that "these people are at war with themselves and are turning this internal conflict outward." A 2016 eye-tracking study showed that heterosexual men with high negative impulse reactions toward homosexuals gazed for longer periods at homosexual imagery than other heterosexual men. According to Cheval et al. (2016), these findings reinforce the necessity to consider that homophobia might reflect concerns about sexuality in general and not homosexuality in particular. In contrast, Jesse Marczyk argued in Psychology Today that homophobia is not repressed homosexuality. Researcher Iain R. Williamson, in his 1998 paper "Internalized Homophobia and Health Issues Affecting Lesbians and Gay Men" finds the term homophobia to be "highly problematic" but for reasons of continuity and consistency with the majority of other publications on the issue retains its use rather than using more accurate but obscure terminology. The phrase internalized sexual stigma is sometimes used in place to represent internalized homophobia. An internalized stigma arises when a person believes negative stereotypes about themselves, regardless of where the stereotypes come from. It can also refer to many stereotypes beyond sexuality and gender roles. Internalized homophobia can cause discomfort with and disapproval of one's own sexual orientation. Ego-dystonic sexual orientation or egodystonic homophobia, for instance, is a condition characterized by having a sexual orientation or an attraction that is at odds with one's idealized self-image, causing anxiety and a desire to change one's orientation or become more comfortable with one's sexual orientation. Such a situation may cause extreme repression of homosexual desires. In other cases, a conscious internal struggle may occur for some time, often pitting deeply held religious or social beliefs against strong sexual and emotional desires. This discordance can cause clinical depression, and a higher rate of suicide among LGBT youth (up to 30 percent of non-heterosexual youth attempt suicide) has been attributed to this phenomenon. Psychotherapy, such as gay affirmative psychotherapy, and participation in a sexual-minority affirming group can help resolve the internal conflicts, such as between religious beliefs and sexual identity. Even informal therapies that address understanding and accepting of non-heterosexual orientations can prove effective. Many diagnostic "Internalized Homophobia Scales" can be used to measure a person's discomfort with their sexuality and some can be used by people regardless of gender or sexual orientation. Critics of the scales note that they presume a discomfort with non-heterosexuality which in itself enforces heternormativity. Social The fear of being identified as gay can