Sexual Orientation: An explaination by a Man on DeviantArt

[DOC PENGUIN]

http://inspiredcreativity.deviantart.com/gallery/#/d2u717m

Matthew Barry is Autistic and Gay. He is a self-made man and lived through a life of Discrimination. His Resilience is very admirable as a sexually confused teenager I found him, very Comforting. However in late readings, i find his information helpful but not Scientific. He often relies on Psychology studies and personal experience with Counseling as his backup. While he is no means a quack, there are some things i would like to say.

He puts up the theory of Sexual Orientation as a Spectrum. This is not the first time, The Kinsey Scale was an influential tool. While not having a scientific background, he has written other (okay) articles on DeviantArt. Among them include Gaydar Science and the science of Homosexuality. My biggest concern is his service on Deviantart. He gives online counseling, while this is noble, i think it is bad as it might be an invasion of privacy. Keep in mind that it is done by priviate messaging. Nevertheless, Mr. Barry is a resiliant figure for everybody and provides a good (but questionable) service. What do you think.

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[vistaril]

http://inspiredcreativity.deviantart.com/gallery/#/d2u717m

Matthew Barry is Autistic and Gay. He is a self-made man and lived through a life of Discrimination. His Resilience is very admirable as a sexually confused teenager I found him, very Comforting. However in late readings, i find his information helpful but not Scientific. He often relies on Psychology studies and personal experience with Counseling as his backup. While he is no means a quack, there are some things i would like to say.

He puts up the theory of Sexual Orientation as a Spectrum. This is not the first time, The Kinsey Scale was an influential tool. While not having a scientific background, he has written other (okay) articles on DeviantArt. Among them include Gaydar Science and the science of Homosexuality. My biggest concern is his service on Deviantart. He gives online counseling, while this is noble, i think it is bad as it might be an invasion of privacy. Keep in mind that it is done by priviate messaging. Nevertheless, Mr. Barry is a resiliant figure for everybody and provides a good (but questionable) service. What do you think.

I read a paragraph and it was already so ridiculous I just stopped......

I don't have any issue with homosexuals and have never said a bad word to one. That said, I do find it annoying and absurd when people(whether straight or guy) write the stuff in that link......

 

[aphenomenon]

I don't have any issue with homosexuals.

I always find that statement so condescending

 

[vistaril]

I always find that statement so condescending

how so?

 

[billypilgrim37]

While he's not a great writer, the spectrum of sexuality is a fairly well-validated concept, and plenty of straight folks fall into the "mostly heterosexual" category rather than the "totally heterosexual category. Or at least that's the data presented at one of our grand rounds by a pretty accomplished researcher on substance abuse risks on lgbt populations.

The counseling issue you bring up seems a little sketchy. Lgbt youth need strong mentorship and support, but I don't know if online counseling by an untrained polemic is necessarily helpful.

 

[hamstergang]

Yeah, disliking the article has nothing to do with the author's sexuality. It just seems poorly written, capitalizes words in a very annoying manner, and I don't even think it's all true.

 

[vistaril]

While he's not a great writer, the spectrum of sexuality is a fairly well-validated concept, and plenty of straight folks fall into the "mostly heterosexual" category rather than the "totally heterosexual category..

oh nonsense.....this is the kind of bs that cause some to think so poorly of the mental health community.

 

[DOC PENGUIN]

While he's not a great writer, the spectrum of sexuality is a fairly well-validated concept, and plenty of straight folks fall into the "mostly heterosexual" category rather than the "totally heterosexual category. Or at least that's the data presented at one of our grand rounds by a pretty accomplished researcher on substance abuse risks on lgbt populations.

The counseling issue you bring up seems a little sketchy. Lgbt youth need strong mentorship and support, but I don't know if online counseling by an untrained polemic is necessarily helpful.

Does anybody here even take kinsey seriously: He F*cked everybody.

 

[splik]

Yes we still take Kinsey seriously, as long as you take those studies for what they are, really a catalog of the diversity of sexual behavior within individuals and within the population. Kinsey didn't want to sample, he overrepresented prison populations, and his male study was overly influenced by one man who had engaged in many different sexual acts with men, women, children, animal and so on... What you can't say from these studies is the prevalence of sexual behaviors etc because they were not (nor were they meant to be) nationally representative samples.

It is very hard to get federal funding for sexual health research and most of the US longitudinal studies have been small, or where sexual health/behavior has been an afterthought.

