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桐梓安
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1 同性戀的迷思改變可能嗎? 有害嗎? 康貴華醫生有關同性戀的最大謎思同性戀是天生, 正常和不能改變企圖改變性傾向會令同性戀者產生更强的自我憎恨, 抑鬱, 甚至自殺同性戀是先天 vs. 同性戀是後天同性戀是否天生? 有關同性戀先天因素的研究 1. 同性戀基因 gay gene 研究 2. 同性戀者腦部結構與普通人士的分別 3. 攣生兒 / 女的研究 ( 同卵及異卵攣生 ) 4. 懷孕期母親性激素對胎兒影響的研究 5. 後天的性激素與性傾向的研究 "Gay gene" researcher Dean Hamer Hamer et al (1993) 從一個愛滋病治療愛滋病治療計劃挑選 76 個男人, 這些男人都有同性戀兄弟, 他們的母方家族大多有同性戀傾向, 而父方家族則沒有研究員檢查這一群男人的 X 染色體, 發現 40 對同性戀兄弟中,33 對兄弟的 X 染色體某區域的模樣是相同的, 遠高於預期的隨機併存水平 (Random Concurrence Level), 研究員便假定這區域涉及決定人類的性傾向 "Gay gene" researcher Dean Hamer Stanton & Yarhouse( ) 1. 其他研究隊進行相同的研究, 卻不能得到相同的實驗結果 2. Hamer 所指的同性戀同性戀不是一般的同性戀, 而是基於強烈的母體傳遞母體傳遞 (Maternal Transmission) 3. 研究員發現這種染色體標記並不是引致同性戀的必需的 (Necessary Necessary) 或足夠的 (Sufficient Sufficient) 條件條件這些染色體標記並不會決定人的性傾向, 它們只能夠使人有較大的機會發展出同性戀傾向, 間接引致同性戀出現 1

2 "Gay gene" researcher Dean Hamer 1. He was asked by Scientific American if homosexuality was rooted solely in biology. He replied: 2. "Absolutely not.. From twin studies, we already know that half or more of the variability in sexual orientation is not inherited. Our studies try to pinpoint the genetic factors...not negate the psychosocial factors." 性傾向的醫學研究近期人類基因學人類基因學 ( Journal of Human Genetics) 的學術期刊中, 刊登美國科學家一項同性戀與基因有關的研究, 證實並無一種男同性戀基因男同性戀基因 (Gay Gene) 並相信性傾向是由多種基因加上環境因素造成 Mustanki et al A genomewide scan of male sexual orientation. Human Genetics LeVay (1991) 研究男同性戀者屍體腦部結構 INAH-3( 腦部一種組織 ) 較發現同性戀者的 INAH 腦部一種組織一般人細小研究方法出了嚴重問題 1. 數目太少 35 具屍體 2. 按著死者的醫療記錄來分辨他們的性傾向 3. 愛滋病病毒及愛滋病療法均可能改變 INAH3 的大小及形狀, 我們不能肯定他的研究結果是跟同性戀有關還是跟愛滋病或其療法有關 4. 研究員無法確定是細小的 INAH-3 導致同性戀傾向, 還是同性戀傾向導致 INAH-3 出現變化孿生子研究 Bailey and Pillard 的研究 (1991, 1993) 男性同卵攣生兒 (Identical Twins) 的一致比率 (concordance rate) 52% 男性異卵攣生兒 (Fraternal Twins) 的一致比率是 22% 女性同卵攣生兒的一致比率 48% 女性異卵攣生兒的一致比率 16% ** 樣本偏誤 (Sample Bias) 孿生子研究 Bailey, Dunne & Martin( ) 澳洲雙生兒登記處登記了的雙生兒寄出問卷, 調查他們的性偏好及性經驗男性同卵攣生兒 (Identical Twins) 的一致比率 20% 男性異卵攣生兒 (Fraternal Twins) 的一致比率 0% 女性同卵攣生兒的一致比率 24% 女性異卵攣生兒的一致比率 0% 若完全是基因引致一致比率應該是 100% 孿生子研究最新的大型孿生子研究 ( 約六千女性和三千名男性 ) 在芬蘭進行 (Santtila et al,2008), 結果顯示, 引致同性戀傾向的後天環境因素遠遠比先天遺傳因素遠遠比先天遺傳因素更重要 2

