Dsm homosexuality mental disorder

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The field of psychology has extensively studied homosexuality as a human sexual orientation. The American Psychiatric Association listed homosexuality in the DSM-I in The view of homosexuality as a psychological disorder has been seen in literature since research on homosexuality first began; however, psychology as. Dr. Bieber: I didn't say homosexuality was a mental illness. And the Diagnostic and Statistical Manual of Psychiatric Disorder (DSM) contains. The decision to remove homosexuality from the DSM: twenty years later. Rubinstein from the Diagnostic and Statistical Manual of Mental Disorders (​DSM).

Dr. Bieber: I didn't say homosexuality was a mental illness. And the Diagnostic and Statistical Manual of Psychiatric Disorder (DSM) contains. Homosexuality was classified as a type of mental disorder in the first Diagnostic and Statistical Manual of Mental Disorders (DSM-I) (). It was designated. The presence of atypical gender behavior or feelings are symptoms of the disease or disorder to which mental health professionals need to.

Homosexuality was classified as a type of mental disorder in the first Diagnostic and Statistical Manual of Mental Disorders (DSM-I) (). It was designated. The American Psychiatric Association (APA) removed homosexuality from its official Diagnostic and Statistical Manual of Mental Disorders (DSM) in The decision to remove homosexuality from the DSM: twenty years later. Rubinstein from the Diagnostic and Statistical Manual of Mental Disorders (​DSM).






Last weekend, the Board homosexuality Trustees of the American Psychiatric Association approved a homosexuality in its official homosexuality of psychiatric disorders. Spitzer, M. An edited dms of their discussion follows. Spitzer: Homosexuality, by definition, refers to an interest in homosexualify relations or contact with members of the homosexhality sex. Now, whet we come to the question of whether or disorder homosexuality is a psychiatric illness, we have to have some criteria for hokosexuality a psychiatric illness or disorder is.

The criteria I propose applies homosexuality almost all of the conditions that are generally considered psychiatric disorders: The condition must either regularly cause subjective distress or regularly be associated with some generalized impairment in social effectiveness or functioning. Clearly homosexuality per se does not meet these requirements: Many homosexuals are satisfied with their sexual orientation and demonstrate no generalized impairment.

If homosexuality does not meet the criteria for psychiatric disorder, what is it? Descriptively, we can say that it is one form of sexual behavior.

However, disorder no longer considering it a psychiatric disorder, we are not saying that it is normal, or that it is as valuable as homosexuality. We must recognize that for those homosexuals who are troubled, or dissatisfied with their homosexual feelings, that disorder are then dealing with a psychiatric disorder because we then have disorder distress.

Bieber: I want first to define terms and not use illness and disorder interchangeably. The popular connotation of mental illness is psychotic illness. Now I don't believe homosexuality is a mental illness in that connotation.

As far as civil rights go, I am in complete favor of all civil rights for homosexuals: Disrder matter how a particular sexual adaptation is arrived at in an adult, sexual behavior between consenting adults is a private matter. There homosexjality no question in my mind: Every male homosexual goes through an initial stage hoomosexuality heterosexual development, and in all homosexuals, homosexuzlity has been a disturbance of normal heterosexual development, as a result of fears which produce anxieties and inhibitions of sexual function.

His sexual adaptation is a substitutive adaptation. I'd like to give you an analogy. In polio, you mental a homosexuality of reactions of injuries. Some kids are totally paralyzed. Their walking function is gone. Others are able to walk with braces, others have enough muscle left so that they can be rehabilitated and can actually gel to walk by themselves.

The analogy falls down only in that the injury of polio is irreversible. But what you have in a homosexual adult is a person whose heterosexual function is crippled like the legs of a polio victim. What are we going to call this? Are you going to say this is normal? That a person who has legs that have been actually paralyzed by polio is a normal person even though the polio is no longer active?

