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Psychologist Anywhere Anytime

Sexual Orientation

Psychologist Anywhere Anytime

Sexual orientation refers to your emotional, romantic, sexual, or affectional attraction toward others. It is different from other aspects of sexuality including biological sex, gender identity (the psychological sense of being male or female), and the social gender role (adherence to cultural norms for feminine and masculine behavior).

"Sexual identity" is sometimes used as a synonym for sexual orientation, but the two are really different in that sexual orientation refers to the object(s) of your sexual fantasies and behavior while sexual identity refers to your view regarding yourself.

Understanding Sexual Orientation

Sexual orientation can be seen as existing along a continuum that ranges from exclusive heterosexuality to exclusive homosexuality and includes various forms of bisexuality. Persons with a homosexual orientation are sometimes referred to as gay (both men and women) or as lesbian (women only). 

Sexual orientation is different from sexual behavior because it refers to feelings and self-concept. Individuals may or may not express their sexual orientation in their behaviors.

The classification called "gender identity disorder" refers to a person who strongly identifies with the opposite sex, sometimes to the degree that they believe that they are, in fact, a member of the other sex who was wrongly labeled at birth or as a person who is trapped in the wrong-sexed body.  A person with a gender identity disorder will often cross-dress and will be seen by others as a member of the sex that their dress and actions portray. Gender identity disorder, more widely known under such terms as transsexuality, transgender, or cross-dressing, is different from transvestism or transvestite fetishism where cross-dressing occurs for sexual pleasure but the transvestite does not identify with, or want to be, the opposite sex.

Classifying Sexual Orientations

People are typically classified as heterosexual if their sexual focus is primarily people of the opposite sex/gender to their own, homosexual if it is people of the same sex/gender, and bisexual if it is both men and women. The less formal terms "straight", "gay", and "lesbian" are more commonly used by people to describe themselves and their friends and family, or to emphasize sexual orientation as a social identity.

The term asexual can be used to describe people with no sexual interest at all, or those who have a sex drive, but not sexual attraction. The term celibacy or sexual abstinence is for those who are not sexually active. Asexuality and celibacy are not compatible terms, as celibacy implies a deliberate effort to refrain from one's desire for sex.

Autosexuality can be considered an orientation with a sexual focus on oneself.

Relationship Between Sexual Orientation and Mental Health

The Gay and Lesbian Medical Association (GLMA) acknowledges that depression and anxiety, as well as substance abuse and alcohol abuse, appear to affect gay men at a higher rate than in the general population. Additionally, gay and lesbian adolescents and young adults may be at particularly high risk of suicide.

The fact that these mental health related problems are greater in the gay and lesbian population are consistent with the social pressures encountered by gays and lesbians in many societies.

However, it is important to note that in today's world, mental health professionals agree that homosexuality is not an illness and homosexuality itself is not associated with mental disorders or emotional or social problems. However, many gay, lesbian, and bisexual people seek professional assistance to help with "the coming out process" and with adjustment issues.  Generally, "coming out" can be seen as a two part process.  The the first part involves the self-knowledge and self-acceptance that one is sexually attracted to, and prefers, the same sex.  The second part of "coming out" involves one's decision to tell others. Coming out can sometimes lead to a life crisis which can create or aggravate emotional problems. 

Terminology Regarding Sexual Orientations

LGBT (or GLBT) is an abbreviation used as a collective term to refer to Lesbian, Gay, Bisexual, and Transgender people. Each term in the acronym is used to refer to members of the specific group and to the community (subculture) that surrounds them.

Lesbian refers to females with a sexual orientation exclusively or almost exclusively towards females.

Gay refers specifically to males with a sexual orientation exclusively or almost exclusively towards males.

Bisexual refers to persons who are attracted more than just one gender. While traditionally bisexuality has been defined as 'an attraction to both males and females', it commonly encompasses Pansexuality, 'an attraction where the gender of the partner is of little or no relevance' (i.e. to male, female, and any other gender identity). Bisexuality covers anywhere between the sexual orientations of asexuality, homosexuality, and heterosexuality.

