"Some Gays Change," Prominent Psychiatrist Says

NEW ORLEANS--A study released [July 9, 2001] which shows that some gays and lesbians can experience a significant shift in sexual orientation is making media headlines across the nation. Dr. Robert L. Spitzer, Chief of Biometrics Research and Professor of Psychiatry at Columbia University in New York City, announced the results of his research in a presentation today at the annual meeting of the American Psychiatric Association.

"Contrary to conventional wisdom, some highly motivated individuals, using a variety of change efforts, can make substantial change in multiple indicators of sexual orientation," Spitzer said.

Dr. Spitzer, a leading figure in the 1973 APA decision that removed homosexuality from the official diagnostic manual of mental disorders, said that he began the study as a skeptic. "Like most psychiatrists, I thought that homosexual behavior could only be resisted, and that no one could really change their sexual orientation. I now believe that to be false. Some people can and do change," he said.

The Spitzer study is reported in today's issue of USA Today, The Washington Post, The New York Times, and was released to hundreds of local newspapers by the Associated Press. The story is also being widely reported on the World Wide Web through such prominent news sites as foxnews.com, cbsnews.com, abcnews.go.com, and msnbc.com. Dr. Spitzer was featured on this morning's edition of "Good Morning America."

Spitzer's study was "based on 45-minute telephone interviews with 143 men and 57 women who had sought help to change their sexual orientation," reported The New York Times. "[Spitzer] and his colleagues found that 66 percent of the men and 44 percent of the women had achieved 'good heterosexal functioning'."

Today's edition of The Washington Times gives more details of the study's results: "Before changing, 20 percent were married. Afterward, 76 percent of the men and 47 percent of the women had tied the knot. The typical respondent started trying to change at the age of 30 but did not feel any different sexually for at least two years. Seventy-eight percent reported a change in orientation after five years.

"Due to a combination of therapy and prayer, 17 percent of the men and 55 percent of the women reported they had no homosexual attractions whatsoever. Twenty-nine percent of the men and 63 percent of the women reported 'minimal' same-sex attractions," The Times said.

Spokespersons for various national pro-gay organizations issued statements today attempting to discredit both Dr. Spitzer and the study's results. "This study has little scientific value because the sample was largely drawn from organizations with strong anti-gay missions and appears to be a reflection of the researcher's personal bias," said Wayne Besen, Human Rights Campaign's Associate Director of Comunications. Bob Davies, Executive Director of Exodus North America, dismissed these protests as invalid. "Dr. Spitzer is a self-identified humanistic atheist," Davies said. "At the beginning of this study, he was skeptical that change was possible. If anything, his bias is against change, not that change is possible."

Besen claimed that lack of acceptance and fear of rejection may have played a key role in the subjects' decision to enter into conversion therapy. However, the subjects themselves gave different reasons for seeking change, including the feeling that homosexuality was "not emotionally satisfying" (81 percent), conflict with religious beliefs (79 percent), and the desire to get married or stay married (67 percent of the men, 35 percent of the women).

ABC News confronted Spitzer with the claim by some gays that "change therapy" causes damage, depression and even suicide among clients who are not successful in finding change. "There's no doubt that many homosexuals have been unsuccessful and, attempting to change, become depressed and their life becomes worse," Dr. Spitzer responded. "I'm not disputing that. What I am disputing is that is invariably the outcome."

Spitzer told ABC News that some of his subjects had been despondent and even suicidal for the opposite reason: "...they had been told by many mental health professionals that there was no hope for them, they had to just learn to live with their homosexual feelings."

Some gays questioned the subjects involved in the study. "The sample is terrible, totally tainted, totally unrepresentative of the gay and lesbian community," David Elliot, a spokesman for the National Gay and Lesbian Task Force in Washington told ABC News. "But Spitzer said that, while the people in his sample were unusual--more religious than the general population--it doesn't mean their experiences can be dismissed. And, he said, it doesn't mean they aren't telling the truth," ABC News said.

The ABC report continued: "A well-designed survey, [Spitzer] said, can determine whether or not a respondent is credible. And his respondents, each of whom was asked some 60 questions over 45 minutes, have all the earmarks of credibility.

"In fact, he said, to dismiss his survey would be to dismiss an awful lot of psychological and psychiatric research. The methods used in designing his study are the same as those used to determine the effectiveness of drugs, he says."

According to the ABC report, Spitzer asked subjects "very detailed questions not only about sexual attraction, but about fantasies during masturbation and sex, and yearnings for romantic and emotional involvement with the same sex and a variety of other variables that indicate sexual orientation. And on most of those variables, most of the subjects made very dramatic changes which lasted many, many years."

"The assumption that people can't change is a political conclusion rather than a scientific conclusion," said Dr. Joseph Nicolosi, director of NARTH and an Exodus member. "It points to the influential gay lobbyists within the profession, of which there are many. When we issued a study last year saying more than 800 people had changed, it was pushed to the side. But when Spitzer issues this, it has to be listened to because of his track record as a gay advocate."

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The results of a study conducted by Dr. Robert L. Spitzer have just been published in the Archives of Sexual Behavior, Vol. 32, No. 5, October 2003, pp. 403-417.

Spitzer's findings challenge the widely-held assumption that a homosexual orientation is "who one is" -- an intrinsic part of a person's identity that can never be changed.

The study has attracted particularly attention because its author, a prominent psychiatrist, is viewed as a historic champion of gay activism. Spitzer played a pivotal role in 1973 in removing homosexuality from the psychiatric manual of mental disorders.

Testing the hypothesis that a predominantly homosexual orientation will, in some individuals, respond to therapy were some 200 respondents of both genders (143 males, 57 females) who reported changes from homosexual to heterosexual orientation lasting 5 years or more. The study's structured telephone interviews assessed a number of aspects same-sex attraction, with the year prior to the interview used as the comparative base.

In order to be accepted into the 16-month study, the 247 original responders had to meet two criteria. First, they had to have had a predominantly homosexual attraction for many years, including the year before starting therapy (at least 60 on a scale of sexual attraction, with 0 as exclusively heterosexual and 100 exclusively homosexual). Second, after therapy they had to have experienced a change of no less than 10 points, lasting at least 5 years, toward the heterosexual end of the scale of sexual attraction.

Although examples of "complete" change in orientation were not common, the majority of participants did report change from a predominantly or exclusively homosexual orientation before therapy to a predominantly or exclusively heterosexual orientation in the past year as a result of reparative therapy.

These results would seem to contradict the position statements of the major mental health organizations in the United States, which claim there is no scientific basis for believing psychotherapy effective in addressing same-sex attraction. Yet Spitzer reports evidence of change in both sexes, although female participants reported significantly more change than did male participants.

The statistical and demographic details of the respondents include the following:

• The study did not seek a random sample of reorientation therapy clients; the subjects chosen were volunteers.
• Average ages: men, 42, women, 44.
• Marital status at time of interview: 76% men were married as were 47% of the female respondents. 21% of the males and 18% of the females were married before beginning therapy.
• 95% were Caucasian and 76% were college graduates.
• 84% resided in the United States, the remaining 16% lived in Europe.
• 97% were of a Christian background, 3% were Jewish, with an overwhelming 93% of all participants stating that religion was either "extremely" or "very" important in their lives.
• 19% of the participants were mental health professionals or directors of ex-gay ministries.
• 41% reported that they had, at some time prior to the therapy, been "openly gay." Over a third of the participants (males 37%, females 35%) reported that at one time, they had had seriously contemplated suicide due to dissatisfaction with their unwanted attractions. 78% had publicly spoken in favor of efforts to change homosexual orientation.

Employing a 45-minute telephone interview of 114 closed end questions, each requiring either a yes/no answer or calling for a scaled rating of between 1 and 10, Spitzer's study focused on the following areas: sexual attraction, sexual self-identification, severity of discomfort with homosexual feelings, frequency of gay sexual activity, frequency of desiring a same-sex romantic relationship, frequency of daydreaming of or desiring homosexual activity, percentage of masturbation episodes featuring homosexual fantasies, percentage of such episodes with heterosexual fantasizing, and frequency of exposure to homosexually-oriented pornographic materials.

In addition, participants were asked to react to a series of possible reasons for desiring change from homosexual orientation to heterosexuality as well as being asked to assess their marital relationships.

Some of the findings of the Spitzer study, particularly regarding motivations for change, included:

• The majority of respondents (85% male, 70% female) did not find the homosexual lifestyle to be emotionally satisfying. 79% of both genders said homosexuality conflicted with their religious beliefs, with 67% of men and 35% of women stated that gay life was an obstacle to their desires either to marry or remain married.
• Although all of the participants had been sexually attracted to members of the same sex, a certain percentage (males 13%, females 4%) had never actually experienced consensual homosexual sex. More of the male respondents (34%) than females (2%) had engaged in homosexual sex with more than 50 different partners during their lifetime. Further, more of the men than women (53% to 33%) had never engaged in consensual heterosexual sex before the therapy effort.
• Dr. Spitzer said the data collected showed that, following therapy, many of the participants experienced a marked increase in both the frequency and satisfaction of heterosexual activity, while those in marital relationships noted more emotional fulfillment between their spouses and themselves.

As for completely reorienting from homosexual to heterosexual, most respondents indicated that they still occasionally struggled with unwanted attractions--in fact, only 11% of the men and 37% of the women reported complete change. Nevertheless this study, Spitzer concludes, "clearly goes beyond anecdotal information and provides evidence that reparative therapy is sometimes successful."

Spitzer acknowledges the difficulty of assessing how many gay men and women in the general population would actually desire reparative therapy if they knew of its availability; many people, he notes, are evidently content with a gay identity and have no desire to change.

Is reorientation therapy harmful? For the participants in our study, Spitzer notes, there was no evidence of harm. "To the contrary," he says, "they reported that it was helpful in a variety of ways beyond changing sexual orientation itself." And because his study found considerable benefit and no harm, Spitzer said, the American Psychiatric Association should stop applying a double standard in its discouragement of reorientation therapy, while actively encouraging gay-affirmative therapy to confirm and solidify a gay identity.

Furthermore, Spitzer wrote in his conclusion, "the mental health professionals should stop moving in the direction of banning therapy that has, as a goal, a change in sexual orientation. Many patients, provided with informed consent about the possibility that they will 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."

Is reorientation therapy chosen only by clients who are driven by guilt--that is, what's popularly known as "homophobia"? To the contrary, Spitzer concludes. In fact, "the ability to make such a choice should be considered fundamental to client autonomy and self-determination."

What Causes Homosexual Desire and Can It Be Changed?

By Paul Cameron, Ph. D.

Dr. Cameron is Chairman of the Family Research Institute of Colorado Springs, Colorado USA. For more information about this organization you may contact him at: Family Research Institute, PO Box 62640, Colorado Springs, CO 80962 USA. Phone number: (303) 681-3113. (No e-mail address.)

Most of us fail to understand why anyone would want to engage in homosexual activity. To the average person, the very idea is either puzzling or repugnant. Indeed, a recent survey (1) indicated that only 14% of men and 10% of women imagined that such behavior could hold any "possibility of enjoyment."

The peculiar nature of homosexual desire has led some people to conclude that this urge must be innate: that a certain number of people are "born that way," that sexual preferences cannot be changed or even ended. What does the best research really indicate? Are homosexual proclivities natural or irresistible?

At least three answers seem possible. The first, the answer of tradition, is as follows: homosexual behavior is a bad habit that people fall into because they are sexually permissive and experimental. This view holds rat homosexuals choose their lifestyle as the result of self-indulgence and an unwillingness to play by society rules. The second position is held by a number of psychoanalysts (e.g., Bieber, Socarides). According to them, homosexual behavior is a mental illness, symptomatic of arrested development. They believe that homosexuals have unnatural or perverse desires as a consequence of poor familial relations in childhood or some other trauma. The third view is "biological" and holds that such desires are genetic or hormonal in origin, and that there is no choice involved and no "childhood trauma" necessary.

Which of these views is most consistent with the facts? Which tells us the most about homosexual behavior and its origins? The answer seems to be that homosexual behavior is learned. The following seven lines of evidence support such a conclusion.

