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Your Doctors and Counselors: Trust, but Verify

There is a longstanding tradition in medicine dating back to the Hippocratic Oath whereby healthcare professionals swear to practice their craft honestly and in the best interest of their patients. 

In recent years, however, the politics of science and medicine have brought this basic and historic assumption into question.  Is decision making still oriented first towards the best interests of the patient, or have advancing social agendas and maximizing resources for society entered into the calculus of medical care?

The Flexibility of Ambiguity

While medical science has made tremendous strides in alleviating human suffering, there are still areas and issues for which doctors have more questions than answers and for which the outcomes of interventions pursued are not entirely certain.  One of these areas is human sexuality. 

In the 1970s and ’80s, for example, doctors had concluded that the best course of action for children born with an intersex condition (ambiguous genitalia) was to assign them to a female gender, and raise them as girls, regardless of their genetic, chromosomal sex identification.  This approach was based on flawed theories [1]of researchers with their own agenda regarding human sexuality and values.  In the end, the inherent dignity of these children was neglected to further the social and political agenda of a few scientists and activists, and the human suffering that resulted was egregious.  

During this same time frame, the American Psychiatric Association also began eschewing science and responding to political pressure to redefine what is understood by healthy sexual functioning.  These changes are apparent by looking at the “DSM”- the official diagnostic manual of the profession.

The Changing View of Same-Sex Attraction

In the initial publications of the DSM (versions 1 (1952) & 2 (1968)), same-sex attraction was viewed as either a disorder of personality or a disorder of sexual functioning, but in either case, a bona fide condition requiring compassionate intervention.  With DSM 3 published in 1973, having same-sex attraction or engaging in such behavior was, per se, no longer to be considered pathological, though there was an allowance that if a person was distressed by this aspect of his life he could still legitimately seek assistance.  This stance endured through version 4 in 1994, though with attenuated language. 

With the recent release of version 5 in 2013, we find that considering treatment for individuals distressed by having same-sex attraction has been eliminated completely.  Furthermore, there are also subtle but important changes in the language related to one’s perception of one’s gender, such that it is no longer considered problematic if a person who is genetically and physiologically male, for example, decides to be identified and live as a female.  In other words, transgenderism is to be affirmed, not challenged [2] and certainly not treated [3]

Sadly, Pedophilia is now beginning the same progression.  Once considered clearly disordered, while the behavior continues to be considered so, the feeling of being sexually attracted to children is not necessarily to be considered a problem.  We know where this ends.

The Healer’s Dilemma

While the DSM provides the official manual for diagnosing and understanding psychiatric problems, it also reflects the thought and perspective of American society.  Many clinicians and consumers will believe mistakenly that these changes are reflective of new ground-breaking research and understanding of human sexuality.  They are not. 

These changes reflect the Signs of the Times – they reflect political and social agendas designed to shift society’s views of what is acceptable sexual behavior—despite the clearly-documented consequences of such behavior.

Surprisingly, or perhaps not, the much-better-documented negative impacts of internet pornography [4] and the increasing prevalence of sexual addictions did not make the cut as new disorders.  So medical and counseling professionals are left in a quandary: Do we accept the mandates from our professional organizations, or do we follow the traditional anthropology and science which guides our understanding of the human person?

While professionals will have to discern how to navigate these waters, the consumers of our services would be wise to become educated.  Not all professionals have the time, resources, or inclination to research the issues, and so many may not realize that the most recent DSM, at least in the areas of human sexuality and addictions, places them at risk of offending the dignity of their patients.  And patients themselves, seeking assistance with distress, deserve to have the reality of that suffering validated and ameliorated to the extent possible, and not to be sent away with affirming platitudes that their distressing experiences have now been officially deemed ‘normal.’

If medicine is to continue to serve the best interests of the patient, doctors must continue to acknowledge the dignity of their patients.  Yet, as the professional medical organizations become increasingly agenda driven, doctors may well need better-educated patients to help them do so.

There is a longstanding tradition in medicine dating back to the Hippocratic Oath whereby healthcare professionals swear to practice their craft honestly and in the best interest of their patients.

With the increasing politics of science and medicine, is this still the case?