Ten years after he first brought us the book Homophobia, which laid bare the harsh realities and harmful effects of this sexual bigotry, psychiatrist Martin Kantor delves again into prejudice and discrimination-even flat-out acts of absolute hatred-against gays in the United States. Have things changed? One might think so. Ten years ago Matthew Shephard was strung up to die on a fence because he was gay. But no such blatant hatred has made headlines here since the turn of the millennium. Ten years ago, Pat Robinson authored a book that assured lasting peace would only occur when a group including drug dealers, assassins, worshippers of Satan, and homosexuals are no longer on top. Yet, by 2007, Robinson was pledging support for pro-gay Republican presidential candidate Rudy Giuliani. And gays only longing for a formal relationship a decade ago are now entering into civil unions, even gay marriage, in states that have legalized the ceremonies. Hate crime laws have been revised to include gays, and gays are now recognized in domestic partner clauses common across insurance polices. People appear open about homosexuality in the media; gays are featured on television shows and in movies alongside straights. The advances seem great.

But they are only surface advances, cautions Kantor. Because the consequences of hate crimes are a lot more severe than they used to be, gays and lesbians are being hunted down and beaten up less frequently than they once were. But people are still full of hate, just more wary of punishment so more circumspect about how they express it. In this new edition, Kantor tells in harsh detail how and why people still fire off slurs like faggot and dyke, and threaten harm, from blowing up their homes to bashing in their heads. Kantor takes us across sites in America - from city streets to hospitals, schools, broadcast stations, and churches to police departments-showing how homophobia is still very much alive. While the problem may be less acute it is still chronic, and while it may not take as many lives, it ruins perhaps even more, he explains. Homophobia is a phenomenon that in significant respects parallels mental illness, adds the psychiatrist. Education alone will not stem the homophobic tide. We also need to uncover and treat the psychoneurotic dimension of homohatred. Yes, we can admire the changes in homophobia over the last decade, but we must not forget or ignore the fact that the human beings who create homophobia haven't changed that much even over the centuries.