1) No researcher has found provable biological or genetic differences between heterosexuals and homosexuals that weren't caused by their behavior

Occasionally you may read about a scientific study that suggests that homosexuality is an inherited tendency, but such studies have usually been discounted after careful scrutiny or attempts at replication. No one has found a single heredible genetic, hormonal or physical difference between heterosexuals and homosexuals - at least none that is replicable. (9, 12) While the absence of such a discovery doesn't prove at inherited sexual tendencies aren't possible, it suggests that none has been found because none exists.

2) People tend to believe that their sexual desires and behaviors are learned

Two large studies asked homosexual respondents to explain the origins of their desires and behaviors - how they "got that way." The first of these studies was conducted by Kinsey in the 1940s and involved 1700 homosexuals. The second, in 1970, (4) involved 979 homosexuals. Both were conducted prior to the period when the "gay rights" movement started to politicize the issue of homosexual origins. Both reported essentially the same findings: Homosexuals overwhelmingly believed their feelings and behavior were the result of social or environmental influences.

In a 1983 study conducted by the Family Research Institute (5) (FRI) involving a random sample of 147 homosexuals, 35% said their sexual desires were hereditary. Interestingly, almost 80% of the 3,400 heterosexuals in the same study said that their preferences and behavior were learned (see Table 1 below).

Table 1

Reasons For Preferring:

*homosexuality (1940s and 1970)

*heterosexuality (1983)

While these results aren't conclusive, they tell something about the very recent tendency to believe that homosexual behavior is inherited or biologic. From the 1930s (when Kinsey started collecting data) to the early 1970s, before a "politically correct" answer emerged, only about 10% of homosexuals claimed they were "born that way." Heterosexuals apparently continue to believe that their behavior is primarily a result of social conditioning.

3) Older homosexuals often approach the young

There is evidence that homosexuality, like drug use is "handed down" from older individuals. The first homosexual encounter is usually initiated by an older person. In separate studies 60%, (6) 64%, (3) and 61% (10) of the respondents claimed that their first partner was someone older who initiated the sexual experience.

How this happens is suggested by a nationwide random study from Britain: (17) 35% of boys and 9% of girl said they were approached for sex by adult homosexuals. Whether for attention, curiosity, or by force, 2% of the boys and 1% of the girls succumbed. In the US, (1) 37% of males and 9% of females reported having been approached for homosexual sex (65% of those doing the inviting were older). Likewise, a study of over 400 London teenagers reported that "for the boys, their first homosexual experience was very likely with someone older: half the boys' first partner were 20 or older; for girls it was 43 percent." (13) A quarter of homosexuals have admitted to sex with children and underaged teens, (6,5,8) suggesting the homosexuality is introduced to youngsters the same way other behaviors are learned - by experience.

4) Early homosexual experiences influence adult patterns of behavior

In the 1980s, scholars (12) examined the early Kinsey data to determine whether or not childhood sexual experiences predicted adult behavior. The results were significant: Homosexual experience in the early years, particularly if it was one's first sexual experience - was a strong predictor of adult homosexual behavior, both for males and females. A similar pattern appeared in the 1970 Kinsey Institute (4) study: there was a strong relationship between those whose first experience was homosexual and those who practiced homosexuality in later life. In the FRI study (5) two-thirds of the boys whose first experience was homosexual engaged in homosexual behavior as adults; 95% of those whose first experience was heterosexual were likewise heterosexual in their adult behavior. A similarly progressive pattern of sexual behavior was reported for females.

It is remarkable that the three largest empirical studies of the question showed essentially the same pattern. A child's first sexual experiences were strongly associated with his or her adult behavior.

5) Sexual conduct is influenced by cultural factors - especially religious convictions

Kinsey reported "less homosexual activity among devout groups whether they be Protestant, Catholic, or Jewish, and more homosexual activity among religiously less active groups." (2) The 1983 FRI study found those raised in irreligious homes to be over 4 times more likely to become homosexual than those from devout homes. These studies suggest that when people believe strongly that homosexual behavior is immoral, they are significantly less apt to be involved in such activity.

Recently, because of the AIDS epidemic, it has been discovered that, relative to white males, twice as many black males are homosexual (14) and 4 times as many are bisexual. Perhaps it is related to the fact that 62% of black versus 17% of white children are being raised in fatherless homes. But even the worst racist wouldn't suggest that it is due to genetic predisposition.

Were homosexual impulses truly inherited, we should be unable to find differences in homosexual practice due to religious upbringing or racial sub-culture.

6) Many change their sexual preferences

In a large random sample (5) 88% of women currently claiming lesbian attraction and 73% of men claiming to currently enjoy homosexual sex, said that they had been sexually aroused by the opposite sex,

85% of these "lesbians" and 54% of these "homosexuals" reported sexual relations with someone of the opposite sex in adulthood, 67% of lesbians and 54% of homosexuals reported current sexual attraction to the opposite sex, and 82% of lesbians and 66% of homosexuals reported having been in love with a member of the opposite sex.

Homosexuals experiment. They feel some normal impulses. Most have been sexually aroused by, had sexual relations with, and even fallen in love with someone of the opposite sex.

Nationwide random samples (11) of 904 men were asked about their sex lives since age 21, and more specifically, in the last year. As the figure reveals, 1.3% reported sex with men in the past year and 5.2% at some time in adulthood. Less than 1% of men had only had sex with men during their lives. And 6 of every 7 who had had sex with men, also reported sex with women.

It's a much different story with inherited characteristics. Race and gender are not optional lifestyles. They remain immutable. The switching and experimentation demonstrated in these two studies identifies homosexuality as a preference, not an inevitability.

7) There are many ex-homosexuals

Many engage in one or two homosexual experiences and never do it again–a pattern reported for a third of the males with homosexual experience in one study. (1) And then there are ex-homosexuals - those who have continued in homosexual liaisons for a number of years and then chose to change not only their habits, but also the object of their desire. Sometimes this alteration occurs as the result of psychotherapy; (10) in others it is prompted by a religious or spiritual conversion. (18) Similar to the kinds of "cures" achieved by drug addicts and alcoholics, these treatments do not always remove homosexual desire or temptation. Whatever the mechanism, in a 1984 study (5) almost 2% of heterosexuals reported that at one time they considered themselves to be homosexual. It is clear that a substantial number of people are reconsidering their sexual preferences at any given time.

What causes homosexual desire?

If homosexual impulses are not inherited, what kinds of influences do cause strong homosexual desires? No one answer is acceptable to all researchers in the field. Important factors, however, seem to fall into four categories. As with so many other odd sexual proclivities, males appear especially susceptible:

1. Homosexual experience:

>any homosexual experience in childhood, especially if it is a first sexual experience or with an adult
>any homosexual contact with an adult, particularly with a relative or authority figure (in a random survey, 5% of adult homosexuals vs 0.8% of heterosexuals reported childhood sexual involvements with elementary or secondary school teachers (5).

2. Family abnormality, including the following:

3. Unusual sexual experience, particularly in early childhood:

>precocious or excessive masturbation
>exposure to pornography in childhood
>depersonalized sex (e.g., group sex, sex with animals)
>or girls: sexual interaction with adult males

4. Cultural influences:

>a visible and socially approved homosexual sub-culture that invites curiosity and encourages exploration
>pro-homosexual sex education
>openly homosexual authority figures, such as teachers (4% of Kinsey's and 4% of FRI's gays reported that their first homosexual experience was with a teacher)
>societal and legal toleration of homosexual acts
>depictions of homosexuality as normal and/or desirable behavior

Can homosexuality be changed?

Certainly. As noted above, many people have turned away from homosexuality - almost as many people call themselves "gay."

Clearly the easier problem to eliminate is homosexual behavior. Just as many heterosexuals control their desires to engage in premarital or extramarital sex, so some with homosexual desires discipline themselves to abstain from homosexual contact.

One thing seems to stand out: Associations are all-important. Anyone who wants to abstain from homosexual behavior should avoid the company of practicing homosexuals. There are organizations including "ex-gay ministries, " (18) designed to help those who wish to reform their conduct. Psychotherapy claims about a 30% cure rate, and religious commitment seems to be the most helpful factor in avoiding homosexual habits.

(For Footnote References on this article and other educational matter click on: FRI Educational Pamphlets)

MEDICAL CONSEQUENCES OF WHAT HOMOSEXUALS DO

By Paul Cameron, Ph.D.

(NOTE: Bracketed {-} numbers refer to footnotes at the end of this article)

Throughout history, the major civilizations major religions condemned homosexuality.{1} Until 1961 homosexual acts were illegal throughout America.

Gays claim that the "prevailing attitude toward homosexuals in the U.S. and many other countries is revulsion and hostility....for acts and desires not harmful to anyone."{3} The American Psychological Association and the American Public Health Association assured the U.S. Supreme Court in 1986 that "no significant data show that engaging in...oral and anal sex, results in mental or physical dysfunction."{4} Let's examine these statements.

What Homosexuals Do

The major surveys on homosexual behavior are summarized below. Two things stand out 1) homosexuals behave similarly world-over, and 2) as Harvard Medical Professor, Dr. William Haseltine,{33} noted in 1993, the "changes in sexual behavior that have been reported to have occurred in some groups have proved, for the most part, to be transient. For example, bath houses and sex clubs in many cities have either reopened or were never closed."

Homosexual Activities:

ORAL SEX
Homosexuals fellate almost all of their sexual contacts (and ingest semen from about half of these). Semen contains many of the germs carried in the blood. Because of this, gays who practice oral sex verge on consuming raw human blood, with all its medical risks. Since the penis often has tiny lesions (and often will have been in unsanitary places such as a rectum), individuals so involved may become infected with hepatitis A or gonorrhea (and even HIV and hepatitis B). Since many contacts occur between strangers (70% of gays estimated that they had had sex only once with over half of their partners{17,27}), and gays average somewhere between 106 and 1105 different partners/year, the potential for infection is considerable.

RECTAL SEX
Surveys indicate that about 90% of gays have engaged in rectal intercourse, and about two-thirds do it regularly. In a 6-month long study of daily sexual diaries,3 gays averaged 110 sex partners and 68 rectal encounters a year.

Rectal sex is dangerous. During rectal intercourse the rectum becomes a mixing bowl for 1) saliva and its germs and/or an artificial lubricant, 2) the recipient's own feces, 3)whatever germs, infections or substances the penis has on it, and 4) the seminal fluid of the inserter. Since sperm readily penetrate the rectal wall (which is only one cell thick) causing immunologic damage, and tearing or bruising of the anal wall is very common during anal/penile sex, these substances gain almost direct access to the blood stream. Unlike heterosexual intercourse (in which sperm cannot penetrate the multilayered vagina and no feces are present),{7} rectal intercourse is probably the most sexually efficient way to spread hepatitis B, HIV syphilis and a host of other blood-borne diseases.

Tearing or ripping of the anal wall is especially likely with "fisting," where the hand and arm is inserted into the rectum. It is also common when "toys" are employed (homosexual lingo for objects which are inserted into the rectum--bottles, carrots, even gerbils {8}. The risk of contamination and/or having to wear a colostomy bag from such "sport" is very real. Fisting was apparently so rare in Kinsey's time that he didn't think to talk about it. By 1977, well over a third of gays admitted to doing it. The rectum was not designed to accommodate the fist, and those who do so can find themselves consigned to diapers for life.

FECAL SEX
About 80% of gays admit to licking and/or inserting their tongues into the anus of partners and thus ingesting medically significant amounts of feces. Those who eat or wallow in it are probably at even greater risk. In the diary study,{5} 70% of the gays had engaged in this activity--half regularly over 6 months. Result? --the "annual incidence of hepatitis A in...homosexual men was 22 percent, whereas no heterosexual men acquired hepatitis A." In 1992,{26} it was noted that the proportion of London gays engaging in oral/anal sex had not declined since 1984.

