Gay and Lesbian Relationships

So I know the microphone is a little strange has a little dull sounding. Is the sound good, okay great. So first I want to thank Sondra Farganis and the Wolfson Center for National Affairs with the New School for inviting us to do this talk and to David Groff who has been just spectacularly helpful in terms of connecting us up with Sondra and this would definitely not have happened without the two of them. So I really am very appreciative. Just to tell you about the Rockway Institute, so Rockway Institute is a new research and public policy institute with a national focus and our overall mission is to transmit accurate knowledge about LGBT issues from the social sciences, mental health professions and medicine to the American public. With the goal of informing public opinion and improving public policies affecting LGBT people. Two ways we are doing that, one is we are very actively refuting miss information about LGBT issues disseminated by the well funded anti gay groups like Focus on the Family, Family Research Council and "ex-Gay" organizations like NARTH which is the National Association for Research and Therapy of Homosexuality. They are the folks that have brought you reparative therapy and Exodus International which is one of the ex-gay organizations. The second focus is to proactively inform the media, legislatures and the courts about policy policies relevant, I am sorry, policy relevant research on LGBT issues. So literally I am trying to assemble a national group of a one hundred at least 100 experts located in every state in the United States and prepare then to convey their research findings, their professional knowledge to the media through broadcast interviews, print media interviews, to legislators through helping shape legislation, helping provide the research rationale for legislation and also to service experts witnesses and legislative hearings and in court cases where there is issues like same sex marriage lesbian and gay parenting rights, protection of LGBT youths in schools those those kinds of issues have turned into court cases. Second thing the Rockway Institute is doing is we are conducting research on a very limited number of areas that we think will help answer some of the most pressing public policy questions for LGBT people in the United States concluding for example we are starting a 25 year longitudinal study of children raised by gay male parents. It will be the first longitudinal study of its kind, we are also evaluating an LGBT affirmative curriculum component in the health science course and the LA Unified School District. LA Unified is putting 60000 ninth graders every year through its required health science curriculum and in that curriculum there is an LGBT affirmative component and to our knowledge it's the first such component of the any public school district in the US. We are doing a pre post and a one year follow up evaluation of the effects of that program on the youths attitude towards LGBT people whether they protect LGBT people from harassment when they see other kids harassing LGBT kids and so on. And the third focus is to become the go-to resource for other organizations in the United States and internationally there need experts and data for their media legislative and court room activities. So as part of that agenda of the Rockway Institute we are presenting this panel. Some of you may have read I I did an interview, a Reuters interview meeting yesterday and has distributed the piece internationally and I don't know if any of you saw that piece but right away Focus on the Family, had it's spokesperson criticizing us, calling us, what was the word they used, homosexual activists. Desperate desperate homosexual activists who were sort of distorting the science to achieve our goals. Yeah talk about projected, let me just say a little bit more than about the anti-gay groups in order to set up the whole talk. Here is a list from the website of people for the American way of list of organizations that have anti-gay policies and platforms. I will just let them read yourself. Pretty amazing! Quite a list, it's astounding. Probably the biggest of these organizations is Focus on the Family. It was founded by James Dobson in late 1977, the same year as Anita Bryant and Jerry Falwell started in Dade County, they got there and started in Dade County, Florida fighting the anti-discrimination ordinance in Dade County, Florida had been passed that year. Focus employs 1300 people, gets 10000 e mails, 50000 phone calls and 173,000 letters a month as it's owns zip code maintains a mailing list of six million names, has an annual budget of a $150 million as estimated in an article in the Economist the last month. Spawned a Washington based think-tank, the Family Research Council and dozens of other family policy councils around the country. What really gets me is the $150 dollars annual budget. That's not their endowment, it's what they would burn through every year. They have 2.3 millions subscribers, to ten monthly magazines. They publish a wide variety of books, tapes, films and videos. Dobsons were daily on more than 3400 radio facilities in North America in 15 languages and approximately 6300 facilities in a 164 countries. Its estimated listening audience is over 220 million people everyday, including a program translation carried on in all state owned radio stations in the People's republic of China. In the United States doubts - Yeah well. In the United States Dobson appears on 80 television shows daily. I am going you read you two quotes of what some anti-gay groups are saying about LGBT people and I am going to turn the presentation over to Ellen Perrin, I will introduce her. So what the anti-gay groups say about, for example, same sex marriage? They say the overwhelming - the evidence is overwhelming that homosexual and lesbian committed relationships are not the equivalent of marriage. In addition there is little evidence that homosexuals and lesbians truly desire to commit themselves for the kind of monogamous relationships as signified by marriage. What remains then is the disturbing possibility that behind the demands for the gay marriage lurks an the agenda of undermining the very nature of the institution of marriage. Another anti-gay group, the New York State's Highest Court, I guess, it's called the court of appeals. Not usually thought of as an anti-gay group but given their last decision what else could one conclude. They said when they'd turned down same sex marriage, they said intuition and experience suggest that a child benefits from having before his or her eyes everyday, living models of what both a man and a woman are like. Now one wonders since when did intuition become a basis for legal decisions that effect the lives of hundreds of thousands of millions of people. What kind of life experience do they have with lesbian and gay parents. I would imagine as to where they are limited. I mean, I don't know that for a fact but if you have limited life experience and you rely on our intuition how will that be different than relying on your stereotypes or your predecessors? If you have noted countervailing experience to correct your prejudices then it seems to me it just throws you back on your stereotypes and your predecessors. Okay so with that if I can technologically find Ellen's presentation. I am going to introduce Ellen Perrin. Ellen Perrin is the