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What the latest (and reputable) research says

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February 12, 2014

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Fluidity is Scary

So you’re 16, and you’ve had a couple of crushes on boys turn into enough of a relationship each time that you changed your status on Facebook and, OMG so did he, and the endings were temporarily tragic and more lastingly awkward, but it all seems pretty par for the course until you find yourself head-over-heels and giddily blindsided by a much deeper love…for a girl. What does that mean?

Are you a real lesbian? Or, if the “you” above is male, are you NOT a real gay guy? That was just puppy love before? Are you actually bisexual? Will you ever fall in love with a boy again? And if you do, what would THAT mean? Can you trust your own feelings? Can sexual orientation re-orient? How do you explain this to your friends? To your ex?

What does the research say? This is a relatively new area. Some work suggests changeable attractions might be more common for women than for men, but maybe only because it has been more studied to date. Lisa Diamond: “After all, if female sexuality is fluid, one might argue that we shouldn’t bother distinguishing between lesbians and bisexuals to begin with. Perhaps all lesbians are ‘potential bisexuals’ and vice versa. Yet this would make sense only if all women appeared to be equally plastic in their sexuality, and the findings of this study suggest that this is not the case. Rather, some women appear to experience (and perceive the possibility for) greater change in their attractions and behaviors than others, and these women appear most likely to adopt non-lesbian labels or to change labels over time, even if they are predominantly attracted to women.” [1]

Diamond’s study seems to open a dangerous avenue for anti-gay proponents. If sexuality is in fact changeable, and if at least some women feel a certain degree of choice in the matter, does that allow for moral judgment, that is, a “better” form of sexuality that one should choose or move toward?

Just because a pattern of attraction might shift over time doesn’t mean we control the shift, any more than we control the attractions.  Human history across the spectrum shows our utter lack of control over the who in our attractions. Think back: haven’t you been mystified or even embarrassed by feeling that zing for someone completely unexpected? Sometimes those attractions are not appropriate to act on (one’s teacher, someone in a committed relationship, etc.), but what if the gender of the person who inspired the zing were the only part outside of your pattern of “appropriate” attractions?

Diamond told Troy Williams in an interview in 2009, “there were women who I studied who identified as bisexual but experienced their bisexuality as something that had more to do with a particular relationship they were in, rather than a stable trait.  They say, ‘I thought I was heterosexual and then I fell in love with this woman. I don’t know what that means, and I don’t know what will happen in the future.’  That open-endedness is why bisexuality gets stigmatized….The majority of women who experience any same-sex attractions at all, actually tend to experience attractions for both men and women…. This is an idea that many people find very threatening.  It’s much more comfortable for the culture at large to imagine that everyone fits into a gay or straight box.” [2]

“If you’re bi, you get pressure to choose. You can’t be both, socially.” – PO
What if your sexual attraction pattern could change, say, next month? What about that is so scary? I think there are 2 things: it would seem to make a long-term successful relationship with anybody more unlikely, and it means we are all in danger of being in this minority for whom life is harder.
So is there any truth to the stereotype of bisexuals having a lower probability of a long-term relationship? Maybe it’s the opposite.  Lisa Diamond, citing her 10-year longitudinal study, found, ” At the beginning of the study, when women were in their teens and early 20s, they tended to be involved in multiple successive relationships, and their ratio of same-sex to other-sex sexual contact tended to parallel their attractions. Yet 10 years later, most women had settled down into committed monogamous relationships (70% of the T5 lesbians, 89% of the T5 bisexuals, 85% of the T5 unlabeled women, and 67% of the T5 heterosexuals).”[3] (“T5” refers to the fifth biannual study time point; some subjects had labeled themselves differently at other time points.)
This study sample was only 79 women, so we can’t say definitively that women who call themselves bisexual in their 30’s are more likely to be in a successful long-term relationship than either their lesbian or straight peers, but it might just be so.
Now, what about the implication that we all could just “turn”  bisexual tomorrow? Then, we wouldn’t actually be in a minority at all….

What do your teens think about this? Is bi “trendy” in their school? So they feel the “pressure to choose?”

 

[1] Diamond, L. M. (2000). Sexual identity, attractions, and behavior among young sexual-minority women over a two-year period. Developmental Psychology, 36, 241-250

[3]Diamond, L. M. (2008). Female bisexuality from adolescence to adulthood: Results from a 10-year longitudinal study. Developmental Psychology, 44, 5-14.

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February 12, 2014

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Turncoat, opportunist, liar: why so much hate for bisexuals?

