Mechanisms of Inversion
of Sexual Orientation
The most common type of inversion of sexual orientation is homosexuality. And this is what we are going to discuss in this chapter. Mechanisms of other types of sexual perversions, which are formed on the basis of conditioned reflex, will become clear as we proceed.
The mechanism of formation of homosexual attraction has been the problem that occupied the minds of numerous scientists for about a century and a half. Yet, until the last decades no theory was proposed that would provide a comprehensive explanation of this phenomenon. A wide use of experiments on animals contributed to a breakthrough in this field.
In the end of 19th and the beginning of the 20th centuries, there appeared two opinions as to the origins of this disorder. A number of scientists [25,33,44,71,95] considered a congenital predisposition as the leading factor in the formation of homosexual orientation, since the first signs of this disorder were observed at a very early age. However, while this hypothesis did explain the passive form of male and the active form of female homosexuality as a �psychic hermaphroditism�, the origin of the active form of male homosexuality with preservation of both outer male features and the nature of sexual attraction (except its object) remained unclear. It is equally impossible to understand from this concept the nature of the passive form of female homosexuality.
Later on, researchers noticed that the initial stages of the development of homosexuality are similar to those of fetishism, which could not be regarded as congenital-type disorder, and they started to work out a new approach that would acknowledge the leading role of environment in the development of these diseases [29-32,53,65-66,95]. This approach was based on the assumption that the formation of a �pathological conditioned reflex� (V.M.Bekhterev) takes place during one of the first sexual arousals: either towards the object or the action, on which the attention of the patient was concentrated at that moment. Scientists considered the stage of adolescent intersexuality as the most dangerous one in terms of possible development of sexual abnormalities.
However, this concept also failed to explain why, although everyone goes through this �dangerous� stage, only relatively few people develop this kind of sexual abnormalities. For example, per Kinsey with coauthors , only 4% of men are exclusively homosexual all their lives (not counting bisexual ones), though 60% had homosexual experience at the adolescent age!
As further research showed, both approaches proved correct to a certain extent. We are going to discuss this below.
In order to explain the possibility of congenital homosexuality, we need to look at the processes of differentiation and development of the reproductive system in embryogenesis.
The sex glands of both male and female fetuses develop from the embryonic gonads, which are originally undifferentiated in terms of sex structures of the embryo. Starting from approximately 6th week of embryonic period of human fetus�s life, under the influence of genetic information stored in the sex chromosomes, sex differentiation begins.
In a male fetus, an internal part of the gonad starts developing, which later forms the testicles, while in a female fetus it is the cortical part of the gonad that starts developing and later forms the ovaries. This differentiation process ends in general by the 7th week of the fetal life, after which the so-called interstitial cells of the male fetus�s sex glands begin producing androgens. Under the influence of androgens, a differentiation of genitalia towards the male type starts. Starting from approximately 32nd week of pregnancy, the interstitial cells of a male fetus undergo a retroactive development, after which they remain in an atrophied state until the beginning of pubescence [67,94, and others].
A female fetus lacks androgens at this stage, and under these conditions the development according to the female pattern takes place.
A lack of androgens in a male fetus or their pathological presence in a female fetus (where they can get, for instance, from the organism of the mother) as well as a number of other outer negative influences can lead to the development of hermaphroditism.
But it was discovered that not only development of the genitalia, but also differentiation of the sex centers of the brain occurs under the influence of sex hormones during another critical stage that takes place some time after the first one.
The most suitable object for the experimental study of this phenomenon turned out to be rats, since the latter critical stage in rats takes place during the first few days after birth and not during the prenatal stage, as it is the case with other animals and humans.
It was discovered that castration of male rats or injection of anti-androgens before the critical stage causes � upon reaching pubescence � the manifestation of sexual behavioral patterns of females and the cyclical production of gonadotropin (hormones of the hypophysis that regulate the activity of the sex glands according to the female pattern) [43,45-46,91]. And vice versa � injection of androgens (or large doses of estrogen that apparently interfere with the functioning of the estrogen-sensitive brain structures) to females during the critical stage causes the manifestation of the male-type sexual behavior and an acyclic production of gonadotropins according to the male pattern [40,45,67].
