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social sciences

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In 1967 the National Institute on Mental Health developed a Task Force on Homosexuality, and by 1971 gay rights activists, including Frank Kameny and Barbara Gittings, were protesting at meetings of the American Psychiatric Association [APA], taunting presenters who recommended using aversion therapy to treat homosexual behavior.

Prominent clinicians, including Judd Marmor, Robert Stoller, and John Money, began to lend support to the idea that homosexuality should not be labeled a mental illness. In 1972, Dr. Anonymous, a gay male psychiatrist, in disguise, presented a panel discussion on homosexuality at the APA meeting. There the need to depathologize homosexuality was emphasized. One year later, homosexuality was officially removed from the APA's Diagnostic and Statistical Manual, paving the way for psychotherapy that was affirming of gay and lesbian people. (However, in 1980, the APA's Diagnostic and Statistics Manual added an entirely new entry and diagnosis, "Gender Identity Disorder in Childhood," or "The Sissy Boy Syndrome," which has sometimes been used as a means to continue pathologizing homosexuality and variant gender identities.)

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Gay Affirmative Psychotherapy

In the 1970s, numerous books appeared denouncing the supposition that gay, lesbian, and bisexual people had significantly more psychopathology than non-homosexuals. Although this argument had been made previously, it gained momentum in the 1970s and was now also addressed particularly to the therapeutic and psychiatric community.

In 1972, for example, Del Martin's Lesbian/Woman, and Out of the Closets: Voices of Gay Liberation, edited by Karla Jay and Allen Young, both made this argument. In the following years, scholarly books such as Alan Bell and Martin Weinberg's Homosexualities (1978) and more popular works such as Dennis Altman's Homosexual: Oppression and Liberation (1973) documented the lived lives of lesbian and gay people, showing them to be emotionally healthy, but under enormous psychosocial strain from a repressive culture. The psychotherapeutic community's negative view of same-sex relationships was identified as exacerbating the problems faced by glbtq people.

The publication of Don Clark's Loving Someone Gay (1975) and Betty Berzon's Positively Gay (1979) marked the first books written by out gay and lesbian psychotherapists. These books advocated the use of psychotherapeutic techniques to improve the lives of glbtq people without stigmatizing them or regarding homosexuality itself as pathological.

In 1982, Haworth Press published a seminal issue of the Journal of Homosexuality titled Homosexuality and Psychotherapy: A Practitioner's Handbook of Affirmative Models. Edited by John Gonsiorek, this issue included groundbreaking articles by such scholars and therapists as Eli Coleman, Martin Rochlin, Barbara McCandlish, and Bronwyn Anthony on psychotherapy with lesbian and gay clients. One article, written by Alan Malyon, specifically used the term "gay affirmative" psychotherapy, introducing a new model that supported homosexual relationships as inherently healthy and a normative expression of human sexuality.

Gay affirmative therapy is based on certain fundamental concepts, including the idea that homosexuality is not a psychopathology and lesbian and gay people do not suffer from mental illness as a result of their homosexuality per se. Additionally, gay affirmative therapy postulates that homosexuality is a normal variation in human sexuality and that there is a normative developmental process of coming out for lesbians and gay men that is obstructed by societal homophobia.

Gay affirmative therapy also holds that therapists who espouse negative views towards homosexuality cannot be effective clinicians with gay or lesbian clients. Gay affirmative therapy requires psychotherapists to become sensitized to the role of homophobia in the psyches of gay men and lesbians so they can recognize the difficulties associated with the internalization of homophobia. Although the psychotherapist need not be homosexual, a sensitive, compassionate, and educated stance is necessary for the development of an honest dialogic communication with the homosexual client.

Gay Affirmative Therapy in Historical Perspective

Gay affirmative psychotherapy was not a new school of therapy per se, but rather one that utilized the diverse theories and techniques available across psychotherapeutic modalities, within a framework that supported the unique developmental processes of lgbtq people. Historically, its great significance is that it was the first therapeutic movement that acknowledged the harm done to glbtq people through heterosexist socialization and institutional homophobia.

The unconditional affirmation of homosexual relationships by psychotherapists was intended to serve as a counterbalance for the negative sociocultural and familial environments within which most glbtq people mature and live. Thus, gay affirmative psychotherapy was supposed to ameliorate the negative impact of growing up gay in an oppressive society, as well as to assist the gay or lesbian client in a coming out process that actualized a healthy homosexual identity. Central to gay affirmative therapy is the attempt to enhance the dignity and self-respect of clients by establishing a supportive and accepting atmosphere.

Lesbian, Bisexual, and Transgender Affirmative Psychotherapies

Gay affirmative psychotherapy developed in the early 1980s, following the depathologiizing of homosexuality. It did not, in its early manifestations, recognize the needs to establish specific therapeutic contexts for exploring lesbian, bisexual, or transgender/transsexual identity development.

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