Nature? Nurture? Neither?

What Makes People Gay?
The Boston Globe Magazine
By: Neil Swidey
August 14, 2005

With crystal-blue eyes, wavy hair, and freshly scrubbed faces, the boys look as though they stepped out of a Pottery Barn Kids catalog. They are 7-year-old twins. I'll call them Thomas and Patrick; their parents agreed to let me meet the boys as long as I didn't use their real names.

Spend five seconds with them, and there can be no doubt that they are identical twins - so identical even they can't tell each other apart in photographs. Spend five minutes with them, and their profound differences begin to emerge.

Patrick is social, thoughtful, attentive. He repeatedly addresses me by name. Thomas is physical, spontaneous, a bit distracted. Just minutes after meeting me outside a coffee shop, he punches me in the upper arm, yells, "Gray punch buggy!" and then points to a Volkswagen Beetle cruising past us. It's a hard punch. They horse around like typical brothers, but Patrick's punches are less forceful and his voice is higher. Thomas charges at his brother, arms flexed in front of him like a mini-bodybuilder. The differences are subtle - they're 7-year-old boys, after all - but they are there.

When the twins were 2, Patrick found his mother's shoes. He liked wearing them. Thomas tried on his father's once but didn't see the point.

When they were 3, Thomas blurted out that toy guns were his favorite things. Patrick piped up that his were the Barbie dolls he discovered at day care.
When the twins were 5, Thomas announced he was going to be a monster for Halloween. Patrick said he was going to be a princess. Thomas said he couldn't do that, because other kids would laugh at him. Patrick seemed puzzled. "Then I'll be Batman," he said.

Their mother - intelligent, warm, and open-minded - found herself conflicted. She wanted Patrick - whose playmates have always been girls, never boys - to be himself, but she worried his feminine behavior would expose him to ridicule and pain. She decided to allow him free expression at home while setting some limits in public.

That worked until last year, when a school official called to say Patrick was making his classmates uncomfortable. He kept insisting that he was a girl.
Patrick exhibits behavior called childhood gender nonconformity, or CGN.

This doesn't describe a boy who has a doll somewhere in his toy collection or tried on his sister's Snow White outfit once, but rather one who consistently exhibits a host of strongly feminine traits and interests while avoiding boy-typical behavior like rough-and-tumble play. There's been considerable research into this phenomenon, particularly in males, including a study that followed boys from an early age into early adulthood.

The data suggest there is a very good chance Patrick will grow up to be homosexual. Not all homosexual men show this extremely feminine behavior as young boys. But the research indicates that, of the boys who do exhibit CGN, about 75 percent of them - perhaps more - turn out to be gay or bisexual.

What makes the case of Patrick and Thomas so fascinating is that it calls into question both of the dominant theories in the long-running debate over what makes people gay: nature or nurture, genes or learned behavior. As identical twins, Patrick and Thomas began as genetic clones. From the moment they came out of their mother's womb, their environment was about as close to identical as possible - being fed, changed, and plopped into their car seats the same way, having similar relationships with the same nurturing father and mother.

Yet before either boy could talk, one showed highly feminine traits while the other appeared to be "all boy," as the moms at the playgrounds say with apologetic shrugs.

"That my sons were different the second they were born, there is no question about it," says the twins' mother.

So what happened between their identical genetic starting point and their births? They spent nine months in utero. In the hunt for what causes people to be gay or straight, that's now the most interesting and potentially enlightening frontier.

WHAT DOES IT MATTER WHERE HOMOSEXUALITY COMES FROM?

Proving people are born gay would give them wider social acceptance and better protection against discrimination, many gay rights advocates argue. In the last decade, as this "biological" argument has gained momentum, polls find Americans - especially young adults - increasingly tolerant of gays and lesbians. And that's exactly what has groups opposed to homosexuality so concerned.

The Family Research Council, a conservative Christian think tank in Washington, D.C., argues in its book Getting It Straight that finding people are born gay "would advance the idea that sexual orientation is an innate characteristic, like race; that homosexuals, like African-Americans, should be legally protected against 'discrimination;' and that disapproval of homosexuality should be as socially stigmatized as racism. However, it is not true."

Some advocates of gay marriage argue that proving sexual orientation is inborn would make it easier to frame the debate as simply a matter of civil rights. That could be true, but then again, freedom of religion enjoyed federal protection long before inborn traits like race and sex.

