Some people are not going to like to hear this. Let the angry comments roll.
The American Psychiatric Association (APA) is the organization that determines for the professional community what is normal and what is abnormal. Their Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook widely used by clinicians to assist in diagnosing and classifying mental, emotional, and sexual disorders. The first edition of the DSM, published in 1952, listed homosexuality as a mental disorder, a severe form of psychopathology.
By 1968, the gay community had a few organizations in place and one of their first targets was the APA. Over the next few years, protestors interrupted APA conferences, shouting at the speakers and taking control of meetings. After three years of disrupted conventions, the APA agreed to let gay activists be involved in the decision-making process, even though the activists were not professionals in psychiatry or psychology. Finally in 1973, the board of trustees agreed to redefine mental illness in a way that accommodated homosexuality. Previously, disorders had been determined by deviations from an objective norm, but this redefinition said that the norm should be more subjective, that people should not be considered disordered if they do not experience distress over their condition and if they show no major impairment in social functioning. With this redefinition, homosexuality was removed as a disorder from the DSM-III.
The decision by the APA board was not based on data and clinical reasoning nor did it represent the professional opinions of the practitioners the APA represents. Surveys show that a majority of mental health professionals believes that homosexuality is not normal. (In 1977, for example, a poll was sent to psychiatrists in the USA. 69% of those responding said they considered homosexuality to be the result of psychological maladaption.) In his book Homosexuality and American Psychiatry: The Politics of Diagnosis, Ronald Bayer describes how clinical decisions are made and the factors that influence those decisions. This subjective standard of normalcy set a dangerous precedent, because without an objective standard nearly any deviation can be considered normal as long as the person is not seriously disturbed by his condition. For example, in the DSM-IV, one of the criteria for diagnosing pedophilia (a disorder in which children are the preferred sexual objects) states, "The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." (Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition, American Psychiatric Association, Washington, DC, 1994, p. 528.) Such changes were also made in the criteria for diagnosing sexual sadism and masochism, transvestitism, voyeurism, and exhibitionism. In their attempt to be politically correct, the psychiatric community has lost the distinction between what is normal and what is right.
Today, a growing number of professionals are dissatisfied with the APAâs political commitments and have formed organizations that oppose the APAâs advocacy of social issues such as abortion, the environment, affirmative action, gay rights, support of special interest groups, and other issues irrelevant to the profession of psychology. (For more information, write to Psychologists For a Free APA, 1807 North Elm #321, Denton TX 76201.)
The elimination of homosexuality as a disorder in the DSM has also had a negative effect on clinical research in the area of homosexuality. It is difficult to get funding or recognition for research in an area not listed in the Diagnostic and Statistical Manual. One of the few organizations currently promoting research and documenting clinical successes in treating homosexuality is the National Association for Research and Therapy of Homosexuality.