An Open Letter to the Bishops
by the Catholic Medical
Association Task Force
May 29, 2002
A Letter to the Catholic Bishops
Your Excellencies:
As a Catholic psychiatrist and psychologist who have treated a significant number of
priests from various dioceses and religious communities over the past 25 years for
same-sex attraction (SSA or homosexuality) and for pedophilia and ephebophilia (homosexual
behavior with adolescents), we believe that our particular expertise and those of our
colleagues in the Catholic Medical Association may be of help to the American bishops as
they seek to create effective long term strategies to prevent the recurrence of the
problems in which the Catholic Church in the United States now finds itself enmeshed.
Many have pointed out that solving the problem of sexual abuse by clergy will
necessarily involve addressing the problem of SSA among priests. Bishop Wilton D. Gregory,
president of the U.S. Conference of Catholic Bishops, admitted at a press conference in
Rome on April 23 the existence of an ongoing struggle to ensure that the Catholic
priesthood is not dominated by homosexual men.
As the revelations of abuse have become public it has become increasingly clear that
almost all the victims are adolescent males, not prepubescent boys. The problem of priests
with same-sex attractions (SSA) molesting adolescents or children must be addressed if
future scandals are to be avoided.
In treating priests who have engaged in pedophilia and ephebophilia we have observed
that these men almost without exception suffered from a denial of sin in their lives. They
were unwilling to admit and address the profound emotional pain they experienced in
childhood of loneliness, often in the father relationship, peer rejection, lack of male
confidence, poor body image, sadness, and anger. This anger, which originated most often
from disappointments and hurts with their peers and/or fathers, was often directed toward
the Church, the Holy Father, and the religious authorities. Rejecting the Churchs
teachings on sexual morality, these men for the most part adopted the utilitarian sexual
ethic which the Holy Father so brilliantly critiqued in his book, Love and Responsibility.
They came to see their own pleasure as the highest end and used others including
adolescents and children as sexual objects. They consistently refused to examine
their consciences, to accept the Churchs teachings on moral issues as a guide for
their personal actions, or regularly avail themselves of the sacrament of penance. These
priests either refused to seek spiritual direction or choose a spiritual director or
confessor who openly rebelled against Church teachings on sexuality. Tragically, these
mistakes allowed these men to justify their behaviors.
The Bishops, individually and collectively, should develop screening protocols which
will identify men who may pose a risk to others and who cannot live the chaste celibacy
required of a priest. This is essential to protect the Church and her children from
further pain, sorrow and future scandals. While no screening system is absolutely
foolproof, sufficient research is available to develop efficient tools for this task.
One of the major problems we have discovered in discussing this issue with the clergy
and the laity is the enormous amount of misinformation about the nature, origins, and
treatment of homosexuality/SSA. This is not accidental. For over twenty years, activists,
intent on changing the laws on sexual orientation, have put forward a massive public
relations campaign specifically designed to spread misinformation that will change the
social acceptance of homosexuality.
For example, many people sincerely believe that scientific research has produced
conclusive evidence that homosexuality is a genetically inherited condition, determined
before birth, and cannot be changed. In fact, no such evidence exists. Several studies
have been promoted in the media as providing the proof, but when one reads
these studies, one discovers the authors do not even claim to have presented such proof.
There is no verifiable evidence that same-sex attraction is genetically determined. If
same-sex attraction were genetically determined, identical twins would always have the
same sexual attraction pattern. Numerous studies of twins have shown that this is not the
case. And there are numerous studies documenting change of sexual attraction pattern (see
Homosexuality and Hope, available at www.cathmed.org).
One of the reasons why people have been so willing to accept the idea that same-sex
attraction is genetically determined is their own experience with men who are extremely
effeminate and have been so since early childhood. This condition of extreme effeminacy is
called Gender Identity Disorder (GID). The differences between boys with GID and other
boys are so profound, that those observing them conclude that the boys with GID must have
been born that way. Those who treat GID have found that effective family therapy in which
the father bonds more closely with the son and affirms his sons masculinity can in a
relatively short time result in the elimination of these symptoms and the emergence of
normal boyish behavior. Tragically, because this information is not widely known most boys
with GID do not receive treatment and approximately 75% of them will go on to develop SSA
in adolescence. Unfortunately, if these boys come from Catholic families, those around
them may point them toward the priesthood. Because they arent attracted to girls,
people wrongly assume that the celibate life will be easy for them.
