Gay Men Tortured on the Basis of Homosexuality

The explicit integration of political asylum advocacy into the frame of psychodynamic psychotherapy is described. Patients are eighteen gay, bisexual, or transgendered men from twelve countries at various stages in the asylum process. Some are HIV+ or living with AIDS. All were persecuted or tortured in their countries of origin because of their sexual orientation. All are at risk of deportation if they do not win their cases. When they were children, several of the men were sexually abused. As latency-age boys and as older youths, most were physically abused because they were gender atypical. Technical recommendations regarding the process of asylum advocacy are provided. Advocacy and psychotherapy are not separate activities, but complex psychotherapeutic experiences. The therapeutic relationship is likely to become the crucible for intense feelings associated with childhood physical and sexual abuse, as well as subsequent persecution and torture. Both the therapist and the patient are vulnerable to acting in the transference-countertransference. It is possible that the necessary, asylum-related activity of the analyst in the early phases of the treatment will be negatively experienced by the patient at a later stage. Obstacles to resolving negative therapeutic reactions are discussed.