The measurement, analytic, and interpretive decision-making displayed in much (though certainly not all) of this literature is troubling, indicative of a lack of standards, poorly defined concepts, impressionistic conclusions derived from small numbers of interviews, the politicization of results, and the overall novelty of the field.
According to a purported deep dive into the social scientific literature, discrimination against LGBT Americans has yielded “a huge human toll.” That was the news greeting readers of the December 19 issue of the Washington Post. Since I was the principal author of the amicus brief that authors Nathaniel Frank and Kellan Baker feature (as a foil) in the first paragraph of their Post article, I figured I should read it carefully.
I did, and what appeared there isn’t new news. It’s the same weak data, small samples, and politicized conclusions to which we have been treated for years. Half of the six studies Frank and Baker discuss in the Post even fail to “prove” that patterns of discrimination widely, systematically, and profoundly harm LGBT Americans.
The pair report that they “spent two years conducting the largest known review of the peer-reviewed scholarship on the relationship between anti-LGBT discrimination and health harms,” but no such comprehensive document is evident online—only a brief overview of findings and a primer on their methods. They began by screening more than 11,000 peer-reviewed articles, a process that yields—in the end—300 articles probing the association between anti-LGBT discrimination and health and well-being.
I don’t blame them for limiting their analyses. The measurement, analytic, and interpretive decision-making displayed in much (though certainly not all) of this literature is troubling, indicative of a lack of standards, poorly defined concepts, impressionistic conclusions derived from small numbers of interviews, the politicization of results, and the overall novelty of the field. It was, after all, not many decades ago that the study of sexuality commenced. It’s been dogged by weakness the entire way. Alfred Kinsey was not just a pathfinder in sexual science; he was the first of many methodological offenders—plenty of whom have had a vested interest in the results of their own studies.
As I said in my amicus brief, that anti-gay discrimination can diminish psychological and physical health is widely acknowledged. But with society’s recent changes in norms and values, there is little evidence that chronic, repetitive, and intense discrimination based on sexual orientation remains a health issue. Moreover, the “minority stress” perspective privileged in such research opposes the idea that gays and lesbians should be seen merely as victims of social stress. They—like any other minority group—have long drawn strength from association and from establishing alternative structures and values, all of which temper the effect of discrimination. Indeed, the concept of resilience, or rebounding from adversity, has a rich history across the social sciences.
Frank and Baker, however, capitalize on the recent explosion of interest in transgender studies to extend the narrative of oppression. Sociologists call this “frame extension.” To merit continued attention to a population whose average income often well exceeds that of heterosexual Americans, the “frame” has been extended to encompass self-identified transgender persons, whose social and workplace experiences, not to mention incomes, appear far more challenging than those of gay and lesbian Americans.
Indeed, the Post’s discussion of such research begins with a study of the cortisol (stress hormone) levels of 65 transitioning (female-to-male) study participants, asserting that “encountering barriers in access to public restrooms predicted higher levels of stress.” But even here a reading of the study shows something different. There is no measure of “encountering barriers in access to public restrooms.” The barrier is internal—a measure of what respondents reported feeling when “using gender-specific public bathrooms.” In other words, they use stress to predict stress. No wonder it’s statistically significant—but barely, and only detectable first thing in the morning after respondents awoke. There were no differences here in cortisol levels the rest of the day. It’s an odd, tiny, and rather weak study to lead with. Meanwhile, they elected not to assess solid international studies, including one that documents how “trans women” (on estrogen) exhibit a doubled risk of stroke or deep vein thrombosis. Now that’s a health outcome. And it’s not the result of stigma.