01:00 AM EDT on Wednesday, June 1, 2005

IN Dr. Michelle Cretella's Commentary column ("Gay households tend to be bad for kids," May 20) and her May 26 letter ("Study versus study on gays and families") in reply to a critical letter, she states that she wouldn't denigrate her gay friends, but with her words she seems determined to do just that.

There are few successes in changing sexuality except those in which the people have been blinded by their religious faith, such that therapy decreases the guilt imposed on them by their religion.

How sad. This is not to say the individuals uncomfortable with their sexuality do not need counseling. However, permanent change in orientation is highly unlikely.

To say that gays are "free to pursue that lifestyle,[yet] do not have the right to subvert an institution that serves the foundation of society" speaks of ignorance. Gays are not subverting religious marriage in any way. This debate is over civil rights and securities only. That distinction is imperative to understand.

First, as physicians, we expect a better analysis of empiric data. The studies used by the American Academy of Pediatrics (AAP) were not from gay-activist groups. Policy statements from the AAP are based on extensive review and credible science -- not beliefs, morals or judgments.

Second, the notion that homosexuality is not biologically or genetically determined but, rather, affected by the environment, preventable, and/or reversible is unfounded.

Dr. Cretella's opinion on reorientation therapy is equally false. No such program has ever reproducibly produced reliable and consistent reorientation.

As long as she believes that homosexuality is a choice, she can rationalize her condemnation. Once it is agreed that homosexuality is a natural sexual orientation for some, it is harder to oppose equal civil rights for this minority population.

Third, long-term outcome data on children from homosexual households is not limited. It may not yet be legal to marry, but gay couples have had children through in-vitro fertilization or adoption for decades, and the children from these families have equally healthy development, with no increase in their sexual confusion, compared with children from heterosexual households.

Again, the studies used by the AAP are not flawed or short-sighted. While promiscuity may be an issue for a segment of the gay population, it is no worse than within the straight population. This is just stereotyping.

Such toxic influences on child development as domestic violence and alcoholism are no less frequent in heterosexual households.

The American Psychological Association and the American Psychiatric Association are both preparing policy statements similar to those of the American Academy of Pediatrics, the American Medical Association, and the American Academy of Family Practitioners in support of gay marriages and families.

The "evidence" that homosexual marriage is harmful to children and teens is not there, except in studies from religious organizations -- not empiric nor peer-reviewed.

The American College of Pediatricians is a relatively small group of pediatricians who have disengaged from the American Academy of Pediatrics over these "family values" issues. In contrast, the AAP, with over 60,000 members, provides the foundation of pediatric policy for children across America. The ACP study that Dr. Cretella cites is by a researcher at the Center for Marriage and Family Studies, a faith-based organization. And the National Association for Research & Therapy of Homosexuality, to which she refers, states that it is dedicated to a male-female model of sexuality.

Hardly unbiased conclusions.

Finally, repeatedly stating that homosexuality is a lifestyle choice doesn't make it true. Nevertheless, Dr. Cretella says that teens who adopt this "lifestyle" are at higher risk of depression, substance abuse, etc. It seems plausible that if true it is because they have to develop and mature contending with discrimination, abuse and ignorance.

The strength and security of committed gay relationships are evidenced by community involvement, leadership and household integrity.

We hope that as a physician Dr. Cretella will stick to the evidence and not the path of bigotry she has chosen.

Andrew M. Snyder, M.D., is vice president of the Rhode Island Chapter of the American Academy of Pediatrics.