were asked to categorize their sexual experiences and desires on a 7-point
scale ranging from exclusively homosexual to exclusively heterosexual.1 Sixty
percent of the respondents indicated that they were mainly or entirely heterosexual,
and 36% identified themselves as mainly or entirely homosexual. Clearly, the proportion
of homosexual respondents in this study is far higher than in the general population.
Sexual orientation was used as an outcome measure and the relationships between
characteristics of the abuse and sexual orientation were assessed. In order to
ensure that the apparent predictive relationships between abuse characteristics
and outcome measures were not due to differences between homosexual and heterosexual
men, sexual orientation was also considered as an independent variable and the
relationships between it and the various outcome measures were examined. These
relationships are displayed in Table 8.2.
There were no significant
differences between homosexuals and heterosexuals in terms of traumatic symptomatology,
overall functioning as assessed by the CIF, self-worth, sexual adjustment, or
8.2 Relationship Between Sexual Orientation and Outcome Variables
(N = 72)
(N = 43)
of psychotherapy (in months)
satisfaction (high numbers = dissatisfaction)
(21% of sample have been hospitalized)
(45% of sample have received medication)
(33% of sample have attempted suicide)
|Composite Index of Functioning
* As a composite variable, the CIF cannot meaningfully be expressed as a mean.
There were no significant differences in overall functioning between homosexuals
and heterosexuals, as assessed by the CIF.
Values are means or percentages.
Percentages are indicated by %; p values < .05 are in boldface type.
finding is itself certainly noteworthy. Two statistically significant differences
did emerge. Homosexual men had a more benevolent view of the world than did heterosexuals,
and they participated in much more extensive psychotherapy. The average duration
of psychotherapy for homosexuals was almost exactly twice that of heterosexuals
(6 years, 11 months compared to 3 years, 6 months). There were, in addition, two
statistical trends (p < .10): Homosexuals were more likely to have received
psychotropic medication and to have attempted suicide, at levels approaching statistical
It is interesting that despite a level of
psychological functioning comparable to heterosexuals, homosexuals attempted suicide
and received medication more frequently and participated in therapy for a much
longer duration than heterosexuals. It is likely that these findings are due in
large part to the difficulties inherent in being gay in our society. The majority
of suicide attempts occurred between the ages of 16 and 23, and a large percentage
of hospitalizations and medications occurred during these life-stages. This is
a life-stage during which the struggle for identity is central (Erikson, 1963).
It is likely to be particularly difficult and wrought with psychic pain for young
homosexuals who must, on top of the identity struggles that characterize all adolescents,
come to terms with a sexual identity different from the norm in a society often
unaccepting of such difference. They must navigate this while at the same time
struggling to cope with their sexual victimization. It may be that the extensive
psychotherapy these individuals have received has resulted in marked psychological
growth and recovery since those times.
The source of the difference between homosexuals
and heterosexuals in terms of perceived benevolence of the world is unclear, though
this is certainly a striking finding. It is possible that these findings are related
and that psychotherapeutic experiences may have contributed to a more benevolent
world-view. That is, interacting over a long period of time with a therapist or
therapists who are benign, supportive, and invested in one's growth and well-being
may alter the abuse survivor's outlook on the world so that he sees it as a more
friendly, benevolent place.
The relationship between factors
associated with childhood sexual abuse and sexual orientation is complex and controversial.
The views of the psychological and medical fields with respect to the etiology
of sexual orientation have swung between the poles of nature and nurture. The
results of several studies have been published thus far in the 1990s documenting
differences in brain structure and genetic markers between homosexual and heterosexual
men (Hamer, Hu, Magnuson, Hu, & Pattatucci, 1993; LeVay, 1991; Swaab &
Hofman, 1990). Studies in the area of child sexual abuse have repeatedly found
a higher incidence of victimization among homosexual than heterosexual men (Bell
et al., 1981a, 1981b; Finkelhor, 1984; Simari & Baskin, 1982). Similarly,
in the current clinical sample of sexually abused men, 34% identified themselves
as primarily or exclusively homosexual. This is considerably higher than the 10%
(or less) commonly cited as an estimate of the proportion of homosexuality in
the population. Other than the finding of higher rates of sexual abuse among homosexual
men, little is known about the relationships among abuse characteristics and sexual
In the current study, factors related to the gender
of the perpetrator were the main predictors of sexual orientation. Specifically,
men sexually abused during childhood by males were much more likely to identify
themselves as homosexual than were men abused by females. The strongest statistical
correlation was that between childhood sexual interactions with a brother and
homosexual orientation. Men reporting sexual activity with mothers were more likely
to be heterosexual, at a level approaching statistical significance. Those abused
more severely were more likely to be homosexual. This last finding appears to
be the result of the more severe abuse typical of male abusers, however, as regressions
indicate only gender of perpetrator independently predicts sexual orientation.
significant correlations between gender of perpetrator and sexual orientation
are striking. They should not, however, be taken to indicate that sexual abuse,
sexual abuse by males, or any other environmental variable causes homosexuality.
