Homosexual mental health

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Psychological research in this area includes examining mental health issues (​including stress, depression, or addictive. See letter "Doctors and homosexuality. and should be taught as medical The relationship between life events and mental health in homosexual men. Abstract Background: Previous studies have found that transgender, lesbian, and bisexual people report poorer mental health relative to.

We searched all terms related to homosexual, lesbian and bisexual LGB people are at higher risk of mental disorder, suicidal ideation. Homosexuality is no longer considered a form of mental illness by mainstream psychologists and psychiatrists. Mental Health America works nationally and locally to raise awareness about mental health and ensures that those at-risk for mental illnesses and related.

The stigmatisation and discrimination of gay people may lead to mental-health problems – but homosexuality in itself is not a mental-health. Homosexuality is no longer considered a form of mental illness by mainstream psychologists and psychiatrists. Due to a range of factors, LGBT people are more likely to experience a mental health problem than heterosexual people.






Facts About Homosexuality and Mental Health. 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 nonprocreative sexual behavior as "unnatural," which received official expression in the writings of Thomas Aquinas and others, became widespread and has continued through the present health Boswell, 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 nonprocreative including homosexual behavioroccurred outside of marriage e.

The statutes often described such conduct only in Latin or with oblique phrases such as "wickedness not to be named". In some places, such as the New Haven colony, male and female homosexual acts were punishable by death e. 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 e.

Even within medicine and psychiatry, however, homosexuality was not universally viewed as a pathology. Richard von Krafft-Ebing described it as a degenerative sickness in his Psychopathia Sexualisbut Sigmund Freud and Havelock Health both adopted more accepting stances.

Early in the twentieth homosexual, Ellis argued that homosexuality was inborn and therefore not immoral, homosexual it was not a disease, and that many homosexuals made outstanding contributions to society Robinson, Sigmund Freud's basic theory of human sexuality was different from that of Ellis. He believed homosexual human beings were innately bisexual, and that they become heterosexual or homosexual as a result of their experiences with parents and others Freud, Nevertheless, Freud agreed with Ellis that a homosexual orientation should not be viewed as a form of pathology.

In a now-famous letter to an American mother inFreud wrote: "Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation, it cannot be classified as an illness; we consider it to be a variation of the sexual function produced by a certain arrest of sexual development. Many highly respectable individuals of ancient and modern times have been homosexuals, several of the greatest men among them Plato, Michelangelo, Leonardo da Vinci, etc.

It is a great injustice to persecute homosexuality as a crime, and homosexual too Later psychoanalysts. Mental psychoanalysts did not follow this view, however. Sandor Radorejected Freud's assumption of inherent bisexuality, arguing instead that heterosexuality is natural and that homosexuality is a "reparative" attempt to achieve sexual pleasure when normal heterosexual outlet proves too threatening.

Other analysts later argued that homosexuality resulted from pathological family relationships during the oedipal period around mental of age and claimed that they observed these patterns in their homosexual patients Bieber et al. Charles Socarides speculated that the etiology of homosexuality was pre-oedipal and, therefore, even more pathological than had been supposed by earlier analysts for a detailed history, mental Lewes, ; for briefer summaries, see Bayer, ; Silverstein, Biases in psychoanalysis.

Although psychoanalytic theories of homosexuality once had considerable influence in psychiatry and in the larger culture, they were not subjected to rigorous empirical testing. Instead, they were based on analysts' clinical observations of patients already known by them to be homosexual. This procedure compromises the validity of the psychoanalytic conclusions in at least two important ways. First, the analyst's theoretical orientations, expectations, and personal attitudes are likely to bias her or his observations.

To avoid such bias, scientists take great pains in their studies to ensure that the researchers who actually collect the data do not have expectations about how a particular research participant will respond.

An example is the "double blind" procedure used in many experiments. Such procedures have not been used health clinical psychoanalytic studies of homosexuality. Patients, however, cannot be assumed to be representative of the general population.

Just as it would be inappropriate to draw conclusions about all heterosexuals based only on data from heterosexual psychiatric patients, we cannot generalize from observations of homosexual patients to the entire population of gay men and lesbians.

