Homosexuality: Clinical and Halakhic Challenges

HOMOSEXUALITY: CLINICAL AND
HALAKHIC CHALLENGES*
By RABBI MOSHE HALEVI SPERO

(Proceedings of the Associations of Orthodox Jewish Scientists, Volume 6:  Edited by Fred Rosner, M.D.; Feldheim Publishers, 5741/1980; Copyright 1980 by the Association of Orthodox Jewish Scientists.)  (Posted on JONAH April 2008)

I

    Understanding and treating homosexuality is fraught with theoretical and therapeutic frustrations and ethical complications. During a crucial developmental period for the study of homosexuality, when assumptions about the nature of sexual orientation in general are currently a matter of much popular and professional debate, the Jewish mental health practitioner involved with this clinical problem faces numerous challenges to his or her ethical value system. Such challenges bear considerably upon clinical practice. Can one choose to not treat homosexuality as an illness, but rather help such clients function better as homosexuals? If one intends to "cure" a homosexual, are halakhically appropriate interventative procedures available? Does the Jewish psychotherapist have certain responsibilities to the non-Jewish homosexual? The purposes of this essay are to examine the halakhic status of homosexuality, to consider halakhic difficulties encountered with the psychoanalytic and behavioral interventative models, and to discuss the confrontation between halakhah and those views subscribing generally to an interpretation of homosexuality as an "alternative sexual preference."

Giving even a basic definition of homosexuality is encumbered by the variety of differing and often contradictory etiological theories. Another complication is that some psychological theorists assume priorily the inherent normality of heterosexuality while others reject this assumption. Thus, for example, while all would accept as valid the description that most homosexuals seen in clinical practice derive little or no sexual pleasure from relationships with opposite sex partners, only those who accept priorily the inherent normality of heterosexuality would take

*The bulk of this paper deals with the topic of arayot.   Discussions of such topics are to guided by the axiom:  “One does not discuss arayot among three”(Hag.11b; M.T.; Hil. Issurei Biah 22:17).  The purpose of this paper is not to broadcast the existence of the problem of homosexuality among Jews, nor is it my intention that these contents be bandied about carelessly among the uninitiated.  It is designed primarily to meet the needs of practitioners who do not have ready access to the relevant halakhic guidelines governing this psychiatric problem and its treatment.

   Giving even a basic definition of homosexuality is encumbered by the variety of differing and often contradictory etiological theories. Another complication is that some psychological theorists assume priorily the inherent normality of heterosexuality while others reject this assumption. Thus, for example, while all would accept as valid the description that most homosexuals seen in clinical practice derive little or no sexual pleasure from relationships with opposite sex partners, only those who accept priorily the inherent normality of heterosexuality would take this description alone as indicative of the homosexual's pathology. Those who accept no single sexual orientation as biologically given could not find a clinical description alone useful in pinpointing the inherent pathology of the homosexual orientation as such. Of course, much of importance is begged by both points of view which shall be discussed in subsequent sections of this paper.

     When talking of "homosexuality," one generally differentiates between genuine homosexuality: chronic, global, and intense erotic drives for same-sex individuals; transient or situational homosexual behavior: the preference for heterosexuality frustrated by social constraints (such as soldiers or prison inmates who, due to extended periods of deprivation, engage in homosexual behavior, or celibate clergy who are prevented from heterosexual relations by their social and religious beliefs); and opportunistic homosexuality: delinquent sexual behavior (such as those who engage in homosexual activity solely for the sake of some form of reward). To avoid complication, I will deal with homosexuality as a behavioral phenomenon: there are those who exhibit this behavior who wish to modify it and who, until such time as treatment is effected, will be anxious, unhappy and conflicted, and, on the other hand, there are those who wish to have their homosexuality accepted as an alternative to heterosexuality. This halakhic examination is necessary in the interests of responding to both parties in a halakhically consistent manner.

     A final introductory point. It is not the primary purpose of this paper to prove any single psychological theory of homosexuality. However, it is unavoidable that the halakhically-oriented professional may take some halakhic interpretation of homosexuality which approximates certain psychological views of homosexuality as a confirmation of such psychological theories. I have noted in previous articles that halakhic understandings of man and human nature are psychological theories in their own right from the standpoint of a pan-halakhic perspective. In this presentation of the halakhic view of homosexuality, I disclaim any inference that these views are intended to supplant empirical research on the topic, though I would defend the possibility that such halakhic understandings represent a valid psychological point of view within a framework different than that of empirical research.

II
    Homosexuality is considered one of the arayot, or forbidden sexual relationships, and is described as to’evahr abomination, in the biblical proscriptions, "Thou shall not lie with a man the lying of woman; it is an abomination,"(1) and "A man that lies with a man the lying of a woman, they have committed an abomination, both shall surely die; their blood is upon them."(2) The homosexual act, intercourse between two males per anum, is punishable by death (stoning) or, in the absence of proper warning, by excommunication (karet).(3) The ritual male prostitute or kadesh is forbidden from the community of Israel.(4) Since the basic prohibition involved in the biblical description of homosexuality is the act of anal intercourse (mishkav zakhor), lesbianism cannot be included in the aforementioned passages, but is rabbinically inferred as forbidden by a separate ban, "Like the deeds of Egypt you shall not do."(5) Lesbianism, known to the rabbis of the Talmud as nashim ha-mesolelot,6 is punishable by makat mardut derabbanan (lashes for rebelling against rabbinic authority).(7) Inasmuch as female homosexuality is primarily considered peritzut, immodesty, rather than zenut, licentiousness, a lesbian may marry a member of the priestly class.(8) Rambam and most authorities concur that the prohibition of homosexuality applies to both Jew and non-Jew.(9)

