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Christian social policy and homosexuality in The Netherlands, 1900-1970.

This essay explores the historical process in which homosexuality became an object for pastoral, medical, and mental health care in the Dutch Catholic community during the twentieth century. The confrontation between a moral-religious approach and the professional (medical and psychological) treatment of homosexuality is the central issue. In a continuing dialogue and a process of changing power relations between clergymen, physicians, psychiatrist, psychologists, and pedagogues as well as Catholic homosexuals themselves, homosexuality was transformed from sin and pathology into a psychological and social problem that could be treated in pastoral and mental health care. The changing attitudes of Catholics towards homosexuality can be explained in the context of the changing relations between religion on the one hand and health care on the other hand. Current viewpoints resulting from sociohistorical studies on the development of the medical and welfare professions have concluded that religion lost importance in modern society because physicians, psychiatrists, psycho-therapists, and social workers not only created new areas of intervention in people's private lives, but also took over the traditional tasks of the church in the field of charity and pastoral care. Medical anamnesis, psychoanalysis, and psychotherapy took the place of confession and pastoral care, thus the argument runs, and remission of sins and redemption were replaced by health and welfare. However, especially in the case of the development of the Dutch welfare state, there was a more complicated interplay between changing religious values and professional strategies. In the Netherlands professional health care and welfare institutions often were organized in a religious context and it is difficult to make a clear differentiation between religious and moral discourses on the one hand and medical and psychological ones on the other hand. Moreover, professional interventions did not take the place of pastoral care; it appears that pastoral care for homosexuals gained ground and was intensified after medical and psychological definitions of homosexuality had found acceptance in the Catholic community. Professional strategies did not supersede religion, but rather contributed to a moral re-orientation and a new pattern of Christian values and appreciations in the field of sexuality.

Attitude↗

The evolution of a social construction: the case of male homosexuality.

Male homosexuality has been viewed by evolutionary psychologists as a Darwinian paradox, and by other social scientists as a social construction. We argue that it is better understood as an evolutionary social construction. Male homosexuality as we now know it is an 18th-century invention, but nonexclusive same-sex sexual behavior has a long evolutionary history. According to the alliance-formation hypothesis, same-sex sexuality evolved by natural selection because it created or strengthened male-male alliances and allowed low-status males to reposition themselves in the group hierarchy and thereby increase their reproductive success. This hypothesis makes sense of some odd findings about male homosexuality and helps to explain the rise in exclusive male homosexuality in the 18th century. The sociohistorical conditions around 1700 may have resulted in an increase in same-sex sexual behavior. Cultural responses to same-sex sexuality led to the spread of exclusive homosexual behavior and to the creation of a homosexual identity. Understanding male homosexuality as an evolutionary social construction can help us move beyond the traditionally polarized debate between evolutionary psychologists and social constructionists.

Attitude↗

Psychoanalytic attitudes towards homosexuality: an empirical research.

Homosexuality is a challenging subject for the psychoanalytic community, which is now rethinking some of its basic theoretical and institutional assumptions. In recent decades psychoanalytic theory has changed, and the classical psychosexual model has been challenged. After a short review of major psychoanalytical theories of homosexuality, the authors focus on the existence of contrasting attitudes towards homosexuality. This plurality of theories and their clinical and institutional consequences stimulated the authors to investigate the relationship between the individual analyst's theoretical model and his/her clinical practice. The authors present the results of empirical research conducted in the Italian psychoanalytic community on the attitude of psychoanalysts towards homosexuality and the implications for cultural, theoretical and institutional issues. A questionnaire was sent to 600 psychoanalysts (206 of which responded), members of the five main Italian psychoanalytic institutions. First, analysts' personal characteristics and preferred theoretical models were investigated. Second, the respondents responded to statements eliciting their theoretical and clinical approach towards homosexuality. Results indicate that: a) cultural and theoretical background influences the analysts' attitudes towards homosexuality more than gender; b) there is a discrepancy between analysts' theoretical position and their clinical practice; and c) IPA institutes are more discriminatory towards homosexual colleagues than are Jungian ones.

Adult↗

Biological explanation, psychological explanation, and tolerance of homosexuals: a cross-national analysis of beliefs and attitudes.

