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Hepple.J, 2024, Exploring homophobia and internalized homophobia through a CAT lens, Reformulation 57, p.18-22
ACAT 2023 Winchester conference workshop presentation summary
Jason Hepple, CAT Psychotherapist and Trainer
Background and Introduction
These thoughts represent a very personal reflection on the subject of homophobia in relation to gay men in the UK, having grown up as a gay man in the sixties and seventies in the south-west of England. I was at medical school in Oxford when the AIDS pandemic hit the news in the mid-eighties. Initially the press labelled it the ‘4H disease’, these stigmatised minority groups being Haitians, Homosexuals, Haemophiliacs and Heroin users (Marc et al 2010). Not being ‘out’ at the time, as I was only then beginning to come to terms with a sexuality I had been in denial over due to my experiences at school, it was shocking to be in one of the stigmatised ‘H’ categories.
The internalised shame sourced from England’s then widespread suspicion and ridicule of gay men was suddenly fuelled by the news that a deadly sexually transmitted pandemic was being spread by ‘them’. This uncovered the annihilating reciprocal roles underlying homophobia that I will explore in this article. The John Hurt narrated ‘AIDS Monolith’ UK public information film released in 1987 (National Archives link), added apocalyptic images of an enormous tombstone, scouring winds and discarded white lilies: ‘(AIDS)… is a deadly disease and there is no known cure…Don’t die of ignorance’, was the take home message, but if you had been a sexually active gay man prior to 1987, the film came across as a death sentence already served. Sadly, for some people I knew, it was.
I was fortunate to have the support, at the time, of some colleagues and the LGBTQ+ charity Oxford Friend. We worked together surviving the illness and losses of some of our members while trying to give out clear and accurate health information and advice. We organised one of the first LGBT health conferences at the John Radcliffe Hospital in the late eighties. Outrage at the stigmatisation and alienation engendered by the way AIDS was first presented as a ‘minority’ disease was tempered by the fact that gay men were more at risk and that denial was a dangerous strategy. AIDS uncovered the ferocity of some of the reciprocal roles that has always been underlying homophobia throughout history, but also pulled us (and by that, I mean the whole LGBTQ+ community) together in order to survive.
I will explore these reciprocal roles and procedures using the CAT lens: Other to Self, Self to Other and Self to Self (internalisation).
The Underlying Reciprocal Roles of Homophobia
The first reciprocal role encapsulates a dilemma then is applicable across the whole LGBTQ+ spectrum: Either admired / accepted as cis / straight / normal or despised and rejected if trans / gay / queer.
Growing up as a gay man in the seventies, for me there was no real option of coming out at school. Working class parents did not consider that their child may not be conventional. At school, to be labelled ‘queer’ was an irreversible stigmatisation that meant that the ‘in-crowd’ had a pack duty to keep well away from you unless you were being actively bullied or attacked. The ridicule and bullying were exaggeratingly sexualised (as were portrayals of gay men in the media). Gay sex (which defined ‘queers’ above and beyond any other attribute the individual may have) was filthy and abhorrent. ‘Queers’ were caricatured as akin to rapists and child abusers in that no one would be safe in their company. These themes played out royally in the school changing rooms where the vulnerability of undressing in public heightened the polarity of ‘them’ and ‘us’.
It is only a short step from here that leads to frenzied ‘queer bashing’, murder and at many times in history, widespread rounding up and annihilation. For example, in addition to the millions of Jews, ethnic and religious minorities, and disabled people who were murdered in Nazi death camps, around 50,000 gay men were charged with homosexuality in Nazi Germany and thousands died in concentration camps (Schwartz, 2021), with a high rate of suicide (Cuerda-Galindo et al, 2017).
‘Thank God for AIDS’ on the T-shirt of a teenage girl in a 1988 photograph, was made into an iconic poster exemplifying the power and horror of the abusive top roles of homophobia that AIDS had re-fuelled (Gran Fury Collection, 1988). While some ‘campness’ had been allowed on mainstream media in the seventies in the form of boundary stretching comedians and presenters, the onset of AIDS appeared to encourage the ‘man in the street’ to think that such tolerance had allowed the underlying sickness of the whole ‘gay’ thing to get of control and that it was time to take a few mighty steps backwards.
The introduction of Clause 28 stating that a local authority ‘…shall not intentionally promote homosexuality or publish material with the intention of promoting homosexuality’ or ‘promote the teaching in any maintained school of the acceptability of homosexuality as a pretended family relationship’, (Local Government Act 1988 (c. 9), section 28), brought these themes into legislation in the UK. If you can’t be normal, shut up and stay in the closet or face the consequences. It wasn’t an easy time to be gay…
Before looking at the procedures / survival strategies that people might use to deal with this kind of oppression using an Other to Self and Self to Self lens, I will pause to ask the question: Why?
