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THE evidence suggests that homosexual behaviour is partly genetic. Studies of identical twins, for example, show that if one of a pair (regardless of sex) is homosexual, the other has a 50% chance of being so, too.

In a paper to be published soon in Evolution and Human Behavior, they suggest the advantage accrues not to relatives of the opposite sex, but to those of the same one. They think that genes which cause men to be more feminine in appearance, outlook and behaviour and those that make women more masculine in those attributes, confer reproductive advantages as long as they do not push the individual possessing them all the way to homosexuality.

Other evidence does indeed show that homosexuals tend to be “gender atypical” in areas beside their choice of sexual partner. Gay men often see themselves as being more feminine than straight men do, and, mutatis mutandis, the same is true for lesbians. To a lesser extent, homosexuals tend to have gender-atypical careers, hobbies and other interests.

“If a 5-year-old black kid came into the clinic and said he wanted to be white, would we endorse that?” he told me. “I don’t think so. What we would want to do is say, ‘What’s going on with this kid that’s making him feel that it would be better to be white?’”

Zucker says that in 25 years, not one of the patients who started seeing him by age 6 has switched gender. Adolescents are more fixed in their identity. If a parent brings in, say, a 13-year-old who has never been treated and who has severe gender dysphoria, Zucker will generally recommend hormonal treatment. But he considers that a fraught choice. “One has to think about the long-term developmental path. This kid will go through lifelong hormonal treatment to approximate the phenotype of a male and may require some kind of surgery and then will have to deal with the fact that he doesn’t have a phallus; it’s a tough road, with a lot of pain involved.”

When they reversed course, they dedicated themselves to the project with a thoroughness most parents would find exhausting and off-putting. They boxed up all of John’s girl-toys and videos and replaced them with neutral ones. Whenever John cried for his girl-toys, they would ask him, “Do you think playing with those would make you feel better about being a boy?” and then would distract him with an offer to ride bikes or take a walk. They turned their house into a 1950s kitchen-sink drama, intended to inculcate respect for patriarchy, in the crudest and simplest terms: “Boys don’t wear pink, they wear blue,” they would tell him, or “Daddy is smarter than Mommy—ask him.” If John called for Mommy in the middle of the night, Daddy went, every time. When I visited the family, John was lazing around with his older brother, idly watching TV and playing video games, dressed in a polo shirt and Abercrombie & Fitch shorts. He said he was glad he’d been through the therapy, “because it made me feel happy,” but that’s about all he would say