81 words

December 24, 2011 10:22 AM

Being gay was considered a mental disorder by psychiatry - until 1973 - when the battle lines were drawn. Reporter Alix Spiegel continues the gripping story that spurred a radical rethink. It's the story of a closeted cartel of powerful, gay psychiatrists; of confrontations with angry activists; a shrink dressed in a Nixon mask, and a pivotal encounter in a Hawaiian bar.

Alix Spiegel --

This is the story of a definition. Three single sentences composed of 81 words. It's the story of how this particular definition became another definition, nine sentences composed of 237 words. Now according to some parties this change from 81 words to 237 words liberated an entire category of humanity. According to other parties it undermined the basic family unit, compromised the scientific authority of psychiatry and 'tampered with the basic code and concept of life'.

Now I should tell you that I know this story not because I read it in a book or learned it in any class, but because it's one of those stories that my family uses to explain itself. Like most family stories, or anyway, like most stories told in my family, the version I heard growing up was an exaggeration, the relevant family member cast as a conquering hero. The actual story, the story I hope to tell you, is of course much more complicated -- but I'm getting ahead of myself.

81 Words: the inside story of psychiatry and homosexuality [Part 1 of 2]

Download audio (mp3, right click, download linked file)

81 Words: the inside story of psychiatry and homosexuality (Part 2 of 2)

Download audio (mp3, right click, download linked file)

Show Transcript "Note: This American Life is produced for the ear and designed to be heard, not read. We strongly encourage you to listen to the audio, which includes emotion and emphasis that's not on the page. Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors. Please check the corresponding audio before quoting in print."

Homosexuality was once labelled a mental disease by psychiatry. But in 1973 the challenge came from within. The American Psychiatric Association had a change of heart. And with the tweak of the 81-word definition of sexual deviance in its own diagnostic manual, lives were reclaimed, and values confronted. Reporter and narrator Alix Spiegel tells the gripping story from the inside, revealing the activities of a closeted group of gay psychiatrists who sowed the seeds of change, amongst them her own grandfather, president-elect of the APA at the time. From Chicago Public Radio's This American Life.

posted by infinite intimation (27 comments total)

Fascinating article.

And despite their reasonable caveats, I applaud having a transcript - because I for one would never ever take the time to listen when I can read a dozen times faster...
posted by lupus_yonderboy at 11:10 AM on December 24, 2011 [4 favorites]

Ah, for those who prefer the speed-ease of reading, these links to further info might be useful or interesting (similar links are found at the first link from the FPP, but at the site there were some dead or missing links, which I updated or filled out).

Guests:
Alix Spiegel, Journalist (National Public Radio, USA), John P. Spiegel's grand-daughter

Dr John P. Spiegel: Psychiatrist, Former president of the American Psychiatric Association (died in 1991).

Dr Toby Bieber: Psychiatrist, Married to Dr Irving Bieber (now deceased)

Dr Charles Socarides: Psychiatrist and psychoanalyst. Died in 2005.

Dr John E. Fryer: Psychiatrist, The American Psychiatric Association John E. Fryer, M.D., Award is named in his honour. Died in 2003.

Adam Spiegel: Son of John P Spiegel, Father of Alix Spiegel

Publications:

A symposium: Should homosexuality be in the APA nomenclature?, Stoller RJ, Marmor J, Bieber I, Gold R, Socarides CW, Green R, Spitzer RL. Am J Psychiatry. 1973 Nov;130(11):1207-16

The Sexual Deviations and the Diagnostic Manual, Charles W. Socarides, American Journal of Psychotherapy, Volume XXXII, Number 3, July 1978

Dr John Fryer (aka Dr H. Anonymous) obituary, British Medical Journal, 2003 March 22; 326(7390): 662.

Homosexuality: A Psychoanalytic Study, Irving Bieber, Toby B. Bieber, Harvey J. Dain, Paul R. Dince, Marvin G. Drellich, Henry G. Grand, Ralph H. Gundlach, Malvina W. Kremer, Alfred H. Rifkin, Cornelia B. Wilbur, Basic Books, 1962

Further Information

More information about the documentary, 81 Words


American Psychiatric Association

Charles Socarides (biography in New York Times death notice)

The Dictionary of Disorder: How one man revolutionized psychiatry.

Article about psychiatrist Robert Spitzer by Ian Buruma published in the New Yorker, January 3rd 2005.

(DSM-V, previously, also 1)
posted by infinite intimation at 11:18 AM on December 24, 2011 [8 favorites]

That was quite moving.
posted by localroger at 11:21 AM on December 24, 2011

I prefer reading to listening too... especially when on a mobile device.

