LGBTQ re­port dis­avowed

Fac­ulty at Johns Hop­kins calls new re­port ‘trou­bling’ and in­com­plete

Baltimore Sun - - COMMENTARY - By Chris Beyrer, Robert W. Blum and To­nia C. Poteat The au­thors are all fac­ulty at the Johns Hop­kins Bloomberg School of Pub­lic Health. Dr. Chris Beyrer (cbeyrer1@jhu.edu) is the Des­mond Tutu Pro­fes­sor of Pub­lic Health and Hu­man Rights. Dr. Robert W. Blum

Re­spect is the cor­ner­stone of univer­sity life: re­spect for speech and a di­ver­sity of views; re­spect for stu­dents, col­leagues and pa­tients; and re­spect for sci­ence, which is our lifeblood as an in­sti­tu­tion.

As fac­ulty at Johns Hop­kins, a ma­jor ed­u­ca­tional, re­search and health in­sti­tu­tion, we are writ­ing to ex­press our con­cern about a re­cently pub­lished re­port that we be­lieve mis­char­ac­ter­izes the cur­rent state of the sci­ence on sex­u­al­ity and gen­der.

Sci­ence, and par­tic­u­larly the fields of psy­chi­a­try and psy­chol­ogy, has made ma­jor ad­vances in our un­der­stand­ing of the com­plex is­sues of sex­ual ori­en­ta­tion and gen­der iden­tity. For in­stance, ac­cu­mu­lat­ing data sup­port the con­cept that gen­der iden­tity is not strictly a bi­nary phe­nom­e­non. And sci­en­tific ev­i­dence clearly doc­u­ments that sex­ual and ro­man­tic at­trac­tions to peo­ple of the same and/or dif­fer­ent sexes are nor­mal vari­a­tions of the di­ver­sity of hu­man sex­u­al­ity.

Ho­mo­sex­u­al­ity is no longer con­sid­ered an ill­ness by the Amer­i­can Psy­chi­atric As­so­ci­a­tion, the Amer­i­can Psy­cho­log­i­cal As­so­ci­a­tion, the Amer­i­can Med­i­cal As­so­ci­a­tion or any of the other main­stream pro­fes­sional or­ga­ni­za­tions in the health field. These or­ga­ni­za­tions have come to af­firm what LGBTQ peo­ple and their loved ones have known for years: that be­ing gay or trans­gen­der is per­fectly con­sis­tent with be­ing healthy and well.

Yet LGBTQ com­mu­ni­ties have been sub­ject to dis­crim­i­na­tion, in­clud­ing in health care ser­vices. A 2011 land­mark re­port by the In­sti­tute of Medicine (IOM) re­viewed this his­tory of mal­treat­ment and af­firmed that sub­stan­tial health dis­par­i­ties ex­ist for LGBTQ peo­ple, most of­ten fu­eled by stigma, dis­crim­i­na­tion and ho­mo­pho­bia. This key IOM re­port out­lines an im­por­tant re­search agenda in the field, and we are learn­ing more each day about gen­der, gen­der iden­tity, and trans­gen­der and gen­der-non­con­form­ing peo­ple and their well­be­ing — in­clud­ing best prac­tices for gen­der­af­firm­ing ser­vices.

As fac­ulty at Johns Hop­kins, we are com­mit­ted to serv­ing the health needs of the LGBTQ com­mu­nity in a man­ner that is in­formed by the best avail­able sci­ence — a man­ner that is re­spect­ful and in­clu­sive and sup­ports the rights of LGBTQ peo­ple to live Dr. Paul McHugh, shown here in 1997, co-au­thored a con­tro­ver­sial re­port on gen­der and sex­u­al­ity. He’s a for­mer head of psy­chi­a­try at Hop­kins’ School of Medicine. full and open lives with­out fear of dis­crim­i­na­tion or bias based on their sex­ual ori­en­ta­tion or gen­der iden­tity.

That is why the re­cent re­port, re­leased by one cur­rent and one for­mer mem­ber of our fac­ulty on the topic of LGBTQ health, is so trou­bling. The re­port, “Sex­u­al­ity and Gen­der: Find­ings from the Bi­o­log­i­cal and Psy­cho­log­i­cal and So­cial Sci­ences,” was not pub­lished in the sci­en­tific lit­er­a­ture, where it would have been sub­ject to rig­or­ous peer re­view prior to pub­li­ca­tion. It pur­ports to de­tail the sci­ence of this area, but it falls short of be­ing a com­pre­hen­sive re­view.

For in­stance, the re­port omits post-2010 work by Dr. Mark Hatzen­buehler of Columbia Univer­sity and thereby un­der­em­pha­sizes the neg­a­tive role that stigma and op­pres­sion play in LGBTQ mor­tal­ity and health be­hav­iors. It comes to dif­fer­ent con­clu­sions about com­plex ques­tions such as the ori­gins of ho­mo­sex­u­al­ity from those reached by a re­cent re­view of the sci­en­tific lit­er­a­ture by psy­chol­o­gist Dr. J. Michael Bai­ley and col­leagues, com­mis­sioned by the pres­ti­gious As­so­ci­a­tion for Psy­cho­log­i­cal Sci­ence. As now stated, the re­port’s find­ings could fur­ther stig­ma­tize and harm the health of LGBTQ com­mu­ni­ties, and the re­port is al­ready be­ing widely touted by or­ga­ni­za­tions op­posed to LGBTQ rights.

Be­cause of the re­port, the Hu­man Rights Cam­paign has warned Johns Hop­kins that it is re­view­ing, and may re­move from the in­sti­tu­tion, its high rank­ing in the HRC Health­care Equal­ity In­dex. The na­tional bench­mark­ing tool eval­u­ates health care fa­cil­i­ties’ poli­cies and prac­tices re­lated to eq­uity and in­clu­sion of their LGBTQ pa­tients, vis­i­tors and em­ploy­ees.

We wish to make clear that there are many peo­ple at Hop­kins who hold a pro­found and long-stand­ing com­mit­ment to the health, well­ness, well-be­ing, and fair and non-stig­ma­tiz­ing treat­ment of LGBTQ peo­ple and com­mu­ni­ties. We do not be­lieve that the “Sex­u­al­ity and Gen­der” re­port cited above is a com­pre­hen­sive por­trayal of the cur­rent sci­ence, and we re­spect­fully dis­as­so­ci­ate our­selves from its find­ings.

We also vig­or­ously sup­port the right to aca­demic free­dom and sci­en­tific dis­agree­ment and de­bate. In­deed, de­bates are the very ba­sis of the sci­en­tific method. That same com­mit­ment to sci­en­tific de­bate means we must en­gage the di­a­logue in a cir­cum­stance such as this, and not stand silently by.

This sum­mer’s tragic events in Or­lando re­minded all of us of the vir­u­lence of the op­pres­sion of LGBTQ peo­ple. We stand with the LGBTQ­com­mu­nity, and with their al­lies, for dig­nity, in­clu­sion and the recog­ni­tion that ho­mo­pho­bia and trans­pho­bia have no place in our in­sti­tu­tions. Re­spect re­quires no less from all of us.

AL­GE­RINA PERNA/BAL­TI­MORE SUN

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