An excerpt from: The A.P.A. Normalization of Homosexuality, and the Research Study of Irving Bieber
"Dr. Bieber was one of the key participants in the historical debate which culminated in the 1973 decision to remove homosexuality from the psychiatric manual.
His paper describes psychiatry's attempt to adopt a new "adaptational" perspective of normality. During this time, the profession was beginning to sever itself from established clinical theory--particularly psychoanalytic theories of unconscious motivation--claiming that if we do not readily see "distress, disability and disadvantage" in a particular psychological condition, then the condition is not disordered.
On first consideration, such a theory sounds plausible. However we see its startling consequences when we apply it to a condition such as pedophilia. Is the happy and otherwise well-functioning pedophile "normal"? As Dr. Bieber argues in this article, psychopathology can be ego-syntonic and not cause distress; and social effectiveness-‹that is, the ability to maintain positive social relations and perform work effectively--"may coexist with psychopathology, in some cases even of a psychotic order."...
Dr. Bieber describes the deletion of homosexuality from the American Psychiatric Association's diagnostic and statistical manual as "the climax of a sociopolitical struggle involving what were deemed to be the rights of homosexuals."
Gay activist groups believed that prejudice against homosexuals could be extinguished only if, as homosexuals, they were accepted as normal. "They claimed that homosexuality is a preference, an orientation, a propensity; that it is neither a defect, a disturbance, a sickness, nor a malfunction of any sort." To promote this aim, Dr. Bieber reports, "Gay activists impugned the motives and ridiculed the work of those psychiatrists who asserted that homosexuality is other than normal."
A task force was set up to study homosexuality, but the members chosen included not a single psychiatrist who held the view that homosexuality was not a normal adaptation. There followed riots at scientific meetings by gay activists who increased the pressure on the Psychiatric Association.
Will preventive therapy for homosexuality be prohibited, Dr. Bieber wondered, when homosexuality is normalized?
Furthermore is it the proper domain of psychiatry to remove diagnoses to eliminate prejudice?
Dr. Bieber pointed out that there were several other conditions in the DSM-II that did not fulfill the "distress and social disability" criteria: voyeurism, fetishism, sexual sadism, and masochism. A.P.A.'s Dr. Spitzer 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.
Summary
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."
An excerpt from: Psychology's sexual dis-orientation, by MIT Psychologist Gerald E. Zuriff, Ph.D:
"DIAGNOSING HOMOSEXUALITY
In 1952 the American Psychiatric Association formalized its system of diagnosis and published the Diagnostic and Statistical Manual of Mental Disorders (DSM). Today, a DSM listing has practical consequences; whether treatment for a problem is paid for by health insurance companies or a psychological problem qualifies as a disability under various laws often depends on whether it is listed in DSM.
Not surprisingly, given the psychoanalytic theory shared by most clinicians, the DSM listed homosexuality as a psychiatric disorder. Interestingly, it was classified as a sociopathic personality disturbance, meaning that the diagnosis could be made purely on the basis of the homosexuality alone, despite the absence of subjectively experienced distress. In the 1968 revision of the DSM, homosexuality was still included as a disorder but classified more descriptively under "sexual deviations" along with disorders such as fetishism and pedophilia. What followed is unprecedented in the annals of medicine.
The publication of DSMII coincided with the founding of a militant gay liberation movement whose goals included the normalization of homosexuality as a legitimate "lifestyle." Gay activists mounted a furious attack on the American Psychiatric Association for designating homosexuality a disease. Their most effective form of protest consisted of demonstrations at several professional conventions, most critically the 1970 disruptions in San Francisco. Over the next three years, the association was forced to reconsider not only the inclusion of homosexuality in DSMII but also the entire conceptual basis for defining a mental disorder.
The gay liberation movement considered the psychiatric designation of homosexuality a major basis for antihomosexual attitudes in American society. It justified a wide variety of antihomosexual legislation, ranging from laws barring homosexuals from immigrating to the United States or serving in the military to regulations in New York requiring homosexual taxicab drivers to undergo semiannual psychiatric examinations. In a broader sense, the designation reinforced the prevalent attitude that homosexuality is an "illness." According to the activists, this stigmatization not only justified bigotry but also caused gay men and lesbians to turn against themselves in self-hatred. The DSMII diagnosis was seen as a societal attempt to control human sexuality under the guise of a medical diagnosis.
