Like many other western countries, Germany still has medical doctors, therapists and priests that believe that homosexuality is an illness that can be cured. For instance, the weekly Der Spiegel recently reported on Gero Winkelmann, a physician and homeopath from Bayern.[1] He is also the chairman of the Bund katholischer Ärzte, an association of Catholic doctors that claims to have 200 members. On its website, the organization offers therapies for homosexuals.[2] Every year up to nine people suffering from this disease ask Winkelmann for healing. The treatment consists of homeopathic substances (i.e., Sulfur and Luesinum Nosode) and extensive prayer and penance.

Winkelmann is not alone. “Conversion therapy” is offered in many evangelical circles in the USA and also in Germany. There is no proof that any therapy ever changed an individual’s sexual orientation.[3] People that are nevertheless sent to or lured into these therapies often leave traumatized: since all this treatment and prayer does not change any feelings of homosexuality, those undergoing this “therapy” must be perverts. For this reason, many practitioners in Germany plea for a law against these conversion therapies.[4] In addition, 61,251 German citizens petitioned the Minister of Health asking for a ban on “Homo-Heilung” in 2018. In Malta, such a law has already existed since 2016: now, suppliers of these therapies can get jailed for half a year.[5] Until now, the German minister has been indecisive. He states not to know how to enforce laws on this matter.

Extreme emotions

Homosexuality is likely the most contentious topic in our deliberative workshops – sometimes stirring extreme emotions. Normally we discuss this topic at the very end as it brings many themes together: freedom, autonomy, emancipation, identity, socialization, respect, societal development and human rights. Because we have discussed these themes prior, we have often paved the way for a more reasonable discussion of the topic. Most of the time this works pretty well, but occasionally the aversions run so deep that sensible exchanges turn out to be rather difficult.

One of the most bizarre encounters we had was with a group of elder Russlanddeutschen (Russian-Germans) that we met in a big town in Sachsen-Anhalt. These “Spätaussiedler” (“late repatriates”) had come to Germany in the nineties – mainly from Kazakhstan. Their German forebears had lived since the 18th century along the Volga; however, they had been transported by Stalin in the Second World War to Kazakhstan or Siberia under the belief that they were potential Nazi collaborators.[6]

The workshop with these Russian-Germans explodes the moment we announce that we would like to discuss homosexuality. One woman leaves the room immediately in anger. The other participants hardly look at the short, objectively informative Arte-documentary[7] that we show – as if looking at the documentary is already a sin. They simply refuse to delve into the subject. The woman, a primary school teacher turning sixty, returns after ten minutes and, with trembling hands, furiously asks why, for heaven’s sake, we have to discuss this. What has this to do with discrimination, tolerance, freedom, emancipation and all the other topics we had discussed so far? Homosexuals are perverts, it is all politics, these people get more and more public attention and slowly take over the entire society. If we do not do anything, they will soon form a majority. It is a shame. In the community she comes from, there are no homosexuals. None of them have ever met one.

The organizer of the meeting tells us that it would be better not to discuss the topic. The audience, having lived in Germany for about two decades, is not ready for it – despite the fact that most of them are relatively well educated (i.e., one engineer, three teachers, one librarian, one economist and one person describing herself as an “coordinator”).

Still, the survey later showed that two of the German-Russian women were tolerant towards homosexuality. But during the workshop, do not speak up. Five of the ten participants from Russia “completely agree” with the statement that “homosexuality is an illness.” Only two completely disagree. Seven “completely disagree” with the statement: “A homosexual couple has the ability to raise children.” Nobody agrees to some level. Of the five people that are convinced that homosexuality is a disease, two completely disagree that it can be cured. The other three are indecisive. Five people in all completely disagree that homosexuality can be cured. Three of these people are also not sure it is a disease.

In a workshop with Chechen, which was another rather extreme experience, we did not even start the discussion. Chechnya is reported to be the only country in the world with a concentration camp for homosexuals. Despite all the disagreements that these people had with the local tyrant Kadyrov,[8] they did not seem to disagree with the leader fundamentally on the topic of homosexuality. Discussing it seemed to be completely out of reach, and addressing it could have undermined all the consensus we hoped to have achieved on other topics.

