The understanding of homosexuality as a construct in society has evolved over time. Until the early 19th century it was perceived and identified as an aberration and classified as unnatural acts, crimes against nature, sodomy, or buggery used for same-sex sexual activity (particularly between men). In Europe and America, whenever there was a condemnation of male-male sodomy, it was based on the Old Testament laws that assigned death penalty for a man who “lies with a male as with a woman”. 

Medico-legal experts were the first to become interested in the scientific study of sexuality in the early 19th century although it came under scientific enquiry only to be diagnosed for the purpose of persecution. Men found to be engaging in sexual intercourse with other male partners (particularly anal intercourse) would be medically examined for confirmation of sodomy. Then the medical literature on homosexuality that grew rapidly in the late 19th century was largely concerned with determining whether certain people accused of ‘criminal’ sexual behavior should be considered innocent because of a constitutional defect or mental illness.

The term “homosexual” was coined in 1869 by the Hungarian writer and journalist Karl Maria Kertbeny. He believed that homosexual attraction was innate.

German sexologist Magnus Hirschfeld put forth that homosexuality was a natural, biological variant in the spectrum between perfect maleness and femaleness. Hirschfeld was also a pioneer in writing about transsexualism and transvestism.

The focus on sexuality was brought into the field of psychology by Sigmund Freud when he put forward sexual theories (1965) including what he thought about homosexuality. He posited that homosexuality arises as an outcome of the Oedipus conflict and the boy’s discovery that his mother is castrated. This induces intense castration anxiety that causes the boy to turn from his castrated mother to a “woman with a penis,” i.e., a boy with a feminine appearance. He also thought that the future homosexual child is so over-attached to his mother that he identifies with her and narcissistically seeks love objects like himself so he can love them as his mother loved him. According to him, if a “negative” or “inverted” Oedipus complex occurs, a boy seeks his father’s love and masculine identification by taking on a feminine identification and reverting to anal eroticism.

Freud 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, instead, he saw homosexuality as the unconflicted expression of an innate instinct. According to him, it allowed for the possibility that the adult homosexual person might sufficiently mature and, if sufficiently motivated, become heterosexual.

Then we go to Sandor Rado (1890 – 1972) who viewed homosexuality as a phobic avoidance of the other sex caused by parental prohibitions against childhood sexuality, thus pathologizing homosexuality. This led some analysts to optimistically claim that they could “cure” homosexuality. This further perpetuated social stigma towards homosexuality even though it was taken out of the realm of sin and immorality and was placed within the realm of pathology and immaturity. 

These developments were the background for the normalization of homosexuality. Alfred Kinsey’s study on male (1948) and female (1953) sexuality showed homosexuality and a normal variant of sexuality and thus began a cultural shift away from the view of homosexuality as pathology.

The American Psychiatric Association (APA) removed homosexuality from its official Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1973. In 1997, APsaA endorsed same-gender couples having equal rights to marry. It affirmed that “reparative” therapy is against fundamental principles of psychoanalytic treatment in 2000, and it opposed discrimination based on sexual orientation in parenting and adoption in 2002. 

The World Health Organization removed homosexuality from the International Classification of Diseases – 10 (ICD-10) in 1992. 

The American Psychology Association (APA) has rightfully quoted that no research has found an inherent association between any of these sexual orientations and psychopathology and that heterosexual, homosexual, bisexual behaviour are normal aspects of human sexuality.

LGBTQ+ Community and Mental Health

The LGBTQ+ community has faced intense prejudice, discrimination, and violence because of their sexual orientation and identity. Prejudice and discrimination have both social and personal impacts. On a social level, the stereotypes and social stigmas, despite having any supportive evidence, can impact psychological health. LGBTQ+ individuals are at great risk for poor mental health across developmental stages. Various research evidence has shown elevated rates of major depression, anxiety disorders, Post Traumatic Stress Disorder (PTSD), substance use and abuse, and suicidal ideations and attempts. The stigma and discrimination that LGBTQ individuals often face can be a serious impediment to well-being. 

Some of the instrumental ways in which we can be better allies and friends as suggested by our team of psychologists at the best mental health center in Pune are:

  1.  We need to educate ourselves to increase our understanding. 
  2.  We need to learn more about the LGBTQ+ community and its struggles. 
  3.  We need to learn more about the human rights laws and how they pertain to the LGBT population. 
  4.  We need to be supportive and encouraging to our family members, friends, and peers. 
  5.  We need to speak up if we witness (or are the victim of) discrimination. 
  6.  We need to share our experiences with others.  
  7.  Seek professional help: You can approach any good psychologist in India that offers LGBTQ+ affirmative therapy to seek help. 

LGBTQ+ affirmative therapy helps empower the individual in all areas of life and relationship; affirmative approach honours the challenges faced on a daily basis and helps them navigate these challenges in an effective way. 

Nupur Dhakephalkar
MPhil in Clinical Psychology (NIMHANS)
Founder and Chief Clinical Psychologist,
Center for Mental Health, Pune