Professor of Pediatrics, Director of the Division of the Developmental-Behavioral Pediatrics at the Floating Hospital which is part of Tufts-New England Medical Center in Boston. She is the author of the book Sexual Orientation in Child and Adolescent Health Care. And I could tell you there is probably no single person more responsible for the American Pediatric Association's policies on same sex marriage and lesbian and gay parent's adoption than Ellen Perrin. So we are very privileged to have her here. Let's welcome her. Thank you. I sometimes have trouble being heard. Is this can you hear me? All right, I think I might take this out. Is that better if I do this? Okay. So first of I wanted to tell you a little bit about children who have gay and lesbian parents although. Don't know nearly enough about them but there are certainly more than a million of them and fewer than eight million. Then that's a very big range. What's really interesting is that we now know as of the last census that parents - gay and lesbian parents are raising children in 96 percent of the counties in the United States. So contrary to some people's opinion would that this is a sort of phenomenon that existed in New York and Washington and Boston and San Francisco in fact these are families that are all over the country. 34 percent of lesbian couples and 22 percent of gay male couples are raising children and an interesting phenomenon is that six percent of same sex couples are raising adopted children and that compares with five percent of heterosexual married couples who are raising adopted children. So it's actually very similar. Also found interesting that 41 percent of gay and lesbian couples have been together for five years or more. And just by way of comparison 20 percent of heterosexual unmarried couples have been together that long. And that's that's the appropriate comparison since obviously accepted unless you live in Massachusetts, gay and lesbian couples can't marry. And they have only been able to do that for three years so you don't have very much data yet and there are lot of ways that gay and lesbian adults become parents. Most of the children who have gay or lesbian parents were conceived in the context of a heterosexual relationship and that's still true although that proportion is getting smaller as more and more committed gay and lesbian couples are bringing children into their families, with in that couple relationship. But clearly foster parenting, adoption, surrogacy and alternative insemination are all possible ways for children to be in a family where gay or lesbian individuals, couple single people or couples are their parents. So the research, kind of, is all over the place. Basically it addresses a couple of questions. First of all and I think in some ways the most important question is how are families that have two parents of the same sex different from traditional families that include two parents of different genders. And so that that's a question that, I think, that's the most important question but it's the one for which we have the fewest data. We know more about parent's adjustment, happiness and their relationship about family and neighborhood integration of these children, about children's adjustment and emotional health, self esteem and so forth and a bit about their experience of stigmatization and social isolation. So I am going to just kind of run through for you the data that we have. And in my mind, it can be classified into three sort of waves. The first set of studies addressed children with lesbian mothers after divorce. The second children born to or adopted to lesbian mothers and the third and really important set of studies that, I will get to later, is community samples. So first the wave one the after divorce studies and this was basically compared lesbian mothers who got divorced and had custody of their children with heterosexual mothers who got divorced and had custody of their children. So it's a fairly nice comparison. There were there are a lot of things that one can't control in that situation and of course those weren't but there were nine studies that I think were good enough. And mostly they were done in the 80s and early 90s and there were quiet a few children there. 260 is probably conservative or probably even more than 260 children in each group. So that even though each study was relatively small taken together we are talking about a lot of children. The children were all young and it was a cross sectional design and that's just kind of the reality of doing small studies. And basically they found no differences in intelligence or in academic success, in psychiatric disorders or self esteem and children's well being or peer relationships and in or in the couple's relationship or in parental stress. And there is only one slide that summarizes this because all the studies found the same thing, basically. This is obviously a summary but the results of these kinds - of these kinds of studies are amazingly monotonous. It's kind of over and over the same results and you will see, I will say the same thing over and over again. One of the studies was able to go back 11 years later to the children that they had studied in 1983 and ask what had happened with those children? Unfortunately not more of them, the others were all cross - well they were all cross sectional but the others weren't able to go back and do a follow-up study. So in 1983 this study consisted of 37 children of 27 lesbian moms and 38 children of 27 heterosexual moms and found what I told you a minute ago. But in 1994 they were able to trace 25 of the now young adults, they were 17 to 25 years old, these kids. With the lesbian moms and 21 of them who had heterosexual moms and again they found no differences in adjustment of the children or self-esteem, no differences in the types or prevalence of psychiatric or psychological problems, no differences they could measure in family relationships and no difference in sexual orientation of the children. They were young adults again. So then we come to wave 2 and there are two large descriptive studies that are actually still going on, One the Bay area family study which consisted of 26 couples and other the national lesbian family study which consisted of 77 couples, that latter one is quite amazing because they have been able to keep all those all those couples involved and the children are now 17. So in that study the person who is in charge of it is now going back and doing interviews with these 17-year-old children whom they followed all this time which is really quite incredible and I am really anxious to hear what they find. But then there is also a group of comparison studies where children whose parents were lesbian couples who became parents were compared with children whose parents were heterosexual couples who became parents. So this is in the context of a lesbian - an ongoing lesbian relationship this is different from the previous one. So there were seven studies during the - basically the 90s and again the number of children if you put all those studies together is fairly reasonable but again they were young children and again its cross sectional and there are no longitudinal data from this. So these are real limitations that I am mentioning, the fact that the children are as young as they are and we don't much about teenagers and that we don't have any possibility of knowing because