To the Editor: The Open Forum, "Evolution of the Antipsychiatry Movement Into Mental Health Consumerism," in the June issue by David and Joshua Rissmiller (1) contains statements about the antipsychiatry movement and the removal of homosexuality as a disorder from the DSM-II that deserve clarification. The Rismillers write: "In May 1970, hundreds in the antipsychiatry movement joined gay activists in forming a human chain barring psychiatrists from entering the American Psychiatric Association's 124th annual meeting. During a similar disruption the following year, gay activist Frank Kameny grabbed the podium and declared war on psychiatry for its DSM classification of homosexuality as a psychiatric disorder."
Standard histories of the gay rights movement and the declassification of homosexuality as a psychiatric disorder, including Ronald Bayer's Homosexuality and American Psychiatry (2) and Out for Good: The Struggle to Build a Gay Rights Movement in America (3) by Dudley Clendinen and Adam Nagourney, fail to mention the participation of "hundreds in the antipsychiatry movement" in the disruptions in 1970 in San Francisco by gay rights activists that were pivotal to the inclusion of activists such as Kameny in programs on homosexuality that were presented at the 1971 APA meeting in Washington, D.C.
Kameny now states: "I was not then aware, and am today still unaware, of an actual, organized 'anti-psychiatry movement.' My—our—sole intent was to reverse what we (and I, as a scientist by training and background) considered a scientifically baseless characterization of homosexuality as pathological. Institutions, such as the APA, often require a very strong nudge to reverse long-standing past positions. That was the case here. Remember, when I seized that microphone, I was present there at the Convocation by formal, official invitation…. Antipsychiatry I am not" (Kameny F, personal communication, 2006).
The Rissmillers also write: "Wanting the protests to stop, the American Psychiatric Association formed a task force, which, by a vote of 58 percent, officially deleted homosexuality as a mental illness in 1973." This statement perpetuates the incorrect assertion that the deletion of homosexuality as a psychiatric disorder from the DSM was primarily a political, not a scientific, decision. In 1973 the APA's Committee on Nomenclature, including Robert Spitzer, reviewed the existing scientific literature on homosexuality and concluded that the available evidence did not support classifying homosexuality as a psychiatric disorder. After this decision was made, a contingent within the APA, led by psychoanalysts that viewed homosexuality as pathological, called for a vote by the entire membership of the APA to reinstate homosexuality as a disorder. This political act failed in 1974 when APA members voted by 58 percent to 42 percent to support the original scientific decision to declassify homosexuality as a disorder from the DSM.
Dr. McCommon is assistant clinical professor of psychiatry at Columbia University, New York City, and a member of the APA's Gay, Lesbian, and Bisexual Issues Committee.
Rissmiller DJ, Rissmiller JH: Evolution of the antipsychiatry movement into mental health consumerism. Psychiatric Services 57:863-866, 2006
Bayer R: Homosexuality and American Psychiatry. Princeton, NJ, Princeton University Press, 1987
Clendinen D, Nagourney A: Out for Good: The Struggle to Build a Gay Rights Movement in America. New York, Simon and Schuster, 1999