A. The individual complains that heterosexual arousal is persistently absent or weak and significantly interferes with initiating or maintaining wanted heterosexual relationships.
B. There is a sustained pattern of homosexual arousal that the individual explicitly states has been unwanted and a persistent source of distress.
Homosexuality that is ego-syntonic is not classified as a mental disorder. In addition, the attitude that "I guess life would be easier if I were heterosexual" does not warrant this diagnosis. This category is reserved for homosexuals for whom changing sexual orientations is a persistent concern. Similarity, distress resulting simply from a conflict between a homosexual and society should not be classified here.
Individuals with Inhibited Sexual Desire may sometimes attribute the lack of sexual arousal to "latent homosexuality." However, Ego-dystonic Homosexuality should be diagnosed only when homosexual arousal is overt, although it may be limited to fantasy.
Homosexuals who develop a Major Depression may then express self-hatred because of their sexual orientation. The diagnosis of Ego-dystonic Homosexuality should not be made if the ego-dystonic quality is judged to be only a transient symptom of a Depressive Disorder.