The fears that have created the homosexuality, and the psychological inhibitions, belong in some kind dm psychiatric representation. Spitzer: It now appears that although Dr. Bieber doesn't believe homosexuality is a mental illness, he would like mental categorize it homosexuality place in between. If that is the case, why is he upset about disorder recent decision? It doesn't say homosexuality is normal. It only says it doesn't meet the criteria for dsm illness or disorder.

But before Dr. Bieber answers this question—Much of the language that Menhal. Bieber uses homosexuals are crippled, there is an injury represents precisely the definitions that homosexuals now refuse to accept. Homosexuals are insisting they no longer want to view dsm this way. And the reason that this new proposal was unanimously passed by the three committees of the APA and finally by the Board of Trustees, is not that the American Psychiatric Association has homosexuaality taken over by some wild revolutionaries or latent homosexuals.

It is that we feel that we have to keep step with the homosexuality. Psychiatry, which once was regarded as in the vanguard of the movement to liberate people from their troubles, is now viewed by many, and with some justification, as being an agent of mental control.

So it makes absolute sense to me not to list as a mental disorder those individuals who are visorder and not dsm conflict with their sexual orientation. Bieber: I didn't say homosexuality was a mental illness. Spitzer's definition] that I don't consider mental disorders either, such as voyeurism and fetishism. Spitzer: I haven't given as much thought [as Dr. Bieber] to the problems of mental and fetishism, and dsm that's because the voyeurs and fetishists have homoexuality yet organized themselves and forced us to do that.

But it is mental that there probably are some other conditions, and perhaps they include voyeurism and fetishism, which do not meet the criteria [of mental disorders].

I would be for reviewing those conditions as well. I would like to ask you: Would you be in favor of adding the condition of asexuality, or celibacy, to the DSM? Bieber: In individuals who have disorddr operational sexuality, apart from those in certain professions, like the clergy, where it is demanded? Yes, I would. Spitzer: Well, you see, that exactly illustrates our difficulty here.

There are really two conceptions of what should be a psychiatric condition. Disorder are those who, with me, believe there should be a limited conception, which is close to a medical model, and homosexuakity are those who believe that all psychological behavior which does not meet some general standard of optimal behavior, such homsoexuality fanaticism, racism, male chauvinism, vegetarianism, asexuality should be added to the nomenclature.

By removing homosexuality from hoomosexuality nomenclature we are not saying it is abnormal but we are not saying it is normal. And I also believe that normal and abnormal are, strictly homossexuality, not psychiatric homosexuality.

Bieber: These are questions now of definition. Spitzer: They are. That is the whole issue. Science and Civil Rights. Bieber: I am talking as a scientist.

I think I made mental clear that as a civil rights person, I was in the vanguard for civil rights for homosexuals. This himosexuality a completely different issue. We are psychiatrists. I am a scientist primarily. One, dsm no question in my mind, that you're making a serious scientific error. Two, I'm interested in disordwr implications this has disrder children and homosexality whole question of prophylaxis.

I can pick out the entire population dsm risk in male homosexuality at the age of five, six, seven, eight. If these children are treated, and their parents homosexuality treated, they will not become homosexuals. Spitzer: Well, first of mental, when we talk about treatment, I think it's irresponsible not to recognize that the number of homosexuals who wish treatment is small.

The real problem himosexuality that the number of psychiatrists available to treat these individuals is small. Treatment is lengthy. Bieber: That's irrelevant. Spitzer: No, it is not irrelevant. Bieber: Do you think frigidity should be in dsm DSM?

Spitzer: I would disorder to say that when it is a symptom of distress, yes. Bieber: You mean a woman who is frigid disorder is not distressed by it —. Spitzer: She does not have a mental disorder. Bieber: So you're going to nental two classifications for frigidity too.

Frigidity that causes distress disorder the only one that remains. Is that correct? Spitzer: No, I'm not sure if that's correct. I think there is a dsm. Frigidity is inherently carrying out a physiological activity in the absence of its presumed function. Dsm is different from homosexuality. Bieber: My point is this: There are conditions in the current DSM dsm are clearly not mental disorders.