the data are all gathered in a cross sectional manner. But nevertheless they looked at the knowledge - of the parent's knowledge and attitudes about parenting and found no differences. They looked at stress self esteem and psychological symptoms among the parents and found again no differences and looked at the couples relationship, did find some interesting things there. Primarily that lesbian couples shared household and child care tasks more equitably than did heterosexual couples. Another thing that was just started to be looked at this time was children's and their parent's relationships with the extended family and there they found again no differences. This was one of the critics, of lesbian couples and their children, was that this was depriving children's relationships with grandparents. So this the reason that these investigators looked into this was to be able to show that in fact that wasn't case which it turned out not to be. Among children, as I said, the results are fairly monotonous. There was no difference in cognitive or academic functioning in these children, no differences in their emotional adjustment or in their peer relationships and no differences in their gender behaviors. They did do better when their parents were doing better which isn't really too surprising and specifically when their parents had a more satisfying and equitable division of labor that was good for kids. There were a few sort of suggestive findings, findings that don't that don't have sort of statistical backing, but that I think are really interesting. Already mentioned the first two actually but some of the children looked like they were more nurturing and less aggressive than the children in the heterosexual families and this finding was not only noted by parents but also by teachers that the that the children whose parents were heterosexual were more aggressive. The children who had lesbian moms also seemed to more tolerant of different-ness again these are very suggestive findings and I I have wondered myself whether this has anything to do with sexual orientation or whether this is about - they have two moms. But that's just, no, we don't know. So I've kind of mentioned along the way that there are definite limitations to this research, especially the small samples but I just have to counter that by saying that if you take all of these studies together the samples aren't really so small. The problem is the studies were done differently enough that one can't do a really formal meta analysis and really end up with sort of very powerful statistics. So we are still limited by that problem. We are also limited by the fact that many of these studies were done at a time when it was difficult for gay and lesbian adults to come out and be involved in a research project because of the various threats to them and their children that might have been forthcoming. So most of the studies involve middle class white, urban, well educated women and that's the in my mind a very serious limitation and one that we really need to be working to correct at this point. I think that's okay. So now I am very excited about the fact that there now are two representatives, two studies that use representative samples. So those, so these overcomes some of the problems that I have just mentioned. The first one is called the ALSPAC Study and that I am not sure I am going to be able to remember how that, what that stands for but it's the first words are the the Avon Longitudinal Study something, something Children and I don't know what the P and the A are. But at any rate it's a cohort study that was done in England of all the children born in a certain county during one year and it was done by people who have no particular interest in gay and lesbian parents. It was done to look at various issues related to child development but then somebody who is interested in gay and lesbian parents and their children went back and said well surely some of these mothers must be lesbians, so let's go back and look. And they found 39 children who had lesbian mothers, about half of them single and half of them in couples and about two thirds of them originally born into a heterosexual relationship and 11 of them born by alternative insemination. And then they did a random sample of the rest of the kids in that county who had heterosexual parents and looked at the difference. So it's a very nice design and it gets - it overcomes some of the problems that have been - existed with the previous studies. Unfortunately at the time that this was published the children were only five to seven years old but that study has been funded and they will be looking at older children, so stay tuned. What four more minutes, okay I will try to talk fast. Okay, so they one of the things is very interesting about this study is that they asked not only parents but also children, teachers and psychologists to report about the children and I will kind of run through quickly the fact that they didn't find any differences in warmth, emotional involvement, parenting quality, conflicts, play, relationships with partners basically they didn't find any difference. The only differences that they did find was between single parents and coupled parents independent of sexual orientations so single, a single lesbian mom or a single heterosexual mom had a little more difficulty not much but a little more difficulty in these areas, I will skip that. And then about the children again there were no differences in the mothers, teachers or psychologists reports or the teacher or the children themselves between those two groups. So the third just moving quickly through it, the second representative sample was the national, what's it called National Longitudinal Study of Adolescent Health which some of you may know about, that's actually ongoing and there are, that was a random sample of high school students across the United States. There were 12000 of them, again done by people who had no particular interest in this topic but then someone else went back and said, can we learn anything from this, you know, big random sample of US high school students and what they did was to try to identify, they tried to identify which children might have had lesbian moms and I won't tell you all of the details about how they did that but they did as good a job as they could given that the question wasn't really asked, so they have to kind of figure out a way to to kind of identify them and then did a random sample or matched actually those kids with kids who had heterosexual parents. And once again then they did not find any difference in any of the relevant variables whether the children were, had lesbian lesbian couple for parents or heterosexual parents. I just want to sort of raise the fact that there are lot of legal issues that are based on all of these data or should be based on all of it rather than on intuition should be based on all of these kinds of data. Issues about custody and visitation, about foster parenting and adoption, about sort of the benefits of death and disability benefits and health insurance and social security but also co-parent adoption, second parent adoption, civil unions and civil marriage are all issues legal and ethical and social issues that should be based on the kind of data that we have been that we do have despite the fact that the Focus on the Family doesn't like it. And essentially all of the national