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疾病概念“同性恋”的影响与副作用

[Effects and side effects of the disease concept "Homosexuality"].

作者信息

Mahler Lieselotte, Mundle Götz, Plöderl Martin

机构信息

Charite Universitätsmedizin Berlin, Psychiatrie und Psychotherapie.

Zentrum für Seelische Gesundheit Oberberg City, Tagesklinik und Ambulanz.

出版信息

Fortschr Neurol Psychiatr. 2018 Aug;86(8):469-476. doi: 10.1055/a-0653-7177. Epub 2018 Aug 20.

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.

摘要

1973年,同性恋诊断从《精神疾病诊断与统计手册》(DSM)中删除,1991年从《国际疾病分类》(ICD)中删除。尽管有这种正式的去病理化,但源于19世纪的“同性恋”作为一种疾病的概念所产生的负面影响至今仍然明显,本文将对此进行重点阐述。此外,我们还展示了社会与医学进程之间的相关互动。首先,我们对性少数群体的法律和社会状况进行全球概述,范围从性别平等到边缘化和迫害。接下来是医学 - 社会话语的历史概述,以便理解社会污名化与同性恋病理化理论之间的联系。由此可以证明,科学和社会进步如何使同性恋去病理化成为必要,但这种去病理化的持续一致和可持续的效果似乎又是多么困难。此外,我们关注持续存在的医学和社会污名对女同性恋、男同性恋、双性恋(LGB)人群健康的影响。为此,将运用科学模型来解释由于各种形式的污名化直接导致的LGB人群中精神疾病风险增加的情况。展望未来,我们指出世界许多地区性少数群体目前岌岌可危的状况,并强调世界医学协会在2013年实施的消除污名化政策和指导方针的重要性。

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