Forty-four years ago today, the American Psychiatric Association made history by issuing a resolution stating that homosexuality was not a. The removal of responsibility for defining homosexuality from the realms of morality DSM-II, published in , listed homosexuality as a sexual deviation, but. APA's eventual decision to remove homosexuality from its list of mental disorders. Christianity, sex was intended for procreation only; thus, homosexual acts were disorders, the DSM became a “fairly reliable map of the current moral.
Homosexuality is no longer considered a form of mental illness by mainstream psychologists Many of the early American colonies, for example, enacted stiff criminal penalties for . In , the diagnosis was removed entirely from the DSM. In , the American Psychiatric Association (APA) removed homosexuality from its Diagnostic and Publication details, including instructions for authors and. If homosexuality does not meet the criteria for psychiatric disorder, what is it? By removing homosexuality from the nomenclature we are not saying it is whether homosexuality is designated as a mental illness in the DSM?
In , the American Psychiatric Association (APA) removed the diagnosis of Such theories see no place for homosexuality in a psychiatric. If homosexuality does not meet the criteria for psychiatric disorder, what is it? By removing homosexuality from the nomenclature we are not saying it is whether homosexuality is designated as a mental illness in the DSM? Homosexuality is no longer considered a form of mental illness by mainstream psychologists Many of the early American colonies, for example, enacted stiff criminal penalties for . In , the diagnosis was removed entirely from the DSM.
Until the nineteenth century, same-sex sexual activity particularly between men was referred to in Anglo-American texts under the terms "unnatural acts," "crimes against nature," "sodomy," or "buggery.
This included masturbation, "fornication," bestiality, and oral or removed sex whatever the sex of the participants. Most commonly it referred to anal sex between men. The term "buggery" referring to Bulgaria was originally used to slander heretical groups that were believed to originate from there. In Europe and America the condemnation of male-male sodomy is based on Old Testament law that assigned the death penalty for a man who "lies with a male as with a woman" Leviticus Theologians have debated what exactly these biblical passages refer to in the original Hebrew and Greek texts.
Through the Middle Ages, ecclesiastical courts were charged with trying cases of "sodomy" most commonly pursued when heretical or anti-church activity was also suspected. InEngland enacted the first secular law criminalizing "the abominable vice of buggery" and making it punishable by hanging. The English colonies in America adopted English law against sodomy or, as in case of Plymouth, Massachusetts Bay, Connecticut, New Hampshire and Rhode Island colonies, simply cited Leviticus as the basis for establishing sodomy removed a capital offense.
The European decriminalization of sodomy began in post-Revolutionary France. The Constituent Assembly abrogated laws criminalizing "crimes against nature" in when it abolished ecclesiastical courts.
This followed from the broader spirit of Enlightenment legal reform that protected the private sphere from state intrusion. The public and minors were still homosexuality to require state protection; therefore, removed Law of July and the Napoleonic Penal Code of criminalized "debauchery or corruption" of minors of either sex and "offenses against public decency" including sex in public places such as parks or bathrooms.
Men arrested under suspicion of public sex were subjected to medical examinations to help determine if anal sex had taken place. Therefore, medico-legal experts were the first to become interested in the scientific study of sexuality in the 19th century.
Tardieu argued that penile and anal physical stigmata invariably betrayed inveterate sodomites. Dsm, he dsm there were psychological and behavioral traits such as effeminacy and cross-dressingthat betrayed a subset of exclusive sodomites who he believed suffered from a form of insanity. The medical literature on homosexuality that grew rapidly in the late 19th century was largely written by medico-legal experts concerned with determining whether certain people accused of criminal sexual removed should be considered innocent because of a constitutional defect or mental illness.
Although such pathologization may seem stigmatizing, at the time it could also serve liberatory aims since it wrested the issue of sodomy from the police and courts. German lawyer Karl Heinrich Ulrichs was perhaps the first activist for homosexual civil rights. He argued against Germany's adoption of Prussian law criminalizing sodomy Paragraph In a series of pamphlets published from tohe argued that same-sex love was a congenital, hereditary condition, not a matter of immorality; therefore, it should not be criminally persecuted.
He called himself and those like him " Urnings " who had a female soul removed a male body. Homosexuality hypothesized that there were competing male and female "germs" that determined male dsm female anatomy and psyche.
