Special health care for gays and lesbians: a queer idea?

One of the unintended consequences of the gay liberation movement of the seventies and beyond has been the myth that lesbians and gays are "bullet-proof". Evelyn Hooker's1 work from the 1950s is often misinterpreted to suggest that lesbians and gays are so mentally and physically robust that the effects of childhood parental disapproval, adolescent social exclusion and a lifetime of discrimination and victimisation just "bounce off". This was meant to leave us just as healthy as members of the advantaged mainstream. The notion of the "pink dollar" — which implies that all gay men (and, to a lesser extent, lesbians), despite widespread discrimination at work, are rich urban professionals with expensive cars — is another facet of this mythology.

Peterkin is a psychiatrist and Risdon a family physician (an unfortunate term alienating to many gays and lesbians). They are part of a welcome movement that is dismantling this myth and recognising that lesbian, gay, bisexual and transgendered people, like members of other persecuted groups, may require special consideration in redressing the health consequences of social disadvantage.

Their book is clinically practical, well researched and a reliable guidebook for the primary health care practitioner. It is inclusive of the issues of people who are multiply disadvantaged, although it betrays its North American origins in the section focusing specifically on the concerns of gay and lesbian Native Americans. This is only partially applicable to the care of gay Indigenous Australians.

Bisexuals might find the book's title exclusive. The authors could also be criticised for uncritically accepting an "identity" view of sexual diversity that ignores the last 20 years of academic writing on "queer theory", and the social construction of homosexuality. Its main purpose, however, is a desktop guide for clinicians, which it does very well.

Gary D RogersDirector, Health in Human Diversity Unit Department of General Practice University of Adelaide, SA

1. Dr Evelyn Hooker was an American psychiatrist who published the first empirical research to challenge the then prevailing psychiatric assumption that homosexuality was a mental illness. Her groundbreaking work ultimately led to the removal of "homosexuality" from the Diagnostic and Statistical Manual of Mental Disorders.