Hendrik's done his homework

A few weeks ago, the Imprint published a letter in which I pointed out that in the case of predominately male homosexual activities such as anal intercourse, fisting, etc., we should ask a few questions before we accept the justification "If someone enjoys something different, accept it, and get on with your life." I asked the following questions: (1) In terms of health care dollars and the effects of redirected health care resources, what is the cost of these sexual activities to Canada's larger population (which does not indulge in such activities)? (2) Does this cost seriously infringe upon the interests of the larger population? (3) Is this cost fair or unfair to the larger population? My letter elicited criticisms, and so I would like to respond to my critics and show that my questions haven't been answered.

Andrew Brouwer (in "Have you done your homework, Hendrik?", Imprint, July 27, 1996) finds it "most disturbing" that in my letter I make the "assumption" that homosexual males "are more likely to acquire the HIV virus which causes AIDS." Mr. Brouwer, however, neglects two facts: (1) I'm discussing Canadian homosexual males; and (2) In a postscript to my letter I point out that according to Susan Martinuk (who obtained her information from Health and Welfare Canada), 94% of all AIDS victims in Canada are males and homosexuality is related to 87% of these cases. Thus, because homosexual males constitute a small percentage of Canada's general population--yet also constitute a vast majority of Canadians AIDS population--we can reasonably conclude that Canadian homosexual males are more likely to acquire AIDS than are other Canadians. Contrary to what Mr. Brouwer asserts, then, I do not make an assumption about homosexual males and AIDS--I appeal to evidence. And it's the evidence that is most disturbing. (For further substantiation, see Statistics Canada's Canadian Social Trends, Summer 1996, p. 6, which points out that 80% of all Canadian AIDS cases are related to male homosexual behaviour.)

Mr. Brouwer also tries to discount the disturbing evidence that in 1992 heart disease killed 83 times as many Canadians as did AIDS yet in 1994 cardiovascular research received half the public health dollars that AIDS research did. According to Mr. Brouwer, the apparent injustice here is to be tempered by two facts: (1) "Smoking can be paralleled with heart disease the same way in which unsafe sexual practices are paralleled with HIV infection, which causes AIDS"; and (2) "a person infected with full blown AIDS experiences exposure to terminal diseases." But isn't Mr. Brouwer forgetting to address a few important questions? For example: Aren't smokers with full-blown heart disease suffering a terminal disease too? And: Why should their lives be less important (from a public dollars point of view) than the lives of AIDS patients? And: Since the illnesses due to smoking and the illnesses due to unsafe sexual practices both arise from life-style choices, why aren't the public health care dollars more equitably distributed?

Kieran Green (in "Fickle statistics and other obscurities," Imprint, July 26, 1996) admonishes me to be careful with statistics, because "Any given figure can be interpreted or reinterpreted to support a variety of different positions." This is correct, and I accept the wisdom of his admonishment. Nevertheless, I think it is also wise to remind Mr. Green that we should be careful not to abandon statistical data altogether. Just because some statistical evidence is poor or misleading, it does not follow logically that all statistical evidence is poor or misleading. Also, just because a specific bit of statistical evidence might be poor or misleading, it does not follow logically that it is. In other words, instead of closing our eyes to statistical data because there exists a possibility that it's poor or misleading, we need to carefully examine the data from the point of view of good reasoning, and then glean what is probably true and thus reasonable to believe.

To his credit, Mr. Green is on target in his desire to be cautious about the statistics I present. However, because he thinks there might be a flaw, he seems simply to dismiss my claim (from Martinuk) that heart disease killed 83 times as many Canadians in 1992, yet in 1994 cardiovascular research received less than half the public health care dollars that AIDS research received. According to Mr. Green, because the data has to do with two different years, I am guilty of "Comparing apples and oranges perhaps." Well, perhaps-- but very apparently not.

