by Donald West
My book reviewed evidence about the supposed causes of homosexual behaviour, its frequency and its manifestations in different cultures and the implications for contemporary society. The text appeared to be a dispassionate discussion from the standpoint of a detached observer, although the real purpose was a plea for tolerance from a member of a despised group. I argued that they (I should have written “we”) were not just a tiny minority, or a bunch of psychopaths, as we were so often depicted in current medical writings, but ordinary individuals capable of contributing to society given a chance. For a young, unmarried professional to have stuck his neck out so recklessly seems, in retrospect, quite crazy. The book might well have been publicly denounced as the ravings of a filthy pervert, but I was protected by the hypocritical medical label, the flattering foreword by a leading criminologist, Hermann Mannheim, the culture of avoiding personal questions about sexuality, and the fact that to accuse a hospital doctor of sexual perversion could have been serious defamation. Nevertheless, the book was confiscated as obscene by Australian customs and achieved publication in the US only after the title was bowdlerised to The Other Man.
The book attracted few reviews, but they were generally favourable and respectful, and it sold steadily over many years, probably because it was bought furtively by many with a personal concern with the subject. Gossip reached me that Princess Margaret had sent a lady-in-waiting to purchase it. What has impressed me in recent years, as I have socialised among gay men of my own generation or slightly younger, is how many have told me that they had read the book when young and found it of help, and reassuring that they were not the sad, exceptional misfits they had once feared. In the fifties and sixties there were still many men ignorant of or without access to the secretive clubs and cruising grounds that were already in existence.
There were not very many letters from readers, but one sticks in my memory. It was from a woman who had been in love with a homosexual and believed, as many women used to do, that her powers of seduction could effect a cure. She seems to have succeeded, for her lover had forsaken her and taken up with another girlfriend. Now she wanted introductions to other such men on whom to exercise her therapeutic talent.
The book was a product of its time. Given the public concern about deviant male behaviour, issues of lesbianism received much less attention. The current politically correct classification of LGBTs (gay, bisexual, lesbian and trans-gendered) had not been invented. Later generations of gay men, living in an era of Gay Pride marches, find the book’s language and outlook reprehensible. They denounce as homophobic the idea that homosexual orientation is a disadvantage or a deficiency or that tolerance is called for, but in 1955 tolerance was sadly lacking.
The book featured the then popular Freudian theory that men’s aversion to sex with women is a reaction against a guilt-ridden closeness to mother, the celebrated Oedipus complex. Nowadays, the relevance of this to the generality of male homosexual development is considered doubtful..
Despite its limitations, the book raised issues that are still matters of controversy. In discussing the frequency of homosexual orientation, it quoted Kinsey’s American figures from the forties, suggesting that “some 4% of men eschew women all their lives”. More recent surveys, such as the national survey Sexual Behaviour in Britain (Wellings et al, 1994), suggest that under 1% of men report exclusively same-sex contacts over long periods of time. Doubtless the circumstances in which questions are put and the way they are framed has a great influence. What is more important than the incidence of transient, occasional or one-off homosexual occurrences is the prevalence of persistent homosexual lust and a comparative lack of satisfaction with, or even a revulsion against, heterosexual activity, that is characteristic of most men who identify as gay. Very small prevalence rates from some surveys are at odds with common observation. What is still uncertain is the prevalence of truly bisexual men with a more or less equal interest in both genders. Certainly there are highly-sexed men who will perform with their own sex when women are not accessible, but I suspect relatively few are equally contented with a partner of either sex. Homophile writers in the past have tended to dismiss bisexual men as hypocrites who go with women for reasons of convenience or social pressure rather than sexual need, but this is unfair. Certainly, marriages undertaken by men whose main sexual drive is predominantly directed to other men often end in disaster, but marriages full of love, even if not completely fulfilling sexual needs, can be viable.
In the 1950s there was a tendency among homophile writers to emphasise the early onset and immutability of homosexual orientation, its probable biological origins, and its resistance to both treatments and social pressure to change. In short, a homosexual orientation was a fact of nature that the law had no business to denounce. The text of Homosexuality inclined towards this line of thought and I was able to cite twin studies showing that identical male twins were likely, although not always, to have the same sexual orientation. With the coming of the homosexual liberation movement, biological determinism, and its suggestion of inherited abnormality, became unfashionable. To follow one’s chosen sexual preferences was arguably a human right. Recent research has tended to restore interest in the influence of heredity. For instance, the discovery of individuals with an exclusive same sex preference among many animal species, whose behaviour is presumably instinctive and neurologically pre-programmed, points to a biological predisposition. The observation of a deficit of males among the siblings of the mothers of male homosexuals suggests something odd passed on in the maternal line. The frequently observed gender imbalance in the sibship of male homosexuals, in the shape of an excess of brothers, is also suggestive. More conclusive is the evidence that identical twins, much more often than dizygotic twins, are both homosexual. However, as discordance does sometimes occur, heredity cannot be the sole determinant of homosexuality. So far, attempts to identify the genes responsible for homosexual predisposition have proved inconclusive.
