Fifty years ago today, the American Psychiatric Association dropped “homosexuality” from its list of mental disorders. The historic event was lauded as a key advancement for the cause of LGBTQ+ equality.
Prior to Dec. 15, 1973, the APA had classified homosexuality as a mental illness. But in 1964, gay men and lesbians began to openly protest that stigmatizing label.
Barbara Gittings and Kay Lahusen were lesbian activists who emphatically opposed the label. They lived together in Philadelphia and managed to convince another Philadelphian, gay psychiatrist Dr. John E. Fryer, to address an APA annual convention in May 1972 in Dallas, Texas.
Dr. Fryer addressed the assembled psychiatrists wearing a mask and with his voice distorted. But he delivered a moving plea for the APA’s removal of the stigmatizing mental-illness label.
Nineteen months later, on Dec. 15, 1973, the APA’s board of trustees agreed to stop classifying homosexuality as a mental illness. (The decision was upheld in April 1974 through a referendum, with about 10,000 psychiatrists voting.) The board also adopted a resolution deploring discrimination against lesbians and gay men in the fields of housing, employment and licensing.
In addition, the board issued this statement: “The APA supports and urges the repeal of all legislation making criminal offense of sexual acts performed by consenting adults in private.”
The APA’s actions made front-page news the next day in the venerable New York Times. Gay men and lesbians across the country felt a significant morale boost. Public opinion regarding them also improved.
Momentum increased for LGBTQ-inclusive antibias ordinances throughout the country. Today, hundreds of such ordinances exist. In 2003, the U.S. Supreme Court struck down sodomy laws that criminalized lesbian and gay sexual activity.
Gittings, Lahusen and Fryer have passed away. But Fryer’s home in Germantown was added to the city’s Register of Historic Places in 2022. A historic marker in front of the property praises Fryer’s efforts on behalf of the LGBTQ+ movement.
LGBTQ+ advocates and allies recalled the pivotal event 50 years ago.
Jack Drescher, M.D. Distinguished Life Fellow of the APA: “It changed the world but it took a while. It didn’t happen overnight. Removing ‘homosexuality’ from the diagnostic manual denied people a rationalization for discrimination. Prior to 1973, the stigma of mental disorder was added to the stigma of homosexuality. So it was a double stigma. At least the mental-disorder stigma was removed by the APA. We’re still fighting on the other front. Conversion therapy is yet another problem we must continue to address.”
Dr. Danna Bodenheimer, licensed clinical social worker: “It was a liberation. It was a vindication, in that people were starting to be accepted and not pathologized. It set the tone for the mental-health field having to reconsider its role as being more supportive rather than trying to cure something that wasn’t an illness. The dropping of the label shifted the expertise back to the queer community and took it out of the hands of the American Psychiatric Association. It started a movement towards feeling more confident in one’s identification with queerness. There’s still tremendous work to be done in how the psychiatric world thinks about queerness. But this was an important breakthrough.”
Tommi Avicolli Mecca, longtime advocate: “That [1973] decision didn’t happen in a vacuum. Many activists and organizations fought hard for years to make that happen. Without a doubt, that decision saved countless lives. And it continues to save lives every day.”
Sarah Kate Ellis, president and CEO of GLAAD: “The APA’s recognition opened the door for the medical and scientific communities to better support LGBTQ people — and that encouraged families, schools, churches and workplaces to do the same. Today more LGBTQ people are out than ever before and acceptance for LGBTQ people and our relationships is at a record high. Opponents of LGBTQ equality are still fighting and losing against this rising tide of acceptance — lately with lies about transgender people’s private health care — which is supported by every major medical association. The APA’s decision a half-century ago should remind every American to continue to speak up for LGBTQ people, for the truth about our lives, and for our right to live and thrive in health, safety and happiness.”
Michael Clark, retired nursing-program director: “My memory is Dr. David Reuben’s book, ‘Everything You Wanted to Know About Sex But Were Afraid to Ask.’ It was a big deal at the time. His whole thing is that we were disgusting freaks. When he got to homosexuality, it was just evil. It was vile. He was laughing at gay people. Very hurtful. It came out at a time when I was very vulnerable. He was using his identity as a psychiatrist to put us down. He reinforced the stereotype of gay men as desperate sex addicts. For gay people, especially young people such as myself at the time, the book was a cause for despair. In this context, the APA’s decision to remove homosexuality as an illness had specific meaning. I was not involved in the protests as I was a little bit too young and had not come out. However, it gave me hope during a very crucial time in my life. My coming out was made much, much easier as the APA decision marked the end of a time when we were only able to endure.”
Ash Orr, spokesperson for National Center for Transgender Equality: “The removal of ‘homosexuality’ from the APA’s second edition Diagnostics & Statistical Manual (DSM-II) was a major victory in the LGBTQI+ community’s fight for freedom as well as a reminder of the mistreatment that previous generations of the LGBTQI+ community were forced to endure. While we celebrate this victory for the broader LGBTQI+ community, transgender people are still pathologized to this very day. As recently as 1980 (in the DSM-III) and 1990 (in the World Health Organization’s tenth edition International Classification of Diseases) ‘transsexualism’ was the official diagnosis for transgender people. While this diagnosis was replaced with ‘gender identity disorder’ with the release of DSM–IV in 1994, our community could not accept a definition that treated our identities as a ‘disorder.’ It was only in 2013 when the DSM–V adopted the term ‘gender dysphoria’ and in 2019 when the World Health Organization’s ICD-11 adopted the diagnosis of ‘gender incongruence’ that a diagnosis did not characterize being trans itself as a disorder. It is important to note that these new diagnoses don’t refer to being transgender itself but the distress that results from external perceptions and behaviors and/or feelings of incongruence between one’s body and gender, for which one may seek out treatment. These shifts towards an affirming formal diagnosis are crucial for trans people seeking transition-related care, especially for those relying on insurance to access this medically necessary care due to healthcare costs in the U.S. Despite this progress, many anti-trans extremists portray transgender people as if our lives are just pain and suffering — but nothing could be further from the truth. Transgender people’s experience of gender is just as natural as cisgender people’s, and we have been a part of societies across the globe for thousands of years. As we celebrate this milestone, we shift our focus to the work that lies ahead. We must continue advocating for improved access to medically necessary transition-related care, and we must continue to combat pervasive misinformation about transgender people in society.”
Victoria A. Brownworth, award-winning journalist: “It’s impossible to overstate the importance and impact of the APA decision. One of the most brutal aspects of the DSM nomenclature was all it supported. Just as GOP lawmakers have made LGBTQ youth their focal point in their anti-LGBTQ laws, the DSM was used against gay and lesbian teenagers like I was as a predicate for conversion therapy. Despite Dr. John Fryer being a close friend of my parents who was a frequent guest at our house while I was growing up, I was put in a mental hospital against my will for conversion therapy after I was expelled from my all-girls high school — Girls High — for being a lesbian. The DSM had just been changed, but that change took time to percolate into the zeitgeist. Dr. Fryer did the world a service that can never be fully honored for how it changed our society and how many gay and lesbian lives it saved.”
Cathy Renna, spokesperson for National LGBTQ Task Force: “This year, the National LGBTQ Task Force also honored our 50th anniversary and it is no coincidence — as several of our founding board members and leaders were part of the historic effort to change the APA’s stance on homosexuality. Barbara Gittings, Bruce Voeller, Frank Kameny and others not only made history but propelled our movement and the lives of gay and lesbian people forward when homosexuality was removed. It was an incredible beginning to what would be a now half-century of advocacy for LGBTQ people.”