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Letters to the EditorFull Access

Etiology of Homosexuality?

Letters to the Editor

Readers are invited to submit letters of not more than 350 words for possible publication. Psychiatric News reserves the right to edit letters and publish them in any of its formats—print, electronic, or other media. Receipt of letters is not acknowledged. Letters should be emailed to [email protected]. Clinical opinions are not peer reviewed and thus should be independently verified.

I am writing in response to the special report on gender dysphoria by Jack Drescher in the June issue.

It comes to me that the phenomena of the majority of transgender children maturing to be cisgender homosexual adults fits with the dynamics of the Oedipal Complex described by Freud. That is, when a child is erotically attracted to one parent, the child experiences conflict or even threat from the other parent who is experienced as a rival. To resolve this conflict, the child identifies with the rival parent and assumes that parent’s gender role in order to seek safety.

Within this dynamic, a homosexual child attracted to the parent of the same sex might assume the gender role of the opposite-sex parent to achieve safety and avoid conflict. As this child matures and proceeds through Erickson’s stage of identity formation, the defensive gender role might no longer fit, and the child reverts to the gender identity of their sex assigned at birth. ■

MICHAEL DELOLLIS, M.D.

Philomath, Ore.

Response From Jack Drescher, M.D.:

Dr. DeLollis is not the first psychoanalyst to speculate about relationships between gender dysphoria and the development of homosexuality. The late Richard C. Friedman did so in the book Male Homosexuality: A Contemporary Psychoanalytic Perspective more than three decades ago.

Friedman believed some types of homosexuality were prenatally caused by deficient androgen exposure in the womb, causing a subsequent disturbance in the development of a masculine gender identity in birth-assigned boys. Homosexuality, he believed, resulted from a “feminine or unmasculine self-concept” independent of family constellations, declaring “A strong case can be made for the hypothesis that a feminine or unmasculine self-concept during childhood is not only associated with the emergence of predominant or exclusive homosexuality in men, it is the single most important causal influence.”

Friedman further theorized that this condition then corrected itself in adolescence, the affected individual’s gender identity then aligning itself with the birth-assigned sex, although an attraction to the same sex remained as a residual effect. In other words, Friedman believed that a gay man’s attraction to men was a feminine trait that grew out of early gender dysphoria and that this residual same-sex attraction persisted into adulthood, even after the gender dysphoria resolved.

However, as I have written in the book Psychoanalytic Therapy and the Gay Man and a paper in The Annual of Psychoanalysis, Friedman and Dr. DeLollis illustrate the ability of psychoanalytic theorists using gender binaries to explain everything yet prove nothing.

For the record, the ways in which any gender identity, cisgender or transgender, develops remains a mystery still to be resolved. ■