It seems that a terrible part of human nature is to form gangs or tribes and to project unwanted parts of the self (vulnerability, sexuality, shame, guilt) on to other groups and to seek to ridicule, defeat and ultimately annihilate them. It takes little analysis of human history to see this played out again and again in the past, present and the likely future, with unimaginable consequences. What is, however, particular about homophobia?
It is possible to hide being gay, so making being gay a less visible aspect of diversity. Apart from some prevalence of ‘Queer Club Culture’ in UK cities between the wars in the 1920s and 1930s, Gay men in the UK did not have much of a history of forming organised groups or a ‘community’ until, I think, homosexuality was decriminalised in 1967 (that was only for private homosexual acts) – for example, the Gay Liberation Front was not founded until 1970. So, from Henry VIII’s introduction of the Buggery Act in 1553 (punishable by death), gay men would have survived by living double lives and in constant fear of exposure and attack.
Gay sexuality has been defined in history by a focus on genital sexual acts, particularly anal sex. Gay men are ‘buggers’ and this act alone, which they may or may not have ever engaged in, is seen by the ridiculing and abusing other as their raison d’être. So, homophobia may be related to projections of shame and self-doubt about one’s own body and sexual desires.
Rachel Pollard has developed the dialogic idea of ‘insideness’ ‘… (that) presumes that there is such a thing as common humanity, that there is an essential similarity between any two human beings regardless of how great the differences between them might be… we can potentially know other people from our “interior” knowledge of ourselves’ (Pollard, 2008, p. 206). Conversely, if there is a part of our physical makeup that we wish to disown it may be safer to project it into others in order to bring them down to earth and to separate ‘us’ from ‘them’. This ‘grotesque realism’ (Bakhtin, 1941) exaggerates and mocks the vulnerability and baseness of the body and its functions. It may be that this mechanism is the source of the content of much oppressive bullying including xenophobia, disablism, sexism, transphobia, ageism and homophobia.
It is not surprising that many gay men in the UK of my generation made an active decision to stay in the ‘closet’ for fear of attack and discrimination. Many gay men I took help-line calls from in the 1980s, had lived for decades in unhappy straight marriages and had kept their sexuality firmly buried. The oldest person who phoned with a ‘coming out call’ was in his nineties. This survival strategy alienates ‘like’ others, as association with them would risk exposure. Sometimes it may be easier to stay in the in-crowd and tacitly or actively engage in the sexualised bullying to protect the vulnerable self.
In a study of Australian gay men, Thepsourinthone et al (2020) found a correlation between internalised homophobia (shame at one’s own sexuality) and the perceived need to conform with masculine norms and to maintain distance from other LGBT people. They link this to the poor mental health outcomes experienced by gay men and suggest that distancing from like others may contribute to mental ill-health.
Semlyen et al (2016). in a metanalysis of studies looking at the mental health of LGB adults, showed that LGB people were around twice as likely to report poor mental health than heterosexual controls. This was most marked in the over 55 and under 35 age groups who may have less contact with the LGBT community. The Sonewall LGBT health report (2018) documents significantly higher levels of anxiety, depression and use of substances and alcohol amongst LGBT people in the UK. Poor mental health can lead to increased drug and alcohol usage and ultimately an increase in suicidality. Although completed suicide data is not routinely correlated with LGBTQ+ status, Kidd et al (2023) report that LGB people in the UK are more likely to report suicidal thoughts and non-suicidal self-harm than heterosexual controls and that this may be linked to lifetime bullying and homophobic discrimination. They note no improvement over time despite seeming improvements in societal attitudes to LGBTQ+ people.
I came across many gay men who, unable to maintain the pretence of conformity, ‘went underground’ and expressed their sexuality in hidden places: outdoor ‘cruising’ spots, public toilets and nightclub back-rooms and saunas. This could involve sexualisation of some of the unmanageable feelings from internalised homophobia in the form of sado-masochistic roleplay and exaggeration of gender stereotypes (for example, dominant and submissive role identification). While not unhealthy and potentially liberating in a non-abusive and consensual sexual relationship, some ‘underground’ activity could leave gay men vulnerable to abuse, exploitation and / or arrest.
As the years pass the survival strategies that we have used to deal with the world of others begin to turn on the self as Self to Self reciprocal roles. Conditional acceptance of the self for being compliant with societal norms is polarised, in a dilemma, into self- hatred for the rebellious / subversive / secret / sexual part of the self. The internalised sexualised ridicule and bullying presents as self-disgust and shame, as well as guilt for one’s own homophobia turned on others in an attempt to stay in the ‘in-crowd’. As time passes, ageing can affect the person’s perceived attractiveness and ability to find sexual partners leading to further self-disgust (internalised ageism) and often depression, self-neglect and isolation.
