What is Sexual Orientation?
“Sexual orientation” is a term frequently used to describe a person’s romantic, emotional or sexual attraction to another person. A person attracted to another person of the same sex is said to have a homosexual orientation and may be called gay (both men and women) or lesbian. Individuals attracted to persons of the other sex are said to have a heterosexual orientation. Sexual orientation falls along a continuum and individuals who are attracted to both men and women are said to be bisexual. Sexual orientation is different from gender identity, which refers to the internal sense of whether one is male or female. Sexual orientation is a relatively new concept. In fact, although same sex behavior has always existed, the idea of a homosexual identity or a homosexual person is only about 100 years old.
The concept of sexual orientation refers to more than sexual behavior. It includes feelings as well as identity. Some individuals may identify themselves as gay lesbian or bisexual without engaging in any sexual activity. 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.
Is Homosexuality A Mental Disorder?
No. All major professional mental health organizations have gone on record to affirm that homosexuality is not a mental disorder. In 1973 the American Psychiatric Association’s Board of Trustees removed homosexuality from its official diagnostic manual, The Diagnostic and Statistical Manual of Mental Disorders, Second Edition (DSM II). The action was taken following a review of the scientific literature and consultation with experts in the field. The experts found that homosexuality does not meet the criteria to be considered a mental illness.
What causes Homosexuality/Heterosexuality/Bisexuality?
No one knows what causes heterosexuality, homosexuality, or bisexuality. Homosexuality was once thought to be the result of troubled family dynamics or faulty psychological development. Those assumptions are now understood to have been based on misinformation and prejudice. Currently there is a renewed interest in searching for biological etiologies for homosexuality. However, to date there are no replicated scientific studies supporting any specific biological etiology for homosexuality. Similarly, no specific psychosocial or family dynamic cause for homosexuality has been identified, including histories of childhood sexual abuse. Sexual abuse does not appear to be more prevalent in children who grow up to identify as gay, lesbian, or bisexual, than in children who identify as heterosexual.
What is “Coming Out”?
“Coming out” is the term used to describe the experience in which a person identifies himself or herself as gay, lesbian or bisexual. Coming out is not a one-time event, but a lifelong process of identifying as gay, lesbian or bisexual to family friends and other significant members of one’s social world. Each person’s experience in coming out is unique and the process always stimulates anxiety as well as provides challenging possibilities for personal empowerment and emotional growth. There are many resources available to people coming out. See below for some of these resources.
Does Stigma Still Exist About Homosexuality?
Yes. Fears and misunderstandings about homosexuality are wide spread. They present daunting challenges to the development and maintenance of a positive self-image in gay, lesbian and bisexual persons and often to their families as well. “Homophobia” is a term that refers to the irrational fear and prejudice against homosexual persons. Public opinion polls in the United States show that in the past twenty years, feelings toward gay men, lesbians and bisexuals have moved in a significantly positive direction. Nevertheless, when compared to other social groups homosexuals are still among the most stigmatized groups in the nation.
What Position Has the American Psychiatric Association Taken Regarding This Stigma?
In 1992, the American Psychiatric Association, recognizing the power of the stigma against homosexuality, issued the following statement:
“Whereas homosexuality per se implies no impairment in judgement, stability, reliability, or general social or vocational capabilities, the American Psychiatric Association calls on all international health organizations and individual psychiatrists in other countries, to urge the repeal in their own country of legislation that penalized homosexual acts by consenting adults in private. And further the APA calls on these organizations and individuals to do all that is possible to decrease the stigma related to homosexuality wherever and whenever it may occur.”
Such organizational recognition of homophobia has been important in changing attitudes about homosexuality.
Is It Possible To Change One’s Sexual Orientation (“Reparative Therapy”)?
There is no published scientific evidence supporting the efficacy of “reparative therapy” as a treatment to change one’s sexual orientation, nor is it included in the APA’s Task Force Report, Treatments of Psychiatric Disorders. More importantly, altering sexual orientation is not an appropriate goal of psychiatric treatment. Some may seek conversion to heterosexuality because of the difficulties that they encounter as a member of a stigmatized group. Clinical experience indicates that those who have integrated their sexual orientation into a positive sense of self-function at a healthier psychological level than those who have not. “Gay affirmative psychotherapy” may be helpful in the coming out process, fostering a positive psychological development and overcoming the effects of stigmatization. A position statement adopted by the Board in December 1998 said:
"The American Psychiatric Association opposes any psychiatric treatment, such as “reparative” or “conversion” therapy, which is based upon the assumption that homosexuality per se is a mental disorder, or based upon a prior assumption that the patient should change his/ her homosexual orientation.”
What Do the Parents of Gay Men/Lesbian/Bisexuals experience?
When a person “comes out “ to their parents, it can be a very emotionally trying experience for all involved. Most parents are concerned for the welfare of their children, recognizing the difficulties posed by being a member of a stigmatized group. Often parents also fear rejection by their own family, friends, religious, or social groups. Fortunately, support exists for parents who are struggling to come to terms with their child’s homosexuality. PFLAG (Parents and Friends of Lesbians and Gays) is an organization comprised of the families of gay men, lesbians, and bisexuals that provides information and assistance to parents and families. Family or individual psychotherapy can be very helpful in dealing with questions and concerns about a gay child.
How Do the Children of Gay/Lesbians Parents Fare?
Many gay men and women are parents and some conceived their children in prior heterosexual marriages. Recently an increasing number of gay parents have conceived children and raised them from birth either as single parents or in committed relationships. Often this is done through alternative insemination, adoption or through foster parenting. Numerous studies have shown that the children of gay parents are as likely to be healthy and well adjusted as children raised in heterosexual households. Children raised in gay or lesbian households do not show any greater incidence of homosexuality or gender identity issues than other children. Children raised in nontraditional homes with gay/lesbian parents can encounter some special challenges related to the ongoing stigma against homosexuality, but most children surmount these problems.
Healthy Minds blog post on supporting gay youth