Evolutionary arguments against the de facto re-pathologising of homosexuality

Homosexuality or same-sex sexual orientation has a very long history in the medical field as pathology of sexuality, starting from the nineteenth century (Bullough, 1974; Adams and Sturgis, 1977; Coleman, 1982; Beckstead 2001; Conrad and Angell, 2004). Officially, however, homosexuality was removed from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1973. This change notwithstanding, the current version of the DSM (DSM-IV-TR), in place since the year 2000, still includes the categories of Gender Identity Disorder (GID) and Sexual Disorder Not Otherwise Specified and its subcategory, Persistent and Marked Distress about Sexual Orientation (Throckmorton, 1998; McCommon, 2009), that leave a door open for the persistence of psychotherapeutic practices that aim at either changing the sexual orientation of homosexuals to heterosexuality, or to maintain the homosexual orientation but eliminate homosexual behaviours. These practices are variably known as conversion therapies, reparative therapies (e.g. Grace, 2008), or re-orientation therapies (Masters and Johnson, 1979). In this chapter I start with the main issues section, where I briefly review the historical background of ‘homosexuality as pathology’, the emergence of conversion therapies, especially those that have a religious motivation; the criticisms that such therapies have received, including the establishment of alternative gay/lesbian affirmative therapies, and the current approaches that aim at integrating the various dimensions that are relevant to the life of homosexuals. In the ‘Looking forward’ section, I propose an evolutionary view of homosexuality as an adaptive expression of sexuality, not as pathology, and endeavour to establish some evolutionarily inspired criteria that may help both therapists and counsellors in their approaches to homosexual clients, especially in cases where those clients feel the necessity to seek consistency between their sexuality and their strongly held religious beliefs.