In 1979, while conducting research for the completion of a textbook for Cambridge University Press on the neuroendocrinology of the genitourinary system (1) , I became briefly distracted by a startling discovery buried deep in the research publications. It was a common belief during this period that 90% of the time erectile dysfunction, or “impotence” as it was loosely labeled, was the result of a psychologic disorder. This belief had gone unchallenged for nearly thirty years in the literature. And yet, as part of due diligence, I traced the original source of this bias to an article written in the British Medical Journal in 1950 by “expert” Dr. S.L. Simpson who stated without evidence that “It is perhaps of clinical interest that for every one case of organic impotence that comes my way, I see at least 10 of psychological impotence.” (2) Tapping into more current studies in the vascular, neurologic and endocrinologic literature, some months later, I published in a US peer reviewed medical journal the paper, “Psychogenic Impotence: A Critical Review”.(3) In that paper I argued for the use of scientific nomenclature (“erectile dysfunction” versus “impotence”), additional research to define the physiology and pathophysiology of erectile function and dysfunction, and for the demystification and greater transparency around this essential bodily function. Twenty years later I spent 2 years traveling with Senator Bob Dole in a campaign to promote transparency and open discussion of erectile dysfunction between patients and their physicians, and the associated risks of underlying heart disease, diabetes and hypertension.

The three failings that victimized those suffering from erectile dysfunction, namely sloppy nomenclature, weak or absent research and non-transparency, have now trapped leaders of the Roman Catholic Church in a downward spiral. The critical question that remains unanswered is whether the Church’s practice of enforced abstinence from sexual activity, either by skewing selection for the priesthood, or by subsequent creation of deviant behaviors and a range of mental illnesses, creates an unacceptable risk for the future priests and for their parishioners.

Words matter in science. Celibacy? What exactly does it mean? It is a religious, not a scientific term, surrounded by controversy. It is derived from the Latin word caelib which means single. Some interpret it to mean “unmarried”; others define it as “refraining from sexual intercourse”; and others still believe a celibate life commits one to refraining from all sexual life including masturbation and sexual ideation. This lack of basic agreement on the meaning of fundamental definitions, as with the definition of “impotence”, cripples scientific research from the onset.

If the nomenclature is weak, so is the body of research. What passes for research in this field, on both sides of the argument, is as weak and unsubstantiated as was Dr. Simpson’s opinions on “psychological impotence” in 1950. Research has been hampered by limited access to the priests who are the subjects, poor study design, and rapid labeling of scientists who would dare tread into this dangerous minefield. As a result, we really don’t know whether mandating control over expression of one’s natural sexuality results in higher rates of sexual abuse, mental illnesses including depression and crippling anxiety, and higher then normal levels of drug and alcohol abuse compared to comparative control subjects.

Finally there is non-transparency with its clear record of institutionalized cover-up, information released in bits and pieces under duress, secrecy and the force of litigation which could threaten the Church’s survival. So, drawing on my past experience, and as a Roman Catholic who would like to see the Church survive and become healthy, here are my suggestions to the Church’s leadership. First, make your priests available to researchers to rigorously and scientifically study the connection, if any, between mandated restrictions on adult sexual function and abnormal sexual behaviors and mental illness. As a derivative of this research, as occurred in the study of erectile function, rigorous scientific terminology will be well defined and agreed upon at the outset. Second, commit to the publication of these peer reviewed studies, whether positive or negative results. Finally, should it be determined that this practice of restricted sexual expression places the priests themselves and their parishioners at risk, commit to eliminating mandatory sexual abstinence as a prerequisite for entry into the priesthood. If careful scientific examination is able to establish that the risks associated with this practice far out distance the benefits, have the courage to admit and correct the error, which is certainly the road that Christ would travel.

References:
1. Magee MC. Psychogenic Impotence: A Critical Review. Urology, Volume 15, Issue 5, Pages 435-536 (May 1980)
http://www.goldjournal.net/issues/contents?issue_key=S0090-4295%2800%29X0129-X

2. Simpson, S.L., Impotence. Br. Med. J., 1950, 1: 692-697. http://www.bmj.com/cgi/reprint/1/4655/692

3. Magee MC. Basic Science For The Practicing Urologist: The Neuroendocrinology of the Genitourinary System. Cambridge University Press. http://bit.ly/de5Ghl