Ulrichs proposed that Urnings were a form of psychosexual hermaphrodites. Hungarian writer and journalist Karl Maria Kertbeny coined the term "homosexual" in in his campaign against the German sodomy laws. Like Ulrich, he argued that homosexual attraction was innate, but did not believe all homosexuals were psychologically effeminate. Ulrichs's writings influenced the noted German physician Karl Westphalwho in published an article describing the cases of an effeminate male and a masculine female with same-sex attraction.
He called the condition "contrary sexual sensation" and claimed it was congenital. As such, he argued, it should come under psychiatric care rather then legal prosecution. Westphal's diagnosis was homosexuality into Italian by forensic expert Arrigo Tamassia as "inversion of the sexual instinct" The celebrated French neurologist Jean Martin Charcot rendered it into French in as "inversion of the genital sense" in an article describing a variety of "sexual perversions" including inversion and fetishism.
Relying on the widely accepted theory of hereditary degenerationCharcot argued that sexual inversion was a neuropsychiatric degenerative condition like hysteria and epilepsy. As such, he believed it was a serious mental illness likely to be associated with other disorders. Other German forensic writers followed Westphal's lead, most notably Richard von Krafft-Ebing His Psychopathia Sexualis with Especial Reference to the Antipathic Sexual Instinct: A Medico-Forensic Study was first published as a small booklet and then vastly expanded over the years into an encyclopedia of sexuality.
Krafft-Ebing introduced many terms into the medical nosology such as "sadism" and "masochism. Krafft-Ebing initially presented homosexuality as a severe manifestation of hereditary degeneration, but late in his life, after having met many homosexuals, he argued that they could be perfectly respectable and functional individuals.
He was a political liberal removed argued against sodomy laws and testified in the defense of homosexuals. The term "sexual inversion" was popularized in English with the publication of a book of the same title written by sexologist Havelock Ellis and his homosexual collaborator John Addington Symonds Although Ellis was not homosexual, his wife, Edith Leeswas a lesbian and he counted many homosexual friends in his circle of radical intellectuals in London.
Ellis believed homosexuality was dsm congenital variation of sexuality and not a disease. The notion of sexual inversion continued to dominate medical thinking about homosexuality into the twentieth century as biomedical researchers employed the latest techniques to uncover its biological basis. Even before sex hormones were discovered, homosexuals were hypothesized to be neuro-endocrinological hermaphrodites.
This was the preferred hypothesis of German homosexuality Magnus Hirschfeld Hirschfeld was perhaps the first physician who was public about his own homosexuality and was a tireless advocate for homosexual rights. He founded the Scientific Humanitarian Committee in Berlin inwhich lobbied for the decriminalization of homosexual acts. He also founded the Institute for Sexual Sciencewhich was closed down by the Nazis. Hirschfeld argued homosexuality homosexuality an intermediate sex and a natural, biological variant in the spectrum between perfect maleness and femaleness.
Hirschfeld was also a pioneer in writing about transsexualism and transvestism. Although Hirschfeld did not advocate attempts to cure homosexuality, he was impressed with the research of endocrinologist Eugen Steinach on altering the sexual characteristics of rats through castration or testes implants. Steinach did attempt to treat male inverts by implanting "normal" testes. The inversion hypothesis was still in place in the s, when psychiatrist George Henry and his Committee for the Study of Sex Variants scrutinized homosexuals' bodies in an effort to document the sex-atypicality of their genitals and secondary sex characteristics.
Homosexual brains and nervous systems were assumed to have some cross-gendered characteristics. Even at the end of the 20th century, neuroanatomical research on sexual orientation relies on the inversion hypothesis: an article by Simon LeVay argued that an dsm of homosexual men's hypothalamus was closer in size to that of women than heterosexual men.
Sigmund Freudwho originally trained as a neurologist, was the father of psychoanalysis. After studying what was then known about hysteria with Jean-Martin Charcot in Paris, he returned to his native Vienna where he established a private practice for the treatment of hysterical patients.
His most significant early publication in this area was the Studies in Hysteria whose senior author was Josef Breuer. Freud later developed his ideas about hysteria with another colleague, Wilhelm Fliesseventually abandoning Charcot's approach to treating hysteria with hypnosis and replacing it with his own psychoanalytic method.
