Religion, deviance, and social control: Stark and Bainbridge 1996

¶ … history of psychology there has been an attempt to categorize persons with mental illness and put a name to the symptoms that were presented. Whether it was Emil Kraepelin and Eugen Bleuler's systematized study of schizophrenia (dementia praecox) versus manic depressive illness or Freud's pointing to the internal conflicts of childhood as playing a causal role in psychoses, psychology has attempted to form categories of symptoms and name them (Holzman, 1996).

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been the most recent tool used by mental health professionals to aid them in formulating a diagnosis based on symptoms presented by a patient. The process of diagnosing is an objective, essential first procedure in the formulation of a treatment plan. The diagnosis often dictates the course of treatment that will follow.

The DSM has undergone several revisions to the present day DSM IV. A revision relevant to this study is the change of diagnosis, and eventual removal of, homosexuality from the diagnostic categories. In 1973 the American Psychiatric Association (APA) removed homosexuality as a mental disorder from the classifications within the DSM II. Homosexuality remained a part of the DSM system, but was put under the alternate category called Sexual Orientation Disturbance. The diagnosis was again revised for the DSM III-R to include Ego-Dystonic Homosexuality. The DSM IV revision contains no category for the diagnosis for homosexuality. Whether mental health professionals agreed or disagreed with these revisions, all revisions pertaining to homosexuality were met with much controversy and debate (Fink, 1975; Schact, 1985; Spitzer, 1981). Despite the changing diagnosis, and eventual removal, of homosexuality as a diagnosis from the DSM, the literature indicates that negative attitudes and bias continue within the psychological community, the general population, and within the homosexual community itself. (Miguel and Millham, 1976; Walters and Simoni, 1993; Plugge-Foust and Strickland, 2000). This literature indicates that these negative attitudes and biases toward homosexuality have been incorporated into the field of psychology. Homosexuals have a long history, in the literature, of undergoing differing analyses and treatments to change sexual orientation. Though homosexuality has been removed from the DSM as a diagnostic category, research continues into reparative treatments and therapies to alter sexual orientation. This research indicates a continuing bias within the mental health field toward homosexuality within treatment. Given this continuing bias it is likely not unfounded to have concerns that many people are not receiving the proper clinical diagnosis simply because they have a sexual orientation that varies from what is considered 'normal'.

Though there is literature specifically addressing the biases toward Homosexuality within the mental health field regarding treatment and diagnosis, this author has found a scarcity of research on bias in diagnosis since DSM IV, and an overwhelming scarcity of research done on diagnosis and treatment of the female homosexual. Given the scarcity of research specifically addressing bias in diagnosis since the removal of homosexuality from the DSM and since diagnosis often dictates the course of treatment to follow, additional research appears necessary to make clear mental health professionals present bias regarding homosexuality in diagnosis, specifically in the female homosexual. Since correct diagnosis leads to correct treatment, examining the biases in diagnosis regarding homosexuality is crucial.

Review

The development of identity is one of the most complicated and time consuming psychological processes that we humans experience and yet most of us do it without really thinking about it. Yet, when the identity of a person is bolstered by an individual character trait such as same gender sexual preference the process become much more forefront to conscious personal thought. If in addition to the rather large individualized identity characteristic of homosexuality an individual also carries a chronic psychological disorder the process becomes exponentially more complicated.

Homosexuality and mental illness to some would be considered labels, everything determined by degrees and yet in the world of diagnostic medicine the significance of the impact of one upon the other is substantial. The historical determination in diagnostic medicine of homosexuality as its own special legacy of a mental disorder that even today is often treated as a simple facet of a disorder, if not overtly at least to some degree covertly.

Historically speaking, homosexuality has been defined as deviant, psychologically abnormal and even criminal. With this history comes a legacy of potential corruption regardless of the attempts professionals make to develop a sense of an unbiased professional regard. Tracing the legacy of homosexuality across the psychological literature traces the history of the homosexuality in both a sociological sense and a scientific sense. With this legacy comes an almost guaranteed set of questions in regard to the treatment of disorders even remotely associated with homosexuality or secondarily with regard to any individual who is openly homosexual. Even today it is acknowledged by nearly every person who has any real awareness of the lifestyle difference associated with an alternative sexual focus that the lives of such people are largely educed to a simple and degrading set of stereotyped ideas that rarely if ever encompass even a small part of the reality of one's life. (Terry, 1999, pg. 15)

In the relatively recent life of modern psychology there have been many attempts to quantify and regulate or normalize diagnosis of psychological problems to such a degree that assessment, treatment and diagnosis of problems can be centered around a scientific model that is predictable and repeatable. In an attempt to legitimize the practice of psychology the disorder bible was created. The DSM began its life as an appendix to a larger work which provided classification and nomenclature for diseases of all kinds and evolved into the politically charged work that it is today through five major rewrites credited to the American Psychology Association. (Zimmer, 1999) In each subsequent carnation of the document politics and propriety are exhibited, depending of coarse upon your perspective.