Homosexuality and Mental Health

Two recent studies reported in the same issue of Archives of General Psychiatry (October 1999, vol. 56, no. 10) have found significantly higher levels of mental-health problems in the gay population than the heterosexual population.

One researcher, J. Michael Bailey, responded in the same issue of the Archives with some thoughts about those findings. In "Commentary: Homosexuality and Mental Illness," Dr. Bailey says,

"These studies contain arguably the best published data on the association between homosexuality and psychopathology, and both converge on the same unhappy conclusion: homosexual people are at substantially higher risk for some forms of emotional problems, including suicidality, major depression, and anxiety disorder...

"Subjects whom they classified as gay, lesbian or bisexual were at an increased lifetime risk for suicidal ideation and behavior, major depression, generalized anxiety disorder, conduct disorder, and nicotene dependence (odds ratios, 2.8-6.2 compared with the heterosexual sample).

Dr. Bailey predicted these findings would be interpreted in different ways:

1. by sexual-reorientation therapists, as vindication that homosexuality should not have been removed from the diagnostic manual in 1973 because of its association with psychopathology;

2. by social conservatives, as evidence of the consequences of promiscuity and an unhealthy lifestyle;

3. by gay activists as proof of the stresses of society's homophobia.

"Commitment to any of these positions would be premature," he cautioned.

Dr. Bailey proposed several possible interpretations of the findings. Social oppression is a very likely stressor, but not demonstrated to be a single source of the problem.

A second possibility, he says, is that since evolution naturally selects for heterosexuality, "homosexuality may represent developmental error." While he does not fully elaborate on this suggestion, he says some research links homosexuality to "developmental instability," as well as some minor physical anomalies.

A third possibility concerns the gender-atypicality of homosexuals as a group; gay men, being as a group more feminine, he says, may be exhibiting more female-like types of neuroticism.

Another possibility is that the psychopathology is due to "lifestyle differences" (particularly promiscuity and fear of sexually transmitted diseases). Lifestyle differences (including the gay community's great stress on physical attractiveness and thinness) might also explain the vastly higher rate of gay men with eating disorders.

To understand why homosexuality is linked with psychopathology, the author calls for more research--particularly, research that is free of politicization and that does not avoid exploring unpopular hypotheses.