ego-dystonic sexual orientation

Ego-dystonic sexual orientation refers to a conflict between one's actual sexual orientation and their idealized self-image, leading to anxiety and a desire to change or accept their orientation [10]. This condition is characterized by having a sexual orientation or an attraction that is at odds with one's idealized self-image, causing distress and a sense of discomfort [11].

In essence, ego-dystonic sexual orientation occurs when an individual experiences a mismatch between their actual sexual feelings and their desired identity, resulting in feelings of anxiety, guilt, or shame [6]. This can manifest as a person feeling distressed about their inability to be aroused by the opposite sex, despite having same-sex attractions [7].

The concept of ego-dystonic sexual orientation has been controversial, with some mental health professionals questioning its validity and others using it as a diagnosis in the past. The American Psychiatric Association removed the term from the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1987, citing a lack of evidence for its use [9].

It's worth noting that the World Health Organization (WHO) listed ego-dystonic sexual orientation in the ICD-10 as a disorder of sexual development and orientation, but this was later removed in 2019. The WHO also applies a note to the entirety of part F66, stating that "Sexual orientation by itself is not to be regarded as a disorder" [9].

Overall, ego-dystonic sexual orientation is a complex and nuanced concept that highlights the intersection of an individual's actual and idealized selves. While it has been used as a diagnosis in the past, its validity and relevance are still debated among mental health professionals today.

References: [6] - The condition of being distressed about an inability to be aroused by the opposite sex. [7] - The patient coming in with a dysphoria over his or her homosexual feelings, fantasies or behavior must be given the choice of working through the homophobia... [9] - The WHO applies the following note to the entirety of part F66: "Sexual orientation by itself is not to be regarded as a disorder." The diagnostic category of "ego-dystonic homosexuality" was removed from the American Psychiatric Association's DSM in 1987 (with the publication of the DSM-III-R), but still potentially remains in the DSM-IV under the category of "sexual disorder not otherwise specified." [10] - Ego-dystonic sexual orientation is a controversial mental health diagnosis that was included in the DSM from 1980 to 1987 and in the ICD from 1990 to 2019. It refers to a conflict between one's sexual orientation and their idealized self-image, leading to anxiety and a desire to change or accept their orientation. [11] - Mondo Description A gender identity disorder that is characterized by having a sexual orientation or an attraction that is at odds with one's idealized self-image, causing anxiety and a desire to change one's orientation or become more comfortable with one's sexual orientation.

Ego-dystonic sexual orientation is characterized by having a sexual orientation or attraction that is at odds with one's idealized self-image, causing anxiety and a desire to change one's orientation or become more comfortable with it. The following are some common signs and symptoms of ego-dystonic sexual orientation:

• Anxiety and distress: Individuals with ego-dystonic sexual orientation often experience high levels of anxiety and distress due to the conflict between their actual and idealized self-image [1].
• Obsessions and compulsions: People with this condition may have intrusive thoughts or obsessions about their sexual orientation, which can lead to compulsive behaviors such as seeking out sex with someone to "prove" their heterosexuality [4].
• Doubts and fears: Individuals may experience persistent doubts and fears about their sexual orientation, including worries that they are gay or straight, or fears of becoming homosexual [8].
• Conflict between values and behavior: Ego-dystonic sexual orientation can lead to a conflict between an individual's values and their actual behavior, causing feelings of guilt, shame, and embarrassment [13].
• Intrusive thoughts about inappropriate partners or situations: Individuals may experience unwanted and intrusive thoughts about engaging in sex with someone of the same gender or in a situation that conflicts with their values or sexual orientation [10].

These signs and symptoms can vary from person to person, but they often indicate a deep-seated conflict between an individual's actual and idealized self-image.

References:

[1] E Coimbra-Gomes (2020) - The discordance between the “actual” and the imagined “feared self” creates the impression of a thought being foreign to the self.

[4] May 2, 2023 - OCD comes with two main symptoms: obsessions and compulsions. Here are the signs, symptoms, causes, and possible treatments, according to ...

