The declassification of homosexuality as a mental disorder marked a pivotal moment in the history of LGBTQ+ rights and mental health. This change reflected evolving scientific understanding and the growing recognition of LGBTQ+ individuals’ rights and dignity. This article explores the timeline and significance of removing homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Historical Context: Homosexuality in Early DSM Editions
When the American Psychiatric Association (APA) published the first edition of the DSM in 1952, homosexuality was classified as a “sociopathic personality disturbance.” This classification mirrored the prevailing societal and medical views of the time, which pathologized same-sex attraction and deemed it a deviant behavior.
In the second edition of the DSM (DSM-II), published in 1968, homosexuality was listed under the broader category of “sexual deviations.” While the wording shifted slightly, the underlying perception of homosexuality as a disorder remained.
The Shift in Scientific Understanding
During the mid-20th century, several factors began to challenge the classification of homosexuality as a mental illness:
- Research Findings: Studies, such as those by Alfred Kinsey and Evelyn Hooker, demonstrated that homosexuality was not associated with mental illness or maladjustment. Hooker’s groundbreaking 1957 study showed that the psychological profiles of gay men were no different from their heterosexual counterparts.
- LGBTQ+ Activism: The Stonewall riots of 1969 and the rise of the LGBTQ+ rights movement brought increased attention to the stigmatization of homosexuality, including its classification as a mental disorder.
- Push Within Psychiatry: A growing number of mental health professionals began advocating for the declassification of homosexuality, citing a lack of scientific evidence to support its inclusion in the DSM.
The 1973 APA Decision
In 1973, after years of advocacy and debate, the APA’s Board of Trustees voted to remove homosexuality from the DSM. The decision was informed by:
- Scientific Evidence: Research had consistently shown that homosexuality was a natural variation of human sexuality and not inherently pathological.
- Public Pressure: Activists and organizations like the Gay Liberation Front demanded that psychiatry stop perpetuating harmful stereotypes about LGBTQ+ individuals.
- Internal Advocacy: Prominent psychiatrists, including Dr. Robert Spitzer, played crucial roles in pushing for the reclassification.
As a result, homosexuality was replaced in DSM-II with a new diagnosis: “sexual orientation disturbance,” which applied to individuals who experienced distress about their sexual orientation. This compromise reflected lingering societal biases but was a step toward depathologization.
Full Declassification in 1987
In 1987, with the publication of DSM-III-R, all remaining references to homosexuality as a mental disorder were removed. This change eliminated the “sexual orientation disturbance” and “ego-dystonic homosexuality” diagnoses, marking a complete departure from viewing homosexuality as pathological.
Global Impact
The APA’s decision had far-reaching implications:
- World Health Organization (WHO): In 1992, the WHO removed homosexuality from the International Classification of Diseases (ICD-10).
- LGBTQ+ Rights: The declassification helped reduce stigma and supported the fight for LGBTQ+ equality worldwide.
- Mental Health Practices: It encouraged a shift towards affirming approaches in therapy and mental health care.
Conclusion
The removal of homosexuality from the DSM was a landmark event in both psychiatry and the broader struggle for LGBTQ+ rights. It underscored the importance of basing mental health practices on scientific evidence rather than societal prejudice. While progress has been made, the journey highlights the ongoing need to challenge stigma and advocate for equality and inclusivity in all areas of society.