THIS YEAR we mark the fiftieth anniversary of the events that led to the declassification of homosexuality as a mental disorder by the American Psychiatric Association—an important milestone on the road to LGBT equality. It was actually seventy years ago, in 1952, that the APA first included homosexuality as a mental disorder in its Diagnostic and Statistical Manual of Mental Disorders, or DSM-1.
At the 1971 APA Annual Meeting in San Francisco, activists Frank Kameny and Barbara Gittings helped stage a demonstration demanding the right to be heard on homosexuality. While not psychiatrists themselves, they were granted the opportunity to present a panel on homosexuality at the 1972 annual meeting. The symposium titled “Should Homosexuality Be in the APA Nomenclature?” included Kameny, Gittings, and two heterosexual psychiatrists. While Kameny and Gittings believed that they knew far more about homosexuality than anyone in the APA, they recognized that there needed to be a gay psychiatrist on the panel for their side to have any impact. That was daunting, since a gay-identified psychiatrist risked losing his license, patients, referrals, and professional standing.
Gittings, who lived in Philadelphia, knew John Fryer, a part-time professor of psychiatry at the Temple University School of Medicine. Fryer agreed to participate on three conditions: he would employ the pseudonym Dr. Henry Anonymous; he would wear a mask to disguise his identity; and he would use a voice modulator. This is the moment to which we’ll return later, along with the story of John Fryer, whose impact on the history of LGBT civil rights was remarkable and needs to be remembered. But first, we need to revisit the situation faced by LGBT people at the time that the APA confrontation occurred.
In 1953, President Eisenhower’s Executive Order 10450 prohibited the federal government from hiring or retaining homosexuals. In many states, liquor licenses could be revoked if there was more than one homosexual at a time in a licensed establishment. Most states would not license homosexuals in medicine. A physician could lose their license if it was later learned that they were gay. It was a crime in almost all states to engage in consensual same-sex intimacy.
Gay people were branded as criminals who were mentally ill. Unable to congregate in bars, gay men resorted to public bathrooms and outdoor cruising areas, each of which had its own secret codes to guard against police entrapment. There were gay bars in most large cities, such as the Stonewall Inn in New York, but these were often owned by the Mafia, with drinks at double the normal price. While the police were bribed to avoid trouble, there were periodic sweeps and publicly reported arrests.
While there were many culprits in the maintenance of society’s antipathy toward homosexuals, the DSM played a major role. The designation of homosexuals as mentally ill implied that their condition was subject to treatment or possibly a cure. A cottage industry grew up around the DSM’s diagnosis and the promise of a “cure.” Various methods of treatment were devised, and their popularity seems to have varied by city. In New York, the cure was electric shock therapy. When Allen Ginsberg was arrested on an unrelated charge, he denied his homosexuality, recognizing what could result from that admission. In Pennsylvania, the cure was mental institutionalization. In California, it was a lobotomy at Atascadero State Hospital.
There were other culprits. Pursuant to Eisenhower’s Executive Order and during the “Lavender Scare” in the 1950s, over 5,000 federal employees, many at the State Department, were fired on the suspicion that they were gay. This had a chilling effect on other areas of employment. Even if you worked as a hairdresser or florist, you were wise to hide your sexuality, even if it meant living your life as a charade.
Three Activists Get Organized
While it’s popularly believed that the gay and lesbian civil rights movement began at the Stonewall Inn in June 1969, that would be tantamount to saying that the American Revolution began with the Boston Tea Party. Both events were manifestations of long-term grievances. The counterparts to Franklin, Adams, Jefferson, and Washington were Frank Kameny and Barbara Gittings, along with a few others.
Kameny was a second-generation Jewish-American who had served in the Army in World War II and was at the Battle of the Bulge. With a doctorate in astronomy from Harvard, he joined the Army Map Service with the goal of working on space exploration. In 1957, it was learned that he might be a homosexual, and Kameny was investigated. Not willing to prevaricate, he acknowledged his sexual orientation and was dishonorably discharged. Unlike many others in the government who lost their jobs, Kameny rejected the judgment that there was something wrong with him for being gay, and he determined to fight the government, and later the psychiatric establishment, on the conviction that a same-sex orientation was morally neutral and had no bearing on how one performed one’s job.
Barbara Gittings was the daughter of a diplomat. When she tried to find information about her sexual feelings in the library, there was virtually no information other than the usual defamations (“unnatural,” “deviant,” “mentally ill,” etc.). So she decided to locate kindred spirits. That was a daunting task in that there were then no lesbian organizations or magazines. Eventually, in San Francisco, she located Del Martin and Phyllis Lyon, the founders of the Daughters of Bilitis. Like the Mattachine Society for gay men, the Daughters of Bilitis was the first national organization for lesbians. Because coming out publicly was not an option in the ’50s and ’60s, membership was secretive and its members closeted; both organizations were often more social than political.