organizations that care about children would support that. The American Academy of Pediatrics is the one that I know the best. And they have been supporting initially gay and lesbian teenagers since 1983 and in 2002 published a policy statement on co-parent and second parent adoption by same sex parents. Since that time they have developed a number of sort of public education materials and in exactly a year ago published an article on civil marriage on sort of a laying out the information that I have presented today on civil marriage and essentially all of these organizations have done similar, have made similar kinds of supportive statements. And this is the so this is the last sort of sentence or two of the article from July of '06 that the American Academy of Pediatrics put out. So conscientious and nurturing adults whether they are men or women, heterosexual or homosexual can be excellent parents. Their rights, benefits and protections of civil marriage can further strengthen these families and this, so this is the conclusion, the concluding paragraph of an article that summarized a lot of the sort of state of the art, so to speak across the country with regard to domestic partnership, civil unions and civil marriage for gay and lesbian parents and is very much the consistent policy or reflects the consistent policy of the Academy of Pediatrics. So thank you. So would you call the American Academy of Pediatrics a homosexual activist organization? You can call that, right. And as far as I know you are a married heterosexual woman but that's besides the point. I mean, the point is that sexual orientation of researchers should not have any bearing on the validity of the research and what was interesting is when Focus on the Family and these groups are confronted with the fact that, you know, is it really likely or possible that these are homosexual activist organization, always professional organizations that have policies, you know, in favor of second parent adoption and so on. But what do they say in response, you know, what their response is? They say, well those are organizations that have been hijacked by homosexuals within those organizations that are pushing the homosexual agenda, all right. Our next speaker is Dr. Jack Drescher, Jack is a psychiatrist here in New York City and the psychoanalyst in New York. He is the training and supervising analyst at the William Alanson White Psychoanalytic Institute here in New York. He is Editor of journal of Gay and Lesbian Psychotherapy and I think it's fair to say that he is the or at least one of the leading experts on conversion reparative ex-gay therapies in the United States. If you are a reader of the New York Times his name will be very familiar to you because for no other reason that during the Ted Haggard episode I think Jack's name was in the paper at least as often this Ted Haggard's if not more and Jack is pardon me. You know Ted Haggard claimed to have been cured in three weeks. And as I said recently it takes longer to cure locks than it's took to cure Ted Haggard in any case. So I'll just let Jack give his thoughts. Hi thank you. I was just mentioning to Ellen that there will be a parallel vein in terms of the politics involved in these issues after the American Academy of Pediatrics did put out this position statement in support of same sex, second adoption and same sex couples the an organization formed called the American College of Pediatrics which had a few members say compared to the the main stream group but provides the kind of cover for these conservative organizations to pretend that there is another organization that opposes these policies. So this is we will hear a little bit about that now Now I am going to talk about 150 years of history in 15 minutes. But I will be quick very quick and we shall go all bit about the history of mental health attitudes towards homosexuality. A little bit about the issue of the sexual conversion therapies and their role in our cultural wars. So briefly touch on some clinical and research issues and then some ethical issues. And I may not finish everything but we can talk about it in the question and A as well. So we'll start with the history of mental health attitudes. Most of you probably know that you know, in Academia we talk about the invention of the homosexual started in 1869 when the word was first coined by journalist named Károly Mariá Kertbeny. The term was picked up by psychiatrist particularly Richard von Krafft-Ebing in a book which he published in 1886 called Psychopathia Sexualis in which he listed all types of sexual behaviors which basically was the beginning of the entrance of unconventional sexualities into the psychiatric lexicon. Freud actually 20 years after Krafft-Ebing, was very critical of the theories which Krafft-Ebing used which considered homosexuality to be a disorder. He instead thought of homosexuality as a normal part of human sexuality. He believed in an essential bisexuality with homosexual being normal to a certain degree in every person but people who grow up to be adult homosexuals suffered from what he referred to as a developmental arrest. So they weren't sick they were immature. Not quite not quite in illness, not quite normal. But Freud's major reporting on the issue of homosexuality was a case he published in 1920, Psychogenesis in which parents brought their 18-year-old girl to be treated by him. He was very pessimistic about the possibility of change, said it there wasn't much prospect for success than the reverse except that for the good practical reasons trying to change a heterosexual into a homosexuals is never attempted. And Freud kept this position pretty much to 19 till his death in 1939 in the letter that came out in the 60s in which he was writing to the mother of an American man who was asking for his help in changing her son. And again he talks about it, there is nothing wrong with homosexuality but that is not an illness but in his words a developmental arrest. Now after Freud in the middle of the 20th century, the science around studying homosexuality is really can be centered around two groups. You have what I refer to is the Neo Freudian analysts, the people who come after Freud, who re-conceptualize homosexuality as an illness based on the theories of people that they treated who came into their offices. That is the entire [0:34:38] ____ like their homosexuality is almost entirely based upon the complaints of people coming - going to see psychiatrist and psychoanalysts. On the other hand you had sex researchers or sexologists who were coming up with another version of homosexuality. That is it's a normal variation of the human sexuality. And as supposed to the the psychoanalysts they are where drawing their theories based on samplings of general populations that is people that they were interviewing, but not necessarily psychiatric patients. And so the people on the let us say on the right although in my slide they are on the left are people like Bergler, Bieber and Socarides and the people on the left on this issue on the slide are on the right, such as Albert Alfred Kinsey, Ford and Beach and Evelyn Hooker. Now these two theories of these two approaches where homosexuality come clash eventually in 1973 when the American Psychiatrists Association decides to remove homosexuality from it's diagnostic manual. And the catalyst for this clash, of course, are gay activists who after