Interrogating Pathology: An Explorationof Mental Distress and Lesbian, Gay and Bisexual Identities

The research was designed to examine the contemporary experiences of lesbian, gay and bisexual people with experience of mental distress, and the current discourses about lesbian, gay and bisexual identities within mental health services. The study offers a critical exploration of the impact and significance ofthe classification and declassification of homosexuality as a form of mental illness. Homosexuality was formally declassified from the American Psychiatric Association's Diagnostic and Statistical Manual in 1973, and from the World Health Organisation's International Classification ofDiseases, in 1993. The research explores this history contextually, in relation to contemporary mental health services, lesbian, gay and heterosexual service providers, and lesbian, gay and bisexual people with experience ofmental distress. The research analyses the contemporary engagement between psychiatry, medical discourses and lesbian, gay and bisexual identities, and analyses how ideas of lesbian, gay or bisexual pathology have continued in present discourses ofmental distress. The study examines contemporary processes ofdiscrimination and exclusion, and institutional processes ofpathologisation. It is argued that discourses ofpathology relating to lesbian, gay and bisexual identities have changed in the years following the declassification of homosexuality, but their continuation is made possible through contemporary discourses of health, wellbeing and individual responsibility. The research concludes that the history ofpathological thinking has a continuing influence in the ways that mental health services currently think about, and negotiate lesbian, gay and bisexual identities, and in the ways that lesbian, gay and bisexual people who use mental health services understand their own mental distress and sexual identities. Mental health services produce a specific context, and this context both problematises and individualises the visibility of lesbian, gay and bisexual identities. The research draws from theories ofthe closet, and in particular, the work ofEve Sedgwick and Steven Seidman in understanding how the closet shifts in significance over time and is contextually specific. The research also draws from the work of Sander Gilman in understanding the medicalisation of difference, and Michel Foucault and Nikolas Rose, in drawing together an understanding ofhow medical discourses interface with aspects of the selfand with social and cultural discourses ofsexuality and identity. The thesis is organised in chapters addressing pathologisation, coming out, and exploring the interface between mental distress and lesbian, gay and bisexual identities. The thesis is a feminist-influenced study involving individual semi-structured interviews with lesbian, gay and bisexual people with experience ofmental distress (n=23), and with lesbian, gay and heterosexual mental health service providers (n=18). Service user participants were drawn from mental health drop-ins, and service provider respondents were drawn from a mental health NHS Trust. The research took place in London, UK.EThOS - Electronic Theses Online ServiceGBUnited Kingdo