Female Bisexuality: Bisexual or Lesbian

Potential barriers to “curing” homosexuality

Every so often, I run into people who are fairly confident that if the precise causes of homosexuality are ever identified, this would lead to either the near-universal abortion of gay fetuses, or widespread “treatment” of gay individuals to eradicate their same-sex attractions. They tend to assume that this would be a relatively straightforward affair, and probably inevitable. In fact, the myriad assumptions in play here are far from established. Most have not even been examined or scrutinized at all, and this simplistic and limited vision shows a profound failure of imagination. While it’s possible that events could occur just as described in this poorly thought-out scenario, there’s good reason to believe that attempts at diagnosing and “treating” homosexuality may not proceed so smoothly.

Let’s first explore the hypothetical phenomenon of gay-targeted abortion. For selective abortion of future homosexuals to be possible, there must first be a way to identify them prenatally. The difficulty here is that current evidence indicates homosexuality is not caused by a single identifiable factor. It can be influenced by genetics, the intrauterine environment and prenatal hormones, early childhood experiences and upbringing, and the overall interaction of these. But as far as we know, there isn’t one feature that’s present in all or even most gay people, and few or no heterosexuals.

This isn’t like testing for sex, or extra copies of a chromosome, or physical birth defects. The identified differences involve such diverse traits as left or right-handedness, finger length ratios, the startle response, auditory system functioning, hair whorl direction, response to sex pheremones, brain activity, brain hemisphere symmetry and the size of other brain structures, genetic linkage, having more older brothers from the same mother, maternal stress levels during pregnancy, skewed X-inactivation in the mother, high fertility in female relatives, early childhood socialization, gender nonconformity as a child, and growing up in urban areas during adolescence, among other things. Additionally, many of these results were not found to be applicable to lesbians.

Even worse for the prospect of prenatal identification, these are average differences that appear in groups of people, not all-or-nothing traits that would be of individual diagnostic value. There’s a substantial overlap between gay and straight populations, with many straight people having gay-associated traits, and many gay people having straight-associated traits – to say nothing of bisexuals. Given our current knowledge, any prenatal tests attempting to discern these features would frequently misidentify future heterosexuals and homosexuals. While mistakenly aborted straight people would never get the chance to reveal their heterosexuality, parents who rely on such tests may be quite surprised when their presumably straight children turn out to be gay.

It would be much too optimistic to believe that few people would engage in gay-targeted abortion if accurate diagnosis were possible, considering that abortion for the mere purpose of selecting against female children is already widespread in certain cultures. The difference here is that the broad biological and environmental basis of sexual orientation could thwart such motives and make reliable prenatal identification practically impossible. Aside from running an extremely detailed and computationally intensive simulation of the brain to determine their sexual inclinations, which is currently far beyond our grasp, it seems the best way to tell a baby’s orientation is simply to wait and ask them yourself.

Rather than abortion, another potential means of eradicating homosexuality would be prenatal treatment of suspected gay fetuses. This actually does have a scientific precedent, though not specifically in relation to homosexuality. Congenital adrenal hyperplasia is known to cause masculinization of girls, with symptoms such as ambiguous genitalia. Women with CAH also have higher rates of bisexuality and lesbianism, and lower interest in childbearing and motherhood. Prenatal use of the steroid dexamethasone was shown to reduce genital ambiguity somewhat in female fetuses with CAH, although it doesn’t cure the underlying condition. Some have speculated that this treatment could also reduce the incidence of same-sex desires in these women.

While lesbianism may be more prevalent in women with CAH, the condition is too rare to account for more than a very small subset of lesbian women overall. However, homosexuality has variously been associated with apparent over-masculinization in men or women, under-masculinization in men, and certain similarities to the opposite sex. Studies have shown that gay men tend to have equally sized brain hemispheres like those of straight women, whereas lesbians tend to have larger right hemispheres like those of straight men. On average, the anterior commissure of the brain is larger in gay men than in straight men or women, though later studies found no difference. The third interstitial nucleus of the anterior hypothalamus tends to be smaller in gay men than in straight men, and similar in size to that of straight women. The suprachiasmatic nucleus in gay men tends to be larger than that of straight men. The auditory systems of lesbian and bisexual women are more like those of men than of straight women. Lesbians tend to exhibit finger length ratios that are similar to men rather than straight women, which is associated with high levels of androgens.

It seems plausible that attempts at preventing or treating homosexuality prenatally might focus on controlling the degree of masculinization or feminization of the developing fetus. But again, the physical differences between gay and straight people are average differences which appear in groups, not reliable markers of an individual’s orientation. In addition to being compromised by the substantial diagnostic inaccuracy of prenatal orientation testing, such treatment could expose suspected gay fetuses to an unknown risk of side effects and birth defects instead of simply aborting them.

