A third aspect of homosexuality is psychological identity, that is, a sense of self defined in terms of one’s enduring attractions to members of the same sex. Individuals who identify as homosexual typically refer to themselves as “gay,” with most women preferring the term “lesbian.” Some use “queer” as a self-descriptive term, thereby transforming a formerly pejorative label into a positive statement of identity. People follow multiple paths to arrive at an adult homosexual identity. Not everyone with homosexual attractions develops a gay or lesbian identity, and not all people who identify themselves as gay engage in homosexual acts.

A fourth component of homosexuality is involvement in same-sex relationships. Many gay and lesbian people are in a long-term intimate relationship and, like heterosexual pairings, those partnerships are characterized by diverse living arrangements, styles of communication, levels of commitment, patterns of intimacy, and methods of conflict resolution. Heterosexual and homosexual relationships do not differ in overall psychological adjustment or satisfaction. However, antigay stigma often denies same-sex partners the social support that heterosexual spouses typically receive, and even forces many same-sex couples to keep their relationship hidden from others.

Fifth, in the United States and many other societies, homosexuality involves a sense of community membership, similar to that experienced by ethnic, religious, and cultural minority groups. Empirical research indicates that gay men and lesbians in the United States tend to be better adjusted psychologically to the extent that they identify with and feel part of such a community.

The fact that the term homosexuality has multiple meanings highlights the difficulties of defining exactly who is gay. Moreover, many gay people do not disclose their sexual orientation publicly because they fear discrimination and harassment. Consequently, no accurate estimate exists for the proportions of the U.S. population that are homosexual, heterosexual, and bisexual. In North American and European studies during the 1980s and 1990s, roughly 1–10% of men and 1–6% percent of women (depending on the survey and the country) reported having had sexual relations with another person of their own sex since puberty.

The American mental health profession regarded homosexuality as an illness for much of the twentieth century. This classification reflected value assumptions and the viewpoints of particular schools of psychoanalysis rather than empirical data obtained scientifically from non-patient samples. Its accuracy came into question when behavioral scientists began to systematically study the psychological functioning of homosexuals. Beginning with Evelyn Hooker’s pioneering research in the 1950s, those studies consistently failed to find an inherent connection between homosexuality and pathology. In 1973, the weight of empirical data, coupled with changing social mores and the emergence of a politically active gay community in the United States, led the American Psychiatric Association to declare that homosexuality would no longer be considered an illness. Since then, the mental health professions have recognized that society’s continuing prejudice against homosexuality is often a source of significant stress for gay men and women and sometimes leads to serious psychological distress and maladaptive behaviors. Consequently, many psychologists, psychiatrists, and other professionals are working to remove the stigma historically associated with homosexuality.

When homosexuality was regarded as an illness, its origin or cause was a topic of much speculation. More recently, researchers have recognized that the etiology of heterosexuality is equally puzzling, and scholarly inquiry now addresses the broad question of how sexual orientation develops in any given individual. A satisfactory answer to this question has not yet been found. It is possible that scientists will eventually identify multiple ways in which a person comes to be heterosexual, homosexual, or bisexual, with biological, psychological, and cultural factors all playing a role in this complex process.

Regardless of its origins, a heterosexual or homosexual orientation is experienced by most people in the United States and other Western industrialized societies as a deeply rooted and unchangeable part of themselves. Many adults report never having made a conscious choice about their sexual orientation and always having felt sexual attractions and desires to people of a particular sex. When homosexuality was assumed to be a form of psychopathology, psychiatrists and psychologists often attempted to “cure” it; that is, they tried to change homosexual people into heterosexuals. Even today, some counselors and psychotherapists continue this practice. However, such treatments are widely rejected by mainstream therapists because they are usually ineffective, often harmful to the client, and ethically questionable. Instead, most mental health practitioners working with lesbian and gay clients try to assist them in developing positive feelings about their sexuality, establishing meaningful intimate relationships, and coping with societal stigma.

Scientific studies demonstrate that gay men and lesbians constitute a highly diverse group. Apart from their sexual orientation, they are no more homogeneous than the heterosexual population. Researchers have failed to find significant differences between homosexual and heterosexual people on a wide range of characteristics, including psychological adjustment, the capacity to form and maintain intimate relationships, the ability to be a good parent, the likelihood of victimizing children or adults, and the ability to function effectively in work groups and organizations.

Psychology today regards homosexuality as a different, rather than pathological, form of sexuality. Psychology also recognizes the considerable diversity that exists among gay men and lesbians, and increasingly seeks to address the problems they face as a result of the stigma historically associated with homosexuality in the United States.

Gregory M. Herek, University of California, Davis