Over the years homosexuality has been seen by the medical community as at best a mental abnormality and at worst the manifestation of insanity and moral depravity. However, in 1973, the American Psychiatric Association declassified homosexuality as a mental disorder. Why did they do this?
The decision to declassify homosexuality as a mental illness was to some degree a product of its time. It arose during the time of the American civil rights and the women’s rights movements. The Stonewall Riots of 1969, in which homosexuals in New York expressed their collective rage over years of being harassed and arrested by police, shone a spotlight on their unique civil rights concerns. However, aside from the political zeitgeist, the majority of psychiatrists had come to realize on scientific grounds that it was a decision whose time had come.
By the late 1800s, there were many European scholars who were theorizing that homosexuality was a congenital variant of human sexual expression and that it need not be seen as a mental disease that prevented an individual from living a normal, happy, productive life. It was the work of several scientists in the middle of the 1900s that provided a firmer basis for this conclusion.
In 1948, Alfred Kinsey and his colleagues published their famous book, “Sexual Behavior in the Human Male.” It was followed several years later by the complementary book, “Sexual Behavior in the Human Female.” Kinsey was not one obsessed by sexual matters. Indeed, he was a biologist with a variety of scientific interests. His doctoral dissertation detailed his research on gall wasps — not a titillating subject. However, his research into the sexual behaviors of American men and women forever changed our simplistic and erroneous notions of what human beings are really like. In his books, Kinsey presented data showing that roughly 4 percent of men and 3 percent of women were exclusively homosexual in their orientations after adolescence. Up to 10 percent of men had long periods of homosexuality in their lives. Homosexuality was described as common and persistent. These exact proportions have been disputed, debated and readjusted over the last 65 years, but with only minor differences from Kinsey’s original reports.
Another critical scientific publication from around this time was “Patterns of Sexual Behavior,” published in 1951 by Clellan S. Ford and Frank A. Beach. My mentor in graduate school at The University of British Columbia was Dr. Boris Gorzalka. Boris had trained with Dr. Richard Whalen, who had been a doctoral student of Frank Beach. Beach was a remarkable fellow, and even in advanced age he maintained his connections with his intellectual progeny. I was privileged to meet him on several occasions. (I recall that he beat me in a spirited game of Pac-Man in a pub in Palo Alto. He was nearly 75 years old at the time. In my own defense, I was new at the game and he wasn’t.) More to the point, “Patterns of Sexual Behavior” detailed the first anthropological, cross-cultural study of homosexuality. Ford and Beach studied sexual behaviors, including homosexuality, in 76 different cultures around the world. They found that in 49 of them, homosexuality was deemed a perfectly acceptable form of sexual expression. Homosexuality didn’t unravel the fabric of those societies, disrupt their heterosexual marriages, damage their children or bring down the wrath of their gods.
Ford and Beach also noted that homosexual behavior was common among non-human primates. They concluded there was a biological basis to homosexuality in humans and primates. This claim has been controversial. Do people choose homosexuality or are they born that way? Because no one is sexually active as an infant and toddler, it is a difficult question to definitively answer. Moreover, there are no simple genetic markers.
In a 2000 study, 27 years after the APA’s declassification, Dr. Martha McClintock found the average age of awareness of sexual orientation by homosexuals was about 10 years old. Another study, published in 2004 by the Sexuality Information and Education Council of the United States, reported that nearly 40 percent of homosexuals were aware of their sexual orientation well before high school. Thus for many, if not most, sexual orientation is already set when the first sparks of sexual interest are kindled.
Since most resistance to homosexuality comes from religious conservatives, there is satisfaction and justification in saying, “I didn’t choose — God made me this way.” Yet, many gays and lesbians still reasonably ask, “If I choose to love another of my sex, what business is it of yours, anyway?”
A third piece of scientific work that changed the minds of psychiatrists about homosexuality was psychologist Evelyn Hooker’s 1957 paper, “The Adjustment of the Male Overt Homosexual.” Dr. Hooker performed a variety of standard psychological tests on healthy homosexual and heterosexual men and found the two groups virtually indistinguishable.
Many studies have shown that homosexuals are more likely to need and seek psychiatric help during their lives. However, in view of the barriers, cruelty and discrimination they have historically faced in our society, such findings would not be surprising. In any case, Hooker’s study showed that homosexuality is neither the cause nor the result of demonstrable psychological pathology.
The complexities of life make simple definitions of mental health impossible. Yet, Freud’s famous maxim that mental health is the ability to work and love has never been improved upon. The American Psychiatric Association was aware that the majority of gay and lesbian people met Freud’s criteria. They came to understand that their sexual orientation was not merely firmly rooted, but irrelevant. Thus, in 1973, the APA wisely concluded that in homosexuality there was no problem that could or should be treated.
• Scott D. Mendelson of Roseburg is lead psychiatrist at the VA Roseburg Healthcare System. He has published numerous research papers and several books in the areas of psychiatry and neuroscience. Submit questions and comments to firstname.lastname@example.org. Questions cannot be answered directly, but may serve as subject matter for future columns.
Homosexuality didn’t unravel the fabric of those societies, disrupt their heterosexual marriages, damage their children or bring down the wrath of their gods.