While the body has defenses against fecal germs, exposure to the fecal discharge of dozens of strangers each year is extremely unhealthy. Ingestion of human waste is the major route of contracting hepatitis A and the enteric parasites collectively known as the Gay Bowel Syndrome. Consumption of feces has also been implicated in the transmission of typhoid fever,{9} herpes, and cancer.{27} About 10% of gays have eaten or played with [e.g., enemas, wallowing in feces]. The San Francisco Department of Public Health saw 75,000 patients per year, of whom 70 to 80 per cent are homosexual men....An average of 10 per cent of all patients and asymptomatic contacts reported...because of positive fecal samples or cultures for amoeba, giardia, and shigella infections were employed as food handlers in public establishments; almost 5 per cent of those with hepatitis A were similarly employed."{10} In 1976, a rare airborne scarlet fever broke out among gays and just missed sweeping through San Francisco.{10} The U.S. Centers for Disease Control reported that 29% of the hepatitis A cases in Denver, 66% in New York, 50% in San Francisco, 56% in Toronto, 42% in Montreal and 26% in Melbourne in the first six months of 1991 were among gays.{11} A 1982 study "suggested that some transmission from the homosexual group to the general population may have occurred."{12}

URINE SEX
About 10% of Kinsey's gays reported having engaged in "golden showers" [drinking or being splashed with urine]. In the largest survey of gays ever conducted,{13} 23% admitted to urine-sex. In the largest random survey of gays,{6} 29% reported urine-sex. In a San Francisco study of 655 gays,{14} only 24% claimed to have been monogamous in the past year. Of these monogamous gays, 5% drank urine, 7% practiced "fisting," 33% ingested feces via anal/oral contact, 53% swallowed semen, and 59% received semen in their rectum during the previous month.

OTHER GAY SEX PRACTICES

SADOMASOCHISM
A large minority of gays engage in torture for sexual fun. Sex with minors 25% of white gays{17} admitted to sex with boys 16 or younger as adults. In a 9-state study,{30} 33% of the 181 male, and 22% of the 18 female teachers caught molesting students did so homosexually (though less than 3% of men and 2% of women engage in homosexuality{31}). Depending on the study, the percent of gays reporting sex in public restrooms ranged from 14%{16} to 41%{13} to 66%,{6} 9%{16}, 60%{13} and 67%{5} reported sex in gay baths; 64%{16} and 90%{18} said that they used illegal drugs.

Fear of AIDS may have reduced the volume of gay sex partners, but the numbers are prodigious by any standard. Morin{15} reported that 824 gays had lowered their sex-rate from 70 different partners/yr. in 1982 to 50/yr. by 1984. McKusick{14} reported declines from 76/yr. to 47/yr. in 1985. In Spain{32} the average was 42/yr. in 1989.

Medical Consequences of Homosexual Sex

Death and disease accompany promiscuous and unsanitary sexual activity. 70%{25} to 78%x,{13} of gays reported having had a sexually transmitted disease. The proportion with intestinal parasites (worms, flukes, amoeba) ranged from 25%{18} to 39%{19} to 59%.{20} As of 1992, 83% of U.S. AIDS in whites had occurred in gays.{21} The Seattle sexual diary study{3}reported that gays had, on a yearly average:

1.fellated 108 men and swallowed semen from 48;
2.exchanged saliva with 96;
3.experienced 68 penile penetrations of the anus; and
4.ingested fecal material from 19.

No wonder 10% came down with hepatitis B and 7% contracted hepatitis A during the 6-month study.

Effects on the Lifespan

Smokers and drug addicts don't live as long as non-smokers or non-addicts, so we consider smoking and narcotics abuse harmful. The typical life-span of homosexuals suggests that their activities are more destructive than smoking nd as dangerous as drugs.

Obituaries numbering 6,516 from 16 U.S. homosexual journals over the past 12 years were compared to a large sample of obituaries from regular newspapers.{23} The obituaries from the regular newspapers were similar to U.S. averages for longevity; the medium age of death of married men was 75, and 80% of them died old (age 65 or older). For unmarried or divorced men the median age of death was 57, and 32% of them died old. Married women averaged age 79 at death; 85% died old. Unmarried and divorced women averaged age 71, and 60% of them died old.

The median age of death for homosexuals, however, was virtually the same nationwide--and, overall, less than 2% survived to old age. If AIDS was the cause of death, the median age was 39. For the 829 gays who died of something other than AIDS, the median age of death was 42, and 9% died old. The 163 lesbians had a median age of death of 44, and 20% died old.

Two and eight-tenths percent (2.8%) of gays died violently. They were 116 times more apt to be murdered; 24 times more apt to commit suicide; and had a traffic-accident death-rate 18 times the rate of comparably-aged white males. Heart attacks, cancer and liver failure were exceptionally common. Twenty percent of lesbians died of murder, suicide, or accident--a rate 487 times higher than that of white females aged 25-44. The age distribution of samples of homosexuals in the scientific literature from 1989 to 1992 suggests a similarly shortened life-span.

The Gay Legacy

Homosexuals rode into the dawn of sexual freedom and returned with a plague that gives every indication of destroying most of them. Those who treat AIDS patients are at great risk, not only from HIV infection, which as of 1992 involved over 100 health care workers,{21} but also from TB and new strains of other diseases.{24} Those who are housed with AIDS patients are also at risk.{24} Those who are housed with AIDS patients are also at risk.{24} Dr. Max Essex, chair of the Harvard AIDS Institute, warned congress in 1992 that "AIDS has already led to other kinds of dangerous epidemics...If AIDS is not eliminated, other new lethal microbes will emerge, and neither safe sex nor drug free practices will prevent them."{28} At least 8, and perhaps as many as 30 {29} patients had been infected with HIV by health care workers as of 1992.

The Biological Swapmeet

The typical sexual practices of homosexuals are a medical horror story --imagine exchanging saliva, feces, semen and/or blood with dozens of different men each year. Imagine drinking urine, ingesting feces and experiencing rectal trauma on a regular basis. Often these encounters occur while the participants are drunk, high, and/or in an orgy setting. Further, many of them occur in extremely unsanitary places (bathrooms, dirty peep shows), or, because homosexuals travel so frequently, in other parts of the world.

Every year, a quarter or more of homosexuals visit another country.{20} Fresh American germs get taken to Europe, Africa and Asia. And fresh pathogens from these continents come here. Foreign homosexuals regularly visit the U.S. and participate in this biological swapmeet.

The Pattern of Infection

Unfortunately the danger of these exchanges does not merely affect homosexuals. Travelers carried so many tropical diseases to New York City that it had to institute a tropical disease center, and gays carried HIV from New York City to the rest of the world.{27} Most of the 6,349 Americans who got AIDS from contaminated blood as of 1992, received it from homosexuals and most of the women in California who got AIDS through heterosexual activity got it from men who engaged in homosexual behavior.{23} The rare form of airborne scarlet fever that stalked San Francisco in 1976 also started among homosexuals.{10}

Genuine Compassion

Society is legitimately concerned with health risks-- they impact our taxes and everyone's chances of illness and injury. Because we care about them, smokers are discouraged from smoking by higher insurance premiums, taxes on cigarettes and bans against smoking in public. These social pressures cause many to quit. They likewise encourage non-smokers to stay non-smokers.

Homosexuals are sexually troubled people engaging in dangerous activities. Because we care about them and those tempted to join them, it is important that we neither encourage nor legitimize such a destructive lifestyle.

References

1. Karlen A. SEXUALITY And HOMOSEXUALITY. NY Norton, 1971.
2. Pines B. BACK TO BASICS. NY Morrow, 1982, p. 211.
3. Weinberg G. SOCIETY AND THE HEALTHY HOMOSEXUAL. NY St. Martin's, 1972, preface.
4. Amici curiae brief, in Bowers v. Hardwick, 1986.
5. Corey L. & Holmes, K.K. Sexual transmission of Hepatitis A in homosexual men. "New England Journal of Medicine," 1980302435- 38.
6. Cameron P et al Sexual orientation and sexually transmitted disease. "Nebraska Medical Journal," 198570292-99; Effect of homosexuality upon public health and social order "Psychological Reports," 1989, 64, 1167-79.
7. Manligit, G.W. et al Chronic immune stimulation by sperm alloan- tigens. "Journal of the American Medical Association," 1984251 237-38.
8. Cecil Adams, "The Straight Dope," THE READER (Chicago, 3/28/86) [Adams writes authoritatively on counter-culture material, his column is carried in many alternative newspapers across the U.S. and Canada].
9. Dritz, S. & Braff. Sexually transmitted typhoid fever. "New England Journal of Medicine," 19772961359-60.
10. Dritz, S. Medical aspects of homosexuality. "New England Journal of Medicine," 1980302463-4.
11. CDC Hepatitis A among homosexual men --United States, Canada, and Australia. MMWR 199241155-64.
12. Christenson B. et al. An epidemic outbreak of hepatitis A among homosexual men in Stockholm, "American Journal of Epidemiology," 1982115599-607.
13. Jay, K. & Young, A. THE GAY REPORT. NY Summit, 1979.
14. McKusick, L. et al AIDS and sexual behaviors reported by gay men in San Francisco, "American Journal of Public Health," 1985 75493- 96.
15. USA Today 11/21/84.
16. Gebhard, P. & Johnson, A. THE KINSEY DATA. NY Saunders, 1979.
17. Bell, A. & Weinberg, M. HOMOSEXUALITIES. NY Simon & Schuster, 1978.
18. Jaffee, H. et al. National case-control study of Kaposi's sarcoma. "Annals Of Internal Medicine," 198399145-51.
19. Quinn, T. C. et al. The polymicrobial origin of intestinal infection in homosexual men. "New England Journal of Medicine," 1983309576-82.
20. Biggar, R. J. Low T-lymphocyte ratios in homosexual men. "Journal Of The American Medical Association," 19842511441-46; "Wall Street Journal," 7/18/91, B1.
21. CDC HIV/AIDS SURVEILLANCE, February 1993.
22. Chu, S. et al. AIDS in bisexual men in the U.S. "American Journal Of Public Health," 199282220-24.
23. Cameron, P., Playfair, W. & Wellum, S. The lifespan of homo- sexuals. Paper presented at Eastern Psychological Association Convention, April 17, 1993.
24. Dooley, W.W. et al. Nosocomial transmission of tuberculosis in a hospital unit for HIV-invected patients. "Journal of the American Medical Association," 19922672632-35.
25. Schechter, M.T. et al. Changes in sexual behavior and fear of AIDS. "Lancet," 198411293.
26. Elford, J. et al. Kaposi's sarcoma and insertive rimming. "Lancet," 1992339938.
27. Beral, V. et al. Risk of Kaposi's sarcoma and sexual practices associated with faecal contact in homosexual or bisexual men with AIDS. "Lancet," 1992339632-35.
28. Testimony before House Health & Environment Subcommittee, 2/24/92.
29. Ciesielski, C. et al. Transmission of human immunodeficiency virus in a dental practice. "Annals of Internal Medicine, 1992116 798-80; CDC Announcement Houston Post, 8/7/92.
30. Rubin, S. "Sex Education Teachers Who Sexually Abuse Students." 24th International Congress on Psychology, Sydney, Australia, August 1988.
31. Cameron, P. & Cameron, K. Prevalence of homosexuality. "Psychology Reports," 1993, in press; Melbye, M. & Biggar, R.J. Interactions between persons at risk for AIDS and the general population in Denmark. "American Journal of Epidemiology," 1992135593-602.
32. Rodriguez-Pichardo, A. et al. Sexually transmitted diseases in homosexual males in Seville, Spain, "Geniourin Medicina," 1990 66;423-427.
33. AIDS Prognosis, Washington Times, 2/13/93, C1.

Health and Homosexuality: How Sexual Behavior Impacts Public Health

Introduction
Today many Americans are asking, "Is there really anything wrong with homosexuality?"

However, there is a deeper question America should be asking: "Is homosexuality healthy for society?" This question has many moral ramifications often discussed in public forums. However, far too often the issues of public health with regard to homosexuality are casually dismissed or conveniently overlooked.