After intense lobbying and debate, in December 1973, the Board of Trustees passed the proposal to remove homosexuality from DSMII. Because of the sharp disagreements within psychiatry, however, the board, as a compromise, replaced homosexuality with "sexual orientation disturbance" for "individuals whose sexual interests are directed primarily toward people of the same sex and who are either disturbed by, in conflict with, or wish to change their sexual orientation." This compromise allowed homosexuality to be dropped as a disorder, giving the gay lobby what it wanted, and, at the same time, it allowed psychiatrists to treat homosexuality under the new diagnosis.
The board's decision unleashed a storm of counterprotest from many psychiatrists. Opponents saw the board's decision as a capitulation to gay activism rather than a reasoned judgment based on medical evidence. They forced the leadership to submit its decision to a referendum of the organization's membership. After an intense campaign, of the approximately ten thousand votes cast, the proposal passed with 58 percent. In retrospect, it seems shocking that the question of whether a condition is a psychiatric disorder should be decided by a vote, but a closer look at the debate indicates that a vote is not as strange as it seems...
THE POLITICS OF HOMOSEXUALITY
Thus, the decision whether homosexuality is a psychopathology is really a social-cultural question rather than a scientific one, and settling the matter by debate and a vote is not as bizarre as it initially appears. Scientific studies may inform the discussion, but the final decision must be a societal value judgment. Accordingly, the continuing controversy in the mental health profession over this issue merely reflects the cultural divergences in our wider society over homosexuality, and politics within the profession have been critical in every stage of this debate.
With the decision voted upon, homosexuality was dropped in the seventh printing of DSMII, and "sexual orientation disturbance" was substituted. In DSMIII, further refinements were introduced. First, "sexual orientation disturbance" was replaced with "ego-dystonic homosexuality" as a term to diagnose clients persistently distressed by their homosexuality and wishing to have heterosexual relationships. This change clarified that only homosexuals were intended and emphasized the impairment in heterosexual functioning. Second, the stated causes of this disorder consisted of the negative attitudes of society toward homosexuality and/or desire for heterosexual life of family and children. Thus, contrary to psychoanalytic theory, the causes were presented as entirely social rather than internal conflicts or family dynamics.
Eventually, even this revised compromise was opposed. Critics charged that the new terminology singled out only homosexuality as an orientation that might lead to distress. Second, it suggested that homosexuality itself can still be considered a disorder rather than a normal variant of human sexuality. Third, it failed to recognize that in the United States, almost all people who are homosexual normally pass through a phase in which their homosexuality is ego-dystonic. Consequently, yet another compromise was devised. In DSMII-Revised, even ego-dystonic homosexuality was omitted. Clients with a "persistent and marked distress about sexual orientation" would now be diagnosed with "sexual disorder not otherwise specified." The term homosexuality no longer appeared..."
Panelists Recount Events Leading to Deleting Homosexuality As a Psychiatric Disorder From DSM
Twenty-five years ago APA leaders, in the glare of a national media spotlight, took the controversial step of deleting homosexuality from the Association's compendium of psychiatric disorders. That action launched APA on a quarter century of efforts to end discrimination against homosexuals and coincided with the increasing willingness of gay and lesbian psychiatrists to insist openly that APA must listen to them.
A panel of psychiatrists who played crucial roles in the fight to end the stigma attached to homosexuality both within and outside the mental health field came together at the APA annual meeting last month to provide insiders' perspectives on that initiative and more recent efforts to alter how psychiatry views gays and lesbians and their sexual orientation.
Melvin Sabshin, M.D., a member of the APA Board of Trustees in the early 1970s and chair of the Scientific Program Committee at that time, described how the alienation gay psychiatrists felt from their APA colleagues led in 1970 to the start of a concerted push for APA to include them in decision making and address their concerns and those of gay patients.
If there was an official kickoff for APA's newly energized gay psychiatrists, it was the 1970 annual meeting in San Francisco, Sabshin suggested, where Gay Liberation Front activists along with political protesters in support of other social and political causes disrupted the meeting. "It was guerilla theater" at that meeting and the one held in Washington, D.C., the next year, he said.
The onset in 1970 of a decline in psycho-analysis's dominance of the field also contributed to the change of mood in psychiatry about pathologizing homosexuality, he noted.
