Scientific Homophobia

! The recent debate about gender conformity and sexual

identity sparked by last week's J. Crew advertisement
controversy has me thinking a lot about gender stereotypes.
Stereotypes can be dangerous. They frequently lead to the type
of black-and-white thinking that is so often associated with
discrimination. Our own psychiatric field is not immune to this
phenomenon; in fact, at times we have even been responsible for
perpetuating it.  While our field has done much to educate
others about the dangers of stereotyping, we have not always
practiced what we preach.  Take, for example, the use of
psychological science to perpetuate homophobia.

Morally-Biased Science

! Throughout history science has been appropriated to support

morality, particularly as it related to sexuality. Often
scientific theories have been presented as objective truths,
analogous to the laws of physics or evolution.  It is certainly
understandable why moralists would wish to use science to
support their beliefs.  In our Western world, good science is
thought to be irrefutable.  Science often provides a framework
for understanding natural and human phenomena without the
apparent bias of emotion and subjective experience.  It relies
on detached observation, logic, and reason.  Unfortunately,
those who practice science have sometimes allowed themselves to
be blinded by morality when studying human sexuality (Mohr,
2010).  

American Psychiatry and Homophobia

! Given all the evidence to the contrary, why did it take so

long for psychiatry to publicly denounce the pathologization of
homosexuality?  The answer to this question is rooted in
morality, not science.

! In 1973, the American Psychiatric Association made the much

belated decision to delete homosexuality as a diagnostic
category from the Diagnostic and Statistical Manual (DSM). 
Ironically, this decision was not based on new scientific
evidence but the result of political pressure from activists in
and out of the Association (Mohr, 2010). 

ⓒ Tyger Latham, Psy.D.

! American psychiatry, as with clinical psychology, has
suffered from "scientific heterosexism," an idea that rests on
the very unscientific assumption that heterosexuality is
"normal" and all other form of sexuality - such as homo- and bi-
sexuality - are aberrant.  If that were not bad enough,
psychiatrists and psychologists have created empirical-supported
treatments designed to correct these so-called sexual
aberrations. 

! Contradicting their own medical training, the American

Psychiatric Association for much of the 20th century argued
against the idea that homosexuality was biologically-based,
claiming instead that it was a response to environmental
conditions interfering with "normal" psychosocial maturation
(Terry, 1999).  This belief led the profession to develop a
disease-based model of homosexuality that remained on the books
until recently.  The original DSM (1952) listed homosexuality as
a "sociopathic personality disorder."  It was later upgraded in
1968 to a "sexual deviation" but it was not until 1973, after
the APA's proclamation against homophobic diagnoses, that
homosexuality was removed entirely from the diagnostic manual. 
However, the revised DSM-II continued to make reference to a
less pathological "ego-dystonic homosexuality," a classification
reserved for homosexuals who were distressed about their sexual
orientation.  In essence, this more benign form of homophobia
allowed psychiatrist and psychologists to continue to treat
their patients' homosexuality as though it were a disorder. It
was only in 1987 that reference to ego-dystonic homosexuality
was removed entirely from the DSM-III. 

Psychoanalytically Informed Homophobia

! Perhaps, the most blatant form of homophobia practiced in

our field was committed by psychoanalysts, who, armed with
poorly developed theories of sexuality, purported to treat
homosexuality as a pathology in need of alteration.  Many
psychoanalytic theories were created to account for
homosexuality.  Concepts such as autoeroticism (i.e., love of
the self), genital fears of the other sex, and the concept of
"arrested development" have all been in vogue within
psychoanalytic literature at different times.  In analyzing gay
men, it was not uncommon for a psychoanalyst to blame their
patient's "overprotective mothers" and "absent fathers" for
their homosexuality. In lesbians, psychoanalysts often argued
that their patients suffered from some form of "penis envy," as
well as an anger directed at their fathers.  

ⓒ Tyger Latham, Psy.D.

! Interestingly, the grandfather of all psychoanalysts,
Sigmund Freud, was anything but homophobic.  In fact, Freud
warned his contemporaries of pathologizing homosexuality and
openly opposed any form of discrimination against homosexuals
that was based on sexual orientation.  Early in his career,
Freud wrote unambiguously that homosexuality was no illness,
stating "homosexual persons are not sick." 

! While Freud never wrote a definitive treatise on

homosexuality, he often discussed the topic in his case reports
and correspondence with clinicians.  In a frequently quoted
letter (1935) to the mother of one of his gay patients, Freud
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" (as cited in Mohr, 2010).  Hardly the words of a
homophobe.

! In fact, it was Freud's later apostles who felt compelled

to pathologize homosexuality, presumably because they had
difficulty tolerating the ambiguity of human sexuality.  Such
analysts argued for a more bifurcated notion of sexuality, one
that unfortunately has continued through the present time. 
Freud on the other hand was far more comfortable with the
ambiguity of human sexuality.  He frequently argued that we are
all bisexual to some degree but that heterosexuality is the
preferred orientation - not for reasons of morality, but simply
for the purposes of procreation and evolution.  I would invite
anyone in the psychoanalytic community who thinks otherwise to
consult Freud's Three Essays on the Theory of Sexuality (1905). 

Concluding Remarks

! Scientific heterosexism operates in a very similar fashion

to that of scientific racism in that it starts with a priori
view - in this case the belief that homosexuality is an
aberration - and then creates a body of empirical evidence
designed to confirm the very theory it purports to
scientifically prove.  The result is a circular form of logic
that ultimately has been responsible for creating a body of
literature used to pathologize a group of people who, as we now
know, are no more capable of changing their sexual orientation
as you or I are capable of changing our DNA.

ⓒ Tyger Latham, Psy.D.

! American psychiatry and clinical psychology have suffered
from unscientific reasoning when conceptualizing and treating
homosexuality.  While this post has focused more on the former,
it is the treatment of gay men and lesbians who have been the
unfortunate victims of poor science and moral relativism.  While
the fields of psychiatry and clinical psychology can come out
with public statements denouncing their past positions of
homophobia and intolerance, the real test to our field will be
how we integrate newer, more scientifically-informed clinical
material into our understanding and treatment of our LGBT
patients.  

References

Freud, S. (2000). Three essays on the theory of sexuality. New

York: Basic Books (originally published in 1905).

Mohr, J.A. (2010). Oppression by scientific method: The use of

science to "other" sexual minorities. Journal of Hate Studies,
77 (22): 21-45.

Terry, J. (1999). An American obsession: Science, medicine, and

homosexuality in modern science. Chicago: University of Chicago.

About Dr. Tyger Latham

Dr. Tyger Latham is a clinical psychologist with a private practice in

Washington, DC. He frequently works with individuals struggling with
issues surrounding trauma, sexuality, and gender. He also counsels
couples and helps them address issues related to differing styles of
communication, sexual problems, and navigating work and family. He
maintains a weekly blog entitled “Therapy Matters,” where he enjoys
reflecting on his work as a psychotherapist. You can visit his blog
at www.psychologytoday.com/blog/therapy-matters or his website at
www.DupontTherapy.com.

ⓒ Tyger Latham, Psy.D.