Into the Present
I have carried out this analysis based mainly on my experience of gay men in the UK in the 1980s and 1990s during the peak of the AIDS crisis. There are some hints from the research cited above that, despite seeming improvements in societal attitudes, the effects of internalised homophobia on mental health and wellbeing may not be improving (Kidd et al, 2023).
It is great to see teenagers able to express their LGBTQ+ selves at school and, from my experiences, the attitudes of many younger people have changed towards acceptance and even celebration of diversity. But is that true for all teenagers in all schools? Do friends necessarily negate the homophobic attitudes of say a parent and grandparent? How many LGBTQ+ people remain hidden and afraid?
The internet and social media have made dating easier but have taken it out of the context of a supportive community. There is no need to go to a café, pub or club to find a date, but dating apps can lead to isolated, sometimes exploitative, sexual encounters that risk replicating the negative patterns of the ‘underground’ scene of the past. Having a social media presence also potentially exposes oneself to 24 hour a day negative commentary and bullying.
As researchers suggest, feeling part of a diverse and supportive sub-culture may be the most important protective factor. While societal attitudes may be moving slowly in the right direction in the UK, this is not at all true for the whole of the world or even for parts of the UK.
In my experience, homophobia is still lurking just around the corner: Someone shouts: ’Queer’ from a passing car, sniggering breaks out in the barbershop, someone tips a drink over you in a crowded pub with the words: ‘Mind your backs, lads.’
It only takes the oppressive attitudes of one person to cause sustained and cumulative damage to the self-esteem of an LGBTQ+ person.
An important lesson from the time of AIDS may be that it is still going to be important to stick together in order to survive and flourish.
Acknowledgement
Many thanks to Stuart Smith for advice on this paper.
References
AIDS Monolith. UK Public Information Filler (1987) https://www.nationalarchives.gov.uk/films/1979to2006/filmpage_aids.htm
Bakhtin, M. (1941) Rabelais and His World. Trans. Hélène Iswolsky. Bloomington: Indiana University Press, 1993.
Cuerda-Galindo, E., López-Muñoz, F., Krischel, M., & Ley, A. (2017). Study of deaths by suicide of homosexual prisoners in Nazi Sachsenhausen concentration camp. PloS one, 12(4),e0176007. https://doi.org/10.1371/journal.pone.0176007
Gran Fury Collection. (1988). ‘Thank God for AIDS. This is to Scare You’. (https://digitalcollections.nypl.org/items/510d47e3-537f-a3d9-e040-e00a18064a99
Hickson, F., Davey, C., Reid, D., Weatherburn, P., Bourne, A. (2016). Mental health inequalities among gay and bisexual men in England, Scotland and Wales: a large community-based cross-sectional survey. Journal of Public Health. 39, (2), 266–273. doi:10.1093/pubmed/fdw021
Kidd, G., Marston, L., Nazareth, I. et al. (2023). Suicidal thoughts, suicide attempt and non-suicidal self-harm amongst lesbian, gay and bisexual adults compared with heterosexual adults: analysis of data from two nationally representative English household surveys. Soc Psychiatry Psychiatr Epidemiol. https://doi.org/10.1007/s00127-023-02490-4
Marc, L. G., Patel-Larson, A., Hall, H. I., Hughes, D., Alegría, M., Jeanty, G., Eveillard, Y. S., Jean-Louis, E., & National Haitian-American Health Alliance (2010). HIV among Haitian-born persons in the United States, 1985-2007. AIDS (London, England), 24(13), 2089–2097. https://doi.org/10.1097/QAD.0b013e32833bedff
Schwartz, M. (2021). "Homosexuelle im modernen Deutschland: Eine Langzeitperspektive auf historische Transformationen" [Homosexuals in Modern Germany: A Long-Term Perspective on Historical Transformations]. Vierteljahrshefte für Zeitgeschichte (in German). 69 (3): 377–414. doi:10.1515/vfzg-2021-0028
Semlyen, J., King, M., Varney, J. et al. (2016).Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys. BMC Psychiatry 16, 67. https://doi.org/10.1186/s12888-016-0767-z
Stonewall (2018). LGBT in Britain: Health. [Online report]. Retrieved from: https://www.stonewall.org.uk/system/files/lgbt_in_britain_health.pdf
Thepsourinthone, J., Dune, T., Liamputtong, P., & Arora, A. (2020). The Relationship between Masculinity and Internalized Homophobia amongst Australian Gay Men. International journal of environmental research and public health, 17(15), 5475. https://www.mdpi.com/1660-4601/17/15/5475
Local Government Act 1988 (c. 9), section 28. Accessed 26 September 2023 on opsi.gov.uk
Pollard, R. (2008). Dialogue and Desire. Michael Bakhtin and the Linguistic Turn in Psychotherapy. UKCP, Karnac Series.