In another workshop with people from Kenya and Cameroon, the men showed an almost physical aversion against homosexuals. It was very hard for them to stay calm and concentrated enough to discuss the subject. They had strong emotions without being able to give clear reasons as for why. The women turned out to be more open-minded and understanding. If everybody should become  homosexual, there would be no children, and societies would die out, the men explained. Besides, men choose to become a homosexual, and they are therefore responsible for making this sickening choice. But when people are getting into so much trouble for making this “choice,” why do they ever make this choice, we ask? The men have no answer. One of the women has another explanation of homosexuality: some men slowly develop increasingly female characteristics and emotions and then fall in love with a man. They are born in the wrong body, so to speak, and have been a woman from the inside the whole time. When we ask about the cases of the men with whom they develop a loving relationship, the women lacked an answer.

Religious arguments against homosexuality are absent, as we also noticed with other groups, including with Muslims. Most remarkable is the ignorance regarding LGTB issues. People have strong aversions, and consequently never talk or read about the topic. As a result, they basically have no idea what homosexual, bisexual, or transgender people are.

The extent of these deep-seated prejudices against homosexuality was also illustrated by a workshop with multiplicators (professionals and civil volunteers active in integration work) we had in Schleswig Holstein, in the north of Germany. The group consisted of 18 people. Half of them had a migrant background and identified in the survey as “Muslim.” Some of them had arrived in Germany already two decades ago. The discussions on topics like democracy, pluralism, freedom, respect, identity went very well. The respondents were well-educated, thoughtful and open minded. At the end of our meeting we delved into discussions of homosexuality. Sometimes, we do a little role-play at this section: playing the devil’s advocate, we put forward and defend all the arguments we have heard during our workshops against homosexuality, and ask the participants to explain why these arguments do not hold.

Much to our surprise, and to the embarrassment of the director of the hosting institute, most participants with a migrant background did not seem to understand that we were playing a role. They happily endorsed many of the arguments against homosexuals we put on the table (see below for an overview of these arguments). Concomitantly, the other group of participants was basically unable to convince them that we were wrong. Only two of the nine participants with a migrant background, had answered to the survey question “Homosexuality is an illness that can be cured”[9] with “totally disagree”. The other seven were indecisive (3) agreed (2) or totally agreed (2).[10]

Adolescents in a secondary school

In a secondary school in a town East of Berlin we had workshops with a group of 15 students between 15 and 18. Half of the students had a migrant background. The school (a so-called “Schule mit Courage”) actively addresses all forms of discrimination, including racism and anti-Semitism. On the third workshop day we discussed homosexuality. All the pupils stated that they had no personal problems with homosexuals. They did know many people, though, that had strong reservations in this field.

One very articulate boy whose parents originated from Kazakhstan revealed that his best friend really hated gays. But it does not make sense to discuss the topic with him. This is what he believes, how he has been raised, and it is not possible to convince him of something different. Beliefs of people can hardly ever be changed. It is also not his duty, the boy remarked. It is not his responsibility to enlighten people. Ideas in societies change because old generations die out and new generations will have other ideas. When his friend would get violent towards gays, he would intervene, because he is against violence. But he does not intervene when people tell jokes or express prejudices about gays. People also have a right on their own beliefs.

Other pupils except a young man from Afghanistan and a bright Syrian girl did not react. The Afghan young man explained that in his culture and religion homosexuality is strongly forbidden. But, he stressed, this is just an idea. And ideas change. It is just a matter of time.

When asked why people “become” homosexuals, the ideas differed. Some believed it was a choice, some defined it as a disease and some saw it as a natural phenomenon.[11]

When asked why it is relevant to discuss the causes of homosexuality, nobody really seemed to grasp the importance of the topic. People intentionally choosing something can be held responsible for their choice and can be asked to justify this choice, to give reasons for it. But do we ever ask people with blue eyes or black hair to justify themselves? Do we ask heterosexuals to justify their sexual orientation? Why would we ask the same of homosexuals? The students mainly argued that people are free to have their own opinions and preferences, and that we cannot change them. Giving positive reasons or justifications for opinions and preferences regularly overburdened the students, but also the volunteers and the professional social workers that participated in our workshops.

The Syrian girl stated that gays should not marry and should not have children. Only a man and a woman can build a family. Women treat children in different ways than men, and children cannot do without a mother. Some others replied that fathers can often be more kind, caring, warm and protective than mothers. They knew this from their own experience. In homosexual relationships one or even both partners can play the role she exclusively ascribes to women. The Syrian girl does not deny this all. She seems to start doubting.