Controversies are commonplace among scientists who endorse different ideas about the determinants of homosexual orientation and their concomitant social and political implications. To measure the relationship between beliefs about the determinants of homosexual orientation and attitudes toward homosexuals, we asked 745 respondents in four societies about their beliefs concerning the origins of homosexual orientation. Analysis indicated that subjects who believed that homosexuals are "born that way" held significantly more positive attitudes toward homosexuals than subjects who believed that homosexuals "choose to be that way" and/or "learn to be that way."

Adult↗

The clinical approach to the homosexual patient.

Since publication of the Kinsey report more than 30 years ago, which estimated that 10% of the white American male population was predominantly or exclusively homosexual, several studies have indicated that heterosexuals and homosexuals cannot be distinguished on the basis of psychological adjustment or sexual response. Recent studies have also indicated the absence of homosexual stereotypes; homosexual men and women are quite diverse in the way they organize their lives sexually as well as socially. The implication of this finding for physicians is that a complete history, including sexual history, is necessary in any patient regardless of sexual orientation to determine factors that may be placing the patient at an increased risk for disease. Additionally, the primary care physician may be called upon by the homosexual patient to provide psychosexual counselling or treatment of sexual dysfunctions. Certain verbal and nonverbal signals may facilitate or inhibit the relationship between the physician and the homosexual patient. Homosexual patients may need special reassurance about confidentiality in the doctor-patient relationship and about the physician's respect for their life-styles and significant relationships.

Attitude of Health Personnel↗

The adult life course and homosexual identity in midlife gay men.

The meaning of homosexual identity as shaped by the adult life course is poorly described in the lives of gay men. In particular, the transition from young adulthood to middle age raises questions of how homosexual identity is redefined as gay men alter their participation in gay sexual culture, experience change in sexual desire and activity, and revise broader psychosocial identity as influenced by psychological and socialization processes related to aging. In addition, the HIV epidemic and historical change in social tolerance of homosexuality have shaped the experience of sexual identity among the generation of currently middle-aged gay men in the United States. A perspective that integrates sociocultural, historical, and psychosocial factors is thus needed to understand thesubjective meaning of homosexual identity as it is experienced in midlife. In this paper I have described exploratory research on the meaning of homosexual identity in the life trajectories of middle-aged men. Such meanings reflect available social and cultural pathways for change in midlife homosexual identity, as well as individual psychological attributes and idiosyncrasies of life history. These findings have heuristic value in further refinement of models of homosexual identity maintenance and support a more inclusive view of the life course that considers the effects of sexual orientation on adult identity.

Aging↗

The psychoanalytic perspective of adolescent homosexuality: a review.

Psychoanalytic theory asserts that adolescent homosexuality is the result of unresolved infantile conflict experienced during the Oedipal and pre-Oedipal periods, in which inadequate object relations and identifications with parents predispose the individual to homosexuality in adolescence. Classical psychoanalytic thought emphasizes the importance of drives and defenses in the formation of homosexuality, while more contemporary approaches understand adolescent homosexuality from a psychosocial and early developmental perspective. In addition to childhood predispositions, the various developmental tasks of adolescence influence the degree and course of homosexuality. This article notes the different types of homosexuality that emerge in adolescence which are influenced by different psychodynamic conditions in each stage of adolescence. Changing developmental roles in relation to individuation, object relations, identification, and identity formation are a few of the factors that contribute to adolescent homosexuality.

Adaptation, Psychological↗

Dermatophytosis and HIV infection. A study in homosexual men.

Mycological and clinical investigations were carried out in 193 homosexual men, 83 of whom had HIV antibodies, and 117 heterosexual men. Dermatophytes were recovered from the feet in 37.3% of HIV seropositive homosexual men, 31.8% of seronegative homosexual men and 8.6% of heterosexual men. Tinea pedis in homosexual men was significantly more common with increasing age. There was an increased number of sexual partners in the group of homosexual men with tinea pedis. Two dermatophytes were recovered from single samples in 14.5% of homosexual men with dermatophytosis. Dermatophytes were occasionally isolated from clinically normal toe clefts. Present results point to the importance of dermatophytes in nail dystrophy affecting patients with advanced HIV infection. Dermatophytosis in homosexual men was not associated with any changes in counts of blood T lymphocyte subsets or skin reactivity to tuberculin.

