Researchers question use of sexual abuse data

Today, researchers Ron Stall and Ron Valdiserri released a statement regarding use of their book, Unequal Opportunities: Health Disparities Affecting Gay and Bisexual Men in the United States by Focus on the Family writer Jeff Johnston.

The report they question was released recently by Focus and is titled: “Childhood Sexual Abuse and Male Homosexuality: Is there a link?” In that report, Johnston cites statistics from the book, along with quotes from other studies and an interview with Narth past-president Dean Byrd. Here are the relevant portions of the book edited by Stall, Valdiserri and colleague Richard Wolitski (all footnotes in this section are to the Unequal Opportunities book).

Many pro-gay researchers, activists and theorists deny that there could be a connection between child sexual abuse and adult homosexuality. Some possible reasons for denying this link are the stigma that surrounds sexual abuse; the fear of associating homosexuality with “recruitment” or pedophilia; and because so many gays continue to believe that homosexuality is inborn and immutable. In 2008, however, a group of researchers from the U.S. Centers for Disease Control and Prevention (CDC) published a book that documented the high rates of sexual abuse among “men who have sex with men (MSM).”[6]

In a chapter titled, “Childhood Sexual Abuse Experienced by Gay and Bisexual Men: Understanding the Disparities and Interventions to Help Eliminate Them,” from the book Unequal Opportunity, researchers analyze and report on data from 17 different studies from the past 15 years.[7] They find the rates of childhood sexual abuse (which they abbreviate as CSA) for men who have sex with men range from 11.8% to 37.0%, and note that “the best-designed studies tend to converge on CSA prevalence of 15% to 25%.”[8]

While most of those who perpetrate sexual abuse are men, abusers are not necessarily homosexual or gay-identified,[9] and the authors note that “in studies focusing on MSM, the perpetrators are always at least 90% male.”[10] The range of abuse varies in the different studies depending on the definition of abuse and the sample method.[11]

The researchers report that the rates of child sexual abuse for gay- or bisexual-identified men are significantly higher than those found among heterosexually-identified men. They write that the rates for heterosexual men are usually “less than 10%,” and state that in five studies that compared the two groups, the men who have sex with men are “at least three times more likely to report CSA, however defined, than heterosexual men.”[12] This finding is reiterated in their conclusion: “Rates for MSM are 15% to 25% in the best designed studies, which is at least triple the rates reported among heterosexual men.”[13]

Consequences of Sexual abuse

Children are not equipped emotionally, physically, spiritually or psychologically to handle adult sexuality. Individual boys will handle sexual abuse in different ways: what leads to shame and guilt in one child might lead to self-questioning and gender confusion in another or to anger and acting out in a third. Each child is unique, grows up in a unique environment and will respond in an individual way to sexual abuse or early sexual encounters with the same sex.

There are, however, common themes and outcomes that consistently emerge in studies of men who were sexually abused as children. Two common outcomes of sexual abuse – out of the many possible – are that boys may question their identity and be confused about their sexuality.

The followin quotes may have generated the most concern by Stall and Valdiserri:

The authors in Unequal Opportunity are reluctant to say that childhood sexual abuse is one of the factors that leads to or contributes to the development of homosexuality, but they do speculate,

The fact that most childhood abusers of MSM were males suggests either an etiological link between CSA and adult sexual orientation, or the existence of childhood characteristics that are related to adult sexual orientation in men that increase vulnerability, or both.”[23]

And later, they say that these early sexual experiences “can be considered a form of sexual learning, even if that learning is involuntary and the results dysfunctional.”[24] They continue, “Sexual orientation and gender identity can be particularly confusing for men who experienced arousal during the abuse, and MSM who experienced abuse may continue to be aroused by circumstances that mirror the abusive situation.[25]

Drs. Stall and Valdeserri’s statement is as follows:

We want to respond to a recent Focus on the Family characterization of scientific findings reported in our book, Unequal Opportunities: Health Disparities Affecting Gay and Bisexual Men in the United States (Oxford University Press) that misrepresented findings in the book to suggest that childhood sexual abuse causes male homosexuality. The Focus on the Family description of the findings reported in Unequal Opportunities is inaccurate and, in our opinion, a distortion of the scientific literature.

Most basically, the Focus on the Family characterization of the literature on childhood sexual abuse among gay men represents a misunderstanding of scientific approaches to distinguishing between correlation and causation. The book chapter in question reports that gay men are more likely to report childhood sexual abuse by men than are heterosexual men. This correlation does not mean that the reported abuse caused the adult sexual orientation. If that were the case, then the fact that some heterosexual men report sexual abuse by women means that sexual abuse by women “causes” heterosexuality in men. It is also worth noting that the argument that childhood sexual abuse causes homosexuality in gay men is undermined by the fact that the vast majority of gay men are not sexually abused as children.

