The Westport Library Resource Guides: Homosexuality and the DSM: About

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History of Homosexuality in the DSM

In 1952, the American Psychiatry Association (APA) Committee on Nomenclature and Statistics developed the first version of the DSM, which served as the first manual of mental health focused on clinical diagnoses and care and provided a glossary and description of psychiatric illnesses. The category of sociopathic personality disturbance included subcategories, such as antisocial reaction, sexual deviation, and addiction. Sexual deviation included different types of behavior classified as pathologic, including “homosexuality, transvestism, pedophilia, fetishism, and sexual sadism including rape, sexual assault, mutilation”. Given the current societal acceptance of homosexuality in many countries—and while it may be difficult to imagine today that homosexuality truly fits into “pathologic behavior”—it is important to understand that inclusion of homosexuality in the DSM served to move same-sex sexual behavior from being regarded as a moral sin and into the secular world of medicine by recognizing it not as a sin but instead as a disorder. Placed within the context of mental health, this formed the foundation for future study of homosexuality by clinicians and for a modern-day understanding of health disparities faced by persons from sexual minority groups.

The publication of the DSM-II in 1968 saw the inclusion of homosexuality again, but in this edition, the heading read simply “personality disorders”. However, it is in this period of history when the push for change began. In 1969, a series of violent uprisings began between police and patrons of a bar in Greenwich Village known as the Stonewall Inn. The Stonewall riot is often viewed as the catalyst for the gay rights movement that resulted over the following years. In 1970, gay rights activists protested at the annual APA meeting in San Francisco. They argued that the psychiatric theories about homosexuality and need for treatment or a cure for their sexuality fueled social stigma around homosexuality. These protests gained the attention of the APA, and at the 1971 meeting, a panel discussion entitled “Gay Is Good” invited gay rights activists to speak on the topic of the stigma and discrimination that they had encountered because of their diagnosis. These activists returned the following year for another panel discussion with Dr. H. Anonymous. Dr. Anonymous was a homosexual psychiatrist who appeared in an oversized suit and mask and spoke into a microphone to disguise his voice. He agreed to appear only with this disguised identity, fearing the impact that it could have on his career. Other influential members of this panel, such as APA Vice President Judd Marmor, would argue that “psychiatry is prejudiced” against homosexual people and that “moral values” of society contributed to the inclusion of homosexuality as a psychiatric condition. He argued for removal of homosexuality from the DSM. Continue reading from American Journal of Psychiatry