Lade Inhalt...

Homosexuality and Pathology in the US

Origins of the disease model in psychotherapy and religion and critical evaluation of sexual orientation change efforts

Hausarbeit (Hauptseminar) 2010 19 Seiten

Amerikanistik - Kultur und Landeskunde


1. Introduction

2. Body
2.1. The disease model of homosexuality: origins in psychoanalytic theory and religion
2.1.1 Key figures of psychoanalytic history in cohesion with the disease model of homosexuality
2.1.2 Homosexualityand right-wing Christians
2.2. Sexual orientation change efforts - a critical evaluation
2.2.1 Internalized homophobia - a sufficient reason fortherapy?
2.2.2 Effectiveness of sexual orientation change efforts
2.2.3 Potential harmfulness of sexual orientation change efforts
2.2.4 Sexual orientation change efforts and its effect on the public views of lesbian, gay and bisexual people

3. Conclusion

4. WorksCited

1. Introduction

For almost four decades now organized mental health has declassified homosexuality as a mental illness in the United States of America. After several years of bitter dispute, the American Psychiatric Association decided to remove homosexuality as a mental disorder from the Diagnostic and Statistical Manual of Psychiatric Disorders, its official list of mental diseases1. Nevertheless it is remarkable that a demise of therapies designed to change homosexual orientation seems improbable at least, given that some religious political activists and marginalized health professionals are apparently seeking to reinstate the disease-model of homosexuality by presenting stories of presumably cured homosexuals to the American public. Aside the professional media, especially religious groups promoting sexual orientation change therapies recently experienced unwanted popular media coverage when comedian Sacha Baron Cohen, undercover in his Bruno character, went trough therapy in an Ex-Gay Ministry in 2009, ridiculing them in the process2.

As US-Historian Jonathan Katz remarks, the treatment of homosexuality by medical practitioners is of relatively recent origin3. According to him, discussion of homosexuality as a medical phenomenon dates to the early 1800s in Europe. Before that, homosexuality was essentially conceived as a merely theological-moral phenomenon. From then onward however, legislative declared it a legal matter until medical professionals declared it a sickness. While at it's time of origin, the medical practitioners' concept of homosexuality as a sickness may have been a liberal and humane advance over the conception and punishment of homosexuality as a crime, at the latest since the post World-War II years, psychiatrists and psychologists can be regarded among the major ideologues of homosexual oppression4.

Sexual conversion therapies or reparative therapies derive from this disease model portraying homosexuality as a mental disorder and a social evil. Since these terms in my opinion inaccurately imply defectiveness in homosexuality and bisexuality, I chose to refer to such therapy as sexual orientation change efforts in the title of this paper. Today the main groups pursuing these kinds of therapies are the before-mentioned marginalized psychotherapists and conservative Christians. This paper will consecutively show that this kind of therapy should not in any way be influential to the development of public policy since the very origins of the disease model are based on badly flawed assumptions. It will subsequently critically evaluate sexual orientation change efforts in general, addressing several issues as its effectiveness, potential harmfulness and its effect on the public view of lesbian, gay and bisexual5 people.

2. Body

2.1. The disease model of homosexuality: origins in psychoanalytic theory and religion

It is remarkable that the disease model of homosexuality has common origins in fields as different as psychoanalytic theory and religion. While in this cohesion it is important to stress once again that since 1973 only marginalized, yet very vocal health professions participate in this discrimination against LGB people, especially in the 1940s until the 1970s6 mental health professionals made a "pathological diagnosis from same-sex desires and promulgated risky and often harmful 'treatments' aimed at creating sexual conformity"7. Katz affirms that in cohesion with the emergence of sexual orientation change therapies he sees a connection between law, religious concepts and medical establishments when he reports that doctors prominent in the business of treating homosexuals were frequently simultaneously employed by the penal system. He continues that therefore the acts of the medicolegal establishment were legally justified when they sought to rehabilitate homosexuals who have come into active conflict with the law. He further explains that this law derived from religious concepts, and Judeo-Christian morality terms, even though such structures supposedly have no place in a society theoretically based on separation of church and state8. This means that at that time psychoanalytic establishment and religion shared the same bias to a certain degree, especially when it came to the disease model. Currently it often becomes difficult to allocate the voices insisting on the value of sexual orientation change efforts to either the psychoanalytic or religious camp - during the last years, relations between these camps became so intertwined that it is hard to distinguish them sometimes.

The commercial aspect is another important factor for either group to pursue and promote this kind of therapy. Sexual orientation change therapies have now for decades been a lucrative business which led, especially during the midst of the last century, to a rise to power of a group of individual medical entrepreneurs, "whose stock in trade was their alleged 'expert' understanding of homosexuality"9. In this context, various sources claim that their facade of scientific objectivity merely served as a cover for their own emotional, economic, and career investments in their status as authorities10. While some conservative Christians groups claim it is their duty to lead gay people out of what they contend is an inherently sinful life, it cannot be denied that they also pursue a political as well as an economical agenda. Kim Ellis11 reports that since the fall of communism, religious political organizations have been seeking new fund­raising hooks, and found a new cash cow in form of sexual orientation change therapies. According to Ellis, "these groups have consistently used the threat of what they have dubbed 'the gay agenda' to motivate their adherents to contribute"12.