Even in communities and venues where liberal-mindedness and inclusion rule,  intolerance for bisexuals mysteriously persists. I wonder why.

Olympic diver Tom Daley announced via YouTube video that he “couldn’t be happier” in love with a man, but “I still fancy girls,” and the New York Times and Huffington post ran stories about snarky commentary skeptical that both these things can be true.

First the fun digression: It’s easy to get distracted by the beauty of a joyous first deep love, as you watch the video and his subsequent appearance on a British TV show , and as you read this tweet: “One day someone will hug you so tight. That all your broken pieces will stick back together.” Cue the Disney falling-in-love songs, say, “A Whole New World.” Ahhh. Except that Disney is so hetero-normative. And so we come back to the matter of non-acceptance, at both ends of the orientation spectrum.

Liar?: Is Bisexuality Real? Or the First Stop on the Gay/Lesbian Train?

Michael Shulman writes in the New York Times that “…Mr. Daley’s disclosure reignited a fraught conversation within the LGBT community, having to do with its third letter.” He quotes expert Lisa Diamond, that people don’t believe “… that bisexuality really exists, feeling that it’s a transitional stage or a form of being in the closet.”

Indeed, for some lesbian- and gay-identified people, “bisexual” was an early stage of self-acceptance:

”It’s easier to say this now [that you are bi] than before, and bi is a step on the path to self-recognition as gay for many guys. The girls include both some who want attention and some who are truly experiencing the turmoil. This is really an issue to be addressed by adults, in that changing the marriage equality laws and otherwise promoting equity will make any orientation accepted, and then kids can say who they really are.” – SQ

While for some bisexual might actually be a “gateway” self-label toward gay or lesbian, that doesn’t make it false for others. Dr. Diamond goes on to cite population studies that suggest there are more bisexual people than gays and lesbians, and Freud and Kinsey both believed bisexuality is quite common.

“I think people have sliding scales of attraction to each sex, and they are sometimes independent of each other.” -GC

“There are so many straight people who have had queer experiences but they won’t describe them that way.” -SH

A recent large study of teens by the Centers for Disease Control and Prevention backs up Dr. Diamond’s assertion. Of teens in 13 different sites over 9 years, between only 1-2.6% identified as gay or lesbian, and 2.9-5.2% said they were bisexual.  How they labeled themselves echoed what they did: 0.7-3.9% had sexual contact only with “members of the same sex,” and 1.9-4.9% with “both sexes”.  (CDC, “Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9–12 — Youth Risk Behavior Surveillance, Selected Sites, United States, 2001–2009,” Morbidity & Mortality Report, June 6, 2011.

Do these figures surprise you? Is bisexuality “trendy” in your area, and if so, does this seem to reflect authentic attraction? What does your teen think?

Check out Science of Relationships for more myth-busting on bisexuality.

Click here to see another common, offensive dismissal of bisexuality: opportunism.

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November 14, 2013

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Sexual Orientation

sexual orientation

How common is non-heterosexuality? A 13-site study of high school students over nine years by the Centers for Disease Control found varying rates of reported sexual orientations. The percentage who identified as gay or lesbian ranged from 1 to 2.6%, 2.9 − 5.2% bisexual, and 1.3 − 4.7% unsure. (1) A Gallup phone survey during the summer of 2012, believed the largest to investigate sexual orientation and gender identity, found that 3.4% of American adults identify as lesbian, gay, bisexual, or transgender. (2)

Trying to measure sexual activity by type of partner does not simplify things. Put simply, a few heterosexual teens have some same-sex activity, and a lot of lesbian and gay teens have some opposite-sex activity.A large 2011 study of men and women aged 15-21 found that 5% of heterosexual women and 1.7% of the heterosexual men had had same-sex sexual experiences. (These were defined as oral or anal sex for the men and any sexual experience for the women; forced sex was excluded.) This study grouped people who identified as homosexual and bisexual together; of those, 82.5% of the women and 60.2% of the men had had heterosexual experiences. More of these women had had same-sex sex (77.9%) than their straight peers had had heterosexual sex. (3)

Some teens are certain about the consistency of their attractions without any sexual partners at all. After all, we tend to assume straight virgin teenagers don’t need to “check” by experimenting with same-sex partners. Some gay and lesbian teens are equally sure before they become sexually active, and resent the question “how do you know if you’ve never tried straight sex?”  For others, the pattern of their attractions may not be clear until well after their sexual activity begins.

