In her response to the article “Clinicians and the care of sexual minorities,” Nancy Lawless describes gay, lesbian, bisexual, and transgendered people as having made a “lifestyle choice” that “leads to an earlier death.” The American Academy of Pediatrics and the American Psychological Association believe that homosexuality probably has many causes. The same could also be said of addiction, which Dr. Lawless referred to as a parallel “lifestyle choice.” A rebuttal to her patently false statement suggesting a causal relationship between homosexuality and early death is beyond the scope of my letter. However, printing these remarks in a professional publication is, in my opinion, gross editorial negligence and undermines our commitment to empirical discourse.

Patrick Burke, ACP Associate Member
Houston

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Dr. Lawless compared the lifestyle choices of sexual minorities to people with “addictions, those who drive drunk, and prisoners.” Although we wonder about the potential impact of her views on her patients and society, we recognize that the First Amendment protects her right to express her views. However, the editors had the ability and—we would argue—the obligation to exercise editorial control in their decision to publish her comments. Dr. Lawless objected to using the term “sexual minorities” because this puts these groups “in the same class as minorities over which people have no control, such as race and handicapped status.” While people may not have control over their race, they presumably have control over the people with whom they have offspring. If you published an excerpt of a book on the effects of Tay-Sachs disease on Jews, and a reader submitted a letter expressing the opinion that the decision of a Jew to have children with another Jew was a “lifestyle choice” that should be controlled, would you have published it, or would you have felt that such an anti-Semitic comment had no place in your publication, even if expressed by a reader, a physician, and an ACP Member?

Colleen Christmas, ACP Member
Jen Hayashi, ACP Member
Roy Ziegelstein, FACP
Baltimore

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