Clinicians Attempt to Prenatally Prevent Homosexuality

(PhysOrg.com) -- "This is the first we know in the history of medicine that clinicians are actively trying to prevent homosexuality," says Alice Dreger, professor of clinical medical humanities and bioethics at Northwestern University Feinberg School of Medicine.

Dreger and collaborator Ellen Feder, associate professor and acting chair of philosophy and religion at American University, have brought to national attention the first systematic approach to prenatally preventing homosexuality and bisexuality. The "treatment" is targeted at one particular population of girls, but the researchers involved in the work say their findings may have implications beyond this population.

The girls and women in question have congenital adrenal hyperplasia (CAH), a serious endocrine disruption that sometimes results in ambiguous genitalia. Their endocrine problem will require medical management from birth onward. Research has shown that females born with CAH have increased rates of tomboyism and lesbianism.

The prenatal treatment at issue, however, does not treat or prevent the CAH. Most clinicians who use prenatal dexamethasone for CAH seek to prevent the development of ambiguous genitalia. But the New York-based group of clinical researchers whose work is traced by Dreger and Feder suggest that prenatal dexamethasone can also be used in this population to prevent the "abnormality" of homosexuality, as well as the "abnormal" interest these girls tend to have in traditionally masculine careers and hobbies.

Dreger and Feder's paper on the topic appears in the Bioethics Forum of the Hastings Center and can be read at www.thehastingscenter.org/Bioe … x?id=4754&blogid=140 .

A new consensus from seven major medical organizations (including the American Academy of Pediatrics) will be published in August indicating that this use of prenatal dexamethasone is experimental and not to be treated as standard of care. This comes in the wake of Dreger and Feder leading an investigation showing that the chief proponent of this off-label use, pediatric endocrinologist Maria New, treated hundreds of women with this experimental drug without proper research ethics oversight. Time magazine related that aspect of the story: www.time.com/time/health/artic … 8599,1996453,00.html .

The FDA and the Office of Human Research Protections are now investigating these formal complaints.