Should We Try to Chemically Reverse Homosexuality?

In light of the recent popular discussion around chemically transitioning children to the opposite sex, I want to explore a potential double standard from a moral perspective.

If you feel unable to read further than the title due to abject disgust at the mere thought of this subject, please have a read through the Bias Busting guide first.

Argument

My primary arguments are:

• Any moral objections to medically treating homosexuality must logically apply to medically treating gender dysphoria.¹
• Any moral objections to conducting medical experiments on homosexual children must also apply to children with gender dysphoria¹

Moral basis

I will be using the moral framework laid out in this repository. Namely, a harm based, consequentiality moral interpretation.

This is often what people think they mean when they think of their morality, when often they simply believe in simply their own, norm based moral superiority. I strongly suggest clarifying what moral means to you before continuing.

Scope

I will assume for the purposes of this argument, that gender dysphoria is a diagnosable disorder (as clarified below), and that it can be effectively diagnosed in children.

Likewise, I will assume that homosexuality is an observed condition that affects humans, and can be effectively diagnosed in children.

I will not be trying to disprove gender dysphoria is “real” or debate the validity of diagnosing children with the condition.

What is the purpose and mechanism of medicine?

Before getting into whether we should medically treat homosexuality or gender dysphoria we need to agree on what medicine is actually used for.

Subjectivity

Your first thought may be that medicine is used to treat someone’s objective symptoms not their subjective experience. This seems like it’s the case, as we are so used to dealing with specific diagnoses and approved treatments for those diagnoses, like a square peg in a perfectly square hole. However, when we start to look at individual scenarios, we see that it’s indeed the subjective over the objective.

Pain medication

If I have a headache, I may take a painkiller to attempt to alleviate my subjective sense of head pain. I didn’t go to an MRI machine and confirm that my brain is suffering some physical anomaly that caused my head pain before self prescribing paracetamol (acetaminophen).

You might think it’s simply because we don’t have an accurate and convenient way to detect headaches, but this presumes that the cause of all headaches is a physical ailment. While it’s true that headaches can be caused by physical changes in the body or brain, this is not actually required.²

Nocebo

The nocebo effect is well demonstrated. Humans have the ability to cause a subjective experience of pain (or other negative symptoms) simply through mere thought alone.

An interesting instance of this occurred as a response to a newly erected 5G tower. Residents in the local area began reporting headaches, demanding the tower be taken down. It turned out that the tower had not actually been turned on.³

Placebo

On the flip side, it is well known that the placebo effect can be induced in a variety of ways.

If I have a headache and I take a sugar pill, and then my headache goes away, does it mean I didn’t really have a headache? No of course not.

Does it mean that there was no underlying physical reason for the headache? No not necessarily, it could be that by some mechanism of the biochemistry of the brain, the headache was resolved or masked by the release of neurotransmitters or some other such capability⁴.

Patient autonomy is paramount

You might think the example of a headache is a special case, but this can be applied to all ailments. Imagine a deaf person, who for reasons of culture decides they do not want a cochlear implant. To that patient there is no treatment required, their subjective experience is that there is no problem to correct.

Where we as outside observers would consider a critical function of their body to be malfunctioning. It’s quite possible that by attempting to help the deaf person, we cause them immense psychological harm.

Take any ailment, and you are likely to find someone who is happier in the malfunctioning (by objective standards) state than if their body would be up to full functionality.

What about terminal illnesses?

It’s possible that a particularly suicidal person would be grateful for their terminal illness. Their subjective experience is that their illness is the cure to their subjective suffering. A patient is permitted to refuse any and all treatment in our society. So again we see that the subjective experience wins out even in the most extreme objective circumstances.

Suicide

We as a society generally consider a suicidal person mentally ill, to a degree that we determine the moral act is to intervene and prevent the death of the person.

Our moral calculus is that if we could resolve the mental defect causing their suicidal ideation, their long term happiness would far outweigh the cost of taking away their individual autonomy.⁵

What about mental illness?

