Psychiatry and Legal Recognition Of Same-Sex Civil Marriage

[kweerwolf]

(From Steven S. Sharfstein, M.D., president of the American Medical Association)

I have been asked by a number of concerned APA members why psychiatry should enter into the current debate on the legalization of same-sex marriage. A few have resigned, on the grounds that as a scientific and medical professional society, APA should not be commenting on this issue. To quote one disgruntled member, "I feel that APA has truly lost sight of its mission as a MEDICAL organization, led by PHYSICIANS, whose principles should be guided only by SCIENCE and what is in the best interest of those with mental illness."

<snip>

APA's action to support legal recognition of same-sex civil marriage is based fundamentally on the research evidence. Many studies have now established that marriage is associated with clear benefits, including better mental and physical health. It is a stabilizing force in our society that enables individuals to make public their commitment to each other and receive acceptance and support from others. Further, research indicates that same-sex partners have the same capacity to form long-term relationships as do heterosexual individuals. To deny this recognition increases the stigma and related distress often experienced by gay and lesbian individuals in other facets of community life.

Against such compelling evidence, opponents of gay marriage cite religious faith and an ideological belief that the institution of marriage is threatened when same-sex partners can participate. In our civil society, which respects freedom of speech, all views should be heard; however, one strain of religious thought (among many) is an inappropriate basis for the official position of APA. APA's position deals with same-sex civil marriage only. And APA has concluded that fears about the future of society have no basis in evidence.

Clarifying the science is just one task of APA. Another is to be true to its implications. The biological basis of sexuality has important implications for civil rights. Gays, lesbians, bisexuals, and transgendered individuals are citizens who deserve the rights and benefits of full participation in society.

http://pn.psychiatryonline.org/cgi/content/full/40/18/3?maxtoshow=&HITS=20&hits=20&RESULTFORMAT=&searchid=1126871859977_1405&stored_search=&FIRSTINDEX=0&tocsectionid=From+the+President*&displaysectionid=From+the+President&journalcode=psychnews

[sui generis]

1. I think I can sum it up

Those members who resigned the organization did so because it no longer qualifies same-sex orientation as a mental illness, but rather merely a notable variation of sexuality, like having brown eyes versus green eyes.

A real scientist has to consider both ideas equally, free of their own social or personal bias, and pick the proof that has the most evidence to support it. Doubtless, the criteria used to establish a "norm", coupled with a very rigid and unrealistic definition of sexual orientation as unipolar doesn't pass scientific muster, and if it did the APA and the AMA would have probably supported viewing it as a serious personality disorder with a range of treatment options.

So goodbye, and good riddance to the non-scientists with medical degrees - we didn't need your kind of thinking in a non-scientific organization anyway, and thank you to the AMA and the APA for standing your ground.

[TaleWgnDg]

2. Well? This is an obvious addition to a long line of

.
Well? This is an obvious addition to a long line of APA professional position papers (.pdf format, see footnotes) regarding homosexuality. In addition, the APA, as a medical professional organization, has been submitting similar information in amicus briefs in legal cases regarding medical/scientific clinical trials, etc., on homosexuality since the APA in its DSM-IV bumped homosexuality from the mental disorder column into the mental healthful column back in 1973!

However, as serious as this obvious addition that caused a schism of whatever number of departing MDs from the APA, I find it amusing. What else to do but laugh?! There's been a counter movement by some who cannot get over it. Cannot accept the science of it all . . . Who want to toss about rebuttal junk science as factual. To them? I say "good riddance and don't let the door hit your *ss on the way out!" Hey, have a great time ruining your medical careers out *there* on the fringe!
.

[bluedawg12]

3. Psychiatry is in the fray and has been

Once upon a time homosexuality was considered pathological.

As mentioned, the diagnosis was dropped from the DSM manual.

DSM=Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV), published by the American Psychiatric Association, Washington D.C., 1994, the main diagnostic reference of Mental Health professionals in the United States of America.

Right wing reactionaries cried foul and claimed a left wing agenda.

Let's get real. Science, and behavioral science in particular, deals with defining and treating medical conditions. True, being gay is not a mental illness. But, patients who are gay, do have unique problem sets to consider and thus to study and treat.

So there is domain over these issues.

Next, the right wing has tried to show that gays do not need marriage because they do not reproduce. But, those that have either adopted, in vitro'ed, or brought from past hetero sexual relationships, children into gay households, are in the view of the right wing propaganda machine not fit to be parents--again no need for marriage. This position does not hold up and needs to be refuted and yes, even further researched.

So yea, the APA needs to tell truth to right wing power and to take a position based on science and research.

Examples of areas of study:

J Homosex. 2005;49(2):23-38. Related Articles, Links

Effects of subtle heterosexism on gays, lesbians, bisexuals.

Burn SM, Kadlec K, Rexer R.

, 1 Grand Ave, San Luis Obispo, CA, [e-mail].

This study examined heterosexism that is not specifically targeted at LGBindividuals, but may be experienced as antigay harassment, and may contribute to the stigma and stress they experience. LGB participants (N = 175, primarily Euro-American college students), read scenarios of heterosexuals saying or assuming things potentially offensive to gay men or lesbian women. For each scenario, they indicated extent to which they would be offended and less open about their sexuality, and their perceptions of the behaviors as evidence of antigay prejudice. Not only did respondents find the scenarios to be offensive and indicative of prejudice, but perceived offensiveness was associated with a decreased likelihood of coming out. In comparison to gay men, lesbian women and bisexuals found the scenarios more offensive and more indicative of prejudice. Limitations of the current study and directions for future research are outlined.
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Doctor's have a way to go towards fairness and in living up to their oath. I dare say.
..........

Health Soc Care Community. 2005 Jul;13(4):345-53. Related Articles, Links

'I daresay I might find it embarrassing': general practitioners' perspectives on discussing sexual health issues with lesbian and gay patients.

Hinchliff S, Gott M, Galena E.

Sheffield Institute for Studies on Ageing, University of Sheffield, Elmfield, Sheffield, UK. [e-mail]

The present paper explores general practitioners' (GPs') perspectives on the difficulties which they face when discussing sexual health issues with lesbian and gay patients in primary care consultations. It draws upon data obtained from a qualitative interview study with 22 GPs aged between 34 and 57 years who were practising in Sheffield, UK. Interviews were transcribed verbatim and the data were analysed thematically. The results indicate that (non-hetero)sexual orientation could form a barrier to talking about sexual health matters for almost half of this GP sample. Difficulties related primarily to ignorance of lesbian and gay lifestyles and sexual practices, and also included concerns about the appropriate language to use and assumptions about the nature of gay men's relationships. Homophobic attitudes were also identified in a minority of the sample. Participants suggested improvements around improving communication about sexual health with lesbian and gay patients. These included training at undergraduate and postgraduate levels, taking a proactive role during consultations, not making assumptions about patients' sexual orientation and having a non-discriminatory policy for their practice.