Over the last 200 years or so, there has been ongoing debate about the relative role of psychology and biology in a range of human behaviours. Autism and homosexuality are two good examples that research has placed firmly on the side of biology. For many years professionals tried talking therapies to help people with autism and homosexuality overcome their ‘afflictions’. In both cases all they served to do was increase the distress of the patient, and their families, by making them feel responsible for their behaviour.
With respect to homosexuality, the psychiatric profession for many years held it to be an illness. This is no longer the case. Although the causes of homosexuality are still debated in nuance, there is increasing consensus that it is biology that determines a person’s sexuality, not psychology, upbringing or indeed, personal choice. Interestingly there are different biological reasons for male homosexuality and female homosexuality, rather than a unified reason that accounts for both.
Furthermore, a survey of all published research about therapies that have tried to change a person’s sexuality has shown that it has always failed to do so, and often causes harm. This has recently led to the American Psychological Society issuing a declaration that therapy to change a person’s sexuality does not work, with the implication that it is unethical to try to do so. Pressure is being put on the British Psychological Society and the Royal College of Psychiatry to issue a similar statement.
Given this backdrop it is alarming that a recent study in MBC Psychiatry found that as many as 1 in 6 therapists have attempted to change at least one person’s sexual orientation in their professional career. On the face of it this seems to go against the evidence. I wonder, though, if something more subtle is going on – namely a difficulty knowing how to deal with gay clients who are unhappy about their sexuality.
In the life history of most gay men there is likely to be a period when they couldn’t accept their sexuality, and therefore really didn’t want to be gay. The pressures of family and society to conform to a heterosexual norm seem insurmountable for many men. It is clear that many gay clients have a lot of soul searching to do before they form an acceptance of their sexuality. Indeed, it could be argued that many gay men, though superficially accepting and adopting a gay lifestyle, still suffer from a hangover of ‘internalised homophobia’ that continues to impact on their emotional wellbeing and ability to form meaningful relationships.
Given the very real unhappiness that finding oneself gay can bring to a person, it seems understandable, if ill advised, to try and help the person to lead a straight lifestyle. I suspect this, rather than a real belief in its possibility, that has led so many of my colleagues to try and change a persons sexuality.
It is within this backdrop, however, that the real danger to gay men’s well-being lies – namely in those religious organisations that still offer ‘treatments’ for homosexuality. Against the grain of science but in the name of God, such organisations can only serve to enhance gay men’s unhappiness with their sexuality, and not in fact offer any real solution to it. At best all they can hope to achieve is an asexual life where sex and relationships are sacrificed for a supposed ‘greater’ ideal of ‘what God wants’. I can’t see this being beneficial to the individual, or, indeed, society.
Homosexuality will continue to be a contentious issue, not least because it raises tensions between individual behaviour and social and religious mores. All I can do as a therapist is help everybody, gay or straight alike, to be more accepting of homosexuality. It is in accepting others how they really are, that we are best able to learn to accept ourselves as we really are. Psychological health, after all, starts by seeing the world as it really is, rather than how we think it should be.
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