Saturday, March 24, 2018

On Using Straw Man Arguments To Support "Conversion Therapy"

If you have been living under a rock for some time, you may not have noticed the uproar over so-called "conversion therapy" techniques.  They have been declared unethical by the major mental health associations, outright banned in a number of states, and so on.  However, that doesn't stop their advocates from promoting an intellectually dishonest, coercive approach to things.

This week, I found the following paper lurking on
Earp, B. D., & Vierra, A. (in press). Sexual orientation minority rights and high-tech conversion therapy. In D. Boonin (Ed.), Handbook on Philosophy and Public Policy. Basingstoke: Palgrave Macmillan. Available online ahead of print at tech_conversion_therapy  
Now, I'm going to give the authors a little more latitude than I might had they been psychologists, psychiatrists or social workers who might actually work with the affected population.  They aren't - they are philosophers, and they are trying to make an argument for a public policy stance.

However, their argument is fundamentally a straw man.  They ask the reader to imagine a future where some combination of technologies allows for an "effective" sexual orientation conversion therapy to take place.

The Straw Man

Problems With The Straw Man Argument

"straw man" argument is one where the person making the argument does so by creating a false or misleading conceptualization of an issue and then proceeds to attack it.  In this case, the "straw man" presented is a little more complex.

First off, they ask us to imagine a possible future where some combination of technologies and skills has come together to form a hypothetical treatment for changing a person's sexual orientation.  This, in itself is deeply problematic for a number of reasons.  We'll come back to it in more detail.

The second dimension of their straw man is their conceptualization of the "born this way" argument.   It is an unnecessarily rigid conceptualization, and that rigidity is actually what they attack in their paper.

Examining The Straw Man

So, what is this imagined future?  Well, the authors speculate that eventually we might reach a place where we can actually manipulate the patterns and direction of human thought and behaviour:
Based on current trends in research, it is not implausible that in the not-too-distant future, scientists will know enough about the genetic, epigenetic, neurochemical and other brain-level factors that are involved in shaping sexual orientation that such variables could be effectively and relatively safely modified, more or less directly, with the application of some biotechnology. Likely in concert with existing or perhaps refined psycho-behavioral approaches, it might then be possible for individuals with predominately or exclusively same-sex sexual attraction to redirect their erotic desires to, as it were, the ‘opposite’ end of the spectrum (very roughly: convert from homosexual to heterosexual), as well as presumably the other way around (i.e., heterosexual people could convert to homosexuality). Call such possible future technology high-tech conversion therapy or HCT.
Okay, let's give them the benefit of the doubt here. This is an imagined future through which to analyze a possible conflict between individual rights, and access to treatment issues.  In all fairness, the former NARTH and its agents are essentially arguing this with respect to sexual orientation "reparative therapy" today.

Based on this, they then launch into a lengthy critique of what they refer to as "born this way theory".    Their critique boils down to essentially arguing that a rigid, polar approach to sexual orientation (and gender identity) fails because there are people "in the middle" who reflect a degree of fluidity in their experience of these attributes.

We do not support the creation or the use of HCT. Rather, we aim to show that the sheer prospect of its development has troubling implications for a human and civil rights movement that is largely centered around a ‘born this way’ response to unjust discrimination (essentially, an appeal to innateness), as well as a purportedly corollary response concerning immutability (‘I can’t change, even if I tried’). Together, these responses are commonly thought to support an argument along these lines:
Premise 1. It is wrong to discriminate against someone on the basis of an unchosen, unchangeable characteristic. 
Supporting Analogy. For example, it is wrong to discriminate against someone on the basis of their race or sex, which are unchosen and unchangeable characteristics. 
Premise 2. Sexual orientation is an unchosen and unchangeable characteristic (like race or sex).
Conclusion. It is wrong to discriminate against someone on the basis of their sexual orientation.

Is this a good argument? In answering this question, we will simply set aside certain heated debates about the nature of (some) trans identities that threaten to undermine the Supporting Analogy.13 14 15 16 Still, we suggest, the above argument is perilously weak both conceptually and legally, as numerous scholars have noted,17 18 and as we will discuss in more detail in the following section.
Here's the core of the "straw man".  Having constructed the idea that there is a possible future in which there might be a functional means to change someone's sexual orientation, the authors are now going to tell us everything that is "wrong" with "born this way" as a rhetorical argument to defend anti-discrimination law.

Born This Way Criticisms

The authors take a very narrow view of the concept of "born this way".  Superficially, "born this way" is really a simplification of a much more complex construct which is used primarily as a tool for helping an often ill-informed public grasp the fundamental point being made.  We have other similarly simplistic characterizations in common use in other areas, such as the "woman trapped in a man's body" description used by some transsexuals.

