© 2001 The Royal College of Psychiatrists
Book reviews |
Homosexuality and the Mental Health Professions: The Impact of Bias
Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
EDITED BY SIDNEY CROWN and ALAN LEE
Formulated by the Committee on Human Sexuality. Hillsdale, NJ: Analytic Press. 2000. 132 pp. £22.50 (hb). ISBN 0 881 63318 6
Gay and lesbian people are vulnerable to prejudice and persecution and have
little protection from antidiscrimination laws. The Group for the Advancement
of Psychiatry has published this short volume in order to address
antihomosexual bias (a term the Group prefers to homophobia) in the practice
of psychiatry and psychotherapy. A number of young American psychiatrists who
were impatient with the conservatism of the American Psychiatric Association
founded the Group in 1946. Its aim was to produce position statements on
relevant and controversial psychiatric issues. This monograph, which is number
144 in the series, draws attention to the problem of antihomosexual bias not
only in psychiatry and psychotherapy but also in the legal system and the
medical response to patients with HIV and
AIDS.
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It briefly traces the historical (particularly religious) origins of antihomosexual bias, before focusing on where it occurs in the health and social services. The style is economical and yet rich in clinical and social illustrations. The text serves both as a warning against negative assumptions about homosexuality and a practical manual on how particular issues might be addressed. For example, it emphasises how gay and lesbian people, having grown up accepting the bias in society against them, might collude with ill-advised therapeutic efforts to modify their sexual orientation. Negative stereotypes held by gay people about their own sexuality may be reinforced by therapists who share them and who do not recognise that they are symptomatic of homophobia. A person's sexuality might count against his or her application for care and control of a child. Therapists may assume that gay and lesbian relationships are inherently unstable, any sign of bisexuality must mean the client is ‘really’ heterosexual or that the presenting disorder, such as depression, must be a consequence of the client's sexual orientation.
The Group recommends changes in the training of doctors and therapists. Supervision provided in psychoanalytical training institutes that, until relatively recently, excluded openly lesbian or gay professionals from training posts, must be free of prejudice. Psychiatric and medical educators must exert decisive, knowledgeable and moral leadership in challenging antihomosexual bias. Professionals must be encouraged to be open about their own sexuality, especially when in training posts, despite fears of discrimination in career advancement.
This short, well-written book is not a manual on political correctness. It is essential reading for doctors, psychotherapists and members of the professions allied to medicine who are curious about their own unconscious antihomosexual bias and who want to familiarise themselves with its manifestations and do their best to prevent it from harming their patients.
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