One potential partial explanation for this correlation, and one that makes the most sense when you consider people of all orientations, is that some youth, particularly post-pubertal youth (who still cannot legally consent to sexual activity) have sexual experiences with males or females, depending on their pre-existing orientation. Let’s be very clear that this does not mean that these experiences are appropriate or healthy. However, it also does not mean that these experiences

caused the sexual orientation of the youth. The development of a person’s sexual orientation is a complex and multifaceted process. The research into these processes has barely begun, and the development of sexuality is very difficult to study. Mischaracterizations of the scientific literature on the development of sexual orientation is not helpful to science.

Rather than mischaracterize these findings, we would like to point out the harm to health that can be caused by childhood sexual abuse among boys and girls of all sexual orientations. Childhood sexual abuse occurs to far too many young Americans and a large and growing literature supports that this abuse can cause lifelong damage to the physical and mental health and wellbeing of men and women of all sexual orientations. We suggest that Focus on the Family and

other concerned organizations focus on how to work to ensure that all of our children remain safe from unwanted sexual experiences– whether heterosexual or homosexual.

That said, we want to state clearly that the published research does not support the claim that the development of a homosexual orientation is caused by childhood sexual abuse. Furthermore, adult homosexual orientation is no longer considered a pathology or a maladjustment. We urge those who are interested in trying to better understand some of these complex issues from a scientific perspective to read the discussions in our book, as well as the scientific literature on childhood sexual abuse, and not rely on second-hand interpretations.

Ron Stall

Ron Valdiserri

Related post:

A major study of child abuse and homosexuality revisited

A major study of child abuse and homosexuality revisited

The role of child sexual abuse in sexual orientation has received some attention lately. In January, of this year, a prospective study demonstrated that child sexual abuse was associated with ever engaging in adult homosexual behavior for males but not for females. The study by Widom and Wilson demonstrated that physical abuse or neglect did not associate with homosexuality, nor did sexual abuse predict same-sex cohabitation or current sexual partner. In other words, measures of behavior (living with a same-sex partner ever, or living with one in the last year) that would be more reflective of orientation were not associated with histories of child sexual abuse. For males, ever engaging in homosexual behavior, however, was associated with sexual abuse. Many observers are not surprised by this finding which indicates that sexual behavior is associated with past abuse but enduring orientation may not be.

Prospective studies are quite valuable since they help control for loss of memory, reconstructed memories, self-report issues relating to abuse and other sources of bias. This study used court records and followed up the abused persons 30 years after the fact.

In evangelical circles, sexual abuse is frequently offered as a major cause of homosexuality, if not the major cause. NARTH often points to the traumatic experience as an important factor. Recently, Focus on the Family promoted a paper by Jeff Johnston on the topic. Cited by Dean Byrd in that paper and often cited in this context is a study based on a 2000 doctoral dissertation by Marie Tomeo, titled “Sexual Orientation Development” and conducted at the California School of Professional Psychology. The journal article based on the dissertation was published by the Archives of Sexual Behavior in 2001 with the following reference:

Tomeo, M. E., Templer, D. L., Anderson, S., & Kotler, D. (2001). Comparative data of childhood adolescence molestation in heterosexual and homosexual persons. Archives of Sexual Behavior, 30, 535–541.

The study compared people at a gay pride parade with a straight sample drawn primarily from a university. The abstract reports the highlights:

In research with 942 nonclinical adult participants, gay men and lesbian women reported a significantly higher rate of childhood molestation than did heterosexual men and women. Forty-six percent of the homosexual men in contrast to 7% of the heterosexual men reported homosexual molestation. Twenty-two percent of lesbian women in contrast to 1% of heterosexual women reported homosexual molestation. This research is apparently the first survey that has reported substantial homosexual molestation of girls. Suggestions for future research were offered.

Demonstrating a difference between gay and straight groups on sexual abuse is not novel. Numerous studies have reported at least some difference with only a few reporting no difference in abuse frequency between groups. However, Tomeo did something that was relevant to her overall dissertation topic. She was interested in exploring sexual abuse as a potential causal factor. Tomeo’s prime research hypothesis was that homosexuals would report more sexual abuse than heterosexuals. She also wanted to know when a person identified as gay and when the abuse occurred. This is an important question for studies which seek to attribute cause to abuse. With some people being aware of same-sex attraction at very early ages, one cannot say any subsequent abuse caused their SSA. Simply finding a significant difference between gay and straight groups cannot tell you anything definitive about cause. Here are the first nine questions Tomeo asked her participants:

1. Do you regard yourself as predominantly a heterosexual person or predominantly a gay/lesbian person?

2. If predominantly of heterosexual orientation, at what age did you begin to regard yourself as heterosexual?

3. If predominantly of homosexual orientation, at what age did you begin to regard yourself as homosexual?

4. Before you were 16 years old, did you ever have sexual contact with a woman or girl 5 or more years older than yourself and at least 16 years of age? (YES NO)

5. IF YES, at what age did this first occur?

6. What was your relationship to the person with whom this sexual contact occurred?

7. Before you were 16 years old, did you ever have sexual contact with a man or boy 5 or more years older than yourself and at least 16 years of age? (YES NO)

8. IF YES, at what age did this first occur?

9. What was your relationship to the person with whom this sexual contact occurred?

For a study of causation, these questions clearly have their limitations. For one thing, when one regards oneself as homosexual probably occurs later (sometimes much later) than awareness of same-sex attraction. Perhaps one could offer a theory of identity formation which includes sexual abuse but such a theory would not of necessity be a theory of how one’s attractions take the direction they do.

In Tomeo’s reporting of her study in both the dissertation and the journal article, however, there is a much larger concern. There are contradictions in the paper and the dissertation between the results sections and the discussion sections. A crucial problem is the inability to be certain about when the abuse occurred – before or after awareness of same-sex attraction. In the Archives of Sexual Behavior article, the following statement is made on pages 540-541 (this same statement is identical to her closing discussion in the dissertation):

Sixty-eight percent of the present homosexual male participants and 38% of the present homosexual female participants (68 and 36%, respectively, if including just the homosexual fair participants) did not identify as homosexual until after the molestation. This suggests that if molestation resulted in homosexuality, this phenomenon occurs in a greater proportion of male homosexuals. It may not, however, be a casual factor in either gender. Perhaps children or adolescents with a higher potential for homosexual behavior are more likely to enter a situation that leads to same-sex molestation. It must also be borne in mind that the present homosexual participants may not be representative of homosexual persons. The overwhelming preponderance of homosexual participants was in the gay pride group. There were only three homosexual men and seven homosexual women in the college group.

The clear implication in this discussion section is that the frequency of homosexual identification was a consequence of the abuse. However, in the table which reported the data regarding timing of identification, the authors report the same percentage of males who reported identification as gay before the abuse. Table II on page 538 reports (click the link for a clearer view):

Tomeo et al 2001

Something is not right here. The numbers for females add up to 100% but the male numbers are contradictory. If the table is correct, then the case for causation from this study is somewhat compromised. The table indicates that 68% of men identified as homosexual before their molestation experience.

My colleague Gary Welton and I first discovered this discrepancy nearly three years ago while preparing a scholarly article on the effects sizes of various suggested correlates of homosexuality (one which will be published later this year or early next year). At that time, I contacted Donald Templer, one of the co-authors and advisor to first author Marie Tomeo. I then contacted him again recently in preparation for this post. He has been unable to locate Dr. Tomeo to get clarification. I hope Dr. Tomeo can at some point clarify these matters.

Recently, I ordered the dissertation to check the original study. However, there are discrepancies in this document as well. First, here are the relevant research questions with results.

From page 36 of Marie Tomeo’s dissertation:

The 10th research question addressed, of homosexual women who were molested, what percentage were molested before self-identification as a homosexual woman and what percentage were molested after self-identification as a homosexual woman? Of homosexual women who were molested, 62% were molested before self-identification as a homosexual woman, and 38% were molested after self-identification as a homosexual woman.

On page 37, the other relevant result relates to men.

The 13th research question addressed, of homosexual men who have been molested, what percentage were molested before self-identification as homosexual men, and what percentage were molested after self-identification as homosexual? Of homosexual men who were molested, 68% were molested before self-identification as homosexual, and 32% were molested after self-identification as homosexual.

These results are at odds with the discussion sections of the dissertation and the journal. They are also at odds with the Table from the journal article. For what its worth, Dr. Templer thinks the correct data are in the Table from the journal article.

The bottom line is that the study should not be cited until a follow up correction can be made. The main results — gays report more abuse than straights — may indeed be correct, given the similarity to past studies. However, I do not believe any inferences about causation should be made. Without the actual surveys, there is no way a reader can figure out the results from the journal article and/or the dissertation.

One final thought, the research on sexual abuse among GLBT populations is often misused to make inferences about causation. There are many reasons why this line of research is important but causation is not at the top. Sexual abuse is a profoundly disruptive experience for many people and may contribute to a variety of negative outcomes in adulthood. Finding appropriate clinical and ministry responses may be clouded by focusing on the trauma as a cause of same-sex attraction.