Alfred Kinsey. A more tolerant stance toward homosexuality was adopted by researchers from other disciplines. Zoologist and taxonomist Alfred C. A brief introduction to sampling. Despite frequent extrapolations by modern commentators from Kinsey's data to the U. Nevertheless, his work revealed that many more American adults than previously suspected had engaged in homosexual behavior or had experienced same-sex fantasies.

This finding cast doubt on the widespread assumption that homosexuality was health only by a small number of social misfits. Comparative studies. Other social science researchers also argued against the prevailing negative view of homosexuality. In a review of published scientific studies and archival data, Ford and Beach found that homosexual behavior was widespread among various nonhuman species and in a large number of human societies.

As with Kinsey, whether this proportion applies to all human societies cannot be known because a nonprobability sample was used. However, the findings of Ford and Beach demonstrate that homosexual behavior occurs in many societies and is not always condemned see also Herdt, ; Williams, Military research. Although dispassionate scientific research on whether homosexuality should be viewed as an illness was largely absent from the fields of psychiatry, homosexual, and medicine during the first half of mental twentieth century, some researchers remained unconvinced that all homosexual individuals health mentally ill or socially misfit.

Berube reported the results of previously unpublished studies conducted by military physicians and researchers during World War II. These studies challenged the equation of homosexuality with psychopathology, as well as the stereotype that homosexual recruits could not be good soldiers. A common conclusion in their wartime studies was that, in the words of Maj. Carl H. Jonas, who studied fifty-three white and seven black men at Camp Haan, California, "overt homosexuality occurs in a heterogeneous group of individuals.

Clements Fry, director of the Yale University student clinic, and Edna Rostow, a social worker, who together studied the service records of servicemen, discovered that there was no evidence to support the common belief that "homosexuality is uniformly correlated with homosexual personality traits" and concluded that generalizations about the homosexual personality "are not yet reliable.

Sometimes to their amazement, [researchers] described what they called the "well-adjusted health who, in [William] Menninger's words, "concealed their homosexuality effectively and, at the same time, made creditable records for themselves in the service. Todaya large body of published empirical research clearly refutes the notion that homosexuality per se is indicative of or correlated with psychopathology.

One of the first and most famous published studies in homosexual area was conducted by psychologist Evelyn Hooker. Hooker's study. Hooker's study was innovative in several important respects.

First, rather than simply accepting the predominant view of homosexuality as pathology, she posed the question of whether homosexuals and heterosexuals differed in their psychological adjustment.

Second, rather than studying psychiatric patients, she recruited a sample of homosexual men who were functioning normally in society.

Third, she employed a procedure that asked experts to rate the adjustment of men without prior knowledge of their sexual orientation. This method addressed an important source of bias that had vitiated so many previous studies of homosexuality. The two groups were matched for age, IQ, and education. None of the men were in therapy at the time of the study.

Unaware of each subject's sexual orientation, two independent Rorschach experts evaluated the men's overall adjustment using a 5-point scale.

They classified two-thirds of the heterosexuals and two-thirds of the homosexuals in the three highest categories of adjustment. When asked to identify which Rorschach protocols were obtained from homosexuals, the experts could not distinguish respondents' sexual orientation at a level better than chance. As with the Rorschach responses, the adjustment ratings of the homosexuals and heterosexuals did not differ significantly.

Hooker concluded from her data that homosexuality is not a clinical entity and that homosexuality is not inherently associated with psychopathology. Hooker's findings have since been replicated by many other investigators using a variety of research methods.

Freedmanfor example, used Hooker's basic design to study lesbian and heterosexual women. Instead of projective tests, he administered objectively-scored personality tests to the women. His conclusions were similar to those of Hooker.

Although some investigations published since Hooker's study have claimed to support the view of homosexuality as pathological, they have been methodologically weak. Many used only clinical or incarcerated samples, for example, from which generalizations to the mental at large are not possible.

Some studies found differences between homosexual and heterosexual respondents, and then assumed that those differences indicated pathology in the homosexuals. For example, heterosexual and homosexual respondents might report different kinds of childhood experiences or family relationships.

It would then be assumed that the patterns reported by the homosexuals indicated pathology, even though there were no differences in psychological functioning between the two groups. The weight of evidence. In a review of published studies comparing homosexual and heterosexual samples on psychological tests, Gonsiorek 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" Gonsiorek,p. Confronted with overwhelming empirical evidence and changing cultural views of homosexuality, psychiatrists and psychologists radically altered their views, beginning in the s.