The dictum that correlation does not imply causality should be kept in mind. Several
alternate explanations have been suggested for the finding of the high rate of
sexual abuse among homosexual men, each of which offers insight into the relationship
between abuse by males and homosexual orientation. Simari and Baskin (1982), in
discussing their finding that 64% of homosexual men in their study reported sexual
activity with a relative during childhood, noted that most of these men indicated
that they were already aware of their homosexual orientation at the time of the
sexual interaction. In other words, sexual orientation preceded the childhood
sexual activity rather than arising out of it. There are several differences between
the Simari and Baskin study and the current one. Sexual interactions in their
study consisted largely of consensual activity between siblings or cousins that
was not perceived by the respondents as abusive, either at the time or in retrospect.
Age at the time of sexual activity ranged from 9 to 16 years, which is considerably
older than the age reported by men in the current study. In short, Simari and
Baskin's study examined the childhood sexual activity of homosexual men and found
very high rates of homosexual interaction in the preadolescent and early adolescent
years. Though it appears that their research involved a population distinct from
that of this study, it is relevant in that the present study found that childhood
sexual activity with a brother is the single best predictor of homosexual orientation
and that such activity is considered abusive at a relatively low rate. Thus, a
large portion of the correlation between same-sex sexual interaction in childhood
and adult homosexual orientation may stem from consensual sexual activity among
boys, as was the case in Simari and Baskin's study.
(1990a) noted that his clinical practice with sexually abused men includes a high
proportion of homosexuals. He speculated that during childhood, even if the victims
themselves have not yet identified themselves as homosexuals, they may have discernible
characteristics that make them vulnerable to sexual abuse. These features may
include such qualities as passivity, a girlish appearance or demeanor, bookishness,
and a lack of interest in stereotypically masculine interests such as athletics.
In his view, such features are risk factors for sexual abuse and are also disproportionately
represented in homosexual populations. Thus these characteristics are predictive
of both sexual abuse and homosexuality, rather than the former causing the latter.
(1993) proposes an explanation similar to that of Lew's, based upon the predatory
nature of perpetrators. He argues that child abusers seek out vulnerable children.
A child in an abusive or neglectful home or in a substance-abusing family would
be vulnerable, as would a child with some sort of narcissistic injury. Gonsiorek
asserts that children who later identify themselves as homosexual are aware from
an early age (by about the beginning of latency) that they are different in some
way from most of their peers and, moreover, that this difference is negatively
valued. This sense leads to considerable self-disparagement, or what Gonsiorek
terms "internalized homophobia," and leaves the child vulnerable to
the sexual offender's predation.
A fourth perspective on
the relationship between sexual abuse and sexual orientation was proposed
by Finkelhor (1984), who found a four times greater incidence of sexual abuse
among homosexuals than among heterosexuals. His view comes closest to being a
causal model of homosexuality. Finkeihor argues that the experiences of sexual
victimization cause the victimized boy to doubt and to question his masculinity
and his sexual orientation. He wonders whether the fact of being victimized, helpless,
and passive means that he is gay or feminine. If, as in the studies reviewed by
Finkeihor, the perpetrator was male, the victim may conclude that he was chosen
for the abuse because of some attribute that signified to the perpetrator that
he was gay and thus susceptible to sexual advances. In the wake of the abuse,
the victim makes attributions about himself-"I must have wanted it; he must
have known I was gay; I'm not a 'real man' "-that contribute to a later identification
as homosexual. In addition, the tendency of males to attribute to themselves desire
and willing participation in all sexual activity-what Gerber (1990) termed "the
myth of complicity"-may also contribute to the victim's assumption that if
sexual activity with a male occurred, he must ipso facto be gay.
doubtful whether cognitive attributions such as those proposed by Finkeihor are
sufficient to explain the etiology of sexual orientation. Recent biomedical research
seems persuasive in demonstrating that there is at least a significant physiological
component in the development of homosexuality-that nature plays a major role.
Moreover, most research on sexual orientation indicates that it is set in place
by the beginning of latency, whereas sexual abuse typically does not begin until
later (Gonsiorek, 1993). Finkeihor's discussion of the thought processes of sexually
abused men is consistent, however, with the comments of the men interviewed here
and with the writings of numerous clinicians in this area who find that their
clientele almost uniformly express doubts and concerns about the implications
of their abuse for their sexual orientation (Bolton et al., 1989; Bruckner &
Johnson, 1987; Dimock, 1988; Lew, 1990b). Thus, regardless of whether one identifies
oneself as a homosexual or heterosexual, the experience of childhood sexual victimization,
particularly by a male perpetrator, is likely to raise profound issues regarding
sexual orientation. It is not possible to determine the precise relationship between
sexual abuse and sexual orientation on the basis of the present study or with
currently available data. Further research on the relationships between childhood
sexual abuse and adult sexual orientation would be extremely valuable.
Matthew, The Male Survivor: The Impact of Sexual Abuse, Sage Publications: London,
Reflection Exercise #7
The preceding section contained information
about the sexual abuse of boys and its impact on sexual orientation. Write three
case study examples regarding how you might use the content of this section in
Studies in the area of child sexual abuse have repeatedly found a higher
incidence of what among homosexual than heterosexual men? Record the letter of
the correct answer the .