Where the mental illness does not go so far as to cause physical injury to oneself or harm to others. All mental illness is treated based on the subjective harm that illness causes.

If I have depression, no one will forcibly interfere in my life.

• It’s my choice to live with depression if I choose.
• It’s possible that I consider it part of my life’s mission to struggle in order to achieve some larger purpose.
• I could have a belief system that prevents me from receiving mental health
• It may be that I just don’t feel like getting treatment.

We consider it morally wrong to take away someone’s autonomy, even when an outside observer would confidently state they are worse off as a result. In western society today, there are few things we value higher than personal autonomy.⁵

Even normally non-terminal illnesses are not treated, if the patient so chooses, even if this results in a completely preventable death. (For example Jehovah’s witnesses refusing blood transfusions).

What counts as mental illness?

We consider many behaviours of individuals disordered when it interrupts our ability to function well in society. For example:

• ADHD
• Autism spectrum disorder
• Learning disorders (e.g., dyslexia, dyscalculia)
• Intellectual disability
• Tic disorders (including Tourette’s syndrome)

Importantly these disorders are only considered disorders when occurring in an incompatible society. I will examine a few here, hopefully sufficient to clarify the definition.

Dyslexia

Someone with dyslexia will have substantial problems functioning in a society dominated by the written language. That same person living in an agrarian society, with very infrequent (or non-existent) use of the written language would be indistinguishable from any other person. Their subjective experience of the mental illness would be non-existent. From their point of view their brain has the same exact structure as every other member of their community.

Autism spectrum disorder

Many of the traits associated with autism - social communication, preference for routine, sensory sensitivity, intense focus on specific interests - become disabling in a society built around rapid social signaling, ambiguous norms, constant sensory stimulation, and high demands for flexible, multitasking behaviour.⁶

It’s not hard to imagine that a society could be crafted in which

• social roles are clearly defined
• communication is explicit rather than implicit
• routines are highly valued and morally important
• environmental stimulus is controlled and managed through force of government (e.g. maximum room illumination, banning of all background audio etc.)

As in the agrarian society it is hard to imagine the autistic individual feeling they had any subjective impairment. It’s quite likely a new disorder would be defined for those whose preferences were not that of this society at large.

In this instance we see that misalignment with the majority state of being in society is what primarily defines a specific brain structure as disordered.

There would likely be classes where the minority are taught how they are expected to behave in society, and how to cover up their natural behaviours.

Tourette’s syndrome

Again we see that the majority of the group sets the standard, and the minority are considered disordered for not having a brain that aligns with the majority.

In a world where 99% of the population has the behaviours associated with Tourette’s syndrome, it is likely that we might label the 1% with something like Compulsive Deficit Disorder or perhaps Expressive Suppression Disorder.

We would then look to treat “ESD” with various treatments to stimulate tics. We might prescribe Amphetamine to attempt to induce tics.

There could be classes on how to behave “normally”, learning what is expected in this world and fighting their instinct only express themselves intentionally. Masking in this world would essentially mean faking tics to fit in. In the same way we coach autistic people what society expects of them and how to mask effectively.

Colour blindness

We also see that with colour blindness, it’s only by the fact that the majority of people have the ability to see the “full” colour spectrum that we can even talk of a “full” spectrum.

In the case of people born colour blind, had they never been told they were lacking a specific ability, they would be completely unaware of it.

Moral Conclusions of Medicine

So given what we’ve explored so far, we can come to the following conclusions:

• We use medication to treat the subjective negative experience of humans.
• Whether a medication has any biological function is irrelevant if it improves the underlying subjective experience.
• To lack the ability to function effectively in the way the majority prefers to function can be deemed a mental illness.
• Regardless of our personal objections, we respect personal autonomy above all else even if results in death.

But aren’t these objective reductions in capability?

You might try to dismiss this framing as obfuscating the fact that individuals with these conditions lack the ability to fit in.

In other words, that societal norms originate in some objective basis.

With this proposed premise, it’s physically impossible (without medical/psychological intervention) for those with the above conditions to fit in to the “objective” societal reality we all live in.

