Psychiatric Association, and the National Association of Social Workers state: The consensus of research and clinical literature demonstrates that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality. There is now a large body of research evidence that indicates that being gay, lesbian or bisexual is compatible with normal mental health and social adjustment. The World Health Organization's ICD-9 (1977) listed homosexuality as a mental illness; it was removed from the ICD-10, endorsed by the Forty-third World Health Assembly on 17 May 1990. Like the DSM-II, the ICD-10 added ego-dystonic sexual orientation to the list, which refers to people who want to change their gender identities or sexual orientation because of a psychological or behavioral disorder (). The Chinese Society of Psychiatry removed homosexuality from its Chinese Classification of Mental Disorders in 2001 after five years of study by the association. According to the Royal College of Psychiatrists "This unfortunate history demonstrates how marginalisation of a group of people who have a particular personality feature (in this case homosexuality) can lead to harmful medical practice and a basis for discrimination in society." In response to claims on The Nolan Show regarding homosexuality being a psychiatric disorder, the Royal College of Psychiatrists wrote:There is now a large body of research evidence that indicates that being gay, lesbian or bisexual is compatible with normal mental health and social adjustment. However, the experiences of discrimination in society and possible rejection by friends, families and others, such as employers, means that some LGB people experience a greater than expected prevalence of mental health difficulties and substance misuse problems. Although there have been claims by conservative political groups in the USA that this higher prevalence of mental health difficulties is confirmation that homosexuality is itself a mental disorder, there is no evidence whatever to substantiate such a claim.Most lesbian, gay, and bisexual people who seek psychotherapy do so for the same reasons as heterosexual people (stress, relationship difficulties, difficulty adjusting to social or work situations, etc.); their sexual orientation may be of primary, incidental, or no importance to their issues and treatment. Whatever the issue, there is a high risk for anti-gay bias in psychotherapy with lesbian, gay, and bisexual clients. Psychological research in this area has been relevant to counteracting prejudicial ("homophobic") attitudes and actions, and to the LGBT rights movement generally. The appropriate application of affirmative