In 1983, Richard Isay, ’61M (MD) then chair of the American Psychoanalytic Association’s program committee, organized a panel called “New Perspectives on Homosexuality.” The psychoanalytic profession would never be the same.
Ten years after the American Psychiatric Association had removed homosexuality from its diagnostic manual, the psychoanalytic association remained both theoretically and clinically committed to the belief that homosexuality was a developmental disorder that was curable with adequate patient motivation and intensive therapy.
Isay and three of his colleagues argued that homosexuality was a normal variant of human sexuality, and that the profession should treat openly gay men and women without attempting to change their sexual orientation.
“Several analysts walked out,” Isay recalls.
Isay had a deep stake in the debate’s outcome. A few years later, he would become the group’s first openly gay member. In 1992, the association removed restrictions against gays, in part, the New York Times reported, the result of “constant badgering by Dr. Isay.” Meanwhile, Isay focused on treating gay men and began to flesh out a major revision in the psychoanalytic approach to homosexuality.
His first two books, Being Homosexual (Farrar, Straus & Giroux, 1989) and Becoming Gay (Pantheon Books, 1996) are being reissued by Vintage Books this spring. His third book, Commitment and Healing: Gay Men and the Need for Romantic Love (John Wiley & Sons, 2006) has generated much debate in the three years since its publication.
According to The Advocate, the nation’s first and most widely circulated gay magazine, Being Homosexual was “one of the earliest works to argue that homosexuality is an inborn identity.”
Isay recalls his years in Rochester as typical for a medical student, with one exception: His feelings for other men, which he had hoped were a passing phase, remained. As he began his residency in psychiatry, he entered psychoanalysis to remove the inhibitions to his supposedly natural attraction to women.
His analyst, whom he saw six times a week, “implied that by becoming aware of the childhood fear of my father’s rage over my closeness to my mother I would become less frightened of the mortal consequences of my heterosexual desire,” Isay wrote.
A determined patient, he even married, and fathered two boys, to whom he remains close.
Becoming Gay answers those whose approach to homosexuality is summed up in the phrase “don’t ask, don’t tell.” Isay argues that a closeted life is psychologically unhealthy. Instead, he offers gay men a model for achieving a positive gay identity. His most recent book, Commitment and Healing, is the capstone to Isay’s nearly 30 years of treating gay men. He’s convinced that while sustaining committed relationships is difficult for all couples, gay men find it especially so.
Too many gay men have given up on the idea that sustained intimacy is either possible or desirable, Isay argues. He is skeptical of the claims made by many gay men that long-term committed relationships are restrictive and “undemocratic.” These are the justifications, he argues, “of men whose history of parental and social rejection has made it especially difficult for them to develop trust that their needs will be met.”
As for gay marriage, Isay is unequivocal in his support. Gays “should not only be permitted to marry—they should be encouraged to do so,” he says.
But he believes that the legal barriers to gay marriage will ultimately prove easier to remove than the emotional barriers of gay men to finding and sustaining love.
“The hope is that gay marriage will solve the problem” says Isay. “But it won’t.”