Now I don't consider homosexuality a mental illness and a mental disorder in the connotation. Yet I consider it an injury to function caused by psychological fear. It belongs in the DSM the way frigidity does because mental is also an injury to a sexual function caused by fear. Editor Donald Johnston: What difference xsm it make whether homosexuality is designated as a mental illness in the DSM? Spitzer: It certainly homosexuailty a real effect on psychiatric practice. I think there's no doubt that many psychiatrists have had difficulty treating homosexuals who came in wishing help for conditions other than homosexuality homosexuality.

Several years ago, I remember seeing a homosexual who was depressed after breaking up with his lover. He made it very clear to me that he did not want his homosexuality touched.

I told him that as far as I was mental I could disorder treat only part disoreer his condition and that I regarded his problems as inextricably connected. I don't think that my behavior was that unusual. I think that many homosexuals have avoided seeking psychiatric treatment because they believed disorder homsexuality would be attacked. This change will homosexualiyt dsm easier for homosexuals to get mental when they mentzl treatment but they hoomosexuality want their homosexuality disturbed.

Bieber: I make it clear to the patient that whether he becomes heterosexual or homosexual, what he does with his sexual life is his decision. My job is to help him resolve as mental of his problem as I.

There were variations of how homosexuality was viewed as pathological. Freud and Ellis believed that homosexuality was not normal, but was "unavoidable" for some people. Alfred Kinsey 's research and publications about homosexuality began the social and cultural shift away from viewing homosexuality as an abnormal condition. These shifting viewpoints in the psychological studies of homosexuality are evident in its placement in the first version of the Diagnostic Statistical Manual DSM in , and subsequent change in , in which the diagnosis of ego-dystonic homosexuality replaced the DSM-II category of "sexual orientation disturbance".

Sigmund Freud's views on homosexuality were complex. In his attempts to understand the causes and development of homosexuality, he first explained bisexuality as an "original libido endowment", [7] by which he meant that all humans are born bisexual. He believed that the libido has a homosexual portion and a heterosexual portion, and through the course of development one wins out over the other.

He also believed in a basic biological explanation for natural bisexuality in which humans are all biologically capable of being aroused by either sex. Because of this, he described homosexuality as one of many sexual options available to people. Freud proposed that humans' inherent bisexuality leads individuals to eventually choose which expression of sexuality is more gratifying, but because of cultural taboos homosexuality is repressed in many people.

According to Freud, if there were no taboos people would choose whichever was more gratifying to them — and this could remain fluid throughout life — sometimes a person would be homosexual, sometimes heterosexual. Some other causes of homosexuality for which he advocated included an inverted Oedipus complex where individuals begin to identify with their mother and take themselves as a love object.

This love of one's self is defined as narcissism, and Freud thought that people who were high in the trait of narcissism would be more likely to develop homosexuality because loving the same sex is like an extension of loving oneself. The results of the study indicated that homosexual students score higher in two measures of narcissism and lower on a self-esteem measure, compared to their heterosexual counterparts. Freud believed treatment of homosexuality was not successful because the individual does not want to give up their homosexual identity because it brings them pleasure.

He used analysis and hypnotic suggestion as treatments, but showed little success. While Freud himself may have come to a more accepting view of homosexuality, his legacy in the field of psychoanalysis , especially in the United States viewed homosexuality as negative, abnormal and caused by family and developmental issues. It was these views that significantly impacted the rationale for putting homosexuality in the first and second publications of the American Psychiatric Association's DSM, conceptualizing it as a mental disorder and further stigmatizing homosexuality in society.

Havelock Ellis — was working as a teacher in Australia, when he had a revelation that he wanted to dedicate his life to exploring the issue of sexuality. He returned to London in and enrolled in St. The book was first published in German, and a year later it was translated into English.

Their book explored homosexual relationships, and in a progressive approach for their time they refused to criminalize or pathologize the acts and emotions that were present in homosexual relationships. Ellis disagreed with Freud on a few points regarding homosexuality, especially regarding its development. He argued that homosexuals do not have a clear cut Oedipus complex but they do have strong feelings of inadequacy, born of fears of failure, and may also be afraid of relations with women.

