Regular Article Gay and Lesbian Issues in U.S. Psychiatry Thaining as Reported by Residency Thaining Directors Mark H. Townsend, M.D. Mollie M. Wallick, Ph.D. Karl M. Cambre, M.S. This study reports the results of a suroey of u.s. residency training directors that explored the training milieu of gay and lesbian psychiatric residents. Of the 198 training directors suroeyed, 134 (67.7%) completed the questionnaire. All but four of the directors reported the inclusion of gay and lesbian issues in the curriculum, most frequently in PGY-3. Using a 5-point rating scale, 47.3% reported that homosexuality was regarded at their programs as "normal" or "somewhat normal," 51.2% as "neutral," and 1.5% as "somewhat pathological" or "pathological." In general, the directors' overall assessment of departmental attitudes about homosexuality paralleled the findings previously reported by lesbian and gay residents, with some discrepancy concerning the disclosure of sexual orientation to psychotherapy patients. In the earlier study, nearly one-third of gay and lesbian residents reported such disclosure; in the current study, only three training directors (2.5%) regarded this practice favorably. The results of the present study reflect the diversity of opinion found among residency training directors on the topic of gay and lesbian issues. (Academic Psychiatry 1995; 19:213-218)

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ittle is known about how homosexuality is addressed within U.S. psychiatric residency training. As a contribution to knowledge in this area, we recently surveyed lesbian and gay psychiatry residents (1), eliciting their perceptions of their training milieu, including instruction on gay and lesbian patient care. We found great variability among their responses: many (41 %) considered their program affirming of their sexuality, whereas fewer (21%) categorized their program's view of homosexuality as a pathologic condition. Responses differed significantly by gender, with men more likely than women to consider their program supportive. Approximately one-third of resiACADEMIC !'SyClIIi\ my

dents reported that they disclose their sexual orientation to psychotherapy patients. In the present study, conducted in 1993, we surveyed residency training directors in U.S. psychiatry programs to explore how they perceive gay and lesbian issues. We were also interested in determining if the Dr. Townsend is assistant professor of psychiatry, Dr. Wallick is professor of psychiatry, and Mr. Cambre is manager of scientific programming in computer services; all are at the Louisiana State University Medical Center in New Orleans. Address reprint requests to Dr. Townsend, Department of Psychiatry, Louisiana State University School of Medicine, 1542 Tulane Avenue, New Orleans, LA 70112. Copyright © 1995 Academic Psychiatry.

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