Gay & Lesbian Issues

American Psychiatric Association Fact Sheet
September 1994

In December 1973, the American Psychiatric Association's Board of Trustees deleted homosexuality from its official nomenclature of mental disorders, the "Diagnostic and Statistical Manual of Mental Disorders, Second Edition" (DSM-II). The action was taken following a review of the scientific literature and consultation with experts in the field. For a mental condition to be considered a psychiatric disorder, it should either regularly cause emotional distress or regularly be associated with clinically significant impairment of social functioning. These experts found that homosexuality does not meet these criteria.

The Board recognized that a significant portion of gay and lesbian people were clearly satisfied with their sexual orientation and showed no signs of psychopathology. It was also found that homosexuals were able to function effectively in society, and those who sought treatment most often did so for reasons other than their homosexuality.

When the DSM-III was published in 1980 homosexuality was not included although "ego dystonic homosexuality" was recognized as a category for people "whose sexual interests are directed primarily toward people of the same sex and who are either disturbed by, in conflict with, or wish to change their sexual orientation."

When the DSM-III was revised in 1987, "ego dystonic homosexuality" was deleted as a separate diagnostic entity because "In the United States, almost all people who are homosexual first go through a phase in which their homosexuality is ego dystonic." (DSM-III-R)

"Reparative Therapy"
"Reparative therapy," also known as conversion therapy, is a term that is used to describe treatment attempts to change a person from a homosexual orientation to a heterosexual orientation.

There is no published scientific evidence supporting the efficacy of "reparative therapy" as a treatment to change ones sexual orientation. It is not described in the scientific literature, nor is it mentioned in the APA's latest comprehensive Task Force Report,Treatments of Psychiatric Disorders(1989).

There are a few reports in the literature of efforts to use psychotherapeutic and counseling techniques to treat persons troubled by their homosexuality who desire to become heterosexual; however, results have not been conclusive, nor have they been replicated. There is no evidence that any treatment can change a homosexual person's deep seated sexual feelings for others of the same sex.

Clinical experience suggests that any person who seeks conversion therapy may be doing so because of social bias that has resulted in internalized homophobia, and that gay men and lesbians who have accepted their sexual orientation positivly are better adjusted than those who have not done so.

APA Position Statement on Homosexuality
The American Psychiatric Association is officially on record with the following position statements:

Homosexuality
Whereas homosexuality per se implies no impairment in judgement, stability, reliability, or general social or vocational capabilities, the American Psychiatric Association calls on all international health orgranizations, and individual psychiatrists in other countries, to urge the repeal in their own country of legislation that penalizes homosexual acts by consenting adults in private. And further, the APA calls on these organizations and individuals to do all that is possible to decrease the stigma related to homosexuality wherever and whenever it may occur. (December 1992)

Bias-Related Incidents
Bias-related incidents, arising from racism, sexism, intolerance based on religion, ethnicity, and national/tribal origin, and anti-gay and lesbian prejudice are widespread in society and continue to be a source of social disruption, individual suffering and trauma. These incidents are ubiquitous and occur in both urban and rural areas. Such hate-based incidents consist of acts of violence or harassment. These incidents result in emotional and physical trauma for individuals, as well as stigmatization of affected groups. Ethnic and cultural biases, vividly manifest in bias-related incidents, serve to frustrate the basic human need for dignity, resulting in despair and hopelessness among the victims that ultimately affect the whole nation.

The APA deplores such bias-related incidents. Moreover, the APA encourages its own members and components to take appropriate actions in helping to prevent such events, as well as to respond actively in the aftermath when such bias-related incidents occur locally. (December 1992)

Right to Privacy

The American Psychiatric Association supports the right to privacy in matters such as birth control, reproductive choice, and adult consensual relations conducted in private, and it supports legislative, judicial, and regulatory efforts to protect and guarantee this right. (December, 1991)

Homosexuality and The Immigration and Naturalization Service
The American Psychiatric Association strongly opposes all public and private discrimination against homosexuals in such areas as employment, housing, public accommodations, licensing and immigration and naturalization decisions.

The Immigration and Naturalization Service, at least until 1990, considered homosexuality to be a mental illness and used this determination as a basis for the discriminatory exclusion of homosexual visitors and immigrants to the United States.

The American Psychiatric Association successfully opposed the continued inclusion of homosexuality as a mental illness by the Immigration and Naturalization Service. The APA believes that neither physical illness nor mental illness nor sexual orientation per se should be a basis for immigration or naturalization exclusion.

The American Psychiatric Association welcomes the changes presented in Title VI of the Immigration and Naturalization Act of 1990 and will be available to contribute to work intended to ensure that the immigration policies and practices of the United States are consistent with the relevant sections of that act. (June 1991)

Homosexuality and Armed Services
APA, since 1973, has formally opposed all public and private discrimination against homosexuals in such areas as employment, housing, public accommodations and licensing. It follows that APA opposes exclusion and dismissal from the armed services on the basis of sexual orientation. Furthermore, APA asserts that no burden of proof of judgment, capacity, or reliability should be placed on homosexuals which is greater than that imposed on any other persons within the armed services. (December 1990)

Discrimination Based on Gender or Sexual Orientation
Irrational employment discrimination on the basis of gender and sexual orientation has received considerable attention in law, business, sociology, and, to a lesser degree, psychology. It is well known that sexual harassment and other forms of irrational gender-based employment discrimination are potentially severe occupational stressors. Complaints of sexual harassment and gender-based discontinue because employees are increasingly aware of legal prohibitions against these and other forms of employment discrimination. While the psychiatric needs of self-identified discrimination victims have been under-recognized, both in and out of the workplace, psychiatrists can expect increasing consultations regarding these issues. It is important that psychiatrists appreciate and help others to understand the emotional consequences of irrational employment discrimination based on gender or sexual orientation. (June 1988)

Homosexuality and Civil Rights
Whereas homosexuality per se implies no impairment in judgment stability, reliability, or general social or vocational capabilities, therefore, be it resolved that the American Psychiatric Association deplores all public and private discrimination against homosexuals in such areas as employment, housing, public accommodation, and licensing, and declares that no burden of proof of such judgment, capacity, or reliability shall be placed upon homosexuals greater than that imposed on any other persons. Further, the American Psychiatric Association supports and urges the enactment of civil rights legislation at the local, state, and federal level that would offer homosexual citizens the same protections now guaranteed to others on the basis of race, creed, color, etc.

Further, the American Psychiatric Association supports and urges the repeal of all discriminatory leglislation singling out homosexual acts by consenting adults in private.

(The American Psychiatric Association is, of course, aware that many other persons in addition to homosexuals are irrationally denied their civil rights on the basis of pejorative connotations derived from diagnostic or descriptive terminology used in psychiatry and deplores all such discrimination. This resolution singles out discrimination against homosexuals only because of the pervasive discriminatory acts directed against this group and the arbitrary laws directed against homosexual behavior.) (November 1973)