SELECTED BIBLIOGRAPHY ON PSYCHOTHERAPY WITH LGBT PATIENTS
JUST ADDED: Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation (Download PDF...)
Cabaj RP, Stein TS, eds. (1996), Textbook of Homosexuality and Mental Health. Washington, DC: American Psychiatric Publishing.
Domenici T, Lesser RC, eds. (1995), Disorienting Sexuality. New York: Routledge.
Drescher J (1998), Psychoanalytic Therapy and the Gay Man. Hillsdale, NJ: Analytic Press.
Group for Advancement of Psychiatry (GAP), Committee on Human Sexuality (2000), Homosexuality and the Mental Health Professions: the impact of bias. Hillsdale, NJ: Analytic Press.
Isay RA (1987), Being Homosexual. New York: Farrar, Straus, Giroux.
Isay RA (1996), Becoming Gay. New York: Pantheon Books.
Jones BE, Hill MJ, eds. (2002), Mental Health Issues in Lesbian, Gay, Bisexual and Transgender Communities. Review of Psychiatry, Volume 21, Number 4, Oldham JM, Riba MB, series editors. Washington, DC: American Psychiatric Publishing.
Magee M, Miller DC (1997), Lesbian Lives: Psychoanalytic Narratives Old & New. Hillsdale, NJ: Analytic Press.
Shidlo, A, Schroeder, M, Drescher J, eds. (2001), Sexual Conversion Therapy: Ethical, Clinical, and Research Perspectives. New York: Haworth.
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 may 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.
• Pedophilia is defined as an adult having "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (DSMIV, reference below)."
• Pedophilia is almost exclusively found in men, and the great majority of these men identify as heterosexual.
• Even among people who sexually abuse children of their same gender, most are attracted to adults of the opposite gender.
• Sexual orientation, whether heterosexual or homosexual, describes attractions to and sexual behavior with consenting adults. Sexual behavior directed at children is a disorder or a crime, and does not constitute a sexual orientation.
1. American Psychiatric Association : Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994
2. Andreason NC, Black DW: Introductory Textbook of Psychiatry, 3rd Edition. Washington, DC, American Psychiatric Publishing, c2001
3. Freund K, Heasman G, Racansky IG, Glancy G: Pedophilia and heterosexuality vs. homosexuality. J Sex Marital Ther 1984; 10(3):193-200
4. Groth AN, Birnbaum HJ: Adult sexual orientation and attraction to underage persons. Arch Sex Behav 1978; 7(3):175-81
5. Jenny C, Roesler TA, Poyer KL: Are children at risk for sexual abuse by homosexuals? Pediatrics 1994; 94(1):41-4
6. Sadock BJ, Sadock VA: Kaplan and SadockÕs Comprehensive Textbook of Psychiatry, 7th Edition. Philadelphia, Lippincott Williams & Wilkins, c2000
Fact sheet prepared by Mary Barber, MD
• Most gay, lesbian and bissexual youth never attempt suicide and never have other serious substance use or mental health problems (depression and anxiety) however,
• Gay, lesbian and bisexual youth are up to 6 times more likely to attempt suicicide during adolescence than heterosexual peers.
• Gay, lesbian and bisexual youth are also up to 6 times more likely to have serious substance use or mental health problems (depression and anxiety) that are known risk factors for both attempted and completed suicide.
• Even after controlling for these and other known risk factors, status as gay, lesbian or bisexual may confer an independent risk for attempted suicide related to difficulties expressing a minority sexual identity in a hostile enviroement permeated by anti-homosexual bias.
• Other possible social risk factors for attempted suicide include gender non-confirmity, early awareness of homosexuality, lack of social support, school dropout, family problems, suicide attempts by friends or relatives and homelessness.
• Attempted suicide may be associated with sexual minority status in young men, but not in young women. In other words, a homosexual orientation may not compound the already greater risk of attempted suicide in women compared to men.
• It is not known whether the risk for attempted suicide among sexual minority youth varies with race or ethnicity.
• It is not known whether the increased risk for attempted suicide among sexual minority individuals peaks between ages 15-25 years or remains constant throughout the life span.
• It is not known whether sexual minority youth have an increased risk for completed suicide. Although the 1989 report of the Secretary's Task Force on Youth Suicide concluded that that sexual minority youth may comprise up to 30% of completed suicides annually, there is not research or clinical evidence that currently supports this.