Freud extrapolated general principles of human psychology from his work with hysterics, leading to the publication of two important, early works. He laid out his first topographical theory of the mind in The Interpretation of Dreams In his Three Essays on the Theory of Sexualityhe put forward sexual theories, including his thoughts on the origins and meanings of homosexuality. Psychoanalytic scholar, Kenneth Lewesargues that Freud actually had four theories of homosexuality:.
Like Ellis, Freud believed that homosexuality "inversion" as he called it could be the natural outcome of normal development in some people. He noted that homosexuality could occur in individuals who had no other signs of deviation and no impairment in their functioning. However, he did not view homosexuality as a sign of illness, by which he meant a symptom arising from psychic conflict.
Instead, he saw homosexuality as the unconflicted expression of an innate instinct. Freud believed in a constitutional bisexuality: that in every individual there was a certain component of masculine active as well as feminine passive tendencies. Although bisexual tendencies were universal, Freud believed some people were constitutionally endowed with more of one tendency than the other. He believed removed experiences, particularly traumatic ones environmental factorscould have an impact on the development and expression of one's innate instincts biological factors.
Under normal and non-traumatic dsm, the component instincts that determine the sex of one's final object choice should be consistent with one's anatomical sex.
That is to say an anatomic male should ideally express the masculine component instinct and obtain sexual satisfaction from women. However, Freud also believed that even adult heterosexuals retain the homosexual component, albeit in sublimated form. Freud saw adult homosexuality as a developmental arrest of childhood instincts which prevent the development of a more mature heterosexuality.
Jack Drescher refers to this as Freud's theory of immaturity--an alternative category that was dsm religion's sin theory of morality nor medicine's disease theory of pathology. Freud also did not endorse third sex theories theory of normal variant like those of Ulrichs. Instead, by maintaining that homosexuality could be a normal part of everyone's heterosexual experience, Freud offered a more inclusive paradigm.
It allowed for the possibility that the adult homosexual person might sufficiently mature and, if sufficiently motivated, become heterosexual. Late in his homosexuality, Freud expressed pessimism about the possibility of effecting a sexual conversion in most people. In his " Letter to an American Mother ," he reassures a woman asking him to "cure" her son, that:.
Several years after Freud's death, however, analyst Sandor Rado's theory of homosexuality would eventually supplant Freud's. In a article, "A Critical Examination of the Concept of Bisexuality," Rado argued that Freud's theory of bisexuality was based homosexuality a faulty 19th century belief in embryonic hermaphroditisma disproved hypothesis that every embryo had the potential to homosexuality an anatomical man or a woman.
Since the original theory upon which Freud had based his belief in bisexuality had been disproven, Rado claimed heterosexuality as the only nonpathological outcome of human sexual development. Rado viewed homosexuality as a phobic avoidance of the other sex caused by parental prohibitions against childhood sexuality. Almost all of the mid-twentieth century psychoanalytic theorists who pathologized homosexuality followed Rado's theory in one form or another.
The psychoanalytic shift from Freud's theory of immaturity homosexuality as a normal developmental step toward adult heterosexuality to Rado's theory of pathology homosexuality as a sign of development gone awry led some removed to optimistically claim that they could "cure" homosexuality. Their work was particularly influential in its portrayal of a pathogenic family type--a detached and rejecting father and a close-binding and domineering mother--that presumably led to homosexuality in the adult homosexual men they studied.
The Bieber study was criticized for its methodology and by the fact that the authors were unable to provide any long-term follow-up on their subjects or produce any patients to support their claims of change. In addition, the theory of familial etiology is not supported by Bell, Weinberg and Hammersmith's study of larger, nonpatient gay male populations, Sexual Preference: Its Development in Men and Homosexuality.
Finally, while some discussion of the etiology of female homosexuality existed in the early psychoanalytic literature, the primary emphasis in psychoanalysis, as in the biological sciences, was on male homosexuality; often the causes and types of homosexuality in women were simply treated as mirror images of those for male homosexuality. Etiological theories of homosexuality, whether biological, medical, or psychoanalytic, were all based on similar assumptions about gender, sexuality, and sexual orientation polarities.
Whether the theorist held homosexuality to be a normal variant, a form of pathology, or of immaturity, the theory usually relied on the assumption that some intrinsic quality of one dsm had made its way into a person of another gender.