Whether you follow the Kinsey 1-6 scale or not, it is clear that it is wishful thinking to state that sexual orientation is as simple as either being heterosexual or not. Sexual orientation is not fixed, sexual behaviors do not necessarily correlate with sexual orientation, and who we fall in love with, who we form attachments to, and who we are sexually attracted to often have areas of zero overlap.

 

[vistaril]

Whether you follow the Kinsey 1-6 scale or not, it is clear that it is wishful thinking to state that sexual orientation is as simple as either being heterosexual or not. Sexual orientation is not fixed, sexual behaviors do not necessarily correlate with sexual orientation, and who we fall in love with, who we form attachments to, and who we are sexually attracted to often have areas of zero overlap.

1) complete nonsense
2) it doesnt have much to do with psychiatry anyways

 

[dl2dp2]

1) complete nonsense
2) it doesnt have much to do with psychiatry anyways

I'm not sure what your objection to the paragraph and the very standard, formulaic, ACGME style teaching on the "spectrum of sexuality" is.

Secondly, hmm...sexuality doesn't have much to do with psychiatry. That can't possibly be true, can it? Oh wait, you work in a system where you hand out celexa 20 and ambien 5 to everyone for $88.00 a pop. I am very sorry but maybe sexuality doesn't have much to do with the kind of psychiatry YOU practice, but the only one who cares about that is you. *shrug*

 

[vistaril]

I'm not sure what your objection to the paragraph and the very standard, formulaic, ACGME style teaching on the "spectrum of sexuality" is.

Secondly, hmm...sexuality doesn't have much to do with psychiatry. That can't possibly be true, can it? Oh wait, you work in a system where you hand out celexa 20 and ambien 5 to everyone for $88.00 a pop. I am very sorry but maybe sexuality doesn't have much to do with the kind of psychiatry YOU practice, but the only one who cares about that is you. *shrug*

no, sexuality is an important part of our pt's lives, and we need to be aware of that. That has very little to do with a bunch of nonsense theories about sexuality spectrums and how someone is 88% hetero and 12% homo and then another straight person may be 84% hetero and 16% homo and all that garbage......

psychiatry has no place in getting involved in such nonsense discussions.

 

[dl2dp2]

no, sexuality is an important part of our pt's lives, and we need to be aware of that. That has very little to do with a bunch of nonsense theories about sexuality spectrums and how someone is 88% hetero and 12% homo and then another straight person may be 84% hetero and 16% homo and all that garbage......

psychiatry has no place in getting involved in such nonsense discussions.

I don't understand how this is garbage. There is an empirical basis to the idea that sexual orientation (and behavior) goes along a spectrum. Psychiatry has every reason to get involved because it's a medical specialty that deals with patients with confusing experiences and we need understand the epidemiology of sexuality in reality before we can label something as deviant. Maybe you don't want to get involved in such discussions because you feel uncomfortable and insecure with freshman stats and need to review what a bell curve and a histogram is before making arbitrary, blanket statements about what is a widely accepted consensus backed by decades of empirical research. Maybe you are just making public statements of that nature to be provocative because you are bored, lonely or both. I don't know.

 

[Qwerk]

Vistaril is clearly trolling. A glance at the literature will indicate that there is a substantial population of people who do not fit standard sexual labels. Any clinician who thinks that clients can only be entirely gay or straight has either never worked with queer clients, never gone into more than perfunctory depth about clients' sexualities, or never had clients who felt comfortable enough with him/her to discuss sexuality. I suspect that the last one has a lot to do with it.

 

[SmallBird]

1) complete nonsense
2) it doesnt have much to do with psychiatry anyways

Could you explain why you don't agree with this comment? It is not very helpful to label it as nonsense without further comment.

 

[notdeadyet]

I don't have any issue with homosexuals and have never said a bad word to one.

Vistaril- would you honestly say

"I don't have any issues with African Americans and have never said a bad word to one.."

If you wouldn't, you might not be as enlightened as you think..

 

[Qwerk]

Vistaril- would you honestly say

"I don't have any issues with African Americans and have never said a bad word to one.."

If you wouldn't, you might not be as enlightened as you think..

Hey, maybe some of his best friends are gay!