2.1.1 Key figures of psychoanalytic history in cohesion with the disease model of homosexuality

Originally there has been a wide variety of treatments for homosexual patients. These ranged from castration over electroshocks to drug- and aversion therapy, just to name a few13. Although these treatment modalities have also promised to cure homosexuality, reparative therapy is generally associated with talking cures employed in psychoanalysis14. This part of the paper will review the history and theoretical assumptions of psychoanalytically-oriented practitioners whose opinions shaped the psychiatric landscape in regards of the emergence of the disease model of homosexuality.

It is remarkable that the innovator of psychoanalysis Sigmund Freud apparently never intended this form of treatment to solve the problem of homosexuality. Greenberg quotes15 Freud from his Letter to an American Mother where he comments that homosexuality is not a sickness16. Furthermore, Faderman and Drescher agree that Freud's attitude toward homosexuality was tolerant for his time even though he was not immune to a certain bias about gender behaviour. Unlike modern reparative therapists, he did not believe in criminalization and social opprobrium as acceptable therapeutic tools17.

In contrast to that Edmund Bergler, who according to gay historian Martin Duberman has been seen as one of the most important theorists of homosexuality in the 1950's, did not refrain from this form of treatment. In his autobiography Cures Duberman reports that in describing his homosexual patients, Bergler adopted an "abusive, scornful tone that bordered on professional incompetence, characterizing the 'great percentage' of them as, among other things, 'swindlers, pseudologues, pimps, spies, brothel-owners, etc.'"18

While Freud himself saw little hope for converting homosexuality, the psychoanalytic opinion began to change after his death in 1938. New theories, offering alternative explanations for same sex attractions emerged, creating new therapeutic approaches. Sandor Rado's theories19 laid the foundations of what would later be known as reparative therapies. He declared with great authority, but without any supporting scientific research or evidence, that heterosexuality is the only non-pathological outcome of human sexual development.20

Irving Bieber and his colleagues conducted a study in 1962 that supported Rado's thesis. It began with the unarguable assumption that homosexuality was pathological21 and concluded that heterosexual adjustment is possible since every homosexual is a latent heterosexual.


1 cf. Bayer, 1987, p.3

2 cf. Charles, Bruno, 2009

3 cf. Katz, 1976, p. 130

4 cf. Faderman, 1992, p. 130

5 In the following LGB

6 "psychoanalysis reached its highest influence in psychiatry and academia during the 1940s and through the 1960s" Drescher, 2001, p.11

7 Schneider, Brown, Glassgold, 2002, p. 273

8 cf. Katz, 1976, p. 131

9 Katz, 1976, p. 130

10 cf. Katz, 1976, p. 130; Faderman, 1992, p. 130-131

11 Education Director of Human Rights Campaign, a group working for LGB and transgender equal rights

12 Ellis, 1998, p.2

13 "In the 1800s, surgical removal of the ovaries and the clitoris are discussed as a 'cure' for various forms offemale 'erotomania,' including, it seems, Lesbianism. Lobotomy was performed as late as 1951. A variety of drug therapies have been employed, including the administratio of hormones, LSD, sexual stimulants, and sexual depressants. Hypnosis, used on Gay people in America as early as 1899, was still being used to treat 'deviant behaviour' in 1967. Other documented 'cures' are shock treatment, both electric and chemical; aversion therapy, employing nausea-inducing drugs, electric shock, and/or negative verbal suggestion; and a type of behaviour therapy called 'sensitization', intended to increase heterosexual arousal, making ingenious use of pornographic photos." Katz, 1976, p.129

14 cf. Drescher, 2001, p.5

15 qtd. in Greenberg, 1993, p.425

16 "That is, it does not and cannot see homosexuals as sick because of their homosexuality per se - they might be sick for other reasons [...] homosexuals are seen, not as people with things wrong with them as such, but rather as people in a state of arrested development." Ruse, 1988, p. 222

17 cf. Faderman, 1992, p. 130; Drescher, 2001, p.7

18 Duberman, 1991, p.54

19 These theories were published in 1969, toward the end of his life; however, they were based on the ideas and lectures that Rado developed and taught in the 1930s and 40s. cf. Drescher, 2001, p. 22

20 Drescher, 2001, p. 11-12

21 cf. Duberman, 1991, p. 64


ISBN (eBook)
ISBN (Buch)
468 KB
Institution / Hochschule
Universität Duisburg-Essen – Institut für Anglophone Kulturen
Homosexuality Pathology NARTH right-wing christians psychoanalytic theory sexual orientation change efforts homophobia homophobie gay pride homosexuality and religion homosexuality and pathology Charles Socarides Joseph Nicolosi ex-gay gay queer reparative therapy homosexuality and psychoanalysis psychoanalysis conservative chrisitans disease model lesbian



Titel: Homosexuality and Pathology in the US