It has been discovered that the center responsible for the male-type sexual behavior is located in the medial preoptic area of the hypothalamus, while the center responsible for the manifestation of the female-type sexual behavior is located in the ventromedial-arcuate complex of hypothalamic nuclei [35,39,57,63]. In genetic males, provided they develop naturally under the influence of androgens produced by their testicles, there happens activation and development of androgen-reactive structures of the center of male-type sexual behavior and inactivation of the female centers that regulate the female-type sexual behavior and the cyclical activity of the hypophysis. In genetic females, provided that androgens are not present during the critical period (this probably happens as a result of influence of estrogens that get into the fetus through the placenta from the mother�s organism), development of only the female sexual centers takes place.
By the way, Dörner with coauthors  showed that hormone-cased homosexuality in experimental male animals can be eliminated by means of destroying the female sexual centers in the ventromedial hypothalamic nuclei, while Röder and Müller  obtained the same result in two homosexual men by means of similar surgery.
Thus it becomes clear how the female-type sexual behavior can form in genetic males and the male-type sexual behavior can form in genetic females as a result of hormonal imbalance during a certain stage of embryogenesis. Such men and women can demonstrate various degrees of congenital physical or mental feminization or masculinization, respectively. The homosexual attraction formed in this way is not subject to the principle of �all or nothing�, but is expressed to a higher or lower extent depending on the size of the injuring factor .
Dörner  points out the following possible pathogenic factors of this type of sexual inversions:
1) pathologic secretion of placental gonadotropins or sex hormones by the placenta; 2) disruption of the synthesis of sex hormones in the fetus; 3) altered sensitivity of hypothalamic sexual centers of the fetus to sex hormones, which may occur as a result of genetic derangements; 4) hormone production abnormalities in the organism of the mother; 5) injection of sex hormones into the mother�s body during pregnancy.
It is possible that in case of men this type of pathology can be also caused by a disproportion of the chromosome set, namely an increase of X-chromosomes. In Klinefelter's syndrome (XXY), physical and mental feminization is frequently observed [26,77-78].
It was also shown that feminization of a male fetus occurs if certain teratogenic (causing fetal deformity) drugs, for example, reserpine [54,58] or chlorpromazine  get introduced into the organism of the mother during the mentioned critical stage.
Such non-specific impacts on the fetus as a reduction of uteroplacental blood circulation during the same critical stage may also produce this effect [10-11].
Although the mechanism that we have just discussed is highly corroborated, it explains the origination of only some cases of the passive form of male and the active form of female homosexuality. Men who demonstrated mental feminization features in their childhood: who wanted to become girls (or even felt themselves as girls) and played with girls in their games, later on shunned a company of boys, liked to dress like girls, etc., � can most likely be classified to this group, just as women who demonstrated similar masculinization features since their childhood.
In order to illustrate another way of formation of the pathology � based on the conditioned reflex � we conducted special studies on dogs.
Sixteen mixed-breed male dogs were taken from their mothers within the first month of their lives and raised by two in cages with an area of 3 square meters (two males per one cage). The walls of the cages were made of non-transparent material to prevent a visual contact with other dogs.
After one year, i.e. after the dogs demonstrated reactions of sexual arousal in response to contact with sex pheromones, each male was brought together with a bitch in heat, and within several days of this � with the same bitch and, at the same time, with the male dog, with which it had been raised. Each test lasted 30 minutes.
Behavior of three animals during the first contacts with the bitch demonstrated their inability to perform a mount. After feeling the smell of sex pheromones, these males would get sexually aroused, which nonetheless did not lead to copulation attempts, but to intensive playing around with the bitch. This kind of behavior persisted despite repeated injections of large doses of androgen (testosterone propionate) (6 ml of 5% solution a day for 6 days in a row). One of the males began to mount the bitch starting from only the seventh test, but its mounts were so few and lacking energy that it failed to perform a single copulation. Despite this fact, it was quite energetically mounting the male dog with which it had been raised when two of them were left together with the bitch.
Two other males started attempting to perform sexual contacts with a bitch only when two of them were brought to the bitch at the same time. That is to say, their sexual arousal was reaching the critical level only in response to inadequate visual signal.
