Homosexuality - Psychology

Psychology

Psychology was one of the first disciplines to study a homosexual orientation as a discrete phenomenon. The first attempts to classify homosexuality as a disease were made by the fledgling European sexologist movement in the late 19th century. In 1886 noted sexologist Richard von Krafft-Ebing listed homosexuality along with 200 other case studies of deviant sexual practices in his definitive work, Psychopathia Sexualis. Krafft-Ebing proposed that homosexuality was caused by either "congenital inversion" or an "acquired inversion". In the last two decades of the 19th century, a different view began to predominate in medical and psychiatric circles, judging such behavior as indicative of a type of person with a defined and relatively stable sexual orientation. In the late 19th century and early 20th century, pathological models of homosexuality were standard.

The American Psychological Association, the American Psychiatric Association, and the National Association of Social Workers state:

In 1952, when the American Psychiatric Association published its first Diagnostic and Statistical Manual of Mental Disorders, homosexuality was included as a disorder. Almost immediately, however, that classification began to be subjected to critical scrutiny in research funded by the National Institute of Mental Health. That study and subsequent research consistently failed to produce any empirical or scientific basis for regarding homosexuality as a disorder or abnormality, rather than a normal and healthy sexual orientation. As results from such research accumulated, professionals in medicine, mental health, and the behavioral and social sciences reached the conclusion that it was inaccurate to classify homosexuality as a mental disorder and that the DSM classification reflected untested assumptions based on once-prevalent social norms and clinical impressions from unrepresentative samples comprising patients seeking therapy and individuals whose conduct brought them into the criminal justice system.

In recognition of the scientific evidence, the American Psychiatric Association removed homosexuality from the DSM in 1973, stating that "homosexuality per se implies no impairment in judgment, stability, reliability, or general social or vocational capabilities." After thoroughly reviewing the scientific data, the American Psychological Association adopted the same position in 1975, and urged all mental health professionals "to take the lead in removing the stigma of mental illness that has long been associated with homosexual orientations." The National Association of Social Workers has adopted a similar policy.

Thus, mental health professionals and researchers have long recognized that being homosexual poses no inherent obstacle to leading a happy, healthy, and productive life, and that the vast majority of gay and lesbian people function well in the full array of social institutions and interpersonal relationships.

The longstanding consensus of research and clinical literature demonstrates that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality. There is now a large body of research evidence that indicates that being gay, lesbian or bisexual is compatible with normal mental health and social adjustment. The World Health Organization's ICD-9 (1977) listed homosexuality as a mental illness; it was removed from the ICD-10, endorsed by the Forty-third World Health Assembly on May 17, 1990. Like the DSM-II, the ICD-10 added ego-dystonic sexual orientation to the list, which refers to people who want to change their gender identities or sexual orientation because of a psychological or behavioral disorder (F66.1). The Chinese Society of Psychiatry removed homosexuality from its Chinese Classification of Mental Disorders in 2001 after five years of study by the association. According to the Royal College of Psychiatrists "This unfortunate history demonstrates how marginalisation of a group of people who have a particular personality feature (in this case homosexuality) can lead to harmful medical practice and a basis for discrimination in society. There is now a large body of research evidence that indicates that being gay, lesbian or bisexual is compatible with normal mental health and social adjustment. However, the experiences of discrimination in society and possible rejection by friends, families and others, such as employers, means that some LGB people experience a greater than expected prevalence of mental health difficulties and substance misuse problems. Although there have been claims by conservative political groups in the USA that this higher prevalence of mental health difficulties is confirmation that homosexuality is itself a mental disorder, there is no evidence whatever to substantiate such a claim."

Most lesbian, gay, and bisexual people who seek psychotherapy do so for the same reasons as heterosexual people (stress, relationship difficulties, difficulty adjusting to social or work situations, etc.); their sexual orientation may be of primary, incidental, or no importance to their issues and treatment. Whatever the issue, there is a high risk for anti-gay bias in psychotherapy with lesbian, gay, and bisexual clients. Psychological research in this area has been relevant to counteracting prejudicial ("homophobic") attitudes and actions, and to the LGBT rights movement generally.

The appropriate application of affirmative psychotherapy is based on the following scientific facts:

  • Same-sex sexual attractions, behavior, and orientations per se are normal and positive variants of human sexuality; in other words, they are not indicators of mental or developmental disorders.
  • Homosexuality and bisexuality are stigmatized, and this stigma can have a variety of negative consequences (e.g., Minority Stress) throughout the life span (D'Augelli & Patterson, 1995; DiPlacido, 1998; Herek & Garnets, 2007; Meyer, 1995, 2003).
  • Same-sex sexual attractions and behavior can occur in the context of a variety of sexual orientations and sexual orientation identities (Diamond, 2006; Hoburg et al., 2004; Rust, 1996; Savin-Williams, 2005).
  • Gay men, lesbians, and bisexual individuals can live satisfying lives as well as form stable, committed relationships and families that are equivalent to heterosexual relationships in essential respects (APA, 2005c; Kurdek, 2001, 2003, 2004; Peplau & Fingerhut, 2007).
  • There are no empirical studies or peer-reviewed research that support theories attributing same-sex sexual orientation to family dysfunction or trauma (Bell et al., 1981; Bene, 1965; Freund & Blanchard, 1983; Freund & Pinkava, 1961; Hooker, 1969; McCord et al., 1962; D. K. Peters & Cantrell, 1991; Siegelman, 1974, 1981; Townes et al., 1976).

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