 

[vistaril]

I don't understand how this is garbage. There is an empirical basis to the idea that sexual orientation (and behavior) goes along a spectrum. Psychiatry has every reason to get involved because it's a medical specialty that deals with patients with confusing experiences and we need understand the epidemiology of sexuality in reality before we can label something as deviant. Maybe you don't want to get involved in such discussions because you feel uncomfortable and insecure with freshman stats and need to review what a bell curve and a histogram is before making arbitrary, blanket statements about what is a widely accepted consensus backed by decades of empirical research. Maybe you are just making public statements of that nature to be provocative because you are bored, lonely or both. I don't know.

the basis that sexual orientation goes along a sprectrum for humans is flawed in many ways. It also fails the bull**** test. I don't have any % of thoughts towards romtantic relations with men. Most of the people I know feel the same way. Im sure there are people who go both ways and have thoughts both ways, but that is different than this nonsense concept that we are all just at some point on a spectrum.

Psychiatry has no role in this ridiculous topic, and your bizarre example of "patients come to us with confusing experiences......." is laughable. Are you a psychiatrist or a late night radio sex talk show wannabe?

Im signing off on this thread as i don't see it going anywhere productive.

 

[beethousand]

the basis that sexual orientation goes along a sprectrum for humans is flawed in many ways. It also fails the bull**** test. I don't have any % of thoughts towards romtantic relations with men. Most of the people I know feel the same way. Im sure there are people who go both ways and have thoughts both ways, but that is different than this nonsense concept that we are all just at some point on a spectrum.

Psychiatry has no role in this ridiculous topic, and your bizarre example of "patients come to us with confusing experiences......." is laughable. Are you a psychiatrist or a late night radio sex talk show wannabe?

Im signing off on this thread as i don't see it going anywhere productive.

Anectdotal evidence at best, first off how do you really know they feel the same way? Secondly, just because you don't have variant thoughts doesn't mean that other people don't. Maybe they aren't comfortable sharing that because of the immense pressure society puts on people to be heteronormative. Or because you dismiss it as a ridiculous notion. When a patient experiencing depression is overwhelmed by the thought of having a variable sexuality (perhaps they are bicurious) and you simply dismiss that as irrelevant to psychiatry and that the internal conflict they are experiencing because societal norms push people towards either identifying as completely gay or completely straight is ridiculous? I hope this isn't common amongst psychiatrists...

 

[vistaril]

Vistaril- would you honestly say

"I don't have any issues with African Americans and have never said a bad word to one.."

If you wouldn't, you might not be as enlightened as you think..

I think it was implied that I have never said a bad word to a homosexual regarding their being gay....same as with any black person regarding them being black.

 

[michaelrack]

1) complete nonsense
2) it doesnt have much to do with psychiatry anyways

 

[Jorje286]

Maybe you are just making public statements of that nature to be provocative because you are bored, lonely or both

Pretty much.

Also, @ psychiatry shouldn't bother with that "grabage" or whatever he called discussions on sexual orientation.

 

[billypilgrim37]

The 10-15% or so of the population that does not identify as "entirely heterosexual" is at increased risk for mood disorders, substance abuse, and suicide. That seems pretty relevant to psychiatry.

 

[vistaril]

The 10-15% or so of the population that does not identify as "entirely heterosexual" is at increased risk for mood disorders, substance abuse, and suicide. That seems pretty relevant to psychiatry.

not really....you treat the patient. If someone is gay and has a problem with alcohol, then take that into consideration. If someone is straight and has a problem with alcohol, then take that into consideration.

I'm not saying psychiatrists should not be aware if someone is obviously gay. I'm saying psychiatrists should not be involved in nonsense discussions on "the spectrum of sexuality"........psychiatry already has an image problem with a lot of america and mainstream medicine as it is; the last thing we need is psychiatry weighing in on these issues that are very very political and not particularly relevant to everyday practice.

 

[OldPsychDoc]

not really....you treat the patient. If someone is gay and has a problem with alcohol, then take that into consideration. If someone is straight and has a problem with alcohol, then take that into consideration.

I'm not saying psychiatrists should not be aware if someone is obviously gay. I'm saying psychiatrists should not be involved in nonsense discussions on "the spectrum of sexuality"........psychiatry already has an image problem with a lot of america and mainstream medicine as it is; the last thing we need is psychiatry weighing in on these issues that are very very political and not particularly relevant to everyday practice.

Patient scenario: recently divorced suburban Christian mom, history of depression and opiate dependence, both largely in remission. Presents for med check. "By the way, Doc, I'm feeling really attracted to my girlfriend--like sexually--and it's making me guilty because part of my thinks it's against my beliefs, but thinking back before I was married I had these feelings sometimes then too... What do you think about that?"

