I refer to Mr Siew Meng Ee's letter, 'Doctor using selective material to justify own conclusion' which was written in response to my letter, 'Homosexuality: disease or immutable trait?'. I thank him for his views that he has expressed. Let me clarify what I have written. It is true that not all people who contract Aids are homosexuals and not all homosexuals have Aids.

Let's look at the statistics from the US' Communicable Diseases Centre (CDC) - in the year 2005, there were 45,669 cases of newly-diagnosed Aids cases of which 18,938 were from male-to-male sexual contact.

This means that 41.5 per cent of cases of Aids were transmitted by male-to-male sexual contact.

The estimated number of cases diagnosed through 2005 (this means the number of people at the end of 2005 having HIV) is 988,376.

The estimated number of this same group of people having Aids through male-to-male sexual contact is 454,106. This means that of the 988,376 diagnosed cases of Aids in the US, 45.94 per cent of these cases were contracted through male-to-male sexual contact.

The number of homosexuals in the US has been estimated to be 2.8 per cent ('the most widely accepted study of sexual practices in the United States is the National Health and Social Life Survey which found that 2.8 per cent of the male, and 1.4 per cent of the female, population identify themselves as gay, lesbian or bisexual.

See Laumann, et al, The Social Organization of Sex: Sexual Practices in the United States (1994).

This amounts to nearly four million openly gay men and two million women who are identified as lesbian.

This means that 2.8 per cent of the population in the US accounts for 41.5 per cent of the new cases and of the number of HIV cases in the States, 2.8 per cent of the population accounts for the 45.94 per cent of the people having Aids. When relative risk is calculated, this means that a person who engages in male-to-male sexual contact has a 2,400 per cent higher chance of getting Aids.

If we look at the Singapore figures for 2005, 2.8 per cent of the population accounted for 31 per cent of the new cases of HIV infection, 2.8 per cent of the population accounted for 22 per cent of the number of people diagnosed with HIV.

I believe the figures speak for itself, that practising homosexuals have a far higher risk of HIV with its numerous complications and increased mortality.

There are two main reasons for this.

1) The rectum is physiologically unsuitable for anal intercourse. Its fragility leads to increased risks of trauma during anal intercourse, accounting for the increased risks of infection, both bacterial and viral including HIV.

2) Homosexuals are sexually more promiscuous.

A 1978 study found that 75 per cent of homosexual white males claimed to have 100 male sex partners, 15 per cent 100-249 male sex partners, 17 per cent 250-499 male sex partners, 15 per cent 500-999 male sex partners and 28 per cent more than 1,000 male sex partners (Alan P. Bell et al, Homosexuality: A Study of Diversity among Men & Women pg 308 Table 7. New York 1978).

In a local publication, People Like Us: Sexual Minorities In Singapore, gay activist Alex Au Wai Pang wrote frankly about homosexual sexual values being different from that of heterosexual males. Both of Mr Au's articles in the book talk frankly about how many homosexuals are more promiscuous than their heterosexual counterparts.

With regard to whether homosexuals can change their sexual orientation, this is an issue that arouses the emotions of all concerned. As gay activists see it, if someone can change his or her sexual orientation, then homosexuality can be considered a lifestyle choice and thus does not qualify to be considered as a protected class under the law.

As why Dr Robert Spitzer's study was quoted, some background information as how this study came about is useful. Dr Spitzer is one of the most renowned psychiatrists in the US, who is called the father of DSM.

In fact, he was one of the key psychiatrists in deciding that homosexuality should be removed from the DSM. However, in the early 2000s, during an APA meeting, Dr Spitzer met some picketers who claimed that they had changed their sexual orientation.

Intrigued, he decided to do a study as, at that time, his view was that homosexuals could not change their behaviour.

He genuinely wanted to know if some homosexual men and women could change from homosexual to heterosexual, and that he wanted science to guide him. Certainly, with more than 275 publications to his credit, this esteemed scientist at Columbia University was more than able to conduct such a study.

With the limitations that are inherent to all such studies, Dr Spitzer employed the best rigours available for such research protocols.

His sample size was larger than those in previous studies. He was very detailed in his assessment and carefully considered the affective components of the homosexual experience.

Any bias in interview coding was virtually eliminated by near-perfect interrater scores. He limited his pool of applicants to those reporting at least five years of sustained change from a homosexual to a heterosexual orientation.

His structured interview clearly described how the participants were evaluated. His entire set of data is available for scrutiny by other researchers.

If his study methods are considered flawed, then all the original research material used by APA to justify the original change in classification is also flawed using the same argument.

Dr Spitzer's conclusions are simply this: Based on his study, there is evidence to suggest that some gay men and lesbians are not only able to change self-identity, but are also able to modify core features of sexual orientation, including fantasies.

