Homosexuality and psychology

Psychology was one of the first disciplines to study homosexuality as a discrete phenomenon. In the late 19th and throughout most of the 20th centuries, pathological models of homosexuality were standard. On December 15, 1973, the American Psychiatric Association, removed homosexuality from its official list of mental disorders. The American Psychological Association Council of Representatives adopted the same measure on January 24-26, 1975. Major psychological research on homosexuality, which has been carried out predominantly in America, can be divided into five categories:
# Which factors determine that people have same-sex desires?)
# What are the causes of discriminatory behavior regarding gays and lesbians and how can this be influenced?)
# Does being gay or lesbian affect one's health status, psychological functioning or general well-being?)
# What determines successful adaptation to a rejecting social climate in gays and lesbians? Why do some gays and lesbians experience homosexuality as central to their identity, while others experience it as peripheral?
# How do children of lesbian and gay parents develop?

Psychological research in these areas has been relevant to counteracting prejudicial ("homophobic") attitudes and actions, and to the LGBT rights movement generally.ed. Sandfort, T; et al. Lesbian and Gay Studies: An Introductory, Interdisciplinary Approach. Chapter 2.]

Major areas of psychological research

Anti-gay attitudes and behaviors

Anti-gay attitudes and behaviors (sometimes called "homophobia" or "heterosexism") have themselves been the object of psychological research, usually focusing on anti-gay-male, not anti-lesbian, attitudes.

* Demographics: Anti-gay attitudes often found in people who do not know gay people on a personal basis. [ [http://web.archive.org/web/20030704111036/http://www.affirmation.org/jeff.htm National Affirmation Annual Conference: "Homosexuality: A Psychiatrist's Response to LDS Social Services", September 5, 1999] ]

Psychological functioning

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.

* Drug and alcohol use: Gay men are not at a higher risk for drug or alcohol abuse than heterosexual men, but lesbian women may be at a higher risk than heterosexual women. This finding is contrary to a common assumption that, because of the issues people face relating to coming out and anti-gay attitudes, drug and alcohol use is higher among lesbian, gay, and bisexual people than heterosexuals. [Bux (1996)] Several clinical reports address methods of treating alcoholism in lesbian, gay, and bisexual clients specifically, including fostering greater acceptance of the client's sexual orientation. [Hall 1994, Israelstam 1986]

* Suicide: Gay and bisexual male youths are over 13 times more likely to attempt suicide than heterosexual male youths. [Bagley and Tremblay (1997)] No such difference was found between lesbian and straight female youths. [Remafedi, et al. (1998)] Gay and lesbian youth who attempt suicide are disproportionately subject to anti-gay attitudes, and have weaker skills for coping with discrimination, isolation, and loneliness, than those who do not attempt suicide. [Rotheram-Boris, et al. (1994); Proctor and Groze (1994)]

* Psychiatric disorders: In a Dutch study, gay men reported significantly higher mood and anxiety disorders than straight men, and lesbians were significantly more likely to experience depression (but not other mood or anxiety disorders) than straight women. [Sandfort, et al. (1999)] This difference is probably caused by the stresses gay and lesbian people face stemming from anti-gay attitudes.

* Physical appearance and eating disorders: Gay men tend to be more concerned about their physical appearance than straight men. [Brand, et al. (1992).] Lesbian women are at a lower risk for eating disorders than heterosexual women. [Siever (1994).]

* Gender atypical behavior: Gay men are more likely to display gender atypical behavior than heterosexual men. [Hiatt and Hargrave (1994).] The difference is less pronounced between lesbians and straight women. [Finlay and Scheltema (1991)]

Coming out as, and being openly gay or lesbian

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.

* Coming out: Many gay and lesbian people go through a "coming out" experience at some point in their lives. Psychologists often say this process includes several stages "in which there is an awareness of being different from peers ('sensitization'), and in which people start to question their sexual identity ('identity confusion'). Subsequently, they start to explore practically the option of being gay or lesbian and learn to deal with the stigma ('identity assumption'). In the final stage, they integrate their sexual desires into a position understanding of self ('commitment')." However, the process is not always linear [Rust (1993)] and it may differ for lesbians and gay men. [Monteflores and Schultz (1978).]

