81 Words: the inside story of psychiatry and homosexuality (Part 2 of 2)81 Words: the inside story of psychiatry and homosexuality (Part 2 of 2)
All In The Mind
Being gay was considered a mental disorder by psychiatry - until 1973 - when the battle lines were drawn. In this final episode, 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. From Chicago Public Radio's This American Life.
30:00•11 Aug 2007
81 Words and a Hawaiian Bar: How Psychiatry Rethought Homosexuality
Episode Overview
- Homosexuality was once officially classified as a mental disorder in the DSM until concerted pressure from gay activists and reform-minded psychiatrists led to change.
- Evelyn Hooker’s research showed that non‑patient gay men were as well adjusted as heterosexual men, undermining assumptions that homosexuality was inherently pathological.
- Robert Spitzer proposed that a behaviour should only be considered a disorder if it causes distress, leading to the creation of "ego-dystonic homosexuality" as an interim category.
- Personal encounters, such as the emotional scene in a Hawaiian bar full of gay psychiatrists, strongly influenced Spitzer’s decision to draft a resolution changing the DSM.
- Historian Ronald Bayer argues that defining homosexuality as illness or health rests on moral judgments as much as – or more than – scientific evidence.
“"The fundamental question of whether or not homosexuality is a disease... is not a scientific question. It's a moral question."”
What drives someone to seek a life without being labelled ill for who they love? This episode of All In The Mind follows the tense, often emotional battle inside American psychiatry over whether homosexuality should be classed as a mental disorder. Reporter Alix Spiegel pieces together a very human political drama: closeted gay psychiatrists secretly organising within the American Psychiatric Association, furious activists disrupting conferences, and an unforgettable turn by Dr John Fryer as "Dr H.
Anonymous" in a wig, a distorted Nixon mask, and an oversized tuxedo. As he says of his masked speech, "I received a standing ovation. And I felt very empowered at that moment." You’ll hear how scientific evidence slowly chipped away at entrenched prejudice, from Evelyn Hooker’s landmark study showing well‑adjusted gay men were indistinguishable from straight men on psychological tests, to the sheer numbers in Alfred Kinsey’s sex survey.
Yet the episode shows that data alone didn’t shift minds: a late‑night Hawaiian bar, a shaken army psychiatrist in tears, and a room full of closeted colleagues also played a crucial role. Central to the story is Dr Robert Spitzer, who moved from accepting the old view to drafting a new definition that depended on whether a person felt distress, leading to the category "ego-dystonic homosexuality".
Historian Ronald Bayer cuts to the heart of it with the line: "The fundamental question of whether or not homosexuality is a disease... is not a scientific question. It's a moral question." Natasha Mitchell hosts with calm curiosity as the episode tracks the eventual removal of homosexuality from the DSM and the fallout for opponents like Dr Charles Socarides.
For anyone interested in how diagnoses shape stigma, identity and rights, this is a powerful reminder that what counts as a "disorder" can change – and that people’s lives hang on those decisions. How might similar debates play out today for other contested diagnoses?
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