The American Psychiatric Association formally voted to remove homosexuality from its list of mental disorders in the Diagnostic and Statistical Manual of Mental Disorders, Second Edition (DSM-II). This action represented a decisive change in official psychiatric classification in the United States. Until that date, homosexuality had been defined within American psychiatry as a pathological condition, a status that carried significant clinical, legal, and social consequences. The 1973 vote marked the first time a major medical authority in the United States rejected the view that same-sex sexual orientation was inherently indicative of mental illness.
The classification of homosexuality as a disorder had been embedded in psychiatric doctrine since the mid-twentieth century. The DSM-I, published in 1952, categorized homosexuality under “sociopathic personality disturbance,” reflecting dominant psychoanalytic theories that framed same-sex attraction as a developmental failure. The DSM-II, published in 1968, retained homosexuality as a diagnosis, listing it under “sexual deviations.” These classifications shaped clinical practice by legitimizing treatments intended to alter sexual orientation and by reinforcing the perception that homosexuality was incompatible with psychological health.
By the late 1960s and early 1970s, empirical research increasingly challenged these assumptions. Studies comparing homosexual and heterosexual populations found no consistent differences in psychological functioning, emotional stability, or social adjustment when sexual orientation was examined independently of social stigma. Researchers noted that distress observed among homosexual individuals often correlated with discrimination rather than with orientation itself. These findings raised questions about whether homosexuality met the APA’s own criteria for mental disorder, which required evidence of inherent distress, dysfunction, or impairment.
Scientific debate coincided with sustained internal and external pressure on the psychiatric profession. Gay rights activists directly engaged the APA through organized protests at annual meetings and through testimony by gay psychiatrists and psychologists. In 1972, a psychiatrist speaking anonymously under the pseudonym “Dr. H. Anonymous” addressed the APA, describing the professional risks faced by gay clinicians. These interventions exposed the gap between psychiatric classifications and emerging scientific evidence, while also highlighting the institutional effects of diagnosis on professional and personal lives.
The APA Board of Trustees reviewed available research and position papers during 1973. On December 15 of that year, the Board voted to approve a resolution stating that homosexuality, by itself, does not constitute a mental disorder. As a result, homosexuality was removed from the DSM-II in subsequent printings. The APA simultaneously adopted a policy statement opposing discrimination against homosexual individuals in areas such as employment, housing, and civil rights, signaling that the diagnostic change carried broader institutional implications.
The decision generated internal controversy. Some members argued that the vote reflected social influence rather than scientific judgment. In response to these objections, opponents petitioned for a membership referendum. In 1974, the APA conducted a vote among its full membership, which upheld the Board of Trustees’ decision by a clear margin. This outcome confirmed that the removal of homosexuality from the DSM reflected consensus within the profession rather than unilateral administrative action.
Although the 1973 vote ended the classification of homosexuality as a disorder per se, it did not immediately eliminate all diagnostic categories related to sexual orientation. The DSM-II revision introduced the diagnosis “sexual orientation disturbance,” which applied to individuals who experienced marked distress about their orientation. Later manuals replaced this category with “ego-dystonic homosexuality” in DSM-III. These residual diagnoses were removed in later revisions as diagnostic standards continued to evolve. By 1987, all classifications treating homosexuality as a pathological condition were eliminated from the DSM.
The historical significance of December 15, 1973, extends beyond psychiatry. Psychiatric diagnoses had been cited in court rulings, employment policies, child custody cases, and military regulations. The removal of homosexuality from the DSM weakened the medical justification for discriminatory laws and practices. It also altered clinical ethics by reducing the legitimacy of treatments aimed at changing sexual orientation, which lacked empirical support and carried documented risks.
The APA’s action influenced other health organizations and professional bodies. In subsequent years, medical and psychological associations in the United States and abroad adopted positions affirming that homosexuality is a normal variant of human sexuality. The 1973 decision became a reference point in discussions about the relationship between science, professional authority, and social values.
December 15, 1973, stands as a landmark in American medical history because it illustrates how diagnostic systems can change in response to empirical evidence and professional self-examination. The APA vote reshaped psychiatric classification, altered clinical practice, and contributed to broader shifts in law and public policy. Its significance lies not in symbolism alone, but in its measurable impact on how mental health, sexuality, and human variation are defined within institutional medicine.
References / More Knowledge:
American Psychiatric Association Foundation. History of the DSM and Homosexuality.
https://www.apaf.org/library-archives/galleries/lgbtq-leaders/history-of-dsm-and-homosexuality/
Bayer, R. (1981). Homosexuality and American Psychiatry: The Politics of Diagnosis. Princeton University Press.
https://press.princeton.edu/books/paperback/9780691023315/homosexuality-and-american-psychiatry
American Psychiatric Association. (1973). Position Statement on Homosexuality.
https://www.psychiatry.org/getattachment/7d7e11f1-1b9f-4e8f-9b4e-8f9fbd84c9e5/Position-Statement-on-Homosexuality.pdf
Drescher, J. (2015). Out of DSM: Depathologizing homosexuality. Behavioral Sciences, 5(4), 565–575.
https://www.mdpi.com/2076-328X/5/4/565
Herek, G. M. (2010). Sexual orientation differences as deficits: Science and stigma in the history of American psychology. Perspectives on Psychological Science, 5(6), 693–699.
https://journals.sagepub.com/doi/10.1177/1745691610388770