Acquired Immunodeficiency Syndrome↗

[Lymphadenopathy and a lower T-helper/suppressor cell (Th/Ts) ratio in homosexual men in West Germany. Studies of 147 patients to evaluate the individual risk of acquiring AIDS].

Investigations on 147 homosexual men in Berlin-West (17-57 years old, kappa = 32 years) revealed the presence of lymphadenopathy in 90 cases (61.2%). In addition, the Th/Ts-ratio was significantly reduced in the entire homosexual group compared to a control group of heterosexual men (n = 13) of comparable age [2P(z) = 0.0001; Mann-Whitney-U-test]. In homosexual men with marked lymphadenopathy (n = 43) the ThlTs-ratio was found to be lower than in those without lymphadenopathy (n = 57); the difference was significant (P less than 0.01). The reduction of the Th/Ts-ratio in the entire group was mainly due to a significant increase of the number of Ts-lymphocytes (P less than 0.005); Th-lymphocytes showed a trend to decrease which only became significant values in the group of homosexual men with marked lymphadenopathy (P less than 0.05). Similarly, no statistical correlation was found between reduction of Th/Ts-ratio and the age of homosexual men in the entire group (n = 147) as compared to controls; whereas, in the group of homosexuals with marked lymphadenopathy (n = 43) the decrease of Th/Ts became significant with increasing age. No statistical correlation was found between lymphadenopathy, reduction of Th/Ts-ratio and promiscuity (lifetime number of partners, number of partners during the last 6 months). The high prevalence of lymphadenopathy and reduction of Th/Ts-ratio, regarded as parameters of the individual AIDS-risk, indicate that a considerable number of homosexual men in Germany may develop that syndrome.

Acquired Immunodeficiency Syndrome↗

Interrelations of lymphocyte subset values, human immunodeficiency virus antibodies, and HIV antigen levels of homosexual males in San Francisco.

Serum and leukocytes from a cohort of homosexual males were analyzed to determine the interrelationships of antibodies to human immunodeficiency virus (HIV), serum HIV antigen levels, and phenotypical differences in lymphocyte subpopulations of HIV antibody-positive (HIV Ab+) and HIV antibody-negative (HIV Ab-) homosexual males. Significant reductions were observed in the percentages of B lymphocytes, CD4+ and CD4+ kappa lambda- T lymphocytes and the CD4+/CD8+ ratios of HIV Ab+ homosexual males in comparison to HIV Ab- homosexual males. Significant increases were observed in the percentages of CD8+, CD8+ CD11b-, CD8+ kappa lambda-, CD8+ DR+, CD8+Leu7+, and Leu7+ lymphocytes of HIV Ab+ study subjects. Statistical analysis revealed that among the immunological variables tested, decreases in the CD4+/CD8+ ratio and in the percentage of CD4+ kappa lambda- lymphocytes showed the strongest associations with HIV-sero-positivity in asymptomatic homosexual males. Only 44 (16.5%) of 267 HIV Ab+ homosexual males had detectable levels of HIV antigen (HIV Ag) in their serum. The percentages of CD4+ or CD4+ kappa lambda- lymphocytes and the CD4+/CD8+ ratios of HIV Ab+ males differed significantly between HIV Ag-positive (HIV Ag+) and--negative (HIV Ag-) homosexual males. These variables, however, did not correlate well with HIV Ag levels,indicating that no clear associations can be drawn between levels of HIV antigen and lymphocyte subset abnormalities of HIV-infected individuals.

Acquired Immunodeficiency Syndrome↗

[Age-related dynamics and conditions for developing male homosexuality].

A comprehensive clinical and psychological investigation was performed in 240 homosexual men. Various factors were established as playing a role in the development of homosexual drive. Therapeutic and preventive methods were designed. Homosexual men were found to have increased sexuality at the age of 5 to 7. First signs of homosexual settings were evident since the age 14-16 and their final shape acquired by 18-20. Parts played by individual partners were largely determined by personality traits (extroversion prevailing in "active" group and introversion in "passive" one). Homosexual orientation was primarily due to psychopathological development of the personality, asociality and external cues providing first sexual impression. In the forced confinement homosexual settings could be easily suppressed with chlorpromazine and then with sulfadiazine treatment. The prevention of homosexuality should be arranged as a complex of means effected through a differentiated medicolegal approach.

Adolescent↗

T-lymphocyte subsets in lymph nodes from homosexual men.

