Isay (Psychiatry/Cornell Medical) contends that homosexuality is genetically endowed and that, like heterosexuals, gay males consolidate and integrate their sexual identity in a series of developmental stages, each of which is fraught with pitfalls. Most of Isay's homosexual patients got their first inkling of their sexual preference at age four or five, when they began having homoerotic fantasies--usually involving their fathers. In later boyhood, they tended to dislike rough-and-tumble sports, preferring ""artistic"" pursuits. If spurned by the father, they became distrustful of others and fearful of emotional involvement, and, as adults, are frequently unable to commit to mutually loving sexual relationships, preferring a series of one-night stands. Although such men have contributed to the homophobia so rampant in Western cultures, they are, says Isay, a minority: most gays enter and maintain longstanding relationships. In adolescence, sexual experimentation promotes the development of a healthy sexual identity. The AIDS crisis, however, has produced a ""developmental lag"" among young gays, many of whom are terrified of the consequences not only of this activity but also of the open acknowledgement of their homosexuality. Isay claims that therapists who aim to ""cure"" gay patients only lower their self-esteem and may propel them into disastrous marriages. He faults Western culture--which devalues feminine attributes--for much of the homophobia directed against gay men. Thought-provoking, and well documented with pertinent case histories; of particular interest to psychiatric professionals and the gay community.