In the early 1970s, homophily was removed from the DSM list of mental illnesses. Was the deletion based on scientific insights, or under pressure from the LGBT movement?

Answer

In 1973, the American Psychiatric Association decided to remove homosexuality (the term homophily is used less often: it was about behavior rather than preference) from the third edition of its diagnosis manual, the DSM. Incidentally, that did not prevent people from being treated for their homosexuality until 15 years later.

The main reason, as admitted in the rationale, was that disorders of thought and behavior are highly dependent on cultural evolution, and that in the United States of the 1970s, many voices were heard against discrimination against people on the basis of their sexual preference. Disorders are closely related to what is accepted or not accepted: in the West we have many more eating disorders than cases of possession, for example. This does not necessarily mean that these are imaginary disorders, but that what is possible, what is not possible or is seen as disturbing or unhealthy evolves.

Arguments were also cited in the APA argument, including that most psychiatrists regarded it as a variant of normal sexuality, and that the majority of homosexuals had no problems with their orientation as such, and showed no additional disorders. Those treated for homosexuality usually did so under external pressure from family or a court. A strange argument was also put forward that the treatments of sexual preference had less effect than the treatments of self-image.

The APA was and is a conservative organization, and there were many supporters and opponents, with their own research.

• Irving Bieber (1962) examined homosexuals among dishonorably discharged soldiers and prisoners and described their problems. His conclusion was that it was a psychopathology (deviation) caused by an overprotective mother figure.
• Alfred Kinsey (1948) described in his controversial report on sexuality in the US how 37% of all men surveyed had had homosexual contact – he considered it part of a normal variation of sexual preferences.
• Evelyn Hooker (1956) examined 30 gay men who had never been convicted or fired and compared them to 30 heterosexual men of similar background and intelligence. Three experienced psychiatrists were unable to identify the 30 homosexual persons, neither on the basis of conversations nor on the basis of the reports.
• Charles Socarides (1978) found that some of the homosexual men he studied did indeed have problems with their own orientation and did not feel well. He also pointed out that the APA had caved in due to statistics: because large parts of the population are homosexual, that does not mean that such a thing is normal, according to him. He cited underlying psychological conflicts as the basis for sexual preference, like Bieber.

And then there was the petite histoire of the whole revolution. In 1970, the venerable APA held its annual convention in San Francisco, stronghold of the gay movement of all places. Several activists disrupted the meeting, which ended prematurely. In 1972 at the APA Congress, a masked psychiatrist-researcher gave a moving speech about his dismissal from the University of Pennsylvania “because of those 81 words” in the DSM. And in 1973, at the Honolulu convention, young proponents of abolition came face-to-face with older opponents—the latter losing ground and even being booed.

Scientific conferences, there is always something going on… Especially since outing parties by homosexual psychiatrists also took place during that conference, not in the least by APA chairman John P. Spiegel.