Kuang, Mei-Fun & Mathy, Robin & M. Carol MPhil, Helen & Nojima PhD, Kazuhiko. (2003).
Journal of Psychology & Human Sexuality.
Abstract: A significantly greater percentage of sexual minorities (lesbian and bisexual females) than heterosexuals reported they had used tobacco or alcohol. Relative to heterosexuals, sexual minorities were significantly more likely to report a serious suicide attempt. Overall, gender identity (masculine, feminine, and androgynous) and gender role (butch, femme, and pure or undifferentiated) were poor discriminators of lesbian mental health. Differences between sexual minorities and heterosexuals were more robust than were the variations in gender identities and gender roles among lesbian and bisexual women. We discuss the implications of these findings for further clinical research.
Kuang, Mei-Fun & Mathy, Robin & M. Carol MPhil, Helen & Nojima PhD, Kazuhiko. (2003).
Homosexuality was removed in 1973 from the official list of mental disorders included in the Diagnostic and Statistical Manual of Mental Disorders, when the American Psychiatric Association (APA) adopted the official policy that homosexuality per se does not constitute a mental health impairment. The American Psychological Association urged mental health professionals to take the lead in removing the stigma of mental illness associated with lesbian and gay sexualities. Researchers in the United States and Western Europe have since then studied lesbian, gay, and bisexual (LGB) mental health issues from a non-pathological view. In part to further these goals, the APA approved in 1984 the establishment of Division 44, dedicated to the psychological study of LGB issues (Perez, DeBord, & Bieschke, 1999). The British Psychological Society (BPS) officially inaugurated the Lesbian and Gay Psychology Section at the organization’s London Conference on 18th December 1998 (Coyle & Kitzinger, 2002). Thus, in recent decades homosexuality has been a topic of scientific inquiry rather than a subject of social deviance.
Concurrent with the change from pathological to non-pathological views of homosexuality, psychological explanations derived from psychodynamic and psychoanalytic perspectives aligned with Freudian psychotherapy have become less viable. The perspective that homosexuality is a normal variant of human sexual experience also was advanced by researchers such as Kinsey, Pomeroy, Martin, and Gebhard (1953), Armon (1960), Bell and Weinberg (1973), and Whitam and Mathy (1986). The non-clinical samples used in these studies focused on homosexuality as part of a common human sexual experience rather than psychological deficits seen in small groups of psychiatric patients (Ponse, 1978).
We have known for several decades that lesbians and heterosexual women have similar mental health profiles, with some notable exceptions. Hopkins (1969) compared lesbians to heterosexual women and found that they were more independent, resilient, reserved, dominant, bohemian, self-sufficient, and composed. Loney (1972) studied non-clinical lesbians and concluded that most sexual minority women were involved in stable, ongoing relationships. Consistent with the findings of Hopkins (1969), Freedman (1971), Saghir and Robins (1973), and Thompson, McCandless, and Strickland (1971), and Seigelman (1972) found that lesbians were better adjusted than a matched control group of heterosexual women (Ponse, 1978).
Far fewer studies have examined the possibility that gender identity (masculine, feminine, or androgynous) or gender role (butch, femme, or neither) moderates lesbian and bisexual women’s mental health. Women are more likely than men to be judged as mentally ill or dysfunctional when they evidence gender-incongruent behavior (Broverman et al., 1970, 1972). Sexual minorities are more likely than heterosexuals to have gender atypical behaviors or appearances (Bailey, Kim, Hills, & Linsenmeier, 1997). Androgyny is associated with greater mental health and self-efficacy than masculine, feminine, or undifferentiated gender identities (Bem, 1975). Therefore, we might expect that relatively androgynous sexual minorities have better mental health outcomes than their gender-typed gay, lesbian, and bisexual peers. For example, Harry (1983) reevaluated data from Bell and Weinberg (1978) and found that gender atypical males (but not females) were more likely to attempt suicide than were their gender typical same-sex peers, regardless of sexual orientation. However, Harry’s finding may suggest that gender-incongruous identities (androgynous, feminine, or masculine) or roles (butch or femme) pose mental health risks for males but not for females.
As psychologists have developed an empirically balanced view toward lesbian mental health, researchers have focused more on the relationship between social stress and sexual minority mental health. There is an underlying presumption in this research that sexual minorities have the same mental health issues as heterosexuals. However, social stress associated with oppression, discrimination, and stigma creates a greater burden for sexual minorities. Because homosexuality is not a psychopathology, we must assume that sexual minorities and heterosexuals have a similar threshold for succumbing to mental illness.
Sexual minorities have somewhat greater risks of succumbing to stress-related disorders because they carry a disproportionate burden of society’s oppression, discrimination, and stigma, not because they are more intrinsically prone to psychological maladies or social dysfunctions. Studies have found that sexual minorities have somewhat higher rates of stress-related disorders than do heterosexuals, including increased risks of suicidal intent (Cochran & Mays, 2000). This research has found that lesbians are significantly more likely than heterosexual women to report that they have issues with identity and psychosocial development, social support, and social stress (Bradford, Ryan, & Rothblum, 1994). Sexual minority females also face biased treatment when they seek help from professional clinicians (Perez, DeBord, & Bieschke, 1999; see also Kerr, Walker, Warner, and McNeill, this volume).
Researchers have conducted a disproportionate amount of research regarding sexual orientation and mental health in the United States, Western Europe, and Australia. Mathy (2002) argued that research concerning the mental health of lesbians in Asia is needed. This paper attempts to address the need for research regarding mental health of sexual minorities on the Asian continent, with attention to the possibility that cultural factors may have significant effects on lesbians’ mental health outcomes and receipt of mental health services.
