I-dystonic sexual orientation

Classification according to ICD-10
F66.1	I-dystonic sexual orientation
ICD-10 online (WHO version 2019)

According to ICD-10, the ego-dystonic sexual orientation describes the desire to have a different sexual orientation than the existing (and unambiguous) sexual orientation. However, the direction of sexual orientation itself is not viewed as a disorder - unless it is classified as “Disorders of sexual preference” according to F65.4 in section F65.

The subject of the diagnosis is solely the feeling of not being able to cope with the respective orientation or the desire to change it because of this. There is no exact equivalent in the DSM-IV . There it can be declared with 302.9 ("Sexual disorder not specified otherwise").

history

The diagnosis of ego-dystonic sexual orientation was introduced with the entry into force of the ICD-10, published in 1992. Until then, only homosexuality (since 1968) was listed as a neurotic disorder in the ICD , which was removed when the ICD-10 was introduced.

Definition and demarcation

"The gender identity or sexual orientation (heterosexual, homosexual, bisexual or prepubertal) is clear, but the person concerned wishes this to be different because of accompanying psychological or behavioral disorders and may undergo treatment to change them."

- ICD-10 F66.1 : 2006 version

The ICD-10 expressly contains the following note for the entire over-section F 66: "The direction of sexual orientation itself is not to be regarded as a disorder."

The ego-dystonic sexual orientation is a differential diagnosis to the following other diagnoses:

• F64.2 includes “ childhood gender identity disorder ” which is defined as pre-puberty only. It is not to be used in children and adolescents who are just about to reach puberty or who have already reached it.
• The “ transsexualism ” defined under F64.0 must also be differentiated from the ego-dystonic sexual orientation, with the desire to belong to the opposite sex .
• In the case of the "sexual maturation disorder" defined under F66.0, in contrast to this, there is uncertainty regarding gender identity or sexual orientation.

Regarding the terms "orientation" and "orientation" used here, it should be noted that experts are discussing whether a prepubertal orientation should be viewed as a sexual orientation or a sexual preference . A young classification concept assumes an age-related orientation, but calls it sexual orientation to differentiate . In the ICD-10, pedophilia as such is located under the code number F65.4 in section F65 as “disorders of sexual preference”.

Causes and effects

The heteronormativity of a society means that homosexuality is more often perceived as ichdyston than heterosexuality. Lesbians and gays, who perceive their sexual orientation as ego-dyston, have difficulties to accept what is perceived as realistic, homosexual orientation or to integrate it into their own personality. This disorder is attributed to the contrast to the socio-cultural background of a predominantly opposite-sex-oriented population and their frequently present, negative or even hostile attitude. In some cases there are still major hurdles to coming out that have to be overcome. As a result, there could be attempts to suppress and deny yourself or others, but these were of short duration and which then led to a categorical rejection of one's own sexual orientation with the desire to change it. Because of the social undesirability, which in some cases was perceived subjectively, many people who felt homosexual (for the time being) entered into heterosexual relationships. However, these remain (sometimes despite "technical" functional sexuality) due to a lack of sexual-structural compatibility without internal ( emotional ) satisfaction and cannot be sustained as a result. The repressed feelings are often brought to light again by the subconscious in various ways. In the worst case, there will be social and sociosexual withdrawal and the ensuing isolation and loneliness. Sexual contacts are often sought anonymously, also in the context of semi-professional prostitution, which is associated with a significantly increased risk for those concerned of becoming infected with sexually transmitted diseases or of falling victim to violent crimes and property crimes.

Positions of different social groups

Medical associations

Numerous professional associations such as the Professional Association of German Specialists in Psychiatry and Psychotherapy , the German Medical Association , the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) , the American Psychiatric Association and the American Psychological Association make it clear that the diagnosis of an ego-dystonic sexual orientation is not a backdoor may be in order to pathologize certain sexual tendencies, especially homosexuality. The associations essentially agree that homosexuality is not a disease, but a common form of human coexistence and does not require any therapy. However, members of sexual minorities could suffer psychological damage from experiences of discrimination. Psychiatric-psychotherapeutic treatment approaches are not the sexual desires deviating from the norm, but the conflicts that arise because of this disposition in connection with religious, social and internalized norms. Therapeutic goals are therefore primarily the prevention of psychiatric complications caused by external circumstances (such as discrimination). If, for example, people living homosexually have mental illnesses, these should be diagnosed and treated independently of homosexuality.

Homosexual associations

Associations that stand up for the interests of homosexuals, transsexuals or other sexual minorities do not see the problem of an ego-dystonic sexual orientation through the sexual orientation itself. Rather, the reactions of other people to the sexual orientation of an affected person are the cause of psychological problems. The Lesbian and Gay Association in Germany publicly warned against misusing the otherwise different diagnosis of an ego-dystonic sexual orientation to "pathologize homosexuality through the back door". The diagnosis concerns dealing with one's own sexual orientation and not its need for change.

