Created May 18 2011 - 9:40am
©Copyright 2011 Paula J. Caplan All rights reserved
Homophobia, servicemembers, and the lords of psychiatric diagnosis
Note: This essay was written on May 17, 2011, but due to technical difficulties could not be posted until now.
Today is International Day Against Homophobia, a fitting time to look at two arenas in which there have been both rocky roads and some progress in the struggle to end this form of bias and resulting mistreatment.
On May 7, I attended a ceremony to mark the 10th anniversary of the setting of a memorial to LGBT servicemembers who have died. Tom Swann, head of the Palm Springs chapter of Veterans for Peace, a gay man who spearheaded the creation of this memorial in Cathedral City, CA (next-door to Palm Springs) and who led the struggles necessary to get the cemetery's permission to set the modestly-sized obelisk, told us that this is the only such memorial in the United States. Think about it.
Some might object that the memorials to deceased servicemembers also include LGBTs so that there was no need for a separate marker. But being at war is hard enough to get through, so let us consider what LGBT servicemembers have additionally endured...solely because of their sexual orientation. Many had to shoulder the almost unbearable burden of never letting slip the slightest indication of that orientation, lest they be drummed out of the military with a dishonorable discharge, otherwise publicly shamed, beaten, or even killed, as we know that some have been.
A gay veteran I interviewed (Caplan, 2011) told me that, although those who went through basic training with him did not know that he was gay, he watched the horrible beating of a heterosexual soldier whom someone erroneously said was homosexual, and after that, the gay veteran lived in terror that someone would find out or even suspect his orientation.
At the May 7 ceremony, Brigadier General Keith H. Kerr recounted some of the struggles that led to the recent repeal of the Don't Ask, Don't Tell (DADT) policy, including many who lobbied to change the law, the Log Cabin Republicans' filing of the lawsuit that led to a federal court ruling that DADT is unconstitutional, and those who chained themselves to the White House fence to protest discrimination and were arrested. Now, he said, DADT "is in its death throes, and seventy percent of the American public believes that LGBT people should be able to serve openly, not live in fear of their military careers, and share their lives, their partners, and families while serving in uniform." He made the point that "Nothing is as destructive to military cohesion as having to conceal part of one's everyday life and loved ones." This point is particularly important, given that a reason often put forward for keeping gays out of the military or insisting that they conceal their sexual orientation has been that to do otherwise would interfere with military cohesion.
General Kerr said that the military services are scheduled to complete their troop training about "open service" this summer, and he fully expects that President Barack Obama and others in the executive branch of the government will later this summer "certify that open service will not harm [military] readiness." But anyone who has studied bias and mistreatment knows that more struggles lie ahead, because changing laws and practices will help in some ways but will not wipe out the homophobia that lives on in many individuals in the armed forces...or anywhere else.
My regular readers will know that I have written a great deal about problems with psychiatric diagnosis, but they may wrongly assume that I have no concerns about diagnosis and homophobia. That assumption would probably be based on the extensive publicity Dr. Robert Spitzer received in the 1970s, when as head of the then-forthcoming Diagnostic and Statistical Manual of Mental Disorders-III (DSM), he announced that the American Psychiatric Association (APA), publisher of the DSM, had decided - by majority vote - that homosexuality was no longer a mental illness. Homosexuality was in the previous edition of the manual but would be removed for the next one, Spitzer proclaimed (Caplan, 1995).
There was rejoicing in the gay community, which had lobbied hard for that change. Many rejoiced even while taking note of the ironies and problems involved in (1) making such decisions by vote; (2) the fact that one second before the results of the voting were announced, homosexuality supposedly was a mental illness, and as soon as the results were known, it was not; (3) the fact that a lobby group, which is what the APA actually is, had the power to make such declarations and to put enormous influence behind them.
In the 1980s, a gay graduate student at the University of Toronto's Ontario Institute for Studies in Education, where I was teaching, corrected me when I said that homosexuality was no longer officially considered a mental illness. When Spitzer announced that it would not go in the next edition of the DSM, who would have thought to question his claim? Most people believed what he said. This student (I wish I could recall his name, because I have always been grateful to him for educating me) had learned that the DSM-III, published in 1980, listed as a mental disorder "Ego Dystonic Homosexuality." What is ego dystonic is what we do not experience as a part of ourselves with which we are comfortable and about which we feel happy. In 1980, in the intensely homophobic societies that were the United States and virtually all of the dozens of other countries where the DSM was used, how many gays and lesbians do you think were able to grow up feeling totally comfortable with their sexual orientation?
