PHOTO: Renate Vanaga
Text: Alejandra Misiolek
Psychologist for LGBT?
People whose sexual orientation is different from heterosexual: lesbian, gay, transsexual or bisexual, have suffered, over many years, misunderstanding and discrimination. Until 1973, homosexuality was considered a mental disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA) and several psychotherapists offered so-called “conversion therapy” to cure this “deviation”.
In this post we will talk about the etiology of homosexuality and the reasons why LGBT people could go to therapy nowadays.
What do scientific studies say about homosexuality and its etiology?
The etiology of homosexuality appears to be multifactorial and the weight of each factor is rather individual and unknown.
For many years homosexuality was thought to be the product of social factors; however, evidence gathered for several decades and particularly during the last twenty years, suggests that homosexuality is a rather biological condition.
On the one hand, we can speak of a certain genetic predisposition. In several studies some heritability of the homosexual condition has been found (the highest concordance rates for homosexuality among twin siblings, compared with rates of concordance between adoptive siblings), although the data do not support the exclusiveness of genetic factors. Furthermore, studies point to a genetic component, but we do not have clear evidence on molecular markers, regulatory genes, or signaling mechanisms.
Apart from genetic factors, we can talk about prenatal hormonal predisposition, such as the level of testosterone and immunity mechanisms, in response to certain environmental variations. There are studies showing that the amount of sex hormones available in the prenatal state affects an individual’s sexual orientation.
Finally, there are brain morphological differences between homosexual and heterosexual men, which do not seem to be a cause but rather a consequence of sexual orientation. On the one hand, it was reported (eg LeVay, S. 1991) that the suprachiasmatic nucleus, the sagittal plane of the anterior commissure and the isthmus of the corpus callosum were larger, while the third interstitial nucleus of the anterior hypothalamus was smaller in gay men, compared to heterosexuals. The latter appears to be of great importance because sexual behavior and male sexual preferences are largely regulated by various regions of the hypothalamus. Additionally, these hypothalamic areas interact with dopaminergic areas such as the mesolimbic system, which plays a very important role in sexual motivations. Therefore, differences between homo and hereosexuals in the hypothalamus suggest that the hypothalamus must be an important site for the regulation of sexual orientation.
On the other hand, to analyze morphological differences, scientists from the Stockholm Brain Institute, analyzed 90 individuals (25 heterosexual men, 25 heterosexual women, 20 gay men and 20 gay women) using volumetric magnetic resonance imaging of the brain and cerebellar hemispheres and measured cerebral blood flow through PET * to analyze the functional connections of the right and left amygdala. As a result of these analyzes, they discovered that heterosexual men and homosexual women showed asymmetry in the right brain region, while the volumes of the cerebral hemispheres were symmetrical in homosexual men and heterosexual women. Furthermore, homosexual subjects also showed an atypical connection between the amygdala and the sexual neurological pathway. In homosexual men, as well as in heterosexual women, the connections were more extensive in the left amygdala; and in homosexual women and heterosexual men, in the right one. The study shows atypical sexual brain asymmetry and functional connections in gay people and indicates that there are more similarities between straight women and gays, on the one hand, and between lesbians and straight men, on the other.
These results suggest the existence of a link with neurobiological entities and demonstrate that homosexuality is not simply social or psychological.
So why therapy?
If homosexuality is no longer considered a mental disorder, why would a homosexual person need therapy?
Although we do not consider homosexuality as a psychological problem, there are still many prejudices and sexual orientation other than heterosexual does not always meet with the acceptance of society, culture, family or the homosexual themselves. This discrimination, which LGBT people may suffer, has important psychological consequences related to self-esteem and identity. Therefore, the psychotherapeutic process is based on overcoming the traumas that the lack of acceptance may have generated. On the other hand, all minorities may have a tendency to create a false self that is more like the majority, rather than being authentic, and therapy based on building the true self can be very helpful.
In addition, sessions with a therapist can be an accompaniment for LGTB families and / or an intervention in the family acceptance process or in couple relationships.