* Different degrees of coming out: One study found that gay men are more likely to be out to friends and siblings than co-workers, parents, and more distant relatives. [Berger (1992)]

* Effects of coming out on the person's well-being: Various studies have found that being out improves one's well-being, that openly gay people have less anxiety and better self esteem and social support than closeted people, [Jordan and Deluty (1998)] and that openly gay people are more satisfied in their relationships. [Berger (1990)] This is attributed to the "negative health consequences of psychological inhibition" found in closeted people.

* Effects of "traditional values" on the coming out process: One study found that "families with a strong emphasis on traditional values - implying the importance of religion, an emphasis on marriage and having children - were less accepting of homosexuality than were low-tradition families." [Newman and Muzzonigro (1993)]

* Determinants of parental attitudes toward homosexuality: One study found that parents who respond negatively to their child's sexual orientation tended to have lower self-esteem and negative attitudes toward women, and that "negative feelings about homosexuality in parents decreased the longer they were aware of their child's homosexuality." [Holtzen and Agresti (1990).]

* Violence against LGBT people ("hate crimes"): One study found that nearly half of its sample had been the victim of verbal or physical violence because of their sexual orientation, usually committed by men. Such victimization is related to higher levels of depression, anxiety, anger, and symptoms of post-traumatic stress. [Herek, et al. (1997)]

Sexuality, intimate relationships, and parenting

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.

* Sexuality: Contemporary psychology views gender, not sexual orientation, as the primary determinant of sexuality. Thus, gay male relationships are more frequently "open" than heterosexual relationships because the individuals are men, not because they are gay. Likewise, lesbian couples have sex less often than heterosexual couples, "although they seem to be more satisfied with their sex lives."

* Attitudes toward sex: One study found that gay and lesbian people "had a better sexual self-understanding, and showed less guilt regarding masturbation and sexuality in general" than straight people. [Crowden and Koch (1995)]

* Non-consensual sex: One study found that among sexually active gay men, over 27% of them had experienced non-consensual sex at least once. [Hickson, et al. (1994).]

Malleability of sexuality

The American Psychiatric Association has stated “some people believe that sexual orientation is innate and fixed; however, sexual orientation develops across a person’s lifetime.”cite web
url=http://www.aglp.org/pages/cfactsheets.html#Anchor-Gay-14210
title=Gay, Lesbian and Bisexual Issues
author=American Psychiatric Association
publisher=Association of Gay and Lesbian Psychiatrics
date=May 2000] A report from the Centre for Addiction and Mental Health states: "Some people believe that sexual orientation is innate and fixed; however, sexual orientation develops across a person’s lifetime. Individuals maybe become aware at different points in their lives that they are heterosexual, gay, lesbian, or bisexual." [cite web
url= http://www.camh.net/Publications/Resources_for_Professionals/ARQ2/arq2_question_a2.html
title= ARQ2: Question A2 - Sexual Orientation
accessdate= 2007-08-28
publisher= Centre for Addiction and Mental Health] One study has suggested "considerable fluidity in bisexual, unlabeled, and lesbian women's attractions, behaviors, and identities." [cite journal
title=Female bisexuality from adolescence to adulthood: Results from a 10-year longitudinal study.
last=Diamond
first=Lisa M.
publisher=Developmental Psychology
date=2008 Jan
volume=44
number=1
url=http://www.apa.org/journals/releases/dev4415.pdf
pages=5–14] [cite news
title=Bisexual women - new research findings
publisher=Women's Health News
date=2008-01-17
url=http://www.news-medical.net/?id=34415] Another study showed that homosexual and heterosexual women report a greater change in sexual orientation over time than men, but that bisexual men and women did not differ with respect to self-reported change in orientation. [ [http://www.ncbi.nlm.nih.gov/pubmed/15803251 Sex differences in the flexibility of sexual orientation: a multidimensional retrospective assessment.] ] Another suggested that sexual orientation is unstable in early adulthood. [ [http://www.outthere.org.nz/documents/Otago.Prevalence.2003.pdf Same-sex attraction in a birth cohort: prevalence and persistence in early adulthood] ]