Now vistaril can happily respond, speaking as he does for psychiatry's image problem, that it is very very political and not particularly relevant to his practice, so "time's up here's your prescription see you next month".

On the other hand, I suspect that many of you might be interested in exploring these thought a bit further with her, at least at her next appointment, so I would argue that the concept of a continuum of sexual attraction IS at least a little clinically relevant, and perhaps it behooves us to understand various ways that others might conceptualize such issues, and to be comfortable addressing them.

 

[DOC PENGUIN]

Patient scenario: recently divorced suburban Christian mom, history of depression and opiate dependence, both largely in remission. Presents for med check. "By the way, Doc, I'm feeling really attracted to my girlfriend--like sexually--and it's making me guilty because part of my thinks it's against my beliefs, but thinking back before I was married I had these feelings sometimes then too... What do you think about that?"

Now vistaril can happily respond, speaking as he does for psychiatry's image problem, that it is very very political and not particularly relevant to his practice, so "time's up here's your prescription see you next month".

On the other hand, I suspect that many of you might be interested in exploring these thought a bit further with her, at least at her next appointment, so I would argue that the concept of a continuum of sexual attraction IS at least a little clinically relevant, and perhaps it behooves us to understand various ways that others might conceptualize such issues, and to be comfortable addressing them.

I am actually seeing Vistiral's point, Psychiatry has become too politicizes in recent years. And part of it is its inborn power. If we start doing studies on stupid ****, without scientific background or the neutrality of medical diagnoses, we lose out. Think about the advances we could have made (most of them are now in neurology.) Thanks to Group pride we have subjected ourselves into politics. I think we should advance research in Conversion therapy and the science of sexuality (so long as we are not politicized from left and right.)

 

[sunlioness]

Advance research in conversion therapy? And you're saying that isn't political? There's no research to suggest that conversion therapy does anything but harm people. To say otherwise strikes me as political.

 

[vistaril]

Patient scenario: recently divorced suburban Christian mom, history of depression and opiate dependence, both largely in remission. Presents for med check. "By the way, Doc, I'm feeling really attracted to my girlfriend--like sexually--and it's making me guilty because part of my thinks it's against my beliefs, but thinking back before I was married I had these feelings sometimes then too... What do you think about that?"

Now vistaril can happily respond, speaking as he does for psychiatry's image problem, that it is very very political and not particularly relevant to his practice, so "time's up here's your prescription see you next month".
.

well even in this most ridiculous of contrived examples, you treat this situation just like you would with anything else......I wouldnt treat it any differently than someone who is very conservative in terms of religion and is having conflicted feelings about engaging in sex outside of marriage......

Im not bothered by other people hooking up with people outside of marriage or hooking up with people of the same sex. Not for me, but if it's for them, whatever. I'm certainly not about to try to define their value system for them though on things like marriage, sex, homosexuality, etc.......

but again, the basic idea of the spectrum of sexuality(in terms of everyone being on some individual point in the spectrum) is absurd....it doesn't pass the bull**** test like I said earlier. I know Im 100% straight and have no attraction whatsoever sexually to men. Most every other guy or girl I know feels the same way about the opposite gender. All of them certainly have no reasonn to lie. I've met some people who do feel sexual feelings(not of a 50-50 nature) towards both sexes, but they clearly represent a minority......

hell if we want we can take a poll here....how many of the "straight" guys here have 10% sexual feelings towards men? 5% 15%?

 

[Salpingo]

not really....you treat the patient. If someone is gay and has a problem with alcohol, then take that into consideration. If someone is straight and has a problem with alcohol, then take that into consideration.

I'm not saying psychiatrists should not be aware if someone is obviously gay. I'm saying psychiatrists should not be involved in nonsense discussions on "the spectrum of sexuality"........psychiatry already has an image problem with a lot of america and mainstream medicine as it is; the last thing we need is psychiatry weighing in on these issues that are very very political and not particularly relevant to everyday practice.

I agree that if your career goal is to operate an efficient suboxone clinic with referrals from insurance companies, you really don't need to study Kinsey in any depth.