In 1972, for the first time, the annual meeting featured exhibits and discussions spotlighting positive aspects of the lives of gay individuals. Also during that year well-known psychiatrists such as Richard Green, M.D., Judd Marmor, M.D., and John Spiegel, M.D., began openly challenging psychiatrists' attitudes toward and treatment of homosexual patients, Sabshin observed. Marmor, a psychoanalyst who would soon be elected APA president, played a particularly significant role in trying to bridge the chasm that existed between his psychoanalytic colleagues and psychiatrists who were convinced that homosexuality was not an illness.
While many APA members welcomed the new openness and opportunities to reassess their thinking, the stubborn polarization and factionalism that dogged this issue did not suddenly retreat into a quiet corner.
Sabshin credited the chair of APA's Committee on Nomenclature in the early 1970s, Robert Spitzer, M.D., with playing a pivotal role in propelling the evolution of APA's position on homosexuality. That committee was charged with revising the initial version of DSM, and Spitzer-armed with research showing there were no valid data to link homosexuality and mental illness-advocated forcefully for the strategy of deleting homosexuality from the disorders list and replacing it with a new one called "sexual orientation disturbance."
In a key vote in December 1973, the Board of Trustees overwhelmingly endorsed Spitzer's recommendation. Opponents of the decision attempted to overturn it with a referendum of the APA membership in early 1974-just as Sabshin was beginning his 23-year tenure as APA medical director. The Board's decision to delete homosexuality from the diagnostic manual was supported by 58 percent of the membership.
At the same time the debates over sexual orientation and psychopathology were occurring, a small group of gay psychiatrists was holding informal meetings to explore forming an organization that would heighten their visibility and that of gay patients. This event, unthinkable two or three years earlier, explained Robert Cabaj, M.D., to the overflow audience, culminated in 1978 in the establishment of the organization that eventually became the Association of Gay and Lesbian Psychiatrists (AGLP), which now has more than 600 members.
Also in 1973 APA passed a position paper calling on psychiatrists to advocate for full civil rights for gays and lesbians and to work to end the discrimination they endure, noted Cabaj, who is medical director of the San Mateo County Mental Health System and coauthor of a textbook on homosexuality and mental health. He hailed that paper as "the cornerstone of everything that has happened since" in APA's relationship to homosexuality.
Gay Psychiatrists More Visible
Through the rest of that decade, while issues affecting gay and lesbian psychiatrists and patients continued to achieve greater visibility in clinical and scientific forums, the voices of openly gay and lesbian psychiatrists were still rarely heard in APA policy discussions. That changed in 1982 when the APA Assembly granted a formal vote to gay and lesbian psychiatrists as a minority/underrepresented group, a status similar to that already achieved by other minority groups.
In the mid 1980s APA formed a task force on homosexuality issues, and by that time, Cabaj emphasized, it was able to focus not on the psychopathology battle but on homophobia, discrimination, and stereotyping. The task force was eventually elevated to a permanent component, the Committee on Gay, Lesbian, and Bisexual Issues. One of its earliest chairs was San Francisco psychiatrist James Krajeski, M.D., who this month became editor of Psychiatric News.
One of that committee's earliest endeavors was to remedy once again a defect that gay psychiatrists and many others perceived in the way in which the latest version of the DSM labeled some homosexuals. With the introduction of DSM-III in 1980 the diagnosis of sexual orientation disturbance had been changed to ego-dystonic homosexuality, which applied to people persistently distressed by their sexual orientation and desperate to change it. With another revision under way in 1986, committee members focused their efforts on successfully convincing the DSM task force to remove any such designation that linked sexual orientation with psychopathology.
Next 25 Years
The next several years will likely be a time of "consolidation of gains as psychiatrists who are more comfortable and open about homosexuality come up through the ranks," predicted Howard Rubin, M.D. A "gay-affirmative psychiatry" that has emerged over the last few years will become more commonplace "as long as we don't become complacent," he said.
While gay psychiatrists "now have a place at the table," APA and psychiatry in general will still have to address several troubling issues related to homosexuality, said Rubin, a research fellow at UCLA and member of the APA Committee on Gay, Lesbian, and Bisexual Issues. Prominent on this list is the large number of psychiatry residency programs where nothing is taught about homosexuality or where the program is "gay for a day," that is, where a few hours are devoted to this topic often via a guest speaker. In addition, psychiatrists will be called upon to take a leadership role in discussions of the relative influence of biological factors on the development of sexual orientation, he said.
