A cross-discipline study has challenged the belief that human sexuality and gender identity are determined by biology and remain fixed, saying that there is no scientific proof of this. The study cautioned against drastic medical treatment for transgender children.

The notion that sexual orientation is predetermined by biology is an important part of the current LGBT discourse. If a person has no choice over whether to be gay or not, society cannot demand that he or she be straight, so the argument goes.

But regardless of its political worth, the “born this way” paradigm is not backed up by sufficient scientific data, according to a new paper published in the autumn issue of the New Atlantis, a journal focusing on political, societal and ethical ramifications of technological advances.

The study does not claim that being gay is a choice, merely that stating the opposite may be wrong.

The 144-page paper was written by Dr. Lawrence S. Mayer, an epidemiologist and biostatistician also trained in psychiatry, who is currently a scholar in residence at the Department of Psychiatry at Johns Hopkins School of Medicine, and Dr. Paul R. McHugh, a renowned psychiatrist, researcher, and educator and former chief of psychiatry at Johns Hopkins Hospital. The paper’s three parts focus on sexual orientation, links between sexuality and mental health, and gender identity.

Drawing on studies in fields varying from neurobiology to social sciences, the authors wrote that “The understanding of sexual orientation as an innate, biologically fixed property of human beings – the idea that people are ‘born that way’ – is not supported by scientific evidence.”

The term ‘sexual orientation’ itself is ambiguous and is used to describe attraction, behavior or identity by different researchers. Sometimes it refers to things such as belonging to a certain community or having certain fantasies.

“It is important, then, that researchers are clear about which of these domains are being studied, and that we keep in mind the researchers’ specified definitions when we interpret their findings,” the paper said.

There are biological factors associated with sexual behavior, the paper acknowledges, but there are no compelling “causal biological explanations for human sexual orientation.” Differences in the brain structures of gay and straight individuals identified by researchers are not necessarily innate and may be the result of environmental or psychological factors.

“The strongest statement that science offers to explain sexual orientation is that some biological factors appear, to an unknown extent, to predispose some individuals to a non-heterosexual orientation,” the paper said.

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LGBT individuals are statistically at greater risk of having mental health problems than the general population, the authors say. As a more dramatic example, “the rate of lifetime suicide attempts across all ages of transgender individuals is estimated at 41 percent, compared to under 5 percent in the overall US population.”

The usually accepted explanation for this is social stress from discrimination and stigma, but the study said that those factors may not solely explain the disparity and that more scientific research on the issue is necessary.

The paper added that the notion that gender identity is fixed and determined by biological factors is also not backed up by data.

“In reviewing the scientific literature, we find that almost nothing is well understood when we seek biological explanations for what causes some individuals to state that their gender does not match their biological sex,” the authors said.

They strongly advocate caution in resorting to drastic medical treatment such as sex-reassignment surgery for people identified or identifying as transgender. This is especially true in children, whose sexuality is mutable and for whom such treatments may do more harm than good, they warn.

“There is little scientific evidence for the therapeutic value of interventions that delay puberty or modify the secondary sex characteristics of adolescents, although some children may have improved psychological well-being if they are encouraged and supported in their cross-gender identification,” the paper said. “There is no evidence that all children who express gender-atypical thoughts or behavior should be encouraged to become transgender.”

“Sexual orientation and gender identity resist explanation by simple theories. There is a large gap between the certainty with which beliefs are held about these matters and what a sober assessment of the science reveals. In the face of this complexity and uncertainty, we need to be humble about what we know and do not know,” it said.

The authors noted that their paper touches upon controversial issues and insist that first and foremost it is about science and the need for additional evidence in the field. Mayer said many people who contributed to the report asked not to be identified so as to distance themselves from the potential backlash.

“Some feared an angry response from the more militant elements of the LGBT community; others feared an angry response from the more strident elements of religiously conservative communities,” he said. “Most bothersome, however, is that some feared reprisals from their own universities for engaging such controversial topics, regardless of the report’s content—a sad statement about academic freedom.”

The paper was specifically written for the general public to draw attention to mental health problems of the LGBT community, the authors said. McHugh is an opponent of sex reassignment surgery for transgender people, arguing that it often fails to improve their well-being and instead does the opposite in the long run.