Over at Respectful Insolence, a lot of people have been discussing the relationship between skepticism and scientific consensus, a topic I brought up recently. And commenter Alvaro has pointed out a kind of counterexample, to whit, that the consensus among US psychiatrists had defined homosexuality as a psychiatric condition up through 1974. This is classic Michel Foucault territory, and I think Alvaro’s point is interesting and apt. Being gay isn’t always easy in an at best semi-tolerant society, but it sure isn’t something that calls for treatment.
Reading up a little, I found something that surprised me. Wikipedia has a meaty article on the issue, demonstrating that there was no consensus among US psychiatrists about gays being nuts prior to about 1953, and only a very weak one after that date.
To begin with, Alvaro’s chronology is slightly off. In 1953, the Diagnostic and Statistical Manual of Mental Disorders Mk. I defined homosexuality as a mental disorder. So did the first (1968) edition of DSM II. But already in 1973, the trustees of the American Psychiatric Association voted unanimously to remove homosexuality from new printings of the DSM II. The following year, amid great controversy, 58% of the APA membership confirmed this decision by vote. So, if we accept the DSM as a direct reflection of the consensus in psychiatry (which is highly debatable), then we only need to discuss a period of 15 years from 1953 to 1968.
In science, no answer can ever be better than the question you ask. My reply to Alvaro is that the issue here is really how “psychiatric condition” was defined in the 50s and 60s. If the definition was something along the lines of “non-standard behaviour and/or mental states that impair a person’s functioning in society”, then gayness clearly did fit the bill. Because it is, statistically speaking, non-standard, and it did pose problems for people living in the even less tolerant US society of the time.
So my take on this issue is that from 1953 to 1968, US psychiatrists may not generally have been very gay-friendly; but their consensus that gayness was something they should try to treat was probably not just a result of homophobia. Many psychiatrists did feel that something must be wrong in the brain of a person who doesn’t want to bonk people of the opposite sex. But they were also asking, “Is being gay a problem for our patients?”. And in the mid-20th century US, it would be hard to argue that it was not. It’s still a problem, because society is intolerant of non-standard lifestyles. What US psychiatrists agreed upon only about 20 years after DSM I was that gayness could not productively be handled as a psychiatric issue, despite the fact that it resides in the brain. In fact, defining gayness as a mental health issue just made the problem worse for the patients through social stigmatisation. Besides, gayness can’t be treated and most gay people don’t want to become straight. This sets it emphatically apart from unequivocal psychiatric diagnoses such as depression and anxiety.
(On a lighter yet kind of sad note, let me mention that the “gays are nuts” perspective survived in unexpected places long after 1968. The 1985 role-playing game Teenage Mutant Ninja Turtles & Other Strangeness has a table that the game master uses to determine a diagnose when a character goes insane for some reason. One of the “afflictions” such a character can be hit with is homosexuality.)
As I’ve said before, in my opinion, a real skeptic accepts scientific consensus. But the 1948 Kinsey report had documented a very high incidence of homosexual behaviour in US men. Therefore, the psychiatrists who drafted the DSM I knew that gay sex was not an unusual aberration among the brain-damaged, but something that a large part of the healthy population was doing for fun. I don’t believe there was any scientific consensus that gayness equalled madness in the 1960s. Apparently, however, a consensus remained that gayness was the business of psychiatrists because it was a problem for many people. And this latter is sadly still the case.