With psychiatry having depathologized homosexuality, he said, the field's next task is to acknowledge that there are real mental health consequences of being gay, but to address them as individual responses to homophobia and social prejudice.
Carolyn Robinowitz, M.D., who recently became dean of Georgetown University's medical school and is a former senior deputy medical director of APA, has long been an advocate and ally on the many of the issues discussed by the other panelists.
"Let's hope," she emphasized, "that we have learned valuable lessons about the harm that comes from imposing a blanket of psychopathology over any group."
Robinowitz added, "While the DSM action was but one of many changes in the past 25 years, and while many people still view homosexuality in value-laden and not always rational ways, the decision had a major impact on other health professionals and the general public. I wish it had more.
"We still have a long way to go," she said, until gays and lesbians gain full acceptance.-K.H.
Here's some information about the other APA - The American Psychological Association:
Former APA President Condemns APA for Barring Research
"The APA is too goddamn politically correct...and too goddamn obeisant to special interests!" said Robert Perloff, 1985 President of the American Psychological Association.
Dr. Perloff delivered those uncensored remarks during a rousing speech to psychologists at the 2001 APA Annual Convention.
In an expression of public anger and frustration, Dr. Perloff condemned the APA's one-sided political activism. Of reorientation therapy with homosexuals, he said: "It is considered unethical...That's all wrong. First, the data are not fully in yet. Second, if the client wants a change, listen to the client. Third, you're barring research." (1)
Dr. Perloff is a recipient of the American Psychological Foundation's Gold Medal Award for Lifetime Achievement in Psychology in the Public Interest. In bestowing the award, the Psychological Foundation recognized Perloff for his noted "love of social justice" and his career-long struggle to champion "the rights and dignity of women, minorities, and homosexuals."
But, Perloff asked, "How can you do research on change if therapists involved in this work are threatened with being branded as unethical?"
Contacted by NARTH, Dr. Perloff added the following comment in an interview:
"I believe that APA is flat out wrong, undemocratic, and shamefully unprofessional in denying NARTH the opportunity to express its views and programs in the APA Monitor and otherwise under APA's purview." (2)
"APA past presidents sounded off about what they think the field, and APA, ought to value in psychology's second century at APA's 2001 Annual Convention.
They advocated wildly divergent--sometimes controversial--goals for psychology, from dismantling organized religion to lifting the stricture on conversion therapy...
Robert Perloff, PhD (APA's 1985 president), of the University of Pittsburgh, unabashedly charged that APA is "too politically correct, too bureaucratic, too obeisant to special interests." He called on APA to ease strictures against:
Conversion therapy. "It is considered unethical....That's all wrong. First, the data are not fully in yet. Second, if the client wants a change, listen to the client. Third, you're barring research."
APA Monitor Online - Letters, VOLUME 30 , NUMBER 8 September 1999:
"IN HIS JUNE 9 LETTER TO REP. Tom DeLay (R-Texas) discussing an article by Rind, Tromovitch and Bauserman (1998), Dr. Raymond Fowler, speaking for APA, asserts:
"We acknowledge our social responsibility...to take into account not only the scientific merit of articles but also their implication for public policy....Clearly the article included opinions of the authors that are inconsistent with APA's stated and deeply held position on child welfare...issues....Three inconsistencies between the conclusions the authors suggest and positions of the association should have caused us to evaluate the article based on its potential for misinforming the public policy process. This is something we failed to do, but will do in the future....We are strengthening procedures within the association to assure that journal editors will fully consider the social policy implications of articles on controversial topics."
This new editorial policy effectively transforms APA's "stated and deeply held positions" into religious dogma, immune from empirical or logical refutation. Any scientifically sound paper presenting empirical data or reasoned argument contrary to APA public policy positions will be rejected by the 37 journals published by APA on the grounds of its "potential for misinforming the public policy process." APA's public policies will reign unchallenged.
Fowler has it backwards. Scientific findings should help determine public policies, not the reverse. The flap over this article demonstrates yet again that the social policy stands of APA are dictated more by the ideology of its leadership than by science.
Gerald E. Zuriff, Ph.D
Cambridge, Mass.
And here's an excerpt from the letter that follows Dr. Zuriff's:
"... Such statements point to a political agenda that we are seeing all too frequently in APA journals..."
A. Dean Byrd, PhD
American Fork, UtahS. Brent Scharman, PhD
Salt Lake City, UtahEd D. Lauritsen, PhD
Phoenix, Ariz.