     The age of culpability for homosexual activity is nine years and one day. (This age is roughly congruent with what is currently considered "late latency" [9-11 years], a biologically as well as psychologically observable stage when prepubertal phenomena begin to encroach on the earlier quiescence of latency proper [7-9 years].) Should an adult involve a minor younger than this age in homosexual acts, both avoid the specific biblical infraction but the adult receives makat  mardut. In such a case, if the minor is older than nine years and one day but younger than thirteen, the adult is punished by death for the biblical infraction and the minor receives makat mardut.(10)

     In an interesting application of the biblical definition of homosexuality, Rambam notes that anal intercourse with a true hermaphrodite (androgenus) is a full violation of the biblical prohibition. However, intercourse per the vaginal-type orifice of the hermaphrodite is patur min ha-Torah yet punishable by flogging.(11) The point is that though the androgenus is generally considered to have a dual male-female status — as opposed to the tum tum who is of doubtful sexual status (safek ish safek ishah) — the specific phrase, "the lying of a woman," emphasizes that the act of anal intercourse is sodomy despite the hermaphrodite's bivalent status.(12) In a case with relevance to the halakhic status of the outcome of transsexual surgery, R.Hananel rules that intercourse with a male who had some form of artificial vagina is still mishkav zachor: i.e., the sex change is not halakhically valid.(13)

     Halakhah recognizes that the prevalence of homosexual behavior varies among communities and cultures. In a fundamental mishnaic and talmudic discussion, R. Judah prohibits two unmarried males (ravakim) from sleeping under a shared blanket in the effort to prevent the outbreak of what must have been considered a latent disposition towards homosexuality.(14) The majority opinion, however, dissented, thereby rejecting the existence of such a disposition, presumably since homosexuality was a rarity in Jewish society. The prevailing norm or hazakah based on the majority view is that Jews are not suspect for homosexuality or zoophilia (lo nihshadu Yisrael al mishkav zakhor ve-al behemah).(15) Though Rambam codified the majority ruling, R. J. Karo reversed the decision to that of R. Judah because of the "lewdness of our times,"(16) while R. J. Sirkis, due apparently to yet another shift in moral climate in his own community, bypassed Faro's decision in favor of the original hazakah.(17) Nonetheless, one consistently finds the following added by codifiers even after citation of the majority ruling, "And, though, Heaven forbid, we never had reason to suspect for this, but the cautious — may blessing come upon them."(18)

     Does halakhah differentiate between homosexual acts and the general condition of homosexual preference or homosexuality? Or, what is the halakhic status of the individual who never has actual sexual relations with males, yet experiences homosexual fantasies and intense and chronic desires for erotic male relationships? What is the status of being a homosexual as opposed to the status of committing specific homosexual acts? I have detailed elsewhere that thoughts about, and certainly preoccupation with sexual evocative material is strictly forbidden in Jewish law. The various codes' prohibitions against even "that which leads to arayot" would indicate that homosexual fantasies are included in the basic interdict.(19) However, it can be further argued that when halakhah prohibits the act of homosexuality, or behavior between males that is in the manner of woman and man, it is indicating its disapproval of the general shift in erotic interest from feminine to masculine object choice. This impression is supported by some of the interpretations that have been offered for Judaism's inability to accept homosexuality.

     The Talmud itself explains, by rendering the Hebrew term to'evah into to'eh atah bah ("you err through it"), that homosexuality destroys family unity.(20) The Sefer ha-Hinukh makes it clear that homosexuality, as an act, is hash'hatat zera levatalah (spilling semen in vain, a separate biblical prohibition)(21) and, as a way of life, is antithetical to the Divine imperatives of propagation (peru u-revu) and the mitzvat onah.(22) One can infer from the arguments of the Sefer ha-Hinukh in explaining the prohibition against zoophilia that perhaps homosexuality also represents a frustration of the fiat min be-mino: the universal bioethical commandment that all creatures propagate in such a way that preserves species specificity, which would include safeguarding the sexual relationship itself. (23)

     Others have commented that homosexuality is a distortion of normal sexual behavior as biblically defined, "And thou shall cleave unto the woman and be as one flesh, "(24) to which the Talmud adds," 'And cleave' — but not unto a man."(25) While the rabbinic exegesis here is obvious, it is perhaps redundant since a specific biblical prohibition already exists. Thus, R.Barukh Halevi Epstein suggests that since the deveikut (lit., cleaving; attachment) highlighted in this passage includes erotic attachment, the Talmud felt the need to stress the specific male-female framework for this attachment, thereby prohibiting the psychological-emotional orientation of the homosexual.26Thus, it is not merely the physical act of intercourse between male and female individuals, but also the emotional relationship (or disposition) of homosexuality which is a primary concern.

Given this background, a halakhic theory of at least one aspect of the development of homosexuality can be suggested. If one considers the beginning of the aforementioned passage, "Therefore shall a man leave [ya'azov] his father and his mother,"(27) in relation to the final portion, "and cleave unto the woman," one can infer that a functional emotional relationship in the halakhically desired male-female pattern is only possible with the successful resolution or relinquishing of the variety of childhood dependency and competitive emotional ties with parents. The homosexual cannot find psychological satisfaction in the "normal pattern" precisely because he or she has been unable to sever such ties, or has yet to resolve neurotic parent-child issues which contribute to the psychological dilemma. Homosexual deveikut, then, is but the replication of emotional conflict involving inappropriate deveikut to the opposite-sexed parent or to both of them. This anticipates Bieber's point that, "The homosexual act is not an analogue to heterosexual intercourse. It is, in part, a masquerade in which multiple role behaviors are enacted."(28)

