… It is manifestly unwarranted and inaccurate, however, to attribute such neuroticism, when it exists, to intrinsic aspects of homosexuality itself. In a society like ours where homosexuals are uniformly treated with disparagement or contempt-to say nothing about outright hostility-it would be surprising indeed if substantial numbers of them did not suffer from an impaired self-image and some degree of unhappiness with their stigmatized status. The basic issue … is not whether some or many homosexuals can be found to be neurotically disturbed. This distinction between prevalences of mental disorders and classification in the DSM was apparent to Marmor (1980), who in an early discussion of the debate said,
The answer, therefore, depends on scientific and social consensus that evolves and is subject to the vicissitudes of social change ( Gergen, 1985, 2001).
To use postmodernist understanding of scientific knowledge, such a debate on classification concerns the social construction of mental disorder-what we as a society and as scientists agree are abnormal behaviors, cognitions, and emotions. It can be answered by debating which behaviors, cognitions, or emotions should be considered indicators of a mental disorder ( American Psychiatric Association, 1994). The question of whether homosexuality should be considered a mental disorder is a question about classification. The debated scientific question was, Is homosexuality a mental disorder? The operationalized research question that pervaded the debate was, Do homosexuals have high prevalences of mental disorders? But the research did not accurately operationalize the scientific question. A retrospective analysis would suggest that the attempt to find a scientific answer in that debate rested on flawed logic. However, a fresh look at the issues should make it clear that whether LGB populations have higher prevalences of mental disorders is unrelated to the classification of homosexuality as a mental disorder. This heritage has tainted discussion on mental health of lesbians and gay men by associating-even equating-claims that LGB people have higher prevalences of mental disorders than heterosexual people with the historical antigay stance and the stigmatization of LGB persons ( Bailey, 1999).
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Although the debate on classification ended in 1973 with the removal of homosexuality from the second edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM American Psychiatric Association, 1973), its heritage has lasted.
That debate posited a gay-affirmative perspective, which sought to declassify homosexuality, against a conservative perspective, which sought to retain the classification of homosexuality as a mental disorder ( Bayer, 1981). The study of mental health of lesbian, gay, and bisexual (LGB) populations has been complicated by the debate on the classification of homosexuality as a mental disorder during the 1960s and early 1970s.
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