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Internalised homophobia refers to negative stereotypes, beliefs, stigma, and prejudice about homosexuality and LGBT people that a person with same-sex attraction turns inward on themselves, whether or not they identify as LGBT. The degree to which someone is affected by these ideas depends on how much and which ideas they have consciously and subconsciously internalised. These negative beliefs can be mitigated with education, life experience and therapy, especially with gay-friendly psychotherapy/analysis. Internalised homophobia also applies to conscious or unconscious behaviors which a person feels the need to promote or conform to cultural expectations of heteronormativity or heterosexism. This can include extreme repression and denial coupled with forced outward displays of heteronormative behavior for the purpose of appearing or attempting to feel "normal" or "accepted." Other expressions of internalised homophobia can also be subtle. Some less overt behaviors may include making assumptions about the gender of a person's romantic partner, or about gender roles. Some researchers also apply this label to LGBT people who support "compromise" policies, such as those that find civil unions acceptable in place of same-sex marriage.

Some studies have shown that people who are homophobic are more likely to have repressed homosexual desires. In 1996, a controlled study of 64 heterosexual men (half said they were homophobic by experience, with self-reported orientation) at the University of Georgia found that men who were found to be homophobic (as measured by the Index of Homophobia) were considerably more likely to experience more erectile responses when exposed to homoerotic images than non-homophobic men. Weinstein et al 2012 arrived at similar results when researchers found that students who came from "the most rigid anti-gay homes" were most likely to reveal repressed homosexual attraction. The researchers said that this explained why some religious leaders who denounce homosexuality are later revealed to have secret homosexual relations. They noted that "these people are at war with themselves and are turning this internal conflict outward." A 2016 eye-tracking study showed that heterosexual men with high negative impulse reactions toward homosexuals gazed for longer periods at homosexual imagery than other heterosexual men. According to Cheval et al. (2016), these findings reinforce the necessity to consider that homophobia might reflect concerns about sexuality in general and not homosexuality in particular. In contrast, Jesse Marczyk argued in Psychology Today that homophobia is not repressed homosexuality.

Researcher Iain R. Williamson, in his 1998 paper "Internalised Homophobia and Health Issues Affecting Lesbians and Gay Men" finds the term homophobia to be "highly problematic" but for reasons of continuity and consistency with the majority of other publications on the issue retains its use rather than using more accurate but obscure terminology. The phrase internalised sexual stigma is sometimes used in place to represent internalised homophobia. An internalised stigma arises when a person believes negative stereotypes about themselves, regardless of where the stereotypes come from. It can also refer to many stereotypes beyond sexuality and gender roles. Internalised homophobia can cause discomfort with and disapproval of one's own sexual orientation. Ego-dystonic sexual orientation or egodystonic homophobia, for instance, is a condition characterized by having a sexual orientation or an attraction that is at odds with one's idealised self-image, causing anxiety and a desire to change one's orientation or become more comfortable with one's sexual orientation. Such a situation may cause extreme repression of homosexual desires. In other cases, a conscious internal struggle may occur for some time, often pitting deeply held religious or social beliefs against strong sexual and emotional desires. This discordance can cause clinical depression, and a higher rate of suicide among LGBT youth (up to 30 percent of non-heterosexual youth attempt suicide) has been attributed to this phenomenon. Psychotherapy, such as gay affirmative psychotherapy, and participation in a sexual-minority affirming group can help resolve the internal conflicts, such as between religious beliefs and sexual identity. Even informal therapies that address understanding and accepting of non-heterosexual orientations can prove effective. Many diagnostic "Internalised Homophobia Scales" can be used to measure a person's discomfort with their sexuality and some can be used by people regardless of gender or sexual orientation. Critics of the scales note that they presume a discomfort with non-heterosexuality which in itself enforces heternormativity.

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