In our practice, we have seen many boys who suffered from distant father relationships,
lacked hand eye coordination and subsequently were subjected to humiliating teasing from
peers because of their inability to play sports. These and other factors lead to feelings
of male inadequacy and loneliness and later to homosexual attractions. The sooner these
problems are addressed in therapy, the more hope there is for a full recovery.
For example, a 26 year old client had experienced severe peer rejection as child and
teenager because of his inability to play sports. In addition, his father was distant, and
his mother overly dependent. At age 10 he began to experience same sex attractions which
intensified in his adolescence. Fortunately, as a faithful Catholic he never gave into the
temptations to act on these feelings. During therapy he was able to identify the causes of
his same-sex attraction, to forgive those who had hurt him, and to develop a stronger and
comforting relationship with God the Father and St. Joseph as another loving father, Jesus
as his loving and accepting friend at every life stage and Our Lady as a cheerful giving
mother. As the emotional pain was resolved, his male confidence grew, his same sex
attraction diminished markedly and later resolved. He came to realize that he was not
homosexual, but a man who had been wounded emotionally in many relationships from early in
his life and who could be healed.
Michael (not his real name) was a seminary student when he came into treatment for same
sex attractions. He gradually understood that the origins of the same sex attractions
arose from a very negative body image which he had had from the time he was a young boy
because he had been overweight. He was regularly picked on by his peers in elementary and
middle school because of his physical appearance. He has intense loneliness in peer
relationships from his childhood and adolescence. During his several years in therapy, he
worked at trying to forgive his peers who ridiculed his physical appearance. He also
attempted to reject the cultures obsession with physical appearance, and began to
thank God for his masculine gifts and body image. He also meditated upon the Lord being at
his side as his best friend in elementary and middle school. He benefited by reflecting
that his body is a temple of the Holy Spirit, in addition to asking for a certain sense of
detachment, and by being thankful for his God-given body. Finally, he also worked out
physically to prevent more weight gain. Slowly his masculine identity and body image
improved. His deep inner loneliness lessened through a profound sense of being loved by
the Lord.
The Catechism of the Catholic Church states that homosexualitys psychological
genesis remains largely unexplained (#2357). While it is understandable that the
writers of the Catechism would not wish to make a definitive statement about a question
which is at the center of such a contentious public debate, this statement does not
accurately reflect what is known about homosexuality. There is ample evidence that
same-sex attraction has many different causes. These lead to significant childhood and
adolescent emotional pain and psychological problems. Among males these could include a
weak masculine identity, social isolation and loneliness, peer rejection or a poor body
image and in females, a mistrust of male love or a weak feminine identity. No one can say
this is the cause for same-sex attraction as though there were a single cause,
but an individual can come to understand the origins of his or her own same-sex
attractions through insight gained in therapy.
Men and women experiencing same-sex attraction may rightly feel that they have
always felt different, but that doesnt mean they were born that way. Children
are born either male or female, but they have to learn what it means to be a man or a
woman. They have to identify with and be accepted by their same-sex parents
and peers. If they are going to grow up psychologically healthy they have to feel safe and
comfortable with their masculinity or femininity. If, for whatever reason, they fail to
pass successfully through this essential developmental stage, they may in adolescence
develop same-sex attractions.
There has been a massive campaign to hide this information from the general public and
from those who sincerely wish to be free from same-sex attraction. In 2000, Dr. Robert
Spitzer of Columbia University, who had been instrumental in the removal from the American
Psychiatric Associations Diagnostic and Statistical Manual of homosexuality as a
diagnosis in 1973, was challenged by men and women healed of their same sex attractions
that change is possible. Spitzer interviewed 200 men and women claiming to have achieved
significant change and found that 60% of the males whom he studied identified themselves
as heterosexual 5 years after their treatment ended. Most of those who were successful
also participated in faith based support programs (Throckmorton, 2002).
