Just 42 years ago, homosexuality was considered a diagnosable mental illness. In an ironic twist, it is now those who wantonly fear gay people that are being labeled as mentally ill.

According to findings recently published in the Journal of Sexual Medicine, if you harbor homophobic views it’s likely you may also endorse some of the following dysfunctions: misogynism, psychoticism, uber-religiosity, immature coping mechanisms, [discomfort] with close relationships, and above-average levels of anger, aggression, hostility, and hyper-masculinity.

Dr. Emmanuele Jannini, senior author of the study, said, “the study is opening a new research avenue, where the real disease to study is homophobia.” The results conclude that homophobia is a “culture-induced disease” and that it must be “condemned.”

These findings arrive at a time of great relevance and could provide us with a working gestalt of those who irrationally fear and are intolerant toward gay people. Consider the recent kerfuffle of county clerk Kim Davis and her ilk of cross-bearing presidential hopefuls. Given their intolerance and hostility toward gay people, is there a pathology behind their discrimination masquerading as religious freedom? Can one say, for instance, that Kim Davis—who even when held in contempt by the Supreme Court wouldn’t admit to any wrongdoing—is operating on a diseased belief system?

Author Salman Rushdie offered a succinct diagnosis of the Davis situation on Bill Maher’s show. He said: “One of the things that is a classic trope of religious bigots is while they are denying people their rights, they claim that their rights are being denied; while they are persecuting people, they claim that they are being persecuted; while they are behaving colossally offensively, they claim to be the offended party. It’s an upside-down world.”

An upside-down world. Though not a disease in classical medical parlance, the phrase warrants attention.

The study at hand interviewed 551 self-reported heterosexual university students between the ages of 18 to 30 years old. A battery of psychological questionnaires was administered to participants asking questions in regards to relationships, defense styles, and myriad other psychopathological markers. It was the first study of its kind to examine psychopathology alongside homophobia. The traits and attitudes found to predict homophobia happen to mirror the attitudes of the conservative, religious right.

To measure one’s level of homophobia, participants were asked to rate how much they agree or disagree with statements such as “I would hit a homosexual for coming on to me”; I think Homosexuality is immoral”; and “Marriage between homosexual individuals is acceptable.”

Similar to Rushdie’s notion that “religious bigots” live in an upside-down world, the authors of the new study suggest equally disorienting tendencies in homophobic viewpoints. “Specific immature defense mechanisms such as projection, denial, devaluation or somatization were demonstrated in association with homophobia.” This means, those who endorsed these defense mechanisms were more likely to hold homophobic beliefs.

In applying these defenses to Kim Davis one could ask: Does she deny that her beliefs hurt others? Does she project her own fears, insecurities, and beliefs onto others? Is she able to step back and examine the logic propelling her objection to same-sex marriage?

The study also linked homophobia with psychoticism. The authors write, “Homophobia levels could be partially linked by pathologic traits of personality, [such] as psychoticism.” It’s worth noting that people who hold irrational hatred toward gays are not in an acute psychotic state—though blaring “Eye of the Tiger” at a media blitz after serving jail time may suggest otherwise. In this case, psychoticism is rendered as a shared group of traits such as interpersonal alienation, isolation, hostility, and anger toward others.

Through looking at Kim Davis supporters, one may get a glimpse of these psychotic traits in action. Signs from the Ku Klux Klan were spotted at Kim Davis’s Kentucky rally alongside Bible verses, and Confederate flags and other symbols of hatred. Motivated by religious fervor, the messages and symbols displayed by those in support of Davis are intentionally hostile and serve to alienate others by condemning entire groups of people.

Those who fear others, who see the world as a dangerous, threatening place, cling to values and beliefs that promote order, cohesion, and security. Following a controversial line of research, it’s being argued that those who cohere to such rigid beliefs as homophobia may, in fact, be the ones who are ill.