英国皇家精神病医学院撤回有关「先天同性​​恋」的声称

陈俊仪

法学博士

根据英国基督教关怀（Christian Concern）在本年五月三十日发布的消息，英国皇家精神病医学院（Royal College of Psychiatrists）就同性相吸的成因及性质改变立场，这是一项值得高度关注的发展。

修订是回应基督徒医学团契及核心问题信托对皇家精神病医学院就此问题处理科学证据所提出的强烈反对。

于最新的声明，皇家精神病医学院表示「性倾向是来自先天及后天环境因素的综合影响」，并继称，「性倾向并非不可逆转，于一生之中也可能出现不同程度的变化。」这与他们之前的立场有重大改变，旧有立场仍见于皇家精神病医学院网页。 （如：「并无充份证据支持家长的性质或早期儿童的经历对基本的异性或同性性倾向有任何影响。」）

皇家精神病医学院辩证其最新的立场，引述超过十年的研究。院方没有解释为什么先前的立场没有对有关研究予以考虑。基督徒医学团契及核心问题信托批评皇家精神病医学院向英国圣公会提交皮宁报告时的处理证据手法。然而，虽然确认后天因素对性倾向发展有所影响，而且性倾向并非不可逆转，但皇家精神病医学院仍然反对帮助受助者寻求改变性倾向的治疗。院方表示有关治疗有「潜在损害」，但院方未能提供任何确实的证据予以佐证。

大律师威廉斯表示：「这是一项值得高度关注的发展。先前基督教机构已要求皇家精神病医学院负起责任，不应由于预设想法造成的盲点而忽略实在的科学证据。而现在皇家精神病医学院无可奈何地改变立场，但仍支持那些不愿意协助希望由同性倾向回复异性倾向的人士。院方表示有关治疗有『潜在损害』，但是否有实在的科学证据支持呢？假设先天同性恋于社会上已根深柢固，导致巨大的政治、社会及文化改变。然而现时皇家精神病医学院已承认事情不是那么简单，后天的环境因素有所影响。这是朝正确方向的一步，我为基督徒医学团契及核心问题信托为的毅力与坚持感到高兴，确保公众讨论时能够得知真相。我们将继续我们的工作，确保希望脱离同性性倾向的人士得到适当的治疗。」

同性恋及公共福祉

很多人将同性恋呈现为快乐健康的生活方式。但研究显示，同性性行为对生理及精神健康造成严重影响。一个研究发现，平常以同性方式生活，缩减寿命达二十。 （Nathaniel S. Lehrman, MD “Homosexuality: Some Neglected Considerations”, Journal of American Physicians and Surgeons, Volume 10 Number 3.，http://www.jpands.org/vol10no3/lehrman.pdf）

另一个研究发现，同样是廿一岁，同性恋者出现重大抑郁及行为失常的风险增加四倍，烟瘾风险增加五倍，其他误用或成瘾风险增加两倍，企图自杀增加六倍。 （Fergusson DM et al. Is sexual orientation related to mental health problems and suicidality in young people? Arch Gen Psychiatry. 1999; 56: 876-80）

迪尔拜德博士的研究发现，同性性行为导致「缩短寿命、自杀、滥用药物及酒精、抑郁及家庭暴力」。 （Dr A. Dean Byrd, “The Family in the Third Millennium: A Compendium of Scholarship and Opinion Supporting Family as the Fundamental Unit of Society,”14 2005，http://www.narth.com/docs/needboth.html）

拜德博士发现男同性性行为导致肛门癌、梅毒、淋病、单纯疱疹病毒及感染爱滋病。因西方社会合理化及推广同性恋，同性恋社群的性交传染病比率大大增加。

根据英国卫生防护局记录，于英国，男同性恋者仍然是感染人类免疫缺乏病毒（爱滋病）最高的组别，而仅于这组别诊断的新症于过去十年已增加七成。 （http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1296683749074）

同性性行为证实对参与者有潜在破坏，然而若同性婚姻引入，则很可能导致更多同性性行为。于全球大量的研究发现，于认同同性性行为的社会，同性性行为有所增加。 「于瑞士、芬兰、丹麦及美国的大量研究显示，同性恋主要是受环境引发。特别是社会及／或家庭因素，以及正面确认同性恋的环境，这些环境因素对发展同性恋行为举足轻重。」（Dr​​ Trayce Hansen，“Legalizing Same-Sex Marriage Will Increase Prevalence of Homosexuality: Research Provides Significant Evidence”，http://www.drtraycehansen.com/Pages/writings_legalizing.html）

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陈俊仪翻译的很微妙，且看原文是如何论述的。此外，他列举的来源于Journal of American Physicians and Surgeons的文章及Association of American Physicians and Surgeons这个协会，有兴趣也可以看一看。

Royal College of Psychiatrists'statement on sexual orientation

April 2014

The Royal College of Psychiatrists considers that sexual orientation is determined by a combination of biological and postnatal environmental factors.1–3 There is no evidence to go beyond this and impute any kind of choice into the origins of sexual orientation.

