Mental health status and homosexuality

Since the LA Times article appeared in October, I have received several emails asking about various aspects of my views that were reported in the article. Some ask about my view that same-sex attraction does not always stem from poor parenting, others ask about my views on homosexuality and increased risk for pathology. I have covered the parenting issues in prior posts and want to address briefly the matter of risk for pathology.

Some wrote to say that when I was characterized by reporter Stephanie Simon as believing homosexuals can have a “fulfilling life” that I ignore research documenting a higher level of mental health problems among homosexuals.

I disagree that the reporter’s characterizations of my views ignore social science research. On the contrary, my views are quite consistent with what we know about homosexual adjustment. While there are consistent reports of elevations of various mental health problems among homosexuals, there are many homosexually identified people who are untroubled by diagnosable conditions.

For instance, the most recent published comparison of gays and straights on suicidality found that homosexuals were more likely to feel suicidal than heterosexual participants, even with psychiatric history considered. However, the effect sizes on dimensions of self-injurious thoughts and behaviors were small to modest (2-4%). For women, when psychiatric history was considered, the relationships disappeared for all indicators except the contemplation of self-harm. Even for men, the modest effect sizes indicate there is much overlap between straight and gay groups; the results cannot be accounted for by sexual orientation differences alone. (Archives of Sexual Behavior, June 2006).

To withhold “even the possibility” (quote from the LA Times article) of homosexuals experiencing happiness is not warranted by the research we have. In all studies of psychiatric problems among homosexuals, large numbers of homosexuals report no psychiatric distress. In the study of suicidality noted above, the majority of homosexuals reported no indication of difficulty. While rates are frequently elevated among homosexual men, and sometime among lesbians, such elevations do not preclude the possibility of a satisfying life. If so, then we would need to extend such thinking to other groups (both essential human categories and those socially constructed as well) where elevated risks are found. For instance, other groups who have elevated risk for depression include the elderly, women, people of low socioeconomic class, people who smoke, people living in high stress situations, and people with chronic medical conditions. Suicide risk is elevated among Native American teens compared to all youth (2.5 times). Higher rates of psychiatric disorders and substance abuse problems have been reported among physicians. Evidence from a large study of physician suicide indicates that the suicide rate among male doctors is twice that of men in general. The rate among female doctors is four times higher than for all women. (South Med J 93(10):966-972, 2000). Women in general are about three times more likely to attempt suicide than men. Would one deny the possibility of a rewarding life to members of these groups? Surely not.

Thus, it would be inconsistent with the research on psychiatric risk to deny members of at-risk groups “even the possibility” of a “fulfilling life,” whether partnered or not. Higher risk, yes; inevitable mental health maladjustment for all members of a group of people? No.

PS – I want to note that some of the correspondence about the LA Times came via a coordinated effort from NARTH to my college with the intent to appear that the effort was not coordinated.