What Can Medical Science Tell Us About Sexual Orientation? – Daniel Beals, MD

Medical Definition of Gender:

Male and Female He created them – Genesis 1:27

Fundamental to self-identity: first question when a child is born, it permeates all of our thinking: blue/pink, different goals in life

Who decides?

How do they decide?
Is a medical definition different from other definitions?

How well has Medicine defined sexual identity in the past?

What can we infer from Sexual Identity to Sexual Orientation?

Medical Definition

Good at defining what is wrong, but not what is normal

Specialist have a narrow perspective on definition

Medical knowledge changes

Gender identity as a definition: first used by Dr. John Money, psychological perspective

Ambiguous Genitalia: Dr. Ladd, Boston Children’s Hospital, Surgical Perspective

Disorders of Sexual Differentiation (> 2000): All inclusive definition of anatomically definable genital disorders

Gender Identity Disorder (Gender Dysphoria): All inclusive definition of distress and discomfort one feels between one’s physical sex and one’s gender

Sexual Orientation: Opposite Sex, Same Sex, Not simple with DSD

What Makes Up Gender Identity?

Genetic: X and Y Chromosomes, the SRY gene

Endocrine: testosterone, estrogen

Phenotype: What do things look like? How do things work?

Environment: Parental role models, assumed gender roles, peer pressure

Spiritual?

What do we Know?

No known genetic link to GD or SO

No known endocrine link to GD but known correlation with SO

No known phenotypic link to SO but known secondary correlation with GD

Known correlation between environmental factors and GD and SO

What do we really NOT know?

Do not have a full understanding of genetics

Do not have a full understanding of endocrine influences

Do not have a good long term follow up of attempted therapies

What does Medicine tell us about Gender Identity and Sexual Orientation?

In cases of DSD, it may be very difficult to have a clear answer

Sexual orientation issues can sometimes be explained by endocrine abnormalities

There is no medical explanation to problems with GD

Environment plays an important role in gender, both normal and abnormal

We must be cautious as medical knowledge is far from complete