t was only recently the US Supreme Court removed sodomy laws from the US. Why it took so long goes back to the puritanical roots of our nation.
For this progressive change I am grateful, but there are other areas especially surrounding sexual desire, that still remain too volatile for most mental health professionals to deal with. Regrettably, this puts the patient in the position of being victimized.
This problem is especially true for homosexual men attracted to boys. The issue in question is whether the medical provider is responsible for the behavior of these men, if treating their depression means increasing their sex drive and assisting them in feeling better about their sexual orientation. Is the provider than responsible if the patient engages in illegal behavior with children? This is the crux of the ethical dilemma.
The issue of treating homosexual men attracted to boys is a labyrinth of dead ends and false starts. Many medical insurance policies do not pay for the treatment of so called �sexual disorders.� When the problem is �depression� however, and the contributing factor is pedophobia, how can the depression be alleviated without addressing the pedophobia?
In an article � A Pre-emptive Strike in Mental Health Treatment� I relate my own experience as a homosexual male attracted to boys, trying to find treatment for depression resulting from the stigma and discrimination surrounding my attraction to boys.
www.geocities.com/proudtolove2001/Pre-empitve-attack.html
I was diagnosed as a pedophile because of my attraction to boys by Dr. Ronald O. Powell, Ph.D. in 3/4/03 at Group Health Cooperatives Central Behavioral Health Service. This was not a new diagnosis, and I had been receiving treatment at Group Health for �depression� related to pedophobia since 1994.
What is new and unique was the fact that Dr. Powell wanted me to receive specialized treatment for pedophilia because as my psychiatrist, Dr. Abramson explained in her notes dated 3/27/03:
�Pt. Accepted frame that concern is state of arousal that could lead to increased risk of potential victimization.� The note goes on to say �Pt. Recognizes Dr. Powell has professional ethical obligation to address risk.� It is precisely this risk that I am addressing.
Contrary to what Dr. Abramson says, I do not recognize that Dr. Powell has any professional ethical obligation to address the risk of my being �attracted� to boys by his recommending specialized treatment. I can find no ethical standard in the mental health profession that relates to the treatment of homosexual men who are attracted to boys. Mandatory reporting laws for illegal behavior certainly do exist, but these laws do not address thoughts and fantasies that are the focus of this article.
The treatment of depression because of the stigma surrounding adults attracted to minors is a new and unexplored ethical arena in the mental health profession. However, such treatment can no longer be swept under the carpet by demanding the patient seek specialized treatment for pedophilia, when it may be the doctor's personal prejudice and concern over personal liability that's at the heart of the problem.
Until the advent of the internet most boy-lovers remained deeply entrenched in the closet. Consequently, the false beliefs and stigma surrounding homosexual men attracted to boys went unchallenged. One such false belief is that boy-lovers cannot control their behavior. Another false belief is that we all either have or will have sex with boys.
Many mental health professional still believe and respond to their patients based on these false beliefs. A comprehensive list of the false beliefs held by most mental health professionals can be found on the �Male Homosexual Attraction to Minors Information Center�
www.mhamic.org/myths/mythsintro.htm
The internet has allowed many homosexual men attracted to boys to form anonymous communities for emotional support. Consequently, more boy-lovers ( men attracted to boys) are now increasingly less likely to tolerate the pedophobic bigotry they encounter in the mental health profession.
What triggered this article was a recent telephone call from a friend. He is also attracted to boys. Like myself he is also depressed. His doctor prescribed a new anti-depressant that had good results and brought greater happiness into his life. My friend expected his doctor would be pleased. This was not the case.
When Jim related a positive change in mood to his psychiatrist the doctor became upset and expressed concern that with this new energy my friend with his new energy could now do something illegal with boys. Like my previous therapist this doctor was in a personal ethical crisis for which his profession had not prepared him.
I would be grateful if anyone could show me an article issued either by the American Psychiatric Association or the American Psychological Association dealing with ethical and/or legal standards in the treatment of depression in homosexual men attracted to boys.
There is an article titled �American Psychiatric Association holds symposium on removal of paraphilias from DSM,� that I found valuable.
www.mhamic.org/newsapasymp.htm
Part of the article reads:
�According to CNS, Moser and Kleinplatz argued that people whose sexual interests are unusual or culturally forbidden should not necessarily be labeled as mentally ill. Because different societies stigmatize different sexual behaviors, and research cannot distinguish people with paraphilias from those with more common sexual feelings, there is no reason to diagnose the former as psychologically unhealthy.�
This is one of the few articles that deals with not only behavior but also sexual �interests� and it is sexual interest not behavior, and its relationship to the treatment of depression that is the focus of this article.
Certainly there are mandatory reporting laws which require that legal authorities be notified if a provider believes a patient is involved in sexual behavior or cannot control their behavior around children. However, simply having romantic feelings for boys does not fall into that category.
The fear being expressed by providers to their patients leaves many of us scared and enhances our anxiety. Where will the therapist draw the line between viewing us as simply people with unique sexual desires as opposed to people who need to be reported to the police because of our desires?
It appears that in order to avoid confronting this new ethical crisis in an open and responsible manner some in the mental health profession have been dealing with this personal crisis by deliberately destroying the sex drive of homosexual men attracted to boys with anti-depressants that have the side effect of destroying libido. Paxil and Prozac are good examples.
I am not advising anyone to stop taking these medications. I am, however, challenging the medical profession to ask itself, �Are you using these medications to help your patient, or are you using these medication to alleviate the conflict you feel by providing support for our sexual orientation which you feel �could� lead to illegal behavior? This conflict is often inseparable from the treatment of depression in homosexual men attracted to boys.
As a homosexual male attracted to boys I will no longer tolerate treatment for depression that assumes I am a danger to children because of my attraction to boys. I will no longer tolerate statements like those made by Dr. Ronald Powell such as � It is not appropriate for me to help him feel comfortable with his sexual orientation as it may be leading to his depression and anxiety.�
Clearly there is nothing inherent in my �sexual orientation� that leads to depression and anxiety. It is the stigma surrounding my sexual orientation that is leading to the depression and anxiety.
Asking the mental health profession to support our sexual orientation without supporting illegal behavior I believe is a legitimate request. However, the problem goes further.
During the early years of the AIDS epidemic the gay community needed money to support the medical needs of those who were struck with AIDS. In order to do so the Gay community needed to sanitize and desexualize its image. The support of boy-lovers (men attracted to boys) was increasingly condemned and our sexual sexual orientation was eventually isolated and we were further stigmatized.
Like the fight for money and funding during the AIDS epidemic many publicly funded mental health agencies and mainstream organizations like Group Health Cooperative resist offending the public by supporting the sexual orientation of unconventional sexual minorities, even though doing so is I believe a form of malpractice.
Most mental health professionals don�t tell gay youth, �It is not appropriate for me to help you feel comfortable with your sexual orientation since it may be leading to your depression and anxiety.�
Rather, caring professionals work with gay youth to educate them about homophobia and how it relates to their depression and anxiety. Part of their treatment involves enhancing their sense of well being over being gay or lesbian. Men attracted to boys deserve the same respect from mental health professionals.
Neither I nor my friends need a self inflicted bullet hole in our head because the mental health profession will not work within its own ranks to establish ethical standards that are responsive to both the concerns of the provider, and the needs of men attracted to boys.
Without these standards each provider will remain an island onto him or herself and out of self preservation will continue to turn us away. The ongoing search for a therapist who �understands� should not be a natural part of our lifestyle.
Dennis Bejin