An excerpt from "The Annals of Homosexuality":
The Sexual Deviations and the Diagnostic Manual," by Charles W. Socarides, M.D., American Journal of Psychotherapy, Volume XXXII, Number 3, July 1978
"... This 1978 article by NARTH past-president Charles Socarides describes the intellectual confusion and diagnostic inconsistency which led to the removal of homosexuality from the diagnostic manual. Those changes rendered chaotic, Dr. Charles Socarides notes, some very fundamental truths about unconscious dynamics...
Those words from Dr. Socarides have indeed proven to be predictive: today, there is a growing movement which conceptualizes gender as a personal choice--one which need not be correspondent with the person's biological sex. Gay activists have been mobilizing in order to rid the diagnostic manual of the category of Gender-Identity Disorder, and they are working to prevent clinicians from treating childhood gender-identity disorder as a problem--instead calling for an acceptance of a child's cross-gender behavior as expressive of "who that child really is."
Dr. Socarides provides a step-by-step account of the historical events leading to the normalization of homosexuality, the rationale presented by those who favored removal of homosexuality as a disorder, and the objections to this position held by other psychiatrists who were versed in the therapy of homosexuality...
This paper presents an historical account and a critical analysis of the diagnostic problems surrounding our understanding of the sexual deviations and their position in our classification system.
Appropriate therapy can only be based on accurate diagnosis. Exceptions of this principle of psychiatric care cannot be made for social/political reasons without incurring formidable difficulties both for the diagnostician and the patient as well...
If such changes are due to social and/or political activism, neither the goal of individual liberties nor the best interests of society are served. These changes would remove from psychoanalysis and psychiatry entire areas of scientific progress, rendering chaotic fundamental truths about unconscious psychodynamics, as well as the interrelationship between anatomy and psychosexual identity.
The tragic consequences of the politicizing of the sexual area of diagnosis have already occurred, as homosexuality has been deleted as a psychiatric disorder from the latest printing (July 1974) of the DSM II, even from its bracketed position beside "sexual orientation disorder." This position misinforms psychiatry, the medical profession, individual homosexuals, their families and governmental agencies which are responsible for mental health policies and third party payments...
Some behavioral sciences insist that there are no sexual deviations, only alternative or different lifestyles, and that these conditions are merely a matter of social definition, some made permissible by society, and others socially condemned. This is in keeping with the behavioristic point of view that all one could see, test, and modify was conscious behavior; and if human beings were allowed to express their sexuality freely, culture would change to reflect and accept all individuals as healthy. The conclusion drawn, as in the case of homosexuality, is: homosexuals are healthy; society is "sick"; consequently in order to remedy society's ills, fundamental changes in psychiatric diagnosis must be undertaken...
Some statisticians, beginning with Kinsey, behavioral psychologists, and psychiatrists (in contrast to most psychoanalysts) supply incidence rates of certain phenomena as if behavior had no connection with motivation. Since neither conscious nor unconscious motivation is even acknowledged, these studies arrive at a disastrous conclusion that the resultant composite of sexual behavior is the norm of sexual behavior. The next step is to demand that the public, the law, medicine, psychiatry, religion, and other social institutions unquestioningly accept this proposition...
On December 14, 1973 the Board of Trustees of the American Psychiatric Association, meeting in Washington, D.C., eliminated homosexuality from the official Diagnostic and Statistical Manual without presenting substantive evidence for such a drastic revision of basic concepts of healthy vs. unhealthy sexual development. It should be noted that the World Health Organization's Diagnostic and Statistical Manual has not as yet followed suit.
One of the two reasons for the removal was an official position paper (12) prepared by Dr. Robert Spitzer (Chairman, Nomenclature Task Force on Homosexuality, A.P.A.) for the Board prior to its decision. According to an article in Psychiatric News, "It was essentially upon the rationale of Dr. Spitzer's presentation that the Board made its decision."(13) This paper in essence repeated Kinsey's earlier assertion that homosexuality did not meet the requirements of a psychiatric disorder since it "does not either regularly cause subjective distress or [is] regularly associated with some generalized impairment in social effectiveness or functioning"...
The removal of homosexuality from the DSM II was all the more remarkable when one considers that it involved the out-of-hand and peremptory disregard and dismissal not only of hundreds of psychiatric and psychoanalytic research papers and reports, but also of a number of other serious studies by groups of psychologists, psychiatrists, and educators over the past seventy years (the Group for the Advancement of Psychiatry Report, 1955; the New York Academy of Medicine Report, 1964; the Task Force Report of the New York County District Branch A.P.A. 1970-72). It was a disheartening attack upon psychiatric research and a blow to many homosexuals who looked to psychiatry for more help, not less...
