In 1998, Jack Drescher published a volume notable for its integration of both research and clinical perspectives in understanding the lives of gay men seeking psychotherapy. Drescher shows that same gender sexual orientation is independent of psychopathology or personal immaturity as still claimed by some in psychiatry. Drescher also shows that efforts to “convert” gay men to heterosexuality are not successful and lead only to enhanced feelings of shame. Finally, Drescher shows the importance of helping gay men in psychotherapy to deal with their feelings of guilt and lowered self-regard, learned over a liftime, in order to realize a better adjustment. Drescher also shows the importance for the therapist of awareness of similar attitudes and feelings and the way in which they might impact on the therapeutic relationship. The papers in the present special issue reflect on Drescher's contribution and elaborate on several of the issues raised by Drescher's work.