Is it a trend these days to be gay?

Homosexuality: Discrimination still exists

THEMES OF THE TIME

Knowledge of homosexuality hardly plays a role in psychotherapeutic and medical training. There is great uncertainty when dealing with gay and lesbian patients.

During the 20th century, homosexuality was first decriminalized and then declared a disease. A trend towards depathologization began in the 1970s and 1980s. In 1987 homosexuality was removed from the DSM-III-R and in 1991 also from the ICD-10. Today homosexuality is "normal". In all fairness, however, one should ask oneself whether one really finds same-sex life normal. In the sense of “conforming to the norm” or “most of them are like that”, it is not normal. This is also not necessary because it does not affect the majority of people. But it is about a large minority. Six to ten percent worldwide, regardless of origin, social class, religion, early childhood experiences and other factors are homosexual.
Before 1991, homosexuality was a common topic in psychodiagnostics: psychoanalytic research has tried to explain where homosexuality comes from and what must have gone wrong for it to arise. In behavior therapy research and practice, attempts have been made to change “sick behavior” * - without asking where it comes from. The aim was heterosexual behavior (1, 2, 6). Today homosexuality is no longer a concept of illness and is no longer pathologized. Instead, she is kept dead silent.
Apart from statistical normality, homosexuality is not really normal. How does a family doctor react when he learns from his patient that she is “partnered” and that there are three children in her family? How does a dermatologist react when she learns from her patient that he is gay? How does a psychoanalyst react when he hears that his client “likes men”? And vice versa? What if a doctor lives openly as a lesbian or if a psychological psychotherapist meets a client in a trendy bar? Do doctors and therapists admit that one of the first associations with the word "gay couple" is AIDS? Or is that not the case? Do you think lesbian and gay are swear words? How common is it still among therapists and doctors that being lesbian / gay is an alleged fixation at an immature stage of development? Or has homosexuality, since it was deleted from the diagnostic manuals, finally seen for what it is, namely as an equivalent variant of sexual experience.
The Association of Lesbian and Gay Psychologists in Germany (VLSP) has been campaigning against discrimination, stigmatization and pathologization since 1993 and organizes a congress once a year together with other organizations, such as the AIDS service and lesbian and gay counseling centers Topics that deal with the homosexual world and way of life. It becomes clear that more and more people - far beyond the psychological profession and beyond the members of the association - are sensitized to this topic.
In the 1980s, the AIDS epidemic was a kind of trigger for the first studies on the sexual behavior of gay men. In the 1990s, general interest in the findings of homosexual research increased as part of the liberalization tendencies. In North Rhine-Westphalia, for example, a social-administrative body was set up in the state ministry to work on the interests of homosexual people. There have been various studies on lesbian and gay issues (4).
Clinical research is still in its infancy
The fact is, however, that knowledge of homosexuality hardly plays a role in the health care system and especially in the psychiatric / psychotherapeutic context. In addition, scientific papers and empirical data on homosexual living environments are so far only available to a very limited extent. Research on questions relating to the clinical treatment of lesbians and gays is still in its infancy (2, 3, 4). One of the few surveys on these questions was carried out by the women's counseling center Donna Klara in Schleswig-Holstein. Affected women and therapists in private practice were interviewed. Since this was a small research project, one can only generalize the results very carefully; overall, however, they are trend-setting. It became clear that sexual orientation was mostly not the reason for starting psychotherapy. It was noticeable that
There was a relatively high degree of uncertainty about addressing one's own homosexual orientation in the first interview, although the first interview is intended to provide an overview of the patient's life situation. When the therapists were interviewed, it emerged, among other things, that today some still hold the view that lesbian women should be supported in developing a heterosexual orientation (3). According to the current state of knowledge, this is discriminatory - albeit often subtly and out of ignorance.
The situation in psychiatric care becomes much more difficult. At last year's VLSP congress with the topic “Different - crazy ?! Lesbians and gays in psychiatry “There were affected gay and lesbian psychiatric experts present, as well as psychologists and doctors who work in psychiatric institutions. Since the depathologization, the term homosexuality has been completely deleted from psychiatry. He doesn't exist anymore. An open approach to their own homosexuality was not welcomed either by those affected or by employees. Many reported a kind of pseudo-acceptance of the staff or colleagues, where "it was okay", but was advised to "keep it a secret on the ward". There is still a lot to be done in the healthcare sector before one can speak of appreciative, fair equality (4).
Not only in healthcare,
Dealing with homosexuality is also still difficult for society as a whole. At least since the Civil Partnership Act came into force, one often hears that “none of this is a problem today”. What is overlooked is the fact that, despite increasing acceptance, it can still be problematic to come out as a lesbian or gay - and not only if the church is the employer. Even today, the psychosocial stresses can be so high that, for example, adjustment disorders occur that are not due to a primary psychological disorder, but rather a consequence of this specific life situation. Same-sex and loving people with mental disorders are in a much more difficult situation than heterosexual mentally ill people (2, 6). Knowledge of this is very important when diagnosing mental and psychosomatic disorders. However, the topic hardly plays a role in basic training (psychology or medical studies). Even in further education and training, homosexuality is currently not or hardly an issue in the training institutes.
There is no differentiated, same-sex orientations appreciative view. On the one hand, this can have a negative effect on the quality of treatment, and on the other hand, it can also have a negative impact on the psychological well-being of the profession (2, 3, 6).
Integration in the curricula required
It is noteworthy that even from the younger generation of psychoanalysts, only a few have dealt with new scientific findings on homosexual orientation, although sexuality plays a central role in psychoanalytic theory. In the USA, the Psychoanalytic Association emphasizes that same-sex orientation cannot be viewed as a sign of deficient personality development or even an expression of psychopathology (1, 2, 6). In Germany, on the other hand, homosexual psychologists and doctors are still excluded from training and professional practice as psychoanalysts.
Silence about homosexuality is not helpful. The reference to the Civil Partnership Act and that everything is much better today is also not helpful. Well-founded, basic information in all human science disciplines would be helpful. In specialist or therapeutic training curricula, it would be desirable to convey knowledge, for example, about the peculiarities of the relationship dynamics of lesbian and gay couples or peculiarities in the therapy process (2, 5).
Psychotherapy patients who feel accepted, understood, supported and valued by their therapists (also) in their sexual orientation can contribute more actively to their recovery. This in turn shortens illness and treatment times and therefore costs less money (3). Doctors and psychologists who do not explicitly present an important part of their personality in everyday work, but do not have to hide it either, are more productive and satisfied (6). Until the topic is integrated into the curricula, it is to be hoped that everyone who works with people will acquire basic knowledge, for example through specialist literature, through communication with homosexuals or through participation in the congresses.

