Tuesday, May 20, 2008

Homophobia persists at the American Psychiatric Association

Homosexuality was listed in the original, 1952 edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM), published by the American Psychiatric Association, as a “sociopathic personality disorder”. In the 1968 revision (DSM-II), it was removed from the list of “sociopathic personality disorders” and listed instead with the “sexual deviations.” In 1973, homosexuality was officially “depathologized”, and listed in the DSM-III as a disorder only when it was ego-dystonic – it was only considered a problem worthy of diagnosis and treatment when a person’s sexual orientation was dissatisfying to them, or caused them significant distress. Through the subsequent three revisions (we are now to the text revision of the fourth edition of the classification system), treatment for ego-dystonic homosexuality has been permissible under the diagnosis, “Sexual Disorder Not Otherwise Specified”, which is appropriate for individuals who experience “marked and persistent distress about sexual orientation”.

“Treatment” for homosexuality is a sad chapter in the history of mental health treatment, with vestiges of such abhorrent practices as aversive conditioning (including plethysmograph-triggered genital shocking following exposure to homoerotic stimulus) still found in select backwaters of the mental health treatment world. But the religious prohibition against homosexuality has ensured that individuals will continue to experience profound conflicts about their sexual preference, and practitioners (almost exclusively affiliated with a major religious institution) have continued to devise methods for “treating” homosexuality.

The most prevalent model, “Reparative Therapy”, was developed by Joseph Nicolosi, director of the Thomas Aquinas Psychological Clinic. Though this approach was roundly criticized as a religious intervention operating under the guise of mental health treatment, a thriving population of conflicted gay Christians seeking relief from their “sinful” orientation provided the impetus for a cottage industry in “treatment” for their homosexuality. This approach soon came under fire, however, after a variety of high-profile cases in which parents had sought “treatment” for their adolescent children, eventually leading the American Psychological Association (the other “APA”) to draft a resolution in 1997 decrying this re-pathologizing of homosexuality, and disavowing coercive treatments for this supposed “disorder”.

But proponents of “Reparative Therapy” have remained active, and have generated some sympathy among powerful professionals, most notably Dr. Robert Spitzer, who as chair of the committee revising the third edition of the DSM was instrumental in the de-listing of homosexuality from the catalogue of mental disorders.

One of the most vocal of the remaining proponents for Reparative Therapy is Dr Kenneth Zucker. Needless to say, news that he has been appointed chair of the committee on Gender Identity Disorders for the fifth revision of the Diagnostic and Statistical Manual for Mental Disorders has created some outrage among members of the LGBT and mental health communities, and interested members of the public.

If you feel the same way, please join us in protesting this appointment, and mitigate the insanity that apparently persists at the American Psychiatric Association.


TenaciousK said...
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