His study was not designed to give the percentage of homosexuals that have changed. Dr Spitzer felt the percentage was low as it was difficult to find subjects willing to be interviewed.

One of the few rational, scientific commentaries on the Spitzer study was offered by Scott L. Hershberger. Dr Hershberger, a distinguished scholar and statistician, elected to respond in a Commentary to the Spitzer research (Hershberger's article was published in the same issue of the Archives of Sexual Behavior as the Spitzer study was) by conducting a Guttman scalability analysis. This is a scalogram to determine whether or not reported changes occur in a cumulative, orderly fashion.

Dr Hershberger's conclusion: 'The orderly, law-like pattern of changes in homosexual sexual behaviour, homosexual self-identification, and homosexual attraction and fantasy observed in Dr Spitzer's study is strong evidence that reparative therapy can assist individuals in changing their homosexual orientation to a heterosexual orientation.

'Now it is up to those sceptical of reparative therapy to provide comparably strong evidence to support their position. In my opinion, they have yet to do so.'

The Schidlo and Schroeder study, funded by the National Lesbian & Gay Health Association, was originally titled 'Homophobic Therapies: Documenting the Damage.'

The title was later changed to 'Changing Sexual Orientation: Does Counseling Work?' because they found that some people reported benefits to reorientation therapy including a change of sexual orientation. Biasness will be an issue as the aim of the National Lesbian & Gay Health Association is to prove that homosexuals are normal and healthy and reparative therapy is harmful.

There are thousands of testimonies of homosexuals who have changed their orientation. Even in Singapore there are testimonies of homosexuals who have changed their sexual orientation.

The point is that even if one person can change, then homosexuality is not an immutable trait and we should not deny anyone the right to change.

Dr Alan Chin Yew Liang

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15 May 2007
Straits Times Online Forum

In response to Assistant Professor Yvonne Lee's reply to my letter, 'Professor's view on gay's prejudiced' (Online forum May 8) [1], I would like to follow up in the interest of clarity and fair comment on the points raised. First, Prof Lee feels that I have questioned her professional qualifications and engaged in a personal attack in asking questions about her essay. I intended no such attack and apologise unreservedly for any offence.

Second, it seems that Prof Lee's article has generated a substantial amount of debate, both reasoned and otherwise. I view this as a welcome effect as I firmly believe that only though public discussion will Singapore become a better civil society on such an important topic as equality under the law.

Therefore, contrary to Prof Lee's assertion, I am delighted to see the muddle scrum of public debate - informed or not, for or against - as it usually produces a consensus that current society can live with until the next evolution in local values dictates further review.

Finally, returning to the substance of Prof Lee's essay, the writer continues to be vague in answering the questions raised in my original letter asking for evidence supporting her generalised statements on the linkage between homosexuality and public health concerns; the existence of a broader slippery slope homosexual agenda in Singapore; and how 'free speech' as construed within Singapore's legal history would be curtailed by decriminalising homosexuality in Singapore.

To the questions above, I would appreciate Prof Tan [2] explaining why only male and not female homosexuality should be a crime under Singapore law; if homosexuality is against Singapore's public interest why criminalise sexual expression and not the person; and how can homosexuals in Singapore follow her advice to live their lives peacefully when Section 377A (whether enforced or not) is explicit in making their private activity a crime.

Brian Selby

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17 May 2007 
Straits Times Online Forum

I refer to Mr Brian Selby's letter, 'Why is male homosexuality a crime but not lesbianism?' (Online forum, May 15), written in response to my three-point rebuttal (ST, May 10) of his first letter, 'Professor's views on gays prejudiced' (Online forum, May 8), which he wrote in reaction to my op ed, 'Decriminalising homosexuality would be an error' (ST, May 4). I thank Mr Selby for his unreserved apology, in relation to the personal and professional allegations made against me in his letter of May 8.

Clearly, the decriminalisation of homosexuality as one aspect of a broader homosexual rights agenda raises politically controversial issues. This has provoked polarised responses and have caused deep social rifts in countries like the US and Canada.

My op ed sought to inform the debate by highlighting relevant legal social and policy issues which will need to be considered in the context of Singapore's multi-racial and multi-religious society by the Government.

I reject Mr Selby's suggestion that my op ed and rebuttal have been deliberately 'vague'. The first was intended for general readership and the intent of the second was not to provide a substantive discourse of these controversial issues of law and social policy, given the restraints of this forum. One might equally ask Mr Selby to substantiate his own views to prove his case.

However, as Mr Selby has in his latest letter highlighted certain issues for my response in a civil fashion, I make the following observations:

First, I agree that my op ed has attracted a substantial amount of debate generated by websites and blogs written by certain individuals of a self-declared 'liberal' or homosexualist persuasion.

