Editorial – Using sexual identity labels to move beyond them

This is the first issue of the Psychology of Sexualities Review. As mentioned in my previous Editorial, this change in name reflects the change made to the Section’s name, following a ballot of the Section’s membership. I trust that the papers in this issue are a testament to the Editorial Team’s promise to continue the legacy of the Lesbian & Gay Psychology Review’s of publishing high quality papers. In this Editorial I focus on the idea of using sexual identity labels, which have served us well and continue to do so, to move beyond them. I must clarify that by suggesting movement beyond these labels, I am in no way implying that we discard them, but permit a flexibility to incorporate other labelled identities and label-less identities to the fold. This plurality and inclusivity, I believe, forms the spirit of the Psychology of Sexualities Review. When thinking about plurality and inclusivity related to sexuality, two landmark judicial judgments in the recent past come to mind, perhaps because of their personal relevance to me, both from my own subject-ship and from those of some of my clients I see in therapy. The first, the Delhi High Court’s reading down of Section 377 of the Indian Penal Code, a section which criminalises private consensual sex between adults of the same sex (reported in the papers as ‘India decriminalises gay sex’, Mitta & Singh, 2009); and the second, the UK Supreme Court ruling related to ‘gay asylum seekers’ (‘Gay asylum seekers’, 2010). There is no question about the importance, the worthiness, the triumph, and the desperate need for both these judgments. A close reading, however, examining the language used in the official judgments and the English language newspaper reporting of these, exposes a certain conservative economy of terms that both reports employ. This is particularly pertinent as both judgments are related to minorities from India, and ‘gay asylum seekers’ from Cameroon and Iran, countries where some sexual minorities2 do not identity as ‘gay’ or even ‘homosexual’. The collapsing of sexual identities (and associated labels) into seemingly ‘neutral’ terminology employing behavioural categories of ‘men who have sex with men’ (MSM) and ‘women who have sex with women’ (WSW) is also problematic. While such usage has almost become the mainstay of epidemiological and public health studies (since the 1990s), social constructionists have highlighted the limits of such terms, but have also critiqued the use of identity labels such as ‘gay’, instead arguing for a ‘more textured understandings of sexuality that do not assume alignments among identity, behaviour, and desire’ (Young & Meyer, 2005, p.1144). My argument is that just as terms such as MSM and WSW tend to obliterate self-determination regarding sexual identities, terms such as ‘gay’ and ‘lesbian’, when applied indiscriminately or as global categories, can be as alienating; obfuscating text and subtext of sexual identities, desires, and practices. These terms then have the potential to become essentialist concepts

Editorial – Using sexual identity labels to move beyond them

This is the first issue of the Psychology of Sexualities Review. As mentioned in my previous Editorial, this change in name reflects the change made to the Section’s name, following a ballot of the Section’s membership. I trust that the papers in this issue are a testament to the Editorial Team’s promise to continue the legacy of the Lesbian & Gay Psychology Review’s of publishing high quality papers. In this Editorial I focus on the idea of using sexual identity labels, which have served us well and continue to do so, to move beyond them. I must clarify that by suggesting movement beyond these labels, I am in no way implying that we discard them, but permit a flexibility to incorporate other labelled identities and label-less identities to the fold. This plurality and inclusivity, I believe, forms the spirit of the Psychology of Sexualities Review. When thinking about plurality and inclusivity related to sexuality, two landmark judicial judgments in the recent past come to mind, perhaps because of their personal relevance to me, both from my own subject-ship and from those of some of my clients I see in therapy. The first, the Delhi High Court’s reading down of Section 377 of the Indian Penal Code, a section which criminalises private consensual sex between adults of the same sex (reported in the papers as ‘India decriminalises gay sex’, Mitta & Singh, 2009); and the second, the UK Supreme Court ruling related to ‘gay asylum seekers’ (‘Gay asylum seekers’, 2010). There is no question about the importance, the worthiness, the triumph, and the desperate need for both these judgments. A close reading, however, examining the language used in the official judgments and the English language newspaper reporting of these, exposes a certain conservative economy of terms that both reports employ. This is particularly pertinent as both judgments are related to minorities from India, and ‘gay asylum seekers’ from Cameroon and Iran, countries where some sexual minorities2 do not identity as ‘gay’ or even ‘homosexual’. The collapsing of sexual identities (and associated labels) into seemingly ‘neutral’ terminology employing behavioural categories of ‘men who have sex with men’ (MSM) and ‘women who have sex with women’ (WSW) is also problematic. While such usage has almost become the mainstay of epidemiological and public health studies (since the 1990s), social constructionists have highlighted the limits of such terms, but have also critiqued the use of identity labels such as ‘gay’, instead arguing for a ‘more textured understandings of sexuality that do not assume alignments among identity, behaviour, and desire’ (Young & Meyer, 2005, p.1144). My argument is that just as terms such as MSM and WSW tend to obliterate self-determination regarding sexual identities, terms such as ‘gay’ and ‘lesbian’, when applied indiscriminately or as global categories, can be as alienating; obfuscating text and subtext of sexual identities, desires, and practices. These terms then have the potential to become essentialist concepts