3 懷孕期母親性激素對胎兒影響的研究 Ellis 和 Ames (1987) 根據動物作實驗提出在懷孕期的第二至第五月, 若胚胎受到多種性激素刺激, 性傾向便從此定型但是人類的情況不一定和動物的相同懷孕期母親性激素對胎兒影響的研究 Money (1987) 認為單憑懷孕期的激素作用, 並不足以注定一個人永遠是同性戀者, 還要考慮他 / 她的成長經歷沒有證據顯示所有同性戀者都受到產前激素作用的影響產後性激素的研究同性戀者和異性戀者的激素成份和生理結構都沒有明顯的分別 Kaplan and Sadock s Synopsis of Psychiatry 美國權威性的精神醫學教科書在提及性屬身分疾患 Gender Identity Disorder 和同性戀傾向的成因時, 只將先天 / 生理 genetic/biological 和心理 psychological 的因素並列, 並沒有將成因全歸咎於先天 / 生理因素同性戀是先天 vs. 同性戀是後天綜合近代有關同性戀研究所得的結論, 性傾向是由多種基因加上環境因素互動造成先天 + 後天若單單強調先天或後天因素, 都是誤導的先天的因素如何影響性傾向? 1. 孩童的性情 child temperament 較剛陽的女仔較陰柔敏感的男仔剛陽或陰柔的性情可進一步影響性屬身分的發展, 繼而影響性傾向的形成男仔易焦慮, 懼怕受傷的性情 3

4 先天的因素 2. 樣貌 physical attractiveness 3. 兄弟姊妹的性別比例 sibling sex ratio 4. 排行的先後 birth order Evidence Based Conclusion on the Causations of Homosexuality Homosexuality develops during an individual s formative years through an interaction of parenting, peer, social and biological influences 同性戀傾向的後天因素 1. 不健全的父母子女關係 2. 童年及青少年期同儕的拒絕或傷害 3. 性侵犯或同性間的性經驗 4. 因異性戀引致嚴重的情感傷害 5. 性別身分和角色混淆為何同性戀是天生的觀點深入民心? 1. 是同志運動在傳媒中不斷宣傳的成功例子 2. 不少同性戀者自少自然地發現自然地發現自己被同性性吸引 ; 錯誤理解自然便是天生, 忽略了童年時家庭及朋輩對日後性傾向的重要影響 Sexual Orientation 性傾向性傾向全是天生的 ( 不符合同性戀醫學研究結論 ) 所以不能改變 ( 不成立 ) 性傾向可以改變嗎? Fixed or Fluid 4

5 Sexual Orientation 性傾向是形容一個人的性衝動或興奮的對象 describes the object of a person s sexual impulses(synopsis of Psychiatry 9th Ed.) heterosexual 異性戀傾向 homosexual 同性戀傾向 bisexual 雙性戀傾向同性吸引 (Same-Sex Attraction SSA) 青少年期的同性吸引 Same Sex Attraction 被同性在愛情上愛情上和性慾上性慾上所吸引 romantic and erotic attractions to the same sex 心性發展 Psychosexual Development 性傾向 (sexual orientation) 開始形成歲小六中一性傾向漸漸確立歲 Remafedi,Resnick,Blum & Harris Pediatrics Apr;89(4 Pt 2): 為約三萬五千個三萬五千個學生進行性傾向調查 *12 歲學生有 25.9% 不肯定自己性傾向 *18 歲學生學生只有 5% 不肯定自己性傾向發現十八歲十八歲的學生表示的學生表示有同性戀或雙性戀傾向的比率比十二歲十二歲學生有兩種性傾向的比率減少了一半心理學家發現, 在青少年中期 (14 至 17 歲 ) 有短暫的同性吸引或同性性經驗, 並不一定演變成長期的同性戀傾向因此, 要提醒青少年不要過早為自己的性傾向定型或標籤別人為同性戀者心性發展 Psychosexual Development 20 歲過後, 性傾向仍可改變 30 多歲才改變性傾向的例子異性戀變同性戀不需別人幫助同性戀變異性戀卻困難重重需要個人的決心堅持和別人的協助才能改變 5