the Stonewall riots which I don't have to explain to this audience I am sure. The riots energized the gay community and one of the first things that they did is they identified psychiatrists as their enemy. Prior to Stonewall many homophile organizations in United States tried to work with mental health professionals in a pre ADA era. That is to say that they argued that since homosexuals were sick they should not be laws against it because it was an illness not a crime. So they tried to work in an ADA model and then decided that that wasn't working. The diagnosis itself is really the problem. So they came and they two meetings of the APA I mean I wasn't I was not in medical school actually yet when this was starting but in 1970 and 71 they came to APA meetings and they zapped them, which means they disrupted them. They came running down the halls grabbed the microphone away from the doctor at the podium who was giving a lecture on how to cure homosexuality. And this got the APAs attention. And so in 1971 APA organized the first panel of nine patients, homosexuals in which they got to tell psychiatrist about their lives and what it meant to be diagnosed by psychiatrist. Then they did the panel against 72 but this time one of them, the late Barbara Gittings and her partner Kay Lahusen got the idea lets lets we should have a gay psychiatrist. But where are you going to find a gay psychiatrist in 1972 when homosexuality is illegal in most states, you could lose your medical license, lose your job etcetera. So they found a doctor who is willing to get on stage in disguise, John Fryer of Philadelphia. And this is what an openly gay psychiatrist looks like in 1972. Wearing a Nixon Halloween mask and a fright way and an over sized tuxedo, disguising his voice on the stage with Barbara Gittings and Frank Kameny of Washington D C. they talked about the experience and John Fryer, this is a picture of Dr. Fryer and shortly before his death in 2003. Dr. Fryer told basically his colleagues you know, the prejudice gay psychiatrist themselves experienced because they have to hide who they are. And this also had an enormous impact on the organization because I think it brought it down to a very personal level in terms of the meaning of what was going on. This is a book that I have just I have edited it it just came out last month which has a lot of an oral history of many of the people who were involved in 1973 decision. And so while all these panels are going on the scientific committees of the APA are also meeting to discuss what's going on and psychiatrist often don't reach outside their own literature so many of them were unfamiliar with the Kinsey research and the various criticisms of the psychiatric approach and they were exposed to it. And the committees decided that the scientific literature from the sex researchers actually was better and more scientific than the skewed samples that were being presented by the psychoanalysts. So the committees decided to they were recommended to the APAs board of trustees that homosexuality be moved from the diagnostic manual which was then in the second edition. We are now in on fourth edition and working toward our fifth. Psychoanalysts at the time protested, they partitioned the organization to have a referendum to have a general membership to vote on the issue. This is a very important piece of historical information because the people on the right wing tend to say that the decision was done in a non scientific way by a vote. They don't tell you that the people that that opposed the removal where the ones who called for the vote in the first place. But that's not what the people that's not what the psychiatrists actually voted on. The 58 percent voted just toward the board of trustees. If you ask those people, most of them probably didn't think that homosexuality was an illness but they trusted the scientific process of their professional organizations and that's what they were really voting on. So this all leads us up to the current cultural debates about conversion therapies in which clinical debates turn into culture war. Now after the APA decision we saw a gradual cultural normalization of homosexuality. In which several ideas come to the surface, that is if homosexuality is not an illness and if one doesn't literally accept biblical prohibitions against it and in fact contemporary secular Democracy separates church and state and if openly gay people are able and prepared to function as productive citizens then what's wrong with being gay? That's where we are today, that's the arguments. In addition polls consistently show that knowing someone who is a gay like a family member, a friend, a co worker increases tolerance and acceptance of homo sexuality. So the culture wars has two sides mostly you probably know. One is a pro gay side which is trying to create the means by which more people come out and that's the basis of the civil rights movement and the anti gay movement is trying to make it more difficult for gay people to come out that is to create obstacles to that process and try to put the genie back in the bottle. So this brings us to the resuscitation of the sexual conversion therapies which in part grew out of the group of psychoanalysts who refused to accept the APA decision for a long time in fact the American Psychoanalytic Association only adopted a sexual orientation non discrimination statement in 1991 after they were threatened with a lawsuit. In mean time though that people who are taking this old view of sexuality are becoming increasingly marginalized in the mental health main stream but they are being adopted by the people on the right. And so in 1992 you get the founding of NARTH the National Association - you heard about the National Association for Research And Therapy of Homosexuality. This is my mnemonic for remembering NARTH and not because they represent an evil empire although some people think they do because it's all science fiction. Anyway so this is a so this is a group that believe that homosexuality is a mental disorder and those who want to change try to change they claim 1500 members the APA my APA for example has 35000 members, American Psychological Association has 150000 members but the newscasters will show ahead from both organizations as if both parties were equal and they couple religious theories, old fashion psychoanalytic theories and they provide the religious and social conservatives a dissenting scientific sounding voice to counter the mainstream views of homosexuality, which are these two models I won't go into the basics of the model but I will just say that after the 1973 the old model which is now marginalized gets taken up by a social conservative political movement and they argue that if homosexual behavior can be changed in just one person then homosexuality cannot possibly be inborn even though this is not true but it is a popular belief and homosexuality is not inborn like race and in many ways the gay rights movement is modeled on the African American Civil Rights Movement. If its not inborn like race then gay people cannot and should not be considered a minority entitled to legislative protections and here is a perfect example here is a group of people who call themselves ex-gays and they are not these is an ad that was printed in newspapers opposing sex hate crimes legislation with the argument that we are more valuable when we are gay or than