AIDS is one disease that has captured the attention of the media. Homosexuals make up over 80 percent of the AIDS cases in America.{1} However, AIDS is but one of the many diseases linked to homosexual behavior. A survey of literature in leading medical journals reveals the host of medical dangers associated with the homosexual lifestyle.

Dr. Steven Wexner of the Cleveland Clinic in Ft. Lauderdale, Florida, chronicled the diseases in 1990. "Up to 55 percent of homosexual men with anorectal complaints have gonorrhea; 80 percent of the patients with syphilis are homosexuals," he wrote. "Chlamydia is found in 15 percent of asymptomatic homosexual men, and up to one third of homosexuals have active anorectal herpes simplex virus." He went on to point out, "In addition, a host of parasites, bacterial, viral, and protozoan are rampant in the homosexual population."{2}

Wexner is not alone in his observations. Dr. Selma Dritz wrote in the New England Journal of Medicine, "Oral and Anal intercourse present physicians with surgical as well as medical problems, ranging from anal fissures and impaction of foreign bodies in the rectum to major diagnostic dilemmas."{3} Dr. Marlys Witte et al. noted in The International Journal of Dermatology, that homosexual male practices such as "receptive anal and oral intercourse and oral-anal contact, recurrent rectal trauma associated with 'fisting,'" and venereal and parasitic infections, lead to many medical problems including tissue inflammation, "... intense angiogenesis, and progressive fibrosis."{4} And Dr. Christina M. Surawicz et al. noted, "Homosexually active men have frequent intestinal and rectal symptoms resulting from sexually acquired gastrointestinal infections."{5}

Despite the evidence of the unhealthy nature of homosexuality, medical doctors have often taken a politically correct view of the gay lifestyle in recent years. A doctor treating a heart patient would urge him to stay away from fatty foods. But instead of urging patients to abstain from dangerous sexual behavior, many doctors have encouraged patients to continue the unhealthy behavior -- as long as they take precautions.

Not all doctors subscribe to this conventional wisdom. In 1990, a study appeared in the Journal of the American Medical Association concluding that homosexuals should use condoms to protect against the transmission of hepatitis B.{6} Dr. Ralph H. Harder wrote to the journal, "I worry about the loss of objectivity and of scientific approach in current research, at least in dealing with certain sacred subjects. . . . A much more valid and useful conclusion, it would seem, is that anal insertive intercourse is inherently dangerous and should be proscribed."{7} Published just below Dr. Harder's letter was the authors' rebuttal. They argued that if homosexual anal intercourse should be proscribed, so should heterosexual vaginal intercourse since it is "a well-known risk factor for transmission of virtually all sexually transmitted diseases."{8} But what the authors do not acknowledge is the well-established fact that sexually transmitted diseases (STDs) strike homosexuals at a rate many times higher than that of heterosexuals.{9,10,11}

This paper surveys the medical literature dealing with health and homosexuality in an effort to investigate the dangers of this lifestyle to public health. Our study reveals that the spectrum of homosexually acquired diseases is vast and includes everything from viruses to bacterium to cancers. The evidence is so overwhelming that even if all moral judgments and religious biases are set aside, homosexuality -- by its very nature -- cannot play a part in a healthy society.

Over the past decade America has watched as homosexual activists have grown more and more powerful in public life. Today, four members of Congress are open homosexuals. Battles are raging in school systems all across our nation over whether homosexuality should be included in sex education. And in 1996, the Senate only narrowly defeated a measure that would have added sexual orientation to the list of groups granted special protection under the civil rights code for employment. The vote was 49 to 50.

The time has come to examine the medical facts and respond with appropriate public policy. Congress, the courts, and America's school systems would do well to examine the following information before placing their stamp of approval on the homosexual lifestyle.

Bacteria
Homosexuals experience a wide range of bacterial infections, including gonorrhea, syphilis, shigella, and campylbacter. One study of homosexuals in New York city found that "... 64.3 percent of the [homosexual] men reported a history of gonorrhea and/or syphilis."{12} The heterosexual community has also experienced many of these sexually transmitted infections -- however it is generally on a smaller scale.

Gonorrhea.
Gonorrhea is a common sexually transmitted disease and perhaps the most common STD found in homosexual men.{13} Gonorrhea is an inflammatory disease of genital track. In the homosexual communities, this disease has appeared in non-traditional locations. For example, gonorrhea traditionally occurs on the genitals, but recently it has appeared in the rectal region and in the throat.{14,15,16}

Gonorrhea is strongly associated with homosexual behavior at a rate higher than heterosexual behavior. In a study published by the Canadian Medical Association Journal in 1991, "...gonorrhea was associated with urethral discharge ... and homosexuality (3.7 times higher than the rate among heterosexuals)."{17}

This is especially true of gonorrhea of the pharynx (throat). A study published in the Journal of Clinical Pathology found, "In homosexual men a much higher prevalence of pharyngeal gonorrhoea (15.2 percent; two of the 13) was observed in comparison with heterosexual men (4.1 percent)."{18}

As pharyngeal gonorrhea results from oral sex with an infected partner, anorectal (anal) gonorrhea is spread through anal sex with a man infected with urethral gonorrhea. Physicians have promoted "safer sex" in an effort to stem the spread of gonorrhea. While for several years statistics seemed to indicate the plan may be working, the numbers began to rise again in the early 1990s. The American Journal of Public Health published a study of Amsterdam STD clinics that found, "After several years of decline, the number and percentage of diagnosed cases of gonorrhea among homosexual and bisexual clients of sexually transmitted disease clinics in Amsterdam started to increase again in 1989. This rise continued in 1990 and 1991."{19} This study mirrors one done in King County, Washington, which yielded similar results.{20}

Unlike its effect on the genitals, when gonorrhea infects the pharynx and rectal regions, it often emerges without symptoms.{21} And even if it does emerge with symptoms, those symptoms can be easily misinterpreted as simply a sore throat or misdiagnosed as part of a simultaneous ailment such as hemorrhoids.{22} The Journal of the American Medical Association stressed the importance of properly diagnosing these infections: "Detection and treatment of these occult infections are essential, because gonococcal "carriers" represent reservoirs of potential infection in the community."{23}

Syphilis.
Syphilis is a venereal disease caused by a bacteria known as a spirochet. If left untreated it can progress through three stages: primary, secondary, and tertiary or latent syphilis.

Primary anal syphilis is marked by anal ulcers that typically appear within two to six weeks of exposure to the spirochet. However, the ulcers may not appear for up to three months after initial exposure. The lesion that appears can be one of two types. One is particularly painful. The other causes little irritation. In the case of the painful variety, it may be mistaken for an anal fissure.{24} If a patient suffers from the less painful ulcers, he may not seek medical attention and the disease can progress into secondary syphilis.

If left untreated, six to eight weeks after the ulcer sores heal, secondary syphilis sets in. Secondary syphilis is marked by a pale brown or pink lesion or it may surface as a rash. Tertiary or latent syphilis is rare and is composed of another type of rectal lesions.

Medical literature shows homosexuals to be at especially high risk for syphilis. The Archives of Internal Medicine reported on a study in 1991 that found, "Homosexually active men are significantly more likely to report syphilis and less likely to present with primary syphilis than heterosexual men."{25} The British Co-operative Clinical Group noted that homosexuals acquired syphilis at a rate ten times that of heterosexuals.{26} Other journals also note a high correlation of homosexuality and syphilis.{27,28,29}

Enteric Infections
An enteric infection is one that involves the intestines, and many of these are caused by various protozoa and bacteria. Decades ago many of these diseases were considered "exotic" diseases acquired through foreign travel or consuming contaminated food or water. However throughout the 1970s and 1980s, medical journals have noted their spread in homosexual communities.{30,31,32}

One study published in the New England Journal of Medicine reported, "At least 80 percent of homosexual men presenting to our sexually transmitted disease clinic with anorectal or intestinal symptoms were infected with one or more sexually transmissible anorectal or enteric pathogens. Such infections were also found in 39 percent of homosexual men presenting to the clinic without intestinal symptoms."{33}

The Annals of Clinical Research published a study in 1985 that examined 153 homosexual men. "Intestinal protozoa were found in 91 of the homosexual men, altogether 198 organisms were identified ..."{34}

Shigellosis
Shigella is a bacterium that commonly infects the intestinal tract of homosexual men. Infection with this bacterium is marked by diarrhea, fever, nausea, and cramps. In the early 1970s, public health officials noted it as a problem. "The San Francisco Department of Public Health has recognized a venereal outbreak of enteritis due to Shigella Flexneri 2a during the first half of 1974," Dr. Selma Dritz noted in the New England Journal of Medicine. "Of the more than 50 cases reported, almost 60 percent occurred in young adult men, a majority of whom were habitués of the city's gay community."{35}

Campylobacter
Campylobacter is another bacteria that often infects the intestinal tract of homosexual men. One study of 113 patients found, "Campylobacter jejuni was the most common organism in the entire cohort, but Shigella species were most common in homosexual men." While that study did not specifically link campylobacter to homosexuality, other doctors have noted the connection. In 1987 eight physicians wrote Lancet noting, "it seems that the sexual practices of male homosexuals may facilitate colonisation with this organism."{36}

Amebiasis
An amebiasis is an infection of the large intestine, caused by Entamoeba histolytica. Homosexual populations have been hit hard by various types of amebiasis. The link was noted in the 1970s. "In 1975, 1,235 cases of amebiasis were reported from New York City. This represented 44.5 percent of the total number of cases nationwide," an article in the New York State Journal of Medicine stated. It went on to comment, "Although sexual orientation cannot be assessed from these statistics, a very significant portion of the cases occurring in native New Yorkers were probably within the homosexual community."{37}

G. Lamblia is a flagellate protozoan that causes giardiasis, which is a disease characterized by diarrhea.{38} Harrisonís Principles of Internal Medicine reports, "In one New York Study, all nontraveled immunocompetent males with giardiasis were, in fact, homosexual."{39}

Both G. Lamblia and Entamoeba histolytica parasites can be transmitted through oral-anal intercourse, as they live in the stool. A study published in the New England Journal of Medicine found that "the most powerful predictors of E. histolytica and G. lamblia infection was homosexuality."{40} Interestingly enough, the study went on to note that homosexuality represented a higher risk for these parasites "not because of its unique association with any sexual practices (anilingus was practiced by 17 percent of heterosexuals, 37 percent of bisexuals and 75 percent of homosexuals in our study) but because only in homosexuals is there both a large reservoir of infection (endemic level) and a prevalent mode of transmission."{41}

A study published in the Canadian Medical Association Journal reports similar findings. In a study of 200 homosexual men and 100 heterosexual men, "Entamoeba histolytica was isolated from 27 percent of the homosexual and 1 percent of the heterosexual men. Giardia lamblia was isolated from 13 percent of the homosexual and 3 percent of the heterosexual men."42 Other studies reinforce these conclusions for E. histolytica43 and G. Lamblia.{44}

Viruses
Hepatitis. Hepatitis is a disease that causes an inflammation of the liver. There are several different types of Hepatitis including hepatitis A, hepatitis B, and hepatitis C.