While there are numerous reports of substantial change through therapy alone, programs
which rely on God or which are specifically Christian provide significant help in dealing
with the compulsive behaviors, loneliness and lack of confidence that accompany SSA. This
should come as no surprise to Catholics who already know the power of Christs
healing love. To those who wish to be free from same-sex attraction it can be said with
confidence that God didnt make them that way and He wants them to be free. The good
news is that SSA attraction can respond to therapy and that membership in a support group
such as Courage can help a person to find healing and freedom.
The road to freedom, however, is long and arduous. For many individuals, it is often
accompanied by other serious psychological problems and addictions. Three recent well
designed studies (Fergusson, Herrell, and Sandfort) have shown that persons with SSA
suffer from other psychological problems at a rate substantially higher than those without
SSA. Some of these problems, such as pathological narcissism and borderline personality
disorder are very difficult to treat.
Additionally, men with SSA are more likely to suffer from substance abuse problems,
sexual paraphilias, and sexual addiction. Such problems complicate recovery. Also, men
with SSA are more likely than other men to have a history of childhood sexual abuse (CSA).
While arriving at an exact percentage is difficult, some experts suggest that about 16% of
all men have experienced CSA. Several studies of men self-identified as homosexual
revealed that 40% had a history of CSA. Given the high level of long term psychological
problems associated with a history of CSA, it is not surprising that men with SSA have
numerous problems.
There are other serious problems which need to be addressed. For example, sexual
harassment exists at certain seminaries. Any Catholic institution which knowingly
tolerates sexual harassment heterosexual or homosexual betrays the moral
teaching of Christ and contributes to the suffering of others. It also risks incurring
financial liability.
Recommendations
Healing for Victims of Sexual Abuse
Forgiveness has been demonstrated in both research studies and in clinical experience
to be of great value in healing the wounds of anger, sadness, mistrust and loss of
confidence in those who have been sexually abused (Enright, 1998, Enright &
Fitzgibbons, 2000). In addition to asking for forgiveness Bishops should encourage the
victims and their families to consider pursuing the healing path of understanding and
forgiving those who have hurt them. The resolution of anger will protect their emotional
and mental health and assist in overcoming the pain of the past.
Treatment for priests with SSA
We observed many priests grow in holiness and in happiness in their ministry as a
result of the healing of their childhood and adolescent male insecurity and loneliness
and, subsequently, their same sex attractions. This healing process has been described in
Fr. John Harveys book, The Truth About Homosexuality and in the statement of the
Catholic Medical Association, Homosexuality and Hope, available at www.cathmed.org.
Bishops would also see this healing if they encourage priests with SSA to pursue
appropriate therapy with those loyal to the Churchs teaching. Most males with SSA
had painful childhood and adolescent peer relationships. Under the stress of loneliness
and insecurity in adult life, there can be an unconscious association to this adolescent
and childhood pain. Attractions to children, adolescents or adult males then develop in an
unconscious attempt to gain acceptance and lessen the pain of sadness, loneliness and lack
of male confidence. These attractions become eroticized and then homosexual behaviors
begin. The treatment of the emotional pain in these priests is essential in order to
protect the Church and her children from further sorrow and scandal.
Priests, with or without SSA, who have themselves been the victims of childhood sexual
abuse should receive counseling. Only a small percentage of victims of childhood sexual
abuse will go on to abuse children, but a significant percentage will suffer from various
problems which affect their ministry.
Our experience over 25 years has convinced us of the direct link between rebellion and
anger against the Churchs teaching, and sexually promiscuous behaviors. This appears
to be a two way street: those who are sexually active dissent from the Churchs
teaching on sexuality to justify their own actions, while those who adopt rebellious ideas
on sexual morality are more vulnerable to become sexually active, because they have little
to no defense against sexual temptations. Growth in forgiveness and in humility are
essential in the treatment of such priests.
Finally, priests should be screened for homosexuality by their bishops or religious
superiors prior to being considered for a position of responsibility in a diocese,
religious community or in the U.S. Conference of Catholic Bishops. The previous attitude
of winking at homosexuality in priests must end. Otherwise, all Church
teaching on sexual morality is undermined. Also, complaints by priests of aggressive
homosexual behavior in rectories and religious communities should be addressed and no
longer ignored.
