Angry Doctor

Tuesday, May 08, 2007

Sick, sick people


Apart from a video of a cartoon, angry doc had not directly commented on the "recent discussion on the issue of homosexuality". angry doc doesn't think this blog is a place to 'show his politics'.

However, this letter compels him to change his mind (emphasis mine):


Homosexuality: Neither a disease nor an immutable trait

I WRITE with regard to the recent discussion on the issue of homosexuality. Homosexuality, until recently, was regarded as a disease.

A disease is defined as an impairment of health or condition of abnormal functioning.

Homosexuality certainly fits the definition of a disease as there is an increased mortality rate mainly from Aids; the life expectancy of a homosexual and bisexual male is up to 20 years shorter compared to a normal male (R.S. Hogg, et al, 'Modelling the impact of HIV disease on mortality in Gay and Bisexual Men' International Journal of Epidemiology 1997).

There is also an increased morbidity rate, with a greater risk of suffering from sexually transmitted diseases, including Aids, and increased risk of psychiatric illnesses such as depression, suicides and drug abuse.

Simply put, being a homosexual (statistically speaking) puts one at risk of suffering from poor health and dying early.

In 1973, homosexuality was removed from the Diagnostic And Statistical Manual of Mental Disorders (DSM) by the American Psychiatric Association (APA).

The question we have to ask is: How did this come about? One would think that the APA would not have taken such a step unless there was strong scientific evidence to justify such a move.

A review of the history of events shows that the decision was not based on scientific evidence, but in fact was the response of an organisation under siege by gay activists. Ronald Bayer's book, Homosexuality And American Psychiatry: The Politics Of Diagnosis, documents the political nature of this battle over DSM.

Dr Bayer defends this move by APA, saying: 'Psychiatry may, under certain circumstances, act upon society, using its cultural influences to challenge social values and practices.'

It is clear from this that the removal of homosexuality from DSM was a political settlement and not due to scientific evidence. Thus, homosexuality should still be regarded as a disease.

The question is, if homosexuality is a disease, can it be treated?

There have been numerous documented cases of people who have changed their sexual orientation.

Dr Robert Spitzer, who was very much involved in the 1973 removal of homosexuality from DSM, found in a 2001 study, that 'there is evidence that change in sexual orientation following some form of reparative therapy does occur in some gay men and lesbians'.

It follows from this that homosexuality is neither a fixed trait nor is it immutable.

Dr Alan Chin Yew Liang


Now what Dr Chin wrote may be true, but it is also irrelevant to "the recent discussion on the issue of homosexuality".

Because the "discussion" isn't really about whether homosexuality is a disease to be cured or not, but whether or not men having sex with men deserve to be jailed for life for doing so.

Substitute the word 'homosexuality' with 'promiscuity', and much of what Dr Chin wrote will still make sense.

Now substitute the word 'homosexuality' with 'smoking', and the words 'AIDS' and 'sexually transmitted disease' with say 'lung cancer' and 'chronic obstructive pulmonary diseases', and much of the letter will still make sense.

Promiscuity and smoking may well fit into the definition of 'disease' as given in the letter (and in fact smoking has its own ICD-code), but we do not jail people for promiscuious behaviour, nor do we jail smokers, do we?

But why let a simple fact like that stop us doctors from using our expert professional opinion to help put those sick, sick people away for the rest of their lives, right?

Labels: , ,

21 Comments:

  • Nope. This letter has no relevance to whether homosexuality should be criminalized or not. Just another homophobe using scare tactics to justify his own views in the hope of making more people make noise against decriminalizing homosexuality.

    By Blogger aliendoc, At May 08, 2007 9:53 pm  

  • I am a medical doctor myself, straight and male, and I must say Dr Alan is a total embarrassment to the medical profession. It's time we allocate more hours to the teaching of critical appraisal/analysis of scientifc/medical information and psychiatry into the medical curriculum. Like the now infamous law professor, this GP has exchanged his common sense and professional judgement for blind religious fervour. It is a sombre day for the medical and legal profession in Singapore.

    By Anonymous Anonymous, At May 08, 2007 11:04 pm  

  • when i saw that choice piece in ST forum my jaw literally dropped. as someone who's been through the system i know logic and common sense probably does not play that much importance in passing your exams to qualify for and graduate from medical school, but still. embarrassing, indeed.

    anyone interested in rebutting him? i'd do so except that i'm queer myself, so there is a conflict of interest there.

    By Anonymous Anonymous, At May 09, 2007 2:00 am  

  • I looked up the paper Dr Chin referred to; it studied the population in Vancouver from 1987 to 1992 - it is a local population and the data is 15 years old. Better awareness and HIV-treatment now may mean that life-expectancy for gay and bisexual men should have improved. However, locally the HIV rate amongst homosexuals is still higher relative to that amongst heterosexuals, so I wouldn't be surprised if gay men still have a lower life expectancy.

