A new report that seems to contradict the basics of LGBT identity falls totally flat.


Anti-LGBT conservative outlets have been abuzz this week about a new report that seems suspiciously designed to make it look like those who oppose LGBT equality have science on their side.

They don’t.

The “Sexuality and Gender” special report, published by The New Atlantis, claims to undermine the belief that LGBT people are “born that way.” It purports to be a thorough analysis of the research on LGBT identities that just so happens to lend legitimacy to many of the arguments against affirming LGBT people and protecting them under the law.

But the report has no new information, no new arguments, and — despite its 143 pages of analysis — is still more notable for what it doesn’t say.

The report’s conclusions include the following:

-Sexual orientation is not biologically fixed.

-Non-heterosexual people seem more likely to have experienced childhood sexual abuse.

-Gender identity is not biologically fixed.

-Both non-heterosexuals and transgender people experience a higher risk of negative mental health outcomes — and stigma and stress don’t seem to fully explain it.

-Nothing supports affirming children as transgender.

-In addition to these claims, digging a bit deeper into the report’s origins supports the idea that it’s little more than anti-LGBT propaganda.

One of its co-authors is Dr. Paul McHugh, the retired Johns Hopkins University professor who is generally the only scientist whom opponents of transgender equality ever cite and who has his own history of overt anti-LGBT bias. The report was published in The New Atlantis, a journal that is affiliated with the anti-LGBT Ethics and Public Policy Center and prides itself on not being peer-reviewed. And when it was released on Monday, the Heritage Foundation’s Daily Signal was ready to promote the report and the fancy featurette video that accompanies it — one that looks suspiciously like plenty of other Heritage-produced videos.

Moreover, the authors are well aware their conclusions will be perceived as anti-LGBT. “We anticipate that this report may elicit spirited responses, and we welcome them,” they wrote. McHugh’s co-author Lawrence Mayer also explains in his preface that some researchers didn’t want to even be acknowledged in the study because they “feared an angry response from the more militant elements of the LGBT community.”

What’s interesting about the report is that most of the analysis is respectable. Mayer and McHugh examine a lot of valid studies and write about them in fair ways, with most of the necessary caveats to avoid distortion. Where it goes wrong is in the research that it omits and the conclusions it draws that seem to completely ignore how LGBT people live their lives, despite claiming not to “discuss matters of morality or policy.” In some places — particularly the case of transgender children — it openly rejects affirmation of LGBT identities, but in many other places it simply lays out all the dots for a reader to connect them that way. As such, instead of serving as any new resource about LGBT lives, the report seems to function more as a litmus test for anti-LGBT bias.

Repackaging Research To Appeal To Opponents Of LGBT Equality

The main thrust of the New Atlantis report is the paired questions of whether sexual orientation is a “fixed and innate biological property” and whether gender identity is “fixed at birth or at a very early age.” In a sense, these are straw man questions that Mayer and McHugh set up to knock down, because their answers are not particularly insightful.

On the question of “sexual orientation,” the authors expound at length about how the very concept is so “ambiguous.” It’s not clear, they argue, whether the term is always being used to describe “sexual desire,” “sexual attraction,” or “sexual arousal,” noting that “sexual orientation and identity are understood not only in scientific and personal terms, but in social, moral, and political terms as well.” That’s true, and likewise, many people’s sexual orientations don’t fit neatly into discrete categories of heterosexuality, bisexuality, or homosexuality.

Despite this ambiguity, the available evidence they provide from twin studies and genetic research nevertheless leads them to the conclusion that a person’s genetics likely does inform their sexual orientation. But, they insist, it just doesn’t tell the full story. For example, it doesn’t explain how sexuality can be fluid over time, nor does it explain one particular study that found that heterosexuality seemed to be more “stable” over time, fluctuating less than other sexualities.