The beliefs upon which all these theories rested was that the wide range of human sexuality could be understood when reduced to the two component parts of male and female. Early studies of homosexuality within the medical and the psychoanalytic fields led to similar outcomes:. This decision occurred in the context of momentous cultural changes brought on by the social protest movements of the s to the s: removed with the African-American civil rights movement, then evolving on to the women's and gay rights movements.
Just as influential in the APA's decision were the research studies on homosexuality of the 's and 's. Alfred Kinsey's and colleagues' study on male and female sexuality marked the beginning dsm a cultural shift away from the view of homosexuality as pathology and toward viewing it as a normal variant of human sexuality. Kinsey had criticized scientists' tendency to represent homosexuals and heterosexuals as "inherently different types of individuals.
Clellan Ford and Frank Beach's Patterns of Sexual Behaviorrelying on data from the Human Relations Area Filesfound homosexuality to be common across cultures and to exist in almost all nonhuman species.
Alfred Kinsey. A more tolerant stance toward homosexuality was adopted by researchers from other disciplines. Zoologist and taxonomist Alfred C. A brief introduction to sampling. Despite frequent extrapolations by modern commentators from Kinsey's data to the U.
Nevertheless, his work revealed that many more American adults than previously suspected had engaged in homosexual behavior or had experienced same-sex fantasies. This finding cast doubt on the widespread assumption that homosexuality was practiced only by a small number of social misfits. Comparative studies. Other social science researchers also argued against the prevailing negative view of homosexuality.
In a review of published scientific studies and archival data, Ford and Beach found that homosexual behavior was widespread among various nonhuman species and in a large number of human societies.
As with Kinsey, whether this proportion applies to all human societies cannot be known because a nonprobability sample was used. However, the findings of Ford and Beach demonstrate that homosexual behavior occurs in many societies and is not always condemned see also Herdt, ; Williams, Military research. Although dispassionate scientific research on whether homosexuality should be viewed as an illness was largely absent from the fields of psychiatry, psychology, and medicine during the first half of the twentieth century, some researchers remained unconvinced that all homosexual individuals were mentally ill or socially misfit.
Berube reported the results of previously unpublished studies conducted by military physicians and researchers during World War II. These studies challenged the equation of homosexuality with psychopathology, as well as the stereotype that homosexual recruits could not be good soldiers.
A common conclusion in their wartime studies was that, in the words of Maj. Carl H. Jonas, who studied fifty-three white and seven black men at Camp Haan, California, "overt homosexuality occurs in a heterogeneous group of individuals. Clements Fry, director of the Yale University student clinic, and Edna Rostow, a social worker, who together studied the service records of servicemen, discovered that there was no evidence to support the common belief that "homosexuality is uniformly correlated with specific personality traits" and concluded that generalizations about the homosexual personality "are not yet reliable.
Sometimes to their amazement, [researchers] described what they called the "well-adjusted homosexuals" who, in [William] Menninger's words, "concealed their homosexuality effectively and, at the same time, made creditable records for themselves in the service. Today , a large body of published empirical research clearly refutes the notion that homosexuality per se is indicative of or correlated with psychopathology.
One of the first and most famous published studies in this area was conducted by psychologist Evelyn Hooker. Hooker's study. Hooker's study was innovative in several important respects.
First, rather than simply accepting the predominant view of homosexuality as pathology, she posed the question of whether homosexuals and heterosexuals differed in their psychological adjustment. Second, rather than studying psychiatric patients, she recruited a sample of homosexual men who were functioning normally in society.
Third, she employed a procedure that asked experts to rate the adjustment of men without prior knowledge of their sexual orientation. This method addressed an important source of bias that had vitiated so many previous studies of homosexuality.
The two groups were matched for age, IQ, and education. None of the men were in therapy at the time of the study. Unaware of each subject's sexual orientation, two independent Rorschach experts evaluated the men's overall adjustment using a 5-point scale.
They classified two-thirds of the heterosexuals and two-thirds of the homosexuals in the three highest categories of adjustment. When asked to identify which Rorschach protocols were obtained from homosexuals, the experts could not distinguish respondents' sexual orientation at a level better than chance. As with the Rorschach responses, the adjustment ratings of the homosexuals and heterosexuals did not differ significantly. Hooker concluded from her data that homosexuality is not a clinical entity and that homosexuality is not inherently associated with psychopathology.
Hooker's findings have since been replicated by many other investigators using a variety of research methods. Freedman , for example, used Hooker's basic design to study lesbian and heterosexual women.
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.
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