we we're not. And what's interesting about this kind of thing is that the people who are featured in these ads are what's one critic has called ex-gay for pay. So if you look at the woman on the left and the man on the right here they appear in the center the woman is carrying the sign changes possible and the protest against the American Psychological Association's meeting. We need to know that the ex-gay movement every year APA we have protesters objecting to psychiatrists being in the middle of people lives ex-gays are only one who come to our meetings who want to be put back in the diagnostic manual. It's a very interesting kind of contrast. But this is going on all the time. To make it appear that there is this group of people who are dying for psychiatric treatment being denied and what's very important about this is that the ex-gay political agenda has paralleled the intelligent design movement because its invented by the same people and so the basics of this movement are to present in the issue to the public not to within the profession but through he public as if it were debate within the mental health professions to finance and promote ideological experts and think tanks like NARTH and the Family Research Council and institutes, to provide personal testimony from these ex-gays for pay, to discredit science, the motives and methods of main stream mental health organization and to attack individuals whose work undermines that agenda and to confuse the public with pseudo science and selective scientific citations. And as mentioned, there has been a lot of media attention to this. I do not have a personal publicist but these are all the places which have sought me out for quotes on this issue because reporters and media are confused by the amount of money being spent primarily by the Focus on the Family to publicize these types of activities and this is really you know the all major networks, all the cable TV news work networks and all the national newspapers and magazines. So this is just what's going on in your back yard. I do not think I have time to go through all the the rest of the issues on clinical issues and research issues. Briefly to say there is little research on whether there are benefits or harms. The majority of people in published reports do not change, the people who proposed these treatments overstate the benefits and minimize any harm done. They believe people that these treatments have not been scrutinized because many people believe that there is no harm in trying to change but that's that's actually not true. They do not select people who have the better chance of changing from those who do not, so there is not what we called selection criteria in choosing patients and they have often blamed the patient when the treatment doesn't work saying that it's the patient's motivation rather than the efficacy of the treatment that determines the outcome. After treatment fails patients can feel worse, they usually blame themselves, they question their faith if it's a religious treatment. They question their motivation and in many cases again this is anecdotal, there is not good studies on this. Failure leads to worsening of depression, onset of anxiety, possible feelings of suicide and these are never reported in the literature of people who do these treatments. People are encouraged to get married, try and help them change families break apart. Or they stay together because they are religious, and they don't believe divorce and live in tragic circumstances and finally people have what one research across the spoiled gay identity that this, they get this concentrated dose of anti-homosexual propaganda and the conversion therapy so that they find that it's not working they do come out they are they delay it coming out. They have learnt more internalized homophobic beliefs and they may interfere with their inter personal intimate function. The American Psychiatrist Association in 2000 came out with a very strong position statement a cop refers to the commission on psychotherapy by psychiatrist where the reparative therapy cops recommending that APA respond against the claims that homosexuality is a disorder and to respond to these religious and political organizations and we recommend that ethical practitioners refrain from attempts to change individual's sexual orientation keeping in mind the medical dictum to first do no harm and that recommends further research into this subject. I won't go into the Spitzer study. Talk just briefly some ethical issues that come up in these treatments. The ethical violations include giving patients what they call subjective informed consent, that is telling the patients that it doesn't mater with the APA say, homosexuality is really is a disorder that APA have been taken over by the homosexual agenda. Confidentialities were often breached many students and religious universities are compelled to go into treatment if the school finds out, the therapist tells the school, tell the parents, students gets expelled because of these breaches of confidentiality, pressures placed on patients improperly to get these treatment and the therapist relinquish what we call the fiduciary responsibility to the patients who come out gay which means that if a patient decides that its not working and they want to be a gay the therapist doesn't provide with them any services to help them to make that adjustment. Either the patient is abandoned or the patient is is continued to be treated as resistant to the treatment. Finally on the religious right they are arguing for something called the patients right to choose. This argument came up in that prestigious medical journal the Wall Street journal by Charles Socarides and his colleagues in which they argue that patient should have the right to choose a treatment that they want and this is a very interesting approach because what they do is they take one ethical principle and they elevate it above all others and so one of the things that we we have been arguing is that ethical principles exist sometimes in conflict with each other. So the patient's right to choose for example may be in conflict with possible harm of the treatment and there is medical precedent for that in the history of literature which people may know about. A medicine which was supposed to be useful in the treatment of cancer which which didn't work and which people sort out and wanted and like the ex-gay movement fought for it and politicized for it but the FDA said no and you can't prescribe it and its malpractice to do that. Unfortunately there is no FDA for reparative - there is no government body that does this. And then in terms of another example recently Vioxx it was a pain medication which would literally did help millions of people but a few thousands people died from the medicine and so the manufacturer took it off the market. There is no my position is that the religious right doesn't care how many gay people they hurt if they create a few heterosexuals in the process and that is something that a lot of straight people need to understand as well. Plastic surgery simply refers to the idea that - it is possible to treat a condition that is not an illness, as cosmetic plastic surgeons often do however the standards of care that plastic surgeons use are not the kinds of standards of care that reparative therapists use. So there is no way you can analogize those two situations. And the