I find it extremely
difficult to offer a review of this book, for any commentary on its merits is
contingent on its prospective use(s). 
At first reading, I found this book disappointing–its coverage is
brief, both in terms of the topics considered and in terms of the depth with
which each of these is covered (chapter 3 on legal issues is, perhaps, the
exception to this latter comment). 
Having immersed myself for some time in the literature dealing with LGBT
psychology, I found the coverage simplistic–and even potentially misleading in
its failure to address the nuances of the topics raised; indeed, one might
argue that it does a disservice to the complexity of these issues (and thereby
to the experiences of LGBT people).  
If, however, one wishes a cursory introduction to certain issues, perhaps
as an avenue toward entering a mental health encounter with a nodding
acquaintance with relevant issues, the book might well prove useful.  In either case, the chapters are uneven in
their style and substance.  Given the
contingent nature of any overall evaluation and the unevenness of the chapters,
I will focus my comments on a brief review of each chapter.

Chapter 1: Normal Development in Sexual Minority
Youth (by Barry Fisher, M.D.).  This
chapter reviews a limited segment of the literature on identity development in
LGBT people—particularly models of lesbian and gay identity development, which
are portrayed as specific to youth. 
This chapter relies on remarkably old material, much of which has been
the subject of considerable critique. 
The failure to include more recent work and more critical analyses of
the literature addressed makes this summary more misleading than helpful.

Chapter 2: Aging and Sexual Orientation (by Douglas
C. Kimmel, Ph.D.).  The strong pragmatic and
experiential frame of this chapter encourages an empathic understanding of the
issues facing aging LGBT people.  The
chapter calls upon recent as well as older work to frame specific proposals for
working with older LGBT people, offering a good overview of major thinking in
this topic area.

Chapter 3: Offering Psychiatric Opinion in Legal
Proceedings When Gay or Lesbian Sexual Orientation is an Issue (by Richard G.
Dudley, Jr. M.D.).  This chapter addresses a
number of legal matters where LGB identity might be relevant to
psychiatric/psychological legal testimony. 
The depth and focus of coverage vary across topics.  Simply by calling attention to the range of
potential issues where LGB identity may play a significant role, the chapter
offers potentially valuable resources to mental health professionals working in
forensic domains.

Chapter 4: Sexual Conversion
("Reparative") Therapies: History and Update (by Jack Drescher,
M.D.). This
chapter is primarily a historical overview of psychiatric and psychological
perspectives on conversion/reparative therapies, which attempt to change the
sexual orientation of LGB individuals. 
As such, it is a valuable resource that draws attention to the
socio-cultural influences on these changing attitudes, as well as to the legal,
scientific, and ethical underpinnings of these shifts.  I was troubled by some problematic
assumptions imbedded in the discussion—such as the notion that only a
biological explanation of sexual orientation is compatible with an identity (vs.
pathology) model of LGB experience, and the suggestion that providing therapy
to alter egodystonic same-sex attractions is comparable to (elective) plastic
surgery.  Certain contemporary
perspectives on sexual orientation would take strong issue with these notions.  This conceptual matter aside, the chapter
would provide useful background for legal matters where reparative therapy is
an issue.

Chapter 5: Transgender Mental Health: The
Intersection of Race, Sexual Orientation, and Gender Identity (by Donald E.
Tarver, II, M.D.).  The title of this chapter is
somewhat misleading; it does not actually explore intersections among race,
gender, and sexual orientation.  Rather,
it points to changes in psychiatry’s historical attitudes toward race, draws an
analogy between those changes and shifting attitudes toward (LGB) sexual
orientation, and then suggests that it is time for the same shift to happen in
attitudes toward transgender identity and gender identity disorder.  Apart from making this (arguably clarifying)
argument, the chapter seems more confusing than enlightening.  The organization of material is unclear;
some headings do not even describe the text that follows. In addition,
terminology is inconsistently used, often in ways quite different from standard
usage in most of the literature on this topic.

Overall, the book contains some useful information
that might serve as preliminary background to further exploration of some
important issues in the field of LGBT mental health.  Many other books and a plethora of articles addressing these and
other mental health issues are available; for the reader who enters the topic
area via this book, I would suggest further reading beyond its limited
scope.  One might read, for example,
Garnets & Kimmel, Psychological Perspectives on Lesbian, Gay, and
Bisexual Experience (2^nd Ed.); Greene & Herek, Lesbian,
Gay, and Bisexual Psychology: Theory, Research, and Clinical Applications;
Perez, DeBord, & Bieschke, Handbook of Counseling and Psychotherapy with
Lesbian, Gay, and Bisexual Clients.

© 2003 Janis S. Bohan

Janis S. Bohan, Ph.D, is Professor
Emerita (retired) at Metropolitan State College of Denver.  She has
published widely in the areas of gender, psychology of sexual orientation, and
history of psychology. 

Categories: Sexuality, MentalHealth