These are often overly simplistic characterizations which do not reflect the complex realities. Sexual orientation is one of the least well understood attributes of human behaviour.  Frankly, it's downright messy.  Even the simple nomenclature of sexual orientation as "heterosexual-bisexual-homosexual" is problematic.  We have people who are asexual (as in just plain not interested in sex at all); people whose sexual orientation shifts regularly; people who understand themselves to be heterosexual, but periodically have same sex experiences; and so on.

"Aha! So sexual orientation can change, right?" - an easy conclusion to come to, isn't it?  Except that it's wrong.  Someone experiencing fluidity in their sexual orientation does not mean that they got to choose that experience, or that it is intrinsically malleable.

A brief perusal of research journal articles turns up a significant body of work that discusses the complex, fluid nature of sexual orientation.

  • Mereish, E. H., Katz-Wise, S. L., & Woulfe, J. (2017;2016;). We're here and we're queer: Sexual orientation and sexual fluidity differences between bisexual and queer women.Journal of Bisexuality, 17(1), 125-15. 10.1080/15299716.2016.1217448
  • Katz-Wise, S. L., Reisner, S. L., Hughto, J. W., & Keo-Meier, C. L. (2016). Differences in sexual orientation diversity and sexual fluidity in attractions among gender minority adults in massachusetts. The Journal of Sex Research, 53(1), 74-84. 10.1080/00224499.2014.1003028
  • Katz-Wise, S. L. (2015). Sexual fluidity in young adult women and men: Associations with sexual orientation and sexual identity development. Psychology & Sexuality, 6(2), 189-208. 10.1080/19419899.2013.876445
  • ARAMBURU ALEGRÍA, C. (2013). Relational and sexual fluidity in females partnered with male‐to‐female transsexual persons. Journal of Psychiatric and Mental Health Nursing, 20(2), 142-149. 10.1111/j.1365-2850.2011.01863.x
*** Note:  This is but a small sampling of papers found that explore issues related to fluidity in sexual orientation.  

It is important, and relevant, to understand that human beings develop along multiple trajectories after birth.  Sexual orientation, and gender identity, are both attributes which develop over the course of human life, before settling fully sometime in early adulthood.
  • Saewyc, E. M. (2011). Research on adolescent sexual orientation: Development, health disparities, stigma, and resilience. Journal of Research on Adolescence, 21(1), 256-272. 10.1111/j.1532-7795.2010.00727.x
  • Olson-Kennedy, J., Cohen-Kettenis, P. T., Kreukels, B. P. C., Meyer-Bahlburg, H. F. L., Garofalo, R., Meyer, W., & Rosenthal, S. M. (2016). Research priorities for gender nonconforming/transgender youth: Gender identity development and biopsychosocial outcomes. Current Opinion in Endocrinology, Diabetes, and Obesity, 23(2), 172.
Why did I bring in a paper about transgender issues when "born this way" is referring to sexual orientation?  There are two reasons for this.  First, the principle of "born this way" applies to transgender people just as much as it applies to sexual orientation; second, no reasonable discussion of sexual identity can ignore gender identity (or vice versa).  Nor should we do so. The second point is that within the world of transgender identities, it is much clearer that we have a spectrum of identities and experiences.

Psychology has long recognized that sexual orientation, and other attributes are better seen as occurring on a spectrum rather than in some rigid taxonomy of "tiny little boxes".   I would point out that the current WPATH Standards of Care is titled "Standards of care for the Health of Transsexual, Transgender and Gender Non-Conforming People", a title which reflects the diversity of experiences seen within the transgender community.

So, understanding that there is an enormous diversity of experiences in both sexual orientation and gender identity, it is fairly easy to understand that taking a rigid view of "born this way" is really poor reasoning.  Fluidity of experience does not equal something which can be consciously altered.  Instead of reducing "born this way" to a rigid, inflexible structure, it seems far more important to recognize it as a construct which reflects the complex development of sexual identity in the human being that is influenced by a wide range of factors, both intrinsic and extrinsic to the individual.  
  • APA. Commision on Psychotherapy by Psychiatrists, & APA. Commission on Psychotherapy by Psychiatrists. (2000). Position statement on therapies focused on attempts to change sexual orientation (reparative or conversion therapies). The American Journal of Psychiatry, 157(10), 1719.

The Hypothetical "Effective" Change Treatment 

The authors have asked us to imagine an "effective change" regimen that uses findings from a variety of different areas of scientific inquiry.  In itself, this is not a big problem, and such speculation is often useful for understanding possible future directions or outcomes of research.  

However, in doing so, the authors fail to respect a critical dimension of the story - namely the ethics of such a development.  First of all, developing such a treatment would stem not from reasonable inquiry, but from inquiry that fundamentally assumes that one's sexual identity is somehow "wrong" if it is not aligned in a specific way.  If we have learned one thing during the fight for LGBTQ rights, it is that all too often objections come from a predominantly religious perspective that argues against the validity of non-cisgender, non-heterosexual identities on the basis of faith, rather than evidence and fact.  