Someday we will stop considering gender dysphoria as a mental illness too.
posted by Foosnark at 11:39 AM on December 24, 2011 [3 favorites]

That is a good point.

various groups suggest that a similar usage of the power of institutions may once again be at risk of singling out and targeting groups based on outdated ignorance, and prejudice, rather than the "hard science" sought by modern Psychology:

"If a man sought therapy due to unhappiness over his attraction to other men, a therapist would likely diagnose him with depression. If a transsexual sought therapy due to unhappiness over his or her biological sex, a therapist would almost certainly diagnose him or her with Gender Identity Disorder (GID). Whereas gay men are diagnosed for how they suffer, transsexuals are diagnosed for who they are. I find the mental illness labels imposed on transgenderism just as disquieting as the label that used to be imposed on homosexuality."

posted by infinite intimation at 11:41 AM on December 24, 2011 [3 favorites]

Wow. That is incredible. Amazing to think of how far we've come, and how much of a battle it's been, to get to even this point.

Re: transgenderism as diagnosable condition (NHS recognizes GID but doesn't consider it a mental illness), that's a difficult question; after all, many trans people agree that the mismatch between their bodies and their gender identities needs to be treated medically.

ALSO.

Metafilter: A closeted cartel of powerful, gay psychologists.
posted by Holy Zarquon's Singing Fish at 11:58 AM on December 24, 2011

On the other hand, the existence of Gender Identity Disorder could be a good thing for insurance reasons, so that hormones/surgery would not have to be paid out of pocket, no?

A gay man or woman doesn't need to change to be psychologically healthy. A transgendered person prevented from changing their sex will not be psychologically healthy.

A diagnosis of Gender Identity Disorder, pre-transition, therefore makes logical sense. No?
posted by lewedswiver at 11:59 AM on December 24, 2011

I prefer to read usually, I will rarely watch the YouTube links, but This American Life is the exception. I heard this a few years ago, it was interesting, but they all are, even the shows I don’t think are going to be.
posted by bongo_x at 12:05 PM on December 24, 2011

Surely there is some way of allowing such a reality for an individual may be a medical/bodily/health related issue... and that yes, medical, social, or other costs are involved (and some sort of "insurance" thing is needed [remembering that many countries don't operate on the same pay/insurance model]), yet not to asset it to be a sickness, an illness, a 'disease' or 'disorder'... labeling things as being products of "mental illness" (particularly with poorly documented, under-studied research and science backing up such a medicalized diagnosis) can be shown to have stigmatizing, distancing effects on those people involved.

It isn't a mental illness, is, I think, the point of people taking issue with the labeling. Like, the "depression" comes from stigmatization, social distancing, ignorance, bigotry &c., not from the gender issue...
posted by infinite intimation at 12:09 PM on December 24, 2011 [2 favorites]

I haven't listened to this yet, but I am a psychotherapist, and I'm more than a little familiar with this story.

I popped in to say that a close friend of mine from training to be a therapist is gay, and quite a bit older than I am (it was a second career for him). He grew up in Nebraska, and his parents, correctly, thought that he was gay and they were quite worried. They sent him to the Menninger clinic in Kansas to get "treated" in the 60s. John said that the first gay men he met that he knew of, were his analyst and the other doctors at Menninger.
posted by OmieWise at 12:14 PM on December 24, 2011 [6 favorites]

Jesus, if that comment is anything to go on, I think I have poorly demarcated clause disorder.

If I can get an academic psychiatrist to study it, and pick up some pharma funding, it's probably not too late to get it into DSM5. /despairoverDSM5joke
posted by OmieWise at 1:32 PM on December 24, 2011

I find the mental illness labels imposed on transgenderism just as disquieting as the label that used to be imposed on homosexuality

I guess I'm part of the problem - I'm no expert on GID, but in my ignorance, how could GID possibly NOT be a disorder?! The person suffering it does not want to be the way they are, does not want to continue suffering it, it causes distress (and dis-ease), it impacts their quality of living, often hugely, such they will entertain huge and dangerous undertakings to change either their bodies or their personality in desperate bid to alleviate it. Any similarity in conflict felt by gay people seems due to not wanting to (or being immensely pressured to not) act in accordance with your nature, rather than fundamentally not being able.

I guess to me it seems that if GID doesn't quality as a disorder, what would?

Sociopaths and schizophrenics often seem happier living with their condition than people with GID - the complaints about them come more from others at their difficulty at integrating productively into communities.

