GLR November-December 2022

a little bit more aggressive. They came to the APA meeting in San Francisco and disrupted the meeting entirely, which did of course get APA’s attention. So that was really the beginning, in 1970, in San Francisco. And then the following year—it was in Hawaii—they had activists like Frank Kameny and Ron Gold and a few others on a panel called “Lifestyles of Non-patient Homosexuals.” It was the first time APA had non-patient gay people talking to psychiatrists about the harm done by the di agnostic manual, the ways in which people’s everyday lives were affected by a psychiatric diagnosis, which I don’t think many psychiatrists had actually thought about. The ’71 panel was very successful, so they decided to invite the activists back. I think it was Kay Lahusen, Barbara Gittings’ partner, who said: “Well, wouldn’t it be great if you found a gay psychiatrist to be on the panel?” But where to find an openly gay psychiatrist in 1972, when homosexuality was still illegal in most states? You could lose your license, your job, referrals. They found Dr. John E. Fryer, who was willing to appear in dis guise as “Dr. H. Anonymous.” On the panel, he wore a Nixon Halloween mask, a fright wig, and an oversized tuxedo, and he used a voice-disguising microphone. I like to show a picture of Dr. Anonymous on my slides and say: “This is what an openly gay psychiatrist looks like in 1972.” And I think that did have an impact. The pure theater of the event had an impact on the audience, because a lot of people didn’t know they had a gay colleague, or two, or three, at all. I’d like to say that trans rights in the U.S. right now are where gay rights were in the 1970s, which is that most people didn’t know that they knew a gay person. Most people today don’t know that they know or have met a trans person. In the

egated to whispers and backrooms. But now conversations began to be had aloud, and once that happened, it desensitized people to the subject. It became possible to engage people in an open dialogue. So, in 1973 homosexuality was removed from the DSM , but it was only in 1989 that the Immigration and Naturalization Service finally removed homosexuality as a reason why you couldn’t immigrate to the U.S. Even though the diagnosis had been removed in mid-’73, it continued to be listed as a mental disorder by the U.S. government. By the way, at this time there was psychiatry and then there was psychoanalysis. The latter was deeply opposed to this change in the ’70s. Psychoanalysis was just at the begin ning of its decline in importance, having ruled American psy chiatry in the middle of the 20th century. You started to have a pharmacological revolution starting in the ‘50s, with med ications being available that were working to treat patients: antidepressants, antipsychotic medications, etc. The Ameri can Psychoanalytic Association (APsA) was threatened with a lawsuit by the late gay psychoanalyst Richard Isay and the ACLU for their discriminatory policies. So they changed their policies in ‘91 and ‘92, and then they started to become a lit tle more forward-looking. In fact, APsA was the first mental health organization in the country to support same-sex mar riage, in 1997. But before that, psychoanalysis was very rigid, very hide bound. They had their theories, and you could not argue with their theories. In psychoanalytic training institutes, if you ar gued with the teachers, it was because there was something wrong with your personality, something to work out in your own analysis.

’70s most people were firmly against gay marriage. It’s only after the long conversation that we’ve had about homosexuality over the last fifty years that a ma jority of Americans now accept gay marriage. So the trans com munity may have to wait fifty years too, unfortunately, for atti tudes to change. G&LR: So it sounds as if there was a time lag from the 1973 vote to acceptance within the psychi atric community. I’m sure the vast majority of psychiatrists today are fine with homosexuality and don’t regard it as a mental illness. So how did this change come about? JD: That’s a good question. I see two parallel processes, not happen ing at the same time. One is the general process within the culture. We didn’t really have a national debate about gay rights until 1993, when President Clinton tried to overturn the ban on gays in the military. Prior to that, discussions of homosexuality were usually rel

G&LR: After the events of 1972 and ’73, homosexuality was effec tively delisted from the DSM , and it seems that gender then rose to the fore. I think it was in 1980 that APA listed “gender identity disorder” as an official diagnosis. It almost seems that this was kind of a sop to conservatives who were still dis gruntled about the ’73 change. JD: Eve Sedgwick wrote a paper, “How to bring your kids up gay,” arguing that the introduction of gen der identity disorder of childhood was a backdoor way to put homo sexuality back into the DSM . Bob Spitzer, the father of the modern DSM starting with DSM-III , and Ken Zucker wrote a paper in which they disagreed with that. They pointed out that DSM-III was markedly different from the DSM-I and -II , which were basically just a list of diagnoses. They didn’t talk about how you make a diagnosis. It just was a way to code things. If you saw a patient, you could put a code

Robert Spitzer holding DSM-III . Courtesy: Columbia University.

The G & LR

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