final question is why don't the patients feel harmed file complaints against their doctors and this is what the patients I have seen has said to me they blame themselves. I asked for it, they see all that therapist's concern but misguided that they only tried to help and often if they decide to come out they feel very ashamed that they went - they asked for this in the first place. So it tends - I have sat on an ethics committee when a person makes - and that - there is complaints is it's often very traumatizing to have to relive the situation with the doctors. So there is not a lot of complaints going on. The Association of Gay and Lesbian Psychiatrists have produced a documentary video on the reparative therapies called Abomination: Homosexuality and the Ex-Gay Movement which is available at our website www.aglp.org. Thank you. Thanks Jack. And I think another medium for to think about is adolescents are sometimes being coerced into treatment, to change their sexual orientation and because parents have the legal right to, you know, determine the treatment that adolescents get there is a serious issue of informed consent or ascent for adolescence being forced in the treatment. They are placed I think in the Arizona where kids are forced to dress in tradition and gender conforming ways and nonverbal conforming nonverbal behaviors and all that in order to how to cross your legs, how to hold your hands, how to walk all that kind of stuff. And also the fact that you know it seems like there is a certain percentage of people in ex-gay therapy who can change their behavior but are unable to change their underlying attractions. So is that you know a change in sexual orientation or is that just matter of temporary suppression of ones underlying attractions is another important distinction that they fail to make you know. Okay I have to find out a place here. So I am going to talk about same sex couple relationships, very brief history in 1999 California passed it's domestic partners legislation. More recently it was made to be equivalent to what we think of a civil union legislation namely that domestic partners in California now have all the rights and obligations that married couples have in California. So it's equivalent to civil union laws in other states. In the year 2000 Vermont passed it's Civil Union Law of 2004 marriages. Currently there are 10 states, I think, might not be 11 with legalized same sex relationships and one with same sex marriage. However, there are 42 states with difference of marriage acts and 26 states with constitutional amendments prohibiting same sex marriage. So if you ask how we are doing in this political struggle it seems like lesbian and gay people are not you know earning - winning their right to marry in most of the states. The anti gay groups continue to point to a number of reasons why they think lesbian gay people should not have the right to marry and among the most important reasons they point to is that they say that lesbian and gay people have shorter relationships and a lower number of children are being raised in those relationships. Of course, they have regulations that would prohibit us from adopting children. So how do you - how do you have a higher number of children being raised in a relationship and even so as Alan pointed out in another survey said 39 percent of same sex couples are raising children. So there are significant - about a third of same sex couples seem to be raising children as it is, so this notion that same sex couples are not raising children is you know doesn't apply and further more there is nothing in the marriage laws in any state, that requires you to raise children in order to be married. Or to stay together for a long time for that matter, or to be monogamous for that matter. Those are not litmus tests for getting married. Those are heterosexual. So what do we know from the research about the same sex couples I am going to try to really be brief, so I really want to leave time for discussion. Your census says that about 594000 household were identified consisting of same sex unmarried partner in census 2000. Well most researchers, demographers believe this is a vast undercount. Because large portions of the lesbian gay same sex couple community probably does not want the government to know and it is afraid that even though the census promises you know, anonymity, confidentiality that in fact - they are afraid of the government having this information about them. What's most striking if you look at all the research that's been done on same sex couples and by now it's pretty voluminous, there is you know, well over a 100 studies that have been published in peer review journals. The identical predictors for same sex couples as for heterosexual couples predict to the satisfaction and stability of couple relationships. And the predictors are partners placing more value on security, permanence, shared activities and togetherness, partners placing lower value on having separate activities and on personal autonomy. Higher expression and this is associated with more satisfaction and stability. More perceived intrinsic rewards for being in the relationship were associated with more satisfaction and stability. Fewer perceived attractive alternatives of the relationship, more perceived barriers to ending the relationships are associated with satisfaction and stability. By stability I mean, longevity or durability of the relationships. Other predictors are there is couples have less belief to disagreement as, destructive are more likely to stay together and satisfied. Couples who had trust in their partners, viewing their partners dependable securely feeling securely attached to the partner. Couples that have better problem solving and conflict negotiation skills show less anger in their conflict discussions, engage in less character criticism directed towards their partners. Show less withdrawal and silence and stonewalling in conflict situations. Couples that have higher shared egalitarian egalitarian decision making and more satisfied. Stay together longer. And couples that have more perceived social support from sources outside the relationship, one of the most interesting findings in this literature is that same sex couples and heterosexual married couples report almost identical levels of support from outside their relationship and heterosexual couples report a lot more of their support comes from their families of origin. And same sex couple report a lot more of their support comes from their friendship networks or what it has been called families of choice. Some differences between the three types of couples. Lesbian couples, in a study that I and two colleagues had lesbian couples turned out to a report that they are much closer than - significantly closer than gay male couples who in turn reported that they are significantly closer than heterosexual married couples and these results were quite dramatic and contrary to predictions. With all the literature up until one where you publish you study said that well two men together are probably disengaged because men are not as relational and nurturing and you know, I guess the ideology was that the idea was that you took two heterosexual men and put them together in a relationship they would be pretty disengaged so when you put, you know, they they wouldn't be very close and that was the thing that they were analogizing from that