Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
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Year : 2008  |  Volume : 29  |  Issue : 1  |  Page : 54-56

Abstract from current literature: Homosexuality

Department of Skin and VD, Medical College, Vadodara, India

Correspondence Address:
Y S Marfatia
OPD-1, Department of Skin and V. D. Medical College, Vadodara
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Modi M, Sarna J, Sharma A, Marfatia Y S. Abstract from current literature: Homosexuality. Indian J Sex Transm Dis 2008;29:54-6

How to cite this URL:
Modi M, Sarna J, Sharma A, Marfatia Y S. Abstract from current literature: Homosexuality. Indian J Sex Transm Dis [serial online] 2008 [cited 2023 Dec 10];29:54-6. Available from:

Homosexuality: Nature or nurture

Origin of homosexuality is one of the most debated topics by sociobiologists. The current debate is whether or not homosexuality is a result of a person's environment and surroundings, or of his biology and genetics. Biological theorists have found substantial instances of anatomical, genetic, and endocrine evidence to support their argument. The pioneering research of Alfred Kinsley became the widely popularized Kinsley Scale of Sexuality. In 1957, Karen Hooker executed the first psychological test for biological determinism on both homosexuals and heterosexuals and concluded a zero correlation between social determinism of sexuality. As a result of Hooker's finding, the American Psychological Association (APA) removed homosexuality from its Diagnostic and Statistical Manual of Psychological Disorders in 1973. In 1990, Swaab found in his postmortem examination of homosexual males' brains that a portion of the hypothalamus (suprachiasmatic nucleus) was twice the size of its heterosexual counterparts. In 1991, Simon LeVay conducted another experiment on hypothalamus of the human brain and concluded that homosexual and heterosexual men differ in the central neuronal mechanisms that control sexual behavior. This difference in anatomy was no product of upbringing or environment, but rather prenatal cerebral development and structural differentiation. In two separate studies, Ernest Kallman and Micheal Bailey and Richard Pillard found a higher concordance rate among monozygotic twins suggesting a genetic link. Later on, Hamer examined the possibility of homosexuality being an X-linked trait. The Superior Heterozygote Theory states the phenotypic (actual) expression of homosexuality is the result of homozygosity for recessive (nonexpressed but present) genes. While all of this scientific experimentation and conclusion seems evidentiary, sociobehaviorists are not convinced. Most social theorists see childhood elements as the largest contributing factors to homosexuality. Often they examine childhood play patterns, early peer interactions and relations, differences in parental behavior toward male and female children, and the role of gender constancy in the household. Two predominant social theorists on homosexuality are David Halperin and Jean Foucault. Both have largely contrasting ideas on the environmental contributions to the formation of an individual's homosexuality. Foucault believed that the depth of desire is only sexual preference, that it is nothing more than superficial tastes and preferences. Halperin contrasts this with saying that homosexuality does go deeper than superficial tastes, and that homosexuality is a psychological condition, with much deeper roots than mere sexual preference. Perhaps there is no one answer that sexual orientation, whether homosexual or heterosexual, gay, straight, lesbian, or bisexual, all are a cause of a complex interaction between environmental, cognitive, and anatomical factors, shaping the individual at an early age.

Ryan D. Johnson, Homosexuality: Nature or Nurture (cited on 30/03/08). AllPsych Journal, April 30, 2003. Available from

The health risks of gay sex

Sexual relationships between members of the same sex expose gays, lesbians, and bisexuals (GLB) to extreme risks of sexually transmitted diseases (STDs). There are five major distinctions between gay and heterosexual relationships in terms of, levels of promiscuity, physical health, mental health, life span, and monogamy. Prior to the AIDS epidemic, a 1978 study found that 75 percent of white, gay males claimed to have had more than 100 lifetime male sex partners. From 1994-1997, the percentage of homosexual men reporting multiple partners and unprotected anal sex rose from 23.6% to 33.3%, which is largest among men under 25 years of age. The medical consequence of this promiscuity is that gays have a greatly increased likelihood of contracting HIV/AIDS, syphilis, and other STDs. Male homosexual behavior possess greater health risks not only because of promiscuity but also because of nature of sex, which is not simply either active or passive, but may involve penile-anal, mouth-penile, hand-anal, or mouth-anal sexual contact for both partners. The potential for injury is exacerbated by the fact that the intestine has only a single layer of cells separating it from highly vascular tissue, that is, blood. Therefore, any organisms that are introduced into the rectum have a much easier time establishing a foothold for infection than the wound in a vagina. The end result is that the fragility of the anus and rectum, along with the immunosupressive effect of ejaculate, make anal-genital intercourse a most efficient manner of transmitting HIV and other infections. Diseases like anal cancer, giardiasis, amoebiasis, hepatitis B and C, kaposi's sarcoma, HIV, etc. are found in extraordinary frequency among male homosexual practitioners. It is well established that there are high rates of psychiatric illnesses, including depression, drug abuse, and suicide attempts, among gays and lesbians which was attributed to homophobia. According to one study, gay and bisexual men lose up to 20 years of life expectancy. Monogamy, meaning long-term sexual fidelity, is rare in homosexual relationships. One study reported that 66% of gay couples reported sex outside the relationship within the first year, and nearly 90% if the relationship lasted five years. Encouraging people to engage in risky sexual behavior undermines good health and can result in a shortened life span. Yet that is exactly what employers and governmental entities are doing when they grant GLB couples benefits or status that make GLB relationships appear more socially acceptable.

