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In this book, the authors present a discussion of scientific research on gender and sexual orientation followed by a series of clinical vignettes illustrating aspects of work with gay/lesbian persons and ending with a brief presentation of problems and controversies. The book is geared to ward psychoanalytically oriented psychotherapists and aims to build bridges between psychoanalysis and extra-analytic fields. Although the title says ‘sexual orientation’, the book equally addresses gender.
The causes of sexual orientation and of gender identity have long been areas of controversy, in particular as to whether biological or psychological factors determine male or female gender identity, that is, one's sense of oneself as male or female, and hetero- or homosexual orientation. Bringing together current extra-psychoanalytic research in an attempt to address these issues is a formidable challenge and the authors should be commended for their effort. However, building a theory based on current research in this area is like building an edifice out of partially formed brick: one must bear in mind how firm the evidence is. The authors throughout their book marshal evidence for innate origins of both homosexual orientation and gender identity, based on the popular hypothesis of androgen hormone influence on the developing infant in utero. They show that research from many fields is compatible with the pre-natal androgen hypothesis. In trying to make their case, they systematically underplay the role of cultural and developmental psychological factors as alternative or contributory explanations. While the authors are both psychoanalysts, they are critical of most psychoanalytic explanations. Psychological factors, such as the impact of parents' conscious and unconscious attitudes on the developing child, are treated in a superficial manner.