Non-heterosexuality: Contemporary Psychiatric Perspectives

非異性戀：當代精神醫學觀點

10.29478/TJP.200906.0003

賴孟泉(Meng-Chuan Lai)；高淑芬(Susan Shur-Fen Gau)；丘彥南(Yen-Nan Chiu)

性特質 ； 同性戀 ； 非異性戀 ； 發展心理學 ； sexuality ； homosexuality ； non-heterosexuality ； developmental psychology

台灣精神醫學

23卷2期（2009 / 06 / 01）

104 - 119

英文

雖然自1973年始，同性戀(homosexuality)已經自精神醫學診斷中「去病理化」，但人類社會對於非異性戀(non-heterosexuality)之性傾向、性行為、與性認同外顯或內隱的偏見與歧視仍持續存在。這些偏見泰半源自社會中具優勢地位的異性戀主義(heterosexism)價值體系，更因人們對於性特質(sexuality)之多樣性及多元本質的誤解而被增強。在過去數十年間，經由許多精神健康專業工作者、心理學家、社會科學家、生物學家、以及不同學門之性別研究者的致力探究，已累積許多對於非異性戀的暸解，而這些知識將能增進我們對於人類性特質的理解，並可能藉之降低長期以來對於非異性戀的偏見與歧視。本文以精神醫學觀點，回顧目前關於非異性戀議題的知識。首先簡介非異性戀的定義與概念架構，並摘要整理人口學資料及生物學發現；其次闡述四項重要的心理學議題，包括認同發展、異性戀主義及內化同性戀恐懼(internalized homophobia)、精神健康及自殺議題、以及同性伴侶關係；最後簡要回顧與非異性戀個體及其家人進行心理治療工作之議題。本文結論向臺灣精神健康工作社群提出四項關於非異性戀議題之建議：1.致力增進對於臺灣非異性戀個體的正確認識與理解；2.採用肯定式立場(affirmative stance)以確保進行不帶偏見、且不具傷害性的臨床工作；3.將這些知識與觀點傳遞予其他健康照護工作者；4.支持並促進臺灣非異性戀個體及社群在法律上所應接受的平權對待。

Background: Although homosexuality has long been de-pathologized from psychiatric diagnoses since 1973, explicit and implicit discrimination toward non-heterosexuality still exists. Most biases are rooted deeply in the prevailing heterosexist value system, yet they are also highly strengthened by misunderstandings toward the diverse and multi-dimensional nature of human sexuality. In the past decades, mental health professionals, psychologists, social scientists, biologists and gender researchers from various disciplines have contributed greatly to the understanding toward non-heterosexuality. The accumulated knowledge is bound to improve our understanding toward human sexuality, and hopefully to reduce the long-standing biases and discriminations toward non-heterosexuality. Method: We reviewed current literature (mainly from Western studies) about non-heterosexuality from psychiatric perspectives. Results: First, we introduced the definition and conceptual framework for non-heterosexuality, along with brief summaries of demographics and biological underpinning. Second, we addressed psychological issues, including identity development, heterosexism and internalized homophobia, mental health and suicidality, and same-sex committed relationship. Third, we gave a brief overview toward psychotherapeutic issues on working with non-heterosexual individuals and their families. Conclusion: We suggest our-Taiwanese mental health colleagues to achieve a better understanding toward non-heterosexuality, to do non-biased and non-harmful clinical practices based on affirmative stance, to distribute knowledge to all health care providers, and to promote legal equality for Taiwanese non-heterosexual people.

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