6 . COMPILATION AND OVERALL AVERAGE OUTCOME Historical Review of Documented Success in Sexual Reorientation F Reorientation assistance includes a variety of approaches, such as psychoanalysis, behavior and cognitive therapies, group therapies, sex therapies, hypnosis, pharmacological treatment, and religiously- mediated activities. Meta-Analyses Clippinger s (1974) 785 homosexuals treated, 307 (40 percent) either significantly improved in the direction of their desired goal, or had made at least some shift toward heterosexuality. E. C. James (1978) the results of all research studies before percent had shifted to heterosexuality 27 percent had improved 37 percent had neither changed nor improved.. Meta-Analyses Jones and Yarhouse (2000) review 30 studies conducted between 1954 and 1994 Of the 327 total subjects from all the studies, 108 (33 percent) were reported to have made at least some heterosexual shift.. COMPILATION AND OVERALL AVERAGE OUTCOME OF Recent Surveys of Reorientation Therapy Consumers Report Number and percent reporting exclusive opposite-sex sex attraction Survey N shift fully successful Nicolosi et al. (2000b) (36%) Shidlo & Schroeder (2002) (4%) Spitzer (2003) (52%) Total (31%) Retrospective studies Sampling bias A longitudinal (prospective)study of religiously mediated changes in Exodus group participants (Jones and Yarhouse 2007) Examined about 100 homosexuals who seek change 1. Change is possible for some Success conversion/heterosexual shift 15% + chastity(reduced SSA) 23% = 38% Modest change(continuing ) 29% Non-response(not given up on change ) 15% Failure (given up on change process) 12% 有關同性戀的最大謎思同性戀是天生, 正常和不能改變企圖改變性傾向會令同性戀者產生更强的自我憎恨, 抑鬱, 甚至自殺 6

企圖改變性傾向會令同性戀者產生更强的自我憎恨, 抑鬱, 甚至自殺 APA cites the work of various authors (Davison, 1991; Gonsiorek & Weinrich, 1991; Haldeman, 1994; Schroeder & Shidlo, 2001; Shidlo & Schroeder, 2002) in support of

Shidlo and Schroeder (2002) 202 participants (182 men and 20 women) 176 reported failure from conversion therapy 26 reported success : 22 helpful only 4 both helpful and harmful 168 failure cases : 9

7 企圖改變性傾向會令同性戀者產生更强的自我憎恨, 抑鬱, 甚至自殺 APA cites the work of various authors (Davison, 1991; Gonsiorek & Weinrich, 1991; Haldeman, 1994; Schroeder & Shidlo, 2001; Shidlo & Schroeder, 2002) in support of its claim that reorientation therapy is (at least potentially) harmful. Shidlo and Schroeder (2002) 202 participants (182 men and 20 women) 176 reported failure from conversion therapy 26 reported success : 22 helpful only 4 both helpful and harmful 168 failure cases : 9 helpful only 72 both helpful and harmful 85 harmful only 2 neither harmful or helpful 31 (16%) helpful only 85(44%) harmful only 76 (39%)both Shidlo and Schroeder (2002) *Recruited subjects through an ad in homosexual publications cited the specific request, Help Us Document the Harm! *After some respondents reported finding therapy at least somewhat helpful, the researchers advertised for additional subjects in a more neutral manner Shidlo and Schroeder (2002) **Since the researchers specifically sought subjects who thought that they had been harmed and who would help the researchers make a case against such therapies, the sample clearly was non-representative of the therapy population as a whole. Spitzer (2003) There was no evidence of any form of harm experienced by the participants in his study. To the contrary, he writes, they reported that it was helpful in a variety of ways beyond changing sexual orientation itself Markedly or Extremely Bothered by Depression 80% 60% 40% 20% 0% 43% 47% 1% 4% Male Female BEFORE AFTER 7

