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Homosexuality and American Psychiatry - The Politics of Diagnosis (Paperback, New Ed)
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Homosexuality and American Psychiatry - The Politics of Diagnosis (Paperback, New Ed)
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In the two decades following the appearance of the American
Psychiatric Association's catalogue of mental illnesses, male
homosexuality changed from a sexual deviation listed among other
serious personality disorders (1952) to no disorder at all - a
"sexual orientation disturbance" only for those in conflict with
that orientation (1973). Why the change? Had the APA capitulated to
angry outside demonstrators, as some charged, or did a process of
scientific re-evaluation take place? And did the nomenclature
change truly represent the convictions of practicing psychiatrists?
Ronald Bayer, a policy studies specialist, has untangled the
twisty, blurry lines of this peculiar sequence of events with
consummate skill. Much of the work, he demonstrates, was initiated
by informed gay activists (Voeller, Kameny, Gold) in sometime
contact with a small circle of psychiatrists committed to
re-appraising the issue. These psychiatrists, Marmor and Spitzer
most prominently, became convinced that the orthodox writings of
Bieber and Socarides were insupportable, that the label "mental
disorder" (which had once protected gays from criminal prosecution)
was in fact unwarranted and served, indefensibly, as the basis for
widespread discrimination - by the armed forces, employers, housing
projects, the Immigration Department, etc. At the same time, public
attitudes toward the civil rights of minorities had shifted, and
concepts of illness had been revised: value judgments and other
subjective criteria had been recognized in scientific disciplines.
Bayer suggests that psychiatrists, usually insulated from
theoretical matters, were forced by organized challengers to
re-examine the evidence. Despite many sharp professional
disagreements, the APA membership was able to acknowledge that the
designation was questionable and that the list of gay grievances
had merit - hence the 1973 referendum which supported deletion of
homosexuality from the "disorders" classification. The change in
nomenclature, still controversial within the APA, has resulted in
some civil rights gains in American society but not the broad
social legitimation which gays sought. Moreover, Bayer believes
that, given the outside influences still at work, the 1973 decision
remains quite vulnerable, especially in the more conservative
present. An exemplary nonpartisan investigation, faithful to
detail, focused on larger themes, and wholly acceptable to a broad
audience - straight, gay, or APA. (Kirkus Reviews)
In 1973, after several years of bitter dispute, the Board of
Trustees of the American Psychiatric Association decided to remove
homosexuality from its official list of mental diseases. Infuriated
by the Board's action, a substantial number of dissident
psychiatrists charged the association's leadership with
capitulating to the pressures of Gay Liberation groups, and forced
the board to submit its decision to a referendum of the full APA
membership. Ronald Bayer presents a political analysis of the
psychiatric battle involved, from the first confrontations
organized by gay demonstrators at psychiatric conventions to the
referendum initiated by orthodox psychiatrists. The result is a
fascinating view of the individuals who led the debate and the
fundamental questions that engaged them: social and cultural
values, the definition of disease, and the nature of sexuality.
Available for the first time in paperback, the book includes a new
afterword by the author.
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