     Given this background, a halakhic theory of at least one aspect of the development of homosexuality can be suggested. If one considers the beginning of the aforementioned passage, "Therefore shall a man leave [ya'azov] his father and his mother,"(27) in relation to the final portion, "and cleave unto the woman," one can infer that a functional emotional relationship in the halakhically desired male-female pattern is only possible with the successful resolution or relinquishing of the variety of childhood dependency and competitive emotional ties with parents. The homosexual cannot find psychological satisfaction in the "normal pattern" precisely because he or she has been unable to sever such ties, or has yet to resolve neurotic parent-child issues which contribute to the psychological dilemma. Homosexual deveikut, then, is but the replication of emotional conflict involving inappropriate deveikut to the opposite-sexed parent or to both of them. This anticipates Bieber's point that, "The homosexual act is not an analogue to heterosexual intercourse. It is, in part, a masquerade in which multiple role behaviors are enacted."(28)

     An additional aspect of the above hypothesis is that homosexuality is not only contrary to the halakhic ideal of family structure or the male-female relationship, but is also destructive of the halakhic ideal of the complete individual as such. Based on the passage, "Male and female He created them ..and He called them Adam,”(29) R. Eleazar commented, "Any man who has no wife is not Man."(30) The halakhic definition of the human individual, as R. Joseph B. Soloveitchik has often pointed out is found in the totality of male united with female composite of traits, functions, and attributes producing a desirable whole.(31) Identity requires the synthesis of opposites. To the degree that homosexuality perverts these ideals, it remains to'evah; a ta’ut, an error. It destroys the individual's ability for ontological fulfillment in the halakhic world. This last problematic aspect of homosexuality would apply not merely to the homosexual act but more so to the quality of individual being represented by homosexuality. Ultimately, in the Jewish view, the goal of the sexual relationship is the sanctification of the individual, the marital relationship, and society. In the words of the Midrash, "Every place where one finds the fence of arayot, one finds holiness."(32)

     It is appropriate to end this section with Rambam's keen awareness of the apparent instability of human sexual-object preferences. "You have nothing in the entire Torah which is as hard for the masses to separate themselves from as the arayot and the forbidden relations.” The rabbis said that when Israel was commanded with the laws of arayot, they cried and accepted these precepts with grudging and lament, as it is written, ‘"Weeping, family by family"(33) — they wept over matters concerning family"'(34) [i.e., over relations which would now be forbidden them]. And our rabbis said, 'Man's soul lusts for theft and arayot';(35) and one finds no community which from time to time does not have immodesty, arayot, and forbidden relations."(36)

III

    Treatment of homosexuality is as fraught with divergent theories as is the issue of its development. Opinions range from pessimistic views that even the most early intervention can only avert the future development of more severe pathology, to views which recognize that relief from anxiety, focal relief of homosexual symptoms, and even cure are possible with some homosexuals.(37) Individual, successful case studies have been reported by psychoanalytically-oriented therapists and by behaviorists. With insight-oriented psychotherapy the focus is primarily to demonstrate the defensive aspects of homosexual relationships and to uncover the positive aspects of the patient's original relationships with women through talking, free association, emotional re-experiencing, etc. Obviously, success is enhanced when the patient is young, serious about change, and certainly when "cure" is cautiously defined as achieving the capacity to control homosexual impulses or, at best, the abolition of overt homosexual responses and possibly the development of some heterosexual response. Behavioral therapies promise rapid, effective, and economical programs of change. Based on the clinical evidence that despite an apparent disinterest in and aversion to heterosexuality, evidence of heterosexual responsivity can be demonstrated in most homosexuals, two major approaches have been devised. One is the behavioral rehearsal of heterosexual activity with deconditioning of the heterosexual anxiety (a learned fear response to heterosexual stimuli).(38) A second approach involves orgasmic re-con-ditioning procedures, using both the patient's own homosexual fantasies as well as erotic audio-visual material, to slowly build-up a response to fully heterosexual stimuli as well as heterosexual relation¬ships.(39) The use of female surrogates in such therapies has not been unheard of (though Masters and Johnson and others have officially discontinued the use of surrogates in their sexual dysfunction and sexual deviance clinics.) Masturbation to increasingly greater amounts of heterosexual stimuli, and initially to autoerotic stimuli, is generally a crucial aspect of both approaches.(40)

     There are halakhic complications involved with both treatment approaches to homosexuality. The first problem, which applies to both methods but is recognized more easily in psychoanalytic or general taking-cure type therapies, involves the carefully guarded domain of discussing or even thinking about material of forbidden sexual content, or material which may be considered profane. With regard to hirhur arayot (thoughts about illicit sexual relations) — which may be involved in talking of homosexual fantasies and wishes, incestuous feelings which underlie homosexual behavior, or autoerotic impulses — the halakhic sentiment is quite strong. "The thought [of arayot] is worse than the deed."(41) "Said R. Pinhas: Do not think of lewdness in the day and come to a seminal emission at night."(42) Improper thoughts are considered forbidden by several biblical imperatives: "And you shall be perfect from before the Lord.''(43) "And sanctified you shall be,"(44) "And guard yourselves from all manner of evil.”(45) Maimonides rules that all which leads to the possible commission of arayot, or that which is prurient in its own right, is forbidden by "Do not approach to uncover their nakedness."(46) Indeed, according to those authorities who maintain that even the "appurtenances"[abizrayhu] of arayot are biblically prohibited, a particularly negative light would be cast upon discussing or viewing audio-visual material comprised of arayot — such as a hier-archically designed series of photographs of females ranging from the patient's mother, female relatives, to unknown nudes — used in some desensitization procedures.(47)

