Social Aspects of Homosexuality.

Social anthropologists have found that homosexuals and homosexual acts have occurred in all civilizations without exception. The reaction to homosexuality has varied from severe condemnation (as in our own society), through indifference, to acceptance, and in a few cases, even to glorification, where the high priests of a religious cult have been exclusively homosexual. No matter what the reactions have been, no civilization has succeeded in stamping it out (Westwood, 1952). In Great Britain homosexual behaviour has been recorded in every century and under every regime. It has appeared in every generation and in every class of society. It is to be found in every section of the community to-day, from those possessing a high degree of intelligence to the "dullest oafs", as the Wolfenden Report (1957) puts it. This is often accepted intellectually, yet people are often surprised by its implications. It means, of course, that some criminals are homosexual, and so are some policemen; some patients are homosexual, and so are some doctors; some spies are homosexual, and so are some politicians. Very little is known about the causes of homosexuality, and only a little progress has been made in its treatment. Broadly speaking there are four ways of treating the homosexual condition. First there is the administration of oestrogens. This can reduce the strength of the sex drive, but it has been found that it has no effect whatever on the direction of the sex drive, and will not turn a homosexual into a heterosexual. It will merely help a man to keep his homosexual desires under control. A similar form of treatment is castration, which has been used in Denmark and Norway (Bremer, 1959). The effects are the same as for oestrogen treatment-it reduces the sexual activity but the fundamental sexual direction remains unchanged. A third form of treatment is aversion therapy for which startling success has recently been claimed (James, 1962), but very little work has been done on homosexuality so far, and the success rate of aversion therapy cannot be judged until a careful long-term study of the results has been carried out. The fourth and most usual way of treating homosexuals is by some form of psychotherapy. It is extremely difficult to find out how successful this is. Our only sources of information are the records kept by individual psychiatrists, and inferences drawn from these records are hazardous at best. Furthermore, psychotherapy is essentially an intellectual process. This means that there are certain minimum requirements before the treatment can work. There is a minimum level of intelligence and there must also be a certain degree of motivation-the patient has got to be interested in the treatment, and at least think some kind of cure is possible. If a man goes to a psychiatrist two or three times and then defaults, the psychiatrist can legitimately claim that this is not a failure of treatment, because the treatment had hardly started. But in attempting to judge the total success rate of psychiatric treatment, we should have to include not only those who gave up treatment, but also those who would not co-operate with a psychiatrist even if you paid them. All we can say at present is that the little evidence available shows that psychiatric treatment has a low success rate and we do not know if it is more effective than the available alternatives. Of course another alternative is to do nothing; for some men go through a period of homosexual behaviour and then just give it up without receiving treatment of any kind. Even if the success rate of psychiatric treatment has been underestimated, there are certainly not enough psychiatrists to treat the many thousands of homosexuals, and they have more urgent and more important cases to treat. Medical research into the