“A fact of life – not a crime”

Fifty years ago today the Stonewall uprising began in the early morning hours of June 28, 1969, at the Stonewall Inn in Greenwich Village. In the 1960s, as in preceding decades, police commonly raided bars that catered to gay and lesbian clientele on the pretext of liquor license violations. This was the case at Stonewall when officers belonging to the NYPD’s now-defunct Public Morals Squad raided the Stonewall Inn because of supposed liquor law abuses. Although the four nights of violence that began with the raid of the Stonewall Inn did not originate the gay liberation movement[1], nor was it the first time gays fought back against police abuses[2], Stonewall was a historic turning point in gay civil rights movement. The first anniversary of the uprising, known as Christopher Street Liberation Day, became the first Gay Pride event.

Nearly two decades before Stonewall, in 1952, the American Psychiatric Association (APA) published the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I). This manual classified homosexuality as a paraphilia – a sexual perversion or deviation. That a professional organization like the APA would label homosexuality as abnormal and deviant had a significantly negative impact on gay men and women, who already faced constant religious bigotry and discrimination or blackmail directly related to laws criminalizing gay sexual acts. The APA’s classification only served to further legitimize these views by classifying homosexual individuals as inherently “sick,” thereby inferring homosexuality was something to be cured through medical intervention.

The APA’s de facto consideration of homosexuality as a pathological condition was especially unfortunate in light of the research studies on male and female sexuality published by researchers in the late 1940s and early 1950s, most famously “Sexual Behavior in the Human Male” (1948) by Alfred C. Kinsey, Wardell B. Pomeroy, Clyde E. Martin, and W.B. Saunders. The book introduced the public to the now-iconic “Kinsey Scale” that places human sexuality on a scale of 0-6 from exclusively heterosexual to exclusively homosexual. Not long after the DSM-I was published, psychologist Evelyn Hooker published her study proving that experienced psychologists could not determine her test subjects’ sexuality by evaluating their unmarked psychological profiles. The results of her study issued a direct challenge to the association between homosexuality and psychopathology that psychiatrists and psychologists typically presumed.[3]

At Washington University School of Medicine in the early 1970s, psychiatrists Marcel T. Saghir and Eli Robins determined to undertake a study of homosexuality and psychopathology from a starting position of neutrality; that is, they attempted to “describe the natural history of this relatively common phenomenon” while keeping sexual orientation itself as a neutral variable.

Robins and Saghir acknowledge that most previous studies would only draw their samples from the most easily accessible populations: men (almost exclusively) already in psychiatric facilities or in prisons. They wrote:

Obviously, generalizations based on such highly biased and selective samples were fraught with the risk of describing the elephant from the feel of his tail, for only a minority of homosexuals were ever psychiatric patients and a smaller minority were ever in prisons for a felony. Consequently, we felt that there was a definite need to utilize samples that are more broadly based and that are a priori functioning individuals in society. Because it was not possible at this time to sample representative populations, we resorted to the next available alternative, namely, homophile organizations[4] and to a lesser extent, gay bars (p. 16).

Book review of “Male and Female Homosexuality: A Comprehensive Investigation” from the St. Louis Post-Dispatch, 1973.

The resulting study, “Male and Female Homosexuality: A Comprehensive Investigation,” was published in 1973 and owes much to the groundwork laid by Kinsey, Hooker, and others, and those groundbreaking works are referenced in the text and the bibliography. Saghir and Robins conclude that homosexual men and women are not sick, and that “it is quite inappropriate and scientifically untenable to label an individual psychiatrically ill because he happens to be a homosexual, for, to do so would only tend to perpetuate the social and legal discriminatory practices against men and women who are primarily different in their sexual preferences but who otherwise show little other differences from their fellow non-homosexual men and women” (p. 317). In the concluding chapter of their book, Saghir and Robins also insist that laws against sodomy must be repealed, as well as the prohibition against gays serving openly in the military. They write that they believe that those legal and governmental changes would go a long way toward easing stigma and discrimination against gay men and women. The same year Robins and Saghir published their study, the American Psychiatric Association removed the diagnosis of “homosexuality” from the second edition of the DSM.

Some pressure from within the psychiatric community factored into the decision, but it was most significantly due to gay activism, including the disruption by activists of the 1970 and 1971 annual meetings of the APA. Also at the APA meeting of 1971, advocates succeeded in getting a “Gay is Good” panel included in the conference. The panel featured gay activists Frank Kameny and Barbara Gittings, who educated conference attendees as to how diagnosing homosexuality as an illness contributed to cultural and legal stigmatization. The pair also spoke at the 1972 annual meeting and were accompanied by Dr. John Fryer, a gay psychiatrist who felt the need to disguise himself and use the name Dr. H. Anonymous for his appearance for fear of discrimination from within his own profession.[5]  As a result of protests, panels, and some changing attitudes from within the psychiatric community (thanks to pioneering studies like those from Kinsey and Hooker that were largely ignored by psychiatrists when they first appeared), the APA’s Board of Trustees voted to remove homosexuality from the DSM in December 1973.

The removal of homosexuality from the DSM in 1973 was not the end of the battle against psychiatry’s pathologizing of homosexuality: the DSM-II replaced homosexuality with Sexual Orientation Disturbance (SOD), essentially diagnosing a homosexual person as ill if they felt anguish over their sexual orientation and wished they could change it. It was not until a revision of the DSM-III was published in 1987 that homosexuality was removed entirely. Saghir and Robins were correct in their conclusion that cultural attitudes about homosexuality could change in this country if the scientific community depathologized homosexuality. In 1990, the World Health Organization (WHO) also removed homosexuality from the International Classification of Diseases (ICD-10). In many countries, this has led to the decriminalization of homosexuality and the passing of legislation to protect the human rights of LGBT people. These human rights laws are an important step toward equality in the United States and in many other countries, though it is imperative to remember that there are still many places in the world where being outed as gay can be a death sentence. As we commemorate events like Stonewall and the heroism of the people involved, we must remember civil liberties only remain in place because humans continue to fight for them.



[1] Organizations such as the Mattachine Society, the Society for Individual Rights (SIR), and the Daughters of Bilitis had been in existence since the 1950s.

[2] Elizabeth A. Armstrong and Suzanna M. Crage, “Movements and Memory: The Making of the Stonewall Myth,” American Sociological Review Vol. 71, No. 5 (Oct., 2006), pp. 724-751.

[3] Evelyn Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques, Volume 21, No. 1 (1957), https://www.tandfonline.com/doi/abs/10.1080/08853126.1957.10380742?journalCode=hzpt20.

[4] Most of Saghir and Robins’ volunteer subjects were members of the Mattachine Society, SIR, or the Daughters of Bilitis.

[5] Jack Drescher, “Out of DSM: Depathologizing Homosexuality,” Behavioral Sciences, Vol. 5, No. 4, (Dec. 2015), pp. 565-575.