Homosexuality Case Study

Introduction2

Although homosexuality is not a mental disorder in and of itself, gay men and other men who have sex with men can present with poorer mental health outcomes as a result of social discrimination, rejection, isolation and marginalization.3 4, 5 According to the Centers for Disease Control and Prevention, gay men and other MSM are at increased risk for major depression, bipolar disorder, and generalized anxiety disorder, the common basis of which is likely homophobia.6 Sustained stress from this can also lead MSM to contemplate suicide or cope through substance use.7 Although providing appropriate mental health support for gay men and other MSM from a clinical perspective is similar to treating anyone else with mental challenges, it is critical to recognize the role that structural and social barriers play in exacerbating negative mental health outcomes among these individuals.

This module will provide an in-depth look at the stigma, discrimination, and stress that contribute to gay men's and other MSM's increased risk of developing a mental health problem. It will cover some of the common mental health disorders that gay men and other MSM may present with and explore how substance use and abuse as well as physical and sexual abuse relate to mental health. This module will also provide basic knowledge of assessment and treatment of mental health problems and how to link to the wider community to better support patients.

Module Overview

1. Homosexuality is not a mental disorder
2. Reparative Therapies
3. Discrimination towards MSM
a. Criminalization
b. Stigma from the health care system and providers
4. Coming out
a. Supporting someone who is coming out
5. Maturing and Late adulthood
6. Mental Disorders
a. Anxiety
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...ternational Classification of Diseases, 10th Revision.10
• In 1995, the Japanese Psychiatric Body removed homosexuality from its list of psychiatric disorders.
• In 2000, the Norwegian Psychiatric Association General Assembly overwhelmingly accepted homosexuality as a non-pathological understanding.
• In 2001, a statement by the Chinese Psychiatric Association helped endorse the fact, in a non-Western context, that homosexual behavior does not signal the need for psychopathological intervention11
• In July 2009, the Delhi High Court in India noted that “there is almost unanimous medical and psychiatric opinion that homosexuality is not a disease or a disorder and is just another expression of human sexuality.”12
• In 2013, the president of the World Psychiatric Association came out as a gay man and called for ending treatment of homosexuality as a mental illness.13