Last year, I sat in the exam room with my doctor. She was new to me and I really liked her. As she talked with me, I glanced over her shoulder to the computer screen that was lit up with my electronic medical record. In the list of my diagnosis I saw, "ego dystonic homosexuality."
My gut sank. I was shocked, angry and scared all at the same time.
I didn't say anything to her because I was scared of what she might say. I asked for a copy of my medical records and found that I had actually been "diagnosed" in 2009 by my previous doctor.
This diagnosis had been in my chart for 3 years and anyone who opened my chart had seen it. This included nurses, medical assistants, and my new doctor. To make things more interesting, it was the medical record at the place of my own employment as a nurse practitioner.
It wasn't that I didn't want people to know I am gay. The upsetting thing was that I had a "diagnosis." As if the person I loved left me pathological.
I went home and Googled "ego-dystonic homosexuality" and I discovered that it has not been supported by the American Psychological Association since 1975. (See Fox cited below). (The diagnosis of "homosexuality" had been removed from official list of mental disorders by the American Psychiatric Association in 1973). Here it was, over 30 years later. In my chart. Looking me in the face. I had just finished my Master's degree and had an article in the Journal For Nurse Practitioners accepted for publication on "Creating a Safe and Caring Health Care Context for Women Who Have Sex With Women." This diagnosis wasn't even on my radar. In fact, I hadn't even heard of it.
To be clear, a diagnosis is defined by "the art or act of identifying a disease from its signs and symptoms" - Merriam Webster Online Dictionary. Or "the nature of a disease; the identification of an illness" - MedicineNet.
The doctor who diagnosed me had never had a conversation with me about my sexuality.
She either knew I was gay from the previous notes in my chart made by the doctor I went to before her, or she put two and two together when I sometimes came into the office with my then-wife. Either way, from what I can deduce from copies of my medical records, the day she diagnosed me as having "ego dystonic homosexuality" was the day I came in to see her for worsening depression.
Some might argue that "ego dystonic homosexuality" is only a diagnosis stating that the individual is having a hard time reconciling their homosexuality and is having a hard time making peace with it within themselves, therefore creating psychological distress. It is true that since the age of 12 I knew something was "wrong" with me. I thought I was going to hell, had self-destructive behaviors, and made some poor choices. Yes, I was having a hard time reconciling my sexuality. I haven't met anyone who is anything other than completely heterosexual that hasn't had a hard time reconciling their sexuality.
However, there are at least two things extremely unprofessional and unethical about this diagnosis: 1) my doctor never once talked to me about my sexuality. Even more importantly, 2) she was treating my sexuality like a disease or an illness.
My sexual orientation isn't the disease. The illness lies with societal prejudice, the way I was taught to reject or hate a core part of myself, the way I was shamed into believing I was sick. That is what causes illnesses within us such as shame, self-hatred, and rejection of our authentic selves.
"All major professional mental health organizations have gone on record to affirm that homosexuality is not a mental disorder." (American Psychiatric Association) This includes (but is not limited to): The American Medical Association, The American Psychological Association, The American Psychiatric Association, The American Academy of Pediatrics, and many many more.
Narth.com and other "reparative" or "conversion" therapies are still used to "treat" homosexuality. The aim appears to be to cure one's homosexuality. In 2006, the American Psychological Association released a statement that says:
"For over three decades the consensus of the mental health community has been that homosexuality is not an illness and therefore not in need of a cure. The APA’s concern about the position’s espoused by NARTH and so-called conversion therapy is that they are not supported by the science. There is simply no sufficiently scientifically sound evidence that sexual orientation can be changed. Our further concern is that the positions espoused by NARTH and Focus on the Family create an environment in which prejudice and discrimination can flourish"
Further research supports this idea.The Human Right's Campaign (HRC) has some useful info on the dangers of reparative therapy. They quote the American Psychiatric Association in stating, "The potential risks of reparative therapy are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient."
It's important to note that there are many health care providers and many parents and teachers who do an amazing job at affirming LGBT people for exactly who they are and accepting them fully.
I appreciate and respect these people and am so grateful for those who are willing to be at the forefront of social change. Unfortunately, the attitude or belief that homosexuality is a disease or pathological diagnosis is still quite pervasive in our society and health care system. As long as society, health care providers, parents, teachers, and others continue to treat homosexuality as a pathological diagnosis, a flaw, something to be ashamed of, or something to be fixed, the mental, physical, and emotional health of our LGBT people as a whole will continue to suffer.
As far as my diagnosis, I contacted the administration at my clinic and got it removed from my chart. It does make me wonder how many other people are walking around with a diagnosis of homosexuality from that doctor.
I feel it is my job as a health care provider, an LGBT advocate, and a human to stand up for the truth: That LGBT individuals are inherently good and worthy of being loved and accepted just as they are. That there is nothing pathological about the way they love or who they love.
How are we going to make social change? By lovingly standing in our truth.
It will look different for all of us. Some will go to the lawmakers and present evidence, some will help with changing school policies, others will teach their children that loving someone, whoever it is, is good and normal. Some will do research, some will be willing to speak up when a friend or a stranger says something hurtful. And some will be willing to stand in who they are to themselves for the very first time. There are numerous ways to take a stand, all of which are nothing short of heroic. My belief is that the answer is found in truth and love. Not in fighting the ignorance, fear, or hatred. I believe the way to make the needed societal change is to stand in the truth and light we know ourselves to be.
"Returning violence for violence multiplies violence, adding deeper darkness to a night already void of stars. Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
-- Dr. Martin Luther King, Jr.
Fox, R. E. (1988). Proceedings of the American Psychological Association, Incorporated, for the year 1987: Minutes of the annual meeting of the Council of Representatives. American Psychologist, 43, 508–531. doi:10.1037/h0091999