Gay or Straight?

Abstract

Abstract Issues pertaining to sexual orientation, while always deeply personal, are most profoundly constructed along traditional lines by cultural factors. The dilemma-gay or straight-appears most frequently in treatment in its interrogative form: “Am I gay or am I straight?” The question is imbued with an urgency considered self-evident by the patient and the therapist. Why? Why do we really want to know? What can the answer mean for the patient? What does it mean to the therapist? What does the necessity of an answer illuminate about Western notions of sexuality? Inherent in this paper's thesis is the supposition that we are unable to clinically comprehend what we do not culturally comprehend. The cultural, like the psychological, is rarely manifest; it must be made visible before it can become comprehensible. Three approaches come to mind: the first method, most familiar to psychoanalysts, is the analysis and deconstruction of language; the second, most familiar to anthropologists, is the contrast and comparison with other cultures; the third, an integration between the cultural and the psychological, can be seen within the developing metapsychology of psychoanalytic theory. The way we use the question of sexual orientation with patients beautifully illustrates the importance of an integrative comprehension. A case vignette is used to illustrate these points.