GLR November-December 2022

INTERVIEW

The G&LR talks with an eminent LGBT psychiatrist

How Psychiatrists Came Around

A S PART OF OUR RECOGNITION of the fiftieth anniversary of the declassification of homosex uality as a mental illness in the American Psy chiatric Association’s Diagnostic and Statistical Manual ( DSM ), we interviewed one of the fore most authorities on this event and on LGBT psy chiatric issues and APA history in general. Jack Drescher, MD, is clinical professor of psychiatry at Columbia University and a faculty member at Columbia’s Division of Gender, Sexuality, and Health. He is a past president of GAP—the Group for the Advancement of Psychiatry—and remains very active in this organization. Dr. Drescher is the author of Psychoanalytic Therapy and the Gay Man (2001) and (with Joseph P. Merlino) editor of American Psychiatry and Homosexuality: An Oral History (2012), among many other books and papers. He is emeritus editor of the Journal of Gay and Lesbian Mental Health . He’s an expert media spokesperson on issues related to gender and sex uality who has appeared on major news networks and in main stream publications. This interview was conducted via Zoom in late August. Gay & Lesbian Review: This being the 50th anniversary of the delisting of homosexuality as a mental illness in the DSM , we’re devoting the next issue of the magazine to that event, which is why we’re very excited to have the opportunity to in terview you. Actually, there’s a slight ambiguity regarding the anniversary year. The famous “John Fryer” panel was in late 1972, the APA board of directors voted to delist late in 1973, and the whole membership voted to do so in 1974. What year or event is recognized as the official turning point? Jack Drescher: It’s 1973, when the board voted. Some mem bers were not happy about that vote, so they challenged the board’s decision by using a bylaw, which doesn’t exist anymore, that allowed 200 people to sign a petition to question an ad ministrative decision by the board. The question that was put to the membership was something along the lines: “Do you sup port the Board of Trustees’ decision to remove homosexuality, and the process that they used to come to that decision?” So, they weren’t really asking the psychiatrists whether they thought homosexuality was an illness, because most of them at the time probably did. They were asking a more narrow ques tion: “Do you support the process that led the board to make its decision?” G&LR: And was it an overwhelming vote in favor of support ing the board? JD: The APA had about 20,000 members at the time. Around

J ACK D RESCHER

10,000 members voted, and 58 percent voted to support the board decision. G&LR: In the next issue, I have what started as a letter to the editor from Lawrence Hartmann, who was responding to an ar ticle about the 1972 panel that we had run, which really stressed the protests as critical to the decision. Dr. Hartmann wrote in to remind us that the decision was made by the APA after much hard work and discussion. [See Hartmann’s “Open Letter” in this issue.] So, there’s a bit of a debate between the role of the demonstrations versus the inner workings of the APA itself. What factor was decisive in your view? JD: That’s a good question. I’ll qualify my response by saying that Larry Hartmann was there, and I was not. In the early ’70s, I was still in college. My first exposure to the story came from a very important book, which I recommend to everybody, Ronald Bayer’s Homosexuality and American Psychiatry: The Politics of Diagnosis . Bayer is an ethicist at the Hastings Insti tute. He interviewed all the players who were involved in those years, and he put together a wonderful story of how the deci sion-making took place. I read the book when it came out in 1981, when I was an in tern or a second-year resident. It became a template for my thinking going forward, about what the issues were that needed to be addressed. Even though homosexuality was removed from the DSM in 1973, I had a rude awakening when I applied for an internship in 1980. I graduated from the University of Michigan in that year, and I wanted to come back to NewYork City, where I’m from, and live and work in Manhattan. Many of the pro grams were run by psychoanalysts who had disagreed with the 1973 decision. I came back to find that in NewYork, this liberal, cosmopolitan city, psychiatry and psychoanalysis were quite conservative. G&LR: You’ve been involved with the DSM in various capac ities over the years. We’re now up to DSM-5-TR [DSM-5-Text Revision] , which is not surprising, given that psychiatry is al ways evolving. But it seems that this change, perhaps more than any other, had an impact that rippled outside the APA and into the larger society. Would you agree? JD: Soon after the Stonewall riots, the Gay Activists Alliance decided that they were tired of polite protests about homosexu ality. In the 1960s, the idea was that gay people would dress up in conservative clothing and carry very well-crafted signs say ing “Please stop discriminating against us.” But following Stonewall, the homophile movement became more politicized. We had the Civil Rights movement, antiwar protests, the women’s movement, so the gay rights movement decided to get

November–December 2022

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