Editorial

An uneasy silence has prevailed for the most part on the subject of homosexuality within psychoanalytic psychotherapy. This special edition breaks that silence and does so in a particular way. Our selection of authors who write both with and without allegiance to psychoanalytic thinking is intended not only to open up a real dialogue but also to signal something more. The formation, three decades ago, of the Association for Psychoanalytic Psychotherapy in the NHS happened in the same year, 1981, that AIDS was discovered (Shilts, 1987). The global estimate of the death toll from AIDS stands at 30 million people (UNAIDS, 2010). At the other end of the actuarial spectrum, modern reproductive technology during this period has transformed the opportunities for lesbians and gay men to start their own families (Tasker, 2002). For psychoanalytic clinicians working in the NHS, then, the almost complete silence of our journal and our mainstream literature on how gay and lesbian people have dealt with these and other life and death issues, as well as with the ordinary realities of sustaining their relationships and work and mental well-being against a backdrop of social prejudice and institutionalized homophobia, including in our health services, demands an explanation.

Today, despite the increased acceptance of sexual diversity, the recent findings from a large-scale survey of over 6,000 lesbian and bi-sexual women indicate a disturbing level of distress. One in five respondents reported having deliberately harmed themselves in the last year, compared to one in 250 people in the general population. One in five report an eating disorder. One in twenty have attempted suicide, with an alarming 16% of those under the age of 20 attempting suicide (Hunt & Fish, 2008). If we reflect on these stark facts of life, juxtaposed with the near-silence of psychoanalysis, we cannot turn a blind eye to our role over many decades in pathologizing homosexuality. If we are to offer help to this