An Israeli researcher found that the average age for queer kids to come out has fallen to 16, from 25 almost 20 years ago. The sample was 461 already-out LGB people aged 16-23. (4) Since it was not longitudinal and did not include any questioning or closeted people, this “new average” may be somewhat exaggerated, but the trend is clear.

1. Laura Kann et al, “Sexual Identity, Sex of Sexual Contacts and Health-Risk Behaviors Among Students in Grades 9-12 – Youth Risk Surveillance, Selected Sites, United States 2001-2009.” Centers for Disease Control & Prevention, Morbidity and Mortality Weekly Report 6 June 2011 Vol 6.

2. Gary J Gates and Fran Newport , “Special Report: 3.4% of Adults Identify As LGBT” 10/18/12

3. Janice McCabe, Karin L. Brewster and Kathryn Harker Tillman, “patterns and Correlates of Same-Sex Sexual Activity Among U.S. Teenagers and Young Adults,” Perspectives on Sexual and Reproductive Health, 2011, 43(3);142-150

4. Guy Shilo, Riki Savaya. “Effects of Family and Friend Support on LGB Youths’ Mental Health and Sexual Orientation Milestones.” Family Relations, 2011; 60 (3): 318

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November 13, 2013

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gender expression, Science, transgender

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Gender Expression

gender exp

A third spectrum is gender expression, a pattern of behaviors that typically “belong” to males or females in your community. It is heavily, if not altogether, culturally defined, and often situation-specific. Acting aggressively and speaking confrontationally in some circumstances may be “unfeminine,” but in a context of threat to her children might be “normal mama bear” behavior. You can see that studying the incidence of this gets very squishy very fast. In recent decades, the blurring of strict gender roles has made this spectrum more open for everybody, but generally more so for women than men.

Many childhood development experts consider some degree of gender-variant play normal for children. (1) When it comes to pretend, gender seems like a small stretch. Some kids’ games could be described as species-variant (“let’s be ponies”), age-variant (“I’ll be the mommy and you be the little baby”), planet-variant (“let’s go to the moon”), geologic-era-variant (“let’s be dinosaurs”), and of course, reality-variant (cartoon, magical and other characters). Some kids occasionally play at being a different gender, but for others it’s a recurring theme.

So why does frequent or consistent gender-variant play and behaviors cause concern? Parents wonder what conclusions to draw for the future, and protectively fear their child may be teased or worse in the present.

What does it mean for the future? Most studies are small, and tend to focus on the children who exhibit the most gender-variant behaviors.

A small study of boys found that three-quarters of the “feminine boys” were homosexual or bisexual using the Kinsey scale, compared to none of the boys in the “masculine” control group. (2) A longitudinal study followed 54 children who had been referred to a Dutch clinic for Gender Identity Dysphoria over 10 years, and found that “Most children with gender dysphoria will not remain gender dysphoric after puberty…. With regard to sexual orientation, the most likely outcome of childhood GID is homosexuality or bisexuality.” In their sample, almost all of those whose gender dysphoria persisted through adolescence identified as non-heterosexual, while all the girls and half the boys whose GID diminished with adolescence identified as heterosexual. (3)

An older but larger study found that 5-13% of boys and 20-26% of girls (ages 12-18) reported their own behavior as sometimes cross-gender; significant subsets reported sometimes wanting to be a different gender. (4)  These rates are far higher than the rates of biologically intersex and transgender people, and noticeably higher than estimates of non-heterosexuality.

But for many parents of kids with “nonconforming” gender behavior, the important challenge is separating concern about sexual orientation (maybe to be revealed soon, maybe in the future) from concern about teasing, manipulation and bullying right now. For young kids, the peers in and out of the dressup corner aren’t thinking about sexual activity, even if they use “that’s so gay” as a taunt. They are, in the words of a Japanese proverb, hammering the nail that sticks up. A parent has no influence on whoever it turns out little Michael-as-Glinda or Kayla-as-Batman will be attracted to a decade from now, but quite a lot of influence on how s/he feels about today’s play and the playmates reactions. More about this is in “Bias: Blatent and Latent” (coming soon).

For older kids, the verbal and physical hammering is real much too often.    GLSEN (Gay, Lesbian and Straight Educators’ Network) has been conducting well-regarded broad-scale research into the social climate of schools for LGBT youth since 1999. Comparing the results from 2001 and 2011 (latest available), it’s remarkable how little has changed.

