Diagnostic and Statistical Manual of Psychiatric Disorders and Homosexuality

[Major Kong]

When was homosexuality removed as a disorder from the DSM? What reasons were stated for it being removed? Why was it ever in the DSM as a disorder?

[Shalmanese]

Someone more experienced will probably chime in but Homosexuality was a disorder in the DSM-III but removed from the DSM-IV. Sometime in the early 70's I think. A simple google would tell you.

Basically, we classify mental disorders based on accepted community standards. In the 50's homosexuality was not acceptable. Nowadays, it can be argued that it has become far mroe acceptable. Sometime between then, it moved from being a mental disorder to a lifestyle choice.

[Odinoneeye]

Actually, if you want to be technical, it was out of the DSM III-R, a revised version of the DSM III which wasn't different enough to warrant it's own number.

[Otto]

Everything (http://psychology.ucdavis.edu/rainbow/html/facts_mental_health.html) you could ever want to know about the topic and then some. In a nutshell, homosexuality was declared a mental illness because it was not the norm. Every piece of objective research on the topic argued against its classification. In the early 1970s the gay liberation movement made a concerted effort to have homosexuality de-listed, which it was in 1973.

[Xgemina]

AFAIR Homosexuality was removed in DSM-IV.

According to my Ab Psych professor, it was removed due to lack of clinical evidence showing it to be a mental disorder and overwhelming support of homsexuality not being a mental disorder.

A WAG here, but ab psych deals conditions that are not the norm of society. For many years the majority of people believed that homosexuality was an abnormality or mental disorder and not in line with "normal" society. Therefore it was included. Unfortunately many people still believe that it is an abnormal disorder that can be "cured."

[Ice Wolf]

This cached page from Google (http://www.google.co.nz/search?q=cache:XwuzKpwUuyUJ:library.ftmaustralia.org/health/92/transsexualism.htm+%22DSM-IV%22+%2B+homosexuality&hl=en&ie=UTF-8) regarding a call to have GID removed from the DSM-IV as well, has some info as to why homosexuality was removed. One being that

non-clinical samples of homosexuals demonstrated no more psychopathology than heterosexuals.

Acording to this page however: (http://www.cchr.org/fraud/eng/page16.htm)


In 1973, the APA voted – 5,584 to 3,810 – to cease calling “homosexuality” a mental disorder after gay activists picketed the APA conferences.

[doctordoowop]

Ice wolf is right-that's what happens if a convention is in SF. AFAIK, 1st DSM -1952.
DSM II--68-80
DSM III- 80-87
DSM IIIR -1987-94
DSM IV-1994
DSM TR (text revision) 2000
DSM V due 2006.
What was remarkable about the 1973 events was it was a major change in the DSM between volumes, possibly the only one. The DSM IV TR doesn't even mention homosexuality,per se.

[don't ask]

This (http://www.soulforce.org/main/psychiatric.shtml) is a particularly clear account of psychiatry's dealings with homosexuality. The vote referred to in Ice Wolf's link actually took place in 1974 after many psychiatrists protested that the 1973 Board of Trustees decision was politically motivated. This source doesn't mention that even after the 1974 vote many psychiatrists remained unhappy about the decision as only a small percentage of eligible practitioners had voted. In 1977 10,000 psychiatrist members of the AMA were asked "Is homosexuality usually a pathological adaptation as opposed to a normal variation?". 68% of responses agreed.

I only quote these facts because in the 1970's I was a psychiatric nurse and I know from personal experience that the absence of homosexuality from the DSM doesn't alter what individual psychiatrists believe.

[t-bonham@scc.net]

I was working on computer systems for the State Hospital system at year-end 2000, and I looked this up in the DSM they were using at the time -- DSM IV, I believe.

This code -- 302.0, as immortalized in the Tom Robinson song -- was still in the DSM. The description had changed from earlier version, where it basically said the psychological problem was "homosexuality" to a new description which basically meant "discomfort about your homosexuality". And changed the code to 302.00 -- big difference.

It may have been a big change to the profession, but it seems to me that this code would still leave quite a loophole for unscrupulous doctors or parents.