Evangelical and Catholic Church

The two large, organized religious communities in Germany, the Evangelical Church in Germany and the Catholic Church, do not take a position on the subject of egodystonic sexual orientation as a psychological disorder . Regarding deviations from the heterosexual norm behavior , both faiths take morally theologically partially approving to very critical positions , but regard homosexuality and transsexuality , for example, not as illnesses, but as norm variants and deal with them as a purely moral and non-medical topic.

Evangelical Movement

In the evangelical movement , deviations from the heterosexual lifestyle are viewed as sin and strictly rejected with reference to the Bible . Contrary to the scientific mainstream , homosexual behavior is often understood as a mental disorder. Therapeutic treatment aimed at changing sexual identification is accordingly welcomed. The evangelical movement is one of many religious groups that morally oppose deviant sexual feelings, but one of the few who consider it a disease that can be treated. Since homosexuality is no longer regarded as a mental disorder in the international disease classifications, some representatives of this view use the category of ego-dystonic sexual orientation as the basis for recommending reparative therapies . In contrast to mainstream science and other social associations, the representatives of the evangelical movement see subjective dissatisfaction with deviant sexual behavior not as a result of social repression, but as an original consequence of deviating sexual feelings. Anyone who is affected by an ego-dystonic sexual orientation suffers from their deviant sexuality and therefore has to be supported in changing their sexual orientation if they wish. As a solution, therapists who are often close to the evangelical movement offer reparative therapies , which are rejected by the medical professional associations. The proponents of this school of thought start from the hypothesis that homosexuality is not genetically founded and innate, but rather is due to a combination of predisposition and various complex life experiences in the childhood and adolescence of those affected. These life experiences include origin, temperament, injuries from parents and siblings, family developments, sexual abuse, and social and cultural injuries. It is postulated that the medical associations wrongly removed homosexuality from the list of diseases. They also complain that the treatment of homosexuality is no longer learned in today's psychological training. Allegedly successfully treated patients refer to themselves as ex-gays , although there is now a group of ex-ex-gays who have "relapsed" patients. Well-known groups that take these positions include: a. Wüstenstrom and the German Institute for Youth and Society .

swell

1. ↑ ICD-10 Catalog of the World Health Organization (WHO), Chapter F66 [1] Accessed March 31, 2014
2. ↑ Frauke Koher, Katharina Pühl: violence and gender: constructions, positions, practices. Vs Verlag, ISBN 3-8100-3626-9 , p. 72.
3. ↑ Kurt Wiesendanger: Gays and Lesbians in Psychotherapy, Pastoral Care and Counseling: A Guide. Vandenhoeck & Ruprecht, 2000, ISBN 3-525-45878-9 , p. 20.
4. ^ Klaus M. Beier, Hartmut AG Bosinski, Kurt Loewit: Sexualmedizin. Urban & Fischer bei Elsevier, 2005, ISBN 3-437-22850-1 , p. 14f.
5. ^ Kurt Wiesendanger: Opinion on polarity reversal therapies for homosexuals from a psychological and psychotherapeutic point of view. 2005.
6. ^ Statement of the Society on the Scientific Investigation of Para-Sciences on Homo-Healing Advertising at Universities, accessed on March 30, 2014.
7. ↑ Position Statement of the American Psychiatric Association: Therapies Focused on Attempts to Change Sexual Orientation Reparative or Conversion Therapies. March 2000, accessed March 30, 2014.
8. ↑ Commentary by the Federal Association for Gay Healthcare (BASG) on fundamentalist organizations and their therapies. 2005, accessed March 30, 2014.
9. ↑ Statement of the professional association of German psychologists on Christian sexual counseling by Wüstenstrom eV, therapy of homosexuality. 2006, accessed March 30, 2014.
10. ↑ ^{a b} DGPPN statement archive link ( memento of the original of March 30, 2014 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved March 30, 2014 
11. ^ Statement of the professional association of German specialists for psychiatry and psychotherapy on the public discussion about "conversion therapies" or "reparative therapies" for homosexuality.
12. ↑ Press release of the German Medical Association World Medical Association: Homosexuality is not a disease Resolutions of the 64th General Assembly of the World Medical Association Archive link ( Memento of the original from March 5, 2014 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved March 30, 2014 
13. ↑ Reparative therapy, conversion therapy, etc .: The choice of words of the DIJG What do the words mean? [2] Retrieved March 30, 2014
14. ↑ Lesbian and Gay Association (LSVD). Mission: Reconnaissance [3] Retrieved March 30, 2014.
15. ↑ Lesbian and Gay Association in Germany: Mission Enlightenment. [4] Retrieved March 31, 2014
16. ↑ Evangelical Church in Germany: Homosexuality Archive link ( Memento of the original from August 30, 2011 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved March 30, 2014 
17. ^ Catechism of the Catholic Church: Homosexuality and Chastity. [5] Retrieved March 31, 2014
18. ^ German Institute for Youth and Society [6] Accessed on March 30, 2014

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