To evaluate further the immunodeficiency of homosexual men, blood and lymph node specimens were obtained from five homosexual men with lymphadenopathy and from seven homosexual men with Kaposi's sarcoma. Monoclonal antibodies were used to identify T-lymphocyte subsets in blood by cytofluorometry and in frozen sections of nodes by immunoperoxidase techniques. The homosexuals with Kaposi's sarcoma had a T-helper/suppressor ratio in blood of 0.7; the homosexuals with lymphadenopathy had a ratio of 0.6, compared with controls of 2.1. Control lymphoid tissue had a ratio of 3.0 in the interfollicular areas compared with the reactive lymph nodes in the homosexuals with lymphadenopathy, which was 0.7, and nodes from patients with Kaposi's sarcoma, 0.9. The nodes from homosexual men had evident numerous suppressor cells in the follicular center and mantle regions, locations in normal lymphoid tissue where suppressor cells were uncommon.

Flow Cytometry↗

Allies and persecutors: science and medicine in the homosexuality issue.

Using Magnus Hirschfeld (1868-1935) and his Zwischenstufentheorie (theory of intersexual stages) as an example, the problems raised for homosexuals by etiological research into homosexuality are scrutinized. Hirschfeld, one of the most influential sex researchers working in the first part of the century, fully intended his biological theory to support his campaign on behalf of homosexuals' rights. However, the Zwischenstufentheorie and modern variations of it, such as the ideas of the endocrinologist, Günter Dörner, have been converted into strategies for preventing or curing homosexuality. From an historical point of view, it becomes clear that, in a society hostile to homosexuals, the results gained from research into the causes of homosexuality can be used against homosexuals and, in fact, have been.

Attitude of Health Personnel↗

Immune responses to spermatozoa in homosexual men.

Immunologic responses to spermatozoa were investigated in homosexual and heterosexual men. Ten of 18 (56%) of the homosexual men had serum levels of IgG antibody to spermatozoa that were at least 2 standard deviations above the mean level for the heterosexual men; only 2 homosexual men had IgA antibody to spermatozoa. Similar increases above heterosexual levels in sperm-related antigen were detected in the sera of 56% (10 of 18) of the homosexual men. Circulating immune complexes (CICs) were detected at high levels (greater than 1000 micrograms/ml) in 61% (11 of 18) of the homosexual men. The CICs were relatively small (less than 14S), as determined by sucrose gradient analysis. Only 3 of 18 (17%) of the heterosexual men had CICs, and these were at a much lower concentration (less than or equal to 700 micrograms/ml). In the homosexual men, CICs and sperm-related antigen levels were positively correlated (r = 0.41, P less than 0.001), while IgG sperm antibody levels were negatively correlated with both CIC levels (r = -0.24, P less than 0.01) and sperm-related antigen levels (r = -0.24, P less than 0.01). CICs from six homosexual men were analyzed for composition. All contained IgG, and two had evidence of sperm-related antigen. The results suggest that intake of spermatozoa via the alimentary canal may lead to the development of a humoral immune response to spermatozoa.

Antigen-Antibody Complex↗

Intestinal parasitic infections in homosexual men: prevalence, symptoms and factors in transmission.

In a controlled study 67.5% of 200 homosexual men but only 16% of 100 heterosexual men were found to be infected with intestinal parasites. Entamoeba histolytica was isolated from 27% of the homosexual and 1% of the heterosexual men, and Giardia lamblia was isolated from 13% of the homosexual and 3% of the heterosexual men. The presence of symptoms could not be correlated with infection except when the infection was caused by more than one organism, including G. lamblia. Symptoms were much more common in both infected and uninfected homosexuals than in heterosexuals. Among the homosexual men recent foreign travel, living in a homosexual household and promiscuity were not correlated with intestinal parasitic infection, but cleansing of the anus before and sex was associated with a significantly lower prevalence of infection. These findings suggest that the male homosexual community may be an important reservoir of potentially pathogenic protozoa.

Adolescent↗

[The homosexual transmission of HIV/AIDS in Mexico].

