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Straight talking: an investigation of the attitudes and practice of psychoanalysts and psychotherapists in relation to gays and lesbians

Department of Psychiatry, St George's Hospital Medical School, London

MICHAEL KING, MRCPsych

Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London

PETER PHILLIPS, MSc

South West London and St George's Mental Health NHS Trust, London

Correspondence: Annie Bartlett, Senior Lecturer on Forensic Psychiatry, Department of Psychiatry, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK

Declaration of interest None.

¹ Usage of ‘client’ in this paper reflects the apparent preference of the majority of respondents and has been used throughout for consistency.

Background Early psychodynamic writing on same-gender sexual preference contributed to its pathologisation and an interest in treatment directed at changing sexual orientation.

Aims To establish the therapeutic approaches taken by contemporary psychotherapists and psychoanalysts to gay and lesbian clients/patients.

Method A random sample of individuals listed as working with adults in the British Confederation of Psychotherapists' register were sent postal questionnaires.

Results Data are available from 274 (69%) of 395 questionnaires. Only one of 218 respondents said that he/she was homosexual. One-third said that gay and lesbian patients did have a right to a gay or lesbian therapist. A total of 179 (82% of 218) respondents described work with gay and lesbian clients/patients, and in the majority of cases sexual orientation was an important aspect of the work.

Conclusions Gays and lesbians seeking psychoanalysis or psychotherapy in the National Health Service or outside it for personal and/or training purposes will be unlikely to find a gay or lesbian therapist if they want one. The British Confederation of Psychotherapists' practitioners take on gay and lesbian clients/patients, although many do not see these social identities as relevant to the therapeutic process. Evidence from this study indicates that such clients/patients may encounter overt or covert bias, including the pathologisation of homosexuality per se.

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