Psychology was one of the first disciplines to study homosexuality as a discrete phenomenon. In the late 19th and early 20th centuries, pathological models of homosexuality were standard. Extensive research in the second half of the 20th century led to the contemporary view that homosexuality is a normal variant of human sexuality. Simultaneously, psychologists began responding to the needs of gay, lesbian, and bisexual people including, most visibly, responses to the AIDS pandemic of the 1980s and 1990s.
Major psychological research on homosexuality, which has been carried out predominantly in America, can be divided into five categories:
Psychological research in these areas has been relevant to counteracting prejudicial ("homophobic") attitudes and actions, and to the LGBT rights movement generally.
The first attempts to classify homosexuality as a disease were made by the fledgling European sexologist movement in the late nineteenth 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 [during birth] inversion" or an "acquired inversion".
In 1896 Sigmund Freud published his ideas on psychoanalysis. Freud believed that all humans were innately bisexual and that whether a particular person manifests heterosexuality or homosexuality could result from environmental factors interacting with biological sexual drives. Freud expressed serious doubts about the potential for therapeutic conversion. In a famous letter to a mother who had asked Freud to treat her son, he wrote:
By asking me if I can help [your son], you mean, I suppose, if I can abolish homosexuality and make normal heterosexuality take its place. The answer is, in a general way, we cannot promise to achieve it. In a certain number of cases we succeed in developing the blighted germs of heterosexual tendencies which are present in every homosexual, in the majority of cases it is no more possible. It is a question of the quality and the age of the individual. The result of treatment cannot be predicted.
In that letter, he also states that "homosexuality is assuredly no advantage but it is nothing to be ashamed of, no vice, no degradation, it cannot be classified as an illness....".
Prominent psychoanalyst Dr. Joseph Merlino, Senior Editor of the book Freud at 150: 21st Century Essays on a Man of Genius, stated in an interview:
From this period through the middle of the 20th century, medical attempts to "cure" homosexuality have included surgical treatments such as hysterectomy, ovariectomy, clitoridectomy, castration, vasectomy, pudic nerve surgery, and lobotomy. Substance-based treatment attempts have included hormone treatment, pharmacologic shock treatment, and treatment with sexual stimulants and sexual depressants. Other attempts include aversion therapy, the attempted reduction of aversion to heterosexuality, electroshock treatment, group therapy, hypnosis, and psychoanalysis.
During the three decades between Freud's death (1939) and the Stonewall riots (1969), conversion therapy enjoyed a "gilded age" of aggressive treatment of homosexuals and approval from the psychiatric establishment. Prominent researchers arguing for therapeutic conversion included Edmund Bergler, Irving Bieber, Albert Ellis, Abram Kardiner, Sandor Rado, and Charles Socarides. Rado rejected Freud's theory of innate bisexuality and argued instead that heterosexuality is nature's default setting and that homosexuality is caused by parental psychopathology. Socarides and Kardiner developed similar theories: Socarides interpreted same-sex desire as an illness arising from a conflict between the id and the ego usually arising from an early age in "a female-dominated environment wherein the father was absent, weak, detached or sadistic".
Similarly, the controversial Kinsey Reports by U.S. biologist Alfred Kinsey are also credited for revolutionizing the study of sexuality, and homosexuality in particular. They found that homosexual thoughts and actions were much more widespread than commonly believed.
In 1969, the Stonewall riots gave birth to the gay rights movement and increased the visibility of LGBT people. In 1973, after intense lobbying by gay and lesbian groups and new scientific information from researchers like Evelyn Hooker and Kinsey, the APA declassified homosexuality as a mental disorder with a vote of 58% of the membership supporting the measure.
Joseph Merlino, M.D., co-editor of the book American Psychiatry & Homosexuality, and psychiatry adviser to the New York Daily News, said in an interview of the APA's declassification:
In 1974 the ABA endorsed the Model Penal Code, including its decriminalization of consensual adult homosexual acts, and in 1992 the WHO removed homosexuality from its list of mental illnesses, replacing it with egodystonic sexual orientation. The UK Government followed suit in 1994, followed by the Ministry of Health in Russian Federation in 1999 and the Chinese Society of Psychiatry in 2001.
A small minority of psychologists dispute the dominant view that homosexuality is not a mental disorder.
The current medical view of sexual orientation is that in combination with genetic and hormonal influences, it is determined in part by environmental influences, though "the reasons may be different for different people". From their research on 275 men in the Taiwanese military, Shu and Lung concluded that "paternal protection and maternal care were determined to be the main vulnerability factors in the development of homosexual males." Key factors in the development of homosexuals were "paternal attachment, introversion, and neurotic characteristics." Other researchers have also provided evidence that gay men report having had less loving and more rejecting fathers, and closer relationships with their mothers, than non-gay men. Whether this phenomenon is a cause of homosexuality, or whether parents behave this way in response to gender-variant traits in a child, is unclear. However, most people believe nature and nurture both play complex roles in the development of homosexuality.
Current research also suggests that sexual orientation is not necessarily innate and fixed, but instead can develop across a person's lifetime. A report from the Centre for Addiction and Mental Health states: "For some people, sexual orientation is continuous and fixed throughout their lives. For others, sexual orientation may be fluid and change over time." One study has suggested "considerable fluidity in bisexual, unlabeled, and lesbian women's attractions, behaviors, and identities."
However, they do not consider sexual orientation to be "a conscious choice that can be voluntarily changed." These attitudes are also more systematically found in people with racist or sexist beliefs, and in people who do not know gay people on a personal basis.
Psychological research in this area includes examining mental health issues (including stress, depression, or addictive behavior) faced by gay and lesbian people as a result of the difficulties they experience because of their sexual orientation, physical appearance issues and eating disorders, and gender atypical behavior.
Psychological research in this area includes examining the coming out process, special challenges facing lesbian and gay youth, parental attitudes toward their children's sexual orientation, the mental health effects of being openly gay or closeted, workplace issues, discrimination and violence against lesbian and gay people, and aging issues.
Psychological research in this area includes examining the sexual behavior of gay and lesbian people (both for its own sake and from a public health perspective), the relative contributions of gender and sexual orientation in determining sexuality and sexual attitudes, same-sex relationships, domestic violence within same-sex relationships, relationship satisfaction, and the impact (if any) on children growing up with same-sex parents.
There are several standard critiques of the much recent research methodology. First, the research samples of gay men are often white, well-educated, upper-middle-class, self-identified gay men, usually drawn from media publications, organizations, and meeting places. Excluding people of color and low-income gay men from the samples may skew the data, and may reinforce existing stereotypes. A barrier to resolving this problem is the increased cost of gathering more representative samples. A second typical critique is that because cultural and historical context significantly influence the expression of homosexuality, gay and lesbian people should not necessarily be studied in unqualified terms: "gay men in the Netherlands [may have less] in common with gay men in the US than with heterosexual men in the Netherlands."
Most LGB people who seek psychotherapy do so for the same reasons as heterosexuals (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 LGB clients.
American Psychological Association
American Academy of Pediatrics
National Mental Health Association
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