Gay and lesbian people are vulnerable to prejudice and persecution and have little protection from antidiscrimination laws. The Group for the Advancement of Psychiatry has published this short volume in order to address antihomosexual bias (a term the Group prefers to homophobia) in the practice of psychiatry and psychotherapy. A number of young American psychiatrists who were impatient with the conservatism of the American Psychiatric Association founded the Group in 1946. Its aim was to produce position statements on relevant and controversial psychiatric issues. This monograph, which is number 144 in the series, draws attention to the problem of antihomosexual bias not only in psychiatry and psychotherapy but also in the legal system and the medical response to patients with HIV and AIDS.

It briefly traces the historical (particularly religious) origins of antihomosexual bias, before focusing on where it occurs in the health and social services. The style is economical and yet rich in clinical and social illustrations. The text serves both as a warning against negative assumptions about homosexuality and a practical manual on how particular issues might be addressed. For example, it emphasises how gay and lesbian people, having grown up accepting the bias in society against them, might collude with ill-advised therapeutic efforts to modify their sexual orientation. Negative stereotypes held by gay people about their own sexuality may be reinforced by therapists who share them and who do not recognise that they are symptomatic of homophobia. A person's sexuality might count against his or her application for care and control of a child. Therapists may assume that gay and lesbian relationships are inherently unstable, any sign of bisexuality must mean the client is ‘really’ heterosexual or that the presenting disorder, such as depression, must be a consequence of the client's sexual orientation.

The Group recommends changes in the training of doctors and therapists. Supervision provided in psychoanalytical training institutes that, until relatively recently, excluded openly lesbian or gay professionals from training posts, must be free of prejudice. Psychiatric and medical educators must exert decisive, knowledgeable and moral leadership in challenging antihomosexual bias. Professionals must be encouraged to be open about their own sexuality, especially when in training posts, despite fears of discrimination in career advancement.

This short, well-written book is not a manual on political correctness. It is essential reading for doctors, psychotherapists and members of the professions allied to medicine who are curious about their own unconscious antihomosexual bias and who want to familiarise themselves with its manifestations and do their best to prevent it from harming their patients.