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Imagine if you could cure a disease simply by taking a vote. Well, that’s sort of what happened on April 8, 1974, when the American Psychological Association (APA) announced that it would remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM). Suddenly, all the millions of queer people around the world were freed of a diagnosable illness as they saw homosexuality removed completely from the DSM.
That homosexuality was even considered a disease was the fault of unexamined prejudices dating at least back to Sigmund Freud, who talked openly about same-sex attraction being linked to paranoia. For decades, it was taken as common knowledge that men who like men and women who like women were in need to treatment.
That started to change around 1970, when organizers protested the APA convention in San Francisco. They marched again in 1971, and by 1973, a task force within the APA wrote that homosexuality be considered normal. The organization didn’t quite go that far, but the next year they removed it from the books as an illness.
“Clearly homosexuality, per se, does not meet the requirements for a psychiatric disorder,” wrote the APA’s Board of Trustees, “since, as noted above, many homosexuals are quite satisfied with their sexual orientation and demonstrate no generalized impairment in social effectiveness or functioning.”
How was such rapid change possible? Well, it was thanks — at least in part — to the work of researchers like Alfred Kinsey. As early as the 1940s, he was writing about the realities of same-sex attraction: That it is normal, that it is healthy, and that it is something that can be enjoyed.
In addition, psychoanalysis was falling out of favor by the 1970s, and much of the stigma around homosexuality could be traced back to that style of therapy.
The 1972 meeting of the APA marked a significant shift from past events. After two years of protests, that year’s meeting featured presentations that highlighted the healthy and affirmative aspects of homosexuality.
The DSM reforms were spearheaded by Dr. Richard Spitzer, who was the chair of the APA’s Committee on Nomenclature. He gathered mountains of evidence that it was inappropriate to link homosexuality with mental illness, and it was his recommendation that the APA eventually endorsed. When thousands of APA members voted on the measure, it passed by 58%.
And behind the scenes, a new group of LGBT therapists was quietly organizing. Initially, they just met for social and support purposes, but eventually, their gathering became the Association of Gay and Lesbian Psychiatrists.
Since then, the practice of psychiatry has undergone massive changes. A new generation of professionals has ascended in a climate where homosexuality has never been a diagnosable illness. Therapists now tend to affirm their patients’ sexuality, and even when patients express discomfort with their sexual orientation, they are guided to come to terms with it rather than changing it.
Still, even decades later, there are advances to be made. Many educational programs still teach nothing or too little about sexual orientation, leaving doctors unprepared for issues that affect queer people.
But this is a problem that is not only fixable, but it is also already being addressed by institutions around the country. Forty years after the APA removed homosexuality from its pages and cured the country overnight, we’re closer than ever to full acceptance.