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Psychiatrists Letter to the Catholic Bishops
As a Catholic psychiatrist and psychologist who have treated a significant number of priests from various dioceses and religious communities over the past 25 years for same-sex attraction (SSA or homosexuality) and for pedophilia and ephebophilia (homosexual behavior with adolescents), we believe that our particular expertise and those of our colleagues in the Catholic Medical Association may be of help to the American bishops as they seek to create effective long-term strategies to prevent the recurrence of the problems in which the Catholic Church in the United States now finds itself enmeshed.
Many have pointed out that solving the problem of sexual abuse by clergy will necessarily involve addressing the problem of SSA among priests. Bishop Wilton D. Gregory, president of the U.S. Conference of Catholic Bishops, admitted at a press conference in Rome on April 23 the existence of an ongoing struggle to ensure that the Catholic priesthood is not dominated by homosexual men.
As the revelations of abuse have become public it has become increasingly clear that almost all the victims are adolescent males, not prepubescent boys. The problem of priests with same-sex attractions (SSA) molesting adolescents or children must be addressed if future scandals are to be avoided.
In treating priests who have engaged in pedophilia and ephebophilia we have observed that these men almost without exception suffered from a denial of sin in their lives. They were unwilling to admit and address the profound emotional pain they experienced in childhood of loneliness, often in the father relationship, peer rejection, lack of male confidence, poor body image, sadness, and anger.
This anger, which originated most often from disappointments and hurts with their peers and/or fathers, was often directed toward the Church, the Holy Father, and the religious authorities. Rejecting the Church's teachings on sexual morality, these men for the most part adopted the utilitarian sexual ethic which the Holy Father so brilliantly critiqued in his book, "Love and Responsibility."
They came to see their own pleasure as the highest end and used others -- including adolescents and children -- as sexual objects. They consistently refused to examine their consciences, to accept the Church's teachings on moral issues as a guide for their personal actions, or regularly avail themselves of the sacrament of reconciliation. These priests either refused to seek spiritual direction or choose a spiritual director or confessor who openly rebelled against Church teachings on sexuality. Tragically, these mistakes allowed these men to justify their behaviors.
The bishops, individually and collectively, should develop screening protocols which will identify men who may pose a risk to others and who cannot live the chaste celibacy required of a priest. This is essential to protect the Church and her children from further pain, sorrow and future scandals. While no screening system is absolutely foolproof, sufficient research is available to develop efficient tools for this task.
One of the major problems we have discovered in discussing this issue with the clergy and the laity is the enormous amount of misinformation about the nature, origins, and treatment of homosexuality/SSA. This is not accidental. For over 20 years, activists, intent on changing the laws on sexual orientation, have put forward a massive public relations campaign specifically designed to spread misinformation that will change the social acceptance of homosexuality.
For example, many people sincerely believe that scientific research has produced conclusive evidence that homosexuality is a genetically inherited condition, determined before birth, and cannot be changed. In fact, no such evidence exists. Several studies have been promoted in the media as providing the "proof," but when one reads these studies, one discovers the authors do not even claim to have presented such proof.
There is no verifiable evidence that same-sex attraction is genetically determined. If same-sex attraction were genetically determined, identical twins would always have the same sexual attraction pattern. Numerous studies of twins have shown that this is not the case. And there are numerous studies documenting change of sexual attraction pattern (see "Homosexuality and Hope," available at www.cathmed.org).
One of the reasons why people have been so willing to accept the idea that same-sex attraction is genetically determined is their own experience with men who are extremely effeminate and have been so since early childhood. This condition of extreme effeminacy is called Gender Identity Disorder (GID).
The differences between boys with GID and other boys are so profound, that those observing them conclude that the boys with GID must have been born that way. Those who treat GID have found that effective family therapy in which the father bonds more closely with the son and affirms his son's masculinity can in a relatively short time result in the elimination of these symptoms and the emergence of normal boyish behavior.
Tragically, because this information is not widely known most boys with GID do not receive treatment and approximately 75% of them will go on to develop SSA in adolescence. Unfortunately, if these boys come from Catholic families, those around them may point them toward the priesthood. Because they aren't attracted to girls, people wrongly assume that the celibate life will be easy for them.
In our practice, we have seen many boys who suffered from distant father relationships, lacked hand/eye coordination and subsequently were subjected to humiliating teasing from peers because of their inability to play sports. These and other factors lead to feelings of male inadequacy and loneliness and later to homosexual attractions. The sooner these problems are addressed in therapy, the more hope there is for a full recovery.
For example, a 26-year-old client had experienced severe peer rejection as child and teen-ager because of his inability to play sports. In addition, his father was distant, and his mother overly dependent. At age 10 he began to experience same-sex attractions which intensified in his adolescence.
