Homosexuality in DSM
Classification of gay, lesbian, and bisexual sexual orientations underwent major changes in different editions of Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association (APA). DSM I classified these orientations under "paraphilia", and DSM II under "sexual orientation disturbance". DSM III further modified this to "ego-dystonic homosexuality", before finally dropping the subject from DSM-III-R (and subsequent editions).
The DSM-II considered homosexuality as one form of paraphilia, but in the seventh printing of DSM-II homosexuality had shifted to another classification, which is sexual orientation disturbance. This major change had been preceded by increasing activities of the LGBT community in the 1960s, specifically the Stonewall riots in 1969. These activities continued in 1970 with the following predominant events:
- As described by Ronald Bayer, a psychiatrist and gay rights activist, specific protests by gay rights activists against the APA began in 1970, when the organization held its convention in San Francisco. The activists disrupted the conference by interrupting speakers and shouting down and ridiculing psychiatrists who viewed homosexuality as a mental disorder. In 1971, gay rights activist Frank Kameny worked with the Gay Liberation Front collective to demonstrate against the APA's convention. At the 1971 conference, Kameny grabbed the microphone and yelled: "Psychiatry is the enemy incarnate. Psychiatry has waged a relentless war of extermination against us. You may take this as a declaration of war against you." This activism occurred in the context of a broader anti-psychiatry movement that had come to the fore in the 1960s and was challenging the legitimacy of psychiatric diagnosis. Anti-psychiatry activists protested at the same APA conventions, with some shared slogans and intellectual foundations. Presented with data from researchers such as Alfred Kinsey and Evelyn Hooker, the seventh printing of the DSM-II, in 1974, no longer listed homosexuality as a category of disorder. After a vote by the APA trustees in 1973, and confirmed by the wider APA membership in 1974, the diagnosis was replaced with the category of "sexual orientation disturbance".
- 1973 – On 15 October the Australian and New Zealand College of Psychiatry Federal Council declares homosexuality not an illness – the first such body in the world to do so; in December the American Psychiatric Association removes homosexuality from its Diagnostic and Statistical Manual of Mental Disorders (DSM-II), based largely on the research and advocacy of Evelyn Hooker.
In DSM-III, homosexuality had been shifted to a new "Ego-dystonic homosexuality" classification.
In DSM-III-R, the new "Ego-dystonic homosexuality" classification was also removed and was largely subsumed under "sexual disorder not otherwise specified", which can include "persistent and marked distress about one's sexual orientation.
- Ronald Bayer Homosexuality and American Psychiatry: The Politics of Diagnosis (1981) Princeton University Press. p. 105
- McCommon, B. (2006) Antipsychiatry and the Gay Rights Movement[permanent dead link] Psychiatr Serv 57:1809, December doi:10.1176/appi.ps.57.12.1809
- Rissmiller, DJ, D.O., Rissmiller, J. (2006) Letter in reply[permanent dead link] Psychiatr Serv 57:1809-a-1810, December 2006 doi:10.1176/appi.ps.57.12.1809-a
- Spitzer, R.L. (1981). "The diagnostic status of homosexuality in DSM-III: a reformulation of the issues". Am J Psychiatry. 138 (2): 210–215. doi:10.1176/ajp.138.2.210. PMID 7457641.
- Mayes, R.; Horwitz, AV. (2005). "DSM-III and the revolution in the classification of mental illness". J Hist Behav Sci. 41 (3): 249–67. doi:10.1002/jhbs.20103. PMID 15981242.
- Spiegel, Alix; Glass, Ira (18 January 2002). "81 Words". This American Life. Chicago: WBEZ Chicago Public Radio.