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Doctors debate the facts surrounding sexual orientation and gender confusion



A letter and fact sheet about teen sexual orientation and gender confusion sent from the American College of Pediatricians to public school administrators have been challenged as non-factual by two of the country's largest and most prestigious professional associations: the American Academy of Pediatrics and the American Psychological Association.

The letter and fact sheet were mailed to 14,800 school superintendents on behalf of Tom Benton, president of the American College of Pediatricians. The letter primarily addresses same-sex attraction, and recommends that "well-intentioned but misinformed school personnel" who encourage students to "come out as gay" and affirm them as such may lead the students into "harmful homosexual behaviors that they otherwise would not pursue."

The letter also states that gender identity disorder (GID) will typically disappear by puberty "if the behavior is not reinforced." GID is a recognized diagnosis in the American Psychiatric Association's Diagnostic and Statistical Manual, but according to Oklahoma public school administrators, neither orientation nor gender confusion are topics addressed by school employees.

Ann Caine, a former Putnam City Schools principal and now the superintendent of Stillwater Public Schools, said she has not seen the material.

"I would certainly remember seeing something like that," she said. "However, we think of adolescent sexual orientation and gender confusion as topics that are best left to the students' parents or legal guardians. I assume most parents or guardians would prefer that role be left to them."

Kathleen Kennedy, executive director of communication for Oklahoma City Public Schools, said OKCPS policy is to be supportive and inclusive of all students.

"It's not our place to tell children what to choose or who they will be," Kennedy said.

The letter and fact sheet were also sent to launch a new website that the ACP hopes will be a resource for administrators, teachers, parents and students to access "accurate information regarding sexual orientation and gender confusion issues."

Lisa Hawkins, a spokesperson for ACP, said the group sent the information as a response to a brochure mailed to schools by the Just the Facts coalition, a group of 13 professional associations, including the AAP and the APA, in 2008.

Hawkins said that while the ACP agrees with the approach of letting parents and guardians talk to their children about the topics, her organization had received several reports of school districts around the country counseling children about the issues. She did not specify any school districts.

In addition to counseling with parents, the ACP document makes the statement that gay and lesbian students, as well as students with GID, respond well to reparative therapy.

Speaking on behalf of the American Academy of Pediatrics, Ellen Perrin, professor of pediatrics at the Tufts School of Medicine in Boston, said the idea that these were disorders that can be cured through therapy have been "proven in study after study to be harmful to patients."

Kim Mills, a spokesperson for the American Psychological Association, said the APA got involved as a way to offset much of the "misinformation being promulgated" about GID and teen sexuality, including reparative therapy.

Meanwhile, Hawkins said the ACP, which she described as "a science-based organization with positions consistent with Judeo-Christian and Muslim positions," wanted parents and educators to have access to the facts.

"There is no scientific evidence that homosexuality is genetically determined," she said. "There is also no evidence that anyone is born transgendered."

Some medical and mental health professionals are concerned that the repeated conflation of GID with sexual orientation will lead to further alienation for patients who feel trapped in the wrong body.

Dawn Singleton, an Oklahoma City-based marriage and family counselor, has worked with GID patients throughout her career. She's seen firsthand the struggle adolescents and teenagers have orienting to a gendered world.

"First, it's important to note that sexual orientation has nothing to do with gender identity disorder," Singelton said. "Patients with GID are born with a brain that doesn't match their body, and they speak of feeling like they were born in the wrong body. Parents tell me that many children with GID exhibit signs and questions as early as 2 or 3 years of age. As they grow up, they feel uncomfortable interacting with their peers, and many of them don't like to look at their own naked bodies; they feel shame and disorientation."

Singleton said she recommends that parents bring their kids in as early as possible for treatment. That position is shared by Perrin.

"My approach is to help parents help their children adjust to a world that is gendered," Perrin said. "There is nothing wrong with gender-variant kids, but the culture in which they live gets upset if the kids don't live up to gender expectations. The culture doesn't allow for a wide variety of diversity within gender."

Perrin makes a distinction between gender variant, GID and gender dysmorphia, the latter referring to those patients whose "body doesn't fit who they are." Gender-variant children may eventually adopt the expected gender roles, but gender dysmorphia is more persistent.

Both Singleton and Perrin said that some parents elect to give gender-dysmorphic children hormone therapy to delay the onset of puberty.

"It's a way of giving the family time to deal with the issues," Perrin said.

For those who never overcome GID or gender dysmorphia, sex reassignment surgery is an option. Singleton said she knows of no doctor in Oklahoma who does the surgery, however " an ironic reality, given that Baptist Medical Center was a leading provider of SRS in the 1970s, according to a 1977 article in The Evening Independent.

Whatever her patients choose, Singleton said her responses are admiration and compassion. "Greg Horton

photo Dawn Singleton. Photo/Mark Hancock

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