2001-10 bigSadly, although it’s becoming slightly less acceptable to say “that’s so gay,” “fag” and “dyke,”  it’s still ok in too many schools to taunt or slam into lockers someone whose behavior doesn’t match what you think a person of their gender should do. Interestingly, in this same time period the number of LGBT teens who reported hearing sexist remarks frequently or often also fell (85% to 71%) but the number who heard racist remarks frequently or often rose (35% to 42%). (5)

1. Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington (DC): National Academies Press (US); 2011. 4, page 2 Childhood/Adolescence. Available from: http://www.ncbi.nlm.nih.gov/books/NBK64808/

2. Green R: The “Sissy Boy Syndrome” and the Development of Homosexuality. New Haven, CT, Yale University Press,  1987, as reported in Kenneth J. Zucker, PhD; Susan J. Bradley, MD: Gender Identity and Psychosexual Disorders, FOCUS. 2005;3:598-617.

3. Wallien MS, Cohen-Kettenis PT “Psychosexual outcome of gender-dysphoric children”, J Am Acad Child Adolesc Psychiatry. 2008 Dec;47(12):1413-23.

4. Achenbach T M & Edelbrock C, Manual for the Youth Self-Report and Profile. Burlington VT : U of VT Dept for Psychiatry; 1987, as reported by W J Meyer III  in his commentary in Pediatrics Vol 129 #3” March 2012, p 571.

5. GLSEN, National Schools Climate Survey 2011 and National Schools Climate Survey 2001.

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November 7, 2013

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Gender Identity: Who You Believe You Are

gender id

Most people’s belief about their gender matches, conveniently, their biological sex, but for some number there is a mismatch. Some psychologists call this Gender Identity Disorder. Note that this is not the same as Disorders of Sex Development. Dr. Jay Hays-Light, director of the UK Intersex Association, makes the distinction this way: “sex is between the legs while gender is between the ears. Most people are ‘hard-wired’ to a gender identity, whether this is male, female or something in between.” (1)

People who change the gender they present to the world to match what they feel about themselves are transgender. (This might or might not include surgery.) Sometimes “transgender” is used to describe behavior outside of gender norms,  for example, a colorfully dressed and made-up man, who considers himself male. (See the post on Gender Expression.) “Gender-bender” is also used in this way, sometimes meaning just dress and behavior, sometimes meaning identity, but this term is offensive to some. This can be confusing!

“Transsexual” is sometimes used as a synonym for transgender, and sometimes to distinguish transgender people who have changed their biology by hormone treatments and/or surgery. Because access to such medical treatment in the US depends on socio-economic factors, some find such distinctions discriminatory and prefer to use “transgender” exclusively, or just “trans.” It might be easier to talk about these matters if the definitions were standardized, but individual experiences and often great pain are behind the various points of view. In the end it can be less awkward just to ask which pronouns to use and how someone identifies, rather than to make assumptions or shrink from the conversation altogether.

“Courage is more exhilarating than fear and in the long run it is easier.” – Eleanor Roosevelt

Happily, some of the language is refreshingly straightforward: the gender label at the end of the word is the target of the transition. A trans-man is a person who has made a transition and is now a man. Also clear are the abbreviations MTF (male to female) and FTM (female to male).

Prevalence

How common is this? The short answer is, we don’t really know. Studies from the last century varied, but all characterized Gender Identity Dysphoria (as clinicians called it) as quite rare. An often cited study in the Netherlands found it to be about 1 in 11,900 for MTF and 1 in 30,400 for MTF , but the researchers were only counting adults who came for hormone treatment and/or surgery. (2)   A questionnaire of mothers showed much higher numbers of children who “wishe[d] to be of opposite sex,” highest in the youngest children studied (4-5 years old) and declining to a couple of percentage points for the 12 and 13 year olds. (3)  But measuring prevalence has many challenges. Most attempts either assess children from a clinical pool (they came to a doctor or therapist for one reason or another), ask parents to report on their children,or ask adults about their childhood experiences. So, the results might vary widely from those you’d get if you randomly sampled all 6th graders, for example. Further, even though gender identity is formed in the preschool years, social pressure prevents many people with gender identity issues from affirming their identities until adolescence or later.

A little development theory for those interested: according to the Kohlberg model (in many psychology textbooks), most children don’t grasp gender constancy until around age 7.  In other words, many children know their gender as toddlers (“Gender Identity”), but aren’t certain that it won’t change as they grow (called “Gender Stability”), or that they can’t change it with behavior or dress (“Gender Constancy”) until later. This seemed to me not to give children enough credit, until I remembered how spotty my own kids’ grasp of various causes and effects were at that time. In those years, what matters in their day-to-day lives about their gender includes who they play with, how they play, and how adults treat them. Gender stereotyping still exists of course, but kids may not feel the limits these stereotypes impose until the end of the dress-up corner. A favorite kindergarten teacher once told me she loved that age because pretend was still so real to 5 and 6 year olds. If it feels real when they “are” dinosaurs, why not also when they “are” the other gender?