The evaluation of seminarians
Protocols should be developed which will allow those professionals who screen
candidates for the priesthood to identify those individuals with serious problems, to
recommend therapy for those with correctable problems, and to accept those who can live
chaste celibacy and pose no threat to others. Simply asking a candidate if he is a
heterosexual or a homosexual, or if he is sexually interested in adolescents or children
is not sufficient. Proper history taking, a clinical interview, and psychological testing
correctly interpreted will uncover most current and potential problems. Two different
studies have found that the answers to a small number of questions about childhood and
adolescent experiences included within a larger questionnaire allowed the clinical
interviewer to conclude, with 90% accuracy, whether the subject was a heterosexual or a
homosexual.
When the evaluation reveals probable SSA, the candidate is not automatically excluded
from consideration. If he is willing to do the hard work required to come to freedom from
his emotional pain, his same sex attractions will be resolved and then he can reapply
later. The Church should not take the moral risk of allowing someone with SSA to enter the
seminary. Also, a period of sexual abstinence for five years should be required of those
with SSA prior to entering the seminary.
It should be noted, that many men with SSA will have problems besides their SSA which
could make admission to the seminary inadvisable. For example, men with SSA are more
likely to have problems with compulsive masturbation, other sexual addictions, substance
abuse problems, history of childhood sexual abuse, and depressive illness.
It is essential that mental health professionals involved in any way with the
evaluation of candidates for seminary or with treating seminarians or priests, as well as
the faculty at the seminaries support the teaching of the Church on sexuality,
particularly on homosexuality. In our experience, there are some dioceses and religious
communities who rely upon the work of mental health professionals who actively disagree
with the Churchs sexual morality. Given the specialized nature of evaluating
candidates for seminaries we recommend that the psychologists and psychiatrists who engage
in this important work be required to participate in ongoing educational programs given by
those loyal to the Churchs teaching on sexual morality.
Seminary/Formation Faculty
Pope John Paul II at his meeting with the American Cardinals on April 23, 2002 stated:
People must know that bishops and priests are totally committed to the fullness of
Catholic truth on matters of sexual morality, a truth as essential to the renewal of the
priesthood and the episcopate as it is to the renewal of marriage and family life.
Many faculty members of seminaries and religious houses do not adhere to the truth on
matters of sexual morality and faith. For decades moral relativism, proportionalism, and
situational ethics have been taught in these centers of formation. These teachings have
contributed to the present crisis in the Church. Seminarians who support Church teaching
on sexual morality, Scripture, the liturgy, and fundamental moral theology have been
labeled as rigid and often expelled from seminaries. Seminary faculty members, members of
formation teams in religious communities, and individuals on vocations committees
who have a rebellious and dissenting or homosexual agenda are driven to remove from the
seminary males who are loyal to the Churchs teachings on matters of faith and
morals.
We recommend that Cardinals, Bishops and religious superiors either personally
interview or send visitation teams to interview all faculty members of seminaries and
formation teams. They need to be certain that these individuals are loyal to the Holy
Father and the Churchs teaching on faith and morals and that they refrain from
intimidating seminarians into questioning the value of orthodoxy. Those who are not loyal
should be removed.
In order to protect the priesthood from further homosexual behavior with adolescent
males by priests, we recommend ending the referral of seminarians to seminaries which are
well known to be heterodox in regard to homosexuality. The purification of the seminaries
is essential to the protection of the Church and her children. Finally, seminarians,
including those in religious orders, with homosexual tendencies should not be ordained
until they understand the emotional causes of their attractions, work to resolve them, and
are emotionally healthy.
The availability of education and treatment in every diocese
Having seen the suffering caused by untreated SSA, the burden of sexual sin and the
freedom that comes when the emotional problems are addressed and healed, we believe that
nothing is more pastoral or more loving than the clear proclamation of the Churchs
teaching on sexual morality, accompanied by effective, accessible treatment. We recommend
that Bishops and religious superiors instruct their priests to communicate the fullness of
truth on sexual morality in their parishes and schools
Courage is the only recovery program for those with same sex attractions which adheres
to the Catholic moral teaching on homosexuality and has been endorsed by the Vatican. This
program should be available in every diocese for both laity and priests. If priests and
laity do not have access to therapy which can help them come to the freedom proper to the
children of God and support groups like Courage, they may fall into despair and feel that
the Church has placed upon them a burden that is impossible to bear. Unfortunately, in
some dioceses groups, such as Dignity, which do not accept the Churchs teaching on
sexual morality, have a voice, while Courage is not welcome.