     Behavioral strategies with male homosexual patients involve an additional prohibition: stimulating an erection to autoerotic or forbidden sexual stimuli. In addition to previous prohibitions, another halakhic principle is operative here. In the halakhic view, a female can claim innocence by virtue of compulsion in sexual crimes involving forced intercourse, but a male cannot because his involvement in such an act would be impossible without some measure of sexual pleasure. The principle here is "Ein kishuy elah le-daas," an erection is impossible without sexual arousal and therefore, some degree of intention.(48)

     Writing on a case involving the placement of an antisocial male patient in an institution where the possibility of illicit sexual activity existed, R. Moshe Feinstein rules that the particular patient's impaired moral and emotional self-control cannot waive the relevant prohibitions or the guardian's need to reject the choice of said institution;(49) R. Feinstein reasons that unlike lenient rulings in cases where persons in life-threatening circumstances have been instructed to eat non-kosher food — where, since food can be eaten in such a way as to not derive pleasure, halakhah permits, in situations of duress, not only the eating but even the enjoyment of such food — sexual acts cannot take place without involving some measure of forbidden pleasure. He substantiates his view with the principle, "Ein kishuy elah le-daas." Even those few authorities who argue that the male can claim compulsion in sexual crimes would concede that where the forced act ended in any degree of pleasure that was acceptable to the individual, which would be analogous to our treatment case, the gravity of isur (prohibitory quality) increases.(50) It would seem that behavioral interventions face serious halakhic objections.

     Of course, in the halakhic system, there has to be some relevant alternative principle active in order to modify the illicit nature of the standing prohibitions which render such psychotherapies halakhically inappropriate. We recall, for example, that even the Sabbath laws may be violated in the interests of saving life; in such cases the obligation to heal supersedes all prohibitions.(51) Often, psychotherapists are quick to assume that any prohibitions which present themselves in the therapeutic encounter can be waived by an appeal to this "medical-healing model" generally operative in cases such as the above example. Indeed, Nahmanides notes that the obligation to heal, stemming from "ve-a'havtah," applies not only to absolute pikuah nefesh, but even situations of lesser gravity such as mental anguish and the general promotion of well-being.(52)  However, it must again be noted that actual threat to life, sakanat nefashot is not usually involved in the treatment of homosexuality. And even when it is, such as a homosexual patient who has become a suicidal risk due to extended lack of treatment and intense anxiety and guilt, etc., no prohibition can he waived where violation of any of the three cardinal sins, arayot, idol worship, and murder, is the alternative. The paradigm is the talmudic case of the individual who literally fell sick-in-love with a married woman and required for cure to sleep with her or at least, to hear her voice from behind a wall. To each alternative offered by this individual's physician, the rabbinic view is to accept death over the "therapy.”(53)

     Actually, the rabbis were of divided opinion whether the woman in question was married, and hence one of the arayot, or merely a penuyah (unmarried virgin).  In the latter case, the stricture against a sexual relationship would be less grave.** [**The Talmud itself asks, according to the one view that the woman was only a penuyah, why the individual did not simply marry her and thereby lawfully satisfy his desires.(54) It responds laconically that "stolen waters are sweet,”(55) and that since the days of the destruction of the Temple the "sweetness" of sexual relations has been abused by the wicked. That is, this individual's lust was inseparable from the forbidden nature of his sexual object choice. Rashi (s. v. miyom) adds an interesting note that the destruction of the Temple caused such a deep seated anxiety in Israel that husbands can no longer enjoy their wives. This brings to mind Lowenstein's similar observation that the destruction of the Temple represents a massive national psychic trauma from which Jews continue to suffer; a reaction of mourning which seems to have never ceased.(56)]  Rambam appears to rule that accepting death remains the halakhic alternative even if the woman involved was only a penuyah, in the interests of safeguarding modesty. And he notes that this stringency is in force "le-dorot," forever.(57)

     It would seem that the prohibitions active when considering the treatment of homosexuality are both grave as well as broad enough to include most critical aspects of the current treatment methods. It might, therefore, seem that the halakhically observant professional has nothing to offer the homosexual patient desirous of change save helping the homosexual accept a halakhic status of oness, one compelled to be in one's condition. H. J. Matt considers this one satisfactory Jewish response to the current state of affairs.(58) Dr. Norman Lamm, in an extensive discussion, notes that Jewish law would grant most homosexual patients the status of oness, but that this status would not make homosexual acts any less abominable.(59) Thus, nothing in the general status of the homosexual condition would readily call for halakhic leniency with regard to breaching the standards of arayot.

     While one awaits a full response on the topic by recognized halakhic authorities, some possible directions toward a more active role for the therapist can be explored. With regard to the problem of verbalizing and thinking about material of otherwise forbidden sexual nature I offer the following: I have noted elsewhere that one can find halakhic schema or models for various psychotherapeutic processes which facilitate one's understanding of halakhically appropriate ways of addressing modern clinical and theoretical problems.(60) I will suggest two relevant factors which may argue for the possibility of an alternative halakhic model for hirhur asur in the psychotherapeutic encounter and then offer the model which satisfies the criteria implied by these factors.

     Firsts halakhic authorities emphasize that the context of hirhur arayot and hirhur asurhirhur derekh hibah ve-nishuk derekh ta’avah — as critical to establishing the gravity of their prohibition. That is, in certain contexts one can differentiate between the affective characteristics of a behavior or thought — e.g., its libidinal nature — and its value characteristics. Illicit motivation, for example, would lend a negative value characterization to affective responses whether these responses are erotic in nature or not. The extension of this is that individuals will differ with regard to temptation and the degree to which given erotic stimuli will elicit wanton or forbidden fantasizing. Indeed, it has been noted that halakhah is less concerned about hirhur in circumstances where fear would prevent undue wanton thoughts: e.g., in the presence of one's teacher or in the synagogue.(61) Thus, for example, while the rabbis warned against holding the membrum while urinating lest this stimulate forbidden hirhurim, this concern was theoretically relaxed in the above situations. While it bears repeating that these same authorities warned against taking latitude in this domain, the principle remains: there are certain contexts wherein the value characteristics of hirhur are not necessarily attached to the behavior.

