Jul 20, 2007  PAUL VARNELL | COMMENTS     

THE MOST IMPORTANT achievement of the early gay liberation movement was its pressure on the American psychiatric establishment to reexamine its evidence for classifying homosexuality as a mental illness. It was important because if gays weren’t mentally ill, it was hard to justify any kind of discriminatory policies or treatment. How did this remarkable change come about?

One of the most interesting books I’ve read lately is “American Psychiatry and Homosexuality: An Oral History,” a collection of interviews with gay and lesbian psychiatrists and their allies who helped persuade the American Psychiatric Association to reverse its long-standing position.

Until now the only extended account of this effort was Ronald Bayer’s “Homosexuality and Psychiatry: The Politics of Diagnosis” (1981). But Bayer denied that there was any objective standard for mental health so the APA decision was essentially arbitrary and “political.”

By contrast, these first-person accounts provide corrective insider views of the process. Several speak of the depressing psychiatric attitudes prior to 1973. Lawrence Hartmann recalls, “The few analysts who wrote about gay people tended to describe them as nasty psychopaths, close to psychosis. I am not making this up!”

Judd Marmor recalls the view that, “homosexuals were inherently seriously mentally disturbed, irresponsible and completely driven by needs over which they had no control.” They were supposedly “emotionally immature, deceptive, impulsive, unreliable and incapable of truly loving.”

Beginning at the 1970 San Francisco APA convention, gays started to sneak into panels about curing homosexuality and shout objections. Richard Pillard recalls, “Gay infiltrators began yelling from the audience and the psychiatrists began yelling back. The psychiatrists’ vitriol was shocking. To many of the audience it revealed a kind of organic hatred toward gays.”

Finally after similar disruptions at a 1971 convention, gay activist Ron Gold arranged for gays to meet with the APA’s Committee on Nomenclature where they laid out evidence from studies supporting gay mental health. Robert Jean Campbell recalls, “They had a lot of data that I had never seen. I don’t know where they got it, but I was really overwhelmed by the data.”

CAMPBELL ARGUED THAT the committee should take its own look at the scientific evidence about homosexuality. The greatest initial resistance came from a young Robert Spitzer who later changed his mind and shepherded the change through the APA.  

Spitzer recalls thinking, “Is there something that they (other mental disorders) all share that I can argue does not apply to homosexuality?” His conclusion was that people with other conditions “were usually not very happy about it. They had distress or ... in some way the condition interfered with their overall functioning.”

Spitzer continues, “If you accepted what the activists said, clearly here were homosexuals who were not distressed by being homosexual. Instead, they might be distressed by how people reacted to their being gay.”

Based on evidence they gathered, the Committee on Nomenclature recommended delisting homosexuality as a mental disorder and sent its recommendation up through the APA bureaucracy — the Council on Research and Development, the Assembly of District Branches, the Reference Committee. Eventually it reached the APA Board of Trustees, which in December 1973 voted 13 in favor of the change with two abstentions and four members absent.

CURE-THERAPISTS, MOSTLY psychoanalysts such as Irving Bieber and the zealously homophobic Charles Socarides (whose son is openly gay), were furious and began gathering signatures demanding a referendum to overturn the board’s decision. Edward Hanin recalls, “The controversy was led by people who essentially said this was politics intruding into science. It wasn’t. The APA Board of Trustees had reviewed very carefully the evidence related to homosexuality.”

Eventually a referendum was held on the Board of Trustees’ action. Of 10,000 psychiatrists voting, 58 percent supported the board’s decision, 37 percent opposed it and 3 percent abstained. With that vote the issue was settled and the APA finally acknowledged that millions of gay American were not, after all, mentally ill.