Not until 1973 did the American Psychiatric Association removed homosexuality from its list of mental disorders.

Richard A. Isay, M.D. | Being Homosexual: Gay Men and Their Development
176 pages. New York: Vintage, 2009. $15 (paperback)

Richard A. Isay, M.D. | Becoming Gay: The Journey to Self-Acceptance
208 pages. New York: Vintage, 2009. $15 (paperback)

There are many dividing lines between the young and the not-so-young: Do you remember when laser discs were the very latest? Do you even know what an LP is? Can you remember going to the beach without packing the sunblock? Less humorously, do you remember when homosexuality was officially classified as a mental illness? Ridiculous as it may sound today, into the 1970s the leading American professional bodies for both psychiatry and psychology considered homosexuality to be a disease; not until 1973 did the American Psychiatric Association removed homosexuality from its list of mental disorders, with the American Psychological Association following suit in 1975.

Psychoanalysis lagged considerably behind. Until 1992 homosexuals were excluded from psychoanalytic training on the grounds that homosexuality was a developmental defect which would preclude an individual from becoming a good analyst. The psychoanalyst Dr. Richard A. Isay was instrumental in getting that policy overturned, a struggle he recounts in detail in Becoming Gay. It was personal as well as professional: Isay now lives as an openly gay man but spent years in the closet, in part so he could practice the profession of his choice and in part to shield his family (and presumably himself) from the stigma of sexual nonconformity. In Being Homosexual (originally published in 1989) and Becoming Gay (originally published in 1996), both now available in revised and updated editions from Vintage, he describes his experiences treating homosexual patients, as well as his personal story within the context of the social climate of the United States and the profession of psychoanalysis.

Being Homosexual is the more practice oriented of the two volumes. It sets forth Isay's beliefs about homosexuality and the patterns he has observed in his patients. The book is meant for both his professional colleagues and for gay men who would like to understand themselves better, although it may occasionally prove tough going for the casual reader.

Isay's core belief that homosexuality is just a normal variant of human sexuality—and, as with all forms of love, will remain somewhat mysterious to us—informs everything in this book, as does his belief that sexual orientation is inborn. This avoids torturous attempts to trace homosexuality back to over-identification with one's mother or neglect by one's father, and allows instead a focus on the patient's actual history and present-day situation. It also precludes any support for the surprisingly popular belief (Google "conversion therapy" if you don't believe me) that homosexuality is something which an individual can and should be cured of. Instead, Isay believes homosexuality is just a fact of life for some people (which may sound obvious but is a far from universal belief), and should not be condemned simply because others in our society hold a prejudice against it.

Being Homosexual is organized into chapters relating to developmental stage (childhood, adolescence) or topic (types of relationships, bisexuality, fear of AIDS—and bear in mind that the first edition was published before antiretrovirals were available). The final two chapters discuss psychotherapy with gay men (Isay concludes, not surprisingly, that accepting a patient's homosexuality is a prerequisite to validating him as a person) and societal attitudes toward homosexuality. Many chapters include a review of research by others (with proper academic endnotes) and this book includes a detailed index; both features make it a useful reference for anyone researching the topic.

Becoming Gay picks up where Being Homosexual left off. Isay believes that some men are born homosexual but must learn to be gay in the sense of choosing to develop an identity as a gay man. It's less technical and more personal, beginning with an opening chapter which recounts Isay's own journey. It will be familiar to many: uninterested in girls, crush on a male roommate, attempts to cure himself by dating women and then by marriage and children, psychotherapy, recurring acts which question the apparently successful conversion, leading to the eventual realization that it's all been a charade. Then delaying acting on that information, remaining in the closet in order to protect his professional career and conventional home life while leading a double life with all the risks involved (in Isay's case, this included soliciting an undercover policeman at a rest stop. He was able to talk his way out of being arrested, which likely would have ended both his career and his marriage) and, ultimately (in the happy cases, anyway), coming out of the closet and adjusting to life as an openly gay man.

Isay devotes separate chapters to and the particular issues in forming a gay identity for men of different ages and circumstances (adolescence, married men, men with HIV/AIDS, older men) and closes with a chapter reviewing the history of how homosexuality was viewed within the profession of psychoanalysis. As with Being Homosexual, references and a detailed index are included. | Sarah Boslaugh

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