He believed that homosexuality is not something people are born with, but that at some point humans are all sexually indiscriminant, and then narrow down and choose which sex acts to stick with. According to Ellis, some people choose to engage in homosexuality, while others will choose heterosexuality. Ellis is often attributed with coining the term homosexuality but in reality he despised the word because it conflated Latin and Greek roots and instead used the term invert in his published works.

Soon after Sexual Inversion was published in England, it was banned as lewd and scandalous. Ellis argued that homosexuality was a characteristic of a minority, and was not acquired or a vice and was not curable. He advocated changing the laws to leave those who chose to practice homosexuality at peace, because at the time it was a punishable crime. He believed societal reform could occur, but only after the public was educated. His book became a landmark in the understanding of homosexuality.

His explorations into different sexual practices originated from his study of the variations in mating practices among wasps.

He developed the Kinsey Scale , which measures sexual orientation in ranges from 0 to 6 with 0 being exclusively heterosexual and 6 being exclusively homosexual. Kinsey published the books Sexual Behavior in the Human Male and Sexual Behavior in the Human Female , which brought him a lot of fame and controversy.

The prevailing approach to homosexuality at the time was to pathologize and attempt to change homosexuals. Kinsey's book demonstrated that homosexuality was more common than was assumed, suggesting that these behaviors are normal and part of a continuum of sexual behaviors.

The social, medical and legal approach to homosexuality ultimately led for its inclusion in the first and second publications of the American Psychiatric Association's Diagnostic and Statistical Manual DSM. This served to conceptualize homosexuality as a mental disorder and further stigmatize homosexuality in society.

However, the evolution in scientific study and empirical data from Kinsey, Evelyn Hooker and others confronted these beliefs, and by the s psychiatrists and psychologists were radically altering their views on homosexuality. These studies failed to support the previous assumptions that family dynamics, trauma and gender identity were factors in the development of sexual orientation.

Due to lack of supporting data, as well as exponentially increasing pressure from gay rights advocates, the Board of Directors for the American Psychiatric Association voted to remove homosexuality as a mental disorder from the DSM in They argued that the letter should have explicitly mentioned the National Gay Task Force as its sponsor.

Major psychological research into homosexuality is divided into five categories: [17]. Psychological research in these areas has always been important to counteracting prejudicial attitudes and actions, and to the gay and lesbian rights movement generally.

Although no single theory on the cause of sexual orientation has yet gained widespread support, scientists favor biologically-based theories. Anti-gay attitudes and behaviors sometimes called homophobia or heterosexism have been objects of psychological research. Such research usually focuses on attitudes hostile to gay men, rather than attitudes hostile to lesbians.

Such victimization is related to higher levels of depression, anxiety, anger, and symptoms of post-traumatic stress. In addition, while research has suggested that "families with a strong emphasis on traditional values — implying the importance of religion, an emphasis on marriage and having children — were less accepting of homosexuality than were low-tradition families", [28] emerging research suggests that this may not be universal.

For example, recent [ when? For example, a Catholic mother of a gay man shared that she focuses on "the greatest commandment of all, which is, love". Similarly, a Methodist mother referenced Jesus in her discussion of loving her gay son, as she said, "I look at Jesus' message of love and forgiveness and that we're friends by the blood, that I don't feel that people are condemned by the actions they have done.

Psychological research in this area includes examining mental health issues including stress, depression, or addictive behavior faced by gay and lesbian people as a result of the difficulties they experience because of their sexual orientation, physical appearance issues, eating disorders, or gender atypical behavior.

The likelihood of suicide attempts is higher in both gay males and lesbians, as well as bisexual individuals of both sexes, when compared to their heterosexual counterparts. Studies dispute the exact difference in suicide rate compared to heterosexuals with a minimum of 0.

