Homosexuality may be misunderstood by some psychiatrists if childhood history is not fully explored.

To determine the sexual orientation effects that may result due to childhood sexual abuse in Saudi males.

To explore whether childhood sexual abuse in Saudi males will change their adult sexual orientation and its psychodynamic understanding.

53 saudi males referred to psychotherapy clinic because of homosexuality were assessed using standard psychiatric clinical interview and followed up for psychodynamic psychotherapy for at least 2 years.

53 Saudi males aged (17–31) years were found to be abused sexually before the age of 10 years.39 (74%) were abused by relatives and others whereas14 (26%) were abused by non- relatives. 46(87%) had full sexual intercourse and for2–5 times but only 19(35.8%) the abuse continued for at least one year .On examination, none of them was found to be homosexual, but 36 (67.9%) were bisexual. As anal intercourse with wife is religiously forbidden, all married 27 (50.9%) had marital problems due to their sexual preference to anal intercourse.

In reserved and closed culture as in Saudi Araibia, sexual abuse of children especially males may be prevalent and especially by relatives. Childhood sexual abuse may affect sexual orientation in adulthood to be bisexual. This may be due to behavioral modification or impulsivity as a deep ingrained revenge by the victims as a redirection of aggression towards males or wives by anal intercourse.