Pride and Progress: How the DSM Came to Celebrate Diversity

 

June is Pride Month to celebrate the LGBT+ community and the ongoing fight for equality. While significant strides have been made, it's important to remember the long journey towards acceptance. Today, the thought of homosexuality being listed as a mental illness seems absurd. But for much of history, the battle for LGBT+ rights included a fierce fight within the medical field.

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  This post explores the changing views of homosexuality in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the most widely used psychiatric guidebook.

From Pathology to Normal Variation: A History of Theories

Throughout history, various theories have attempted to explain homosexuality. Some, like Richard Von Krafft-Ebing's, viewed it as a disease. On the other hand, Sigmund Freud saw it as a stage in development, a theory categorized as " immaturity." Thankfully, others like Karl Heinrich Ulrichs and Karl Maria Kertbeny recognized homosexuality as a natural variation within human sexuality.  (Drescher 2015)

 The Pendulum Swings: Homosexuality in the DSM

The mid-20th century saw a back-and-forth struggle within the DSM, and in 1952, homosexuality was labeled a sociopathic personality disturbance, followed by a reclassification as a sexual deviation in 1968 (Drescher 2015a).

The Fight for Liberation and the Power of Protest

A turning point came in the early 1970s. Galvanized by the Stonewall Riots and other LGBT+ activism, gay rights advocates disrupted the American Psychiatric Association (APA) meetings in 1970 and 1971. This powerful act of protest finally led to the removal of homosexuality as a diagnosis in 1973.

A Step Forward, But Not a Finish Line

• However, the fight wasn't quite over. While removed as a diagnosis, homosexuality was replaced with sexual orientation disturbance in 1973. This terminology still pathologized same-sex attraction, allowing insurance companies to endorse harmful conversion therapies designed to change someone's sexual orientation.
• Finally, in 1987, with the publication of the DSM-III-R, the term sexual orientation disturbance was removed entirely. Homosexuality was no longer considered a mental illness.

Pride Month: Celebrating Progress and Looking Forward

The story of homosexuality and the DSM is one of progress, fueled by activism and a growing understanding of human diversity. Pride Month is a time to celebrate this progress and remember the ongoing fight for full equality. We must continue to advocate for LGBTQ+ rights and ensure mental health services are inclusive and affirming of all sexual orientations and gender identities.

References

Drescher, J. (2015a). Out of DSM: Depathologizing Homosexuality. Behavioral Sciences, 5(4), 565–575. https://doi-org.ezproxy.snhu.edu/10.3390/bs5040565