I can see that there is utility in measuring disorder in terms of social productivity, but in these individualistic pursuit-of-happiness times, we also measure in terms of distress.
posted by -harlequin- at 3:00 PM on December 24, 2011

That said, it's only been in the last few years that psychiatrists have discovered that an interest in BDSM games isn't a mental illness, so I kind of regard the "profession" as the same hopeless quacks they've always been.
posted by -harlequin- at 3:19 PM on December 24, 2011 [2 favorites]

-harlequin-, the idea is that GID isn't a mental disorder, it's a physical one. Something that requires fixing the body, not fixing the mind.
posted by jiawen at 4:20 PM on December 24, 2011 [1 favorite]

Still, it's awfully odd that trans folks are diagnosed with a psychiatric disorder. I'm not even thinking about the political issues, the stigma that comes with a psych diagnosis, any of that. It's just not a very useful or accurate way to categorize things.

It's as if sometime back in the 50s we had decided that haircuts would count as automotive maintenance, or potatoes would count as livestock.
posted by nebulawindphone at 4:21 PM on December 24, 2011

Or, yeah, what jiawen said.
posted by nebulawindphone at 4:21 PM on December 24, 2011

Proving once again that, for some, learning to distinguish 'reason' from 'witchhunt' is a long, slow process - littered with victims.
posted by Twang at 5:41 PM on December 24, 2011

Closeted cartel of powerful, gay psychologists.

I read this instantly in the old Justice League "meanwhile..." voice.
posted by juiceCake at 6:14 PM on December 24, 2011 [2 favorites]

You know, as a person who is actually mentally ill, I'm sometimes a little put off by how LGBT groups can't run fast enough to disassociate themselves with the likes of me.
posted by mellow seas at 9:08 PM on December 24, 2011 [2 favorites]

You know, as a person who is actually mentally ill, I'm sometimes a little put off by how LGBT groups can't run fast enough to disassociate themselves with the likes of me.

I don't suppose you bothered listening to the program?
posted by roger ackroyd at 10:03 PM on December 24, 2011

Not to pile on, but speaking as someone who's queer and mentally ill, yeah, I think you may have misunderstood where LGBT folks are coming from on this.

This isn't about disassociating ourselves from Those Crazy People. I am one of Those Crazy People, and I'm pretty loud and open about that.

It's more like... okay, if I show up at a psychiatrist's office complaining about some symptom or other and he tells me "You need to convert to Hinduism immediatly" or "Your symptoms will improve if you start voting Republican" or "Your problem is that you don't like falafel," I'm gonna feel like "Okay, dude, you are really not addressing my actual concerns" — and if he says "You need to stop being attracted to men," I'm gonna feel just as irritated, for just the same reason.

Luckily, I'm young enough — and grew up in a liberal enough town — that nobody has ever tried to tell me with a straight face that my depression would go away if only I could stop checking out dudes. But in my parents' generation, that's what would have happened. As is, getting good psychiatric care is what basically saved my life. If, instead of real psychiatric care, I'd gotten a well-meaning lecture about how I Had A Problem With gay sex (or Republicanism, or falafel...) then I doubt things would have gone so well for me.
posted by nebulawindphone at 10:41 PM on December 24, 2011 [8 favorites]

Alix's voice is a great sample of vocal fry for those wanting more field examples.
posted by ao4047 at 12:23 AM on December 25, 2011

There was this huge article a while back about the DSM. The story is pretty ridiculous. The guy who basically edited the whole thing had, at one point, believed the universe was full of orgasmic energy, which could be harnessed using collectors. I mean obviously he wasn't a total crackpot later in life.

But yeah psychology definitely had it's genesis in some pretty non-scientific gobbledygook.
posted by delmoi at 3:25 AM on December 25, 2011

I've never heard that Wilhelm Reich had anything to do with the DSM, and I can't find anything to that affect with a quick search. Do you have a citation?
posted by OmieWise at 6:38 AM on December 25, 2011

"But yeah psychology definitely had it's genesis in some pretty non-scientific gobbledygook"

Are you saying this to contrast psychology with modern gender studies?
posted by falameufilho at 7:28 AM on December 25, 2011

Are you saying this to contrast psychology with modern gender studies?

I had no idea anyone was ever, for example, given shock treatment by people teaching modern gender studies.
posted by me & my monkey at 11:25 AM on December 25, 2011

I had no idea anyone was ever, for example, given shock treatment

Are you using 'shock treatment' as an example of 'non-scientific gobbledygook' ?
posted by falameufilho at 4:23 PM on December 25, 2011