The same happened after she had explained that homosexuality develops when a man cannot find a wife, a reasoning we have heard several times before: males substitute lacking females. So, in China there will be many homosexuals, the girl suggested. In Germany, though, 51% of the population is female and 8% of the population still states to be homosexual, we counter. Maybe homosexuality is not something people intentionally choose, whether or not in particular circumstances. Homosexual orientations just happen.

Growing homophobia

We often noted that aversion against homosexuality was predominantly directed towards males. Many overlooked that females too could have a sexual preference for people of the same sex. The explanation might be, several multiplicators in Neuruppin pondered, that women are supposed to care and love anyway. So why not love another woman too? The much stronger and demanding narrative of masculinity does not allow this liberty: more than females, males have to prove they are “real”, and a real man obviously only loves women.

In several workshops teachers and youth workers reported a growing homophobia, especially among young male adolescents, with or without a migrant background. The explanation was sought in the current youth culture, especially rap-music, and, underlying this, in the growing uncertainties about what it means to be a man.[12] More than in the past, boys feel it necessary to stress that they are “real men,” which is interpreted as not-homosexual. Real men are dominant rulers, homosexuals are spineless weaklings.

Lack of knowledge about homosexuality

As was illustrated already above, we encountered often an astonishing lack of knowledge about homosexuality. A young, very intelligent woman from Nicaragua, who had a Master’s in Intercultural Studies and had taught at a university in her native country, believed that homosexuals want to be female and that they all also want to have a sex-operation. Because Germany is such a rich country, this type of operation is more feasible, which explains why there are so many German homosexuals. In the same workshop a highly educated Chinese woman was very eager to hear more about the topic, because in the whole of China there were no homosexuals, at least, as far as she had heard. Both were convinced that people deliberatively choose to become homosexual and both were unaware of the existence of lesbians, bisexuals or trans genders (the QIA in LGBTQIA we left out at this stage).

A group of Afghan young men in a workshop in a town in Brandenburg believed that homosexuality originates in boredom or scarcity. When there are no women available, as in prisons, men live out their lust on other men. But even when men can be with plenty of women, they sometimes get bored and want to try out something else. Thus, especially when the society allows this freedom, they have a relationship with a man for a while. After this experience they usually get back to normal and want to become intimate with women again. The number of homosexuals varies per country, they stated. In Afghanistan these people also exist, but their numbers are way smaller than in Germany. They themselves had never met a homosexual. They also could not imagine ever to become friends with such a person.

Inability to counter homophobe reasonings

Overall, many migrants were poorly informed about LGTB. For the most part they predominantly had strong prejudices and intense negative emotions on this topic. In a sense, the native Germans we talked to did not always do fundamentally better. Most of the time they were of the opinion that homosexuality was not a disease, and, consequently, could not and should not be cured (we present some statistical data below). Nevertheless, these relatively well educated multiplicators (i.e., not a representative sample of the population) often had a hard time to give convincing reasons for these opinions.

As said, we often played devil’s advocate and asked the participants to counter arguments we heard against homosexuality. Thus we stated,

  1. that homosexuality is ‘unnatural’;
  2. that reproduction is the natural goal of every species, and only men and women can reproduce themselves;
  3. that only a man and a woman can form a family;
  4. that children need a father and a mother in their life and not (in the case of homosexuals having children) two fathers or two mothers;
  5. that homosexuality is a (loathsome) choice because in some cultures there are many more homosexuals than in others;
  6. that homosexuality spreads more and more and destroys societies;
  7. and that our religion prohibits homosexuality.