But I don't think that the lay public or medical community will then give you more respect for somehow being apolitical. If anything, I'd say its the opposite. Both non-psychiatric physicians and the public have been disappointed by the way psychiatrists and pharmaceutical companies have lumped all mood symptoms into one amorphous, moving target for psychopharm, leading to crappy, discouraging studies (see Marcia Angell) and protests outside of conferences. My sense is that people would be encouraged by their psychiatrist having some breadth and awareness of psychosocial theories beyond the DSM and their own personal experiences (not necessarily proselytizing, but educating). Some of the deeper connections I made with patients was sharing some psychodynamic theory that I personally felt was bull****, but somehow made sense to them.

To tie this to another thread/flame-war, the psychiatrists I know and truly respect (and who have successful out-of-pocket, private practices), seem to have developed and made a living out of that knowledge/skill.

 

[vistaril]

I agree that if your career goal is to operate an efficient suboxone clinic with referrals from insurance companies, you really don't need to study Kinsey in any depth.

But I don't think that the lay public or medical community will then give you more respect for somehow being apolitical. If anything, I'd say its the opposite. Both non-psychiatric physicians and the public have been disappointed by the way psychiatrists and pharmaceutical companies have lumped all mood symptoms into one amorphous, moving target for psychopharm, leading to crappy, discouraging studies (see Marcia Angell) and protests outside of conferences. My sense is that people would be encouraged by their psychiatrist having some breadth and awareness of psychosocial theories beyond the DSM and their own personal experiences (not necessarily proselytizing, but educating). Some of the deeper connections I made with patients was sharing some psychodynamic theory that I personally felt was bull****, but somehow made sense to them.

To tie this to another thread/flame-war, the psychiatrists I know and truly respect (and who have successful out-of-pocket, private practices), seem to have developed and made a living out of that knowledge/skill.

you are falsely equating not incorporating bull**** sociopolitical theories with cookie cutter by the book psychiatry.

Nobody is more skeptical of our drugs than I am, and the marcia angell piece was spot on in many ways and struck right at the core of the limitations and weaknesses of psychiatry.

That has nothing to do, however, with psychiatrists needing to incorporate sociopolitical bull**** and kinsey type studies into their practice.

 

[OldPsychDoc]

well even in this most ridiculous of contrived examples, you treat this situation just like you would with anything else......I wouldnt treat it any differently than someone who is very conservative in terms of religion and is having conflicted feelings about engaging in sex outside of marriage......
...

There was nothing ridiculous or contrived in this example. 100% real patient.
But then again, you ARE the arbiter of bull**** here these days, so I suppose you know better...

 

[BritTrooper]

1) complete nonsense
2) it doesnt have much to do with psychiatry anyways

Spot on. We are physicians first.

 

[Salpingo]

you are falsely equating not incorporating bull**** sociopolitical theories with cookie cutter by the book psychiatry.

Nobody is more skeptical of our drugs than I am, and the marcia angell piece was spot on in many ways and struck right at the core of the limitations and weaknesses of psychiatry.

That has nothing to do, however, with psychiatrists needing to incorporate sociopolitical bull**** and kinsey type studies into their practice.

I'm confused (1) why this is political, and (2) why something that is "political" shouldn't be discussed by psychiatrists. For example, its malpractice not to ask a suicidal patient about guns, even though gun control is a hot-button political issue.

 

[vistaril]

There was nothing ridiculous or contrived in this example. 100% real patient.
But then again, you ARE the arbiter of bull**** here these days, so I suppose you know better...

well even if it was real, I addressed how to handle it.....

I've had obviously gay patients ask me if I support gay marriage.(med mgt patients). I tell them no, that I do not. That doesn't mean I can't be a good psychiatrist for them.....

 

[vistaril]

I'm confused (1) why this is political, and (2) why something that is "political" shouldn't be discussed by psychiatrists. For example, its malpractice not to ask a suicidal patient about guns, even though gun control is a hot-button political issue.

guns are a well established direct and immediate risk factor for self harm. That said, I think we make far too much of the gun thing, but that's another issue....and some states(fl I believe) has taken steps to protect this sort of questioning....I have mixed feelings about it.

 

[billypilgrim37]

We are discussing determinants of sexual behavior. This is a significant focus for health behavior research independent of psychiatry.

This is an empiric question, not a political one. Ignoring Kinsey, there is extensive literature on this subject. The fact that some of you would prefer to ignore it is a much more politically motivated decision than accepting an established evidence base of epidemiologic research.

 

[vistaril]

We are discussing determinants of sexual behavior. This is a significant focus for health behavior research independent of psychiatry.