As the APA, and other mental health organizations have found through research and experience, attempting to change someone's sexual orientation is a fundamentally coercive process which can be profoundly damaging to the person.  Should such a process be developed in the future for any reason, we would have to demonstrate that it is not only necessary, but that it is also non-coercive. 

Today, so-called "reparative therapies" are recognized as intrinsically coercive to begin with.  The motivations for pursuing such therapy are generally societal pressures.  Perhaps it is one's family is deeply uncomfortable with a relative's homosexuality and conveys that feeling to such an extent that the individual feels obliged to "try".  Or, the religious community that the person belongs to is strongly opposed to homosexuality and demands that the person take steps.  In both cases, although the individual may be "choosing" to pursue the therapy in question, the fact is that they have been subjected to a great deal of external coercive pressure.  

Even if this hypothetical treatment were not "coercive" in itself, the authors fail to acknowledge the coercion that is associated with the pursuit of that education.  

The Authors' Conclusions

But this still leaves certain issues unaddressed. In particular, it leaves unaddressed the conceptual problem with ‘born this way’ approaches to securing fundamental rights for sexual orientation minorities. Even if HCT were successfully banned—and there is no guarantee that this would happen—the ‘magic words’ we referred to earlier, based on the argument that ‘ought implies can; therefore cannot implies that it is not the case that one ought’ would still be on very weak footing. Specifically, ‘cannot’ would be reduced to ‘cannot in practice, because of current legislation,’ leaving ‘can in fact, if not for current legislation’ rejoinders available to those who oppose rights for sexual orientation minorities. Instead of relying on the vagaries of future legislative efforts concerning technological development or accessibility, we argue, it would be far better to build the case for sexual orientation minority rights on stronger conceptual footing.
The authors' concluding remarks here are profoundly flawed.  In large part, because they have failed through their entire paper to evaluate the ethical considerations of altering a naturally occurring set of patterns.  Even if we were to assume the ability to manipulate someone's gender or sexual identity _without_ causing emotional trauma, we find ourselves in the place where doing so has profound implications for the person in terms of their overall self-concept, relationships with others, and so on.

Although gender identity and sexual orientation may in some future turn out to be individually malleable, they become deeply intertwined with how a person socializes, and changing the one does not necessarily mean the person has the ability to change those other patterns.  The consequences of changing sexual orientation without being able to adapt socially to a heterosexual social world would be to effectively isolate someone socially. Any possible HCT would necessarily have to address these issues, or it would run the risk of outcomes such as those seen in the coercive treatment of Kirk Murphy or David Reimer.  Both of these cases are important in understanding the damage that coercive approaches to changing core attributes of someone's identity can do.

Source Materials

The real flaws in the authors' work shows up in their choice of references.  At no time to they dig into the science of gender and sexuality. If they had, as well as taking a closer look at the ethical dimensions of working with people who are members of sexual and gender minority groups, I think they would have come to a much different understanding of what "born this way" really means.  Few of the references come from high quality, peer reviewed sources.  Most of it is references to a handful of books, and media articles on the subject.

While I can appreciate that this is a paper intended to guide the development of public policy, and therefore materials that reflect public opinion and media presentations of the issues are significant, it is unfortunate that the authors failed to avail themselves of the breadth and depth of more scientific literature which fundamentally calls into question their imagined future.

Wrapping It Up

Whether the authors have intended to do so or not, they have crafted an argument which arguably is going to be used as fodder by anti-LGBTQ forces to justify their hostility.  The straw man of a rigid and inflexible conceptualization of "born this way" is more revealing of the authors' own biases, and their failure to more closely examine their own assumptions has created a hollow argument devoid of merit.

The failure to adequately explore the relevant clinical and ethical literature on this subject leaves the authors in a place where they feel free to expound upon a topic which they clearly have at best limited understandings.  They come to an "either/or" conclusion regarding access to such a therapy, but because they did not fully consider the implications of such a therapy (effective or not), they in fact erred in concluding "nobody or all" should have access.  Instead, they should have returned to the observation in the early part of the paper which stated that conversion therapy has been found to be damaging.  From that point alone, the more rational conclusion would be that the creators of any future HCT would have to demonstrate that their model is non-coercive, and it addresses the expected impacts on a person's social identity beyond the attributes intended to be changed.  Then, and only then, can we have a reasoned discussion about access to such a treatment.

Finally, we should bear in mind that developing a new "conversion therapy" should be viewed in the same light as eugenics programs of the past.  Even if a working therapy were to emerge, the validity of using said therapy must consider the prior uses of similar approaches.

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