Three major groups of homosexuals are delineated. The first group consists of latent heterosexuals, often anxious, hysterical, or obsessional personalities who are likely to respond well to psychotherapy. The second group consists of true homosexuals, for whom homosexuality serves as a defense mechanism for warding off overwhelming separation and psychotic anxieties, including mutilation and disintegration. Subcategories of this second definition include: (a) narcissistic disorders, (b) homosexuality as a defense against severe depression, and (c) homosexuality as a defense against paranoid anxieties and related states. The homosexuality of this second group is unlikely to respond to psychotherapy and, in fact, may be necessary in the psychic economy to prevent psychosis. the third group consists of bisexuals. The author urges cautious differential diagnosis before any attempt is made to remove the homosexual orientation.