Consider the following data: (1) Covering approximately a 15 year period, the total number of reported AIDS-related deaths in Canada by the end of 1995 has amounted to 9,133 (Canadian Social Trends, p. 8); (2) the average number of Canadian women who die from breast cancer each year is about 4,500 (Alberta Report, January 18, 1993, p. 8.); and (3) the average number of Canadians who die from cardiovascular disease each year is about 75, 000 (Causes of Death 1992-94, Statistics Canada). Now, consider the federal government 's spending. That is, consider the fact that in 1993-94 the AIDS Strategy program received $35 million, Breast Cancer received $2.5 million, and Cardiovascular Disease received $3.8 million. Also, consider the fact that in 1994-95 the AIDS Strategy program received $43.5 million, Breast Cancer received $4.0 million, and Cardiovascular Disease received $3.8 million. (For substantiation of these allocations of federal funds, see "The Reform Party Dissenting Opinion on the Study of the National AIDS Strategy," available from Sharon Hayes, M.P., Port Moody-Coquitlam.) Thus, considerable data still points strongly in the direction of some very disproportionate allocations of public health care dollars.

Near the end of his letter, Mr. Green raises some very important questions about the possibility of achieving equitable public health care. He asks: "[A]t what point do we start curtailing rights because they are going to cost us more?" And he asks: should motorcyclists be banned from riding their motorcycles since they are prone to more seriously injurious accidents? These are tough questions, and Mr. Green seems to think that their toughness precludes the possibility of any reasonable social response. But a reasonable social response is not impossible.

Consider Mr. Green's example about the motorcyclists. In the case of a motorcyclist whose driving directly endangers the physical health and welfare of others, we deprive that person of his/her driver's license and we might even throw that person into prison (depending on the extent of the injustice perpetrated by that person). The point: As a society, we actively limit socially irresponsible behaviour, and we do curtail rights when we have determined that behaviour to be unjust to others. Now, suppose we have a small group of motorcyclists who are so prone to personal accidents that they tax the public health care system to such an extent that non-motorcyclists--who also have an equal right to health care-- are given, say, 83 times less health care. Wouldn't it seem reasonable for the motorcyclists and non-motorcyclists to think that such motorcycling is unjust (even though the exact point at which any injustice enters the picture is difficult to determine)? And (if such motorcycling is unjust) wouldn't it seem reasonable to suggest to these motorcyclists (after we look after their health) that, if their safe-motorcycling lessons continue to fail, perhaps they should consider the options of driving a car? So far, so good.

Of course, at this juncture some persons will object that when discussing homosexual behaviour, the motorcyclist analogy breaks down. That is (or so the argument would go), unlike our hypothetical motorcyclists, homosexuals are "born" that way--i.e., their homosexual orientation and behaviour stems from a propensity which originates in their genes or hormones or brain structures--and so the rest of society must accept and affirm their right to behave the way they do. Three points, however, can be made to seriously weaken this argument. First, the scientific jury is presently still out on the issue of homosexual origin (homosexuality seems likely to be due to a combination of differing degrees of biology and environment, nature and nurture). Second, there is considerable and growing evidence that many homosexuals desire to change, can change, and do change to heterosexuality; which means that we have evidence that shows that homosexuality is for many not an immutable characteristic. (For substantiation, see Joseph Nicolosi's Healing Homosexuality: Case Stories of Reparative Therapy (1993); or write HOMOSEXUALS ANONYMOUS, P.O. Box 7881, Reading PA 19603; or phone Toronto's NEW DIRECTION FOR LIFE at 1-416-921-6557.) And third, and very importantly, we need to remember the logical point that from the fact of merely having a biological propensity to behave in a certain way, it does not follow that the behaviour in question is socially acceptable.

Thus, I still maintain that a few questions need to be asked about homosexual and other variant sexual behaviours before we blindly accept the maxim "If someone enjoys something different, accept it, and get on with your life." And so, in spite of Mr. Brouwer's and Mr. Green's unsuccessful criticisms, here again are some reasonable-to-ask questions concerning the predominantly male homosexual activities of anal intercourse, fisting, etc.:

Question 1: In terms of Canada's public health care dollars and the effects of redirected health care resources (i.e., effects such as suffering and lost lives), what is the cost (i.e., dollars plus suffering and lost lives) of these activities to Canada's larger population (which does not indulge in such sexual activities)?

Question 2: Doest this cost seriously infringe upon the interests of Canada's larger population?

Question 3: Is this cost fair or unfair?

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