However, I do not share Mr Selby's delight in what he calls the 'muddle scrum of public debate'. The right to free speech which the Constitution safeguards for Singapore citizens is not absolute but subject to express limitations.

Not all types of 'speech' will help 'Singapore become a better civil society' as certain types of 'speech' seek to prevent the articulation of differing viewpoints through intimidatory and hateful tactics.

''Speech' which attacks my character or professional ability seeks to chill my rights of free conscience and speech as a concerned Singaporean as well as to violate the principle of academic freedom.

Further, 'speech' which demonises and labels the views expressed in my op ed as 'religious' or 'bigoted' opinions, in an attempt to paint them as irrelevant to an important public policy debate within the context of a multi-racial, multi-religious Singapore, may well be an insidious cover-up for subjective prejudices and biases. This undermines pluralism and constructive debate.

Some comments thrown up in this debate seem to indicate that arguments based on or inspired by 'religious' values should be excluded from public debate. This rests on a certain assumption about what a secular state requires.

The assumption seems to be influenced by one school of constitutional thought that 'Church' (or Mosque or Temple) and 'State' be strictly separated. This version of 'secularism' rests on an unspoken anti-theism and is not universally endorsed.

There is a broad spectrum of positions which countries have adopted in relation to the role of views inspired by religious convictions in public debate.

This ranges from anti-theistic separationists (for example, Stalinist regimes or radical liberals/'secular fundamentalists') who seek a 'religious cleansing' of the public square, to those who seek a genuine pluralism by protecting the expression of all moral viewpoints whether based on 'religious' or 'secular' convictions (assuming these can even be separated). All viewpoints are subject to public scrutiny and debate, rather than being censored by law or social pressures.

Indeed, Singapore's version of secularism is not benighted or anti-religion; Singapore is secular but not atheistic, as a minister once stated. Singapore's model of secularism is more appropriately characterised as agnostic or accommodative as defined by the Singapore Court of Appeal, which is committed to freedom of religion and the role of the state in removing restrictions to one's choice of religious belief.

Therefore, in our aspirations towards democracy, no view should be gagged just because it is identified as a 'religious' one. Otherwise, secular humanism and its morally relativist viewpoint, which forms part of its comprehensive world view, would by default be privileged and foisted on society as a new sort of 'secularised religion'.

Second, there are medical opinions that homosexual sex (that is, anal sex) is inherently unhealthy.

One may argue that this is a 'private' matter, affecting only individuals who contract diseases such as 'gay bowel syndrome'.

However, this is a narrow view of what amounts to 'public health' concerns, given that the activities and diseases of individuals may affect the public at large.

Further, the possibilities of allocating public funds to resolve these sorts of health problems make this a matter of public concern as it could mean that funding for research into other illnesses like cancer and diabetes is reduced.

Concerned citizens who would like to be informed on this matter may usefully refer to the medical opinion of one Dr John R. Diggs, Jr's (August 16, 2000), which was set out in his affidavit in relation to a Massachusetts lawsuit (concerning homosexual activists' legal claims against parents who opposed sexual 'orientation' education in schools):

'There are a variety of significant medical and health risks associated with homosexuality and the gay 'lifestyle'. These include promiscuity, multiple sexual partners, assault and battery and anal intercourse. The sexual practices of male homosexuality consist primarily of oral-genital contact and anal intercourse. These practices are inherently dangerous because of the proclivity to produce occult and overt physical trauma, often spreading sexually transmitted disease. The rectum is particularly vulnerable to sexual trauma, where breaks in the protective membrane barrier facilitate blood exchange and, in turn, the transfer of infectious agents. Furthermore, certain male homosexual practices, such as 'fisting', that is, the insertion of the entire hand into the recipient's anal canal, are likely to cause more serious injuries... Studies have repeatedly shown that lesbians and gay men are at increased risk for mental health problems, including depression, substance abuse, and suicidal behaviour, compared to heterosexuals... Homosexuals perpetrate child sex crimes at a rate many times their number in the population...'

Full text available at http://www.massnews.com/past_issues/2000/9_Sept/900fist3.htm

Third, my observations on the development of the homosexual rights agenda in countries like the US, Canada and Europe and how this seeks to coerce changes in moral and social attitudes towards a broad range of issues are factually based.

Mr Selby should consider the effects of decriminalising homosexuality in other jurisdictions, and how it affects the community, as documented in news reports and case law.

For example, if homosexuality is decriminalised, this will require changes in other aspects of law and life such as changes in insurance and tax benefits laws; schools may have to teach that a range of family set-ups (for example, having two fathers instead of a father and mother) is possible or that homosexuality and heterosexuality are morally equivalent.