The German participants usually “knew” that these standpoints were “untrue,” but often could not formulate in a constructive, convincing way why they thought this was the case. The most used argument was that it is nobody’s business what happens in your bedroom. Although this argument, building on liberal ideas of negative freedom,[13] is not invalid, even in very liberal states we intervene when siblings sleep together, or when mothers sleep with their sons, also when these sons are consenting adults. Therefore, it is helpful to have some more arguments to counter the standpoints cited above:

  1. Regarding the first position – that homosexuality is unnatural – one could counter that homosexuality appears to be widespread in nature. The observation and interpretation of sexual behaviors of animals is obviously heavily steered by paradigmatic assumptions. Consequently, for many years, observers did not want to see these immoral deeds. In our times, though, biologists have observed homo- and bisexual behaviors among many creatures. To name just a few: bison, cats, dogs, elephants, giraffes, foxes, horses, lions, panda’s, raccoons, brown bears, chimpanzees, bonobos, orca’s, dolphins, chickens, ostriches, swans, penguins, seagulls, vultures, ravens, sparrows, chars, graylings, salmons, rattlesnakes, turtles, geckos (I knew it!), lizards, salamanders, frogs, toads, cockroaches, blowflies, fruit flies, red ants, tsetse flies and Southeastern blueberry bees.[14] Besides, one could point to the fact that in the “natural” world also cannibalism exists and the law of the jungle rules. Does this prove we should take over these habits, just because they are “natural”? What is “natural” anyway? What does a “natural” life look like? Is it “natural” to live in cities, to go to work every day, to eat meat, to invent the atomic bomb?
  2. Do we really have to reproduce ourselves? Aren’t there enough people? Can’t we think this over, and does this thinking not make us different? Not so long ago, families in the Western world had many more children than today. What were the possible social and economic reasons for this? Are parents that choose to have only two children, although biologically and economically they could have many more, in some way “immoral”? Is reproduction the only goal of sex? Can’t we have sex without this goal? How does this look like in the animal world?
  3. What exactly is a family and why would two men or two women be unable to create and upheld the values that we associate with “family”?
  4. On average there might be biologically caused differences between men and women (what exactly are these?), but some men are more “feminine” than most women and some women are more “masculine” than most men. Consequently, the qualities that many associate with males can be cared for by a woman in a lesbian relationship. Besides, it takes a village to raise a child. Qualities needed in raising children can partly be provided by the social environment.
  5. When homosexuality really is a choice, why have so many people made this choice despite the fact that, certainly in the past, the results of this choice were often disastrous: homosexuals have been tortured and murdered, have been put in concentration camps, were sent to psychiatrists, priests and homeopaths, were abandoned by their families and friends, have severely been discriminated, are reported to have much higher suicide rates and a higher risk on mental health issues? Why would somebody ever do this, when he has the option to stay straight?[15] Might it not be that homosexuality just happens and that it does not help to suppress these feelings, despite the fact that many people in many cultures are trying to do that, out of fear of the consequences when they come out of the closet? Besides, when homosexuality is a choice, and a wrong choice at that, the assumption seems to be that being heterosexual is “normal”. Therefore, 5 to 8 per cent of the population practices sexual activities that the individuals, at the end of the day, do not really “like,” because they are intrinsically Is this not a bit implausible?
  6. We found that the fear that the world is increasingly populated by homosexuals – especially without immediate intervention – is prominent in many of our conversations with people from Africa. The idea seems to be that homosexuality is contagious and is spreading like a disease. Aids and homosexuality regularly are conflated here. Homosexuality is not a disease though and does not spread via infections. It also does not spread via reproduction, rearing, nurturing or education. This all explains why the percentage of homosexuals of the total population is fairly constant (somewhere between 5 and 8%). That there are countries like Hungary that report to have only 1.5% of homosexuals,[16] says more about the local discrimination and oppression of homosexuality than about its occurrence.
  7. My religion, and the holy book that supports it, tells me that homosexuality is a sin. Remarkably, this argument was not often brought up. People tried to give arguments like the ones above, referred to culture and tradition, or to their stomach (“it’s sickening!”). One could reply that interpretations of holy books vary and change, and that religions are adapting constantly to changing environments and insights. The original formulations of religions do not just reflect eternal and universal truths, but also local circumstances and needs. In general, references to religions are of course not always helpful when one wants to, or needs to, live together with people that have different belief systems. What we have in common, though, are our abilities to observe and to reason. We have a higher chance to find the necessary minimal consensus in this sphere than in the sphere of conflicting exegeses of competing holy books.

Concluding remarks

What can we achieve with deliberating homosexuality for 90 minutes? The emotions run deep on this topic. We are talking about sex and identity. First and foremost, it seems important to inform people, natives and newcomers, about the issues at stake. Talking and informing about the topic prepares the foundation for acceptance and respect, already by making clear that we can sensibly and coherently argue about sexual orientations, that there is no reason to treat it as a taboo.

