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In the early 1980s generally accepted clinical ideas about homosexuality changed radically. The most important reflection of such change was deletion of the category “homosexuality” from the Diagnostic and Statistical Manual (DSM-III-R) of the American Psychiatric Association (1987). The profound consequences of this decision have been discussed in many forums (Bayer, 1981). At about the same time, a set of observations and inferences about the origins and treatment of psychopathology in gay patients was published, which came to be labelled “gay affirmative” ideas about psychotherapy. In a carefully reasoned and highly influential article that focused on “internalized homophobia” in gay men, Malyon (1982) noted that socialization involves internalization of values, attitudes, and beliefs. Because children who ultimately become homosexual adults are raised in heterosexist and homophobic settings, their socialization leads to internalization of negative attitudes and beliefs about homosexuality. Malyon pointed out that negative internalizations influence “identity formation, self-esteem, the elaboration of defenses, patterns of cognition, psychological integrity and object relations. Homophobic incorporations also embellish superego functioning and in this way, contribute to a propensity for guilt and intropunitiveness among homosexual males.” Negative attitudes and beliefs about homosexuality become part of the self and negative attitudes and beliefs about the self come to be signalled by homosexual desires.
The concept of internalized homophobia is applicable to psychosexual development as well as current mental functioning. For example, Malyon