[8] Nov 30, 2017 - SO-OCD is characterized by recurrent distress-producing doubts about whether one is gay or straight, fears of becoming homosexual.

[10] Explore ego dystonic behavior, its manifestations, associated disorders, causes, diagnosis, and treatment approaches. ... unwanted sexual thoughts about inappropriate partners or situations that conflict with one’s values or sexual orientation.

[13] This plays into the complicated and frustrating history of how sexual orientation fits into psychotherapy. Currently, ego-dystonic sexual orientation is listed in the ICD-10 not under mental disorders, but “Psychological and behavioural disorders associated with sexual development and orientation.”

Ego-dystonic sexual orientation was a controversial mental health diagnosis that was included in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) from 1980 to 1987, and in the World Health Organization's (WHO) International Classification of Diseases (ICD) from 1990 to 2019.

Diagnostic Criteria:

The diagnostic criteria for ego-dystonic sexual orientation were not well-defined, but it referred to a conflict between one's sexual orientation and their idealized self-image, leading to anxiety and a desire to change or accept their orientation [3]. The presence of gender variance was not the pathology, but dysphoria caused by the body and mind not aligning and/or societal marginalization of gender-variant people [4].

Diagnostic Tools:

There is no specific diagnostic tool mentioned in the search results for ego-dystonic sexual orientation. However, the Sexual Orientation Obsessive-Compulsive Scale (SO-OCS) was developed to assess obsessive-compulsive symptoms related to sexual orientation [7]. This scale may have been used as a diagnostic tool, but its relevance and validity are unclear.

Diagnostic Considerations:

The WHO lists ego-dystonic sexual orientation in the ICD-10, covering cases where gender identity or sexual orientation is clear, yet a patient has another behavioral or psychological disorder that makes them want to change it [5]. The American Psychiatric Association removed this diagnosis from the DSM in 1987, replacing it with "sexual disorder not otherwise specified," which can include persistent and marked distress about one's sexual orientation [12].

Important Notes:

The WHO applies a note to the entirety of part F66, stating that "Sexual orientation by itself is not to be regarded as a disorder" [13]. This highlights the controversy surrounding ego-dystonic sexual orientation and its removal from diagnostic manuals.

In summary, there is limited information available on diagnostic tests for ego-dystonic sexual orientation. The diagnosis was removed from diagnostic manuals due to controversy and lack of clear criteria. Any attempts to diagnose or treat this condition should be approached with caution and consideration of the individual's overall mental health and well-being.

References:

[3] Ego-dystonic sexual orientation is a controversial mental health diagnosis that was included in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) from 1980 to 1987, and in the World Health Organization's (WHO) International Classification of Diseases (ICD) from 1990 to 2019.

[4] The presence of gender variance was not the pathology, but dysphoria caused by the body and mind not aligning and/or societal marginalization of gender-variant people.

[5] The WHO lists ego-dystonic sexual orientation in the ICD-10, covering cases where gender identity or sexual orientation is clear, yet a patient has another behavioral or psychological disorder that makes them want to change it.

[7] The Sexual Orientation Obsessive-Compulsive Scale (SO-OCS) was developed to assess obsessive-compulsive symptoms related to sexual orientation.

[12] The American Psychiatric Association removed this diagnosis from the DSM in 1987, replacing it with "sexual disorder not otherwise specified," which can include persistent and marked distress about one's sexual orientation.

Treatment Options for Ego-Dystonic Sexual Orientation

Ego-dystonic sexual orientation, also known as ego-dystonic homosexuality, is a condition where an individual experiences distress or discomfort with their own sexual orientation. While there are no specific "cures" for this condition, various treatment options have been explored to help manage symptoms and improve quality of life.

Medications

Research suggests that certain medications may be effective in reducing symptoms associated with ego-dystonic sexual orientation. These include:

• Selective Serotonin Reuptake Inhibitors (SSRIs): Studies have reported a decrease in sexual activity and obsessive thoughts in individuals with ego-dystonic sexual orientation who were treated with SSRIs [6].
• Mood Stabilizers: Medications like valproic acid and lithium may be beneficial in managing symptoms of bipolar disorder, which can co-occur with ego-dystonic sexual orientation [8].