This would be in contrast to subjective societal norms defined in a preferential sense, for example as one might be through religious or historic grounds.

This argument sounds appealing, but again it uses the majority state to define what counts as mandatory ability in order to fit in.

In the autistic society described above, we can imagine there are many people who would state that the inability to be direct when communicating, was the non-autistic person lacking the ability to fit in.

It could be that in this society you are expected to have one or more special interests, and that someone lacking a special interest suffers greatly due to missed opportunities or lack of social standing.

In the Tourette’s society it could be viewed that someone who does not intermittently tic, is viewed as strange.

It could be that they are seen to be less honest, because they don’t vocalise their thoughts spontaneously. It could be society developed in such a way that those who had the most distinctive tics were revered, and such that if you were born without them, you suffer greatly socioeconomically.

In these societies we would say that those individuals were “objectively lacking capabilities”. It is clear that the “objectivity” here is simply the subjective norms being so universal that they are taken to be objective.

Homosexuality

Throughout history people have tried to convert homosexuals by force. This has led to an immediate moral reaction to the concept of trying to “treat” homosexuality. To properly discuss this topic we need to temporarily suspend our moral intuitions, social conditioning, and detach the concept from the horrors of history on the topic.

The origins of homosexuality

The culmination of science on the subject is pretty conclusive at this point, there are genetic and environmental factors at play. There appears to be no single “gay gene” that we can detect, it seems that genetics may account for 25%⁷ of variation in same-sex sexual behavior, and the predictive capability of genetics for individuals is not significant.

The science also shows that sexual preference is mostly stable over time, most people don’t stop being gay later in their lives, for example.⁸

For the purposes of this analysis the specifics are not important, we can safely assume that through some combination of involuntary factors, sexual preference develops.

We will assume that the person involved has no choice over their sexual preference and is unable to voluntarily change it through force of will alone.

Can homosexuality cause harm to the individual?

There are many situations where discovering that you are homosexual could lead to a terrible set of outcomes for you as the individual.

In some countries you can be summarily executed for simply being a homosexual. Even in countries where it’s completely legal and morally accepted to be gay, there can still be substantial personal harms due to the reaction of one’s local community or family.

In a highly religious family group one can be ostracised. This is not exclusive to religious cultural norms. There are numerous countries where heterosexuality is both the norm and mandated by law with no religious basis.

Societal factor

For many countries, the concept of family duty, conformity, honour, social hierarchy, can be immensely important for one to “fit into”. The specific values a culture holds can crystalise into outright homophobia and discrimination, or it can simply be that a person is unable to live a “normal” life within that society, no matter how much they may desire to.

Subjective harm

We have no choice over the location we are born in. The culture you are raised in is a key driving force to your own sense of self, group, and place in the world. You as the individual have no control over what the norms are for the majority.

An autistic individual cannot shape an overstimulating world into their own personal quiet place. Just as a gay person is unable to change the morals basis and values of the majority of their neighbours.

With this in mind, it’s clear that being attracted to the same sex can cause a great deal of internal, subjective, distress in an individual. We can easily conceive of a person for which this distress harms them to a far more substantial degree than many recognised mental disorders. It’s plain to see that someone, given the choice, might choose to have Autism Spectrum Disorder over same-sex attraction.

Can homosexuality be modelled as a mental illness?

By all standards that apply to other currently prescribed mental illnesses, we see that homosexuality can be modelled to have the same set of factors, deemed severe enough to warrant medical intervention.

As far as it can be reasoned, there is no objective basis to classify autism spectrum disorder a “disorder” while declaring it morally wrong to label homosexuality with the same classification.

Example society

It seems that by all the criteria defined above it is logically consistent in certain cultural contexts that we could imagine a mental disorder being defined for homosexuality.

In Japan for example, it is likely that all criteria required would be met:

• High societal pressure to conform with traditional sexuality
• Significant social, psychological, economic consequences for non conformity
• Subjective experience of harm
• Involuntary affliction, no choice in your sexual preference

It follows logically that Japan should be permitted to define homosexuality a mental illness and offer voluntary treatment (if such a treatment existed).