This will violate the conscience of certain teachers and also can violate parental rights in the moral education of their children. This is not fictional nor can it be brushed aside as a 'slippery slope' argument. This would obfuscate matters which are of real concern to the majority of Singaporeans. Indeed, perhaps this is the intent of those deriding 'slippery slopes'.

Fourth, as stated in my op ed, the Singapore Constitution does not prohibit all types of differentiating classifications. In layman words, classifications which are not rational and do not serve a legitimate policy, are unconstitutional.

The critical issue is whether the criminalisation of homosexual acts has a rational basis.

The views in my op ed show the broader legal social and policy issues forming the rational basis for S377A of the Penal Code which criminalises homosexual acts by male.

To argue that S377A is not rational because the laws do not criminalise lesbianism assumes that the law must achieve a technically 'perfect classification' which includes all homosexual acts under its ambit.

There is no such requirement. Broader social objectives may be served by S377A, so as to validate it and its classification, under Singapore equality jurisprudence.

Fifth, Mr Selby has assumed that laws do not and should not affect our 'private activity'.

However, human beings while desiring a sphere of autonomy are also social beings and live in community. Laws do reflect community standards which place limits on 'private activity' - that is the basis for laws against incest, paedophilia or even surfing and downloading Internet porn, for example.

The critical question is what constitutes 'private' activity and when does 'private activity' have repercussions for the public, so as to be subject to legal regulation and sanction?

No law is morally neutral and it is intellectually dishonest to assert that there are moral values which are objective, and some which are subjective.

To call for the decriminalisation of homosexual acts, on grounds of non-discrimination on the basis of 'sexual orientation' is to assert a moral or amoral position which cannot claim 'neutrality'. No one is neutral in this debate.

The Ministry of Home Affairs has stated that 'ur enforcement approach also remains the same' as Section 377A will not be proactively enforced 'against adult males engaging in consensual sex with each other in private.'

This is the current practice and reflects a pragmatic compromise. This does not mean the law will not be enforced but one can take the government at its word to continue the current practice.

Thus, under the proposed Penal Code amendment, homosexuals wishing to lead 'private' lives may do so 'peacefully' in Singapore, provided they do not foist their homosexual acts on the public or seek to mainstream homosexuality as an acceptable lifestyle.

Yvonne C. L. Lee
Assistant Professor, Faculty of Law 
Deputy Director, The Asian Law Institute (ASLI)
National University of Singapore

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19 May 2007
Straits Times Online Forum

I am writing in response to Dr Alan Chin Yew Liang's letter titled, 'Figures speak for themselves: Practising gays have higher risk of HIV'.

I thank Dr Chin for keeping the discussion on an emotional topic grounded in rational discourse, and such an effort deserves a considered response.

First, with regard to Dr Chin's point about the higher relative incidence of Aids in homosexual people - the risk of contracting Aids among people who 'practise' homosexual sex is not a justification for continued criminalisation, but by safer-sex education and outreach programmes. This is exactly society's approach towards addressing the risk of contracting STDs among people who actively 'practise' heterosexual sex or that of lung cancer among people who smoke.

Dr Chin goes on to address the question of whether or not a person can change his sexual orientation, and quotes a study by Dr Robert Spitzer to draw the conclusion that 'even if one person can change, then homosexuality is not an immutable trait'.

Unfortunately, Dr Chin's conclusion is a skyscraper erected upon a foundation of straw. Dr Spitzer's study does not support Dr Chin's claim that homosexuality is not immutable because the sample population was not random but specially hand-picked for a special purpose.

Sadly, this is a mistake that is made so often by non-specialists that Dr Spitzer himself was compelled to respond. On May 21, 2001, the Wall Street Journal published a commentary by Dr Spitzer about his own study where he said (verbatim):

'In reality, change should be seen as complex and on a continuum.

'Some homosexuals appear able to change self-identity and behavior, but not arousal and fantasies; others can change only self-identity; and only a very few, I suspect, can substantially change all four.

'I suspect the vast majority of gay people would be unable to alter by much a firmly established homosexual orientation.

'I did not conclude that all gays should try to change, or even that they would be better off if they did.'

In other words, just because one person among millions might possibly be able to change his intrinsic sexual orientation and attractions after years of therapy, it does not therefore mean that everyone else is able to (or should even try, given the potential destructive consequences of failure). After all, can you imagine what it would take to make a red-blooded straight man stop being attracted to a Playboy centrefold?

Lastly, I will turn again to Dr Spitzer's commentary to address the issue of equal treatment (not protection, mind you!) for homosexual people:

'My study concluded with an important caveat: that it should not be used to justify a denial of civil rights to homosexuals, or as support for coercive treatment.

'Gay rights are a completely separate issue, and defensible for ethical reasons.'

I could not have said it any better myself.