The In PsyDA Per­spec­tive?

Ho­mo­sex­u­al­ity - a Men­tal Dis­or­der

The Star (St. Lucia) - - COMMENT - Ms. Ginelle Nel­son Con­sul­tant Clin­i­cal Psy­chol­o­gist/Man­ag­ing Di­rec­tor (PsyDA Con­sul­tancy Ltd)

On 26th June, 2015, via a U.S. Supreme Court de­ci­sion, the United States of Amer­ica be­came the 21st coun­try to le­galise ho­mo­sex­ual mar­riages. Given the Caribbean’s propen­sity to catch the cold when­ever Amer­ica sneezes, not sur­pris­ingly, this sparked a re­li­gious furore through­out the re­gion. In light of this, I thought it best to elu­ci­date the ge­n­e­sis of ho­mo­sex­u­al­ity’s as­so­ci­a­tion with men­tal ill­ness. The fol­low­ing ex­tract is taken from the ar­ti­cle “Facts about Ho­mo­sex­u­al­ity and Men­tal Health” and is merely meant to catal­yse fur­ther, more ob­jec­tive dis­course.

“Mod­ern at­ti­tudes to­ward ho­mo­sex­u­al­ity have re­li­gious, le­gal, and med­i­cal un­der­pin­nings. Be­fore the High Mid­dle Ages, ho­mo­sex­ual acts ap­pear to have been tol­er­ated or ig­nored by the Chris­tian church through­out Europe. Be­gin­ning in the lat­ter twelfth cen­tury, how­ever, hos­til­ity to­ward ho­mo­sex­u­al­ity be­gan to take root, and even­tu­ally spread through­out Euro­pean re­li­gious and sec­u­lar in­sti­tu­tions. Con­dem­na­tion of ho­mo­sex­ual acts (and other non-pro­cre­ative sex­ual be­hav­ior) as “un­nat­u­ral,” be­came wide­spread and has con­tin­ued through the present day. Re­li­gious teach­ings soon were in­cor­po­rated into le­gal sanc­tions. Many of the early Amer­i­can colonies, for ex­am­ple, en­acted stiff crim­i­nal penal­ties for sodomy, an um­brella term that en­com­passed a wide va­ri­ety of sex­ual acts that were non-pro­cre­ative (in­clud­ing ho­mo­sex­ual be­hav­ior), oc­curred out­side of mar­riage (e.g. sex be­tween a man and woman who were not mar­ried), or vi­o­lated tra­di­tions (e.g. sex be­tween hus­band and wife with the woman on top). By the end of the 19th cen­tury, medicine and psy­chi­a­try were ef­fec­tively com­pet­ing with re­li­gion and the law for ju­ris­dic­tion over sex­u­al­ity. As a con­se­quence, dis­course about ho­mo­sex­u­al­ity ex­panded from the realms of sin and crime to in­clude that of pathol­ogy. This his­tor­i­cal shift was gen­er­ally con­sid­ered pro­gres­sive be­cause a sick per­son was less blame­ful than a sin­ner or crim­i­nal.