Medication intended to influence sexual and neurological development prenatally could have a number of unforeseen adverse effects such as those seen in the children of pregnant women who had taken the synthetic estrogen DES. Considering that various physical traits of gay people suggest either over-masculinization or under-masculinization, and that many straight people exhibit these characteristics while many gay people do not, any medication designed to enhance or inhibit prenatal masculinization could conceivably have an effect that’s precisely the opposite of what was intended.

Another potential treatment might rely on the hypothesis that homosexuality in men is caused by the immune sensitization and response of a mother who had previously given birth to one or more sons. Suppressing this immune reaction could prevent any effects it may have on the developing fetus, although this hypothesis could only account for a small fraction of male homosexuals overall. Given what little we know about the precise developmental causes of sexual orientations, any attempt at prenatal treatment would be poorly targeted and little more than a shot in the dark, especially when there’s no way to be certain whether a fetus will be gay or not. Unless we’re able to identify a trait or process that occurs in most homosexuals and few heterosexuals, the possibilities for treatment seem limited, to say the least.

Finally, if homosexuality can’t be identified or counteracted before birth, there might be attempts to eliminate same-sex desires in childhood or adulthood. Unlike prenatal diagnosis or treatment, there’s an extensive and tragic history of trying to “convert” gay adults to heterosexuality. If the only goal is to prevent same-sex attraction or sexual activity, and nothing else is of any concern, then there are plenty of ways to do this, such as chemical castration, surgical castration, genital mutilation, capital punishment, or just psychologically damaging someone so extensively that they can no longer form intimate relationships. All of this has been done before.

But nowadays, most people recognize that there should be some kind of limit to the suffering that’s considered acceptable in exchange for the eradication of same-sex desires. Many people would rightly place that limit at zero. As therapeutic efforts have become somewhat more humane, focusing instead on voluntary celibacy, religious devotion and straightforward repression, they’ve also become much less effective. Now that the more visibly harmful and damaging “treatments” of the past face widespread disapproval, some people have speculated that there could eventually be a medical treatment that would reduce homosexual inclinations without being physically or psychologically crippling.

This, too, seems likely to be overly optimistic. Whatever its physical basis, which often appears to be inconsistent, homosexuality can manifest in differences throughout the entire body, just as with heterosexuality. Altering the biological correlates of homosexuality on a permanent basis may turn out to be quite a tall order. This isn’t as simple as taking a painkiller, or a vaccine, or an antidepressant – unless it does turn out to be that simple, which it hasn’t so far. Yet proponents of a gay “cure” scenario often seem to think that this would be as easy as taking a pill and turning straight. But altering such a significant feature of the body and mind is rarely so effortless, if it’s possible at all.

Why assume that any eventual treatment would be so basic? What if it’s actually much more complex than that? It might require an expensive course of gene therapy with a risk of causing cancer or other life-threatening reactions, as seen in the SCID gene therapy trials in France and the death of Jesse Gelsinger. Or it might be a kind of neurosurgery, with all the risks of cracking open the skull and cutting out pieces of the brain. It might take the form of hormone therapy, with all of the known side effects and possibly some new ones. Maybe it’ll be a daily medication that people have to take for the rest of their lives. The risks or adverse effects of the treatment might be so undesirable that the goal of eliminating same-sex attraction is simply no longer worthwhile. And given that sexual orientation appears to have multiple etiologies, it may only be treatable to varying degrees depending on the individual. Some people may still turn out to have untreatable homosexuality, depending on the “treatment”.

Furthermore, hardly any consideration is given to the potential social implications of medically altering sexual orientation. The treatment for homosexuality might be so expensive, it would be beyond the reach of the poor. Health care agencies might refuse to cover it, given that homosexuality is not a medical condition. Adolescents might resist having such treatment forced upon them by their parents. And whatever the nature of the therapy, there might also be a counterpart treatment to turn heterosexuals gay. Maybe these treatments would be weaponized for military or political purposes – and it’s not beyond the realm of possibility that someone might release the “cure for heterosexuality” at the Republican National Convention.

If any of this seems implausible, that’s because it’s just as speculative as the assumption that a “cure” for homosexuality would be simple, widely accepted and universally employed. So what makes people think this would be so easy? If they were asked to reflect on the kind of effort it would take to negate their own heterosexual attractions and give them a homosexual orientation, they would probably perceive this as a much more significant change. It seems that some people tend to view being straight as a default state for everyone, with homosexuality as an additional deviation that’s simply masking an underlying heterosexuality, which would emerge on its own once homosexuality is taken out of the picture – just like curing an ear infection. They fail to consider that homosexuality is actually just as complex and deeply rooted as their own heterosexuality.

So while there certainly might be various attempts to treat or abort gay people, the prospects for their success aren’t looking very good right now, and many people don’t find such efforts appropriate at all. There’s no telling what new discoveries might be made about sexual orientation in the future, but on this front, social progress has a good chance of outpacing scientific progress. Even if this is inevitable, by the time it becomes possible, there may just be no one who’s interested.

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