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Fryer appeared as Dr. While protests and panels took place, APA engaged in an internal deliberative process of considering the question of whether homosexuality should remain a psychiatric diagnosis. Having arrived at this novel definition of mental disorder, the Nomenclature Committee agreed that homosexuality per se was not one. Several other APA committees and deliberative bodies then reviewed and accepted their work and recommendations. Psychiatrists from the psychoanalytic community, however, objected to the decision. They petitioned APA to hold a referendum asking the entire membership to vote either in support of or against the BOT decision.

It should be noted that psychiatrists did not vote, as is often reported in the popular press, on whether homosexuality should remain a diagnosis. However they usually neglect to mention that those favoring retention of the diagnosis were the ones who petitioned for a vote in the first place. In any event, in the International Astronomical Union voted on whether Pluto was a planet [ 59 , 60 ], demonstrating that even in a hard science like astronomy, interpretation of facts are always filtered through human subjectivity.

SOD regarded homosexuality as an illness if an individual with same-sex attractions found them distressing and wanted to change [ 56 , 57 ]. The new diagnosis legitimized the practice of sexual conversion therapies and presumably justified insurance reimbursement for those interventions as well , even if homosexuality per se was no longer considered an illness.

The new diagnosis also allowed for the unlikely possibility that a person unhappy about a heterosexual orientation could seek treatment to become gay [ 61 ]. However, it was obvious to psychiatrists more than a decade later that the inclusion first of SOD, and later EDH, was the result of earlier political compromises and that neither diagnosis met the definition of a disorder in the new nosology.

Otherwise, all kinds of identity disturbances could be considered psychiatric disorders. What about short people unhappy about their height? Why not ego-dystonic masturbation [ 62 ]? In so doing, the APA implicitly accepted a normal variant view of homosexuality in a way that had not been possible fourteen years earlier [ 63 ]. Similar shifts gradually took place in the international mental health community as well.

As a consequence, debates about homosexuality gradually shifted away from medicine and psychiatry and into the moral and political realms as religious, governmental, military, media, and educational institutions were deprived of medical or scientific rationalization for discrimination. As a result, cultural attitudes about homosexuality changed in the US and other countries as those who accepted scientific authority on such matters gradually came to accept the normalizing view. For if homosexuality was no longer considered an illness, and if one did not literally accept biblical prohibitions against it, and if gay people are able and prepared to function as productive citizens, then what is wrong with being gay?

Additionally, if there is nothing wrong with being gay, what moral and legal principles should the larger society endorse in helping gay people openly live their lives? National Center for Biotechnology Information , U. Journal List Behav Sci Basel v. Behav Sci Basel. Published online Dec 4. Jack Drescher 1, 2, 3, 4. Author information Article notes Copyright and License information Disclaimer. Received Oct 26; Accepted Dec 1. This article has been cited by other articles in PMC.

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Theories of Homosexuality It is possible to formulate a descriptive typology of etiological theories of homosexuality throughout modern history in which they generally fall into three broad categories: pathology, immaturity, and normal variation [ 14 , 15 , 16 ]. Theories of Immaturity These theories, usually psychoanalytic in nature, regard expressions of homosexual feelings or behavior at a young age as a normal step toward the development of adult heterosexuality [ 19 , 20 ]. Theories of Normal Variation These theories treat homosexuality as a phenomenon that occurs naturally [ 21 , 22 , 23 , 24 ].

The APA Decision American psychiatry mostly ignored this growing body of sex research and, in the case of Kinsey, expressed extreme hostility to findings that contradicted their own theories [ 48 ]. Conflicts of Interest The author declares no conflict of interest. References 1. Bayer R. Drescher J. An interview with Robert L. Spitzer, MD. Gay Lesb. An interview with Lawrence Hartmann, MD.

Rosario V. An interview with Judd Marmor, MD. Sbordone A. An interview with Charles Silverstein, PhD. American Psychiatric Association.


Diagnostic and Statistical Manual of Mental Disorders. Psychoanalytic Therapy and the Gay Man. Causes and becauses: On etiological theories of homosexuality. Queer diagnoses: Parallels and contrasts in the history of homosexuality, gender variance, and the diagnostic and statistical manual.

Krafft-Ebing R. In: Psychopathia Sexualis. Wedeck H. Bergler E. Homosexuality: Disease or Way of Life. Freud S. Three Essays on the Theory of Sexuality. Hogarth Press; London, UK: []. Standard Edition Volume 7. Sullivan H. The Interpersonal Theory of Psychiatry. Ulrichs K. Lombardi-Nash M. Kinsey A.

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Lessons from the Intersexed. Bullough V. Homosexuality: A History.

Lesbian/Gay/Bisexual/Transgender Communities and Mental Health

Katz J. The Invention of Heterosexuality.

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Hirschfeld M. In: The Homosexuality of Men and Women.