image to you know, gay men. They didn't think that maybe gay men are different than heterosexual men in a variety of ways, that might lead them to actually be closer to one another than what have heterosexual married couples that consists of one heterosexual man and one heterosexual woman. So and we also found that lesbian and gay male couples were dramatically I mean dramatically more egalitarian and showed greater role flexibility in terms of sharing of household household tasks. Taking turns doing different household tasks, not having fixed gender roles or division of labors in the same way that heterosexual couples do. This is a whole literature on gender roles and heterosexual married couples and one of the most significant findings is that after the birth of children most heterosexual couples despite their best intensions devolve more and more towards traditional gender roles. And that's very hard to do if you are two women after the birth of children or two men after the birth of children it's not there. But partner A or partner B is supposed to play which role. There is no prescription about it. So for force, same sex couples are forced to negotiate that [0:59:24] ____ for each couple. And it's also seem to be the case that same sex couples are short have shorter duration than heterosexual married couples. And why do they have shorter duration. We don't really know but some speculation is there are some greater challenges and stresses for same sex couples in particular facing prejudice and discrimination from their families. And from their surrounding communities, sometimes couples report different levels partners report different levels of out-ness, that's a source of significant conflict in their relationship because one can't afford to be out. And the other can't afford to be out and the other can't afford to be out because of her or his work setting and that creates a lot of conflict in terms of way they are leading their lives. Also same sex couples are faced a lot of relation of what I have called the relational ambiguity. It's not clear what it means to be a same sex couple, does it mean for example that you live together or not. Probably, you know, same sex couple would define themselves as couples but don't live together. Probably, you know, same sex couples who have monogamous relationships and some who have non-monogamous relationship that's part of their agreement. So the very definition of what it means to be a couple is completely up in the air for same sex couple whereas heterosexual couples have this sort of received template, the sort of prescribed way of being a couple that they can fall back on and devolve into in the lack of when there is ambiguity. Well at least they have a set of expectations that they believe is going to hold for their own couple relationships where same sex couples don't even have that set of expectations whether they are preamble to models they learned about couple relationship with growing up, is that going to apply to their same sex couple relationship is, you know, what they saw on their aunts and uncles and parents with heterosexual married relationships. And the third issues and I think this is quite significant, is the lack of family support is a is a loss for many long term same sex couples. You know, the inability to have consistent family support. I mean in fact most families of origin of same sex couples are somewhat accepting in the United States. They usually let the partner come around, hang around but they often treat the partners as a friend of the family rather than a bona-fide family member. And I think that is a significant difference psychologically for a lot of same sex couples. So lets see another reason that married couples might stay together longer is they have greater family and peer pressure to stay together, I mean who is rooting for most same sex couples to stay together, you know, do your parents care whether you stay together or they are just kind of a neutral about it. You know, married couples are much, much more likely to be raising children. And whether we would like to think it or not children are a very strong incentive for couples to stay together. If you are raising three kids together and and you love your kids and you wanted to be part of your kid's lives, every single day and watch them grow up that is a strong incentive to work out problems in a couple relationship. So I think couples that are raising children we don't know this for sure but are probably more likely to stay together as a result of having children and also there is economic consequence. If you are raising children your budget stretched thinner so its harder to separate because if you are living alone you are separated. We know the people's disposable income goes down especially women's disposable income goes down sometimes men goes up after divorce but women's almost always goes down especially if they have primary custody of of the children. I could go on saying more about this but I think in the interest of time I won't. I want to leave you with this really interesting findings. Tony D'Augelli, Arnold Grossman and what his name Jonathan Rendina just reported this past year they did a large scale study in New York City of youth aged 16 to 22, mean age 19. 42 percent Hispanic, 39 percent kids of color and 83 male and 50 female. In the survey they asked them their couple and family aspirations. 92 percent of lesbian youths and 82 percent of gay male youths said that they wanted to be in a long term monogamous relationship within 10 years. And even more interesting 66 percent of lesbian youths and 52 percent of gay male youths said it was very or extremely likely that they would be raising children in the future. I want you to think about the implications of these data, if they hold up with other samples. What are the implications of these data for the LGBT community? How it will affect the community and how the rising family aspirations of lesbian and gay youths are going to clash with the anti gay groups contention that these that lesbian and gay people are incapable of you know, satisfying and durable couple relationships and and satisfactorily raising children. Nobody has argued that marriage rights would harmful rather than helpful to same sex couples. I have never heard that argument. Even from the anti gay groups. And we should really ask them if they care about same sex couples, do they think or lesbian gay people they think they would be harmed by same sex marriage or helped with that. Probably they would say something like that. We would rather cure them and support them. There is also no credible evidence that same sex marriage will be harmful to heterosexual marriage. For a while the anti gay groups tried to claim that in Scandinavia the rate of divorce and the decision to remain single increased as a result of the advent of same sex marriage in Scandinavia. Lee Badgett and others sort of proved that there was no cause of connection between the two. In fact the rate of heterosexual divorce was increasing and the rate of heterosexuals choosing to remain single was increasing before the advent of same sex marriage in Scandinavia and the rate of increasing divorce and so on did not increase after the advent of same sex marriage. So that idea was disproved. Not that the anti group groups accepted that countervailing evidence and so on that note, lets open it up to discussion.