P.S. As recently as 2001, there were several dozen patients in the State Hospital system with a diagnosis of "302.0 - homosexuality".

[AHunter3]

homosexuality was declared a mental illness because it was not the norm.

Insofar as the presence of any diagnosis within DSM-IV does not necessarily mean that there exists etiological evidence of a genuine brain disorder, that's pretty much how everything in that axis (II, I think?) of the DSM got in there.

"Mentally ill" means a disturbance exists, at least as often as not taking the form "we, the community, find this nut very disturbing".

[doctordoowop]

t-well there is no 302-homosexuality- in the DSM IV or TR. But knowing the competence ,or lack thereof of the"docs," I"m not surprised at anything a state hospital psych does.

A- axis II is for personality disorder/traits & mental retardation. Any diagnosed sexual dysfunction goes on I. BTW, it is mental disorder,not illness. It is rather amazing to read the introduction to the DSM , & the cautionary statements. Basically, they say" this is about mental disorders, but we are not really sure what they are. Bear w/us please." Being in the field, much of psychiatry is still in a gray area-I always say" you can do an MRI of the brain, but not of the mind."

[AHunter3]

Well put, doc -- I could certainly find nothing in any of that to disagree with!

[handsomeharry]

one of the professors at my school pointed out that homosexuality was de-dsm'd after the insurance companies quit paying for it's treatment.

[doctordoowop]

No, not related to insurance $$; the above posts describe what happened after a psych convention in SF in 1973. It is correct however, that post traumatic stress disorder was put in the DSM III in 1980 for public policy reasons-an easy diagnostic label for Viet Nam vets.

[Qadgop the Mercotan]

Doesn't the DSM IV still have the diagnosis of "ego-dystonic homosexuality"? That is, an individual who is so disturbed by their attraction to the same sex that it interferes with their lives?

[Otto]

From my cite: In 1986, the diagnosis [of ego dystonic homosexuality] was removed entirely from the DSM. The only vestige of ego dystonic homosexuality in the revised DSM-III occurred under Sexual Disorders Not Otherwise Specified, which included persistent and marked distress about one's sexual orientation (American Psychiatric Association, 1987; see Bayer, 1987, for an account of the events leading up to the 1973 and 1986 decisions).

<snip>

_ 2. The APA voted in 1987 to "urge its members not to use the '302.0 Homosexuality' diagnosis in the current ICD-9-CM or the '302.00 Ego-dystonic homosexuality' diagnosis in the current DSM-III or future editions of either document" (APA, 1987). They took this action because, although the American Psychiatric Association dropped homosexuality from the DSM-IIIR, the revised manual was not expected to be published immediately. Furthermore, at the time, another widely used listing of mental disorders – the World Health Organization's International Classification of Diseases 9th edition (ICD-9) – still included homosexuality as a diagnosis. In 1992, the WHO removed homosexuality from the ICD-10.

[doctordoowop]

Originally posted by Qadgop the Mercotan
Doesn't the DSM IV still have the diagnosis of "ego-dystonic homosexuality"? That is, an individual who is so disturbed by their attraction to the same sex that it interferes with their lives?

QtM- you're right. Ego dystonic homosexuality was a mental disorder until at least 1980, possibly 1987. As of 1994 and I think 1987 also, there is no specific diagnostic category for homosexuality. The only possible "waste basket diagnosis" would be 302.9: Sexual disorder not otherwise specified. One example given is "Persistent and marked distress about sexual orientation." So if somebody's gay and doesn't want to be, the diagnosis goes here. Regarding insurance payment, this would qualify as a mental disorder and would have to be paid if the person had mental health insurance.

[t-bonham@scc.net]

Originally posted by handsomeharry
one of the professors at my school pointed out that homosexuality was de-dsm'd after the insurance companies quit paying for it's treatment. It was more the other way around: after the APA vote & the de-listing, insurance companies started to decline to pay for treatments to 'cure' homosexuality. (But not due to any moral instinct on the part of the companies -- just that insurance companies will try anything to avoid paying claims.)