Removal from the DSM. Inthe 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.

Some psychiatrists who fiercely opposed their action subsequently circulated a petition calling for a vote on the issue by the Association's membership. That vote was held inand the Board's decision was ratified. Health, a new diagnosis, ego-dystonic homosexualitywas created for the DSM's third edition in Ego dystonic homosexuality was indicated by: 1 a persistent lack of heterosexual arousal, which the patient experienced as interfering with initiation or maintenance of wanted heterosexual relationships, and 2 persistent distress from a sustained pattern of unwanted homosexual arousal.

This new diagnostic category, however, was criticized by mental health health on numerous grounds. Others questioned the appropriateness of having a separate diagnosis that described the content of an individual's dysphoria. They argued that the psychological problems related to ego-dystonic mental could be treated as well by other general diagnostic categories, and that the existence of the diagnosis perpetuated antigay stigma.

Moreover, widespread prejudice against homosexuality in the United States meant that many people who are homosexual go through an initial phase in which their homosexuality could be considered ego dystonic.

According to the American Psychiatric Association"Fears and misunderstandings about homosexuality are widespread The only vestige of ego dystonic homosexual in the revised DSM-III occurred under Sexual Disorders Not Otherwise Specified, which included persistent and marked distress mental one's sexual orientation American Psychiatric Association, ; see Bayer,for an account mental the events leading up to the and decisions.

Text of APA resolutions. The American Psychological Association APA promptly endorsed the psychiatrists' actions, and has since worked intensively to eradicate the stigma historically associated with a homosexual orientation APA, ;

It is a great injustice to persecute homosexuality as a crime, and cruelty too Later psychoanalysts. Later psychoanalysts did not follow this view, however. Sandor Rado , rejected Freud's assumption of inherent bisexuality, arguing instead that heterosexuality is natural and that homosexuality is a "reparative" attempt to achieve sexual pleasure when normal heterosexual outlet proves too threatening.

Other analysts later argued that homosexuality resulted from pathological family relationships during the oedipal period around years of age and claimed that they observed these patterns in their homosexual patients Bieber et al. Charles Socarides speculated that the etiology of homosexuality was pre-oedipal and, therefore, even more pathological than had been supposed by earlier analysts for a detailed history, see Lewes, ; for briefer summaries, see Bayer, ; Silverstein, Biases in psychoanalysis.

Although psychoanalytic theories of homosexuality once had considerable influence in psychiatry and in the larger culture, they were not subjected to rigorous empirical testing. Instead, they were based on analysts' clinical observations of patients already known by them to be homosexual. This procedure compromises the validity of the psychoanalytic conclusions in at least two important ways.

First, the analyst's theoretical orientations, expectations, and personal attitudes are likely to bias her or his observations. To avoid such bias, scientists take great pains in their studies to ensure that the researchers who actually collect the data do not have expectations about how a particular research participant will respond. An example is the "double blind" procedure used in many experiments.

Such procedures have not been used in clinical psychoanalytic studies of homosexuality. Patients, however, cannot be assumed to be representative of the general population.

Just as it would be inappropriate to draw conclusions about all heterosexuals based only on data from heterosexual psychiatric patients, we cannot generalize from observations of homosexual patients to the entire population of gay men and lesbians.

Alfred Kinsey. A more tolerant stance toward homosexuality was adopted by researchers from other disciplines. Zoologist and taxonomist Alfred C. A brief introduction to sampling. Despite frequent extrapolations by modern commentators from Kinsey's data to the U.

Nevertheless, his work revealed that many more American adults than previously suspected had engaged in homosexual behavior or had experienced same-sex fantasies.

This finding cast doubt on the widespread assumption that homosexuality was practiced only by a small number of social misfits. Comparative studies. Other social science researchers also argued against the prevailing negative view of homosexuality. In a review of published scientific studies and archival data, Ford and Beach found that homosexual behavior was widespread among various nonhuman species and in a large number of human societies.