    (If Dr Chin is so concerned for gay men's health, perhaps the fact that there a few studies which show that gay couples in civil unions enjoy better health just as married heterosexual couples have better health over unmarried persons will prompt him to advocate civil union for them?)

    But like I said, life expectancy is not the issue here.

    Whether or not it is "natural" is irrelevant. Whether it is "nature" or "nurture" is also irrelevant. Whether or not gay people are more "artistic" and that they can also "contribute to society" is also irrelevant. We do not jail or indemnify people for any one of those things, separately or in combination.

    Even if we can show that animals in "nature" also have same-sex sex, even if we can prove a strong genetic predisposition for homosexuality, even if homosexuals all adopt safe sex practices and reduce their STI rates to equal to or lower than that of heterosexuals, even if we can show that gay people have contributed significantly to society and continue to do so... even if we can do all that, there will still be people who will oppose decriminalisation of gay sex. They need to ask themselves why, and then argue from that answer, and not confuse the issue with all the others above.

    By Blogger angry doc, At May 09, 2007 4:58 pm  

  • Homosexuality may not be a physical medical disease in the correct sense but it certaintly is a psychological disorder of misusing people's bodies as pleasure objects.

    The law is a moral guidline that sets the moral limits of a society. The law is not based on what one person thinks is right, but is based on the greater good of society, in this case it does not recommend promoting sexual misuse as something positive for the whole of society.

    Even medical doctors should realise that homosexual sex is a misuse of a person's body.

    I don't think medical doctors are qualified to talk about homosexuality as it involves the psyche, I am waiting to hear what psychologists has to say on the issue.

    By Anonymous whybegay, At May 09, 2007 7:19 pm  

  • Why should the misusing of one's body for pleasure be a crime punishable by imprisonment, whybegay?

    What other misuses of one's body for pleasure do you think we should punish by imprisonment?

    If society decided that misusing one's body for pleasure isn't against "the greater good", will you change your position?

    If pyschologists all agreed that homosexuality isn't a psychological problem, will you change your position?

    Why don't you just be honest and tell us what the real reason behind your dislike for gays is?

    By Blogger angry doc, At May 09, 2007 10:53 pm  

  • "Why should the misusing of one's body for pleasure be a crime punishable by imprisonment, whybegay?"

    Since the Penal code is not an active law, it cannot be enforced. Therefore it is only against its promotion.

    "If society decided that misusing one's body for pleasure isn't against "the greater good", will you change your position?"

    Get out of your fantasy.

    "If pyschologists all agreed that homosexuality isn't a psychological problem, will you change your position?"

    Too much wishful thinking.

    "Why don't you just be honest and tell us what the real reason behind your dislike for gays is?"

    They are illogical, childish and emotional most of the time and don't seem to live in the real world? Help me to talk some sense into them and you too.

    By Anonymous whybegay, At May 09, 2007 11:20 pm  

  • Not being able to respond in the ST forum page, I thought I'd leave a few words here. As a caveat, I have to say that I'm straight and male. That out of the way, the law professor and the (presumably medical) doctor's comments leave me amazed and scared that people that are responsible for teaching our jurisprudence and our health can be so irrational beyond the pale. (If they were bus driver or people whose views on this matter didn't affect their work, I wouldn't really care. If they were preacher or pastor I would also not care, since such conservative views are expected).

    Some comments.

    If a disease is any condition or behaviour that results in reduced life expectancy, then poverty is a much greater disease, or being born in zimbabwe, or being born male, relative to the human average, riding motorcycles etc.

    He quotes an expose on DSM. There have been other books written that charge that the entries in DSM are arbitrarily constructed according to the whims of the contributors, which is not surprising, given the nebulous nature of psychiatric diseases. This isn't exactly diagnostic science - your leg is broken, you have to cast it. You are homosexual. The two just don't equate.

    Third, the default state is not necessarily the correct one. In the early 20th century, eunuchs, bound feet, caucasian superiority, female castration, slavery were all common behaviour. Is he suggesting that since those were the prevailing practise we should stay with them, in the same way that social attitudes were against homosexuality then (and which invariably influenced DSM)?

    4th, he talks about numerous documented cases of changes in sexual orientation. There have been even more numerous cases where attempts to treat homosexuality didn't work out. Electro-shock, hormones etc. Von Neumann was a famous casualty of this regime. There have also been numerous documented cases of spontaneous human combustion, but I'm not holding my breath for it to happen anytime soon.

    On the comment on self-abuse. Being an avid extreme sports enthusiast, I've shortened my life expectancy climbing mountains, freefalling, doing ironman triathlons etc. That certainly qualifies as misuse of the body, but if we all wanted to live to a 100, we'd cut our daily caloric intake in half and live in a monastry.

