Psychiatry, Psychology, and the Evolution of Attitudes about the Gay Lifestyle among the American Public

Up until 1973, the Diagnostic and Statistical Manual of Mental Disorders, which is recognized as the "bible" of psychiatric disorders by mental health professionals, still listed homosexuality as a form of mental illness. In 1953 it had been classified by psychiatrists as a "sociopathic personality disturbance" before being downgraded – or upgraded, depending on your perspective – to a "sexual deviation" in 1968.

The decision to remove homosexuality from the Manual was made by the president of the American Psychiatric Association and later ratified by a majority vote of the Association membership. This decision was not universally supported, however, as a sizeable minority of practicing professionals still believed that homosexuality was a form of psychopathology that could be traced back to childhood abuse, and they made a determined effort to get the Association to change its mind.

Perhaps as an attempt to mollify this faction, in 1980 a new mental condition called "ego-dystonic homosexuality" was added to the Manual. This "disorder" was used to describe those psychiatric patients in clinical settings who were expressing great distress over their homosexual tendencies and inability to sustain desired heterosexual relationships.

The opinion of those who continued to view homosexuality as a disorder was mainly based on clinical experiences such as these. But skeptics had been arguing for quite some time that the adjustment problems seen in homosexuals seeking therapy were driven by the societal stigma attached to the gay lifestyle and not by anything inherent to their sexual identity. Eventually this viewpoint won out, and ego-dystonic homosexuality was removed from the Manual in 1986.

Those who believed homosexuality was abnormal have often claimed – and still continue to claim in some cases – that the psychological problems gay people frequently suffered from were proof that a mental illness was present. But starting with a landmark study performed by psychologist Evelyn Hooker in 1957, mental health researchers began to carry out controlled testing of homosexuals to determine their overall levels of mental health, and it was discovered that in general gay people were no more or no less well-adjusted on average that heterosexuals. Eventually this type of research made it clear that homosexuality could not be correlated in any way with psychological disturbance, and this provided the scientific rationale for the decision to remove homosexuality from the list of officially recognized mental illnesses in 1973.

Changes in Latitude, Changes in Attitude

But in searching for explanations as to why the American Psychiatric Association made such a sudden about-face, it would be a mistake to overlook the social context of the era. In the early 1970s social activism and unrest were at an all-time high, and the issue of gay rights had just begun to emerge from the shadows, where supporters joined an eclectic mix of anti-war activists, feminists, environmentalists, and civil rights advocates who were clamoring for justice.

The shift toward more progressive attitudes that marked this period had a profound effect on the academic and scientific subcultures, and there seems little doubt that the actions of the APA were motivated in part by a desire to keep up with the evolving standards of the times. So while it would be tempting to assert that the move by the therapeutic establishment helped to play a causative role in the evolution of societal attitudes toward the homosexual lifestyle, in reality the relationship is more complex than that. On one hand, more enlightened attitudes toward sexuality and a deeper commitment to the recognition of basic human rights on the part of psychologists and psychiatrists has undoubtedly helped to move society as a whole in a more constructive direction on this issue. But on the other hand, the social turmoil of the early 1970s included strong gay and lesbian voices demanding to be heard, and mainstream institutions were left with no choice but to make some attempt to keep up with changing ideas about fairness and justice, or else face the risk of being branded as hopelessly reactionary.

As recently as the 1980s, it was still considered politically acceptable (at least in conservative circles) to criticize the gay lifestyle as immoral and to refer to homosexuality as a choice rather than a natural proclivity. These attitudes still exist among religious evangelicals and among many from older generations, but for the most part such opinions are no longer expressed openly by elected representatives, talk show hosts, or guests on political discussion forums. Now, when political leaders, business executives, or media types are caught making statements that would appear to support discrimination against any group, including gays and lesbians, it will inevitably cause a backlash, and the person responsible for making such statements will face consequences as a result.

The Long Road of Progress

Polls released by the Pew Research Center in 2011 show how attitudes about the gay lifestyle have evolved over the past few decades. When asked whether homosexuality should be accepted by society, 58 percent answered "yes" and only 33 percent said "no." Only 35 percent felt that gay and lesbian couples raising children was bad for society, while the rest believed it was either good or made no difference one way of the other. Perhaps the most encouraging thing in these polls is that attitudes toward the gay lifestyle were most positive or anti-discriminatory among the youngest generations and among Hispanics, the latter of whom represent the fastest growing segment of the U.S. population.

But before we become too complacent about the future, we should be sobered by the revelation that basically one-third of the U.S. population continues to view homosexuality in an entirely negative light. Also, the public was essentially split down the middle on the issue of gay marriage, with 45 percent in favor and 46 percent opposed. Just the fact that the Pew Research felt the need to ask these types of questions shows that we still have a long way to go before a commitment to fairness and justice for all is so deeply ingrained in the American psyche that it is no longer necessary to ask where people stand.

It is heartening that we have evolved to the point where psychological authorities no longer feel justified in automatically classifying 6 to 10 percent of the population as mentally defective based on their sexual preference alone. It is also a significant step that the open expression of prejudice is no longer considered acceptable in respectable company. But the darkness that lies hidden in the hearts of those who cannot embrace others who are different from themselves continues to limit humanity’s quest to realize its highest aspirations. Unfortunately, we undoubtedly have a long way to go before the gay lifestyle is accepted without pause or comment and before we can truly proclaim that we live in a society where a commitment to equality is thoroughly engrained in the deepest recesses of our collective soul.

There is still hope.

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