JAMA, The Journal of the American Medical Association

Gay Is Okay With APA-Forum Honors Landmark 1973 Events.(Medical News & Perspectives)

It's been 25 years since the American Psychiatric Association (APA) voted to delete homosexuality from its official list of mental disorders and issued a strong statement of support for gay rights. A forum marking this anniversary drew a standing-room-only crowd at the APA's annual meeting in Toronto, Ontario, in June. Speakers discussed the controversy that surrounded efforts to depathologize homosexuality, traced the evolution of psychiatric and psychoanalytic attitudes toward homosexuality and explored the significance of these changes for the mental health of gay, lesbian, and bisexual persons today. Melvin Sabshin, MD, who recently retired after 23 years as medical director of the APA, recalled "tumultuous" demonstrations by gay activists objecting to the classification of homosexuality as an illness and by Vietnam War protesters at the APA's annual meeting in San Francisco, Calif, in 1970, a year when he served as program director. "It was guerrilla theater," he said, "with lots of hard words," so disruptive, in fact, that the APA hired a security consultant to try to ensure more orderly demonstrations at future annual meetings. The screaming eased into discussion, said Sabshin, now adjunct professor of psychiatry at the University of Maryland School of Medicine, Baltimore. At the 1972 annual meeting, a gay psychiatrist, who feared professional repercussions if his identity were known, spoke while wearing a mask. By 1973, however, there were exhibits at the meeting on being "gay, proud, and healthy." Scientific Evidence Was Impetus The social and political impetus for change, Sabshin said, was supported by scientific evidence. The APA's Committee on Nomenclature reviewed numerous studies that used standardized instruments and nonpatient populations and showed that most gay persons were satisfied with their sexual orientation and were not impaired in their social functioning. Pressure to abandon the psychoanalytic view that the "homoerotic level" is simply a stage in development toward mature sexuality, Sabshin said, was part of a broader movement to reexamine ideas about psychopathology in general, "to accept that all of us have some problem or another," and to redefine what is and is not normal. "The development of a rational approach to pathology," Sabshin said, "was salient and helpful to the gay group." Proposals to drop homosexuality from the Diagnostic and Statistical Manual of Mental Disorders, second edition (DSM-II; Washington, DC: APA; 1968) advanced within the APA from local to national levels. In December 1973, Sabshin said, the APA's board of trustees voted in favor of the deletion. …

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