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The purpose of this article is to review the book ‘Psychotherapy With Gay Men and Lesbians’, a collection of articles from the US Journal of Gay and Lesbian Psychotherapy (JGLP). Given the complex history of psychiatry and psychoanalysis’ relationship with the LGBT+ community, I would like to approach this by considering the evolution of this relationship and the cultural shift that made possible the publication of this book. Research into attitudes of the British Psychoanalytic Council (Bartlett, King, & Phillips, 2001) indicated that a significant number of respondents still believed that LGB sexual orientation could be favourably changed to heterosexual at the start of the century. However, the struggle in the US will be the focus of this discussion because of the extent of LGBT+ activism, beginning at the Stonewall Riots in 1969, against the American Psychiatric Association (APA) and the direct influence this had in the creation of this book.
The term ‘homosexuality’ was first coined in the mid-nineteenth century by Karl Kertbeny (Bullough, 1979). He was among the first to describe same-sex sexual behaviour as a natural and normal variant of human sexuality, arguing that it was not immoral and should not be criminalised. However, it was Richard von Krafft-Ebing (1965) who popularised the term in academic communities, describing the behaviour as a ‘degenerative’ neurological disorder.
Freud later took issue with both of the above ‘aetiologies’, instead proposing a developmental model, according to which homosexuality was understood as ‘immature sexuality’ (Freud, 1908). He suggested that before mature sexuality is achieved, an individual has ‘bisexual instincts’ which may persist in the event of a regression or fixation. Such a psychosexual disturbance could result in an individual seeking pleasure in ways other than penile–vaginal intercourse, such as receptive anal sex or fellatio. These represented stages of sexual development before the mature, genital stage,