Christopher R Martell

Decades of research have demonstrated that lesbian, gay, and bisexual (LGB) sexual orientations are not symptomatic of psychopathology. In her pioneering research, Evelyn Hooker (1957) was the first to report that gay men were no more pathological than heterosexual men on measures considered acceptable at that time. Literature on lesbian and gay couples demonstrates that same-sex relationships are as happy and healthy as those of heterosexual couples (Kurdek, 1992, 1998). Children of lesbian and gay parents fare as well as children from heterosexual homes, and differences that have been reported are due to children living in single-parent homes (regardless of the sexual orientation of the parent) rather than two-parent households (Flaks, Ficher, Masterpasqua, & Joseph, 1995; Golombok & Tasker, 1996; Wainright, Russell, & Patterson, 2004). By all accounts, being lesbian, gay, or bisexual is not a symptom of any underlying pathology or failure of development (Gonsiorek, 1991). Yet, LGB people exist in a different context than that of their heterosexual counterparts—one that is often invalidating and stressful. Societal values shift between prohibition and acceptance of homosexual or bisexual identity and same-sex partnerships. There are dramatic differences in the treatment of LGB people, and their ability to live openly in their communities, depending on the geographic area in which they live. Within religious denominations there are progressive voices that call for the open reception of LGB people in the congregation and there are vocal, intolerant, condemning attitudes that promote religiously directed prohibition of LGB people.

The stressors begin early in life for LGB people. LGB youth face increased harassment and victimization (D'Augelli, 1998), and have higher rates of attempted suicide than their heterosexual counterparts. Some clinicians within the field of clinical psychology have recommended treating gay or lesbian people who want to change their sexual orientation (Adams, Tollison, & Carson, 1981), whereas others recognize that such self-denigrating desires result from living as part of an oppressed group. Treating LGB people to change their sexual orientation has been criticized on ethical grounds (Davison, 1976; Schroeder & Shidlo, 2001); its treatment effectiveness has been challenged (Haldeman, 1994,2002) and so-called "conversion therapy" has been rejected or discouraged by most professional mental health organizations (e.g., American Psychiatric Association, 2000; American Psychological Association, 1998). The idea that gay or bisexual men and lesbian or bisexual women are able to change their sexual orientation with help persists, couched in the guise of allowing patient autonomy in decision making. Such an argument overlooks the enormous pressure to be heterosexual that is placed on LGB people from birth forward. The pressure is greatest in families that hold strong religious opinions proscribing same-sex, intimate relationships, and many LGB individuals from such backgrounds experience emotional conflicts (Schuck & Liddle, 2001).

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