|By Dr. Nadia El-Awady
IslamOnline’s Health & Science Editor
Homosexuality in Psychiatry
Until the early 1970s, the U.S psychiatric establishment classified homosexuality as a mental illness. Homosexuality appeared before this in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official reference book for diagnosing mental disorders in America and through much of the world, listed as a sexual disorder. Under growing political pressure from homosexual activists, a task force was set up to review the status of homosexuality; but the members chosen included not a single psychiatrist who held the view that homosexuality was not a normal adaptation. Riots were organized at scientific meetings by gay activists in order to increase the pressure on the Psychiatric Association. Homosexuals wished to be seen as individuals exercising different sexual preferences rather than as being aberrant personalities. Dr. Bieber pointed out that there were several other conditions in the DSM-II that did not fulfill the “distress and social disability” criteria that were used to define a disorder. These included voyeurism, fetishism, sexual sadism, and masochism. Dr. Spitzer of the American Psychological Association replied that these conditions should perhaps also be removed from the DSM-II, and that if the sadists and fetishists were to organize as did the gay activists, they too might find their conditions normalized!
The APA vote was taken with unconventional speed that circumvented normal channels for consideration of related issues.
The factors that determined the decision of the APA to delete homosexuality from DSM-II were summarized as follows:
Gay activists had a profound influence on psychiatric thinking.
A sincere belief was held by liberal-minded and compassionate psychiatrists that listing homosexuality as a psychiatric disorder supported and reinforced prejudice against homosexuals. Removal of the term from the diagnostic manual was viewed as a humane, progressive act.
There was an acceptance of new criteria to define psychiatric conditions. Only those disorders that caused a patient to suffer or that resulted in adjustment problems were thought to be appropriate for inclusion in the Diagnostic and Statistical Manual.
As a result, homosexuality was eliminated from the Diagnostic and Statistic Manual as a sexual disorder in 1973. The DSM did, however, retain a category called “ego-dystonic homosexuality-the feeling of extreme distress over one’s homosexual preference”. Since then, DSM-III has dropped even this category, and the issue of homosexuality is no longer even mentioned.
However, it appears that in contrast to the results of the vote, the majority of the APA membership continued to view homosexuality as a pathology. A survey four years after the vote found that 69% of psychiatrists regarded homosexuality as a “pathological adaptation.” A much more recent survey suggests that the majority of psychiatrists around the world continue to view same-sex behavior as signaling mental illness. (Introduction