From a medical point of view, homosexuality has long been considered a deviance, a perversion. The medical profession is interested in it first and foremost as a symptom, an illness. The term "homosexuality" appeared in 1869 by Dr. Bankert, linking it to deviations in certain sexual behaviors and to a psychopathological disorder or illness.
In psychoanalysis, if Sigmund Freud is interested in psychic bisexuality, he will nevertheless name homosexuality as "an inversion"; classified among sexual deviances. This seems paradoxical, since he "campaigned, with other sexologists of his time, for the decriminalization of homosexuality". In 1935, he defended a young man to his mother who wrote him a letter to cure her son. His daughter, Anna Freud, although homosexual, considered that it was an illness to be cured and was strongly against a homosexual being a psychoanalyst.
Homosexuality was thus considered a psychiatric pathology until 1973 in the USA and until 1992 in France. It had its place in a psychiatric diagnosis in the same way as schizophrenia or depression. Homosexuality was only removed from the international list of mental illnesses by the World Health Organization (WHO) in 1990. Even today, 72 out of 194 countries condemn homosexual relations with prison sentences, forced labor or even torture. In thirteen countries, homosexuality is still punishable by the death penalty. This is worse for transidentity, which has often been classified as ‘fetishistic cross-dressing’ and then as a sexual identity disorder in the DSM, passing through gender dysphoria and finally being considered as gender incongruence (ICD 11, 2022).
Homosexuality, long perceived as an illness, has been the subject of the work of several doctors who have been interested in how to ‘remedy’ the symptoms: conversion therapies are emerging.
Thus, unethical therapeutic procedures have been put in place to try to ‘cure’ homosexuality. From 1976 in the United States, secular organizations, focused on forms of personal development, offer conversion therapies. Conversion therapies also emerge in religious circles, with theologian Elizabeth Moberly (1983) who was the first to link conversion therapy and the Christian religion. She writes in her book ‘Homosexuality: A New Christian Ethic’ that homosexuality does not depend on a genetic or hormonal predisposition, but on difficulties in the parent-child relationship, which is in line with the psychoanalytic current.
Conversion therapies use techniques similar to those used in the treatment of paraphilias, yet homosexuality was duly removed from the list of paraphilias in the third volume of the DSM in 1980. Conversion therapies, which are therefore not based on any scientific theory, have been blamed for worsening the mental health of people who have undergone these ‘therapies’. Indeed, homosexuals who had undergone this type of therapy had a greater risk of suicide attempts. This was confirmed by a large study that looked at the effects of so-called conversion treatments on trans people (Meredith Wadman, 2019). The study found that transgender people who reported having undergone conversion therapy were more than twice as likely to have attempted suicide in their lifetime as their peers who had undergone other types of therapy. Additionally, for those who were under the age of 10 when practitioners attempted to align their gender identity with the sex they had been assigned at birth, the relative risk of attempting suicide was four times higher. The study, based on a 2015 survey of nearly 28,000 transgender people, also found that survivors of conversion therapy were 1.5 times more likely than their peers who had undergone other types of therapy to have experienced “serious psychological distress.”
In 2020, the UN published alarming figures describing that conversion therapies are carried out as much by religious organizations as by medical and mental health providers in the rest of the world. The percentages of people affected in the LGBTI community are more than 10% in the southern United States and the age group remains predominantly minors with 4 out of 5 people who are victims of these therapies being under 24 years old. Despite their serious repercussions, it was only recently that these forms of therapy were banned in France in January 2022. However, the idea that it is a mental disorder is still relevant and conversion therapies are still rampant in a disguised form.
Although some types of homophobic therapies have been banned, homophobia is still very present in the medical field. We note that in the medical field 17% of gays and 20% of lesbians have already experienced homophobic comments and have faced discrimination (Santé Publique France, 2021). The fear of such incidents, combined with a lack of trust in healthcare personnel, can lead to the forgoing of services. This discrimination can lead to the development of trauma: development of psychological disorders induced by rejection and trauma which in some cases can develop into post-traumatic stress disorder.
Chloé ROSATI,
Psychopraticienne
Bibliographie :
Genre et santé Inserm, La science pour la santé. (s. d.). Inserm. https://www.inserm.fr/dossier/genre-et-sante/
P, J. (2023, 7 septembre). Quelle égalité des chances entre hommes et femmes dans la santé ? Santé Sur le Net, L'information Médicale Au Cœur de Votre Santé. https://www.sante-sur-le-net.com/egalite-chance-homme-femme-domaine-sante/
VIDAL C, Rapport du Haut Conseil à l'Égalité entre les femmes et les hommes," Prendre en compte le sexe et le genre pour mieux soigner : un enjeu de santé publique"
Inégalités de santé entre femmes et hommes : comment agir concrètement ? (s. d.). Institut Montaigne. https://www.institutmontaigne.org/expressions/inegalites-de-sante-entre-femmes-et-hommes-comment-agir-concretement
Santé Publique France, 2021. Discriminations : un enjeu majeur de santé publique. https://www.egalite-femmes-hommes.gouv.fr/sites/efh/files/migration/2021/05/Dossier-de-presse-Impact-des-discriminations-sur-la-sante-Vdef.pdf
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