As Warren Throckmorton points out, they notably omit a massive recent review of research on sexual orientation, which found that generally only women’s sexuality is fluid, and that there is “considerably more evidence supporting nonsocial causes of sexual orientation than social causes.” Whereas the researchers behind that massive review concluded that “sexual orientation is an important, fundamental trait that has been understudied because it is politically controversial,” Mayer and McHugh suggest instead downplaying the importance of identifying with sexual orientation:

We may have some reasons to doubt the common assumption that in order to live happy and flourishing lives, we must somehow discover this innate fact about ourselves that we call sexuality or sexual orientation, and invariably express it through particular patterns of sexual behavior or a particular life trajectory. Perhaps we ought instead to consider what sorts of behaviors — whether in the sexual realm or elsewhere — tend to be conducive to health and flourishing, and what kinds of behaviors tend to undermine a healthy and flourishing life.

It’s these kinds of dogwhistles that undermine the report’s attempts at impartiality. For years, religious conservatives have used “love the sinner, hate the sin” rhetoric to try to distinguish identity from behavior, as if loving a person in spite of their orientation is on par with loving a person, including their orientation. Anyone who believes that people shouldn’t identify with their sexuality or that gay sex is unhealthy will feel affirmed in those beliefs by this conclusion.

Another dogwhistle reinforces a trope frequently used by proponents of ex-gay therapy. Mayer and McHugh cite research that shows that LGB people tend to have experienced higher rates of childhood sexual abuse. They then speculate as to whether this suggests that such abuse causes a non-heterosexual orientation, finding no conclusive answer. They don’t bother to mention that such speculation does nothing to explain the majority of LGB people who never experience such abuse.

Likewise, Mayer and McHugh show absolutely no evidence that there is any way to manipulate people’s sexual orientation, either as children or adults, openly acknowledging that it’s not a choice and not even mentioning ex-gay therapy. But that doesn’t stop them from insinuating otherwise:

The most commonly accepted view in popular discourse we mentioned above — the “born that way” notion that homosexuality and heterosexuality are biologically innate or the product of very early developmental factors — has led many non-specialists to think that homosexuality or heterosexuality is in any given person unchangeable and determined entirely apart from choices, behaviors, life experiences, and social contexts. However, as the following discussion of the relevant scientific literature shows, this is not a view that is well-supported by research.

The evidence they collected about the nature of sexual orientation really isn’t all that new or interesting. They’ve simply packaged it in a way for those wishing to undermine the validity of LGB identities to see it as supporting that goal.

Rejecting Trans Identities

Mayer and McHugh’s discussion of gender identity mirrors their sexual orientation discussion pretty directly. They highlight a lot of studies that suggest that there are biological components to being transgender, but that are inconclusive. But then they are much more overt about rejecting the affirmation of trans identities, particularly in children.

Using a similar argument offered by the fake anti-LGBT American College of Pediatricians, they claim that there’s just not enough good research to support affirming transitions. “The high level of uncertainty regarding various outcomes after sex-reassignment surgery makes it difficult to find clear answers about the effects on patients of reassignment surgery,” they argue. They cite a few studies that showed that trans people still struggled in certain ways after surgery, but none that showed that the surgery had anything to do with the continued struggles.

Of note, Mayer and McHugh never even mention the existence of the World Professional Association for Transgender Health, which has maintained research-informed standards of care for transgender health since 1979. The fact that there is enough research that a consensus of major medical organizations supports trans-affirming health care never comes up at all.

The authors’ bias against affirming trans kids’ gender is propped up by another straw man. “The notion that a two-year-old, having expressed thoughts or behaviors identified with the opposite sex, can be labeled for life as transgender has absolutely no support in science,” Mayer opines in his preface. “Indeed, it is iniquitous to believe that all children who have gender-atypical thoughts or behavior at some point in their development, particularly before puberty, should be encouraged to become transgender.”