8 A longitudinal (prospective)study of religiously mediated changes in Exodus group participants (Jones and Yarhouse 2007) Examined about 100 homosexuals who seek change 1. Change is possible for some Success conversion/heterosexual shift 15% + chastity(reduced SSA) 23% = 38% Modest change(continuing ) 29% Non-response(not given up on change ) 15% Failure (given up on change process) 12% 2. On average the attempt to change is not harmful Haldeman (2001), a gay-activist activist clinician Haldeman has treated dissatisfied former consumers of reorientation therapy, writes: Not all individuals appear to be harmed by conversion therapy. It is not uncommon, in fact, for some to report that a failed attempt at conversion therapy had an odd, indirectly beneficial effect [such as] an individual s final letting go of the denial surrounding his sexual orientation. He qualifies his risk assessment by asserting, This is not to suggest that all conversion therapies are harmful, or that the mental health professions should try to stop them Is Reorientation Therapy Harmful? The present literature does not support the conclusion that predominant harm is a regular result of reorientation therapy Banning therapy for those who want it would potentially create much greater harm On the basis of such evidence, it would be highly unethical to deny therapy to all informed clients who seek it Categories of People with SSA 同性吸引 Same Sex Sex Attraction Romantic and anderotic 同性戀身分 Homosexual Identity Gay Gay Activist 同志們同志們 Gay Gay // Lesbian Ego-syntonic or Wanted Sexual Orientation 接受自己性傾向的 Ego-dystonic or Unwanted Sexual Orientation 不接受自己性傾向的 Post-Gay/Post-SSA 後同性戀 / 後同性吸引 Reasons for Wanting to Change Pressure from family or society is not one of the most common reasons for wanting to change Reasons for Wanting to Change (Spitzer 2003) Gay life-style not emotionally satisfying 81% Religious conflict 79% Desire to get, or stay married Male 67% Female 35% 8

Commentary: Psychiatry and Homosexuality Robert L. Spitzer, M.D.

cannot always be reduced to succumbing to society's pressure.

Gay affirmative approaches 幫助接受自己的同性戀傾向 2.

9 Commentary: Psychiatry and Homosexuality Robert L. Spitzer, M.D. Wall Street Journal, May 23, 2001 However, I continue to hold that desire for change cannot always be reduced to succumbing to society's pressure. Helping people with Unwanted Sexual Orientation 幫助不接受自己性傾向的人士 1. Gay affirmative approaches 幫助接受自己的同性戀傾向 2. Reparative/conversion/ reorientation therapies 幫助改變自己的同性戀傾向 Both approaches of therapy have reported successes, but also failure in certain cases Is APA still justified in banning reorientation therapy? 9

10 Commentary: Psychiatry and Homosexuality Robert L. Spitzer, M.D. Wall Street Journal, May 23, 2001 Many patients, informed of the possibility that they may be disappointed if the therapy does not succeed, can make a rational choice to work toward developing their heterosexual potential and minimizing their unwanted homosexual attractions. Commentary: Psychiatry and Homosexuality Robert L. Spitzer, M.D. Wall Street Journal, May 23, 2001 Sometimes, such a choice can be a rational, self-directed goal The mental health professions should stop moving in the direction of banning such therapy Former President of the American Psychological Association: Dr. Robert Perloff "The individual has the right to choose whether he or she wishes to become straight. It is his or her choice, not that of an ideologically driven interest group Many renowned American psychiatrists and psychologists also respect the right of choice and self-determination of struggling homosexuals in seeking conversion therapies They include: former President of American Psychiatric Association, Dr. Robert Spitzer, former Presidents of American Psychological Association, Dr. Robert Perloff, Dr. Nicholas Cummings and Dr. Martin Seligman, former President of the American Mental Health Counselors Association, Dr. Warren Throckmorton,, and Dr. Mark Yarhouse of Regent University 10

11 **APA has recently revised its policy in relating to this issue APA's New Pamphlet on Homosexuality includes this key statement: "Mental health organizations call on their members to respect a person's [client's] right to self-determination." 性屬身分和性傾向是性格的一部份 1. 性格的形成是先天或後天? 2. 性格形成後是否可以改變? Acknowledgement Part of the slides in English are adopted from Dr. Melvin Wong s power points 問答時間網上參考文章 << 同性戀全面睇 >> 網上版 / 香港明光社香港性文化學會 : 黃偉康博士同性戀過來人見證國際 Exodus 見證 international.org/testimonials_left_homosexualit y.shtml New Hope Ministries(Frank Worthen), 新造的人協會 newcreationhk.org 台灣走出埃及 7.org.tw/enter.html 11

同性戀的起源：天生抑或後天

同性戀的起源：天生抑或後天同性戀的起源 : 天生抑或後天香港的同志團體一直聲稱同性戀是與生俱來的, 這種性傾向不應受到歧視他們甚至要求制訂反性傾向歧視條例, 防止同性戀者的權利被剝奪究竟同性戀是天生的還是後天的呢? 本文嘗試從生物學心理學及