Gittings helped found the New York chapter of the Daughters of Bilitis, and Kameny helped organize the D.C. chapter of the Mattachine Society. Through their activism, their paths eventually crossed. Each recognized the other’s commitment and talents, and they began to collaborate and strategize. Both understood that they were up against a fortress of homophobia supported by religion, the media, the law, public opinion, and of course the psychiatric establishment.
Gittings took on the American Library Association (ALA), staging demonstrations at their annual meetings to encourage fair and informed literature in the nation’s libraries, and she staged a widely publicized “kissing booth” with “women only” and “men only” sides at the ALA convention in 1971. Kameny took on the Civil Service Commission and its regulations barring homosexuals from serving in the federal government. His 1960 lawsuit against the Army for wrongful termination set the stage for a litigation strategy that eventually overturned this anti-gay policy.
Together, Kameny and Gittings organized demonstrations called Annual Reminders each July Fourth from 1965 to 1969. Set in front of Independence Hall in Philadelphia, these demonstrations called for equality pursuant to the promises of the Declaration of Independence and the Constitution. Similar protests were also staged in New York and Washington. The men wore suits and the women wore dresses to demonstrate that they were normal and employable. They carried placards that called for “Equality” and “Opportunity.” This was the first time “equality” was used publicly to advocate for LGBT civil rights.
The initial Annual Reminder on July 4, 1965, had forty demonstrators, making it possibly the largest demonstration for gay rights to date. Being at Independence Hall, part of a national historic site policed by Park Rangers, protected them against physical assault. Every July Fourth after that, the number of activists increased. The 1969 Annual Reminder, which was being publicized in Greenwich Village before and after the Stonewall Riots, was the largest to date, with 160 demonstrators, many of whom came from New York, having been galvanized by the Stonewall Riots, which had occurred only days before.
When the first anniversary of Stonewall rolled around, organizers in New York led by Craig Rodwell prevailed upon Kameny and Gittings to suspend their annual demonstration and join him in a march to celebrate the Stonewall rebellion instead. The New York march followed a route from Greenwich Village to Central Park in what turned out to be a much larger throng than had ever assembled before. For Kameny and Gittings it meant suspending the successful but modest Annual Reminders. They recognized that Stonewall had the potential to become the movement’s Boston Tea Party, as would soon come to pass. The Christopher Street march of June 28, 1970, attracted not 160 but 2,000 participants, and that number would mushroom rapidly—as would the number of U.S. cities holding similar marches—throughout the 1970s and beyond.
Once they had passed the Annual Reminder baton to New York, Kameny and Gittings turned their sights to the American Psychiatric Association and its bible, the DSM-II (1968). They understood that no civil rights movement had a chance if the people it championed were automatically labeled as mentally disturbed. However, as mentioned above, they knew they needed a card-carrying member of the APA and a licensed psychiatrist to be effective, which is where John Fryer comes in.
Fryer grew up in a middle-class family in rural Kentucky. A gifted student, he graduated from high school at age fifteen. In 1962, at 24 years old, he received his medical degree from Vanderbilt. He began his psychiatry residency at the Menninger Foundation, but left—on the advice of a psychoanalyst—due to depression caused by having to hide his homosexuality. He moved to Philadelphia, where he had a psychiatry residency at the University of Pennsylvania School of Medicine. Penn expelled Fryer when it learned of his homosexuality, which was then a DSM-designated mental disorder. He completed his residency in 1967 at the Norristown State Hospital outside of Philadelphia. That same year, he joined the psychiatry faculty at Temple University School of Medicine. There he moved up the academic ladder to become a full professor of psychiatry. He was well aware that his homosexuality posed a professional risk. Nonetheless beginning in the mid-1960s, he treated gay men who had run afoul of the law in his clinical practice, and he sometimes testified in court on their behalf.
The Main Event
The APA’s annual meeting was held in Dallas in 1972. Gittings organized a booth under the banner “Gay, Proud and Healthy: The Homosexual Community Speaks.” The booth included literature: essays by gays and lesbians on their hurtful experiences with psychiatrists; an article by Evelyn Hooker on her 1950s study that showed that psychiatrists could not distinguish in standardized test results between homosexuals and heterosexuals; a study by biologist Frank Beach that concluded that human homosexuality was a reflection of the bisexual character of our mammalian inheritance; and an article by Judd Marmor, an APA vice president, titled “Homosexuality—Mental Illness or Moral Dilemma?” that strongly refuted the illness theory. Because of the controversial nature of the topic, the panel was well attended. Fryer as “Dr. Henry Anonymous,” wearing a mask and using a voice modulator, started by stating that he was a psychiatrist, a member of the APA, and a homosexual. He explained that homosexuality was not a mental illness, while anti-homosexual attitudes were a social prejudice, nothing more. After concluding, he received a standing ovation.