Priests need to understand the origins of SSA and the healing approaches which have
been demonstrated to be effective. In addition, because of the tremendous confusion over
homosexuality, it would be beneficial that conferences for priests and seminarians be
given by experts such as Fr. John Harvey, O.S.F.S., the founder of Courage, and by other
mental health professionals who accept the Churchs teaching on homosexuality and are
experienced in the successful treatment of SSA. Education for priests concerning the
nature, origins, and treatment of SSA should increase their compassion and help priests
who regularly deal with these problems in the confessional.
Unfortunately, conferences have been offered to priests and seminarians in which
homosexuality is presented as being genetically determined and no hope for healing is
offered. The recognition of chastity as a healthy virtue is rejected. Chastity, in the
experience of many mental health professionals, is, in fact, a positive quality in any
individuals life.
At the present time, a number of treatment centers to which priests are sent for sexual
disorders treat homosexuality as an identity to be embraced. Influenced by the politics
within the American Psychiatric Association and American Psychological Association, the
possibility of healing is censured. Patients are encouraged to participate in 12 step
groups for compulsive sexual behaviors, but the emotional origins of their same sex
attractions are not explored nor is a plan offered for healing unresolved emotional pain.
These vulnerable men are often returned to ministry with serious untreated problems. Fr.
Harveys program could be modified for incorporation into the present inpatient
treatment programs in group and individual therapy, as well as in spiritual direction.
Since training in the treatment of SSA and GID in conformity with the Catholic
understanding of the human person is not being provided at most secular institutions, it
is important that this training be available either in Catholic institutions or through
separate programs.
On April 23, 2002 the Holy Father encouraged the American Cardinals: We must be
confident that this time of trial will bring a purification of the entire Catholic
community, a purification that is urgently needed if the Church is to preach more
effectively the Gospel of Jesus Christ in all its liberating force. Now you must ensure
that where sin increased, grace will all the more abound (Romans 5: 20). So much pain, so
much sorrow must lead to a holier priesthood, a holier episcopate, and a holier Church.
There are reasons for hope. The problems of homosexuality in the priesthood have been
painfully uncovered and need to be addressed. There is no proven genetic basis for
homosexuality. The emotional wounds which cause same sex attractions can be identified and
healed. Large numbers of people, including clergy, who had SSA are now substantially
cured, especially if they brought the power of faith into the healing process. These men
and women no longer view themselves as being homosexual. The statement of the Catholic
Medical Association on homosexuality, Homosexuality and Hope t(www.cathmed.org), should be
made available to all priests, educators and Catholic families. With the Lords help,
the Catholic priests who struggle with homosexuality can be healed.
Richard P. Fitzgibbons, M.D..
Peter Rudegeair, M.A.
Eugene F. Diamond, M.D.
For the Catholic Medical Association
159 Washington Street, Suite 3
Boston, Massachusetts 02135
Richard P. Fitzgibbons is a psychiatrist and director of Comprehensive Counseling
Center, W. Conshohocken, PA. He is the author of chapters on the origins and healing of
same sex attraction disorder in The Truth About Homosexuality, Rev, John Harvey,
O.S.F.S.(ed), Ignatius Press 1996, and Homosexuality and American Public Life, C. Wolfe
(ed.), Spence, 1999 and coauthor of Homosexuality and Hope of the Catholic Medical
Association, 2000, www.cathmed.org. He has authored articles on Resolving Loneliness in
Priestly Life and Resolving Conflicts in Priestly Relationships in The Priest.
Peter Rudegeair is a licensed psychologist at Comprehensive Counseling Services in W.
Conshohocken, PA. He is a coauthor of Homosexuality and Hope of the Catholic Medical
Association. He has given many conferences to priests and seminarians, Courage groups,
educators and physicians on the origins and healing of same sex attraction disorder.
Eugene Diamond is a pediatrician in Chicago and professor of pediatrics at the Loyola
University School of Medicine. He chaired a task force of the Catholic Medical Association
which produced the document Homosexuality and Hope and has authored 200 articles on
pediatrics and bioethics.
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