    By Anonymous Anonymous, At May 10, 2007 2:04 am  

  • Another life-shortening trait that was formerly penalized: left-handedness.

    Using one's body for pleasure is universal: along with sex, there includes acting, dancing, singing, sports, thinking, writing, eating, communicating, playing an instrument, creating visual art, sculpting, exploring, and yes, warring, to name just a very few forms off the top of my head.

    Using science spuriously to oppress others is commiting a foul against society.

    Interesting post - thanks for writing this.

    By Anonymous N=1, At May 10, 2007 2:24 am  

  • "They are illogical, childish and emotional most of the time and don't seem to live in the real world?"

    That's it?

    So should illogical, childish and emotional heterosexuals be threatened with a jail term?

    Can logical, mature and rational homosexuals be allowed to have sex with each other?

    By Blogger angry doc, At May 10, 2007 8:21 am  

  • No. We do what the law says we can do.

    We don't do what the law says we cannot do.

    We are not supposed to think. Because we are not smart enough to think for ourselves.

    Only the government can think.

    If you think about it that seems to be what some of the commenters here are saying.

    By Anonymous Anonymous, At May 10, 2007 10:27 am  

  • "So should illogical, childish and emotional heterosexuals be threatened with a jail term?"

    If they are misusing people's bodies then yes.

    "Can logical, mature and rational homosexuals be allowed to have sex with each other?"

    Why would logical, mature and rational people want to misuse each other's bodies?

    Your broken logic in your reasoning is a waste of time for me to follow up.

    By Anonymous whybegay, At May 10, 2007 1:09 pm  

  • So is it being illogical, childish and emotional you are against, or is it misusing one's body you are really against?

    By Blogger angry doc, At May 10, 2007 2:10 pm  

  • I read whybegay's blog entry " I was harassed today by a terrorist of human rights"

    totally illogical.

    By Anonymous Anonymous, At May 10, 2007 2:21 pm  

  • Legalisation of homosexuality is not a medical issue, it's a social, political and religious matter. I agree with angrydoc that statistics and studies will be quoted by both sides in support of their positions.

    I believe the laws of the land should reflect the views of the population on the matter. Like abortion and pornography, whether Singapore should legalize homosexuality primarily depends on whether most Singaporeans (a large number of whom may be conservative and religious) will support it. Gay activists would do well to persuade and convince practising Muslims, Catholics, Protestant Christians etc. that legalizing homosexuality will not be a threat to the practice of their religion, that their children can still be brought up in the tenets of their own faith (many of which disapprove of homosexuality). This is not an issue for us medical men...it's for the religious leaders and politicians to deal with.

    By Blogger pathdoc, At May 11, 2007 3:13 pm  

  • I agree with you that it is not us medical men's business, but since we are discussing the topic I would like to disagree with this part of your second last sentence:

    "... that legalizing homosexuality will not be a threat to the practice of their religion, that their children can still be brought up in the tenets of their own faith"

    Legalisation of homosexuality cannot be said to be more of a threat to religions that the legalisation of eating of pork, beef, drinking of alcohol, prostitution, or divorce. Those things are legal under secular law and forbidden by certain religions, but religious people are still free to bring their children up to observe these bans. And whether or not something is legalised, it will not stop parents from threatening to call the police when their kids misbehave.

    By Blogger angry doc, At May 11, 2007 4:24 pm  

  • anytime anyone quotes anything from narth. you already know they are psycho

    By Anonymous Anonymous, At May 11, 2007 10:38 pm  

  • Legalisation of homosexuality cannot be said to be more of a threat to religions that the legalisation of eating of pork, beef, drinking of alcohol, prostitution, or divorce.

    It need not be, but it can be and has been in some western nations. Put discrimination laws together with legalisation of homosexuality and we can expect lawsuits. Let me explain.

    Once we legalize homosexuality (and I must say I do support that), gay rights activists will argue that schools have to teach children against discrimination of people with different sexual orientations. That sounds logical enough and how can the government object? But can you imagine catholic convent schools and the muslim madrassahs being forced to teach that homosexuality is perfectly acceptable? Radical Muslims will point to this as an example of the government's oppression of Islam. We have to be careful.

    Second, remember what has happened in the UK. Catholic adoption agencies are now compelled to place orphans with same-sex couples and churches are required to allow same sex marriages in their premises. Essentially, you have to allow gay people equal access to every service or job opportunity available. Theoretically, a gay person can file a lawsuit if he is not allowed to be considered fairly for the job of an imam.