1. “The Third Sex: the Truth About Gender Ambiguity,” The Independent,  20 March 2010   

2. Bakker A et al, “The Prevalence of Transsexualism in the Netherlands” Acta Psychiatr Scand. 1993 Apr;87(4):237-8.

3. Achenbach and Edelbrock, 1981 as reported in  Kenneth J. Zucker and Susan J. Bradley, Gender Identity Disorder and Psychosexual Problems in Children and Adolescents (New York: The Guilford Press, 1995) 30

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November 6, 2013

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intersex, Science

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Biological Sex: body parts & hormones

In nature, many species show a normal diversity within species, across many characteristics.. You can arrange the individuals on a spectrum (nose: Barbra Streisand to Mia Farrow; height: Willy Shoemaker to Wilt Chamberlain, etc.) Why not also gender?  Most humans have chromosome and hormonal mixes that put them pretty close to the “male” or “female” ends of the gender spectrum, but there are more people in between – intersex – than you might think.

bio sex

Incidence

How common is it to be not completely male or female? The Accord Alliance website notes, “Estimates from specialists working in major medical centers suggest that about one in every 2,000 births at a hospital involves a child whose genitals are atypical enough to make the child’s sex unclear. But… if we count all types of sex anomalies, DSD [Disorders of Sex Development] must be considered much more numerous than 1 in 2,000. [Here they mean not only variations in genitalia but also variations in chromosomes and hormones, which may  not have visible effects.] One review estimates that about one in a hundred persons has some kind of sex anomaly.”(1) A review of medical literature from 1955 to 1998 estimated that as many as 2 in 100 babies had some difference, in body organs, XY chromosomes, and/or hormonal patterns from ‘standard male or female.’  (2)

1-2% is a pretty small minority, but in the context of normal biodiversity it compares to other ‘natural’ differences among humans. For example, we each have 1 of 4 ABO blood types: A, B, O (neither A nor B) and AB (both). and either positive or negative for Rhesus factor, meaning everyone has one of 8 types. People who are B- are only 0.6% of the US population; these folks present a matching challenge to hospitals when they need transfusions, but we don’t consider them freakish.

In fact, given all the different factors involved in the ways our biological sex functions, you might expect even more diversity.  British neurologist and intersex expert Milton Diamond, interviewed in the British newspaper Independent, noted “Nature loves variety. Unfortunately, society hates it.”  The 2010 article gives a good overview of the history of oppression, compounded by some of the common past medical practices.

Intersex and Trans…

“Intersex” is a biological means simply having a variation from the usual binary (male/female) pattern of sex organs, hormones, and chromosomes.

“Transgender” is a psychological term, usually meaning someone who self-identifies differently from the sex s/he was assigned at birth. The biology of transgender people can vary; some have some intersex characteristics, others do not. Most transgender people identify as male or female, but some identify as a combination or separate, third sex. See the Gender Identity post.

What difference do these differences make?

What do these variations mean for the  “real lives” of intersex people? According to the Accord Alliance, many of the people with these variations are not sterile (before any surgery), and most will not be transgender.

The fact that some of these intersex conditions are not readily apparent might work against expanding awareness and inclusion. For those whose looks and/or behaviors push gender boundaries, bullying, harrassment and violence are certainly more prevalent. But most studies do not break out intersex people separately from LGBTQ. There is more about this in the Gender expression post.

“Not monsters, nor marvels, nor battering rams for gender theory, people born intersexed have given the rest of the world an opportunity to think more about the odd significance we give to gender, about the elusive nature of truth, about the understandable, sometimes dangerous human yearning for simplicity – and we might, in return offer them medical care only when they need it, and a little common sense and civilised embrace when they don’t.”  Amy Bloom, in “The third sex: The truth about gender ambiguity,” The Independent 20 March 2010

1. Accordance Alliance, http://www.accordalliance.org/learn-about-dsd/faq.html]

2. Blackless, M et al “How Sexually Dimorphic Are We? Review and Synthesis,” American Journal of Human Biology, 12, Page(s): 151-166, 2000, http://transgenderinfo.be/wp-content/uploads/2013/01/Blackless-How-Dimorphic-2000.pdf