Hepatitis A and B can be sexually transmitted and homosexuals are at high risk for both.45 One study of a community-wide outbreak of Hepatitis A concluded, "Hepatitis A infection among homosexual and bisexual men is associated with oral-anal and digital-rectal intercourse, as well as with increasing numbers of anonymous sex partners and group sex."46 Another study found that Hepatitis B is easily spread through homosexual contact. The study stated: "These data suggest that HBV [hepatitis B virus] is transmitted 8.6-fold more efficiently than HIV-1 among homosexual men studied ..."{47}

Hepatitis C appears to be less of a threat to the homosexual community. The Journal on Infectious Disease found, "In a cross-sectional study of homosexual or bisexual men in San Francisco, only 4.6 percent of 735 men were positive for anti-HCV [hepatitis C virus] antibody while 81 percent were positive for any HBV [hepatitis B virus] serologic marker ..."{48}

Human papillomavirus. Human papillomavirus (HPV) is a virus that causes genital or anal warts and is associated with cancer. For years HPV was linked to vaginal and cervical cancer in women. In recent years, medical studies have noted the spread of HPV in homosexual communities. One study published in the Journal of Infectious Diseases stated, "Reports of an association between clinically identified anal warts and homosexual behavior predate the AIDS epidemic and undoubtedly reflect increased exposure of this population to HPV during receptive anorectal intercourse."{49}

Today, studies suggest a link between HPV and anal cancer in homosexual males -- particularly those who are HIV+. An article published in the Journal of the American Medical Association stated, "These studies indicate that immunosuppressed male homosexuals have a high prevalence of anal human papillomavirus infection and anal intraepithelial neoplasia, and this population may be at significant risk for the development of anal cancer."{50}

Along the same lines, an article published in the New England Journal of Medicine concluded: "Anal intercourse may predispose to anal cancer through the transmission of an infection, most probably infection with human papillomavirus."{51}

Herpes Simplex
Herpes simplex is a common STD marked by watery blisters on the genitalia. It can also occur in the anorectal area, primarily in passive homosexual men.52 Homosexuals suffering from herpes simplex proctitis experience severe anorectal pain and may have difficulty urinating.{53}

While Herpes is a disease that affects both homosexuals and heterosexuals, a side-by-side comparison of heterosexual males to homosexual males shows that homosexual men are at a higher risk.

The Journal of the American Medical Association found that "among men, report of any lifetime homosexual activity was associated with an elevated risk for HSV-2 [herpes simplex virus - 2]."{54} The link between homosexuality and herpes simplex-2 has also been noted in other journals.{55}

Cytomegalovirus
Cytomegalovirus is a virus that commonly infects homosexual men and can be serious when the patient suffers immunosuppressed conditions such as AIDS. This virus can infect both heterosexuals and homosexuals, but again, homosexuals seem to suffer from cytomegalovirus at a much higher rate. A study published in the American Journal of Medicine showed,"...heterosexual men in a sexually transmitted disease clinic have a substantially lower prevalence of cytomegalovirus seropositivity than do homosexual men."{56}

In fact, an article published in the British Journal of Venereal Disease noted "Sexual orientation was shown to be the most important determinant of antibody to CMV [cytomegalovirus] in this population."{57}

In a population that represents the majority of AIDS cases, CMV is particularly frightening. A study published in the Journal of Infectious Diseases reported, "DMAC [disseminated Mycobacterium avium] and CMV are causing substantial and increasing morbidity among AIDS patients."{58}

HIV/AIDS
AIDS is the one disease that most Americans are familiar with and readily associate with homosexuality. It has captured the mediaís attention and won the nation's sympathies. AIDS is a terrible and tragic syndrome that attacks the patient's immune system so that it cannot fight off disease, making common ailments potentially fatal. It is not unusual for AIDS patients to die from pneumonia that begins as a common cold.

While no one would deny the horrible nature of AIDS, some confusion has erupted over who is at risk for contracting it. In 1987, the federal government embarked upon an education campaign to protect the nation against the spread of AIDS. It was called "America Responds to AIDS." This media campaign flooded the airwaves with the horrifying message that "anyone" could get AIDS. The risk of contracting AIDS through heterosexual vaginal intercourse is many times lower than anal intercourse or IV drug use.

Consider the odds:
The problem was that although that message may be technically true, it is terribly deceptive. AIDS remains primarily a disease of homosexuals and IV drug users. Homosexuals and IV drug users make up more than 80 percent of AIDS cases in the United States.{59}

Health officials understood AIDS enough in 1987 to know how the disease was spreading and who was at risk. But the campaignís job was to bring an understanding of AIDS to the masses. Dr. Walter Dowdle, a virologist at the Centers for Disease Control involved with the education campaign, told the Wall Street Journal, "As long as this was seen as a gay disease or, even worse, a disease of drug abusers, that pushed the disease way down the ladder" in priority in Americans' minds.{60}

And so the deception began. John Ward, a health official involved with the tracking of AIDS cases at CDC, told the Wall Street Journal, "I don't see much downside in slightly exaggerating [AIDS risk]."{61} But the exaggeration was more than slight, and the downsides were enormous.

Not only did the 1987 campaign institute a lie into American government, media, and education, it led the government to waste millions in research on the spread of HIV in populations who are least likely to acquire it.

In March 1994, the headlines once again filled with the threat of heterosexual AIDS. The New York Times reported with tabloid sensationalism: "In a development that reflects the changing demographic face of the AIDS epidemic in this country, heterosexual transmission accounted for the largest proportionate increase in AIDS cases reported last year..."{62} However, when non-drug abusing heterosexuals comprise only 8 percent of the total AIDS population, it doesn't take but a small shift in figures to create "the largest proportionate increase."

The latest statistics from the Centers for Disease Control reveal that homosexuals and IV drug abusers make up 83 percent of all AIDS cases in America. Heterosexual contact accounts for only 8 percent of the cases, and nearly half (47 percent) of heterosexuals who have contracted AIDS were the sexual partners of drug abusers.{63}

Cancers and Tumors
Homosexual behavior, especially when practiced by those infected with HIV, places people at an especially high risk for various cancers, as well.

ANAL CANCER. Homosexual men's practice of anal sex has left many of them victims of anal cancer. One article in the New England Journal of Medicine commented, "Our study lends strong support to the hypothesis that homosexual behavior in men increases the risk of anal cancer: 21 of the 57 men with anal cancer (37 percent) reported that they were homosexual or bisexual, in contrast to only one of 64 controls."{64} The Journal of the American Medical Association also published similar findings: "Epidemiological studies have shown that risk factors for anal cancer include homosexuality, history of receptive anal intercourse, presence of anal condylomata, and smoking."{65} And the International Journal of Cancer stated, "Being single and having practised anal intercourse appears to be associated with anal cancer and case reports have suggested a recent increase in the number of cases of anal cancer."{66} Other studies have yielded the same conclusions.{67,68}

Kaposi's Sarcoma
Kaposi's sarcoma (KS) is an AIDS-related cancer that affects the mucous membranes and the skin of its victims. It is marked by reddish-brown or bluish tumors. In years past it was primarily a benign disease that affected older men in the Mediterranean regions. In recent years it has earned a reputation for being a deadly disease in AIDS patients.

Homosexuals' sexual behavior places them at high risk for this disease. The International Journal of Dermatology explains why: "In this high risk group [the gay male population], the predominant portal of entry of free and cell-bound HIV as well as the brunt of associated cofactors and opportunistic infections can be traced to both ends of the gastrointestinal tract (mouth and anus) and also the genitalia, which happen to be common sites for KS lesions in addition to their lymphatic watersheds."{69}

Kaposiís sarcoma has taken a particularly tragic toll on HIV-infected homosexual men, sending them to an earlier grave than their IV-drug user counterparts. AIDS reports: "According to our data, homosexual men had a significantly higher risk of progression to AIDS and shorter survival compared with IDU [IV drug users] and other categories. In a multivariate analysis the increased risk was found to be independent of demographic and clinical characteristics but was accounted for by the higher probability of developing Kaposi's sarcoma."70 The Journal of the American Medical Association noted the difficulty in treating this disease in the mid-1980s, "Kaposi's Sarcoma as currently seen in young, homosexual men is less responsive to chemotherapy, and in many cases displays a more aggressive, rapidly progressive course."{71}

Hodgkin Disease
Homosexual men suffering from HIV/AIDS also suffer from other cancers and lymphomas. One study published in the Annuls of Medicine noted the connection between homosexual AIDS patients and Hodgkin disease. The study concluded, "An excess incidence of Hodgkin disease was found in HIV-infected homosexual men."72 The Journal of Clinical Oncology published a study that further supports a connection between homosexual male AIDS patients and Hodgkin disease.{73}

Drug/Alcohol Abuse
Another unhealthy aspect of the homosexual population is their vulnerability to dependance on drugs and alcohol. A study that surveyed 3,400 homosexuals found, "Substantially higher proportions of the homosexual sample used alcohol, marijuana, or cocaine than was the case in the general population."{74} Other studies support these findings.{75,76}

One study published in Nursing Research noted that lesbians experience alcohol problems at a rate three times that of American women as a whole. The study also found: "Like most problem drinkers, 32 (91%) of the participants had abused other drugs as well as alcohol, and many reported compulsive difficulties with food (34%), codependency (29%), sex (11%), and money (6%). Forty-six percent had been heavy drinkers with frequent drunkenness; ..."{77}

Homosexual activists would argue that this population suffers from a higher rate of drug and alcohol problems because society will not accept their sexual orientation. However, a psychological study of nearly 2,000 lesbians from all 50 states found that most lesbians (57 percent) considered money the biggest worry in their life. The study went on to state, "Only 12 percent of respondents indicated that they were concerned about people knowing that they were lesbian."{78}

"Safe Sex"
When gay rights activists concede to the health facts regarding their lifestyle they argue that homosexuals simply need to be taught how to perform their sex acts safely. However, despite innumerable education efforts, the homosexual male population remains plagued by disease.

For a few years, activists had some statistics to back up this philosophy as rates of gonorrhea and syphilis dropped after education efforts. However, homosexuals, even after receiving education, did not sustain their "safe" activities for very long. A study conducted in Amsterdam and another study conducted in Washington state found a drop in gonorrhea and syphilis for several years in the 1980s. In both studies, that trend was followed by a marked increase in the rate of these diseases in the homosexual population, while the rate in the heterosexual population continued to fall.{79,80}

The relapse into "risky" behavior has been documented in relation to other STDs as well, including HIV. One study published in the British Journal of Medicine stated, "This study provides evidence of continuing unsafe sexual behavior among homosexual or bisexual men infected with HIV-1 attending genitourinary medicine clinics up to the end of 1993." The study further pointed out, "This is consistent with other data indicating an increase in the incidence of sexually transmitted diseases, including HIV, within the male homosexual or bisexual community in England and Wales between 1988 and 1990."{81}

While it appears clear that homosexual men have a difficult time sustaining "safe" sexual behavior, the inevitable question is why? Medical and psychological experts have developed several explanations. Some homosexual men believe that once they have established a monogamous relationship, they aren't at risk. The American Journal of Public Health published a study in 1990 that found, "Being in a monogamous gay relationship was associated with higher risk sex throughout the entire study."{82}

Another theory is that the few years of decline in the rates of HIV and other STD infections have led homosexual men to let down their guard. The Journal of the American Medical Association reported, "Because of declining incidence of STD and human immunodeficiency virus (HIV) infections, some homosexually active men may have relaxed behaviors regarding sexual safety."{83}

A journal known as Sexually Transmitted Diseases developed a more psychological explanation. Dr. Edward W. Hook III wrote, "After all, if higher risk behaviors for HIV/STD remain desirable albeit dangerous for some, their status as 'forbidden fruit' might paradoxically serve as a stimulus rather than a deterrent to those practices."84 In other words, the very fact that these behaviors are dangerous may make them all the more titillating.

The simple ineffectiveness of condoms likely also contributed to the spread of disease. A study published in Social Science and Medicine found that the rate of condom effectiveness in protecting against HIV infection is only 69 percent. The study noted, "Thus, efficacy may be much lower than commonly assumed ..."{85}

All of these factors may well play a part in explaining why there appears to be no such thing as "safe sex."

Born or Bred?
Despite the clear medical evidence that homosexual behavior is at its very essence unhealthy, many advocates and activists insist that we cannot counsel these people to change their behavior, because it is an innate genetic trait.

These advocates make reference to several medical studies that claim to have established a biological link to homosexuality. However, fair evaluation of these studies proves that they are anything but conclusive.

One of the most often touted studies was conducted by Simon LeVay. His study, published in Science in 1991, noted a difference in a brain structure called the hypothalamus when evaluating homosexual and heterosexual men. LeVay found that in the specimens he studied, the hypothalamus was generally larger in heterosexual men than in homosexual men. Therefore he concluded that these findings "suggest that sexual orientation has a biologic substrate."{86}

While LeVay's study received top-notch billing in the media, it was anything but conclusive. An analysis of the study and its methodology reveals some notable weaknesses. The first problem, which LeVay himself readily admits, is the fact that all 19 of his homosexual subjects had died of complications associated with AIDS. Therefore the difference in the hypothalamus might well be attributed to the AIDS rather than homosexuality. LeVay attempted to compensate for the weakness by including a few heterosexuals who died of AIDS complications in the heterosexual sample. However, LeVay did not know for sure whether all subjects in his heterosexual sample were indeed heterosexual; all of these subjects were simply "presumed heterosexual."