It appears that an individual’s sexual orientation is the outcome of a complex interaction of factors, including genes, hormonal influences on foetal brain development, social learning and life experiences. In short, in this, as in all aspects of human behaviour, a continuous intertwining of nature and nurture is involved. Unfortunately, fundamental research into the origins of homosexuality is hampered by lack of funding, which reflects society’s unease with the topic and the lurking suspicion of researchers’ reasons for choosing it. Until scientific understanding is more advanced, it is probably best to act on common experience, which suggests that homosexual desire is largely out of a person’s conscious control and generally unresponsive to exhortation, punishment or psychological manipulations. Nevertheless, the homosexual/heterosexual dichotomy is an over-simplification. Sexual desire can vary in intensity and direction over the years and loving relationships do not necessarily go hand in hand with ideal erotic affinity.
The circulation of my book was helped by the release of the Wolfenden Report in 1957 and by the long-continued public controversy that followed the recommendation to decriminalise homosexual behaviour in private between men over twenty-one. The suggestion that there is a sphere of private behaviour ‘not the law’s business’ has influenced legislation and popular thinking ever since. The Wolfenden Committee had had the benefit of evidence from homosexual men prominent in their professions, including the sociologist Michael Schofield and the ophthalmic surgeon Patrick Trevor-Roper, both of whom I was privileged to know. The Chairman himself had a son who was gay. It was not until 1967 that the Sexual Offences Act, 1967, finally made the first step towards decriminalisation. Throughout this period the Sexual Law Reform Society and its indefatigable gay lawyer, the late Anthony Grey, were promoting the cause with educational publications and lobbying, but in a style that presented a respectable, non-threatening front, far removed from confrontational protest demonstrations and gay parades sporting erotic attire.
Through later publications, (e.g. Homosexuality Re-
examined, Duckworth, 1977 and papers in academic journals) I have continued to contribute in a small way, and I have been surprised to find that some persons known to me in the field of parapsychology have also been involved. The late Bishop John Robinson, Dean of Trinity College, Cambridge and one of the Managers of the Perrott Fund for Psychical Research, was sometime Chairman of the Sexual Law Reform Society, and. the philosopher, Professor C.D.Broad, a former SPR President, was a supporter of the that Society.
To be taken seriously in the Fifties, one had to keep a low profile and avoid public admission of a homosexual orientation (fortunately something it was unlikely people would dare to ask outright). The modern generation does not always appreciate the need for this painful hypocrisy. Anthony Grey has been criticised because he did not at the time emphasise the equal value of heterosexual and homosexual living and push for equal rights in every sphere. My early writings are out of fashion for their gloomy tone and a tendency to depict homosexuality as a regrettable shortcoming. On the other hand a more frequent comment by men who read my book in the Fifties has been that at the time they found it reassuring and a relief from popular condemnation.
Back to Maudsley
Work at the Marlborough clinic was only part-time, so I applied for a further training post at Maudsley Hospital. Unexpectedly, in spite of not having followed the advice to obtain further experience in general medicine, I was accepted and remained there for five years. The system of annual re-appointments, the awareness of being under constant scrutiny and the uncertainty of ever obtaining a permanent consultant post made for a busy and anxious time. While performing full time hospital duties, one was simultaneously attending lectures and studying for and entering an examination for the Diploma in Psychiatric Medicine. I failed the neurological section and had to take the examination again, which did nothing to boost confidence. In order to gain a variety of experience there were obligatory moves to different sections, such as child psychiatry, in-patient psychotherapy, and the awe-inspiring ‘professorial unit’. Practice in the proper administration of ECT with appropriate muscle relaxant and sedatives contrasted with the experience at Northumberland House. All in all the experience was beneficial. I felt at home with academic questioning of theory and what has come to be called ‘evidence based’ practice. The need for empirical research and objective statistical evaluation of outcome was something already ingrained as a result of previous immersion in experimental parapsychology. Although in later years I became more sceptical about some of his conclusions, I was much impressed by the teachings of the psychologist, Professor Hans Eysenck, with his insistence on the application of methods of objective definition and measurement to mental concepts such as intelligence, introversion and symptomatic recovery.
The homosexuality book had been published by the time I returned to Maudsley and let it be known I wanted to research the topic and organised a small study of male homosexual patients’ accounts of their relationships with their parents. This was to test the hypothesis, suggested by psychoanalytic writings, that attachment to mother and a difficult relationship with father was commoner among homosexual than heterosexual patients. Descriptions of these relationships were abstracted from the Maudsley Hospital case notes and presented for evaluation to colleagues ignorant of the patients’ sexual orientation. They found this constellation present significantly more often among the homosexuals. Knowing my interest in ESP, one of the consultants suggested facetiously that the evaluators might have been influenced by psychic awareness of the patients’ sexual orientations. A more serious objection was that the original case note descriptions, set out by the patients’ doctors, could have been biased by their familiarity with Freudian ideas. Another point was that the sample consisted of neurotic patients under treatment so that the findings might not be true for the generality of homosexuals. Indeed, some subsequent sociological surveys have not confirmed the trend, but even if, as I still believe, many male homosexuals have uneasy relationships with fathers and a close attachment to mothers, this could be explained other than by Freudian theory. Traditionally, fathers have greater difficulty in accepting gay sons than mothers. Flawed or not, the survey helped secure an MD degree. The results were cited in the 1960 edition of Homosexuality (1960).