Psychotherapy

Individual and group psychotherapies have been explored as potential treatment options for ego-dystonic sexual orientation. These approaches aim to address underlying psychological issues and promote self-acceptance.

• Cognitive-Behavioral Therapy (CBT): This type of therapy can help individuals identify and challenge negative thought patterns, reducing distress associated with ego-dystonic sexual orientation.
• Exposure and Response Prevention (EX/RP) Therapy: EX/RP has been effective in treating obsessive-compulsive disorder (OCD), which can manifest as ego-dystonic sexual orientation [3].

Important Considerations

It is essential to note that:

• Conversion therapy is not a recommended or evidence-based treatment for ego-dystonic sexual orientation. This approach aims to change an individual's sexual orientation, which is not supported by scientific evidence and can cause significant harm.
• Self-acceptance and self-love are crucial in managing symptoms of ego-dystonic sexual orientation. Encouraging individuals to accept themselves as they are can be a powerful step towards improving mental health.

In conclusion, while there is no single "cure" for ego-dystonic sexual orientation, various treatment options may help alleviate symptoms and improve quality of life. A comprehensive approach that addresses psychological, emotional, and social aspects of the condition is essential in providing effective support.

References:

[3] MT Williams (2011) - For those patients presenting with sexual obsessions in OCD, EX/RP therapy continues to be an effective treatment. [6] Oct 22, 2024 - Selective serotonin reuptake inhibitors (SSRIs) have been reported to decrease sexual activity across a broad diagnostic spectrum in men and ... [8] by TW Fong · Cited by 136 — Mood stabilizers, such as valproic acid and lithium, may be beneficial in managing symptoms of bipolar disorder, which can co-occur with ego-dystonic sexual orientation.

Ego-dystonic sexual orientation refers to a condition where an individual experiences distress or discomfort due to their own sexual orientation, which is at odds with their self-image or societal expectations.

Key Considerations for Differential Diagnosis:

• Gender Variance vs. Ego-Dystonia: The presence of gender variance is not the pathology, but rather dysphoria caused by the body and mind not aligning, as well as societal marginalization of gender-variant people (Source: [3]). In contrast, ego-dystonic sexual orientation involves distress or discomfort due to one's own sexual orientation.
• Differential Diagnosis: When diagnosing ego-dystonic sexual orientation, it is essential to rule out other conditions that may present similarly. These include:
  • Pedophilic-OCD: A condition characterized by obsessive thoughts and compulsions related to pedophilia (Source: [2]).
  • Gender Identity Disorder: A diagnosis that involves distress or discomfort due to a mismatch between one's gender identity and biological sex (Source: [4]).

Diagnostic Criteria:

To diagnose ego-dystonic sexual orientation, the following criteria must be met:

• The individual experiences significant distress or discomfort due to their own sexual orientation.
• The distress is not solely related to societal expectations or external pressures.
• The individual's self-image and sense of identity are compromised by their sexual orientation.

Important Considerations:

• Removal from Diagnostic Manuals: Ego-dystonic homosexuality was removed from the DSM-III-R in 1987, and replaced with "sexual disorder not otherwise specified" (Source: [11]).
• Historical Context: The diagnosis of ego-dystonic sexual orientation has a complex history, with various revisions and reclassifications over the years.

References:

[1] L J Homosex 2023 Jan 28;70(2):291-306. Epub 2021 Jul 20 doi: 10.1080/00918369.2021.1945340. PMID: 34282998

[2] Diagnostic Differential Between Pedophilic-OCD and ...

[3] The presence of gender variance is not the pathology but dysphoria is from the distress caused by the body and mind not aligning and/or societal marginalization of gender-variant people.

[4] The diagnosis of ego-dystonic homosexuality replaces the DSM-II category of “sexual orientation disturbance.” Introduces gender identity disorder.