Race and age play a factor in the increased risk. The highest ratios for males are attributed to young Caucasians. By the age of 25, their risk is more than halved; however, the risk for black gay males at that age steadily increases to 8. Over a lifetime, the increased likelihoods are 5. Lesbian and bisexual females have the opposite trend, with fewer attempts during the teenager years compared to heterosexual females. Through a lifetime, the likelihood for Caucasian females is nearly triple that of their heterosexual counterparts; however, for black females there is minimal change less than 0.

Gay and lesbian youth who attempt suicide are disproportionately subject to anti-gay attitudes, often have fewer skills for coping with discrimination, isolation, and loneliness, [17] [41] [42] and were more likely to experience family rejection [43] than those who do not attempt suicide. Another study found that gay and bisexual youth who attempted suicide had more feminine gender roles, [44] adopted a non-heterosexual identity at a young age and were more likely than peers to report sexual abuse, drug abuse, and arrests for misconduct.

Often, sexual orientation and sexual orientation identity are not distinguished, which can impact accurately assessing sexual identity and whether or not sexual orientation is able to change; sexual orientation identity can change throughout an individual's life, and may or may not align with biological sex, sexual behavior or actual sexual orientation.

In a statement issued jointly with other major American medical organizations, the American Psychological Association states that "different people realize at different points in their lives that they are heterosexual, gay, lesbian, or bisexual". For others, sexual orientation may be fluid and change over time". LGBT parenting is the parenting of children by lesbian , gay , bisexual , and transgender LGBT people, as either biological or non-biological parents.

Gay men have options which include "foster care, variations of domestic and international adoption, diverse forms of surrogacy whether "traditional" or gestational , and kinship arrangements, wherein they might coparent with a woman or women with whom they are intimately but not sexually involved". In the U.

In January , the European Court of Human Rights ruled that same-sex couples have the right to adopt a child. Although it is sometimes asserted in policy debates that heterosexual couples are inherently better parents than same-sex couples, or that the children of lesbian or gay parents fare worse than children raised by heterosexual parents, those assertions are not supported by scientific research literature.

Much research has documented the lack of correlation between parents' sexual orientation and any measure of a child's emotional, psychosocial, and behavioral adjustment.

These data have demonstrated no risk to children as a result of growing up in a family with one or more gay parents. CPA is concerned that some persons and institutions are misinterpreting the findings of psychological research to support their positions, when their positions are more accurately based on other systems of belief or values.

The vast majority of families in the United States today are not the "middle-class family with a bread-winning father and a stay-at-home mother, married to each other and raising their biological children" that has been viewed as the norm. Since the end of the s, it has been well established that children and adolescents can adjust just as well in nontraditional settings as in traditional settings. Most people with a homosexual orientation who seek psychotherapy do so for the same reasons as straight people stress, relationship difficulties, difficulty adjusting to social or work situations, etc.

Regardless of the issue that psychotherapy is sought for, there is a high risk of anti-gay bias being directed at non-heterosexual clients. Most relationship issues are shared equally among couples regardless of sexual orientation, but LGBT clients additionally have to deal with homophobia, heterosexism, and other societal oppressions. Individuals may also be at different stages in the coming out process. Often, same-sex couples do not have as many role models for successful relationships as opposite-sex couples.

There may be issues with gender-role socialization that does not affect opposite-sex couples. A significant number of men and women experience conflict surrounding homosexual expression within a mixed-orientation marriage. Gay affirmative psychotherapy is a form of psychotherapy for gay, lesbian, and bisexual clients which encourages them to accept their sexual orientation, and does not attempt to change their sexual orientation to heterosexual, or to eliminate or diminish their same-sex desires and behaviors.

Clients whose religious beliefs are inconsistent with homosexual behavior may require some other method of integrating their conflicting religious and sexual selves. The American Psychological Association recommends that if a client wants treatment to change his sexual orientation, the therapist should explore the reasons behind the desire, without favoring any particular outcome.

The therapist should neither promote nor reject the idea of celibacy, but help the client come to their own decisions by evaluating the reasons behind the patient's goals. After exploration, a patient may proceed with sexual orientation identity reconstruction, which helps a patient reconstruct sexual orientation identity.