Logically we must also conclude that Japan would be morally coherent with western morality to conduct research on consenting adults in an effort to change their sexuality. To state otherwise would be hypocritical in relation to our acts around other mental illnesses.

We can’t medically treat homosexuality

You might think that this entire discussion is a moot point because we have no medical or psychological intervention that could possibly change someone’s sexual preferences. But this raises and important question, why do we believe it is medically impossible to change a person’s sexual preference?

It has long been considered immoral to carry out experiments in changing sexual orientation. No significant scientific research has been carried out since the 1970s. This has the makings of a self-fulfilling prophecy.

The argument from ignorance - “since we have not been able to find a method to change sexuality effectively, one must not exist” - is even more preposterous given that research into the topic is effectively banned.

• Canada Criminal Code amendment (Bill C-4, 2021) No research exemption. Applies regardless of consent.
• More than 20 states + D.C. have bans. Most explicitly prohibit licensed professionals from engaging in conversion practices, which blocks clinical trials.
• Germany Federal ban (2020)
• France Criminal ban (2022)
• United Kingdom - professional bans NHS, GMC, BPS prohibit practitioners from engaging in conversion therapy

To state that the science shows there is no way to change a person’s sexual preferences is misleading at best.

In addition, there are many conditions we simply have no viable treatments for, yet we still recognise them as disorders. E.g. Alzheimer’s disease, many diagnosable personality disorders.

Sexuality is too complex to be altered by medical intervention

To claim that sexuality is too complex to be meaningfully changed by medication or psychotherapy techniques is simply untrue.

• SSRIs/SNRIs (antidepressants) are widely documented to cause sexual side effects across desire, arousal, and orgasm. PMC
• Flibanserin (Addyi) has randomized controlled trial evidence showing improvement on validated desire and distress measures versus placebo in women with HSDD. PubMed
• A 2024 systematic review reports evidence that mindfulness-based interventions can be effective for sexual arousal/desire disorders PMC

We also see a case of an individual reporting unprecedented homosexual attraction as a result of psychotropic medication.⁹ The attraction ceased when an alternate medication was prescribed.

Experimentation on homosexual children would be immoral

It seems apparent that childhood plays a key role in the formation of sexual preferences. In order to make a serious effort in this area of study we would likely have to experiment on children.

This violates one of the highest western moral values, the value of personal autonomy discussed above. As a child cannot consent to voluntary experimentation, such an effort would necessarily be immoral by that standard.

This standard is satisfied in the case a reasonable adult, with parental/carer responsibility will make the decision on the child’s behalf. With the view that if we do not act now, it will be too late to correct the consequences later on.

This is the reasoning being used to justify experimenting on chemically (irreversibly^{10 11}) transitioning children to a closer approximation of the opposite sex¹², in order to treat gender dysphoria.

Common arguments

Gender is not the same as sexuality

Proponents of medical diagnosis and treatment of children with gender dysphoria may claim that sexuality is fundamentally different to gender in some way. Their argument being that these differences mean that we should chemically treat gender dysphoria, but that we should not treat sexuality.

It’s hard to get clarity on what proponents of this line of reasoning actually believe the differences are, but from what I can tell it is a subjective feeling that the two are different. Appealing to one person’s subjective feelings can never be a rational argument, because we can simply appeal to another person who has the opposite feeling.

Gender is part of someone’s identity

A common distinction made, is that gender is part of your identity whereas sexuality is not. Again this is just an arbitrary redefining of the word “identity”. For many, sexuality is a key part of their identity, for many it is not.

It also hides the implicit axiom that we must never change an attribute of someone’s identity for some unspecified reason. When we do this all the time through psychological interventions. Even if they explicitly ask for that part of their “identity” to be changed.

Transgender individuals want to change, homosexuals don’t

This is a biased perspective (likely selection bias). As laid out above, it is very easy to imagine many vast numbers of homosexual people who would happily accept medical treatment for their “disorder” if such a treatment existed. This argument also does not actually refute any premise above.