Louis Diamant

I open this precis on sexuality and psychology with an awareness and concern
that much of what is written about here bears the stamp of politics, social notion,
and convention more than the print of the physiological, behavioral, and genetic
sciences--that is, what is specified as this or that in terms of personality, think-
ing, drives, or biology has often a tenuous and maybe more faddish existence
than our idealistic construction of science should allow. Labels, nomenclature,
etiology, and definitions have often been argued in committees and have been
created and deserted by the rule of bureaucracy, constituent pressure--diagnoses
by vote, in other words. Thus, designates representing the various aspects of
sexuality have come, gone, and reappeared, sometimes meaning normalcy,
sometimes disorder, sometimes sin, sometimes drive, sometimes illness. An ad-
ditional meaning to an old word has evolved, and psychiatry has adopted it. It
is a word used very parsimoniously in diagnosis and is ordinarily preceded by
the modifier ego-dystonic, which roughly means that it goes against the grain
of the patient ( American Psychiatric Association 1980, 1987, 1994). The word
is orientation, and though it remains undefined in the latest edition of the Di-
agnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psy-
chiatric Association 1994), it most likely refers to the propensity for
homosexuality since that was the previous connection in DSM-III and DSM-III-
R. It could, of course, also mean heterosexuality, falling as it does within the
new "acceptable" usage, but heterosexuality has never in the history of the
DSMs been designated a pathology. And although my notion that orientation

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