This is the very argument that trans activists have been making as they challenge the “desistance myth” — the claim that most “transgender” kids turn out to not be transgender adults (they “desist”). The myth is based upon research that made the same conflation Mayer objects to — that all gender nonconforming kids are transgender. But McHugh and Mayer seem oblivious to the fact that even the American Psychiatric Association now makes this distinction in the latest edition of the Diagnostic and Statistics Manual (DSM-5):

The DSM-5 criterion for diagnosing gender dysphoria by reference to gender-typical toys is unsound; it appears to ignore the fact that a child could display an expressed gender — manifested by social or behavioral traits — incongruent with the child’s biological sex but without identifying as the opposite gender.

It’s true that back in the DSM-4, a child could be diagnosed with what was then called “gender identity disorder” based solely on gender stereotypes about the kid’s toy and clothing preferences, friendships, and mannerisms. Counting those kids as “transgender” even when they weren’t insisting they were a different gender is largely how the desistance myth came about in the first place. But the DSM-5 diagnostic criteria for what’s now called “gender dysphoria” in children specifically always requires that children demonstrate “a strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from one’s assigned gender).” In other words, the diagnostic standards have already addressed the concerns Mayer and McHugh are using to object to affirming transgender kids.

Noticeably absent from the report are many of the newer studies about the benefits of affirming kids when they assert a gender different from what they were assigned at birth. For example, researcher Kristina Olson has found that trans kids identity as much with their gender as their cisgender peers. She also found in a separate study that trans kids who are affirmed by their parents are as happy and healthy as other kids. A similar study by Maja Marinkovic found that trans kids allowed to fully identify with their gender had decreased levels of depression and anxiety. Conversely, analysis of the 2011 National Transgender Discrimination Survey found significant correlations between family rejection and negative mental health outcomes in transgender people.

Instead, Mayer and McHugh worry that gender dysphoria referrals for both children and adults are increasing rapidly. “Whether this increase can be attributed to rising rates of gender confusion, rising sensitivity to gender issues, growing acceptance of therapy as an option, or other factors, the increase itself is concerning,” they write, because “family dynamics,” “social rejection,” or “developmental issues” could be leading researchers to misdiagnose. They don’t elaborate.

As they did with non-heterosexual sexual orientations, they offer a “skeptical view” about affirming transgender identities:

The scientific evidence summarized suggests we take a skeptical view toward the claim that sex-reassignment procedures provide the hoped-for benefits or resolve the underlying issues that contribute to elevated mental health risks among the transgender population. While we work to stop maltreatment and misunderstanding, we should also work to study and understand whatever factors may contribute to the high rates of suicide and other psychological and behavioral health problems among the transgender population, and to think more clearly about the treatment options that are available.

It’s another perfect dogwhistle for conservatives who object to respecting trans people’s genders, for those who want to block trans people from obtaining affirming health care, and particularly for those — including, notably, McHugh himself — who insist that being transgender is, itself, a mental illness.

The Daily Beast, which identified some additional gaps in the report, asked McHugh about being at odds with major medical organizations. “My answer to that is this is not the first time I’ve been contradicting traditions,” he responded, “and, in these areas, I am saying that they do not have evidence-based medicine on which to back their prescriptions.” The irony, it seems, was lost on him.

Assuming LGBT People Inherently Suffer

Mayer and McHugh dedicate a third of the report to research on the negative mental health outcomes LGBT people experience and the evidence that social stress plays a part. Their conclusion is that there’s definitely stigma and discrimination, and that it definitely has a negative impact on LGBT people, but it doesn’t fully explain the negative outcomes. “As we will see, social stressors such as harassment and stigma likely explain some but not all of the elevated mental health risks for these populations.” It’s another fill-in-the-blank dogwhistle: If you believe LGBT people are inherently destined to be miserable, you might not be wrong!