To­day, a large body of pub­lished em­pir­i­cal re­search clearly re­futes the no­tion that ho­mo­sex­u­al­ity per se is in­dica­tive of or cor­re­lated with psy­chopathol­ogy. In a re­view of pub­lished stud­ies com­par­ing ho­mo­sex­ual and het­ero­sex­ual sam­ples on psy­cho­log­i­cal tests, Gon­siorek (1982) found that, ‘although some dif­fer­ences have been ob­served in test re­sults be­tween ho­mo­sex­u­als and het­ero­sex­u­als, both groups con­sis­tently score within the nor­mal range.’ Gon­siorek con­cluded that, ‘Ho­mo­sex­u­al­ity in and of it­self is un­re­lated to psy­cho­log­i­cal dis­tur­bance or mal­ad­just­ment. Ho­mo­sex­u­als as a group are not more psy­cho­log­i­cally dis­turbed on ac­count of their ho­mo­sex­u­al­ity.’ Con­fronted with over­whelm­ing em­pir­i­cal ev­i­dence and chang­ing cul­tural views of ho­mo­sex­u­al­ity, psy­chi­a­trists and psy­chol­o­gists rad­i­cally al­tered their views, be­gin­ning in the 1970s. In 1973, the weight of em­pir­i­cal data, cou­pled with chang­ing so­cial norms and the de­vel­op­ment of a po­lit­i­cally ac­tive gay com­mu­nity in the United States, led the Board of Di­rec­tors of the Amer­i­can Psy­chi­atric As­so­ci­a­tion to re­move ‘Ho­mo­sex­u­al­ity’ from the Di­ag­nos­tic and Sta­tis­ti­cal Man­ual of Men­tal Dis­or­ders (DSM), a book used by clin­i­cians which out­lines stan­dard cri­te­ria for the clas­si­fi­ca­tion of men­tal dis­or­ders. A new di­ag­no­sis, ego-dys­tonic ho­mo­sex­u­al­ity, was cre­ated for the DSM’s third edi­tion in 1980. In 1986, the di­ag­no­sis was re­moved en­tirely from the DSM. The only ves­tige of ‘ego dys­tonic ho­mo­sex­u­al­ity’ in the re­vised DSM-III oc­curred un­der Sex­ual Dis­or­ders Not Oth­er­wise Spec­i­fied, which in­cluded per­sis­tent and marked dis­tress about one’s sex­ual ori­en­ta­tion. (It should be noted that the Amer­i­can Psy­cho­log­i­cal As­so­ci­a­tion Coun­cil of Rep­re­sen­ta­tives fol­lowed in de-clas­si­fy­ing ho­mo­sex­u­al­ity in 1975. There­after other ma­jor men­tal health or­ga­ni­za­tions fol­lowed, in­clud­ing the World Health Or­ga­ni­za­tion in 1990.) The DSM V, the most re­cent ver­sion of the Di­ag­nos­tic and Sta­tis­ti­cal Man­ual of Men­tal Dis­or­ders, in­cludes a di­ag­no­sis of ‘Gen­der Dyspho­ria’ (Other Spec­i­fied or Un­spec­i­fied), which in­volves a marked in­con­gru­ence be­tween one’s ex­pe­ri­enced or ex­pressed gen­der and one’s as­signed gen­der but makes no men­tion of ho­mo­sex­u­al­ity.

In clos­ing, Halo­nen and Santrock, in the book en­ti­tled Psy­chol­ogy: Con­texts and Ap­pli­ca­tions, wrote: “An in­di­vid­ual’s sex­ual ori­en­ta­tion – het­ero­sex­ual, ho­mo­sex­ual, bi­sex­ual (or trans­sex­ual) – is most likely de­ter­mined by a com­bi­na­tion of ge­netic, hor­monal, cog­ni­tive, and en­vi­ron­men­tal fac­tors. Most ex­perts on ho­mo­sex­u­al­ity be­lieve that no one fac­tor alone causes ho­mo­sex­u­al­ity and that the rel­a­tive weight of each fac­tor may vary from one in­di­vid­ual to the next. In ef­fect, no one knows ex­actly what causes an in­di­vid­ual to be ho­mo­sex­ual. Sci­en­tists have a clearer pic­ture of what does not cause ho­mo­sex­u­al­ity. For ex­am­ple, chil­dren raised by gay or les­bian par­ents or cou­ples are no more likely to be ho­mo­sex­ual than are chil­dren raised by het­ero­sex­ual par­ents. There also is no ev­i­dence that male ho­mo­sex­u­al­ity is caused by a dom­i­nant mother or a weaker fa­ther, or that fe­male ho­mo­sex­u­al­ity is caused by girls choos­ing male role mod­els. One of the bi­o­log­i­cal fac­tors be­lieved to be in­volved in ho­mo­sex­u­al­ity is pre­na­tal hor­mone con­di­tions. In the sec­ond to fifth months af­ter conception, the ex­po­sure of the fe­tus to hor­mone lev­els char­ac­ter­is­tic of fe­males may cause the in­di­vid­ual (male or fe­male) to be at­tracted to males. If this crit­i­cal pre­na­tal pe­riod hy­poth­e­sis turns out to be cor­rect, it would ex­plain why re­searchers and clin­i­cians have found that a ho­mo­sex­ual ori­en­ta­tion is dif­fi­cult to mod­ify.”

Food for thought. PsyDA Con­sul­tancy (pro­nounced ‘Cider’) pro­vides psy­cho­log­i­cal ser­vices in­clud­ing in­di­vid­ual and fam­ily psy­chother­apy, psy­cho­log­i­cal eval­u­a­tions and assess­ments, coun­selling and foren­sic con­sul­ta­tions. Con­tact 727-1490 for week­end ap­point­ments.

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