It is crucial to present the facts as clearly as possible.[17] Homosexuality is not a disease, it is not a mental disorder, it is not contagious; it is a “normal” condition that cannot and should not be “cured,” and no third person gets harmed. That is precisely why we have no good arguments to deprive these people of their human rights. They should be as free and equal as heterosexuals and should be treated with the same tolerance that we treat other various life paths that we might not have chosen for ourselves or been naturally disposed to, but which can co-exist alongside our own path. Stating and explaining the facts and connecting the issue to the fundamental themes of freedom, autonomy, emancipation, respect and human rights is the most one can achieve with an issue that is, for many people, as contentious and emotional as homosexuality. But when that conversation is done, we may already have moved more than one might think possible.

*Many thanks to Jeanne Lenders and Christina Pao for their comments on a draft of this article. Special thanks to Christina for her editing.

 

Empirical data

Data from 2017 (in collaboration with Alexandra Johansen)

In 2017 we asked 150 participants, half of them German multiplicators, to respond to the statement “Homosexuality is a disease that can be cured”.  As remarked before, we implicitly assumed that people who think that homosexuality is a disease, also think that it can be cured. Obviously, logically these are two different questions, so in 2018 we separated them. People who do not believe that homosexuality is a disease, also do not believe that it can be cured: there is nothing to heal. But people thinking it is a disease can either believe it can be cured or not. Our 2018 survey shows that some people indeed make this difference. Nevertheless, we have the strong impression that most people that were asked the first question concentrate in their answer on the illness, and not on the possible healing.

Our analyses of the data of 2017 show that homosexuality is the issue where Germans and non-Germans differ the most. They have their disagreements regarding democracy, freedom, gender and many other issues that we discuss in our workshops (we report on that separately), but homosexuality stands out. The mean score of the 75 German respondents was 1.053 (1 = totally disagree; 5 = totally agree) with a standard deviation of 0.28. The mean score of the 74 non-German respondents was 2.743 with a standard deviation of 1.57. Most negative on homosexuals were the 22 participants from the Middle East (mean 3.5), followed by the 21 participants from Afghanistan (mean 3.05), the 15 participants from North and East Africa (mean 2.7) and participants from other countries like Mexico, Sri Lanka, Niger and the Netherlands (mean 1.17). The standard deviation of the answers of the non-Germans ranged from 1.24 to 1.63. One explanation for this deviation was that some participating refugees were (mostly silent) homosexuals themselves.

The differences between Germans and non-Germans also hold when we control for age, gender, profession/education and religion. Thus the country (or better: culture) of origin is decisive for the attitude towards homosexuality.

 

Data from 2018 (in collaboration with Raíssa Silveira)

In 2018 we asked multiplicators in Germany to respond to three different statements:

  • (item 24) Homosexuality is an illness.
  • (item 30) A homosexual couple has the ability to raise children.
  • (item 34) Homosexuality can be cured.

The respondents could answer on a scale from 1 (completely disagree) to 5 (completely agree). 103 participants answered the questions. 12 people were Russian-Germans. 17 other people had a migration background. The results were as follow:

81.6% of all respondents completely disagreed and 5% disagreed that homosexuality is an illness. 4% maintained a neutral position, 2% agreed and almost 8% answered “completely agree”. The mean answer is 1.5.

Compared to the previous statement, the responses to the statement that a homosexual couple has the ability to raise children, were less liberal. 62% of the respondents “completely agreed” and 11% “agreed”, adding up to 73% of positive answers. Neutral answers represent another 11% of the total. 15% of the respondents “completely disagreed” with this statement and 2% “disagree”. The mean answer is 4.

72% of the participants completely disagreed with the statement that homosexuality can be cured. 3% of them disagreed, 8% were not certain and only 2% “completely agreed”. Consequently, in total 10% was supporting or was probably willing to try out a conversion therapy. As a comparison with the first question shows, the number of people who agree that homosexuality is an illness, is bigger than the number who believe that it can be cured. This confirms that it was helpful to split the previous years’ survey statement. In the chart, “8” stands for missing answers and represents 13% of the total. Most of these respondents had first completely disagreed with the statement that homosexuality is an illness. For them, as several wrote on the form or told us, the question whether it can be cured was therefore nonsensical.

Which variables explain the different responses?