There are no surprises in this section. LGBT people experience higher rates of depression, substance abuse, and suicidal thinking and attempts. Plenty of studies have demonstrated this, though Mayer and McHugh leave many out. For example, they highlight a 2009 study by Mark Hatzenbuehler that found inconclusive results about the impact of anti-LGBT state policies on LGBT mental health, but they ignore several other relevant studies Hatzenbuehler has published since then. For example, he found in 2011 that LGB youth are more likely to attempt suicide when they live in communities with conservative attitudes about their identities. Then in 2014, he found that LGB people living in such unwelcoming communities actually die younger — and more often from cardiovascular disease. For a report billed as “a careful summary and an up-to-date explanation of research,” its attempt to be comprehensive is neither careful nor up-to-date.

But for all the studies they do cite, they don’t offer any alternative ideas for what else might be harming the mental health of LGBT people. Nevertheless, they suggest that it might actually hurt LGBT people to ignore that something else might be a factor. “The social stress model deserves further research, but should not be assumed to offer a complete explanation of the causes of mental health disparities if clinicians and policymakers want to adequately address the mental health challenges faced by the LGBT community.”

The insinuation is that even if society were 100 percent affirming of LGBT people, both legally and culturally, LGBT people would still inherently suffer anyway and they should be made aware of this reality. As is evident from the way anti-LGBT conservatives responded to the New Atlantis report, this somehow justifies continuing to stigmatize LGBT people.

The Dogs Come Barking

Right-wing outlets and organizations were quick to seize on the report and point to its findings as justification for their positions.

The Daily Signal was first out of the gate to praise the report and draw policy implications from the not-new information presented. Heritage Foundation fellow Ryan T. Anderson concluded that policies that protect transgender students in schools could “result in prolonged identification as transgender for students who otherwise would have naturally grown out of it” — an outcome that is not only not supported by the research, but that has also never actually been demonstrated to have happened.

He also took significant umbrage that Supreme Court Justice Anthony Kennedy described homosexuality as “both a normal expression of human sexuality and immutable.” According to Anderson’s reading of the new report, “the science does not show this,” except of course that nowhere in the study does it challenge the notion that sexual orientation is “immutable” — that it cannot be changed or chosen. Still, he bemoans that “incorrect scientific claims about sexual orientation were consistently used in the campaign to redefine marriage.”

The Liberty Counsel, well known for defending anti-LGBT clients like Kentucky County Clerk Kim Davis and Alabama Supreme Court Justice Roy Moore, saw Mayer and McHugh’s report as validation for their efforts. Chairman Mat Staver boasted, “The scientific facts do not support the harmful LGBT agenda. Common sense demands we stop rebelling against nature.”

The Alliance for Therapeutic Choice, the ex-gay professional organization formerly known as NARTH, wrote in an email that the study “confirms the importance of our mission and the validity of the principle positions of the Alliance for Therapeutic Choice and Scientific Integrity since our founding more than twenty years ago.”

The National Organization for Marriage, which has spent the year since losing its fight against marriage equality mostly begging for donations, praised the study as “groundbreaking.” President Brian Brown urged supporters to help “promote this research and expose the lies of the media and LGBT activists that contradict not only common sense but also the best scientific knowledge.”

Writing at The Federalist, Mary Rice Hasson, a fellow at the very Ethics and Public Policy Center that supports The New Atlantis, provided the most telling summation of the new report: “This new report gives us language and authority to push back, as it challenges these false narratives, and by extension, the policy protocols that rely on them.”

Indeed, the report offers talking points and an air of authority to bolster the effort to push back on LGBT equality.

Ultimately, it’s important to remember that the expression “born this way” was never a scientific explanation for LGBT identities. It is a shorthand way to describe the way that LGBT people experience their identities, their significance, and in most cases, their consistency since the earliest age they can remember. As Lady Gaga advises in the song, “Don’t hide yourself in regret, Just love yourself and you’re set.” That’s the real sentiment of “born this way,” and nothing in the Mayer and McHugh report contradicts it.