Fortschr Neurol Psychiatr 2018; 86(08): 469-476
DOI: 10.1055/a-0653-7177
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Wirkungen und Nebenwirkungen des Krankheitskonzepts „Homosexualität“

Effects and side effects of the disease concept “Homosexuality”
Lieselotte Mahler
1   Charite Universitätsmedizin Berlin, Psychiatrie und Psychotherapie
,
Götz Mundle
2   Zentrum für Seelische Gesundheit Oberberg City, Tagesklinik und Ambulanz
,
Martin Plöderl
3   Universitätsinstitut für Klinische Psychologie, > Christian –Doppler – Klinik, > Paracelsus Medizinische Privatuniversität, Bereich für Krisenintervention und Suizidprävention
› Institutsangaben
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Publikationsverlauf

eingereicht 06. Februar 2018

akzeptiert 15. Juni 2018

Publikationsdatum:
20. August 2018 (online)

Zusammenfassung

Die Diagnose Homosexualität wurde 1973 aus der DSM- und 1991 aus der ICD- Klassifikation gestrichen. Trotz dieser formalen Entpathologisierung zeigen sich bis heute negative Auswirkungen des im 19. Jahrhundert entstandenen Krankheitskonzeptes „Homosexualität“, welche in diesem Artikel aufgezeigt werden. Dabei wird auch auf die Wechselwirkungen von gesellschaftlichen und medizinischen Prozessen eingegangen. Im ersten Abschnitt des Artikels wird ein weltweiter Überblick über die rechtliche und gesellschaftliche Situation von sexuellen Minderheiten, deren Bandbreite von Gleichstellung über Ausgrenzung bis hin zur Verfolgung reicht, gegeben. Um den Zusammenhang zwischen gesellschaftlicher Stigmatisierung und pathologisierenden Theorien zur Homosexualität zu vertiefen, wird ein historischer Umriss des medizinisch-gesellschaftlichen Diskurs gegeben. Es wird aufgezeigt, welche wissenschaftlichen und gesellschaftlichen Fortschritte die Entpatholgisierung von Homosexualität notwendig machten, aber auch wie schwierig eine konsequente und nachhaltige Wirkung dieser Entpathologisierung zu seien scheint. Zudem werden Effekte anhaltender medizinischer und gesellschaftlicher Stigmatisierung auf die Gesundheit von LGB- (lesbian, gay, bisexual) Menschen aufgezeigt. Dazu werden wissenschaftliche Modelle erläutert, die das erhöhte Risiko für psychische Erkrankungen bei LGB- Menschen als Folge von verschiedenen Formen von Stigmatisierungen empirisch gut erklären können. In einem Ausblick weisen wir auf die anhaltend prekäre Situation von sexuellen Minderheiten weltweit hin und betonen die Wichtigkeit entstigmatisierender Positionspapiere und Leitlinien wie 2013 durch den Weltärztebund (World Medical Association).

Abstract

The diagnosis of homosexuality was removed from the DSM in 1973 and from the ICD in 1991. Despite this formal depathologization, negative effects of the concept of “homosexuality” as a disease, which stems from the 19th century, are still evident to this day and will be highlighted in this article. Furthermore, we also demonstrate the related interactions between social and medical processes. First, we give a global overview of the legal and social situation of sexual minorities, ranging from gender equality to marginalization and persecution. This is followed by a historical outline of the medical-social discourses in order to understand the connection between social stigmatization and pathologizing theories on homosexuality. Thereby, it can be demonstrated how scientific and social progress made the depathologization of homosexuality necessary, but also how difficult a consistent and sustainable effect of this depathologization appears to be. Additionally, we focus on the effects of persistent medical and social stigma on the health of LGB (lesbian, gay, bisexual) people. For this purpose, scientific models will be utilised in order to explain the increased risk of mental illness in LGB people arising as a direct result of various forms of stigmatization. In an outlook, we point out the ongoing precarious situation of sexual minorities in many parts of the world and emphasize the importance of destigmatizing polices and guidelines as carried out by the World Medical Association in 2013.

 
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