From Perversion to Sexual Identity: Concepts of Homosexuality and Its Treatment in Germany

SUMMARY

The article describes the attitudes towards gays and lesbians as found in the theory and practice of psychiatry and psychotherapy in Germany. After providing a brief historical background, it presents the concepts of homosexuality prevailing in psychiatry, psychoanalysis and sexology after 1945, primarily focusing on West Germany. In the early years of West Germany, the ideas of anthropological psychiatry, psychoanalysis and those fields of sexology dealing with this subject exclusively followed normative concepts. During the subsequent period of social liberalization this normative fixation was revised by a new generation of sexologists. During this period, Fritz Morgenthaler also formulated the first psychoanalytical conception of a non-pathological homosexuality in Germany. The psychoanalytic concepts of the last few years emphasize the different modi of sexual identity. After homosexuality ceased to be a diagnosis in itself, it became impossible to determine a consistent psychiatric model. There are few empirical studies documenting the actual situation of gay and lesbian patients or of gay and lesbian health care professionals in the German health service. Consequently, what is known about their current situation is based primarily on anecdotal evidence and indirect references. This article is the first to report on three surveys about the admission policies of German psychoanalytic institutes toward gay and lesbian applicants and candidates, including previously unpublished data showing changes in institute policies. Attitudes in the mental health fields mirror the general social climate and range from patho-logization and other more subtle forms of homophobia to almost complete acceptance.

KEYWORDS:

• Developmental theory
• gay/lesbian mental health professionals
• gay/lesbian patients
• German Association of Gays in the Health Service (BASG e.V.)
• German psychiatry
• German psychoanalysis
• homosexuality
• mental health
• psychoanalytic training
• sexology