Moreover, Dr. William Byne argued in Scientific American that "[LeVay's] inclusion of a few brains from heterosexual men with AIDS did not adequately address the fact that at the time of death virtually all men with AIDS have decreased testosterone levels as the result of the disease itself or the side effects of particular treatments.... Thus it is possible that the effects on the size of the INAH3 [hypothalamus] that he attributed to sexual orientation were actually caused by the hormonal abnormalities associated with AIDS."{87}

Finally another weakness of LeVay's study is the fact that even in his sample there were "exceptions" -- that is, there were some homosexuals who had larger hypothalamus structures than some of the heterosexuals examined. Even LeVay admits that these exceptions "hint at the possibility that sexual orientation, although an important variable, may not be the sole determinant of INAH3 [hypothalamus] size."{88}

LeVay is an open homosexual, and his interview with Newsweek appears to indicate he had an agenda from the outset. LeVay lost his gay partner to AIDS, an event that made him re-evaluate what he was doing with his life. As a result, he took on this project. LeVay believes America must be convinced that homosexuality is determined biologically. "It's important to educate society," he told Newsweek. "I think this issue does affect religious and legal attitudes."{89}

In 1993 a group of medical researchers at the National Cancer Institute led by Dr. Dean H. Hamer released a study that linked homosexuality to the X chromosome. While the study won a great deal of media attention, it also offered little proof of a biological link to homosexuality.

Hamer's results are often misunderstood. Many believe that the study found an identical sequence (Xq28) on the X chromosome of all homosexual brothers. In reality, what it found was matching sequences in each set of brothers who were both homosexual. Dr. Byne argues that in order to prove anything by this study, Hamer would have had to examine the Xq28 sequence of gay men's heterosexual brothers. Hamer insisted that such an inclusion would have confounded his study. Byne responded, "In other words, inclusion of heterosexual brothers might have revealed that something other than genes is responsible for sexual orientation."{90}

Hamer's motives are also questionable. Although Hamer's research is sponsored by the National Cancer Institute, his work has had little to do with cancer. This study alone took $419,000 of the instituteís taxpayer-backed funds, according to the Washington Times.{91}

One of Hamer's researchers told the Times that homosexuality is "not the only thing we study," but it is "a primary focus of study." Hamer reportedly stated that he has pushed for an Office of Gay and Lesbian Health inside the National Institutes of Health. And he testified in opposition to Colorado's Amendment 2. Sen. Robert C. Smith (R-NH) accused the doctor of "actively pursu[ing] ...a gay agenda."{92}

Another study that has advanced the theory that homosexuality is a biological phenomenon is the famed "Twin Study" by J. Michael Bailey and Richard C. Pillard. Bailey and Pillard examined identical and fraternal twin brothers and adopted brothers in an effort to establish a genetic link to homosexuality. The study results yielded some statistics that seem to support the hypothesis and other statistics that appear to refute it. Fifty-two percent of the identical twins shared the same homosexual sexual orientation while only 22 percent of fraternal twins fell in the same category. This finding appears to support the argument for biology since identical twins share the same genes. However, the rate of non-twin conformity should mirror that of fraternal twins. In the Bailey and Pillard study, the rate was only 9.2 percent. And the rate in adopted brothers -- which, if the biological hypothesis were true, should have been even lower than non-twin brothers -- was actually higher (11 percent).{93}

In his article analyzing the medical evidence supporting a biological cause of homosexuality, Dr. Byne noted other twin studies. He wrote, "Without knowing what developmental experiences contribute to sexual orientation ... the effects of common genes and common environments are difficult to disentangle. Resolving this issue requires studies of twins raised apart."{94}

Other physicians have also criticized the study for overvaluing the genetic influence.{95}

Dr. Byne's arguments might lead some activists to label him a "homophobe." He is, in reality, quite the contrary. Byne readily advocates societal acceptance of homosexuality, but nevertheless concludes, "Most of the links in the chain of reasoning from biology to social policy [regarding homosexuality] do not hold up under scrutiny."{96}

Conclusion

Homosexuality has become an increasingly prevalent part of modern society. It has infiltrated our schools, our news media, our entertainment media and may soon redefine our concept of marriage.

However, homosexuality is by its very nature dangerous to those who practice it. And society is doing homosexuals a disservice when it endorses and promotes homosexuality as normal. In doing so, it is encouraging these Americans to engage in self-destructive behavior.

Homosexuality is an issue of morality. But it is also an fundamental issue of public health. The evidence is clear. American government, educational systems, and courts should note the facts presented in this paper and advance public policy and curricula that encourage sound behavior rather than offering special protection and endorsement to a behavior that threatens individuals as well as public health.

The future of America hangs in the balance. If society is not willing to address the homosexual issue on moral grounds, then the medical evidence alone should be enough to convince the fair-minded that homosexuality is incompatible with good public health.

