the culture of his day,
for which he was derided and chastised even by his closest associates and
disciples. It is he whom we recognize as The Judge. It is his example we
seek to emulate—including his manner of judging (or as he has wisely
commanded, not-judging—withholding the impulse to judge and condemn one's
fellow human beings—the remedy for prejudice and a corrective for pride). I
make this point to demonstrate that the LDS Church (or its members)
discriminating against any group of people according to stereotypes and
prejudices is incompatible with core LDS beliefs. Indeed, we are obligated
morally to weed out of society and the church lies which perpetuate attitudes
and actions of hate. LDS Social Services should be at the forefront of this
struggle, using insights gathered from the mental health and social sciences
to help "perfect the saints" by eliminating such individually and collectively
corrupting falsehoods rather than distort knowledge and facts to justify
oppressive standards and norms.
There are several tasks which need to be accomplished by LDS Social Services:
This list of suggestions is a starting place. Prejudice, hate and
discrimination against people whom we don't know and don't understand prevents
mutually beneficial interactions. There is much we can learn about our common
humanity if we can get past the tendency to reject those who think, feel, or
believe differently or who come to represent aspects of ourselves which we may
wish to banish. Christ taught that God is love. Let us recommit to honoring
this principle in our personal and professional endeavors.
- As a matter of personal and professional integrity, firmly commit to the
principles of ethics established by the mental health professions to which LDS
Social Services providers belong.
- Carefully read (or read again) the abundant scientific literature on
homosexuality even if it seems to contradict one's personal biases.
Critically assess all literature according to the objective standards accepted
by the scientific committees of the various mental health professions.
- Be willing to reevaluate one's own biases and prejudices. This is an
opportunity for personal and professional growth.
- As an obligation to one's society, use insights gained through one's
professional and personal development to combat social prejudice and
- Do not make the mistake of denying any church leader his humanity.
Psychology has taught us that we all have conflicts, fears, and unfounded
biases—conscious or otherwise—which influence our thoughts and behavior; it
is not fair to church leaders to assume that they do not. They, too, are in
need of growth experiences.
- Refrain from utilizing stereotypes in clinical and personal endeavors.
Each personal and professional encounter with another human being is a chance
to learn and share on equal grounds with someone as complex and deserving of
respect as oneself. Emmerson said: "The sign of a true scholar is that in
every man there is something wherein I may learn of him. In that, I am his
pupil." This humble approach to one's clinical work and interpersonal
engagements can only better oneself as a clinician and as a human being.
- Since only one-third of Americans know an openly homosexual man or woman,
an important way to challenge one's own culturally-sanctioned heterosexist
prejudices is to associate with openly homosexual persons on equal social
footing rather than as a leader, therapist, or otherwise social judge.
Stereotypes lose their validity when confronted with the whole reality of
another human being.