Summary
Prior to 1973, the Diagnostic and Statistical Manual had made valuable contributions our comprehension of the sexual deviations so that clinical research was beginning to fathom their ineluctable secrets. The "normalizing" of homosexuality and the consequent revision of the DSM reflecting this position cannot help but slow scientific progress, produce despair in those with a sexual deviation, and diminish efforts at prophylaxis based on sound principles of causation and treatment.
This author provides a step-by-step account of events leading to the "normalization" of one of the major sexual disorders, the rationale presented by those who favor removal of homosexuality as a disorder, and the objections to this position held by other psychiatrists versed in the therapy of these conditions..."
"In 1973, the APA removed Homosexuality from its diagnostic category of mental illnesses. This action came not as a result of new research and findings, but was ultimately brought about by militant protest staged by activists at the APA annual convention. In other words, intimidation was a key motivation. In fact, only 16% of the entire APA membership actually voted in favor of the radical change."
-- Homosexuality, Dr. James Mallory, Head of Psychiatric unit – Rapha Center, Atlanta, Ga.; Ronald Bayer, Homosexuality and American Psychiatry: The Politics of Diagnosis (N.Y.: Basic Books, 1981), 101-54; Wm. Dannemeyer, Shadow in the Land (San Fran.: Ignatius Press, 1989), 24-39.
"The short answer to the question, "Is homosexuality a psychopathology?" is no, if a person were to mean that the answer can be found by a quick look through the Diagnostic and Statistical Manual of Mental Disorders; Fourth Edition (DSM-IV) of the American Psychiatric Association. Homosexuality is not listed as a formal mental disorder in the DSM-IV, and hence it is not a "mental illness." But, as we will see in this chapter, answering the question, "Is homosexuality a psychopathology?" is much more complicated than simply checking a manual...
A Review of the Scientific Literature It is widely known that in 1974 the full membership of the American Psychiatric Association (APA) followed the 1973 recommendation of its board by voting to remove homosexuality as a pathological psychiatric condition as such (or "in itself") from the DSM, which is the official reference book for diagnosing mental disorders in America (and through much of the world).
The removal of homosexuality from the DSM was in response to a majority vote of the APA. The original APA vote was called at a time of significant social change and was taken with unconventional speed that circumvented normal channels for consideration of the issues because of explicit threats from gay rights groups to disrupt APA conventions and research.
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.
The removal of homosexuality from the DSM does not answer the thorny question of the morality of homosexual behavior, as we will discuss later. It also does not answer the question of whether or not homosexual orientation is "healthy." Removal of the diagnostic category from the DSM is not the same thing as an endorsement of homosexual orientation or lifestyle as healthy or wholesome, as the two surveys conducted since the APA vote would indicate. By analogy, a person can certainly be in a condition where he or she fails to manifest an identifiable physical disease, yet also fails to be an exemplar of health and fitness...
Summary
- Homosexuality is not formally recognized as a mental disorder in the DSM. However, some mental health professionals disagree: a few years following the removal of homosexuality from the DSM, the majority of psychiatrists in America viewed homosexuality as a pathology, and the majority of psychiatrists around the world continue to see same-sex attraction as signaling a mental illness.
- Research has shown that it is not the case that all homosexuals are inherently pathological. Sometimes these findings are misrepresented to suggest that homosexuals do not experience any greater distress than heterosexuals.
- Research supports a relationship between homosexuality and personal distress (e.g., rates of depression, substance abuse and suicidality), though not all homosexuals are distressed. Some view the distress as indicating something inherently wrong with homosexuality; others view homosexuals who are distressed as a reflection of societal prejudice.
- Research on maladaptiveness is inconclusive primarily because of the lack of agreement as to what constitutes maladaptiveness. The clear evidence of relational instability and promiscuity among male homosexuals must figure as problematic for Christians.
- Homosexuality violates societal norms; however, mental health organizations have taken the formal position that societal norms have to be changed toward accepting homosexuality as a normal sexual variant.
- Research on whether homosexuality is a pathological condition is not formally relevant to the moral debate in the church. Psychological abnormality and immorality are two different things, although sometimes they overlap."