ENDNOTES

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2.Wexner, SD. "Sexually Transmitted Disease of the Colon Rectum and Anus." Diseases of the Colon and Rectum, 1990; Vol. 33 (1048-1062).
3.Dritz SK. "Medical Aspects of Homosexuality." The New England Journal of Medicine, 1980; Vol. 302 No. 8 (463-464).
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6.Kingsley LA, Rinaldo CR, Lyter DW Valdiserri RO, Belle SH, Ho M. "Sexual Transmission Efficiency of Hepatitis B Virus and Human Immunodeficiency Virus Among Homosexual Men." Journal of the American Medical Association, 1990; Vol. 264 (230-234).
7.Harder R, "HBV, HIV, and the Proscription of Intercourse." (Letter). Journal of the American Medical Association, 1990; Vol. 264 (2625).
8.Kingsley LA, Rinaldo CR, Ho M. "In Reply." (Letter). Journal of the American Medical Association, 1990; Vol. 264 (2625).
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10.Felman Y, Morrison JM. "Examining the Homosexual Male for Sexually Transmitted Diseases." Journal of the American Medical Association, 1980; Vol. 238 No. 19 (2046-2047).
11.British Co-operative Clinical Group. "Homosexuality and Venereal Disease in the United Kingdom -- A Second Study." British Journal of Venereal Diseases, 1980 Vol. 56 (6-11).
12.Koblin BA, Morrison JM, Taylor PE, Stoneburner RL, Stevens CE. "Mortality Trends in a Cohort of Homosexual Men in New York City, 1978-1988." American Journal of Epidemiology, 1992; Vol. 136 No. 6 (646-656).
13.Judson FN, Penley KA, Robinson ME, et al. "Prevalence and Site Pathogen Studies of Neisseria meningitides and Neisseria gonorrhea Infections in Homosexual Men." American Journal of Epidemiology, 1980; Vol. 112 (836-843).
14.Owen W. "Sexually Transmitted Diseases and Traumatic Problems in Homosexual Men." Annals of Internal Medicine, 1980; Vol. 92 (805-808).
15.Janda WM, Bohnhoff M, Morello JA, Lerner SA. "Prevalence and Site-Pathogen Studies of Neisseria meningitides and N gonorrhea in Homosexual Men." Journal of the American Medical Association, 1980; Vol. 244 No. 18 (2060-2064).
16.Rompalo A. "Sexually Transmitted Causes of Gastrointestinal Symptoms in Homosexual Men." Medical Clinics of North America, 1990; Vol. 74 No. 6 (1633-1645).
17.Vincelette J, Baril JG, Allard R. "Predictors of Chlamydial Infection and Gonorrhea Among Patients Seen by Private Practitioners." Canadian Medical Association Journal, 1991; Vol. 144 No. 6 (713-721).
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20.Handsfield H, Schwebke J. "Trends in Sexually Transmitted Diseases in Homosexually Active Men in King County, Washington, 1980-1990." Sexually Transmitted Diseases, 1990; October-December (211-215).
21.Janda WM, Bohnhoff M, Morello JA, Lerner SA. "Prevalence and Site-Pathogen Studies of Neisseria meningitides and N gonorrhea in Homosexual Men." Journal of the American Medical Association, 1980; Vol. 244 No. 18 (2060-2064).
22.Owen W. "Sexually Transmitted Diseases and Traumatic Problems in Homosexual Men." Annals of Internal Medicine, 1980; Vol. 92 (805-808).
23.Janda WM, Bohnhoff M, Morello JA, Lerner SA. "Prevalence and Site-Pathogen Studies of Neisseria meningitides and N gonorrhea in Homosexual Men." Journal of the American Medical Association, 1980; Vol. 244 No. 18 (2060-2064).
24.Wexner SD, "Sexually Transmitted Diseases of the Colon, Rectum, and Anus." Diseases of the Colon and Rectum, 1990; Vol. 33 (1048-1062).
25.Hutchinson CM, Rompalo AM, Reichart MT, Hook EW. "Characteristics of Patients With Syphilis Attending Baltimore STD Clinics." Archives of Internal Medicine, 1991; Vol. 151 (511-516).
26.Hutchinson CM, Rompalo AM, Reichart MT, Hook EW. "Characteristics of Patients With Syphilis Attending Baltimore STD Clinics." Archives of Internal Medicine, 1991; Vol. 151 (511-516).
27.Felman Y, Morrison JM. "Examining the Homosexual Male for Sexually Transmitted Diseases." Journal of the American Medical Association, 1980; Vol. 238 No. 19 (2046-2047).
28.Catteral RD. "Sexually Transmitted Diseases of the Anus and Rectum." Clinics in Gastoenterology, 1975; Vol. 4, No. 3 (659-669).
29.Quinn TC, Lukehart SA, Goodell S, Mkrtichian E, Shuffler MD, Holmes KK, "Rectal Mass Caused by Treponema pallidum: Confirmation by Immunofluorescent Staining." Gastroenterology, 1987; Vol. 82 (135-139).
30.Most H. "Manhattan: 'A Tropical Isle?'" Am J Trop Med Hyg, 1968; Vol. 17 (333-354).
31.Phillips SC, Mildvan D, William DC, Gelb AM, White MC. "Sexual Transmission of Enteric Protozoa and Helminths in a Venereal-Disease-Clinic Population." The New England Journal of Medicine, 1981; Vol. 305 No. 11 (603-606).
32.Koblin BA, Morrison JM, Taylor PE, Stoneburner RL, Stevens CE. "Morality Trends in a Cohort of Homosexual Men in New York City, 1978-1988." American Journal of Epidemiology, 1992; Vol. 136 No. 6 (646-656).
33.Quinn TC, Stamm WE, Goodell SE, Mkrtichian E, Benedetti J, Corey L, Shuffler MD, Homes KK. "The Polymicro Origin of Intestinal Infections in Homosexual Men." The New England Journal of Medicine, 1983; Vol 309 (576-582).
34.Jokipii, L. et.al.. "Frequency, Multiplicity and Repertoire of Intestinal Protozoa in Healthy Homosexual Men and in Patients with Gastrointestinal Symptoms," Annals of Clinical Research 1985; Vol. 17 (57-59).
35.Dritz SK, Back AF. "Shigella Enteritis Venereally Transmitted." The New England Journal of Medicine, 1974; November 28 (1194).
36.Aceti A, Attanasio R, Pennica A, Taliani G, Sebastiani A, Rezza G, Ippolito G, Perucci CA. "Campylobacter Pylori Infection in Homosexuals," [letter], Lancet, 1987; July 18 (154-155).
37.William DC, Felman YM, Marr JS, Shookhoff HB. "Sexually Transmitted Enteric Pathogens in Male Homosexual Population." New York State Journal of Medicine, 1977; November (2050-2051).
38.Merriam-Webster Medical Desk Dictionary. Merriam-Webster Inc. 1993.
39.Petersdorf, R.G., et. al. "Giardiasis," Harrison's Principles of Internal Medicine, Tenth Edition, New York: McGraw Hill Book Company).
40.Phillips SC, Mildvan D, William DC, Gelb AM, White MC. "Sexual Transmission of Enteric Protozoa and Helminths in a Venereal-Disease-Clinic Population." The New England Journal of Medicine, 1981; Vol. 305 No. 11 (603-606).
41.Ibid.
42.Keystone JS, Keystone DL, Procter EM. "Intestinal parasitic infections in homoseuxal men: prevalence, symptoms and factors in transmission." Canadian Medical Association Journal, 1980; Vol. 123 (512-514).
43.Allason-Jones E, Midel A, Sargeaunt P, Katz D. " Outcome of untreated infection with Entamoeba histolytica in homosexual men with and without HIV." British Journal of Medicine, 1988; Vol. 297 (569-802).
44.Simmon PD. "Sexually transmitted diseases in homosexual men." The Practitioner, 1985; Vol. 229 (1003-1008).
45.Andrews H, Wyke J, Lane M, Clay J, Keighley MRB, Allan RN. "Prevalence of Sexually Transmitted Disease Among Male Patients Presenting with Proctisis," Gut, 1988; Vol. 29 (332-335).
46.Henning KJ, Bell E, Braun J, Barker N. "A Community Wide Outbreak of Hepatitis A: Risk Factors for Infection Among Homosexual and Bisexual Men." The American Journal of Medicine, 1995; Vol. 99 (132-136).
47.Kingsly LA, PH, Rinaldo CR, Lyter DW, Valdiserri RO, Belle SH, Ho M. "Sexual Transmission Efficiency of Hepatitis B Virus and Human Immunodeficiency Virus Among Homosexual Men." Journal of the American Medical Association, 1990; Vol. 264 No. 2 (230-234).
48.Osmond D, Charlebois E, Sheppard HW, Page K, Winklestein W, Moss AR, Reingold A. "Comparison of Risk Factors for Hepatitis C and Hepatitis B Virus Infection in Homosexual Men." The Journal of Infectious Diseases, 1992; Vol. 167 (66-71).
49.Kiviat N, Rompalo A, Bowden R, Galloway D, Holmes K, Corey L, Roberts PL, Stamm W. "Anal Human Papillomavirus Infection Among Human Immunodeficiency." The Journal of Infectious Diseases, 1990; Vol. 162 (358-361).
50.Palefsky JM, Gonzales J, Greenblatt RM, Ahn DK, Hollander H. "Anal Intraepithelial Neoplasia and Anal Papillomavirus Infection Among Homosexual Males With Group IV HIV Disease." Journal of the American Medical Association, 1990; Vol. 263 No. 21 (2911-2916).
51.Daling JR, Weiss NS, Hislop G, Maden C, Coates RJ, Sherman KJ, Ashley RL, Beagrie M, Ryan JA, Corey L. "Sexual Practices, Sexually Transmitted Diseases, and the Incidence of Anal Cancer." The New England Journal of Medicine, 1987; Vol. 317 (973-977).
52.Catteral RD. "Sexually Transmitted Diseases of the Anus and Rectum." Clinics in Gastoenterology, 1975; Vol. 4, No. 3 (659-669).
53.Goodell SE, Quinn TC, Mkrtichian E, Shuffler MD, Holmes KK, Corey L. "Herpes Simplex Virus Proctisis in Homosexual Men." The New England Journal of Medicine, 1983; Vol. 308 (868-871).
54.Seigel, D, Golden E, Washington E, Morse SA, Fullilove MT, Catania JA, Marin B, Hulley SB. "Prevalence and Correlates of Herpes Simplex Infections: The Population-Based AIDS in Multiethnic Neighborhoods Study." Journal of the American Medical Association, 1992; Vol. 268 No. 13 (1702-1708).
55.Simmons PD. "Sexually Transmitted Diseases in Homosexual Men." The Practitioner, 1985; Vol. 229 (1003-1008).
56.Collier AC, Meyers JD, Corey C, Murphy VL, Roiberts PL, Handsfield H. "Cytomegalovirus Infection in Homosexual Men." American Journal of Medicine, 1987; Vol. 82 (593-600).
57.Mindel A, Southerland S. "Antibodies to Cytomegalovirus in homosexual and heterosexual men attending an STD Clinic." British Journal of Venereal Disease, 1984; Vol. 60 (189-92).
58.Katz MH, Hessol NA, Buchbinder SP, Hirozawa A, O'Malley PO, Holmberg SD. "Temporal Trends of Opportunistic Infections and Malignancies in Homosexual Men with AIDS." Journal of Infectious Diseases, 1994; Vol. 170 (198-202).
59.U.S. Department of Health and Human Services -- Centers for Disease Control. "HIV/AIDS Surveillance Report." July 1993 Vol. 5 No. 2.
60.Bennett A, Sharpe A. "Health Hazard: AIDS Fight Is Skewed by Federal Campaign Exaggerating Risks," The Wall Street Journal, May 1, 1996.
61.Ibid.
62.Altman L, "AIDS Cases Increase Among Heterosexuals," The New York Times, March 11, 1996.
63.U.S. Health and Human Services -- Centers for Disease Control. AIDS Statistics Year End 1995. Table 3.
64.Daling JR, Weiss NS, Hislop G, Maden C, Coates RJ, Sherman KJ, Ashley RL, Beagrie M, Ryan JA, Corey L. "Sexual Practices, Sexually Transmitted Diseases, and the Incidence of Anal Cancer." New England Journal of Medicine, 1987; Vol. 317 No. 16 (973-937).
65.Palefsky JM, Gonzales J, Greenblatt RM, Ahn DK, Hollander H. "Anal Intraepithelial Neoplasia and Anal Papillomavirus Infection Among Homosexual Males With Group IV HIV Disease." Journal of the American Medical Association, 1990; Vol. 263 (2911-2916).
66.Melbye M, Palefsky J, Gonzales J, Ryder L, Henrik N, Bergmann O, Pindborg J, Biggar R. "Immune Status as a Determinant of Human Papillomavirus Detection and its association with anal epithelial abnormalities" International Journal of Cancer, 1990; Vol. 46 (203-206).
67.Frisch M, Melbye M, Moller H. "Trends in Incidents of Anal Cancer in Denmark." British Medical Journal, 1993; Vol. 306 (419-422).
68.Wexner SD, Milson JW, Dailey TH. "The Demographics of Anal Cancers are Changing." Dis. Colon and Rectum, 1987; Vol. 30 (942-946).
69.Witte M, Stuntz M, Witte C, Way D. "AIDS, Kaposiís Sarcoma, and the Gay Population." International Journal of Dermatology, 1989; Vol. 28 No. 9 (585-586).
70.Vella S, Giuliano M, Floridia M, Chiesi A, Tomino C, Seeber A, Barcherini S, Bucciardini R, and Mariotti S. "Effect of Sex, age and transmission category on the progression to survival of zidovudine-treated symptomatic patients." Current Science Ltd. AIDS, 1995; Vol. 9 (51-56).
71.Cole H. "AIDS Associated Disorders Pose Complex Therapeutic Challenges." Journal of the American Medical Association, 1988; Vol. 252 (1987-1988).
72.Hessol N, Katz MH, Liu JY, Buchbinder DP, Rubino CJ, Holmberg SP. "Increased Incidence of Hodgkin Disease in Homosexual Men with HIV Infection." Annals of Internal Medicine, 1992; Vol. 117 No. 4 (309-311).
73.Lyter DW, Bryant J, Thackeray R, Rinaldo CR, Kingsley LA. "Incidence of Human Immunodeficiency Virus -- Related and Nonrelated Malignancies in a Large Cohort of Homosexual Men." Journal of Clinical Oncology, 1995; Vol. 13 No. 10 (2540-2546).
74.McKirnan DJ and Peterson P. "Alcohol and Drug use Among Homosexual Men and Women: Epidemiology and Population Characteristics." Addictive Behavior, 1989; Vol. 14, (545-553).
75.Rankow EJ. "Lesbian Health Issues for the Primary Care Provider." Journal of Family Practice, 1995; Vol. 40 No. 5 (486-492).
76.Bradford J, Ryan C, Rothblum ED. "National Lesbian Health Care Survey: Implications for Mental Health Care." Journal of Consulting and Clinical Psychology, 1994; Vol. 62 No. 2 (228-242).
77.Hall J, "Lesbians Recovering from Alcoholic Problems: An Ethnographic Study of Health Care Experiences." Nursing Research, 1994; Vol. 43 No. 4 (238-244).
78.Bradford J, Ryan C, Rothblum ED. "National Lesbian Health Care Survey: Implications for Mental Health Care." Journal of Consulting and Clinical Psychology, 1994; Vol. 62 No. 2 (228-242).
79.deWit JBF, Van den Hoek JAR, Sandfort TGM, Griensven GJP. "Increase in Unprotected Anogenital Intercourse Among Homosexual Men." American Journal of Public Health, 1993; Vol. 83 No. 10 (1451-1453).
80.Van Den Hoek JAR, Van Grienven GJP, Coutinho RA. "Increase in Unsafe Homosexual Behavior" (Letter). Lancet, 1990; Vol. 336 (179-180).
81.Catchpole MA, Mercey DE, Nicoll A, Rogers PA, Simms I, Newham J, Mahoney A, Parry JV, Joyce C, Gill ON. "Continuing Transmission of Sexually Transmitted Disease Among Patients Infected With HIV-1 Attending Genitourinary Medicine Clinics in England and Wales." British Medical Journal, 1996; Vol. 312 (539-542).
82.McKusick L, Coats TJ, Morin SF, Pollack L, Hoff C. "Longitudinal Predictors of Reductions in Unprotected Anal Intercourse Among Gay Men in San Francisco: The AIDS Behavioral Research Project." American Journal of Public Health, 1990: Vol. 80 No. 8 (978-983).
83.Handsfield HH, Krekeler B, Nicola, RM. " Trends in Gonorrhea in Homosexually Active Men --King County, Washington, 1989." Journal of the American Medical Association, 1989; Vol. 262 No. 20 (2985-2986).
84.Hook, EW. "Behavioral Relapse Among Homosexually Active Men: Implications for STD Control." Sexually Transmitted Diseases, 1990; October/December (161-162).
85.Weller S. "A Meta-Analysis of Condom Effectiveness in Reducing Sexually Transmitted HIV." Soc Sci Med, 1993; Vol. 36 No.12 (1635-1644).
86.LeVay S. "A Difference in Hypothalamic Structure Between Heterosexual and Homosexual Men." Science, 1991 Vol. 253 (1034-1037).
87.Byne E. "The Biological Evidence Challenged." Scientific American, 1994; May (50-55).
88.LeVay S. "A Difference in Hypothalamic Structure Between Heterosexual and Homosexual Men." Science, 1991 Vol. 253 (1034-1037).
89.Gelman D, Foote D, Barrett T, Talbot M. "Born or Bred." Newsweek, 1992; February 24 (46-53).
90.Byne E. "The Biological Evidence Challenged." Scientific American, 1994; May (50-55).
91.Price J. "Federal Cancer Lab Hunts for Gay Gene." The Washington Times, 1994; April 3.
92.Ibid.
93.Bailey JM, Pillard RC. "A Genetic Study of Male Sexual Orientation." Archives of General Psychiatry, 1991; Vol. 48 (1089-1096).
94.Byne E. "The Biological Evidence Challenged." Scientific American, 1994; May (50-55).
95.Lidz T, "A Reply to 'A Genetic Study of Male Sexual Orientation.'" [Letter]. Archives of General Psychiatry, 1993; Vol. 50 (240)
96.Ibid.

Gay And Lesbian Medical Association Lists Homosexual Ailments
Thursday, August 08

The Gay And Lesbian Medical Association (GLMA) has just published a list of diseases and social pathologies that afflict those who engage in homosexual conduct.

According to the Gay And Lesbian Medical Association, men and women who engage in homosexual behaviors are at greater risk of a series of diseases and mental problems than are heterosexuals. These risks include: HIV/AIDS; substance abuse; depression/anxiety; STDs; prostate/testicular/colon cancer; alcohol and tobacco abuse; gynecological cancer; domestic violence; heart problems; osteoporosis; breast cancer and more.

