The traditional psychoanalytic concept of homosexuality as pathology, as well as our etiological speculations, have been seriously challenged by scientific research. An alternative is proposed here viewing sexual identities (whether hetero- or homo-) as socially constructed. The meaning of sexual behavior thus arises from the interplay between unique individual experience and the cultural milieu in which the individual develops. The effects of exclusion and stigmatization are particularly salient to the identities of homosexual men and women in Western society, as are the effects of gender ideologies.