The APA states "most people experience little or no sense of choice about their sexual orientation.."cite web
url = http://www.apa.org/topics/orientation.html
title = Answers to Your Questions About Sexual Orientation and Homosexuality
accessdate = 2008-05-26
publisher = American Psychological Association] American medical organization have further stated therapy cannot change sexual orientation, and have expressed concerns over potential harms. [http://www.apa.org/pi/lgbc/publications/justthefacts.html Just the Facts About Sexual Orientation & Youth: A Primer for Principals, Educators and School Personnel ] ] The director of the APA's LGBT Concerns Office explained: "I don't think that anyone disagrees with the idea that people can change because we know that straight people become gays and lesbians.... the issue is whether therapy changes sexual orientation, which is what many of these people claim." [cite web
url= http://www.cnsnews.com/Culture/Archive/200608/CUL20060815a.html
title= Psychologists Disagree Over Therapy for Homosexuals
last= Bansal
first= Monisha
publisher= Cybercast News Service
accessdate= 2007-08-28] The American Psychiatric Association has stated "To date, there are no scientifically rigorous outcome studies to determine either the actual efficacy or harm of "reparative" treatments," and supports research to further determines risks versus its benefits.cite web
quote=some people believe that sexual orientation is innate and fixed; however, sexual orientation develops across a person’s lifetime.
url=http://www.aglp.org/pages/cfactsheets.html#Anchor-Gay-14210
title=Gay, Lesbian and Bisexual Issues
author=American Psychiatric Association
publisher=Association of Gay and Lesbian Psychiatrics
date=May 2000] Similarly, United States Surgeon General David Satcher issued a report stating that "there is no valid scientific evidence that sexual orientation can be changed". [ [http://www.surgeongeneral.gov/library/sexualhealth/call.htm#III The Surgeon General's call to Action to Promote Sexual Health and Responsible Sexual Behavior] ", A Letter from the Surgeon General U.S. Department of Health and Human Services, 2001-07-09. Retrieved 2007-03-29.]

Psychotherapy with lesbian, gay, and bisexual clients

Most lesbian, gay, and bisexual 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 lesbian, gay, and bisexual clients.Cabaj, R; Stein, T. eds. "Textbook of Homosexuality and Mental Health", p. 421 ]

Gay clients of color

See also

* Association of Gay and Lesbian Psychiatrists
* Environment and sexual orientation

References

Resources and external links

;American Psychological Association
* [http://www.apa.org/topics/orientation.html Answers to Your Questions About Sexual Orientation and Homosexuality]
* [http://www.apa.org/pi/lgbc/publications/bibliography.html A Selected Bibliography of Lesbian, Gay, and Bisexual Concerns in Psychology]
* [http://www.apa.org/pi/lgbc/guidelines.html Guidelines for Psychotherapy with Lesbian, Gay, & Bisexual Clients]
* [http://www.apa.org/pi/lgbc/publications/research.html Avoiding Heterosexual Bias in Psychological Research]
* [http://www.psychologymatters.org/hooker.html Being Gay Is Just as Healthy as Being Straight]
* [http://www.apa.org/pi/lgbc/policy/marriage.pdf Resolution on Sexual Orientation and Marriage]
* [http://www.apa.org/pi/lgbc/policy/parentschildren.pdf Resolution on Sexual Orientation, Parents, and Children]

;American Academy of Pediatrics
* [http://pediatrics.aappublications.org/cgi/content/full/113/6/1827 Sexual Orientation and Adolescents]

;National Mental Health Association
* [http://www.nmha.org/index.cfm?objectid=CA866DCF-1372-4D20-C8EB26EEB30B9982 Factsheet: Bullying and Gay Youth]
* [http://www.mentalhealthamerica.net/go/whatdoesgaymean What Does Gay Mean? How to Talk with Kids about Sexual Orientation and Prejudice]