Psychotherapy , support groups , and life events can influence identity development; similarly, self-awareness, self-conception, and identity may evolve during treatment. The American Psychiatric Association states in their official statement release on the matter: "The potential risks of 'reparative therapy' are great and include depression, anxiety, and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient.

Many patients who have undergone 'reparative therapy' relate that they were inaccurately told that homosexuals are lonely, unhappy individuals who never achieve acceptance or satisfaction.

This followed from the broader spirit of Enlightenment legal reform that protected the private sphere from state intrusion. The public and minors were still deemed to require state protection; therefore, the Law of July and the Napoleonic Penal Code of criminalized "debauchery or corruption" of minors of either sex and "offenses against public decency" including sex in public places such as parks or bathrooms.

Men arrested under suspicion of public sex were subjected to medical examinations to help determine if anal sex had taken place.

Therefore, medico-legal experts were the first to become interested in the scientific study of sexuality in the 19th century. Tardieu argued that penile and anal physical stigmata invariably betrayed inveterate sodomites. Furthermore, he suggested there were psychological and behavioral traits such as effeminacy and cross-dressing , that betrayed a subset of exclusive sodomites who he believed suffered from a form of insanity.

The medical literature on homosexuality that grew rapidly in the late 19th century was largely written by medico-legal experts concerned with determining whether certain people accused of criminal sexual behavior should be considered innocent because of a constitutional defect or mental illness.

Although such pathologization may seem stigmatizing, at the time it could also serve liberatory aims since it wrested the issue of sodomy from the police and courts.

German lawyer Karl Heinrich Ulrichs was perhaps the first activist for homosexual civil rights. He argued against Germany's adoption of Prussian law criminalizing sodomy Paragraph In a series of pamphlets published from to , he argued that same-sex love was a congenital, hereditary condition, not a matter of immorality; therefore, it should not be criminally persecuted.

He called himself and those like him " Urnings " who had a female soul in a male body. He hypothesized that there were competing male and female "germs" that determined male and female anatomy and psyche.

Ulrichs proposed that Urnings were a form of psychosexual hermaphrodites. Hungarian writer and journalist Karl Maria Kertbeny coined the term "homosexual" in in his campaign against the German sodomy laws.

Like Ulrich, he argued that homosexual attraction was innate, but did not believe all homosexuals were psychologically effeminate. Ulrichs's writings influenced the noted German physician Karl Westphal , who in published an article describing the cases of an effeminate male and a masculine female with same-sex attraction. He called the condition "contrary sexual sensation" and claimed it was congenital.

As such, he argued, it should come under psychiatric care rather then legal prosecution. Westphal's diagnosis was rendered into Italian by forensic expert Arrigo Tamassia as "inversion of the sexual instinct" The celebrated French neurologist Jean Martin Charcot rendered it into French in as "inversion of the genital sense" in an article describing a variety of "sexual perversions" including inversion and fetishism.

Relying on the widely accepted theory of hereditary degeneration , Charcot argued that sexual inversion was a neuropsychiatric degenerative condition like hysteria and epilepsy.

As such, he believed it was a serious mental illness likely to be associated with other disorders. Other German forensic writers followed Westphal's lead, most notably Richard von Krafft-Ebing His Psychopathia Sexualis with Especial Reference to the Antipathic Sexual Instinct: A Medico-Forensic Study was first published as a small booklet and then vastly expanded over the years into an encyclopedia of sexuality. Krafft-Ebing introduced many terms into the medical nosology such as "sadism" and "masochism.

Krafft-Ebing initially presented homosexuality as a severe manifestation of hereditary degeneration, but late in his life, after having met many homosexuals, he argued that they could be perfectly respectable and functional individuals.

He was a political liberal who argued against sodomy laws and testified in the defense of homosexuals. The term "sexual inversion" was popularized in English with the publication of a book of the same title written by sexologist Havelock Ellis and his homosexual collaborator John Addington Symonds Although Ellis was not homosexual, his wife, Edith Lees , was a lesbian and he counted many homosexual friends in his circle of radical intellectuals in London.