    I want anti-discrimination laws to be brought into Singapore. But you can see the problems that will arise with anti-discrimination laws and legalisation of homosexuality in a society where the population is not prepared to accept the implications. We cannot exclude gay people from anti-discrimination laws if homosexuality is perfectly legal but is MUIS prepared to accept gay religious teachers into their mosques?

    By Blogger pathdoc, At May 12, 2007 2:43 pm  

  • "But can you imagine catholic convent schools and the muslim madrassahs being forced to teach that homosexuality is perfectly acceptable?"

    Not 'perfectly acceptable', but 'not illegal'. As it is they are already teaching that many things which are legal are not 'right'.

    They are and will still be free to teach that non-believers may eat pork/commit adultery/have homosexual sex, but good believers don't.

    "Second, remember what has happened in the UK. Catholic adoption agencies are now compelled to place orphans with same-sex couples and churches are required to allow same sex marriages in their premises."

    If we can have a law that jails men for having sex with men, I doubt we cannot have a law that forbids men from marrying men or adopting children (not that I am for same-sex couples adopting... I'm conservative like that).

    "Theoretically, a gay person can file a lawsuit if he is not allowed to be considered fairly for the job of an imam."

    Unlikely. I doubt an uncircumcised man who eats pork can file a suit for not being considered fairly for the job of an iman, or a married man for not being considered fairly for the job of a Catholic priest.

    I agree with you there will be much unhappiness and protest if we decriminalised men between men, but is that reason enough to threaten them with a jail term?

    By Blogger angry doc, At May 12, 2007 5:29 pm  

  • Not 'perfectly acceptable', but 'not illegal'. As it is they are already teaching that many things which are legal are not 'right'.
    I am afraid it's not so simple. If we have anti-discrimination laws in Singapore, are you suggesting that we exclude homosexuality from the protection of the law (I doubt the gay community will allow that). Otherwise, the catholic school that teaches homosexuality is legal but is an abomination and sinful act may be guilty of inciting discrimination against gay people. In fact, one can even argue for the use of the Sedition Act against any church leader or imam for that teaching, because it is an offence to incite hatred against a group of people, if homosexuality is legalized.

    If we can have a law that jails men for having sex with men, I doubt we cannot have a law that forbids men from marrying men or adopting children
    We can, but isn't that discrimination against people on the basis of their sexual orientation? Perhaps you are saying we can continue to discriminate against them, just don't put them in jail. But as someone had posted in another thread, nobody has ever been sent to jail and the government has said they won't prosecute gay people under the law either.

    Unlikely. I doubt an uncircumcised man who eats pork can file a suit for not being considered fairly for the job of an iman, or a married man for not being considered fairly for the job of a Catholic priest.
    That won't happen as long as we do not protect gay people from discrimination in the workplace. If we bring in anti-discrimination laws like those in the UK, it will become illegal to discriminate on account of sexual orientation in the selection of a candidate. Employers can only argue that a gay person is unable to do the job of a catholic priest. But if that person has successfully completed the training, been appointed as a priest and then come out as gay, the church will not be able to dismiss him.

    If we legalize homosexuality but yet continue to discriminate against them in the workplace and other arenas of social life, why bother changing the law at all? Yes, it is true that technically homosexuality is illegal and can attract a jail term, but the government has already said they will never prosecute anyone under the law. So what will legalization achieve if we are not going to protect them from all forms of discrimination as well? As I said previously, this is a complex and highly emotive issue that is better handled by politicians, religious leaders and social scientists, rather than medical professionals.

    By Blogger pathdoc, At May 13, 2007 3:00 am  

  • "Otherwise, the catholic school that teaches homosexuality is legal but is an abomination and sinful act may be guilty of inciting discrimination against gay people."

    Yes, they will be discriminating against gay people.

    "In fact, one can even argue for the use of the Sedition Act against any church leader or imam for that teaching, because it is an offence to incite hatred against a group of people, if homosexuality is legalized."

    You can teach that something is wrong, but you do not have to teach hatred against the people who do it. And if you do teach hatred, why shouldn't the Sedition Act be invoked against you?

    "We can, but isn't that discrimination against people on the basis of their sexual orientation?"

    Yes, I myself am guilty of doing that...

    "But if that person has successfully completed the training, been appointed as a priest and then come out as gay, the church will not be able to dismiss him."

    Yes they will; priests are supposed to be celibate.

    "So what will legalization achieve if we are not going to protect them from all forms of discrimination as well?"

    I think all the problems you have raised arise from the fact that, yes, many of us (myself included) are still not comfortable with granting them full rights including right to civil union and adoption. I guess the question is whether you think decriminalisation should follow society's change of attitude, or should it be the first step towards changing soceity's attitude.

    By Blogger angry doc, At May 13, 2007 12:36 pm  

Post a Comment

Subscribe to Post Comments [Atom]



Links to this post:

Create a Link

<< Home