By Alisha Vaswani (she/her), Level 1 Psychology Student, University of Glasgow
Question: How has psychology historically pathologised gender and/or sexual diversity and what impact has this had on LGBTQ people?
The term LGBTQ+ is used to refer to individuals who identify as lesbian, gay, bisexual, transgender (Parent et al., 2013), and other identities associated with gender and sexual diversity. In the past, the Psychological community has associated non-heterosexual and non-cisgender identities with pathological illnesses. While the entirety of the LGBTQ+ community has been historically stigmatised by the field of Psychology, this essay will focus on the stigmatisation of sexual orientation. This research is particularly important because of the severe consequences that the misrepresentation of LGBTQ+ people has had on members of the community, such as how internalised homophobia has contributed to the prevalence of depression in sexual minorities (Crowell et al., 2014). Whilst much of the psychological literature has focused specifically on homosexuality, this essay will use the term “queer” to refer to non-heterosexual identities in recognition that sexuality is a continuum and that many of the studies reported in this essay will have included identities such as bisexuality and pansexuality, even if they were not labelled as such.
The institutional stigmatisation of homosexuality occurred as part of a system of bias known as heterosexism, which assumes heterosexual relationships to be normative (Herek, 2010). The 19th Century brought about a shift from religious mindsets to scientific thought processes, which created the perception of homosexuality as a matter of medical and psychiatric concern (Drescher, 2015).
Despite this historically negative psychological view on homosexuality, the American Psychological Association (APA) declassified it as a mental disorder in 1973, and now considers homosexuality to be a natural form of sexual activity (Morgan & Nerison, 1993). However, the stigmatisation of queer identities has had severe, long-lasting impact on the LGBTQ+ community. For instance, in the 1990s, a movement of reparative therapies for queer identities was popularised by psychologists who believed that homosexuality should have remained in the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Zucker, 2003). This demonstrates how the stigmatisation of queerness as a mental illness has continued to harm the LGBTQ+ community for decades following its formal declassification as a psychological disorder. This essay will discuss both the historical stigmatisation of queer identities, as well as the impact that this has had on the community.
It has been argued that the origins of heterosexism can be traced back to religions such as Christianity, which placed importance on procreation as a primary reasoning for sexual intercourse. Therefore, homosexuality originally came to be considered a sin because it could not result in offspring (Baughey-Gill, 2011). According to Morgan and Nerison (1993), this concept of homosexuality was then popularised by psychological researchers such as Kraft-Ebbing in the 19th Century. Kraft-Ebbing’s case studies attempted to link pathology, severe mental illness, and substance abuse to the practice of non-procreative sexual intercourse (Morgan & Nerison, 1993). From this, it can be inferred that religion facilitated the attempts of early psychologists to pathologise sexual diversity. This then lead to the use of several conversion techniques in the 1900s, such as castration, testicular implants (Graham, 2019) and electroshock therapy (Herek, 2010). Lobotomies, for instance, were used as a form of treatment for homosexuality until 1948 (Herek, 2010), showing how the treatment of queerness as a pathological condition led to the long-term use of several controversial and harmful treatment forms.
Whilst the APA’s declassification of homosexuality as a mental disorder in 1973 was significantly ahead of the ICD who took until 1992 to do the same, the initial decision to include homosexuality in the DSM in 1952 (Herek, 2010) had long-lasting consequences. While Graham (2019) argues that the 1960s brought an end to the primary age of conversion therapy practices, researchers such as Charles Socarides were still promoting forms of conversion therapy at this time. Socarides claimed a 35% conversion success rate (Drescher, 1998). Similarly, also during the 1960s, Irving Bieber’s research into queerness was used as evidence that homosexuality was a pathological condition. His work is still a prominent basis for conversion therapies used today (Anderson & Holland, 2015), demonstrating the long-lasting impact of this period in psychological research. The writings of Socarides and Bieber resulted in protests by LGBTQ+ activists at APA conventions (Anderson & Holland, 2015), demonstrating how the 1960s marked the beginnings of rebellion against the psychological community for their heterosexist views. However, following the APA’s declassification of homosexuality, a committee set up by Socarides and Bieber organised a referendum to appeal the APA’s decision (Anderson & Holland, 2015). This shows how despite the growing activism of the LGBTQ+ community in the field of Psychology, several prominent Psychological researchers still believed that anything other than heterosexuality was pathological, as of the 1970s.
In addition, past research into differences between heterosexuals and the LGBTQ+ community have used biased methodology and sampling to pathologise queerness. Sarantakos (1996), for example, found that children with homosexual parents functioned significantly more poorly than those with parents in heterosexual marriages. Herek (2010) argues that this study was widely promoted despite several issues with the research. One issue was that the confounding variable of divorce was not controlled for, and therefore most of the children of homosexual couples had divorced parents, while the children of the heterosexual couples had not (Herek, 2010). This demonstrates how flaws in research methodology have historically been an enabling factor for heterosexist psychological theories, hence allowing queerness to be pathologised and stigmatised.
The Psychological community’s past attempts to pathologise homosexuality have resulted in significant social stigma against queer individuals that is still visible in the 21st Century. One significant impact is the prevalence of mental health disorders in the LGBTQ+ community. For instance, one study found a correlation between internalised homophobia and depression in queer participants (Crowell et al., 2014). It could be argued that this internalised homophobia results partially from the further marginalisation of this minority group by the fields of sexology and psychology. However, Crowell et al. (2014) alludes to a phenomenon known as minority stress, in which minority group membership itself is already a risk factor for mental illness and stress. Therefore, it may not be possible to allocate all responsibility for this to stigmatising psychological research conducted in the past, as minority group membership itself may contribute to these findings.