     Second, and related to the above, is the need for becoming a gibor, a master over one's impulses, The consensus of talmudic opinion is that such mastery is not gained by repression of these impulses, but rather by rerouting them along acceptable lines.(62) A confrontation with such impulses, even forbidden ones, becomes part of the process of their respective conquest. However, this alone would not require that one force such confrontation into existence. Indeed, Rambam warns against seeking out situations of temptation so that one can willfully succumb and then do teshuvah — the logic of ehtah ve-ashuv is one of the things which actually hamper repentance.(63) Thus, an additional step is necessary before these two factors — the context of hirhur and the need for confrontation with one's yetzer — can be operationalized. This third step involves the proposal of an alternative model for hirhur in the context of the psychotherapeutic encounter: therapy as viduy.

     Viduy, generally translated as confession, is a critical component of repentance and kaparah, atonement. Repentance from any sin, whether of interpersonal nature or between man and God, requires full recognition of all aspects of the sin. This viduy must be both an internal and verbal experience.(64) In Rembam’s general definition of teshuvah, he specifies that the basic version of repentance includes a fully particularized and verbalized viduy as well as having re-experienced the original situation of sin — while one is in full possession of equal temptation and willingness to commit the sin (“. . . ve-hu omed beahavato bah u-bekoah gufo") — and resisting the need to sin.(65)

     Inasmuch as Rambam elsewhere states that repentance is a model for the appropriate response to both the ordinary understanding of sin as well as to personality flaws (de’ot ra’ot), it is hypothesized that the modern tool of psychotherapy can be conceptualized halakhically as following the models of teshuvah and viduy. This is not to say that merely reciting "Al Het" (the confession prayer) can be equated with full psychotherapy when psychotherapy is what is indicated, but rather that psychotherapy is accepted into the halakhic world via its meta-psychological form as viduy. If so, then all the halakhic details of viduy, its goals and mechanics, obtain with regard to the psychotherapeutic encounter as well.

     What was formerly hopelessly to be construed as hirhur asur now becomes a halakhic desideratum if it is therapeutically necessary for the successful modification of behavior- if it is something which should rightfully be confronted and dealt with during viduy. Even hirhur arayot becomes acceptable in this limited context.

     For, in the halakhic definition of the context as viduy, one deals with the affective nature of the thought/act divorced from its negative value characteristics — qua the experience of viduy — while, reflectively, one is aware that in other contexts the thought/act has negative value. In this capacity, hirhur asur is transformed into hirhurei teshuvah.

     Practically speaking, it becomes halakhically tenable to expect the fully religious patient to nondefensively probe, examine, and discuss the realm of hirhurim. At the same time, it becomes the onus of the therapist to ensure that the atmosphere of the therapeutic encounter remains consistent with the halakhic guidelines noted above. Resistance beyond this point needs to be handled like any other resistance in psychotherapy, paying careful attention to the secondary gain such cultural standards can afford the neurotic individual while recognizing, at the same time, the values of religious sensitivities. Viewed in this fashion, the psychotherapeutic process becomes an intrinsically halakhic process.

IV

     With regard to the problems encountered with behavior modification, some alternative approaches are also possible. First, one notes that the inviolability of the three cardinal sins, requiring yeihareg ve-al ya'avor ("Be killed rather than violate"), is generally limited to biblical levels of prohibition which, according to most authorities, includes the abizrayhu. Rabbinic levels of arayot, such as audio-visual material comprised of non-Jewish female models, would not demand yeihareg ve-al ya'avor — especially where life-threatening risk or severe psychiatric hazard is involved.(66) More important, the prohibitions referred to until now (even according to those who consider abizrayhu also a biblical infraction) evolve around the sexual act and impulse solely as a function of kiruv ve-nishuk derekh hibah u'be-derekh ta’avah: acts of intimacy in the manner of conscious desire for a forbidden relationship or forbidden relationships in general.(67) There should be a sense, then, in which the sexual act can be separated from the motive, if not from the biological mechanism of sexual arousal, such that one could conceive of a halakhically appropriate manner in which the homosexual patient might be allowed, certainly passively, to produce an erection to therapeutically introduced sexual arousal (stimuli of the type discussed in the beginning of this paragraph.) Some examples reflect the differentiation I am suggesting.

     According to one talmudic account, R. Ahah would dance with new brides on his shoulders, but advised others not to do so if they could not control their thoughts.(68) Though this example does not have direct bearing to the problem of “Ein kishuy elah le-daas, " it serves to separate motivation from an otherwise forbidden act. In another example, a ruling exists that when faced with an irrepressible desire to cohabit with one's menstruant wife, it is better to masturbate and thereby reduce this desire than to violate the biblical prohibition against sexual relations with a niddah.(69) In this case, the generally forbidden act of masturbation takes on a new identity since it is not motivated by primarily autoerotic desires. In a third example, the Talmud discusses the definition of saris (lit., a castrated individual, yet which includes any post-natal damage which causes sterility in generative organs) in the case of an individual who had an opening in the penile shaft which had subsequently healed. A satisfactory reversal of the status of saris is defined as a wound so well healed that a normal ejaculation would not re-open the wound. In an attempt to operationalize this definition, Abaye suggests showing the individual some women's colorful clothing so that an ejaculation might be caused.(70) Though this opinion is rejected by the Talmud and is not included by subsequent codifiers, the implicit point is that there may be motivationally-based exceptions to the principle "Ein kishuy elah le-daas," such as where the erection is not the result of an object- specific forbidden sexual relation. Though a biological urge as part of a complex psychophysiological mechanism is involved in these cases — the affective characteristic — the problematic ta'avah or illicit arousal — the value characteristic of the act — need not be operative. Interestingly, in a careful and cautious consideration of the standard methods of obtaining a sperm sample where medically indicated, R. Moshe Feinstein uses Abaye's approach as a justification in permitting some methods (though he prohibits wanton behavior in this regard or any immodesty such as a couple having intercourse in the physician's office so as to obtain a fresh sample).(71) R. Feinstein, ruling leniently so as to permit the individual in question to marry, is proposing that in this context masturbation is a different phenomenon than that usually prohibited. Nevertheless, precisely from the standpoint of the clinical requirement that the patient undergoing behavioral therapies experience the sexual sensations of pleasure without anxiety and as desirable and pleasurable sexual responses, it is difficult to say that the psychological factors concomitant to the physical evidence of arousal are separable.

