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Review Article | DOI: https://doi.org/10.31579/2578-8868/138
1* Psychologist sp.ing in psychotherapy with a strategic approach, Forensic Criminologist expert in sectarian cults, esoteric and security profiles, Jurist sp.ed SSPL, Essayist
*Corresponding Author: Giulio Perrotta, Psychologist sp.ing in psychotherapy with a strategic approach, Forensic Criminologist expert in sectarian cults, esoteric and security profiles, Jurist sp.ed SSPL, Essayist
Citation: Perrotta G., (2020 Bisexuality: definition, humanistic profiles, neural correlates and clinical hypotheses . J. Neuroscience and Neurological Surgery. 6(5); DOI:10.31579/2578-8868/138
Copyright: © 2020 Giulio Perrotta, This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Received: 26 September 2020 | Accepted: 12 October 2020 | Published: 19 October 2020
Keywords: clinical hypotheses;neural correlates
This work focuses on the study of neurobiological and functional profiles in terms of bisexuality, to carefully evaluate the direct correlation between anatomical and physiological elements and the choice of sexual preferences oriented on both sexes, hypothesizing any clinical profiles.
According to the current position of the scientific community, "bisexuality" can be considered as a sexual orientation that is substantiated in experiencing attraction, drive and emotions, linked to the affective and sexual sphere both for one's sex and for the opposite sex. In the clinical setting, the status of "bisexuality" has always been nosographically absorbed by the general category of homosexuality, almost as if it were one of its ribs. Bisexuality has been known since ancient times and, historically, society's evaluation of this phenomenon has gone through alternate phases: appreciated by Greek civilization (which, however, did not accept only homosexual relationships), tolerated (depending on context) by Roman civilization, but condemned by the Judeo-Christian tradition. [1]
From the second half of the twentieth century, the first idea of "homosexuality" was declassified, moving from the psychopathological condition inherent to the sociopathic personality disorders of the 1954 version of the DSM to the sexual deviance of 1968, only to gradually become an ego-dystonic form of one's own in 1974 sexual perception and finally a natural sexual orientation only in 1987 and in the revised version of 1990, being finally decriminalized reeds by the International Statistical Classification of Diseases, Accidents, and Causes of Death (ICD) of 17 May 1990, although psychoanalytic thinking was well oriented towards the opposite; in fact, homosexuality had hitherto been considered a morbid obsession (Charcot), sexual psychopathy (von Krafft-Ebing), an arrest of normal development (S. Freud), a narcissistic fixation (Mann and Ferenczi), a neurotic escape (Adler) or a parapathic neurosis that originates from the conflict between instinct and inhibition (Stekel). In particular, Freud spoke, with great scandal for that time, of the "perverse polymorphic" child, that is, with the potential possibility of having any type of sexual activity and who, only through education and culture, then makes a more defined choice. He wrote: “A certain degree of anatomical hermaphroditism is typical of normality: in no individual of normal male or female training are there traces of the apparatus of the opposite sex which, or continued to exist, without having a function, as rudimentary organs or they have been transformed to take on other functions”. And again: "the proportion with which the male and female intertwine in the individual is subject to very significant oscillations". The father of psychoanalysis took the ancient Greeks as an example: “Among the Greeks, among whom the most virile men appear among the inverted, it is clear that not the boy's virile character, but his physical proximity to the woman, as well as his female psychic qualities - shyness, restraint, the need to learn, to be helped - ignited man's love. Having become a man, the boy ceased to be a sexual object for man and perhaps became a pederast himself. In this case, therefore, the sexual object, as in many cases, is not the same sex, but the union of the characters of the two sexes, almost the compromise between an impulse that requires the man and another that requires the woman, firm while remaining the condition of the virility of the body (of the genitals), so to speak the mirroring of one's bisexual nature”. However, this evolution has certainly led to an opening towards social rights but also to a fluidity in sexual orientation, where the main problems emerge especially in the bisexual position. [2] [5]
With reference therefore to bisexuality, understood as the choice of sexual orientation to bind sentimentally and sexually to both women and men, the discussion takes on broader and characterizing contours, precisely because of the less defined and precise nature of the sexual orientation choice. The aforementioned fluidity on sexual orientation leads to rather bizarre decision-making developments and often motivated by unconscious dynamics not better identified even by the subjects: [2]
a) "bi-curiosity", understood as a series of limited and sporadic behaviors about the desire to approach sexually individuals of the same sex, but who do not have the characteristic of persistence and recurrence over time;
b) "bi-chic", a term describes people who engage in seductive relationships with both men and women to make people talk about themselves in a glamorous perspective;
c) "bi-permissive", understood as the subject who does not actively seek sexual relations with people of a specific sex but who is "open", that is, available to make new experiences;
d) "Bi- for pay-bi": the term is applied to people who call themselves heterosexual but who engage in sexual relations with people of the same sex in exchange for money;
e) "Heteroflexibility": this term of American origin, often used derisively or to deny one's bisexuality, refers to a predominantly straight individual, but who can engage in a homosexual relationship occasionally because he is temporarily in a favorable context to it;
f) "Lesbians until graduation": this term describes young British (and American) women who, during their years of study at university, engage in relations with other women, to then adopt, once they graduate, a strictly heterosexual attitude and end up getting married with a man.
