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Family & Relationship Issues

by Billy E. Jones and Marjorie J. Hill (editors)
American Psychiatric Press, 2002
Review by Janis S. Bohan, Ph.D. on Sep 4th 2003

Mental Health Issues in Lesbian, Gay, Bisexual, and Transgender Communities

I find it extremely difficult to offer a review of this book, for any commentary on its merits is contingent on its prospective use(s).  At first reading, I found this book disappointing--its coverage is brief, both in terms of the topics considered and in terms of the depth with which each of these is covered (chapter 3 on legal issues is, perhaps, the exception to this latter comment).  Having immersed myself for some time in the literature dealing with LGBT psychology, I found the coverage simplistic--and even potentially misleading in its failure to address the nuances of the topics raised; indeed, one might argue that it does a disservice to the complexity of these issues (and thereby to the experiences of LGBT people).   If, however, one wishes a cursory introduction to certain issues, perhaps as an avenue toward entering a mental health encounter with a nodding acquaintance with relevant issues, the book might well prove useful.  In either case, the chapters are uneven in their style and substance.  Given the contingent nature of any overall evaluation and the unevenness of the chapters, I will focus my comments on a brief review of each chapter.

Chapter 1: Normal Development in Sexual Minority Youth (by Barry Fisher, M.D.).  This chapter reviews a limited segment of the literature on identity development in LGBT people—particularly models of lesbian and gay identity development, which are portrayed as specific to youth.  This chapter relies on remarkably old material, much of which has been the subject of considerable critique.  The failure to include more recent work and more critical analyses of the literature addressed makes this summary more misleading than helpful.

Chapter 2: Aging and Sexual Orientation (by Douglas C. Kimmel, Ph.D.).  The strong pragmatic and experiential frame of this chapter encourages an empathic understanding of the issues facing aging LGBT people.  The chapter calls upon recent as well as older work to frame specific proposals for working with older LGBT people, offering a good overview of major thinking in this topic area.

Chapter 3: Offering Psychiatric Opinion in Legal Proceedings When Gay or Lesbian Sexual Orientation is an Issue (by Richard G. Dudley, Jr. M.D.).  This chapter addresses a number of legal matters where LGB identity might be relevant to psychiatric/psychological legal testimony.  The depth and focus of coverage vary across topics.  Simply by calling attention to the range of potential issues where LGB identity may play a significant role, the chapter offers potentially valuable resources to mental health professionals working in forensic domains.

Chapter 4: Sexual Conversion ("Reparative") Therapies: History and Update (by Jack Drescher, M.D.). This chapter is primarily a historical overview of psychiatric and psychological perspectives on conversion/reparative therapies, which attempt to change the sexual orientation of LGB individuals.  As such, it is a valuable resource that draws attention to the socio-cultural influences on these changing attitudes, as well as to the legal, scientific, and ethical underpinnings of these shifts.  I was troubled by some problematic assumptions imbedded in the discussion—such as the notion that only a biological explanation of sexual orientation is compatible with an identity (vs. pathology) model of LGB experience, and the suggestion that providing therapy to alter egodystonic same-sex attractions is comparable to (elective) plastic surgery.  Certain contemporary perspectives on sexual orientation would take strong issue with these notions.  This conceptual matter aside, the chapter would provide useful background for legal matters where reparative therapy is an issue.

Chapter 5: Transgender Mental Health: The Intersection of Race, Sexual Orientation, and Gender Identity (by Donald E. Tarver, II, M.D.).  The title of this chapter is somewhat misleading; it does not actually explore intersections among race, gender, and sexual orientation.  Rather, it points to changes in psychiatry's historical attitudes toward race, draws an analogy between those changes and shifting attitudes toward (LGB) sexual orientation, and then suggests that it is time for the same shift to happen in attitudes toward transgender identity and gender identity disorder.  Apart from making this (arguably clarifying) argument, the chapter seems more confusing than enlightening.  The organization of material is unclear; some headings do not even describe the text that follows. In addition, terminology is inconsistently used, often in ways quite different from standard usage in most of the literature on this topic.

Overall, the book contains some useful information that might serve as preliminary background to further exploration of some important issues in the field of LGBT mental health.  Many other books and a plethora of articles addressing these and other mental health issues are available; for the reader who enters the topic area via this book, I would suggest further reading beyond its limited scope.  One might read, for example, Garnets & Kimmel, Psychological Perspectives on Lesbian, Gay, and Bisexual Experience (2nd Ed.); Greene & Herek, Lesbian, Gay, and Bisexual Psychology: Theory, Research, and Clinical Applications; Perez, DeBord, & Bieschke, Handbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual Clients.


© 2003 Janis S. Bohan


Janis S. Bohan, Ph.D, is Professor Emerita (retired) at Metropolitan State College of Denver.  She has published widely in the areas of gender, psychology of sexual orientation, and history of psychology. 


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