OBJECTIVE: To analyze HIV homosexual transmission in Mexico, epidemic trends and biological and social risk factors. METHODS: This analysis is based on 19,090 notifications of AIDS cases and on a review of two previous studies that include 3,029 behavioral interviews (together with HIV serological screening tests) carried out at the Information Center of the Mexican Council for Control and Prevention of AIDS (CONASIDA) (1988-89) and during a 1988 study in six Mexican cities. Cities were included because they were the larger in the country and/or because they were the larger in the country and/or because they were touristic places (Mexico City, Guadalajara, Monterrey, Acapulco, Tijuana and Merida). Logistic regressions were used to estimate the odds ratios for HIV seropositivity and for condom use. RESULTS: Seventy-two percent of the total reported AIDS cases (19,090) up to June 30, 1994, were associated with male homosexual behaviors. In absolute numbers, cases under this category exhibited a rising trend until the end of 1993. HIV seroprevalence was 31% in 2,314 men with homosexual practices who attended "FLORA", the AIDS Information Center in Mexico, from January 1988 to June 30, 1989. The main predictive variables for seropositivity were exclusive homosexual behavior, more than 40 lifetime sexual partners, mixed sexual behavior (both insertive and receptive and intercourse), sex with a person with AIDS, history of syphilis, and anal or genital warts. In general, these risk factors (data from the Information Center) are similar to those found in the six Mexican cities study. There were significant differences in HIV prevalence among the high-risk city samples (the highest in Mexico City with 25% and the lowest in Monterrey with 2.4%). Reported condom use was very low in both studies: only 5% used a condom in all of their sexual relationships. A statistically significant protective effect for HIV infection was found only for those who reported using a condom in all sexual encounters. In the six cities study, city of residence was a strong predictor of condom use. CONCLUSIONS: HIV homosexual transmission is steadily increasing; the recent decline in the percentage of homosexual cases is artificial because of the increment of cases under other categories. Men who report exclusive homosexual behavior have higher prevalence rates of infection than bisexual men. Individuals with insertive/receptive behavior (mixed) have the highest risk for HIV seropositivity, mainly because of sociological, rather than biological reasons. This difference in risks for HIV and condom use may be related to the selection of sexual partners from specific social networks. Condom use was demonstrated to be an effective method for preventing HIV seropositivity among those who always use condoms. However, it is alarming that only 5% of respondents reported condom use in all sexual encounters. Social and geographic differences in the cumulative numbers of cases, HIV prevalence, sexual practices and condom use must be taken into account in the planning of preventive programs.

Acquired Immunodeficiency Syndrome↗

Self-image and emotional stability of Oedipal and non-Oedipal male homosexuals.

The past several years have brought about some changes in the legal status of the homosexual in USA. In some states, the homosexual is labelled as a criminal; in others, homosexuality is not a legal affair. Psychological theories tend to consider the homosexual from two general positions: the Oedipal and the non-Oedipal. The present study was conducted to try to determine how Oedipal and non-Oedipal male homosexuals perceived their self-image and emotional stability. Significant differences were found between the two groups. Considering self-image, Oedipal subjects were found to be more negative. They had less self-worth, self-confidence and self-acceptance than non-Oedipal. They had more negative self-concepts, self-attitudes, and self-motivation. Oedipal homosexuals had less emotional stability. They had more emotional problems, shame, guilt, withdrawal, and depression than non-Oedipal subjects, as well as less success in sexual activity and commitment to the homosexual partner.

Adult↗

The ratio of 2nd to 4th digit length and male homosexuality.

Sexual orientation may be influenced by prenatal levels of testosterone and oestrogen. There is evidence that the ratio of the length of 2nd and 4th digits (2D:4D) is negatively related to prenatal testosterone and positively to oestrogen. We report that (a) 2D:4D was lower in a sample of 88 homosexual men than in 88 sex- and age-matched controls recruited without regard to sexual orientation, (b) within the homosexual sample, there was a significant positive relationship between mean 2D:4D ratio and exclusive homosexuality, (c) overall, there was a decrease in 2D:4D from controls to homosexual men to bisexual men and (d) fraternal birth order, a positive predictor of male homosexuality, was not associated with 2D:4D in a sample of 240 Caucasian men recruited without regard to sexual orientation and 45 homosexual men.Further work is needed to confirm the relationships between 2D:4D and sexual orientation. However, these and other recent data tend to support an association between male homosexuality and high fetal testosterone. Very high testosterone levels may be associated with a sexual preference for both men and women.

Journal Article↗