Later that year, at the annual conference of the Association for the Advancement of Behavior Therapy, the Gay Activists Alliance (GAA) staged a demonstration at a panel on aversion therapy for homosexuals. The session advocated electroshock therapy and chemically induced vomiting. Members of the GAA took over the panel and shut down the scheduled program. As luck would have it, in the audience was Dr. Robert Spitzer, a member of the APA’s Committee on Nomenclature. After the program, Dr. Spitzer had an elucidating conversation with the GAA’s Ron Gold, who shared with Frank Kameny that Spitzer was probably an ally. Of particular interest was that Dr. Robert Campbell, a member of the Committee on Nomenclature, was a closeted homosexual. Kameny contacted Campbell and lobbied him directly. Dr. Campbell, in turn, joined Spitzer by inviting some gay activists to the February 1973 meeting of the Committee on Nomenclature.
At the 1973 APA Annual Meeting in Hawaii, the Committee on Nomenclature sponsored a symposium titled “Should Homosexuality Be in the APA Nomenclature?” On the program was the GAA’s Ron Gold, who titled his presentation “Stop It, You’re Making Me Sick!” Gold called on the APA to remove homosexuality from its list of pathologies and went on to argue for the repeal of anti-sodomy laws, and he urged the APA to support civil rights protections for sexual minorities. He received a standing ovation upon concluding his talk.
Gold was invited to join members of “GayPA,” a secret society of gay psychiatrists, at a private party at a Honolulu gay bar. Gold asked the APA’s straight vice president Robert Spitzer to join him. Spitzer was shocked when he saw psychiatrists that he recognized and respected. As Spitzer was about to depart, a man in military uniform arrived. The Army psychiatrist burst into tears. In Spitzer’s presence, he told Gold that this was his first time at a gay bar, and that it was Gold’s speech that had given him the courage to attend. Galvanized, Spitzer became a gay ally. That evening, Dr. Spitzer drafted an APA resolution calling for the removal of homosexuality from the DSM.
At its next meeting, the Committee on Nomenclature approved the resolution. In December 1973, the APA’s Assembly endorsed the resolution by 13 to 0, with three abstentions. In response, Dr. Charles Socarides, who opposed the change, successfully circulated a petition requiring a vote of the full membership to decide the issue. In a 1974 referendum by mail, the membership voted by a 58 percent margin to remove homosexuality. The following day, The Philadelphia Bulletin ran the headline: “Ten Million Americans Cured.” In an epic irony, Socarides’ son Richard, who was then a teenager and not yet out as gay, would later work in President Clinton’s White House as an openly gay man, serving as liaison to the LGBT community.
While homosexuality per se was deleted by the 1973 vote—which led to a special printing of the DSM-II in 1974—it was replaced by the diagnosis of “sexual orientation disturbance.” In 1980 (DSM-III), this diagnosis was narrowed to “ego-dystonic homosexuality,” whatever that is. By 1987, in the DSM-III-R, homosexuality was delisted and subsumed under “sexual disorder not otherwise specified.”
In 1978, six years after John Fryer’s testimony in disguise, the Association of Gay and Lesbian Psychiatrists was formed. The AGLP is one of the oldest national gay professional organizations in the world. A few years later, when the AIDS epidemic first appeared in the U.S., Fryer was among the first practitioners to provide psychiatric services to those with AIDS or those grieving a loved one lost to AIDS.
With homosexuality delisted from the DSM, gays were no longer subjected to aversion therapy, chemical castration, electric shock therapy, or other techniques. The classification could no longer be cited to buttress homophobic legislation and regulations. Public perceptions of LGBT people began to change once the stigma of mental illness had been removed, and the effort to advance LGBT rights by activists became a lot easier.
While homosexuality was removed from the DSM, its remnant is “conversion therapy,” which is still inflicted on many young people in the U.S., particularly those raised in Evangelical Christian families. In 1998, the APA issued a position statement opposing the use of conversion therapy on homosexuals, and has strengthened that position in the intervening years. Currently, twenty states and the District of Columbia ban conversion therapy. In the remaining thirty states, 83 municipalities prohibit its use. This reversal by the APA signals a remarkable evolution that has occurred over the past fifty years.
Malcolm Lazin, an attorney and civil rights activist, is the founder and executive director of Equality Forum and LGBT History Month.