DIGGS JR. The Health Risks of Gay Sex (cited on 30/03/08). Catholic Education Resource Center. Available from

Criminalising high-risk groups such as MSM

All three core groups affected and infected in the HIV epidemic - men having sex with men (MSM), sex workers, and injecting drug users - are criminalized in India. These core groups were not only invisible to health structure but were also stigmatized and criminalized under Indian law, so the government had to search and hunt these populations. MSM in India are at significant risk of HIV infection because of frequent anal sex (45-55% of MSM in India practice anal sex), infrequent use of condom for anal sex (5-20%), large number of partners (between 11-28 casual partners per month), and poor health-seeking behavior, with only 20-30% of MSM going for STI checkup. In Humsafar Trust prevention programs, for example, it was discovered that conflating gender and identity to fit into a particular kind of risk behavior did not work. While effeminate homosexual men, or kothis, were said to be at the highest risk, we found from our grassroots work that, behaviorally, homosexual men who had furtive sex in public toilets, parks, and beaches were as much at risk as castrated hijras in sex work. Even among eunuch, the Humsafar Trust street outreach program indicated that nearly 75% of cross-dressing males were not castrated; they were fully functional males, who also penetrated other males if offered adequate monetary incentives. MSM also include bisexuals, a huge bridge population or link between a subpopulation with very high-infection rates and a subpopulation with much lower-infection rates. In India, only in the third stage of the National AIDS Control Program (NACP- III) did the NACO acknowledge that MSM required urgent attention. Behaviorally homosexual population has finally been identified as a core segment with which national health programs have to engage seriously if NACP III is to have a modicum of success. The program is yet to address some major difficulties in providing support services to MSM. There is no sensitivity to MSM issues. STI clinics directed at oral or anal sex services do not exist, and STI doctors are not culturally sensitized to MSM issues. Further, MSM community-based organizations are not encouraged to take up health issues which directly affect their communities. Basic structural changes are necessary for health programs to be effective. These include deletion or reading down of Section 377 of the Indian Penal Code on sodomy, decriminalizing sex work, and changing the approach to narcotics control by tightening up on trafficking and not punishing end-users. Only then can we openly talk about stigmatized behaviors like anal sex, intravenous drug use, and sex work, and engage these groups.

Kavi AR. Criminalising high risk groups such as MSM (cited on 30/03/08). Available from

Medical consequences of what homosexuals do

Homosexuals behave similarly world over and the changes in sexual behavior that have been reported to have occurred in some groups have proved for the most part, to be transient. Homosexuals fellate almost all of their sexual contacts during oral sex, ingesting semen, and thereby increasing risk of contracting infections like hepatitis A, B, and gonorrhea. Almost 90% of gays engage in rectal intercourse. It is probably the most sexually efficient way to spread hepatitis B, HIV, etc. as sperms readily penetrate the rectal wall (one cell layer thick) causing immunological damage. Tearing and bruising of anal wall occurs during anal sex or fisting, which further enhances the susceptibility to infection. About 80% of gays admit to fecal sex. It is the major route of contracting hepatitis A, typhoid fever, and other enteric parasites. About 29% reported to engage in urine sex. Many of them engage in sadomasochism, that is, they engage in torture for sexual fun. The median age of death for homosexuals was 39 years if AIDS was the cause of death and 42 years if they died of something other than AIDS. Less than 2% survived to old age. Two point eight percent of gays died violently. They were 116 times more apt to be murdered; 24 times more apt to commit suicide; and had a traffic-accident death - rate 18 times the rate - compared to aged white males. Heart attacks, cancer, and liver failure were exceptionally common. Twenty percent of lesbians died of murder, suicide, or accident - a rate 487 times higher than that of white females aged 25-44 years. Homosexuals are sexually troubled people engaging in dangerous activities. Because we care about them and those tempted to join them, it is important we neither encourage nor legitimize such a destructive lifestyle.

Paul Cameron . Medical consequences of what Homosexuals do (cited on 30/03/08). Available from


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