Instead of discouraging these behaviors, however, the GLMA simply encourages health care providers to be aware of these diseases, addictions, and mental health problems.

If your school is pushing the homosexual agenda, school officials may wish to read about the dangerous health consequences of promoting sodomy among teenagers. GLMA has published reports on homosexual males and females. To access this information, go to: http://www.glma.org.

TEN THINGS LESBIANS SHOULD DISCUSS WITH THEIR HEALTH CARE PROVIDERS

SAN FRANCISCO — A survey of members of the Gay and Lesbian Medical Association (GLMA) released today listed 10 health care concerns lesbians should include in discussions with their physicians or other health care providers.

"We did the survey," said GLMA Executive Director Maureen S. O’Leary, RN, "because many lesbians and far too many health professionals are not comfortable or do not know how to discuss health issues related to sexual orientation. Unfortunately, there are some health risks that are of greater concern to lesbians, and we need to make sure they are addressed."

Gynecologist and former GLMA President Kathleen O’Hanlan, MD, said that the medical community must look at all factors — gender, age, family history, and current health — but that there are cultural competence issues involved in treatment of lesbians that many do not understand.

"We in the medical community need to find remedies for all the factors that reduce utilization of medical services and screening compliance among lesbians," she said. "Short of changing the laws of the country to reduce the sting of ubiquitous disdain, clinicians need to provide a safe haven for medical care for all women.

"We know from research," said O’Hanlan, "that lesbians are less likely to seek medical care than other women because of the stigma they experience everywhere in society. They also experience it when they go for medical care. Health care providers may feel uncomfortable asking questions they feel to be personal. They then limit their visit and dash out without counseling the patient.

"Although more research is needed to understand the prevalence and causes," O’Hanlan continued, "there is evidence that lesbians smoke more and drink more. It is also more likely they are overweight, which adds significant health risks. Unfortunately, some health care providers make the presumption of heterosexuality or they may offend the lesbian patient in their conversations since they lack understanding of the salient cultural issues. Either way, it reduces the likelihood that the lesbian patient will return for care."

"We need to get the discussions going," O’Leary said. "Most health care professionals understand that there are certain risks that come with being a woman or with the aging process. However, need to make sure that lesbians get equal care and that means incorporating this kind of understanding into the regular approach to treatment."

Lesbian Health Concerns
1. Breast Cancer
2. Depression/Anxiety
3. Gynecological Cancer
4. Fitness (Diet and Exercise)
5. Substance Use
6. Tobacco
7. Alcohol
8. Domestic Violence
9. Osteoporosis
10. Heart Health

"Of course," O’Leary added, "— and it is important to repeat — many of the health concerns for lesbians are the same as they are for other women. But we must have a medical community that understands that there are cultural issues — orientation, gender identity, ethnicity, race, economic status — that must be understood as well. For lesbians, the "Ten Things" list is a place to start."

TEN THINGS LESBIANS SHOULD DISCUSS WITH THEIR HEALTH CARE PROVIDERS COMMENTARY

1. Breast Cancer
Lesbians have the richest concentration of risk factors for this cancer than any subset of women in the world. Combine this with the fact that many lesbians over 40 do not get routine mammograms, do breast self-exams, or have a clinical breast exam, and the cancer may not be diagnosed early when it is most curable.

2. Depression/Anxiety
Lesbians have been shown to experience chronic stress from homophobic discrimination. This stress is compounded by the need that some still have to hide their orientation from work colleagues, and by the fact that many lesbians have lost the important emotional support others get from their families due to alienation stemming from their sexual orientation.

3. Gynecological Cancer
Lesbians have higher risks for some of the gynecologic cancers. What they may not know is that having a yearly exam by a gynecologist can significantly facilitate early diagnosis associated with higher rates of curability if they ever develop.

4. Fitness
Research confirms that lesbians have higher body mass than heterosexual women. Obesity is associated with higher rates of heart disease, cancers, and premature death. What lesbians need is competent advice about healthy living and healthy eating, as well as healthy exercise.

5. Substance Use
Research indicates that illicit drugs may be used more often among lesbians than heterosexual women. There may be added stressors in lesbian lives from homophobic discrimination, and lesbians need support from each other and from health care providers to find healthy releases, quality recreation, stress reduction, and coping techniques.

6. Tobacco
Research also indicates that tobacco and smoking products may be used more often by lesbians than by heterosexual women. Whether smoking is used as a tension reducer or for social interactions, addiction often follows and is associated with higher rates of cancers, heart disease, and emphysema — the three major causes of death among all women.

7. Alcohol
Alcohol use and abuse may be higher among lesbians. While one drink daily may be good for the heart and not increase cancer or osteoporosis risks, more than that can be a risk factor for disease.

8. Domestic Violence
Domestic violence is reported to occur in about 11 percent of lesbian homes, about half the rate of 20 percent reported by heterosexual women. But the question is where do lesbians go when they are battered? Shelters need to welcome and include battered lesbians, and offer counseling to the offending partners.

9. Osteoporosis
The rates and risks of osteoporosis among lesbians have not been well characterized yet. Calcium and weight-bearing exercise as well as the avoidance of tobacco and alcohol are the mainstays of prevention. Getting bone density tests every few years to see if medication is needed to prevent fracture is also important.

10. Heart Health
Smoking and obesity are the most prevalent risk factors for heart disease among lesbians; but all lesbians need to also get an annual clinical exam because this is when blood pressure is checked, cholesterol is measured, diabetes is diagnosed, and exercise is discussed. Preventing heart disease, which kills 45 percent of women, should be paramount to every clinical visit.

TEN THINGS GAY MEN SHOULD DISCUSS WITH THEIR HEALTH CARE PROVIDERS

SAN FRANCISCO -- A survey of members of the Gay and Lesbian Medical Association (GLMA) released today listed 10 health care concerns men who have sex with men (MSM) should include in discussions with their physicians or other health care providers.

"Clinicians providing health care to gay and bisexual men may not be aware of all of the things that should be discussed during the visit," said GLMA President Christopher E. Harris, MD. "We are concerned that physicians and other health care providers who do not understand the health risks in the gay community cannot provide competent care. This is why we asked our members to help us define the health care concerns most relevant to MSM. Our purpose is to inform health providers and allow patients to be proactive in their relationship by knowing what questions to ask."

"Naturally, not everyone has the same set of risks," said educator and medical journal editor Vincent M. B. Silenzio, MD, MPH. "But after we look at gender (men in general are increased risk of heart disease, for example) age, family history, and other basic factors, we need to consider issues that relate to the culture or subculture. We know that gay men face greater discrimination than their heterosexual counterparts, for example. Family pressures, combined with social pressure, cause significant stress. It might be important to discuss depression or anxiety, and possibly substance use. If you know that someone is sexually active, it is important to talk about safe sex, the need for hepatitis immunization, or periodic tests for anal papiloma."

Both Harris and Silenzio stress that this list broadens previously held views about appropriate treatment for gay men. They indicated this doesn’t represent special treatment for gay or bisexual men, but appropriate treatment. Patients often don’t know what they should ask their health care provider. And worse, many providers don’t know what to look for. To effectively provide the best in health care, knowledge and honesty are essential.

"Both the provider and the patient should be aware of these concerns and they should be addressed non-judgmentally as part of a patient’s regular health care program," Harris said.

Gay Men and MSM Health Concerns
1. HIV/AIDS, Safe Sex
2. Substance Use
3. Depression/Anxiety
4. Hepatitis Immunization
5. STDs
6. Prostate/Testicular/Colon Cancer
7. Alcohol
8. Tobacco
9. Fitness (Diet & Exercise)
10. Anal Papiloma

TEN THINGS GAY MEN SHOULD DISCUSS WITH THEIR HEALTH CARE PROVIDERS COMMENTARY

1. HIV/AIDS, Safe Sex
That men who have sex with men are at an increased risk of HIV infection is well known, but the effectiveness of safe sex in reducing the rate of HIV infection is one of the gay community’s great success stories. However, the last few years have seen the return of many unsafe sex practices. While effective HIV treatments may be on the horizon, there is no substitute for preventing infection. Safe sex is proven to reduce the risk of receiving or transmitting HIV. All health care professionals should be aware of how to counsel and support maintenance of safe sex practices.

2. Substance Use
Gay men use substances at a higher rate than the general population, and not just in larger communities such as New York, San Francisco, and Los Angeles. These include a number of substances ranging from amyl nitrate ("poppers"), to marijuana, Ecstasy, and amphetamines. The long-term effects of many of these substances are unknown; however current wisdom suggests potentially serious consequences as we age.

3. Depression/Anxiety
Depression and anxiety appear to affect gay men at a higher rate than in the general population. The likelihood of depression or anxiety may be greater, and the problem may be more severe for those men who remain in the closet or who do not have adequate social supports. Adolescents and young adults may be at particularly high risk of suicide because of these concerns. Culturally sensitive mental health services targeted specifically at gay men may be more effective in the prevention, early detection, and treatment of these conditions.

4. Hepatitis Immunization
Men who have sex with men are at an increased risk of sexually transmitted infection with the viruses that cause the serious condition of the liver known as hepatitis. These infections can be potentially fatal, and can lead to very serious long-term issues such as cirrhosis and liver cancer. Fortunately, immunizations are available to prevent two of the three most serious viruses. Universal immunization for Hepatitis A Virus and Hepatitis B Virus is recommended for all men who have sex with men. Safe sex is effective at reducing the risk of viral hepatitis, and is currently the only means of prevention for the very serious Hepatitis C Virus.

5. STDs
Sexually transmitted diseases (STDs) occur in sexually active gay men at a high rate. This includes STD infections for which effective treatment is available (syphilis, gonorrhea, chlamydia, pubic lice, and others), and for which no cure is available (HIV, Hepatitis A, B, or C virus, Human Papilloma Virus, etc.). There is absolutely no doubt that safe sex reduces the risk of sexually transmitted diseases, and prevention of these infections through safe sex is key.

6. Prostate, Testicular, and Colon Cancer
Gay men may be at risk for death by prostate, testicular, or colon cancer. Screening for these cancers occurs at different times across the life cycle, and access to screening services may be negatively impacted because of issues and challenges in receiving culturally sensitive care for gay men. All gay men should undergo these screenings routinely as recommended for the general population.

7. Alcohol
Although more recent studies have improved our understanding of alcohol use in the gay community, it is still thought that gay men have higher rates of alcohol dependence and abuse than straight men. One drink daily may not adversely affect health, however alcohol-related illnesses can occur with low levels of consumption. Culturally sensitive services targeted to gay men are important in successful prevention and treatment programs.

8. Tobacco
Recent studies seem to support the notion that gay men use tobacco at much higher rates than straight men, reaching nearly 50 percent in several studies. Tobacco-related health problems include lung disease and lung cancer, heart disease, high blood pressure, and a whole host of other serious problems. All gay men should be screened for and offered culturally sensitive prevention and cessation programs for tobacco use.

9. Fitness (Diet and Exercise)
Problems with body image are more common among gay men than their straight counterparts, and gay men are much more likely to experience an eating disorder such as bulimia or anorexia nervosa. While regular exercise is very good for cardiovascular health and in other areas, too much of a good thing can be harmful. The use of substances such as anabolic steroids and certain supplements can adversely affect health. At the opposite end of the spectrum, overweight and obesity are problems that also affect a large subset of the gay community. This can cause a number of health problems, including diabetes, high blood pressure, and heart disease.

10. Anal Papilloma
Of all the sexually transmitted infections gay men are at risk for, human papilloma virus —which cause anal and genital warts — is often thought to be little more than an unsightly inconvenience. However, these infections may play a role in the increased rates of anal cancers in gay men. Some health professionals now recommend routine screening with anal Pap Smears, similar to the test done for women to detect early cancers. Safe sex should be emphasized. Treatments for HPV do exist, but recurrences of the warts are very common, and the rate at which the infection can be spread between partners is very high.