     Finally, consider Rambam's specific phraseology when discussing the case of the Talmud, Sanhedrin 75a: "He who sets his eyes upon a woman and becomes moribund ... he should die rather than have intercourse with her even if she be a penuyah. And even to talk with her from behind a wall we do not instruct him to, and he should die and do not rule for him to speak with her from behind the wall. . .”(72) That is, as far as the abizrayhu of arayot is concerned, there may be no real imperative to die rather than accept some alternative, yet we do not openly instruct individuals to follow the alternative. That is, this stringency may be the case of halakhah ve-ein morin kain.(73)

V

    We are now in a position to discuss certain social and ethical issues confronting the mental health practitioner. There is no need to repeat considerations here which have been carefully examined in Rabbi Lamm's essay. However, I wish to add a few issues regarding the professional's response to homosexuality.

     On December 14, 1973, The American Psychiatric Association voted to eliminate the classification "homosexuality" from the list of non-psychotic sexual deviations in future editions of the widely used Diagnostic Statistical Manual (Vol. 3, January, 1980). This decision had been lobbied for over a period of time, The APA, supported its decision with documentation that homosexuals do not show evidence of other psychopathology and do not, as a group, exhibit any greater amount of personality disturbances than do heterosexuals as a group.(74) Opposing views were expressed through a referendum signed by some 3,700 psychiatrists, but were ignored.(75) This was, in effect, to ignore many extensive studies of homosexuality that had carefully concluded that homosexuality was inherently pathological or that, at least, homosexuals do exhibit greater to lesser degrees of additional personality disturbances related to their sexual orientation.(76) A more pivotal issue, however, appears to have been a statistical one; i.e., given that homosexuality, in view of the APA favored evidence, was merely a sociological artefact,  in what sense could it continue to be considered a "deviant" sexual orientation? The decision of the APA was clearly a response to this question.

     An important issue begged by this decision is whether the numerical frequency of a constellation of behaviors says anything about the inherent normal or abnormal status of such behavior. On the one hand, this issue was made obsolete by prior convention to replace the medical term "sickness" and certainly the concept of "sin" with more libertarian terms such as "maladaptive" or "inappropriate" when describing pathology. For, it had already been accepted that "deviance is not inherent in but conferred upon" such that all standard pathologies are potentially capable of being reabsorbed into the normal end of the continuum when sufficient "evidence" presents itself. The implications of the demarcation "sin" are clearly antithetical to this supposition. Psychology, indeed, cannot consider homosexual behavior "sinful" for sin is a relevant concept only in a system that places distinct values on the uses and misuses of human freedom. Psychology, as primarily a restorative system, does not dictate the terms in which humans make freedom meaningful. This is the prerogative of religion. At the same time, this limitation in psychology does not mean that it is incapable of making any statements about the intrinsic qualities of certain acts or states of being. The APA decision, however, indicates that many professionals are willing to accept this limitation in extremis.

     Another assumption implicit in the APA decision seems to be that the purpose of diagnosis is demarcating social norms, in which ease the frequency of behavior rightfully serves to determine normality or abnormality. However, diagnosis is also an evaluative scheme which involves statements about the intrinsic qualities of behaviors or traits which, as was noted, have been glossed over in this case. Most important, diagnosis is also an interventative scheme. As such, some have argued, if we continue to consider homosexuality a sexual deviation,(77) one falsely implies that all homosexuals need or should obtain treatment since intervention by definition requires application to pathology. This violates the rights of those homosexuals who do not feel the need for treatment and who wish to live their lives as homosexuals. It can be counterargued that characterising an entity or constellation of behaviors as pathological is not itself a necessary or sufficient condition for intervention (e,g., one could imagine "intervening" at a heterosexual's behest and transforming him or her into a homosexual. via conditioning procedures). It can be further argued that the falsity of the implication that all homosexuality requires treatment should not affect its status as a sexual deviance. The possibility that the pathology label is not a necessary or sufficient condition for treatment should mean only that one can rightfully suspend judgment. on whether or not homosexuality is inherently deviant (which halakhah would reject), but not that one can conclude that homosexuality is eo ipso nondeviant. I am suggesting that the type of a fortiori arguments offered to question the deviant status of homosexuality are not as valid as supposed.

     Can Judaism accept homosexuality as an "alternative sexual preference?" Clearly, since by their use of the phrase, gay rights advocates intend acceptance of homosexuality as a normal preference, Judaism cannot admit this sexual orientation into its continuum of sanctified behavior. Homosexuals are, without. doubt, bona fide members of the Jewish community but are unable to satisfy the halakhic goals for sexuality. Should Judaism openly preach its negative stance? Lamm has discussed this question with regard to a Jewish policy on gay synagogues.(78) I cannot amply cover this topic here but wish to consider the following: H. Matt notes that even if Judaism adopts a negative stance toward the status of homosexuality, such a policy will still help reduce anxiety, guilt and self-blame -- frequently secondary problems for the otherwise marginal homosexual — in that it allows the individual to gain a sense of his halakhic responsibility vis-a-vis homosexuality.(79) Which is to say, according to Matt, that a homosexual aware of the halakhic view can, without self-blame, accept this condition not as a sin or sickness but as oness.

