Position Statement PS02/2014 April 2014
Royal College of Psychiatrists London
Approved by the Policy Committee: March 201
The Royal College of Psychiatrists considers that sexual orientation is determined by a combination of biological and postnatalتال للولادة مباشرة environmental factors.
1–3 There is no evidence to go beyond this and imputeيعزو any kind of choice into the origins of sexual orientation.
The College wishes to clarify that homosexuality is not a psychiatric disorder.
In 1973 the American Psychiatric Association (APA) concluded there was no scientiﬁc evidence that homosexuality was a disorder and removed it from its diagnostic glossary of mental disorders.
The International Classiﬁcation of Diseases of the World Health Organization followed suitمتابعة in 1992.
The College holds the view that lesbian, gay and bisexual people are and should be regarded as valued members of society, who have exactly similar rights and responsibilities as all other citizens. This includes equal access to healthcare, the rights and responsibilities involved in a civil partnership/marriage, the rights and responsibilities involved in procreating and bringing up children, freedom to practise a religion as a lay person or religious leader, freedom from harassment or discrimination in any sphere and a right to protection from therapies that are potentially damaging, particularly those that purport to change sexual orientation.
Leading therapy organisations across the world have published statements warning of the ineffectiveness of treatments to change sexual orientation, their potential for harm and their inﬂuence in stigmatising lesbian, gay and bisexual people.
4,5 There is now a large body of research evidence that indicates that being gay, lesbian or bisexual is compatible with normal mental health and social adjustment.
However, it is eminently reasonable that the experiences of discrimination in society and possible rejection by friends, families and others (such as employers), means that some lesbian, gay and bisexual people experience a greater than expected prevalence of mental health and substance misuse problems.
Lifestyle issues may be important in some gay men and lesbians, particularly with respect to higher rates of substance misuse.
6–8 It is not the case that sexual orientation is immutableغير قابل للتغيير or might not vary to some extent in a person’s life. Nevertheless, sexual orientation for most people seems to be set around a point that is largely heterosexual or homosexual.
Bisexual people may have a degree of choice in terms of sexual expression in which they can focus on their heterosexual or homosexual side.
It is also the case that for people who are unhappy about their sexual orientation – whether heterosexual, homosexual or bisexual – there may be grounds for exploring therapeutic options to help them live more comfortably with it, reduce their distress and reach a greater degree of acceptance of their sexual orientation.
The College believes strongly in evidence-based treatment. There is no soundصحيح scientiﬁc evidence that sexual orientation can be changed.
Systematic reviews carried out by both the APA5 and Serovichetal9 suggest that studies which have shown conversion therapies to be successful are seriously methodologicallyمنهجي ﬂawedصدع شق . Furthermore, so-called treatments of homosexuality can create a setting in which prejudiceتحيز أذى and discriminationتعصب ﬂourish, and there is evidence that they are potentially harmful.
5,10,11 The College considers that the provision of any intervention purporting to ‘treat’ something which is not a disorder is wholly unethical.
The College would not support a therapy
for converting people from homosexuality any more than we would do so from
3 Royal College of Psychiatrists
Psychiatrists should be committed to reducing inequalities, not supporting practices that are explicitly based on pathologising homosexuality. As such, the College remains in favour of legislative efforts to banادانة تحريم such conversion therapies.
Good Psychiatric Practice clearly states: ‘A psychiatrist must provide care that does not discriminateمتعصب and is sensitive to issues of gender, ethnicity, colour, culture, lifestyle, beliefs, sexual orientation, age and disability’ (p. 12).
12 The College expects all its members to follow Good Psychiatric Practice.
1. Mustanski BS, Dupree MG, Nievergelt CM, et al (2005) A genomewide scan of male sexual orientation. Human Genetics, 116, 272–278.
2. Blanchard R, Cantor JM, Bogaert AF, et al (2006) Interaction of fraternal birth order and handedness in the development of male homosexuality. Hormones and Behavior, 49, 405–414.
3. Bailey JM, Dunne MP, Martin NG (2000) Genetic and environmental inﬂ uences on sexual orientation and its correlates in an Australian twin sample. Journal of Personality and Social Psychology, 78, 524–536.
4. UK Council for Psychotherapy, British Psychoanalytic Council, Royal College of Psychiatrists, et al (2014) Conversion Therapy: Consensus Statement. UK Council for Psychotherapy.
5. American Psychological Association (2009) Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation. APA.
6. Gilman SE, Cochran SD, Mays VM, et al (2001) Risk of psychiatric disorders among individuals reporting same sex sexual partners in the National Comorbidity Survey. American Journal of Public Health, 91, 933–939.
7. King M, McKeown E, Warner J, et al (2003) Mental health and quality of life of gay men and lesbians in England and Wales: controlled, cross-section study. British Journal of Psychiatry, 183, 552–558.
8. Bailey JM (1999) Homosexuality and mental illness. Archives of General Psychiatry, 56, 883–884.
9. Serovich J, Craft S, Toviessi P, et al (2008) A systematic review of the research base on sexual reorientation therapies. Journal of Marital and Family Therapy, 34, 227–238.
10. BBC News (2013) ‘Ex-gay’ group Exodus International shuts down. BBC News, 20 June (http://www.bbc.co.uk/news/world-us-canada-22992714).
11. Harris P (2012) Psychiatrist who championed ‘gay cure’ admits he was wrong. The Observer, 19 May (http://www.theguardian.com/world/2012/may/19/ psychiatrist-admits-gay-cure-study-ﬂ awed).
12. Royal College of Psychiatrists (2009) Good Psychiatric Practice (3rd edn) (College Report CR154). Royal College of Psychiatrists.
This guidance (as updated from time to time) is for use by members of the Royal College of Psychiatrists. It sets out guidance, principles and speciﬁ c recommendations that, in the view of the College, should be followed by members. None the less, members remain responsible for regulating their own conduct in relation to the subject matter of the guidance. Accordingly, to the extent permitted by applicable law, the College excludes all liability of any kind arising as a consequence, directly or indirectly, of the member either following or failing to follow the guidance.