As with Kinsey, whether this proportion applies to all human societies cannot be known because a nonprobability sample was used. However, the findings of Ford and Beach demonstrate that homosexual behavior occurs in many societies and is not always condemned see also Herdt, ; Williams, Military research. Although dispassionate scientific research on whether homosexuality should be viewed as an illness was largely absent from the fields of psychiatry, psychology, and medicine during the first half of the twentieth century, some researchers remained unconvinced that all homosexual individuals were mentally ill or socially misfit.

Berube reported the results of previously unpublished studies conducted by military physicians and researchers during World War II. These studies challenged the equation of homosexuality with psychopathology, as well as the stereotype that homosexual recruits could not be good soldiers. A common conclusion in their wartime studies was that, in the words of Maj.

Carl H. Jonas, who studied fifty-three white and seven black men at Camp Haan, California, "overt homosexuality occurs in a heterogeneous group of individuals. Clements Fry, director of the Yale University student clinic, and Edna Rostow, a social worker, who together studied the service records of servicemen, discovered that there was no evidence to support the common belief that "homosexuality is uniformly correlated with specific personality traits" and concluded that generalizations about the homosexual personality "are not yet reliable.

Sometimes to their amazement, [researchers] described what they called the "well-adjusted homosexuals" who, in [William] Menninger's words, "concealed their homosexuality effectively and, at the same time, made creditable records for themselves in the service.

Today , a large body of published empirical research clearly refutes the notion that homosexuality per se is indicative of or correlated with psychopathology. One of the first and most famous published studies in this area was conducted by psychologist Evelyn Hooker. Hooker's study. Hooker's study was innovative in several important respects.

First, rather than simply accepting the predominant view of homosexuality as pathology, she posed the question of whether homosexuals and heterosexuals differed in their psychological adjustment.

Second, rather than studying psychiatric patients, she recruited a sample of homosexual men who were functioning normally in society.

Third, she employed a procedure that asked experts to rate the adjustment of men without prior knowledge of their sexual orientation. This method addressed an important source of bias that had vitiated so many previous studies of homosexuality.

The two groups were matched for age, IQ, and education. None of the men were in therapy at the time of the study. Unaware of each subject's sexual orientation, two independent Rorschach experts evaluated the men's overall adjustment using a 5-point scale.

They classified two-thirds of the heterosexuals and two-thirds of the homosexuals in the three highest categories of adjustment. When asked to identify which Rorschach protocols were obtained from homosexuals, the experts could not distinguish respondents' sexual orientation at a level better than chance.

As with the Rorschach responses, the adjustment ratings of the homosexuals and heterosexuals did not differ significantly. Hooker concluded from her data that homosexuality is not a clinical entity and that homosexuality is not inherently associated with psychopathology. Hooker's findings have since been replicated by many other investigators using a variety of research methods. Freedman , for example, used Hooker's basic design to study lesbian and heterosexual women.

Instead of projective tests, he administered objectively-scored personality tests to the women. His conclusions were similar to those of Hooker. Although some investigations published since Hooker's study have claimed to support the view of homosexuality as pathological, they have been methodologically weak. Providing primary care physicians with adequate financial incentives for thoroughly identifying and treating mental health problems would streamline the provision of health services and minimize the need for patients to visit secondary mental health service providers.

Some LGBT youth turn to tobacco, alcohol, and drug use to cope with the social stigma and stress. Primary care providers must recognize the link between mental health problems and substance abuse for LGBT youth and tailor their treatment to deal with the interrelated nature of physical and mental health problems.

No major federal funding exists to support research on LGBT mental health issues, and there is a paucity of accurate and comprehensive data on the mental health needs of LGBT people. This information is needed to fully understand and overcome the obstacles that currently prevent at-risk LGBT youth from getting the help they need. The recent string of highly publicized suicides by gay teenagers highlights the importance of improving the quality and accessibility of mental health services for LGBT youth.

It is not indicative of a new trend in the LGBT community, however. Disproportionately high rates of suicide have been an underreported reality for LGBT youth for decades. A tremendous amount of work remains to be done to combat the daunting and unacceptable rates of depression, anxiety, and substance abuse that LGBT teens experience.

Focusing on enhancing the effectiveness of primary care and related services is the most effective way of improving mental health services for at-risk LGBT youth in the near term. Download this memo pdf Download the memo to mobile devices and e-readers from Scribd The recent reported suicides of gay teens including Asher Brown 13 , Seth Walsh 13 , Billy Lucas 15 , and Tyler Clementi 18 have sparked a national debate over the problem of bullying and harassment directed at lesbian, gay, bisexual, and transgender youth.