For much of the 20th century, the dominant thinking connected homosexuality to upbringing. Freud, for instance, speculated that overprotective mothers and distant fathers helped make boys gay. It took the American Psychiatric Association until 1973 to remove "homosexuality" from its manual of mental disorders.

Cornell psychologist Daryl Bem has proposed an intriguing theory for how CGN might lead to homosexuality. According to this pathway, which he calls "the exotic becomes erotic," children are born with traits for temperament, such as aggression and activity level, that predispose them to male-typical or female-typical activities. They seek out playmates with the same interests. So a boy whose traits lead him to hopscotch and away from rough play will feel different from, and ostracized by, other boys. This leads to physiological arousal of fear and anger in their presence, arousal that eventually is transformed from exotic to erotic.

The cases of children born with disorders of "sexual differentiation" offer insight. William Reiner, a psychiatrist and urologist with the University of Oklahoma, has evaluated more than a hundred of these cases. For decades, the standard medical response to boys born with severely inadequate penises (or none at all) was to castrate the boy and have his parents raise him as a girl. But Reiner has found that nurture - even when it involves surgery soon after birth - cannot trump nature. Of the boys with inadequate penises who were raised as girls, he says, "I haven't found one who is sexually attracted to males." The majority of them have transitioned back to being males and report being attracted to females.

Canadian researchers have consistently documented a "big-brother effect," finding that the chances of a boy being gay increase with each additional older brother he has. (Birth order does not appear to play a role with lesbians.) So, a male with three older brothers is three times more likely to be gay than one with no older brothers, though there's still a better than 90 percent chance he will be straight. They argue that this results from a complex interaction involving hormones, antigens, and the mother's immune system.

By now, there is substantial evidence showing correlation - though not causation - between sexual orientation and traits that are set when a baby is in the womb. Take finger length. In general, men have shorter index fingers in relation to their ring fingers; in women, the lengths are generally about the same. Researchers have found that lesbians generally have ratios closer to males. Other studies have shown masculinized results for lesbians in inner-ear functions and eye-blink reactions to sudden loud noises, and feminized patterns for gay men on certain cognitive tasks like spatial perception and remembering the placement of objects.

New York University researcher Lynn S. Hall, who has studied traits determined in the womb, speculates that Patrick was somehow prenatally stressed, probably during the first trimester, when the brain is really developing, particularly the structures like the hypothalamus that influence sexual behavior.

This stress might have been based on his position in the womb or the blood flow to him or any of a number of other factors not in his mother's control. Yet more evidence that identical twins have womb experiences far from identical can be found in their often differing birth weights. Patrick was born a pound lighter than Thomas.

Taken together, the research suggests that early on in the womb, as the fetus's brain develops in either the male or female direction, something fundamental to sexual orientation is happening. Nobody's sure what's causing it. But here's where genes may be involved, perhaps by regulating hormone exposure or by dictating the size of that key clump of neurons in the hypothalamus. Before researchers can sort that out, they'll need to return to the question of whether, in fact, there is a "gay gene."

Homosexuality runs in families - studies show that 8 to 12 percent of brothers of gay men are also gay, compared with the 2 to 4 percent of the general population.

Meanwhile, the mother of twins Patrick and Thomas has done her own sifting and come to her own conclusions. She says her son's feminine behavior suggests he will grow up to be gay, and she has no problem with that. She just worries about what happens to him between now and then.

After that fateful call from Patrick's school, she says, "I knew I had to talk to my son, and I had no clue what to say." Ultimately, she told him that although he could play however he wanted at home, he couldn't tell his classmates he was a girl, because they'd think he was lying. And she told him that some older boys might be mean to him and even hit him if he continued to claim he was a girl.
Then she asked him, "Do you think that you can convince yourself that you are a boy?"

"Yes, Mom," he said. "It's going to be like when I was trying to learn to read, and then one day I opened the book and I could read."

His mother's heart sank. She could tell that he wanted more than anything to please her. "Basically, he was saying there must be a miracle - that one day I wake up and I'm a boy. That's the only way he could imagine it could happen."
In the year since that conversation, Patrick's behavior has become somewhat less feminine. His mother hopes it's just because his interests are evolving and not because he's suppressing them.

"I can now imagine him being completely straight, which I couldn't a year ago," she says. "I can imagine him being gay, which seems to be statistically most likely."

She says she's fine with either outcome, just as long as he's happy and free from harm. She takes heart in how much more accepting today's society is. "By the time my boys are 20, the world will have changed even more."