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Homosexuality and the DSM

Last night I listened to This American Life on NPR, and as usual, the program was fascinating and well done. This particular program was the story of how homosexuality transitioned from being considered a pathology (a result of "close binding mothers" and "detached rejecting fathers") to being seen among psychiatrists as a "normal variant".

The DSM, or Diagnostic and Statistical Manual of Mental Disorders, is the "bible" of psychological disorders. It is published by the American Psychiatric Association, and the first edition came out in 1952. I have a copy of the 1987 DSM-III-R, the revised third version. The DSM-IV is most current, and the DSM-V is slated to come out in 2011. The DSM catalogs everything that could possibly be wrong with your mind, from dementia to paranoia and lots more. Professionals use the DSM to diagnose and decide on treatment plans.

In 1974 the DSM downgraded homosexuality from a disorder to a "sexual orientation disturbance". This revision, and subsequent ones that removed homosexuality entirely from the list of pathologies, were the result of activist work from inside and outside the APA. This American Life (TAL) considers the whole story, told by the players of the drama.

One of the TAL reporters is the daughter of a psychiatrist who remained closeted until homosexuality was no longer considered "sick" within his own profession. It turns out there were a whole lot of gay shrinks in the closet. As long as they were considered pathological, they could not legally practice in their field. The story of how gayness was removed from the DSM is a fascinating one. I'm sure you can find this hourlong program online as a podcast or otherwise.

A couple of tidbits gleaned from the program:

Irving Beaver was an army psychiatrist in the 1970's who thought that the army treatment of gays was unconscionable. Once outed, gays were dishonorably discharged. Beaver thought they should be treated, not dishonored. Prompted by what he saw in the army, he completed the largest survey of homosexual behavior. He looked at over 100 gay men, with reports from 77 doctors, and he came up with the idea that gayness was caused by "close binding mothers" and "detached rejecting fathers".

Later on, psychiatrist Evelyn Hooker befriended a gay student of hers, and through him met a whole population of perfectly happy, well-adjusted young homosexual men. This got her to thinking. She found a sample of 30 happy homos, and compared them with 30 happy heteros, collecting the same personal data on all. She then took the personal data, without sexual preference info, and dared psychiatrists to tell them apart. They couldn't.

Hooker made the observation that all previous research on homosexuals had studied men who were in counseling, or institutionalized. She was the first to study "well adjusted" homosexuals, which you wouldn't know existed from the previous literature.

Later on the DSM came to require "subjective distress" in the diagnosis of a disorder. In other words, if you're perfectly happy, and not hurting anyone, you must not be sick.

Feb 2010 notes:

I just hear the same program on TAL again, excellent program. Then I run across this story about how California law requires an investigation into the "cures" for homosexuality. There is some evidence that people ARE cured of their limitation to one gender, so it occurs to me that phobias of any sort of sexuality may also be cured. For example a hetero might become able to be homo with suitable counseling.

It also occurs to me that the lesbian populations with whom I have socialized definitely have some deep family of origin issues. I would like to read Irving Beaver's findings, because he studied gays and decided that there were psychological origins for men being unable to approach a woman. I think that in the lesbian populations I've been around, there are quite a few women who have darned good reasons not to trust men. In my own case, I attempted a lesbian relationship after having been betrayed and hurt in several sequential attempted relationships with men. Once burned-->twice shy is a fundamental rule of human nature. It something hurts too bad, we won't keep trying it.

I think that people who say homosexuality is inborn and that you have no choice in the matter are in denial. And I think that the people who say that homosexuality is entirely choice and that there is no physiological component are ignorant. Both are factors. A person's expression of sexuality has everything to do with their early experiences with gender, their hormonal makeup and that of their mothers during gestation, and with their experiences and opportunities as an adult. This last variable depends substantially on the culture in which the individual comes of age. All three of these factors weigh in, with different weightings for each individual.

An interesting article: http://www.vidahumana.org/english/family/homosex-condition.html

Dr. Nicolosi: What I'd like to do is go over four myths that people have slowly begun to believe, which are certainly not true, but that we have to look at. If we believe these four myths then we will believe that homosexuality is totally acceptable by our society. Homosexuality is not a sexual problem, it is an identity problem. And that's the foundation for the understanding of the homosexual condition. Homosexuality is not a problem about sex. It's not about sexual behavior. It's about identity, specifically gender identity. And we'll go into that a little more.

The four gay myths: -- that ten percent of the population is gay. Absolutely not true. It's a fallacy that has been repeated so many times -- you know they say if you repeat a lie many times people just begin to believe it. In fact, it's really 2.5 % of the population. And people ask the question, how is it possible that 2.5% of the population should have such an incredible influence on the rest of society? That's a very good question.

People are born gay -- there might be something predisposed -- there's a gay gene, perhaps. A number of studies have come out that have claimed that. None of those studies really hold up. The media jumps on these studies and then when the other scientists look at these studies in more detail, we see that they're full of flaws. But in the mean time, people think that they've just discovered some sort of gay gene or something.

Number three: once gay always gay. That's part of the gay agenda to have us believe that. That's absolutely not true. And this is why gay activists are very much opposed to the work I'm doing -- because basically I work with people who come in as homosexual and are able to make a significant change in their life. I do not pretend to claim that they come in homosexual and walk out heterosexual. It's a long term process. In certain cases it might be a lifetime process. But I can tell you that in a significant way many of the men I work with do change.

Number four: that the homosexual is normal in every way except for his sexual preference. That's a euphemism, sexual preference. As we begin to understand the cause of homosexuality, the nature of homosexuality, we are going to see that homosexuality is not just about sexual choice, or sexual preference, but it's a whole psychology, beginning and always staying with the idea that the homosexual suffers from a gender identity.

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