Homosexuality is neither a pathology nor a mental illness

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Dear Editor,

I wish to respond to the letter `Fact, truth detail and evidence should take centre stage when discussing gay rights’ by Roger Williams published in your paper on June 28, 2012.  I agree strongly with his call that sound, scientific evidence is to inform any debate on gay rights in the region.  As such, I went to great lengths to read the articles proposed to the public by Mr. Williams.  Mr. Williams suggested the work of psychoanalyst Charles Socarides who founded NARTH (The National Association for Research and Therapy of Homosexuality), the work of Dr. Jefferey Satinover—a psychologist whose work is heavily cited by the Christian evangelical right in the United States—and two other prominent psychologists.  While NARTH is officially a secular fringe organization comprised of a small group of psychologists, it typically partners with religious groups in administering reparative therapy.  The common thread that unites the works recommended by Mr. Williams is the argument that the American Psychological Association’s move to declassify homosexuality as a medical disorder was politically motivated and that the association continues to ignore evidence affirming the success of reparative therapy.

I wish to respond to those arguments with two observations: First, homosexuality was declared a pathological illness in 1952 when the APA published its first Diagnostic and Statistical Manual of Mental Disorders.  Its decision to do so was in line with societal prevailing attitudes. Just as science was enlisted to affirm the biological inferiority of certain races across the globe, so too was the APA’s initial decision to classify homosexuality as a mental illness in line with the societal feelings about sexual orientation.  As scientific evidence emerged, particularly the works of Alfred Kinsey, Clellan Ford, Frank Beach and Evelyn Hooker, the APA decided to review its official stance on homosexuality.  The review coincided with the protests by the Gay Liberation Front who offered overwhelming evidence that the practice of conversion therapy—some of which included electric shocks to hands and genitalia of patients—was harmful to subjects and furthered the stigmatization and social exclusion of the LGBT community. The APA conducted its own internal, scientific review and declassified homosexuality as a mental disorder in a vote by members of the association in 1973.  The vote won by a 65% majority.  While the dissenters eventually pushed to have a re-vote, the declassification of homosexuality as a mental illness was upheld in the re-vote in 1974.  In a compromise with dissenters, the APA reclassified it as ego-dystonic homosexuality but that classification was ultimately removed altogether by 1986. The APA removed the classification entirely citing concern that the claim homosexuality could be cured was based on an a priori assumption that homosexual orientation itself was an aberration that needed to be changed.

Dr. Jefferey Satinover’s book recommended by Mr. Williams is a perfect example of this.

Given that Mr. Williams had endorsed a debate based on factual scientific evidence, I was disappointed to discover that Dr Satinover’s book

*Homosexuality and the Politics of Truth*, published by the Christian Evangelical group Bakers Book in 1996, is not steeped in scientific evidence verifying reparative therapy, but is instead, a reflection on homosexuality as it relates to Christian and Jewish principles.  In the “study”, Dr. Satinover proclaims that although homosexuality is not actually an illness, the APA should classify it as such due to its “undesirability” on the basis of moral and religious grounds.  He declares, “In the end, the debate over homosexual behavior and its implications for public policy can only be decided conclusively on moral grounds, and moral grounds will ultimately mean religious grounds. He continues: “Homosexuality is not a true illness, though it may be thought an illness in the spiritual sense of “soul sickness” innate to fallen human nature. Once again, curing homosexuality is not grounded in any scientific fact of it as an illness but, instead in faith-based belief systems that deem it an aberration.

Let us be clear of the political and social context of APA’s move to declassification: In 1986, President Ronald Reagan was in power, the leader of a Republican party known for its opposition on issues of gay rights in the US. This declassification took place well before the advent of the legalization of gay marriage in 2004 in Massachusetts and across the United States.  It also took place at a time where public perceptions of homosexuality were overwhelmingly negative in the United States.  Indeed, public perceptions have only shifted in the last two years—some 20 years after its declassification. The political context and public perceptions of homosexuality in 1986 suggest that the APA declassified homosexuality as a mental disorder well before it was politically expedient to do so.

Secondly, even if the APA were to have simply succumbed to political “pressure”, psychological associations across the world have declassified homosexuality as an illness and agree that the emotional and psychological challenges facing LGBT people often stem from societal stigma and discrimination they experience on a daily basis.  Here are some organizations internationally who take similar stances on that issue: World Health Organization’s (WHO) ICD (The International Statistical Classification of Diseases and Related Health Problem), The Chinese Society of Psychiatrists, The Royal College of Psychiatry in the UK, Hong Kong College of Psychiatrists, Brazil’s federal council of Psychology and the list goes on.

These declassifications occurred at different historical moments ranging from the 1970s to the 2000s. The affirmations that homosexuality is neither a pathology nor mental illness and that reparative therapy does not work, are not unique to the APA.  They have been recognized internationally and in varying political contexts.  Enlisting international standards of medical practice to inform local debates on gay rights is in line with Mr. Williams’ call to let fact, truth, detail and evidence take centre stage.

Yours faithfully,
D. M. Roper

Taken from Stabroek News.

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