     Unfortunately, Matt bases his view on the mistaken assumption that there is nothing psychotherapy can offer the homosexual patient. This is not completely the case.(80) Second, whether or not the homosexual condition is categorizable as oness does not change the fact that, in a certain metapsychological sense, halakhah views the status of homosexual being as to’evah or sinful. Third, even if the condition begins as oness there is halakhic concern that subsequent homosexual acts, committed in full knowledge of the halakhic view and where the individual is not overtaken by psychotic compulsion, are reprehensible. The danger is that homosexuals may come to accept their condition not merely as oness but as normal for homosexuals. This is the thinking which has led to the encouragement of the "non-treatment" approaches to homosexuality.(81)

     How Judaism's negative stance will help reduce guilt and self-blamer according to Matt, also needs consideration. Surely, halakhah shares in the desire to reduce neurotic self-blame and guilt where the latter stand in the way of productive living.  However, anxiety and guilt operate on two levels. One must differentiate dynamic conflict — based on psychosexual issues relating to the development of homosexuality in an individual and as evidence of the incompleteness of the neurotic compromise represented by the homosexual orientation — and religious conflict — uniquely characteristic of an individual's awareness of the incompatibility between the homosexual preference and the halakhic ideal. The second type of conflict is also "dynamic" in that it involves different levels of consciousness and internal disequilibrium, through conflict between halakhic ideals and ego rather than merely between ego and intrapsychic factors. Yet it is uniquely a "sinful" conflict in that the parameters of conflict are not necessarily merely the result of irrational superego tensions, but rather are characteristic of the primacy of halakhic values for such individuals. There is no a priori requirement that such conflict be labeled neurotic in the strictly clinical sense.(82) Precisely when such conflict is evident does one know that the individual's endeavor to distort the relationship between halakhah and reality has begun to weaken. In this case, guilt and self- blame become halakhically desirable.

     I have discussed the halakhic view of homosexuality and considered some of the ethical issues which face the Jewish professional and social policy maker. The halakhic view of homosexuality is not a popular one nor is it likely to seem a very compassionate one. The halakhically observant professional must look upon the growth of psychiatric specialists who treat sexual dysfunctions (e.g., impotence, ejaculatory incompetence) solely in homosexual couples, or any attempt to treat homosexuality as a normal sexual preference, as an infraction of "ve-lifney iver lo titen mikhshol.”(83) Maintaining this halakhic view in professional circles and in public may come as an embarrassment to many. However, halakhah’s obligations to society and the individual must be understood as reflecting a higher understanding of human nature.


Moshe HaLevi Spero received his M.S.W. in psychiatric social work from Case Western Reserve University, School of Applied Social Sciences, Cleveland, Ohio, and an M.A. in psychology from the University of Michigan, Ann Arbor, where he is currently a doctoral candidate in clinical psychology at the Department of Social Work and Social Sciences (Psychology). Spero is associate editor of the Journal of Psychology and Judaism. The present essay is a chapter from his new text, Judaism and Psychology, Halakhic Perspectives (N.Y.: Ktav/Yeshiva University Press), 1980.