Transgender is generally used as a catch-all umbrella term for a variety of individuals, behaviors, and groups centered around the full or partial reversal of gender roles as well as physical sexual reassignment therapies (which can be just hormonal or involve various degrees of surgical alteration). Transsexualism (also called Gender Identity Disorder or GID) is a condition in which a transsexual person self-identifies as a member of the gender opposite to the one assigned to them at birth. Transsexualism often manifests itself as a dysphoria toward one's biological birth sex, as well as conflict living in one's social role. If untreated, it can lead to mental and emotional problems, and sometimes, suicide.

The term LGBT became increasingly common from the mid 1990s and as of 2005, LGBT has become mainstream terminology, and has been adopted by the majority of lesbian (L), gay (G), bisexual (B), and transgender (T) community centers and the LGBT press, in most English-speaking countries. However, in some circles the term LGBT is controversial. For example, some transgender and transsexual people do not like the term because they do not believe their cause is the same as that of LGB people; they may also object when an organization adds a T to their acronym when the level of service they actually offer to trans people is questionable. There are also LGB people who don't like the T for the same or similar reasons.

There are numerous theories about the origins of a person's sexual orientation. Most professionals today agree that sexual orientation is most likely the result of a complex interaction of environmental, cognitive and biological factors. In most people, sexual orientation is shaped at an early age. There is also considerable recent evidence to suggest that biology, including genetic or inborn hormonal factors, play a significant role in a person's sexuality. Although we can choose whether to act on our feelings, psychologists do not consider sexual orientation to be a conscious choice that can be voluntarily changed.

Although most homosexuals live successful lives, some homosexual or bisexual people may seek to change their sexual orientation through therapy, often coerced by family members or religious groups to try and do so.  But  psychologists, psychiatrists, and other mental health professionals agree that homosexuality is not an illness, a mental disorder, or an emotional problem. More than 35 years of objective, well-designed scientific research has shown that homosexuality, in and itself, is not associated with mental disorders or emotional or social problems. However, many gay, lesbian, and bisexual people seek assistance from a mental health professional to help with adjustment issue and to help with the coming out process or for strategies to deal with prejudice.

Some therapists who undertake so-called conversion therapy report that they have been able to change their clients' sexual orientation from homosexual to heterosexual. Close scrutiny of these reports, however. show several factors that cast doubt on their claims. The American Psychological Association is concerned about such therapies and their potential harm to patients. In 1997, the Association passed a resolution reaffirming psychology's opposition to homophobia in treatment and spelling out a client's right to unbiased treatment and self-determination. Any person who enters into therapy to deal with issues of sexual orientation has a right to expect that such therapy will take place in a professionally neutral environment, without any social bias.

The more you understand about sexual identity issues and problems, the better you can cope with the effects.  The links to other topics on this website may be helpful including the links to gay and lesbian sexuality, bisexuality, gender identity disorder, and sexual deviations.

Treatment for Sexual Orientation Problems

Mental health professionals generally agree that sexual orientation is typically shaped at an early age and is not voluntarily changeable.  Over two decades ago homosexuality was removed as a diagnostic category by the American Psychiatric Association, and is no longer regarded as a mental illness or as needing treatment.  However, many gay, lesbian, and bisexual individuals and couples  face many personal, interpersonal, and social problems for which they seek help.  Their need to seek assistance is consistent with research findings that depression and anxiety, as well as substance abuse appear to affect gays at a higher rate than in the general population and that gay and lesbian adolescents and young adults show a higher than average risk of suicide.

Although many gays and lesbians live successful lives, some seek to change their sexual orientation through therapy, and some therapists undertake so-called conversion therapy where the therapist and client work to change the client's sexual orientation from homosexual to heterosexual. The results of such conversion therapy do not appear to be positive and I professionally do not engage is this type of treatment.

I have found the most successful types of treatment include Reality Therapy, cognitive therapy, and traditional psychotherapy.

Therapy for a person with gender identity disorder may also include sex reassignment therapy, hormonal therapy and “transgender transition services” (medical treatments and procedures that alter primary and secondary sexual characteristics).  Typically, transgender transition services include psychological, medical, speech, and surgical specialists.  While sex-change surgery is not a common type of treatment, studies have shown positive results for many transsexuals who have had this type of treatment.

Additional Information

For more information about sexual orientation and other sexual issues, please click on the linked websites listed below.

 Gay and Lesbian Medical Association

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