Kinsey, author of the editorial work "Sexual behavior in the human male", proposed a taxonomic scale, which suggested a value from 0 to 6, to describe those who were exclusively heterosexual (value 0), by those who considered themselves predominantly straight but with homosexual tendencies (value 1), with homosexual components (value 2), bisexual (value 3), mainly homosexual with heterosexual components (value 4), with heterosexual tendencies (value 5) and finally exclusively homosexual (value 6). However, this approach does not completely exhaust the complexity of sexual orientation. In the academic field, therefore, the issue of bisexuality as an innate orientation or consequence of factors is still strongly discussed. [2]
The strong interdependence between the concept of "bisexuality" and "homosexuality" therefore appears evident, despite representing two different dimensions. This also happens because there is a widespread belief in the community, in the absence of targeted scientific studies, that bisexuality is a transitory phase that should lead the person to complete acceptance of his homosexual nature; these beliefs are strengthened by some investigations that elaborate certainties on statistical bases (with unrepresentative samples) such as those which support the following: bisexuals experience friendship and family ties in a significantly less stable and lasting way than homosexuals; bisexuals are more likely to experience unequal treatment in the workplace and intrapersonal settings; bisexuals have greater difficulties in living a monogamous relationship, being more oriented towards polygamy. [3-5]
The social identity of the bisexual is still strongly conditioned by the difficult acceptance of the concept of homosexuality and as such, the interdependence between the two dimensions slows the natural progress of the acceptance process also at the socio-cultural and anthropological level of the former; this difficulty is also accentuated by the clinical hypothesis, not verified statistically, with a representative sample, that bisexuality is a paraphilia. [6]
What is evident from the scientific research published so far is that:
Based on what has been said so far, the writer proposes a theoretical classification to better frame "bisexuality" and its possible forms: [5-6]
2. The neural correlates
The data confirming the substantial (and incorrect) absorption of the bisexual category in the macro-category of homosexuality are offered to us by scientific research which, although careful in distinguishing the two dimensions in theory, in practice does not happen [22-50] and the studies [51-60] that examine the bisexual category distinguishing it from the homosexual one; however, even these studies, recently temporally, are not on statistically representative samples. Trying to summarize therefore in terms of neural correlates in bisexuality these data emerge:
3. Clinical hypotheses
Sexual orientation is therefore commonly debated as a characteristic of the individual, as well as for biological sex, gender identity, or age. However, this perspective is incomplete, since sexual orientation is always defined based on relational terms and necessarily concerns relationships with other individuals. Sexual acts and romantic attractions are categorized as homosexual or heterosexual based on the biological sex of the individual involved in them, relative to the partners. Indeed, it is through performance - or the desire to lend - with another person that individuals express their heterosexuality, homosexuality, or bisexuality. Thus, sexual orientation is fully connected to the intimate personal relationships that human beings form with others to meet their deepest sentimental needs for love, bond, and intimacy. In addition to sexual behavior, these constraints include not-sexual physical affections between partners, sharing goals and values, mutual support, and constant commitment. Consequently, sexual orientation is not merely a personal characteristic that can be defined in isolation. Likewise, one's sexual orientation defines the universe of people with whom a person can find satisfying and fulfilling relationships which, for many individuals, comprise an essential component of personal identity. [2]
On the subject of "bisexuality", the etiological theories that try to explain this sexual dimension are essentially four:
There are well-founded reasons, neurobiological, genetic, psychodynamic, and socio-environmental, to question the derubrication of bisexuality, from a clinical point of view. The research currently published cannot satisfy the need for clarification regarding the subject of this publication and therefore we refer to a subsequent historical moment to resume the discussion from an exclusively clinical point of view.
In the future, research should focus on the following investigation points:
a) studies aimed at distinguishing paraphilic forms from definitive orientation choices;
b) studies aimed at finding any differences between heterosexual, homosexual and bisexual subjects concerning brain structures and the levels of serum markers of sexual steroids, both in fetuses and in adults, in all its evolutionary development, thus highlighting any conditioning can lead to certain sexual orientation choices other than heterosexuality;
c) studies able to determine the precise direction of the neural circuits underlying sexual preferences, comparing the results with heterosexual subjects;
d) studies able to focus research on genetic factors capable of influencing sexual orientation.
The direct and indirect implications on the confirmation of the clinical hypothesis of the bisexual condition would bring further complications, concerning the management of the patients' treatments and therapies, while making important differences between highly adaptive patients and those who perceive their condition as dysfunctional concerning the surrounding environment.
The question to ask, in this theoretical hypothesis, is whether we must intervene clinically to correct the bisexual condition and lead the patient towards a heterosexual orientation, or simply accompany him towards a better perception of his emotions, desires and needs strategically. [70] What seems certain is that the static and nosographic evaluation of "mental illness" about bisexuality is not at stake, the more the awareness of a clinical reality concerning the topic treated and the evaluation by the therapist of any anamnestic profiles related to high adaptive functionality or the patient's ego-dystonic and dysfunctional perception.
The confirmation of the clinical nature of bisexuality could also revive or reawaken the theses set aside in the last century on possible therapies aimed at correcting dysfunctional sexual orientation, through psychotherapy (mainly post-Freudian dynamic orientation) or the use of neurostimulation equipment (for example electroshock), with a whole series of ethical, moral, social, political and psychological implications that are not indifferent to the daily needs of the patients.
These profiles must necessarily be directed to the appropriate research sites, carefully evaluating the patient's medical history and whether his or her choice of sexual orientation is experienced or not by the patient in a highly adaptive or dysfunctional way.
In general, even if the clinical nature of the not-heterosexual choice proves, this condition should not in itself justify treatments contrary to the dignity and will of the person. The scientific evidence received so far is not definitive and deserves further investigation to reach meaningful conclusions capable of determining collective awareness.