Homosexuality and the Mental Health Professions: The Impact of Bias
For more than half a century, The Group for the Advancement of Psychiatry (GAP) has produced position statements on relevant and controversial psychiatric topics. This latest monograph, Homosexuality and the Mental Health Professions: The Impact of Bias,continues a tradition of timely publications dealing with specific aspects of bias, discrimination, and human sexuality.\ This monograph acutely identifies problems of bias, overt and covert, as they affect the treatment of lesbian and gay...
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For more than half a century, The Group for the Advancement of Psychiatry (GAP) has produced position statements on relevant and controversial psychiatric topics. This latest monograph, Homosexuality and the Mental Health Professions: The Impact of Bias, continues a tradition of timely publications dealing with specific aspects of bias, discrimination, and human sexuality. This monograph acutely identifies problems of bias, overt and covert, as they affect the treatment of lesbian and gay patients and as they influence the training of mental health professionals. Incorporating clinical vignettes that detail actual incidents from a wide range of clinical and professional encounters, the report enables the clinician not only to review his or her own experience, but also to envision alternative possibilities of constructive and caring intervention. As psychiatry enters a new era of understanding the full range of normal variation in human sexuality, this monograph will serve both as an indispensable teaching tool and as an invaluable touchstone for assessing quality of care with gay and lesbian patients.
I. INTRODUCTION II: THE DIMENSIONS OF ANTIHOMOSEXUAL BIAS A. Historical Influences on AHB B. Attitudes Toward Homosexuality 1. Attitudes in the General Population 2. Attitudes within Dynamic Psychiatry 3. Attitudes in Fundamentalist Religion C. Definitions and Issues D. Psychological Mechanisms in AHB 1. Paranoid Mechanisms 2. Phobic Mechanisms 3. Internalized Homophobia E. The Impact of AHB on Psychological Growth and Development 1. AHB in Boys 2. AHB in Girls F. Conclusions III: AHB IN THE CLINICAL SETTING A. Introduction B. Types of AHB in the Clinical Setting Pathologizing Stereotype, stigma, misattribution Empathic Failure Heterosexism Unsolicited attempts to change a patients sexual orientation C. Psychotherapy with Individuals D. Psychotherapy with Families, Couples, Children, and Adolescents E. AHB in Hospital Settings IV: THE IMPACT OF AHB ON SUPERVISION AND PROFESSIONAL TRAINING A. Introduction B. The Special Problem of Institutional AHB and Disclosure of Gay or Lesbian Identity ("Coming Out") C. Power Differential between supervisor and trainee D. Antihomosexual Bias in Training Settings 1. Medical School 2. Residency Training 3. Psychoanalytic Training Programs E. Conclusion V.LEGAL ASPECTS OF ANTIHOMOSEXUAL BIAS AND MENTAL HEALTH A. Introduction B. Privacy and Rights of Association C. Institutions and Employment D. Marriage and Spousal Benefits E. Custody, Adoption, Procreation and Visitation F. Conclusions VI: HIV AND AHB IN MENTAL HEALTH A. AHB and Bias Against Persons With AIDS in Society B. AHB and AIDS Bias In Health Care Professionals C. Fear of Contagion as a Source of Bias D. Cultural Aspects of AHB and Fear of HIV in Health Workers E. Impact of AHB on Patient Care F. Implications for the Clinician G. Conclusion VII: CONCLUSION
