Fifty years ago, on the 15th of December 1973, the American Psychiatric Association’s Board of Trustees voted unanimously to remove what it called “homosexuality per se” from the Diagnostic and Statistical Manual of Mental Disorders. That act of declassification was by any standard an astonishing reversal of decades of medical theory and a stunning victory for the still-nascent Gay Liberation Movement. As the activist Frank Kameny put it, it marked the moment when millions of gay men and women went to bed suffering a mental illness and woke up to find themselves cured en masse.

This week, as we approach the 55th anniversary of the Stonewall riots, we take a fresh look at the relationship between queer life and psychiatric power. For much of the twentieth century, American psychiatrists defined homosexuality as a diagnosable, treatable mental disorder, a disease that was amenable to psychiatric cure. It was a claim that gave them enormous authority as arbiters of gender normativity, a fact that recent historians have not been slow to point out. Yet in building that critique, historians by and large have had to rely on their reading of psychiatric literature. Far more elusive have been the decades of real-life encounters between queer and gender-variant people and the psychiatrists they (willingly or otherwise) turned to for treatment. Pretty much by definition, most of those encounters left no trace.

That heretofore inaccessible history of psychiatric encounters is the subject of a new book: In the Shadow of Diagnosis: Psychiatric Power and Queer Life, written by the historian Regina Kunzel. The book examines the history, dynamics, and lingering impact of the psychiatric pathologisation of homosexuality as a mental illness – its impact both on the psychiatric profession and on the queer and gender variant people who ran up against it. At the heart of the book is a newly discovered archival collection, the files of Benjamin Karpman, a Washington DC-based psychiatrist who treated queer patients by encouraging them to write. What resulted were thousands of pages of detailed accounts of their lives, their histories, their response to their treatment, and their sense of themselves as human beings. The lives and subjectivities opened up by those documents allows the book to raise fresh, provocative, and sometimes unsettling questions – about what it means to live with pathology and stigma, about the links between queer and disability histories, about the enduring afterlife of the psychiatric equation of queerness and sickness, and about some of the costs of Gay Liberation rhetoric predicating gay people’s worth and entitlement to full citizenship on assertions of their mental health.

A large Victorian brick building, covered with ivy, with a central tower, and a curved driveway in front of it.
St Elizabeths Hospital in Washington DC, where Dr Karpman treated his patients. Wikimedia Commons.

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