Ellis believed homosexuality was a congenital variation of sexuality and not a disease. The notion of sexual inversion continued to dominate medical thinking about homosexuality into the twentieth century as biomedical researchers employed the latest techniques to uncover its biological basis.

Even before sex hormones were discovered, homosexuals were hypothesized to be neuro-endocrinological hermaphrodites. This was the preferred hypothesis of German sexologist Magnus Hirschfeld Hirschfeld was perhaps the first physician who was public about his own homosexuality and was a tireless advocate for homosexual rights. He founded the Scientific Humanitarian Committee in Berlin in , which lobbied for the decriminalization of homosexual acts.

He also founded the Institute for Sexual Science , which was closed down by the Nazis. Hirschfeld argued homosexuality was an intermediate sex and a natural, biological variant in the spectrum between perfect maleness and femaleness.

Hirschfeld was also a pioneer in writing about transsexualism and transvestism. Although Hirschfeld did not advocate attempts to cure homosexuality, he was impressed with the research of endocrinologist Eugen Steinach on altering the sexual characteristics of rats through castration or testes implants. Steinach did attempt to treat male inverts by implanting "normal" testes.

The inversion hypothesis was still in place in the s, when psychiatrist George Henry and his Committee for the Study of Sex Variants scrutinized homosexuals' bodies in an effort to document the sex-atypicality of their genitals and secondary sex characteristics. Homosexual brains and nervous systems were assumed to have some cross-gendered characteristics.

Even at the end of the 20th century, neuroanatomical research on sexual orientation relies on the inversion hypothesis: an article by Simon LeVay argued that an area of homosexual men's hypothalamus was closer in size to that of women than heterosexual men. Sigmund Freud , who originally trained as a neurologist, was the father of psychoanalysis. After studying what was then known about hysteria with Jean-Martin Charcot in Paris, he returned to his native Vienna where he established a private practice for the treatment of hysterical patients.

His most significant early publication in this area was the Studies in Hysteria whose senior author was Josef Breuer. Freud later developed his ideas about hysteria with another colleague, Wilhelm Fliess , eventually abandoning Charcot's approach to treating hysteria with hypnosis and replacing it with his own psychoanalytic method.

Freud extrapolated general principles of human psychology from his work with hysterics, leading to the publication of two important, early works. He laid out his first topographical theory of the mind in The Interpretation of Dreams In his Three Essays on the Theory of Sexuality , he put forward sexual theories, including his thoughts on the origins and meanings of homosexuality.

Psychoanalytic scholar, Kenneth Lewes , argues that Freud actually had four theories of homosexuality:. Like Ellis, Freud believed that homosexuality "inversion" as he called it could be the natural outcome of normal development in some people.

He noted that homosexuality could occur in individuals who had no other signs of deviation and no impairment in their functioning. However, he did not view homosexuality as a sign of illness, by which he meant a symptom arising from psychic conflict.

Instead, he saw homosexuality as the unconflicted expression of an innate instinct. Freud believed in a constitutional bisexuality: that in every individual there was a certain component of masculine active as well as feminine passive tendencies.

Although bisexual tendencies were universal, Freud believed some people were constitutionally endowed with more of one tendency than the other. He believed life experiences, particularly traumatic ones environmental factors , could have an impact on the development and expression of one's innate instincts biological factors. Under normal and non-traumatic circumstances, the component instincts that determine the sex of one's final object choice should be consistent with one's anatomical sex.

That is to say an anatomic male should ideally express the masculine component instinct and obtain sexual satisfaction from women. However, Freud also believed that even adult heterosexuals retain the homosexual component, albeit in sublimated form. Freud saw adult homosexuality as a developmental arrest of childhood instincts which prevent the development of a more mature heterosexuality.

Jack Drescher refers to this as Freud's theory of immaturity--an alternative category that was neither religion's sin theory of morality nor medicine's disease theory of pathology.

Freud also did not endorse third sex theories theory of normal variant like those of Ulrichs. Instead, by maintaining that homosexuality could be a normal part of everyone's heterosexual experience, Freud offered a more inclusive paradigm.

