Homosexuality

Homosexuality, an exclusive or predominant sexual preference for the same sex, is no longer classed as a psychiatric disorder. It is mentioned here because it may be associated with increased rates of depression, alcoholism, and neurosis, probably because of the associated social stigma. Social attitudes to male homosexuality have become well publicized since the advent of HIV and AIDS.

Female homosexuality was not illegal in the UK, as, when such a law was mooted to Queen Victoria, she declined to believe that it existed. Male homosexual acts were illegal until 1967, when they were legalized between consenting males over the age of 21 (in private). Recently, the age of consent has been changed to 16 in the UK (17 in Northern Ireland). Male homosexuality remains illegal in many jurisdictions, however.

Homosexual interests or experiences are common in adolescence. According to community surveys, up to 4 per cent of adult males are exclusively homosexual (gay) and an additional minority of men are bisexual to some degree. The percentages for females are similar. Some homosexuals resemble the opposite sex in their physical habits, mannerisms, or dress.

Causation of homosexuality, like heterosexuality, remains unclear. Reported biological factors include a genetic component, as demonstrated by twin studies. Hormone differences in the prenatal period have been suggested. Psychody-namic factors have also been postulated. The review by Bancroft (1994) concluded that 'it remains difficult, on scientific grounds, to avoid the conclusion that the uniquely human phenomenon of sexual orientation is a consequence of a multifactorial developmental process in which biological factors play a part, but in which psychosocial factors remain crucially important.'

In the past, various interventions, including psychotherapy, behaviour therapy, and hormone treatments, were tried in order to modify homosexual orientation, all to little effect. This is no longer considered appropriate, and modern approaches are designed to aid adaptation to the homosexual state, any coexisting psychiatric disorder being treated in standard fashion. For homosexuals facing other difficulties, services organized by gays themselves, such as telephone advice and self-help groups, may be appropriate sources of support.

Further reading

Bancroft, J. (1994). Homosexual orientation. Br J Psychiatry 164, 437-440. Tomlinson, J. (2002). ABC of Sexual Health. Oxford: Blackwell.

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