The remaining 13 males manifested their sexual reactions towards a bitch and made their first copulation quite fast. But during consecutive meetings with the same bitch and a male, 9 of them also demonstrated sexual reactions towards the male. Three of them performed an insignificant number of mounts on the male compared to those on the female; two � 25-30% of the total number of mounts each; another two � approximately 60% each; and two males that had been raised together mounted strictly each other without paying any attention towards the bitch, with which both of them had had sexual contacts earlier.
It was also observed that homosexual manifestations took place only in those male pairs where at least one animal reacted positively to the mounts that another one performed on it (which we had never observed in case of male dogs that had been raised under regular circumstances). At that, the male that was the object of the mounts obviously enjoyed what its partner was doing (the sacral region of the back is the dogs� erogenous zone) and frequently had erection.
Thus, these experiments demonstrated that homosexual attraction can form on the basis of conditioned reflex. Observations of the passive form of homosexual pattern on the basis of conditioned reflex are also of value.
This is an interesting fact that homosexual men are usually not attracted to women even after injection of androgens; the only exception is certain young men, who apparently are still at the stage of adolescent intersexuality [38,72,81].
In 1972, basing on examination of homosexual men, we  pointed out different origins of the active and the passive forms of the disease.
In a case of female homosexuality, we also noticed that its active form was innate, while its passive form was acquired .
The observations of homosexual patients that we conducted during the next several years allowed us to classify homosexual people not into two, but into three groups � according to the mechanism of the origin of the disease:
1) Men with the passive and women with the active form of congenital homosexuality. Such men and women felt themselves respectively girls and boys since their childhood; they preferred to play games and wear clothes typical of the opposite sex. Many men had congenital feminine features, while women � congenital masculine features. In sexual relationships, the men felt themselves as women, while the women � as men. A high percentage of them have some kind of hereditary anomalies and report pregnancy pathologies or premature birth.
2) Men with the passive and women with the active form of acquired homosexuality. These patients do not have congenital homosexual mentality and perverted feminine or masculine features. Their attraction to the same sex forms on the basis of conditioned reflex during the stage of adolescent intersexuality.
3) Men with the active and women with the passive form of acquired homosexuality. Such men look masculine and possess male-type sexuality. Correspondingly, the women possess feminine features and female type of sexual behavior. Their pathological attraction forms also on the basis of conditioned reflex, usually at the juvenile age. Later on their homosexual attraction either a) transforms into regular but then reverts to homosexual as a result of mental traumas caused by heterosexual contacts or impossibility of heterosexual contacts due to various reasons, or b) moves on to their adult life either totally displacing the regular-type sexual attraction or coexisting with it. A significant fraction of patients of this group report hereditary abnormalities, various serious somatic diseases in their childhood as well as pregnancy pathologies and premature birth. Such anamnesis indicates an influence of some injuring factor that could impair the brain structures that regulate the congenital component of one�s sexual orientation.
It follows from the above stated data that homosexuality represents a disease of polymorphic origin, which explains the difficulties that exist in its treatment. This is why there can be no universal method applicable to all those who want to be cured of homosexuality; the specific treatment has to be chosen depending on the etiologic group that the patient belongs to. Apart from psychotherapeutic measures various medications can also be used.
In some cases of male homosexuality, drugs (in combination with psychotherapy) can be used in order to induce or intensify the reaction to the �key stimuli� of sexual behavior and thus to increase a regular-type sexual attraction.
In case of women who do not have heterosexual attraction as a result of disrupted differentiation of the brain centers, a sygethin (sygethinum) therapy, which proved to be effective for treating these problems in our experiments on animals , can be used.
It goes without saying that only those patients who insist on their treatment should be subject to it. On the whole, they should realize that homosexuality should not be considered as an obstacle on the way to realization of the meaning of their lives. What is really important though � is to understand in what this meaning consists. And having transcended this problem, without getting stuck with it, they should move further along the path of development pointed out by God.
It is also essential to learn to distinguish between ethical principles, which are a part of the Teachings of God, � and people�s morality, which always changes and which is not always ethically pure. And it�s not morality that we should follow but the Teachings of God [14-23] (though we should take into account other people�s opinions).