Cognitive rehabilitation for memory deficits following stroke

Background: Memory problems are a common cognitive complaint following stroke. Memory rehabilitation programmes either attempt to retrain lost or poor memory functions, or teach patients strategies to cope with them. Objectives: To determine the effectiveness of cognitive rehabilitation for memory problems following stroke. Search methods: We searched the Cochrane Stroke Group Trials Register (last searched September 2006). In addition, we searched the following electronic databases; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to June 2005), EMBASE (1980 to June 2005), CINAHL (1982 to June 2005), PsycINFO (1980 to July 2006), AMED (1985 to June 2005), British Nursing Index (1985 to June 2005), CAB Abstracts (1973 to May 2005) and the National Research Register (June 2006). We handsearched relevant journals and searched reference lists. Selection criteria: We selected controlled trials of memory retraining in stroke. We excluded studies with mixed aetiology groups unless 75% or more of the participants had a stroke or separate data were available for the stroke patients. Data collection and analysis: Two review authors selected trials for inclusion, assessed quality, and extracted data. Main results: Two trials, involving 18 participants, were included. One study compared the effectiveness of a mnemonic strategy treatment group with a 'drill and practice' control, while the other compared the effectiveness of an imagery mnemonics programme with a 'pragmatic' memory rehabilitation control programme. Formal meta‐analyses could not be performed due to a paucity of studies and lack of commonly‐employed outcome measures. The results do not show any significant effect of memory rehabilitation on performance of objective memory tests, and no significant effects of treatment on subjective and observer‐rated measures of memory. Authors' conclusions: There was no evidence to support or refute the effectiveness of memory rehabilitation on functional outcomes, and objective, subjective, and observer‐rated memory measures. There is a need for more robust, well‐designed and better‐reported trials of memory rehabilitation using common standardised outcome measures

The effectiveness of memory rehabilitation following neurological disabilities: a qualitative inquiry of patient perspectives

The evidence for the effectiveness of memory rehabilitation following neurological conditions, mainly studied through quantitative methodologies, has been equivocal. This study aimed to examine feedback from participants who had been through a randomised controlled trial (RCT) comparing two types of memory rehabilitation with a self-help control. It was envisaged that this information would offer a detailed understanding of patient experience of going through a trial and the perceived effects of having attended group sessions. Through 31 in-depth interviews, data collected were thematically analysed. The seven themes identified highlighted improvements in insight and awareness of memory problems and their neurological conditions, knowledge and skills about using memory aids; and as a consequence, improvements in cognitive functions, mood, and confidence, assertiveness and control over their condition. Participants also reported an altered perspective of life that helped them deal with their problems, and the therapeutic effects of attending group sessions. While these improvements were mainly reported in the intervention groups, even those in the control group reported some benefits. This study highlights that it is both feasible and advantageous to embed qualitative research within the traditional RCT methodology to arrive at a more nuanced understanding of patient experiences and intervention outcomes

Outcome measurement in cognitive neurorehabilitation

Introduction: The aim of this chapter is to consider the criteria for selecting outcome measures for evaluating the effects of cognitive neurorehabilitation. The International Classification of Function, Disability and Health (ICF) (World Health Organization, 2001) is used as a framework for deciding what to measure. The properties of the ideal outcome measure are discussed. Examples of outcome measures commonly used in clinical studies are provided and their strengths and limitations considered. The focus is on self-report measures rather than neuropsychological tests as these reflect the effect of cognitive rehabilitation on daily life

Translating knowledge into practice: content analysis of online resources about sexual difficulties for individuals with traumatic brain injury

For many individuals with traumatic brain injury (TBI), the Internet is the only available source of information regarding their sexual problems following TBI. This study aimed to evaluate the content and the quality of patient or carer information that is readily available on the Internet about specific aspects of sexuality after TBI. A purposive (non-exhaustive) sample of eight leaflets available on the Internet related to sexuality following TBI was analysed using content analysis. Decreased desire was reported as the main sexual difficulty following TBI (87.5%), followed by inappropriate sexual behaviour (62.5%). Among the strategies to overcome these difficulties, all leaflets recommended seeking help from healthcare professionals; 42.8% were centred on the carer or the family, and only 28.5% was directly addressed to the individual with TBI. The information available overemphasises disinhibition, underscores other aspects of sexuality (e.g. sexual risk and inability to fantasise), and is conceived mainly for carers and families. A bias assuming that most individuals with TBI are involved in a romantic relationship was also present. Adolescents, women, older people, single people, and non-heterosexual individuals were not adequately represented. There is a need for Internet resources to provide specific recommendations for these groups

Politics of desire: exploring the ethnicity/sexuality intersectionality in south asian and east asian men who have sex with men (MSM)

Intersectionality’ has been used to interrupt dominant discourse surrounding LGB experiences, and has exposed their heterogeneity. Complexities of negotiating desire within a matrix of race/ethnicity and sexuality in South and East Asian men who have sex with men (MSM) has been under-explored in Black and Minority Ethnic LGB research. Our internet survey found discordance between sexual identities and sexual practices amongst Asian MSM. Many did not access LGB physical and cyberspaces, and some experienced abuse attributed to their race/ethnicity. Feeling undesired was read as a function of racism, but racism from Asian MSM, manifesting as dispreference for certain races/ethnicities, was also found. We also explored intersections between internalised racism and homophobia which affect the lived experience of diasporic Asian MSM