Fortunately, as a faithful Catholic he never gave into the temptations to act on these feelings. During therapy he was able to identify the causes of his same-sex attraction, to forgive those who had hurt him, and to develop a stronger and comforting relationship with God the Father and St. Joseph as another loving father, Jesus as his loving and accepting friend at every life stage and Our Lady as a cheerful giving mother. As the emotional pain was resolved, his male confidence grew, his same-sex attraction diminished markedly and later resolved. He came to realize that he was not homosexual, but a man who had been wounded emotionally in many relationships from early in his life and who could be healed.
Michael (not his real name) was a seminary student when he came into treatment for same-sex attractions. He gradually understood that the origins of the same-sex attractions arose from a very negative body image which he had had from the time he was a young boy because he had been overweight.
He was regularly picked on by his peers in elementary and middle school because of his physical appearance. He has intense loneliness in peer relationships from his childhood and adolescence. During his several years in therapy, he worked at trying to forgive his peers who ridiculed his physical appearance. He also attempted to reject the culture's obsession with physical appearance, and began to thank God for his masculine gifts and body image.
He also meditated upon the Lord being at his side as his best friend in elementary and middle school. He benefited by reflecting that his body is a temple of the Holy Spirit, in addition to asking for a certain sense of detachment, and by being thankful for his God-given body. Finally, he also worked out physically to prevent more weight gain. Slowly his masculine identity and body image improved. His deep inner loneliness lessened through a profound sense of being loved by the Lord.
The Catechism of the Catholic Church states that homosexuality's "psychological genesis remains largely unexplained" (#2357). While it is understandable that the writers of the Catechism would not wish to make a definitive statement about a question which is at the center of such a contentious public debate, this statement does not accurately reflect what is known about homosexuality.
There is ample evidence that same-sex attraction has many different causes. These lead to significant childhood and adolescent emotional pain and psychological problems. Among males these could include a weak masculine identity, social isolation and loneliness, peer rejection or a poor body image and in females, a mistrust of male love or a weak feminine identity. No one can say "this is the cause" for same-sex attraction as though there were a single cause, but an individual can come to understand the origins of his or her own same-sex attractions through insight gained in therapy.
Men and women experiencing same-sex attraction may rightly feel that they "have always felt different," but that doesn't mean they were born that way. Children are born either male or female, but they have to learn what it means to be a man or a woman. They have to identify with -- and be accepted by -- their same-sex parents and peers. If they are going to grow up psychologically healthy they have to feel safe and comfortable with their masculinity or femininity. If, for whatever reason, they fail to pass successfully through this essential developmental stage, they may in adolescence develop same-sex attractions.
There has been a massive campaign to hide this information from the general public and from those who sincerely wish to be free from same-sex attraction. In 2000, Dr. Robert Spitzer of Columbia University, who had been instrumental in the removal from the American Psychiatric Association's Diagnostic and Statistical Manual of homosexuality as a diagnosis in 1973, was challenged by men and women healed of their same-sex attractions that change is possible.
Spitzer interviewed 200 men and women claiming to have achieved significant change and found that 60% of the males whom he studied identified themselves as heterosexual five years after their treatment ended. Most of those who were successful also participated in faith-based support programs.
While there are numerous reports of substantial change through therapy alone, programs which rely on God or which are specifically Christian provide significant help in dealing with the compulsive behaviors, loneliness and lack of confidence that accompany SSA. This should come as no surprise to Catholics who already know the power of Christ's healing love. To those who wish to be free from same-sex attraction it can be said with confidence that God didn't make them that way and he wants them to be free. The good news is that SSA attraction can respond to therapy and that membership in a support group such as Courage can help a person to find healing and freedom.
The road to freedom, however, is long and arduous. For many individuals, it is often accompanied by other serious psychological problems and addictions. Three recent well-designed studies (Fergusson, Herrell and Sandfort) have shown that persons with SSA suffer from other psychological problems at a rate substantially higher than those without SSA. Some of these problems, such as pathological narcissism and borderline personality disorder are very difficult to treat.
Additionally, men with SSA are more likely to suffer from substance abuse problems, sexual paraphilias, and sexual addiction. Such problems complicate recovery. Also, men with SSA are more likely than other men to have a history of childhood sexual abuse (CSA). While arriving at an exact percentage is difficult, some experts suggest that about 16% of all men have experienced CSA. Several studies of men self-identified as homosexual revealed that 40% had a history of CSA. Given the high level of long-term psychological problems associated with a history of CSA, it is not surprising that men with SSA have numerous problems.
There are other serious problems which need to be addressed. For example, sexual harassment exists at certain seminaries. Any Catholic institution which knowingly tolerates sexual harassment -- heterosexual or homosexual -- betrays the moral teaching of Christ and contributes to the suffering of others. It also risks incurring financial liability.
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On Friday, Part 2 of this letter looks recommendations for treatment for priests with SSA, and for the screening of seminarians.
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For the Catholic Medical Association by
Richard P. Fitzgibbons, M.D.
Peter Rudegeair, MA
Eugene F. Diamond, M.D.