The American Psychological Association overwhelmingly passed a resolution last August on "Appropriate Therapeutic Responses to Sexual Orientation," which received national attention. Using a reasoned approach based on its policies and principles, the APA declared that since homosexuality is not a mental illness, and since psychologists support the principles of nondiscrimination and respect for autonomy and privacy, psychologists should approach therapy with gay men and lesbians based on the principle of "informed consent."

This issue was raised because there are still many mental health care practitioners who see homosexuality as pathological. Despite our APA’s position that homosexuality is not a mental illness, some practitioners see themselves as moral advocates who must uphold the denigration of homosexuality to protect heterosexuals. There are many clinicians who, in sympathy with the pain of their homosexual patients’ dilemma of living in a homophobic society, try to "change" the sexual orientation of those persons seeking treatment because they are distressed by their homosexual feelings.

Those of us who accept our gay and lesbian identities recognize this distress as a normal and unavoidable stage in coming to terms with a differing sexual orientation in a society that declares homosexuality is wrong, immoral, illegal, or an illness. An ethical therapist should provide a safe, nonjudgmental therapeutic environment in which a person can sort out his or her sexual feelings and come to self-acceptance. This would be the appropriate stance if a therapist were dealing not only with sexual orientation, but with any other differences causing distress, such as appearance, race, gender, size, intellect, or mental or physical illness. The goal of treatment is to help individuals accept themselves as they are and develop their full potential.

There is no valid scientific evidence that so-called conversion therapies for sexual orientation are effective, and there is a growing body of literature describing the damage that can be done to a person’s mental health by attempts to change his or her basic orientation.

As members of the gay and lesbian community and as respected colleagues in psychiatry, the membership of the Association of Gay and Lesbian Psychiatrists (AGLP) hopes that the American Psychiatric Association will publicly acknowledge the importance of appropriate treatment of gay and lesbian patients by developing a statement similar to that of the American Psychological Association.

Daniel W. Hicks, M.D.
President, Association of Gay and Lesbian Psychiatrists