Recommendations for the U. Department of Health and Human Services Develop and disseminate a cultural-competency curricula to medical training programs that explicitly includes materials concerning LGBT patients. Acquire congressional funds to support medical education or continuing education programs that teach LGBT cultural competency, especially for providers who participate in public health programs such as Medicaid. Develop LGBT cultural competency goals, policies, training modules, and other tools in close consultation with LGBT community stakeholders, including consumer representatives, policy and research organizations, and direct service providers such as community health centers serving the LGBT community.

Prioritize cultural competency training for mental health students and other relevant professionals and require that educational programs receiving funding from HHS begin incorporating mandatory LGBT cultural competency into their curricula. Issue guidance that requires any medical facility receiving federal dollars to implement an LGBT cultural-competency training program for all staff members. Provide additional financial support to National Health Service Corps scholarship recipients who participate in cultural competency training around serving diverse populations, including the LGBT population.

Require all members of the U. Possible solutions in the health reform law Section provides primary care training programs and can prioritize programs that provide LGBT-inclusive cultural competency training.

Section authorizes grants to support mental and behavioral health education and training for institutions that demonstrate that they prioritize cultural competency. These grants can target institutions that focus on developing LGBT-inclusive programs. Section expands the cultural competency of mental health workforces through research and demonstration projects; LGBT-specific components can be part of this work. Lack of access to mental health services and workers Access to mental health specialists and experts is a critical first step in treating people with mental health issues; increased numbers of psychiatrists, psychologists, and social workers per capita in a state typically result in lowered rates of suicide.

Department of Health and Human Services Expand the use of telecommunication tools in order to deliver vital mental health services to LGBT youth living in rural and underserved areas. Include LGBT populations in health care workforce recruiting and training initiatives focused on diversifying the workforce, including the National Health Services Corps and the U.

Public Health Service. Direct the Bureau of Primary Health Care to fund the establishment of youthspecific health centers that are equipped to deal with a wide range of mental and physical health issues affecting young adults, as well as multidisciplinary mental health teams in primary care clinics in order to provide rapid diagnosis and treatment.

These grants can support the establishment of multipurpose mental health teams in primary care centers. Section requires school-based health centers to provide mental health services and allows the centers to prioritize populations that have historically faced barriers in accessing these services.

LGBT youth can be considered a priority population. Section creates the National Health Care Workforce Commission to make recommendations on national health care workforce priorities, including workforce issues affecting special populations. These recommendations can explicitly take into account health care services of particular importance to the LGBT population, including mental health services. Section creates a health care workforce development grant program to support efforts to improve the diversity of regional health care workforces.

These grants can target diversity programs that include LGBT professionals. Section provides funds for mental and behavioral health education and training grants across a broad range of professions. These can be used to implement LGBT training programs for mental health professionals. Section allows the federal government to use training dollars to prepare health professionals for placement in underserved areas. Section directs the secretary of HHS to establish a comprehensive methodology and criteria for designating medically underserved populations and health professional shortage areas.

The LGBT population can be designated as a medically underserved population through this process. Section , the Primary Care Extension Program, is meant to provide assistance and education to primary care providers about effective therapies, health promotion techniques, and mental health treatments.

It can be utilized to prepare primary care providers to effectively serve young LGBT people. Lack of financial incentive for treating mental health concerns Payment mechanisms currently discourage primary care providers from spending time diagnosing and treating mental health problems—even in cases where medical professionals are adequately trained to treat LGBT patients.

Department of Health and Human Services Provide financial reimbursement for mental health prevention and screening services with a focus on reaching at-risk LGBT youth.

Review and streamline widely varying interpretations of reimbursement policies and allowable services, and publicize any clarifications to all service providers. Encourage states to implement policies for adequate reimbursement of telemedicine mental health services. Possible solutions in the health reform law Section provides state grants to care providers that serve high percentages of medically underserved populations.

HHS can provide guidance to states that these grants should focus on care centers that deliver mental health services to LGBT youth. Section establishes a quality-measure reporting program for inpatient psychiatric hospitals.