It’s a Miracle!
That’s a cry most frequently heard on televangelist healing campaigns by the disciples of Oral Roberts or Reverend Ike. “It’s a Miracle!” is also occasionally heard on Saturday Night Live as a parody. But it’s not a phrase associated with the American Psychiatric Association, the APA. That august group of psychiatrists and psychoanalysts, however, preformed a miracle in May 1973.
They removed homosexuality from the Diagnostic and Statistics Manual of Mental Disorders, the DSM, which is the official handbook of mental illnesses. Before that time, all lesbians and gays were considered sick—pathologic. After May of 1973, we were cured. We were normal. That instant cure certainly qualifies as a miracle.
The fascinating history of the DSM change has been beautifully detailed by Chicago Public Radio in a 2002 broadcast of This American Life, hosted by Ira Glass. One of the delights of this program is the narration by Alix Spiegel, granddaughter of John P Spiegel, the President Elect of the APA when this drama unfolded at the annual meeting of psychiatrists, that year in Honolulu.
Few people realize the DSM is what determines who is mentally ill and who isn’t. It’s the manual doctors use to insure uniformity in diagnosis and it’s what insurance companies rely on to make reimbursement decisions. In a 1970 survey, over 90% of psychiatrists in the APA said homosexuality was pathologic. Homosexuals were sick. Even the loose underground of closeted gay psychiatrists within the APA, who called themselves the GAYPA, saw homosexuality as pathologic—striking evidence of their own internalized homophobia.
One year after the Stonewall riots in 1969, gay activists broke up several scientific sessions at the annual meeting of the APA, held that year in San Francisco. Their targets were Irving Bieber, a New York psychiatrist, who had published widely that homosexuality was the result of a “close binding mother” and a “rejecting father” and Charles Socarides, a prominent New York analyst, who proclaimed homosexuals could be changed to heterosexual, with appropriate analysis and therapy. The demonstrations were disruptive enough that even the closeted gay psychiatrists within the APA were embarrassed. Gay activist demonstrations were repeated at the 1971 annual APA meeting.
In 1972 Barbara Gittings, a Philadelphia librarian and activist, prevailed upon her friend, John Fryer, to testify before the APA at their 1972 annual meeting as to how the eighty-one words in the DSM classifying gays as pathologic affected him personally and professionally. As an aspiring academic psychiatrist, Fryer had recently been dismissed from his psychiatric residency at the Univ. of Pennsylvania because it was suspected he might be gay. Initially reluctant, Fryer finally appeared before his peers in May of 1972 as Dr. Anonymous. His voice was disguised. He wore a full-head, rubber Nixon mask and a flamboyant tuxedo several sizes too large. At the conclusion of his testimony, he received a standing ovation from the assembled psychiatrists.
During this same post-Stonewall period, a group of “young Turks” within the APA who were not gay, were unhappy with the antipathy of the conservative leadership within their organization. The young Turks wanted the APA to address social issues like Viet Nam, feminism, segregation—and homosexuality. They began proposing candidates for organizational office with the goal of transforming the APA to a more socially relavant organization.
At the same time, Eveyln Hooker, a UCLA psychologist had published the results of her study in which she administered a battery of psychological tests, including the Rorschach, to thirty gay men and thirty straight men matched as to age, education and income. The results of the tests were submitted to three prominent psychiatrists and reported in her paper, The Adjustment of the Overt Male Homosexul. The reviewing psychiatrists were unable to pick out the gay men from the straight men on the basis of the tests. They concluded two-thirds of both groups were “well adjusted.” Prior to Hooker’s study, all studies on homosexuality had been done on men seeking psychiatric help. None had been done on homosexuals who felt no need for a psychiatrist. Hooker’s study was the first to challenge the assumption that all homosexuals were ill and needed therapy.
In order to “hear” what the gay activists had to say and diffuse their wrath at the 1973 APA annual meeting in Honolulu, Robert Spitzer, an ambitious straight New York psychiatrist, organized a panel discussion for the 1973 meeting. Before a packed auditorium, Ronald Gold, Media Director for the Gay Activist Alliance, addressed the psychiatrists. His presentation was titled “Stop It. You’re Making Me Sick.”
Gold invited Spitzer, who was a member of the APA Committee on Nomenclature, the committee which recommended to the Board of the APA changes for the DSM, to go with him that evening to the annual party of the GAYPA. It was being held quietly and surreptitiously at a campy lounge, the Bamboo Bar. When they entered, Spitzer was astounded to find standing at the bar several heads of university psychiatry departments, well known researchers, and the man in charge of dispensing federal grants to psychiatric training programs. All were closeted gay men who were paying the price extracted by the eigfhty-one words in the DSM—the price eloquently described at the 1972 meeting by Dr. Anonymous.
Adding to his amazement, Spitzer saw an Army psychiatrist stationed in Honolulu enter the bar in full uniform. The Army doctor had never heard of the GAYPA and had no idea other psychiatrists would be in the bar. He had, however, heard Gold’s talk at the meeting earlier in the day and was so moved by it that he ventured for the first time in his life into a gay bar. When he saw Gold, he embraced him and wept. “Thank you for saying what you did,” he cried.
That night Spitzer experienced first hand the pain caused for the Army psychiatrist by the eighty-one words in the DSM. For the first time he saw colleagues and peers who were gay and, of necessity, closeted. Then he returned to his hotel room and wrote the resolution that removed homosexuality from the DSM. In its place was a new term, Ego Dystonic Homosexuality. To qualify for this diagnosis the patient had to have symptoms of subjective distress.
There are some interesting post scripts to this miracle.
• Ego Dystonic Homosexuality was quietly removed from the DSM in 1987.
• Richard Socarides, the eldest son of the New York psychiatrist, Charles Socrarides, is gay and, as a member of the Clinton administration, helped organize the first White House Conference of HIV/AIDS. The relationship between Richard and his analyst father Charles, was strained by the intransigency of Charles in continuing to proclaim he was “doing God’s work” in attempting to change homosexuals into heterosexuals.
• John P. Spiegel, the APA President-Elect in 1973 when these momentous changes occurred, was himself gay and closeted at the time. He had told his wife he was gay two weeks prior to his marriage and, after her death, came out to the rest of his family at his 70th birthday party by introducing his lover, David.
• Robert Spitzer, author of the resolution deleting homosexuality from the DSM, became Professor of Psychiatry at Columbia University. At the 2001 APA Annual Meeting he presented a controversial paper which was a study of 200 motivated homosexuals who, in his judgment, had experienced “meaningful change” in their attempts to become heterosexual.
• Evelyn Hooker, the west coast psychologist whose study laid the groundwork for this change, was a friend and neighbor of Christopher Isherwood, an out gay writer and Hollywood notable.
• John Fryer, Dr. Anonymous, prior to becoming an activist, considered the possibility of marriage. He was briefly engaged to a close friend of mine, a vibrant Philadelphia clergywoman, who, I later learned, was lesbian. To celebrate their engagement, my wife and I hosted a dinner party for them in our suburban Philadelphia home in 1968.
The full hour program, 81Words, can be obtained on disc from This American Life at Chicago Public Radio.
John Siegfried, a former Rehoboth resident, lives in Ft. Lauderdale. He can be reached at jdsiegfried@comcast.net.