Mental Health

Douglas Berger’s response to ““Doctor, Am I Gay?” A Primer on Sexual Identities” from Psychiatric Times, October 28, 2016, By Jack Drescher, MD

Dr. Drescher’s model of complex feelings regarding sexual orientation is mainly based on psychological and social factors. His discussion is not wrong, but it seems hard to me to write an article about this topic without noting the basic genetic concepts of genotype vs phenotype and rare type vs wild type.

More and more evidence is pointing to considerable genetic influence on the determinism of sexual orientation. The National Health Interview Survey reported in July 2014 that 1.6 percent of Americans identify as gay or lesbian, and 0.7 percent identify as bisexual, that would be a total of 2.3% of the population. It is hard to imagine this huge number of persons having a psychosocial determinant or just “wishing” to have this strong proclivity to same-sex sexual interest. It seems prudent to assume this is built into them to large degree.

Science is getting closer in this regard. For example this study,

details how a study of more than 800 gay participants shared notable patterns in two regions of the human genome – one on the X chromosome and one on chromosome 8.

Because same-sex sexual desire does not lead to reproduction as frequently as opposite-sex desire would, mathematically it must be a smaller percent of the population making it the “rare type” vs the heterosexual “wild type” (reproductive technology may begin to level that difference).Even so, genotype is not everything, and there can be some movement along a phenotypic behavioral spectrum depending on a mix of biological, and psychosocial influences. A genotype will likely set some phenotypic anchor-point from which one can move along to some degree in fantasy or in behavior while they confirm their “set-point” in a biological sense.

For example, some persons are better at concepts and thinking and some are better at making things with their hands-and this is probably genetically determined-but most people can do both to some degree. We do not necessarily need to invoke complex psychological theory to describe how persons find their set-point and proclivity in the phenotype that fits them best.

I’m not saying Dr. Drescher’s ideas are incorrect, but I do think they need to be better integrated to the hardwired background that determines who we are.

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