The most important variable is the place of origin: native Germans versus Russian Germans and other migrants.

As we found in 2017, in our group of participants, age, religion or gender hardly influence the views on homosexuality.

The very same tendencies we could observe regarding the responses to the statement “women should have the same rights as men”: the place or culture of origin is decisive.

So when we relate the answers to the first question – homosexuality is an illness – to the place of origin, the graph looks like this:

And when we relate the answers to the second question – a homosexual couple has the ability to raise children – to the place of origin, the graph looks like this:

The Means and the Standard Deviations for the three questions are as follows:

 

 

Notes

[1] Marco Karp and Christoph Koopmann. Diagnose lesbisch. Der Spiegel. 5.1.2019

[2] https://www.bkae.org/index.php?id=1005

[3] https://en.wikipedia.org/wiki/Conversion_therapy

[4] Frank Ulrich Montgomery, Präsident der Bundesärztekammer, declared in Der Spiegel: „Da Homosexualität keine Krankheit ist, kann und darf sie auch nicht behandelt werden“. (Since homosexuality is not a disease, it cannot and should not be treated).

[5] The new law imposes fines and jail terms “on those advertising, offering, performing or referring an individual to another person which performs” any practice “which aims to change, repress or eliminate a person’s sexual orientation, gender identity or gender expression.” It said “no sexual orientation, gender identity or gender expression constitutes a disorder, disease or shortcoming of any sort.” Liam Stack. Malta outlaws ‘conversion Therapy’, a first in Europe. New York Times. 7.12.2016.  https://www.nytimes.com/2016/12/07/world/europe/malta-outlaws-conversion-therapy-transgender-rights.html

[6] We will come back to this workshop in another article. On this group of migrants, the Bundeszentrale für Politische Bildung offers valuable information: http://www.bpb.de/gesellschaft/migration/russlanddeutsche/

[7] Mit offenen Karten: Homosexualität – Welches Recht auf Anderssein? https://www.youtube.com/watch?v=2WhC-RYU-tk

[8] https://www.theguardian.com/world/2019/jan/14/chechnya-two-dead-and-dozens-held-in-lgbt-purge-reports ; http://www.eatg.org/news/chechnya-opens-worlds-first-concentration-camp-for-homosexuals-since-hitlers-in-the-1930s/ ; https://www.newyorker.com/news/our-columnists/a-damning-new-report-on-lgbt-persecution-in-chechnya

[9] In our first survey we implicitly assumed that people who think that homosexuality is a disease, also believe that it can be cured. Obviously, logically these are two different questions, so in 2018 we separated them. People who believe that homosexuality is not a disease, also do not believe that it can be cured: there is nothing to heal. But people thinking it is a disease can either believe it can be cured or not. Our later survey shows that some people indeed make this difference. Nevertheless, we have the strong impression that most people that were asked the first question concentrate in their answer on the illness, and not on the possible healing.

[10] The survey also shows that the very same people that see homosexuality as a disease, were also agreeing with the statement “There are professions which should only be done by men or women”.

[11] Fourteen people reacted to the statement in the survey “Homosexuality is an illness that can be cured”. On a scale from 1 to 5, ten replied “completely disagree” (1). One replied with “completely agree” (5). Two replied with 2, and one with 4.

[12] See also: The crisis of masculinities – a brief overview by Jeanne Lenders.  http://socialscienceworks.org/2018/05/the-crisis-of-masculinities-a-brief-overview/

[13] Berlin 1958; Blokland 1997.

[14] https://en.wikipedia.org/wiki/Homosexual_behavior_in_animals

[15] Cf. Dean Burnett. 2015. Why would people ‚choose‘ to be gay? The Guardian. January 8 2015. https://www.theguardian.com/science/brain-flapping/2015/jan/08/homosexuality-gay-choice-psychology. Burnett cites another great counter argument for those who believe that homosexuality is a chosen life style: “if you genuinely believe sexuality is a choice, then you’re not actually straight, you just haven’t met anyone persuasive enough yet.”

[16] https://infographic.statista.com/normal/chartoftheday_6466_europe_s_lgbt_population_mapped_n.jpg

[17] cf. Blokland, Hans and Nils Wadt. 2018. Deliberative Wertevermittlung: Ein Leitfaden. Potsdam. BAMF/SSW. p.19-21.