NOTES

  1. Lev. 15:23.
  2. Lev. 20:13. Sanh. 52a cites Jer. 3:20:’’ ‘Thus has Israel rebelled against Me, says the Lord, and an abomination has been committed in Israel and in Jerusalem’ — this refers to mishkav zakhor.” However, the passage cited does not contain the critical final clause. It rightfully belongs to Mal. 2:11 and possibly a reconstruction of Jer. 6:15, 8:12. That homosexual acts are arayot is also supported both by the fact that it is an illicit sexual relationship punishable by karet and by Rambam’s compsrison in M. T.;Hil. Rotzeah u’Shmirat ha-Nefesh 3:11 (to Sanh. 72b-73a), “But one who is
    being homosexually attacked (ha-zakhor), one may save his life by sacrificing the life of the pursuer as is the case u4th all the arayot
  3. Lev. 20:13 and supra, note 2.
  4. Deut. 23:18; cf. Targ. Onkelos loc. cit; Sanh. 24b; M. T.; Hil. Isurei Biah
    12:14. An animal that is involved in zoophilia is stoned because of the travesty (kalon) that occurred due to it. Such an animal is also unfit to be brought as a sacrifice, even if its involvement in such an act was accidental. Such is the level of sanctity that is required even of the lower species! See Sanh. 65b: Tem. 28b; M. T.; Hil. Isurei Mizbe’ah 3:6.
  5. Lev. 18:18.
  6. Yev. 76a; Sanh. 69; and as me‘soledot, Jer.Git. 8:8.
  7. Tur Sh. A.; E. H. 20; M. T.; Hil Isurei Biah 21:8.
  8. Yev. 76a; Sifra 9:8;cf. Tos., Shab. 65b; R. Schindler incorrectly states that a lesbian is not permitted to the priestly class; in fact, only the High Priest may not marry a lesbian; see his “Homosexuality, the Halacha, and the Helping Professions,”Journal of Religion and Health, 1979, 18 (2), 132-137.
  9. Sanh. 58a; M. T.; Hil. Melakhim 9:5-6.
  10. Tur Sh. A.; E. H. 20.
  11. M. T.; Hil. Isurei Biah 1:15
  12. Yev. 83a: M.T.; Hil. Isurei Biah 10:18, Hil. Nashim 2:24, Hil. Nazir.2:10; see Resp. Yavetz: E.H. Vol. 1, 171.
  13. Cited in Ibn Ezra to Lev. 18:22.
  14. Kid. 81b-82b.
  15. M. T.; Hit.Isurei Biah 22:2.
  16. Sh. A.; E. H. 24.
  17. BaH to Tur Sh. A.; E. H. 24,
  18. Ibid., see Arukh ha-Shalchan: E. H. 24.
  19. M.T.;Hil. Isurei Biah 21;19 (on Niddah 13b); Peirush ha-Mishnayot to Sanh. 54a; Tur Sh. A.; E. H. 23:2; Shab, 64a; M. T. Hil Yesodei Torah 5:6, 9; Hil. Isurei Biah 21:1, RaN to Pes.25b; Rama to Sh. A.; Y. D. 157:1; cf. SHaKH to Sh. A.; Y. D. 157:9.
  20. Ned. 51a.    
  21. See the interchange between Rabbis M. Tendler and 0. Feldman in Tradition, 1967, 9(1-2), pp. 205-212; 1968, 9(4), pp. 140-147.
  22. Sefer ha-Hinukh, #209-210.
  23. Ibid., #210; see Sanh. 57a, 108a; Gen. 6:12.
  24. Gen. 2:24
  25. Sanh, 58a; Jer. Kid. 1:1
  26. Torah Temimah to Gen. 2:24.
  27. Gen. 2:24
  28. Bieber, I. "Homosexuality," pp. 963-976, In A. Freedman & H. Kaplan (eds.} Comprehensive Textbook of Psychiatry (Baltimore; 1972), p971.
  29. Gen. 6:2
  30. Yev. 63a.
  31. See j. Epstein (Ed.) Shiurei ha-Rav (New York:1974), pp. 64-67 and P. Peli (ed. and trans.) Besod ha-Yahad ve'ha-Yihud (Jerusalem:1976), P.217.
  32. Lev. R. 24:6; Jer, Yev. 2:4
  33. Num 11:10
  34. Shab. 130a; Yoma 75a; Jer. Tan. 4:6.
  35. Hag. 11b; Makot 23b.
  36. M. T.; Hil. Isurei Biah 22:18-19.
  37. See H. Benjamin, "Should Surgery Be Performed on Transsexuals?" American Journal of Psychotherapy, 1971, 25(1), pp. 74-82; J. Marmor, "Homosexuality and Sexual Orientation Disturbances,” pp. 1510-1620, In A. Freedman, H. Kaplan and B. Sadock (eds.) Comprehensive Textbook  of Psychiatry (Baltimore: 1975); Bieber, op. cit., 1972; J. Hinrichsen and M. Katahn, "Recent Trends and New Developments in the Treatment of Homosexuality," Psychotherapy: Theory, Research & Practice, 1975, 12(1), pp.83-90.
  38. S. Gold and I. Neufeld, "A Learning Approach to the Treatment of Homosexuality," Behavior Research and Theory, 1965, 3, pp. 201-204; J. LoPiccolo, "Case Study: Systematic Desensitization of Homosexuality," Behavior Therapy, 1971, 2, pp. 394-401.
  39. J. Marquis, "Orgasmic Reconditioning: Changing Sexual Object Choice Through Controlling Masturbatory Fantasies,” Journal of Behavioral Therapy and Experimental Research, 1970, 1, pp. 263-270.
  40. Ibid., and A. J. Wabrek and C. J. Wabrek, "Ejaculatory Incompetence," Connecticut Medicine, 1976, 40, pp. 450-453.
  41. Yoma 29a
  42. Ket. 46a; A. Z. 20b; B. B. 164b; Niddah 18b on Gen. 38:10; TDE Zuta 6; Hul. 37a on Ezek. 4:14; see also M. K 18b; Zeb. 46b; Meg. 20a; Kid. 59b.
  43. Num.32:22.
  44. Lev. 11:44-45, 20:7, 26; Num. 15:40.
  45. Deut. 23:10.
  46. Lev. 18:6; M. T.; Hil.Isurei Biah 21:1, Hil. Teshuvah 4:5; and see Resp. Igrot Moshe; E. H., #69.
  47. RaN to Pes. 25b.
  48. Yev. 53b;  Sefer ha-Hinukh #556; M. T.; Hil. Sanhedrin 20:3, Hil. Isurei Biah 1:9
  49. Resp. Igrot Moshe: Y. D., Vol. II, #59; see also Mishneh la-Melech (8) to M. T.; Hil. Yesodei Torah 5:8.
  50. Minhat Hinukh #556.
  51. See Hul. 10a;   Yoma 85a; Jer. Yoma 8:5; Jer. Ber. 4:4;  Sh. A.; Y. D. 116.
  52. C. Chavel (ed.), Kol Kitvei Ramban (Jerusalem: 1968), Vol. II, p. 43; and see Ramban to Sanh, 30a; RaN to Taan. 22b.
  53. Sanh. 74a-75a.
  54. Sanh. 75a.
  55. Prov. 9:17
  56. R. Lowenstein, "The History and Cultural Roots of Anti-Semitism," pp. 313-357, In G. Roheim (ed.) Psychoanalysis and the Social Sciences (New York: 1947), p. 350; R. Lowenstein, Christians and Jews: A Psychoanalytic Perspective (New York 1965, p. 1.69.)
  57. Tashi and Tos. to Sanh. 75a and Pes. 25b consider that abizrayhu is not in the category of yeihareg. The RaN, R. Yonah and Rambam (M.T.; Hil., Isurei Biah 21:1) hold that abizrayhu is of this category (unlike