Thus, a socially-created effect of homophobia - gays' and lesbians' (few people then talked much about bisexuals or people we now called transgendered) discomfort about their sexual orientation - was cast as a mental illness. This is particularly disturbing, given that mental illness is so generally construed as a consequence of individual, intrapsychic problems, so to construe social problems as mental illnesses is to mask the harm done by social evils and reduce the chances that people will work to reduce them.
In 1987, the next DSM edition appeared (DSM-III-R), and Ego Dystonic Homosexuality did not appear. However, Sexual Disorders Not Otherwise Specified was there, and that pretty much amounts to whatever your therapist decides is a sexual disorder. So any sexual orientation other than heterosexuality could be given that mental disorder label. And you might want to have a look at dsm5.org to see what they are telling us they have in store at this point. (In a future essay, I will write about what the DSM authors call Gender Identity Disorder.)
In 2003, Spitzer said publicly that he had done some rethinking about homosexuality and mental illness. On what grounds? He had done some research that he called "Can some gay men and lesbians change their sexual orientation?" (Spitzer, 2003). The very title implies that being gay or lesbian is pathological, for a less biased piece of research might have been called, "Can people of any sexual orientation change to another sexual orientation?" A report about this study appears in Thinking Critically about Research on Sex and Gender:
"[Spitzer] carried out some research that he described as gauging the effectiveness of so-called reparative therapy, which is aimed to transform homosexuals into heterosexuals and frequently conducted by members of fundamentalist religious groups. Spitzer (2003) said he conducted 45-minute telephone interviews with 200 people who had undergone such ‘treatment' and found that 66 percent of the 143 men and 44 percent of the 57, all of whom he said were ‘extraordinarily religious,' told him they had been having heterosexual sex at least monthly for at least five years. On this basis, he reported that reparative therapy was extremely effective. There were major flaws in this research: the practitioners of this program and religious groups helped him find interviewees; extremely religious people may be highly motivated to disclaim homosexual feelings and present themselves as happy heterosexuals; despite the skewed selection of interviewees, fully one-third of the men and more than half of the women did not report switching their sexual orientation to heterosexual; some would question whether having heterosexual sex once a month is sufficient evidence of transformed sexual orientation; and it is not clear whether Spitzer made any attempt to interview people for whom the program had not been effective or had in fact been harmful, despite widely available information about such harm (Boodman, 2005)."
(Caplan & Caplan, 2009, pp. 83-4)
Given the frequency with which mental health professionals and especially those who write the diagnostic manual are considered (wrongly, I believe) to base their conclusions and classifications on well-done scientific studies, it is important to remember the vast number of serious methodological problems with what Spitzer offered as his research.
The road to eradicating homophobia is long enough without those in the mental health professions providing fuel for the fires of this hatred.
Switching from the focus on homophobia to a view of a better future in which sexual orientation will not be used oppressively, let me give the last words to American Veterans for Equal Rights President Danny Ingram, who said at the May 7 memorial commemoration of the small obelisk that honors LGBT veterans, an obelisk that is shaped like the Washington Monument:
"In a few weeks when President Obama, Admiral Mullen, and Secretary Gates certify the repeal of Don't Ask, Don't Tell, America will be more free than she was the day before. That is what we celebrate here today. That is what this monument means. Today this small monument casts a mighty shadow that dwarfs the one cast by the great Washington Monument in our nation's capitol. That shadow not only reaches from one beautiful shore of our nation to the other, but back through the long passages of time. Back beyond the founding of our nation. Back beyond the birth of the great religious traditions. Back beyond the first awkward experiments with democratic government. This monument reaches beyond the shadows of prehistory to the time when two human tribes crossed each other's path for the first time. And different colored eyes, locking there together, would wonder if all people, ALL people, ALL PEOPLE, would ever live as one."
S. Boodman. (2005). Vowing to set the world straight. Washington Post. August 16.
Paula J. Caplan. (2011). When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans. Cambridge, MA: MIT Press.
Paula J. Caplan. (1995). They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal. Addison-Wesley.
Paula J. Caplan & Jeremy B. Caplan. (2009). Thinking Critically about Research on Sex and Gender. Boston: Pearson.
Robert L. Spitzer. (2003). Can some gay men and lesbians change their sexual orientation? Archive of Sexual Behavior 32(5), 403-17.