Similar to this research, however, Cohen et al. (2016) found that the concealment of sexual identity by individuals belonging to a minority sexual identity was an important predicting factor for social phobia. The researchers inferred from this that concealing one’s sexual identity contributed to social phobia (Cohen et al., 2016). This demonstrates how the stigmatisation of queerness has contributed to the prevalence of mental illness. Moreover, it has been argued that this higher prevalence of mental illness in queer individuals may be used to encourage incorrect notions of homosexuality itself being a mental illness (Anderson & Holland, 2015).
Along with the prevalence of certain mental illnesses in the queer community, forms of conversion therapy are still used in parts of the world. These practises are typically carried out in secret, however, conversion therapy is still legal in several countries, including the UK (Trispiotis & Purshouse, 2021). This is particularly significant due to the undeniable link between previous psychological concepts of homosexuality and the genesis of conversion therapy, as established earlier.
Furthermore, the sexual stigma facilitated by the Psychological community may also contribute to the physical health of sexual minorities. For instance, Leluţiu-Weinberger et al. (2018) found that queer men who perceived significant sexual stigma in their social context were more likely to have been involved in sexually risky behaviour in their previous sexual encounter. This could have important implications regarding the impact of social stigma on sexual health.
In conclusion, psychologists such as Kraft-Ebbing, Bieber and Socarides were instrumental in pathologising queerness and the Psychological community bears significant responsibility for the use of conversion therapies, electroshock therapies and lobotomies as treatments for homosexuality. The use of such techniques has made a prominent contribution to the stigmatisation of queer identities in the 21st Century, which has resulted in several consequences for the community, including the increased prevalence of mental and sexual health conditions in the queer community.
February is LGBT History Month in the UK and to celebrate we want to take the opportunity to showcase work from students in the School of Psychology and Neuroscience, University of Glasgow. As part of their first year curriculum, students study the history of psychology and are asked to write an essay detailing psychology’s history regarding race, gender identity and sexual orientation, women in STEM, the replication crisis, psychology and government policy, or neurodiversity. You can find more information about the assignment here. For LGBT History Month, the TILE Student Voice will publish a weekly essay from the gender and sexual orientation category.
TILE Student Voice
This is a section of the TILE Network that features the student voice in learning and teaching. We want to shine a light on the student perspective when it comes to teaching and learning practice and what better way to do this than letting the students express this themselves. This series also aims to give students to opportunity to engage in science communication and writing. Broadcasting scientific findings to a wider audience is a valuable skill and TILE provides students with the platform to practice that skill.
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Baughey-Gill, S. (2011). When Gay Was Not Okay with the APA: A Historical Overview of Homosexuality and its Status as Mental Disorder. Occam’s Razor, 1, 5-16. Available at: https://cedar.wwu.edu/orwwu/vol1/iss1/2
Cohen, J. M., Blasey, C., Barr Taylor, C., Weiss, B. J., & Newman, M. G. (2016). Anxiety and related disorders and concealment in sexual minority young adults. Behavior Therapy, 47(1), 91-101. https://doi.org/10.1016/j.beth.2015.09.006
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Drescher, J. (1998). I’m Your Handyman: A History of Reparative Therapies. Journal of Homosexuality, 36(1), 19-42. https://doi.org/10.1300/J082v36n01_02
Drescher, J. (2015). Out of DSM: Depathologizing Homosexuality. Behav Sci (Basel), 5(4), 565-575. https://doi.org/10.3390/bs5040565
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Graham, T. C. (2019). Conversion Therapy: A Brief Reflection on the History of the Practice and Contemporary Regulatory Efforts. Creighton Law Review, 52(4), 419-426. http://hdl.handle.net/10504/124721
Herek, G. M. (2010). Sexual Orientation Differences as Deficits: Science and Stigma in the History of American Psychology. Perspectives on Psychological Science, 5(6), 693-699. https://doi.org/10.1177/1745691610388770
Leluţiu-Weinberger, C., Rendina, H. J., Mirandola, M., Gios, L., Folch, C., Rafila, A., & Pachankis, J. E. (2018). The role of gay-related stigma in HIV-risk behavior among sexual minority men in Europe. AIDS and Behavior, 23(3), 684-694. https://doi.org/10.1007/s10461-018-2306-z
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Parent, M. C., DeBlaere, C., & Moradi, B. (2013). Approaches to research on intersectionality: Perspectives on gender, LGBT, and racial/Ethnic identities. Sex Roles, 68(11-12), 639-645. https://doi.org/10.1007/s11199-013-0283-2
Sarantakos, S. (1996). Children in three contexts: Family, education and social development. Children Australia, 21(3), 23-31. https://doi.org/10.1017/s1035077200007173
Trispiotis, I., & Purshouse, C. (2021). ‘Conversion therapy’ as degrading treatment. Oxford Journal of Legal Studies. https://doi.org/10.1093/ojls/gqab024
Zucker, K. J. (2003). Editorial: The Politics and Science of “Reparative Therapy”. Archives of Sexual Behaviour, 32(5), 399-402. https://doi.org/10.1023/A:1025691310172