This is an empiric question, not a political one. Ignoring Kinsey, there is extensive literature on this subject. The fact that some of you would prefer to ignore it is a much more politically motivated decision than accepting an established evidence base of epidemiologic research.

the "literature" and "research" I've seen that is being promoted out there by sexuality spectrum types is stuff evidence based medicine would do well to stay the heck away from.....

 

[surftheiop]

well even if it was real, I addressed how to handle it.....

I've had obviously gay patients ask me if I support gay marriage.(med mgt patients). I tell them no, that I do not. That doesn't mean I can't be a good psychiatrist for them.....

While your certainly entitled to your political views, I dont see how you can possibly consider yourself libertarian* to any extent if you hold this position.

*Unless your one of those libertarians who believe that government recognized marriage shouldn't exist at all, so therefore your against all forms of marriage, but you don't strike me as someone shooting from that angle.


Otherwise your just bastardizing the term libertarian to mean you actually just don't want to pay taxes for social programs, but you really don't accept the fundamental philosophy of libertarianism, your republican, not libertarian.

 

[vistaril]

While your certainly entitled to your political views, I dont see how you can possibly consider yourself libertarian* to any extent if you hold this position.

*Unless your one of those libertarians who believe that government recognized marriage shouldn't exist at all, so therefore your against all forms of marriage, but you don't strike me as someone shooting from that angle.


Otherwise your just bastardizing the term libertarian to mean you actually just don't want to pay taxes for social programs, but you really don't accept the fundamental philosophy of libertarianism, your republican, not libertarian.

Im not a pure libertarian....that is correct.

 

[billypilgrim37]

Since I keep saying there is important literature out there, here are two very good papers, both by the same author who gave the visiting grand rounds I was saying nice things about way above. I don't expect this to convince anyone who has already made their mind up, but for those of you still forming your opinions, this is pretty sound epidemiology through and through, and representative of the prevailing mood among the research community.

http://www.ncbi.nlm.nih.gov/pubmed/18339100
http://www.ncbi.nlm.nih.gov/pubmed/21783042

 

[vistaril]

Since I keep saying there is important literature out there, here are two very good papers, both by the same author who gave the visiting grand rounds I was saying nice things about way above. I don't expect this to convince anyone who has already made their mind up, but for those of you still forming your opinions, this is pretty sound epidemiology through and through, and representative of the prevailing mood among the research community.

http://www.ncbi.nlm.nih.gov/pubmed/18339100
http://www.ncbi.nlm.nih.gov/pubmed/21783042

neither of those say anything controversial or anything that I suspect anyone in here would disagree with. Not sure how useful they are either of course.

It was the spectrum of sexuality nonsense that I found ridiculous(and really outside of psychiatry)

 

[BobA]

Doesn't psychiatry deal with people's emotions? It's hard to imagine a more emotionally charged topic than sex. Just look at all the emotion this thread has dug up.

I don't claim to have the objective data that there is or isn't a spectrum of sexuality, but having a discussion about makes perfect sense to me if we're going to be dealing with people's emotional lives.

 

[vistaril]

Doesn't psychiatry deal with people's emotions? It's hard to imagine a more emotionally charged topic than sex. Just look at all the emotion this thread has dug up.

I don't claim to have the objective data that there is or isn't a spectrum of sexuality, but having a discussion about makes perfect sense to me if we're going to be dealing with people's emotional lives.

none of the above means psychiatry needs to have anything to do with(or take any position on) research into what % of gay thoughts the average heterosexual has

 

[BobA]

none of the above means psychiatry needs to have anything to do with(or take any position on) research into what % of gay thoughts the average heterosexual has

I don't think there is some monolithic entity "psychiatry" that is deciding to do one thing or another. Most of us are just individual physicians trying to understand and help people.

There's research out there on people's sex lives. Sex is highly emotional. I am a physician who specializes in, among other things, emotions. Therefore, it's important that I am willing to enter into a discussion about sex and sexuality. If the topic of research happens to be about whether there is a spectrum of sexuality or not, it's important to at least entertain that notion.

 

[vistaril]

I don't think there is some monolithic entity "psychiatry" that is deciding to do one thing or another. Most of us are just individual physicians trying to understand and help people.

There's research out there on people's sex lives. Sex is highly emotional. I am a physician who specializes in, among other things, emotions. Therefore, it's important that I am willing to enter into a discussion about sex and sexuality. If the topic of research happens to be about whether there is a spectrum of sexuality or not, it's important to at least entertain that notion.

