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Question:  I read on another website a reply a psychologist wrote to a question about the difference between alternative lifestyles and mental illnesses. He said: "...an alternative lifestyle is living according to custom, behaviour, culture and attitudes that deviate significantly from the dominant culture. Mental illness, I guess, could look similar, except that it adds on that living in such a manner causes distress or impairment in functioning to the indivdiual. An alternative lifestyle could be done in the context of an alternative community, whilst mental illness is an issue for an individual."

How does this apply in say, a situation where a gay person is living in a homophobic environment (e.g. with homophobic parents)? Obviously such a situation could easily cause distress and/or impairment for the person, but homosexuality is a lifestyle, not a mental illness, isn't it? The part where the psychologist says that an alternative lifestyle can be performed in the context of an alternative community works well with the gay person example. But what if a person's form of 'alternative lifestyle' is more abstract, and they can't find a community of their peers no matter how much they search? Suppose also that a psychologist or psychiatrist could not understand such a person's lifestyle, despite repeated attempts to explain it to them. Would these signs indicate that the person's 'alternative lifestyle' is actually a mental illness? Thanks, Chris

Answer (1)  I personally don't believe homosexuality is just an alternative lifestyle. Often it is not a choice that homosexuals have (although sometimes it is). It is quite simply a form of sexuality that is not always socially acceptable or easily understood by hetrosexuals, especially parents who have certain expectations of their children. This of course can cause great distress and imprairment for the person as you say but this does not mean it is a mental illness. If a therapist or psychiatrist did not understand homosexuality then I would say it is the failing of the said therapists not the homosexual. Unfortunately this does occur and as a therapist who sees many gay and lesbian clients, I've come across the situation where I had to "undo" harm caused by a previous therapist who felt uncomfortable about the idea of homosexuality. This saddens me as homosexuals have enough to contend with in their every day life which most hetrosexuals would never be able to fully appreciate.

Answer provided by Jacqueline McDiarmid, Psychotherapist
 

Answer (2)  Gosh, what a struggle Chris. It sounds like you've been thinking about this for some time. I personally don't think that homosexuality is a mental illness or an alternative lifestyle. An alternative lifestyle suggests to me a choice - to get out of the mainstream and live in an alternative way. The gay/lesbian people I know and have worked with say that their homosexuality isn't a choice but a deep expression of who they are. It would be just as strange to say that being heterosexual is an alternative lifestyle choice. Whether we're gay, straight, bi, queer, transexual - people who attempt to try and change who they authentically are end up suffering. In terms of a homosexual community - well all communities have incredible diversity. That's what makes us so fabulous. Finding the community we connect to, our 'tribe' can be tricky. I want to say, keep searching. Start with one or two individuals first - people who see you, value you and share some of the things you value and believe in. From this, a community may slowly grow. best wishes

Answer provided by Shushann Movsessian, Psychotherapist

Answer (3)  This is a complex question with many layers and therefore, can only be answered in generalities, which may not clarify much for you. Without knowing the details, I could not responsibly even hazard a guess as to whether what you are hinting at, may or may not be a mental illness. However, what I can say is that officially, just being homosexual per se, has long been off the books as a diagnosable mental illness. You hint at living a lifestyle that is not understood by others, despite it being "explained" many times. Not understood or not endorsed? You've gone this far to get answers to your questions, I suggest you find a therapist with whom you can talk through the issues you've outlined here.

Answer provided by David White, Psychotherapist

Answer (4)  I read into what you have written that you have tried very hard to find a community for yourself and that perhaps this question is another search for belonging. If so I salute you for your continued efforts to come home. You are not alone and not the only queer person who feels isolated by homophobic rejection. The application of the label 'mental illness' has the function of authorizing intrusions and coercions of various kinds from family, friends and society and in your hypothetical - mental health professionals. Homosexuality is not a mental illness and increasingly not an alternative lifestyle (if it ever was) - many legislatures now allow for legal marriage of same sex couples, granting them the same privileges and responsibilities as mainstream marrieds. 'Suppose a psychologist or psychiatrist could not understand' a queer lifestyle suggests both repeated personal experience of the rejection that follows judgement, and that the said professional harbours and likely denies homophobia - 'Mental illness' is anything in human mentality greatly disliked by the person describing it.'. None of the signs indicate that the hypothetical person has a mental illness - and that's not even entering the argument about the validity of applying disease or illness models to sexual orientation. Some folk actually come from the position that queer needs to be cured because it exposes the 'sufferers' to higher rates of other pathologies. Seems to me that this is the case of any oppressed minority subject to hate crimes at any point in history. We would not be surprised to discover that homosexuals, gypsies and Jews had high rates of depression, paranoia and suicide during Hitler's era.

Answer provided by Peter Fox, Clinical Psychologist

Answer (5)  I think that when we choose the gender of sexual partners, be that same-sex, opposite sex, or both, that it is neither a mental illness or a simple lifestyle choice. Life style is a common term for optional activities like living by the beach or turning your bayard into a barbeque area. Rather, for most people, our comfort with engaging in sexual activity which is same sex, opposite sex, or both sexes is informed by much deeper constructs which are psychological, emotional and social. You might add religious belief for some. It is thus significant and important to us. Thankfully the American Diagnostic and Statistical Manual no longer lists homosexuality as a mental disorder either. If you find that your therapist is unable to understand the choices you make and their importance to you, seek out someone else to talk to. Therapy should not be about the client having to convince the therapist, but rather for the therapist to hear, empathise, and facilitate the client's exploration and progress as desired by the client.

Answer provided by John Hunter, Counsellor

Answer (6)  Although homosexuality is no longer listed by name in the DSM therapists can still consider it a Sexual Disorder Not Otherwise Specified. Homosexuality was listed as a mental disorder in the DSM until 1974 when the American Psychiatric Association made headlines by announcing that, as a result of legislative vote by the APA, it had decided homosexuality was no longer a mental illness. The claim that it would be deleted was functionally false because the next DSM included homosexuality with which the patient was not fully comfortable. This could easily be considered a reality based "normal" discomfort for homosexuals growing up in a homophobic culture known for hate crimes against their population. The 2000 DSM-IV still includes "Sexual Dysfunction Not Otherwise Specified" and, similarly, "Paraphilias Not Otherwise Specified," allowing ample room for therapists to justify their personal or religious prejudices and "diagnose" a homosexual as having a mental disorder. quoted from drzur.com

Answer provided by Peter Fox, Clinical Psychologist