The College wishes to clarify that homosexuality is not a psychiatric disorder. In 1973 the American Psychiatric Association (APA) concluded there was no scientific evidence that homosexuality was a disorder and removed it from its diagnostic glossary of mental disorders. The International Classification of Diseases of the World Health Organization followed suit in 1992.

The College holds the view that lesbian, gay and bisexual people are and should be regarded as valued members of society, who have exactly similar rights and responsibilities as all other citizens. This includes equal access to healthcare, the rights and responsibilities involved in a civil partnership/marriage, the rights and responsibilities involved in procreating and bringing up children, freedom to practise a religion as a lay person or religious leader, freedom from harassment or discrimination in any sphere and a right to protection from therapies that are potentially damaging, particularly those that purport to change sexual orientation.

Leading therapy organisations across the world have published statements warning of the ineffectiveness of treatments to change sexual orientation, their potential for harm and their influence in stigmatizing lesbian, gay and bisexual people.4,5

There is now a large body of research evidence that indicates that being gay, lesbian or bisexual is compatible with normal mental health and social adjustment. However, it is eminently reasonable that the experiences of discrimination in society and possible rejection by friends, families and others (such as employers), means that some lesbian, gay and bisexual people experience a greater than expected prevalence of mental health and substance misuse problems. Lifestyle issues may be important in some gay men and lesbians, particularly with respect to higher rates of substance misuse.6–8

It is not the case that sexual orientation is immutable or might not vary to some extent in a person’s life. Nevertheless, sexual orientation for most people seems to be set around a point that is largely heterosexual or homosexual. Bisexual people may have a degree of choice in terms of sexual expression in which they can focus on their heterosexual or homosexual side.

It is also the case that for people who are unhappy about their sexual orientation – whether heterosexual, homosexual or bisexual – there may be grounds for exploring therapeutic options to help them live more comfortably with it, reduce their distress and reach a greater degree of acceptance of their sexual orientation.

The College believes strongly in evidence-based treatment. There is no sound scientific evidence that sexual orientation can be changed. Systematic reviews carried out by both the APA5 and Serovich et al9 suggest that studies which have shown conversion therapies to be successful are seriously methodologically flawed.

Furthermore, so-called treatments of homosexuality can create a setting in which prejudice and discrimination flourish, and there is evidence that they are potentially harmful.5,10,11 The College considers that the provision of any intervention purporting to ‘treat’ something which is not a disorder is wholly unethical.

The College would not support a therapy for converting people from homosexuality any more than we would do so from heterosexuality. Psychiatrists should be committed to reducing inequalities, not supporting practices that are explicitly based on pathologising homosexuality. As such, the College remains in favour of legislative efforts to ban such conversion therapies.

Good Psychiatric Practice clearly states: ‘A psychiatrist must provide care that does not discriminate and is sensitive to issues of gender, ethnicity, colour, culture, lifestyle, beliefs, sexual orientation, age and disability’ (p. 12).12 The College expects all its members to follow Good Psychiatric Practice.

References

1. Mustanski BS, Dupree MG, Nievergelt CM, et al (2005) A genomewide scan of male sexual orientation. Human Genetics, 116, 272–278.

2. Blanchard R, Cantor JM, Bogaert AF, et al (2006) Interaction of fraternal birth order and handedness in the development of male homosexuality. Hormones and Behavior, 49, 405–414.

3. Bailey JM, Dunne MP, Martin NG (2000) Genetic and environmental influences on sexual orientation and its correlates in an Australian twin sample. Journal of Personality and Social Psychology, 78, 524–536.

4. UK Council for Psychotherapy, British Psychoanalytic Council, Royal College of Psychiatrists, et al (2014) Conversion Therapy: Consensus Statement. UK Council for Psychotherapy.

5. American Psychological Association (2009) Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation. APA.

6. Gilman SE, Cochran SD, Mays VM, et al (2001) Risk of psychiatric disorders among individuals reporting same sex sexual partners in the National Comorbidity Survey. American Journal of Public Health, 91, 933–939.

7. King M, McKeown E, Warner J, et al (2003) Mental health and quality of life of gay men and lesbians in England and Wales: controlled, cross-section study. British Journal of Psychiatry, 183, 552–558.

8. Bailey JM (1999) Homosexuality and mental illness. Archives of General Psychiatry, 56, 883–884.

9. Serovich J, Craft S, Toviessi P, et al (2008) A systematic review of the research base on sexual reorientation therapies. Journal of Marital and Family Therapy, 34, 227–238.

10. BBC News (2013) ‘Ex-gay’ group Exodus International shuts down. BBC News, 20 June (http://www.bbc.co.uk/news/world-us-canada-22992714).

11. Harris P (2012) Psychiatrist who championed ‘gay cure’ admits he was wrong. The Observer, 19 May (http://www.theguardian.com/world/2012/may/19/ psychiatrist-admits-gay-cure-study-fl awed).

12. Royal College of Psychiatrists (2009) Good Psychiatric Practice (3rd edn) (College Report CR154). Royal College of Psychiatrists.