I dont agree because even if there was a *true* spectrum of sexuality(and there isnt), how would that change management? it wouldnt.

 

[splik]

this is not about what % of "gay thoughts" (whatever that means) people have. but it is relevant to psychiatry to consider and understand that some patients may be feel conflicted regarding their sexuality. I recently had a patient who confided in me he was troubled by various same sex experiences and looking at gay porn. upon discharge (where he told me he would seek out christian counselling) he attempted suicide. he didn't come back to us so i am not sure why he attempted suicidal (in a potentially very lethal way) but seeing as he told me if he were gay (though he identified as 100% straight) he would kill himself, it is hard to conceive there was another main driving factor.

I have many many patients (surprisingly, more than I would expect) - who appear very conflicted re: their sexual orientation. Whether that is a driving factor in their presentation or a manifestation of psychosis/mood disorder I don't know. But it is there and whether I would like to or not, I can't really ignore it.

Not to mention those individuals who only have same sex experiences within the context of a manic episode. Have made a number of (usually female pts) who have had this, and then regretted it later.

This is not to forgot the countless patients I have seen in the clap clinic in a previous life who despite being 100% heterosexual, they have had same sex experiences which is why they have chlamydia, gonorrhea, syphilis etc. 'honest guv, i'm as straight as a ruler, i just have a bit of bum fun every now and again is all...' - or words to that effect.

I don't believe we are all x% gay and y% straight and I don't think anyone is suggesting that. But it is naive to think that people who identify as heterosexual do not or have not ever had same sex experiences, and vice-versa. There is a rich biological anthropological literature (not all of which I agree with) that looks at the different domains neurobiologically of sexuality- separating attraction, love, and attachment. We also know that particularly among women, those who identify as heterosexual earlier in the life course can experience same-sex attractions, relationships or sexual encounters later on (and not having been 'in denial' or 'repressed' these feelings/behaviors/experiences etc. Human sexuality is complex, and both the socially conservative (a polite term) and the LGBTQ community have politicized the issue ignoring the facts (which there are some) to suit their own agendas.

 

[Jorje286]

Maybe it's just me, but I find it a bit disturbing that a psychiatrist in training would just scoff at a topic like sex and sexual orientation so critical to human behavior and mental health, especially with his "bull**** test" which basically means "oh I feel 100% hetero, therefore there's no spectrum of sexuality" - I mean really, that's the definition of bull**** right there. Vistaril's arguments are incredibly unscientific. Empirical science knows better than that. Regardless of your views anyway, this is an extremely important topic and a healthy discussion on what makes people gay or straight or what makes them confused and depressed because of their sexual feelings is part and parcel of psychiatry.

 

[beethousand]

maybe it's just me, but i find it a bit disturbing that a psychiatrist in training would just scoff at a topic like sex and sexual orientation so critical to human behavior and mental health, especially with his "bull**** test" which basically means "oh i feel 100% hetero, therefore there's no spectrum of sexuality" - i mean really, that's the definition of bull**** right there. Vistaril's arguments are incredibly unscientific. Empirical science knows better than that. Regardless of your views anyway, this is an extremely important topic and a healthy discussion on what makes people gay or straight or what makes them confused and depressed because of their sexual feelings is part and parcel of psychiatry.

+1

 

[BobA]

I dont agree because even if there was a *true* spectrum of sexuality(and there isnt), how would that change management? it wouldnt.

Scenario: 65 yo M has been married to his wife for 40 years, but is depressed because he finds that he is attracted to men and women and he feels "trapped" in his marriage. How are we to help this man understand himself? Is his experience "normal" to some extent? Is his attraction to men a "disease" that must be cured? Clearly, having some knowledge about how humans experience sexuality could be helpful to this patient. And if you're not seeing these patients then you're not looking because they are everywhere.

"management" isn't just eliciting symptoms and popping out a pill. A vending machine could do that.

 

[vistaril]

Scenario: 65 yo M has been married to his wife for 40 years, but is depressed because he finds that he is attracted to men and women and he feels "trapped" in his marriage. .

then he is either gay or bisexual.....it's a conflict that he will have to deal with, and he's going to have to choose between his marriage or his sexual desire to be with men.

Telling him "it's ok, you just fall somewhere along the sexual spectrum" is completely useless and does nothing to help him.