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Freud's discovery of childhood sexuality and its importance in the formation of personality and psychopathology has astounded and stimulated students of human behavior for close to a century. Yet we have not illuminated the source of erotic desire, the determinants of sexual object choice, the variations in sexual fantasy, sexual intensity, or sexual role much beyond Freud's original formulations. In some ways we have lost ground. By assuming we knew the answers, we have disrupted the unbiased ambiance necessary for learning by neutral observation.
Isay's thoughtful, lucid, and clinically informed account of his experiences in treating homosexual men is a welcome guide to get us back on track. There is very little theory, no arcane language, no polemic in his book. This makes it of value to the interested layman as well as to the experienced clinician.
The experiential is especially salient for clinicians who frequently are versed in psychoanalytic theories of male homosexuality, but have very limited opportunity to confirm or modify the theories from their clinical observations. Isay uses his wealth of experience to reappraise those theories. He reminds us of Freud's statement that psychological factors seemed unlikely to account for homosexual orientation without some biologically based compliance. Further, Isay presents his conviction that sexual orientation, homosexual, heterosexual, and very rarely bisexual, is constitutionally set and "immutable from birth" (p. 21). He has arrived at this conclusion from his clinical observations. He has found no differences in the parenting of gay men as compared