Working relations with colleagues were generally friendly and harmonious. Whatever their personal opinions none of them openly questioned my personal reasons for concentrating on homosexuality. I was pleased when eventually promoted to Senior Registrar working on a unit directed by the pioneer forensic psychiatrist Peter Scott. Today, forensic psychiatry, like child psychiatry, is a well-established sub-speciality with its own Section within the Royal College of Psychiatrists, its own training requirements and its own specialist posts. The ‘medium secure’ specialist units extend way beyond the confines of the historic institutions for the criminal insane at Broadmoor and Rampton. Scott was visiting psychiatrist to London’s Brixton Prison, where dealings with the prison medical officers, who had had hitherto a commanding position as advisors to the courts on mentally abnormal offenders, were not always easy. He ran an out-patient service for adults at Maudsley Hospital. Many of the clients were men referred by the courts for psychiatric treatment as a condition of a probation order, very often having been convicted of minor sex offences, such as indecent exposure to women or girls, or homosexuals caught in public lavatories or gay cruising areas. I was destined to deal with such cases for many years to come.
Peter Scott was also visiting psychiatrist to London’s Stamford House remand centre for juvenile delinquents. He organised the compilation of psychiatric reports on the boys detained there. Since anything approaching a psychotic state was very rare among them, diagnosis was largely a matter of character assessment and an opinion as to whether, considering his attitude, social circumstances and history of behaviour disorder, the boy could be expected to respond to advice and supervision by a probation officer, whether he was sufficiently ‘maladjusted’ to require the specialist attentions of a child guidance clinic, or whether there was no particular reason why he should not be dealt with by the customary punishments of detention or a fine. I had to write many such reports. Although I worked at the interviews and the reporting conscientiously, it occurred to me then, and nothing since has caused a change of opinion, that the task rarely required specialised medical expertise. Many of these documents ended with a stock phrase such as “there is no contra-indication to whatever disposal the court may decide”. Others were just thinly disguised pleas for leniency, for instance on the grounds of exemplary response to discipline at Stamford House. There were also social reports done by a psychiatric social worker, Herschel Prins, who interviewed the parents. His experience and judgement were more relevant than mine and he was to become a distinguished academic and author of books on the social and psychological problems linked to criminality and, many years later, a fellow member of the Mental Health Act Commission.
An Interesting Story
One of the Stamford House reports stays in my memory on account of its unusual sequel. Rupert was sixteen when I first saw him in the remand home; healthy looking and talkative. He achieved high scores on intelligence tests, which was unusual among delinquents. He was both fluent and dramatic in explaining his situation. He came from a family of delinquents and social misfits and had been boarded out with a succession of foster parents, never settling for long, usually being ousted for stealing or difficult behaviour. He expressed great resentment against his rejecting family. In the remand home he behaved well but kept himself apart and spent time reading and writing. He said he just wanted to be shut up in an institution to pursue his reading undisturbed. I noted: “He would like to study further and become a monk. He has read a lot about occultism and witchcraft. He has a vivid fantasy life that includes a prophetic fatalism regarding his own future, and ideas of homicide. He denies any interest or concern with sex, but on pressing admits to homosexual feelings towards young boys”.
I concluded t
hat “this boy is disturbed in his emotions and of eccentric personality, but he is not mad and has considerable potentialities. He has no adequate home to return to … he would be difficult to handle in an approved school. I think he would be better suited to the special regime at Finchden Manor”. This was a private boarding school for delinquents described by Michael Burn in a book Mr Lyward’s Answer (London: 1956).
Eloquent talkers tend to obtain special attention. After he appeared before Barbara Wootton, an eminent liberal minded sociologist, acting in her capacity as a magistrate, the local authority agreed to fund Rupert’s treatment at Fincheden Manor. The probation officer’s car being out of service, I helped to conduct him to this residential school and was able to learn something of its very relaxed regime. Boys had to look after themselves and their environment, so the uniform attire and conventional tidiness of penal institutions was conspicuously lacking. There was no set curriculum and boys were allowed to take up studies as and when they felt ready. Treatment consisted of group talking sessions and leadership was in the hands of the charismatic Mr Lyward helped by residents who had already learned to make the most of the opportunities provided. Here is a quote from the Bethlem-Maudsley Hospital Gazette (June 1959) in which I recorded my favourable impressions: “My enthusiasm was just a little shaken a few weeks later when a letter from my charming offender to one of his pals in custody was intercepted by authority… He expressed himself delighted with the soft life at Finchden, where you don’t have to do a thing, and it was a pity one had to eat. It was as good as the West End, so he had not yet bothered to walk out. A month later I heard that indeed he had not walked out and that he now seemed quite contented among the school group.” In fact Rupert stayed there quite some time and when due to leave was disappointed not to be allowed to become a member of staff! One untoward incident during his stay was reported back to me. He had got into trouble for tying up and beating a younger boy.