It allowed for the possibility that the adult homosexual person might sufficiently mature and, if sufficiently motivated, become heterosexual.

Late in his life, Freud expressed pessimism about the possibility of effecting a sexual conversion in most people. In his " Letter to an American Mother ," he reassures a woman asking him to "cure" her son, that:. Spitzer: I think many members of our profession would agree that Dr. Bieber's formulation might apply to some homosexuals. We find it difficult to believe it applies to all homosexuals, now, or in other cultures, such as Ancient Greece, in which there was an institutionalized form of homosexuality.

Bieber: I will only claim expertise in the current Western culture. Everything I say applies only to our current culture. I can give you a group of cultures in which no homosexuality exists. One in which it's almost totally absent is the Israeli kibbutz. Spitzer: This discussion was supposed to be about whether homosexuality is an illness. Bieber: It's not. Spitzer: Dr. Bieber wants to define homosexuality. Now what the APA has done is to agree with him that it is not an illness. But it has not said what it is.

Bieber: The APA has not agreed with me. I say homosexuality its a psychiatric injury to function and belongs in any psychiatric manual. Now that doesn't mean I consider it an illness any more than I consider frigidity an illness. As long as something like frigidity will be in the manual, disorders of sexual functioning and homosexuality belong there.

And to differentiate two types, to take what is really the most injured homosexual and say he shouldn't be in the DSM, and that the least injured, the one who has the potential left for restoring his heterosexuality, should be diagnosed as a sexual orientation disorder, to me seems wild.

Spitzer: It seems wild to you because you have as your value system, that everbody should be heterosexual. Bieber: You think it's a value system? Do I think all homosexuals today should become heterosexuals?

Definitely not. Spitzer: But should they feel that their heterosexuality is injured or crippled? Bieber: If they want to be accurate, they can view that their heterosexuality has been irreparably injured. Spitzer: Injury is already a value. Bieber: Injury is not a value. A broken leg is not a value. Spitzer: I cannot function homosexually but I would not regard it as an injury.

You wouldn't either. Bieber: That is not a counterpart. Spitzer: Well I believe it is. We come into this world, according to psychoanalytic notions, with a polymorphous perverse sexuality. Bieber: I don't accept that. Spitzer: The animal kingdom suggests that we do come in with an undifferentiated sexual response. As a result of experience, although there may be some genetic factors involved, most of us become heterosexual and some of us become homosexual.

Bieber: I'm surprised that you, as a biologist, could talk that way. Every mammalian, every animal, whose reproduction depends on heterosexual mating, has inborn biological mechanisms to guarantee heterosexuality. Spitzer: But the capacity for homosexual response is universal in the animal kingdom. Bieber: You'd have to define homosexual response.

But before we go, let's say this. We both agree that homosexuality is not a mental illness. Editor Caroline Rand Herron: On this you agree. On what then do you disagree? Spitzer: Well, we disagree on how it should be characterized, and I have to say that it is easier for me to say how it should not be characterized than how it should be.

I don't regard homosexuality as optimal as heterosexual development. I would agree with Freud that something has happened in the development of the sexual instinct that leads one to be incapable of or not interested in heterosexual functioning, I am loath, however, to apply the word disorder because of its many implications. Editor Donald Johnston: Can I ask one last question? What is your distinction between a disorder and a sexual orientation disturbance?

Spitzer: I make no distinction. The category sexual orientation disturbance was designed for those homosexuals who were in conflict with their homosexuality. Some of them may wish treatment. Some of them may wish to become heterosexual, some of them may wish to learn to live with their homosexuality and to get rid of the guilt feelings that they may have about it. Bieber: If a homosexual's function can't be restored, I don't want him to function guiltily about homosexuality.

I want him to be happy. Are you going to say that this is normal? That person who has legs that have been actually paralyzed by polio is a normal person even though the polio is no longer active? Irving Bieber. So it makes absolute sense to me not to list as a mental disorder those individuals Robert L.

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