literature
1. Parkkinen: Ulos kaapista, LIKE Gummerus Kirjapaino Oy, Jyväskylä 2003.
2. Rauchfleisch, Frossard, Waser, Wiesendanger, Roth: Same and yet different. Psychotherapy and counseling for lesbians, gays and bisexuals and their relatives. Stuttgart: Klett-Cotta, 2002: 36-37, 223-227.
3. Tailor: Lesbian women in psychotherapy. Psychosocial women's counseling center Donna Klara e.V., Kiel, 2003.
4. Steffens I (Ed.): Yearbook Lesben-Schwule-Psychologie (on behalf of the VLSP), Pabst Science Publishers,
Digital Druck Ag, Frensdorf, 2003: 72-87.
5. Symalla W: Systemic counseling for gay couples, Deutsche AIDS-Hilfe, Heidelberg: Carl Auer Systems, 1997.
6. VLSP: Counseling for lesbians and gays. Documentation of the VII symposium of the Association of Lesbian Psychologists in Germany (VLSP). "Of course. Counseling Psychotherapy with Lesbians and Gays “Munich, 7. – 9. April 2000. Editor: Deutsche AIDS-Hilfe, Berlin, 2001: 20–62.

Author's address:
Dipl.-Psych. (FIN) Pia Voss
Schillerstrasse 43
73630 Remshalden

Contact and further information:
Association of Lesbian and Gay Psychologists eV (VLSP), c / o sales office, Merseburger Strasse 4, 10823 Berlin, phone: 0 30/78 00 63 34, fax: 030/78 71 17 53, email: wir @ vlsp .de, Internet: www.vlsp.de

Federal Association for Gays in Health Care (BASG), phone: 0 69/70 72 01 58
Homosexuality: Discrimination still exists

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