Internalized homophobia also applies to conscious or unconscious behaviors, which a person feels the need to promote or conform to cultural expectations of heterosexism, which refers to a system of negative attitudes, bias, and discrimination in favor of opposite –sex sexual orientation and relationships. It can include the presumption that everyone is heterosexual or that opposite-sex attractions and relationships are the only norm and therefore superior. This can include extreme repression and denial coupled with forced outward displays of hetero-normative behavior for the purpose of appearing or attempting to feel "normal" or "accepted". The degree to which someone is affected by these ideas depends on how much and which ideas they have consciously and subconsciously internalized. Homophobia encompasses a range of negative attitudes and feelings towards homosexuality or people who are identified or perceived as being lesbian, gay, bisexual or transgender. It can be expressed as antipathy, contempt, prejudice, aversion, or hatred, and may be based on irrational fear, and is sometimes related to religious beliefs. Among lesbians, gay men and bisexuals, internalized sexual stigma, also known as internalized homophobia refers to the personal acceptance and endorsement of sexual stigma as part of the individual's values system and self-concept. It is the counterpart to sexual prejudice among heterosexuals. Homophobia manifests in different forms, and a number of different types have been postulated, among which are internalized homophobia, social homophobia, emotional homophobia, rationalized homophobia, and others. There were also ideas to classify homophobia, racism, and sexism as an intolerant personality disorder. .
When looking back on this historical period the story begins in 1963, six years before the Stonewall riots in Greenwich Village that ignited the gay rights movement; and ten years before the APA decided that homosexuality is not a disorder.