Doctors and demons and unsung heroes

It turns out that one of the doctors in yesterday’s piece on families coping with gender identity issues, Kenneth J. Zucker, Ph.D., is on the Sexual and Gender Identity Disorders Work Group for the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders.

Pam says that’s not good news:

Needless to say, gender-variant LGBT and straight youth, as well as transsexual adults, will likely have to deal with another decade plus of being considered seriously disordered — with its conversion therapy implication for children. Reform models for, or different takes on Gender Identity Disorder in DSM-V aren’t likely to be seriously considered with forceful advocates Zucker and Blanchard on the Sexual and Gender Identity Disorders Work Group, advocating to continue listing gender-variant youth and adult transsexuals as disordered.

Pam makes the analogy to 1973, when Homosexuality was was removed as a disorder from the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders, Second Edition (DSM-II).

It was the step that recognized that individuals whose sexual interests are directed primarily toward people of the same sex weren’t afflicted with a psychiatric disorder.

I make that leap, too. And will share this personal story only to inform the reader of how my experience shapes my beliefs…

As a runaway still in Harrisburg, PA, in 1973, I went to a psychiatry clinic and cried, “I’m a homosexual, please fix me.” The psychiatrist looked at me with kind empathy and answered back, “Why do you think you need fixing?”

Dumb luck Good fortune had me sitting with a founder of New York City’s Identity House, an organization set up in 1971 to find the few therapists who knew even then that homosexuality was a normal, healthy human expression, not a “neurotic adaptation.”

To this day I have to wonder what would have come of me had he tried to “cure” me instead. When I see the wreckage of repression — priests, politicians, and panderers in public parks, rest stops, and playgrounds — I think I know.

Shortly afterward I moved to NYC where I would become a gay filmmaker. As a student I worked on the film Before Stonewall with my friend Greta Schiller and was privileged to meet many of the early movement veterans.

One person interviewed for the film whom I did not get to meet was Dr. Evelyn Hooker. Because her work led the American Psychiatric Association to decide in 1973 – the very same year that I cried in that Pennsylvania psychiatrist’s office – that homosexuality was no longer a mental illness, she is a hero of mine.

This American Life did a profile of Hooker in January 2002 entitled 81 Words. I was moved to transcribe this portion:

[35:34] …Until Evelyn Hooker met Sam From. Evelyn was a psychologist at UCLA and Sam was her student. He was also a homosexual. They started spending time together in the mid 1940s and Sam introduced Evelyn to his group of friends most of whom, like Sam, were gay.

Now, as I said, everyone in this group was homosexual but curiously, none was in therapy. They were all well-adjusted young men who utterly failed to conform to the traditional psychiatric image of the tortured, disturbed homosexual.

This, naturally, got Evelyn thinking.

Now, prior to Evelyn Hooker, all of the research on homosexuality – all of it – was done on people who were already under serious psychiatric treatment. Let me repeat that: In the history of psychiatric research, no one had every conducted a study on a homosexual population that wasn’t either in therapy, in prison, a mental hospital, or the disciplinary barracks off the armed services.

Evelyn thought about this and decided that this kind of research was distorting psychiatry’s conclusions about homosexual populations. To test her theory, Evelyn came up with an experiment. Through her former student she located 30 homosexuals who had never sought therapy in their lives and matched those homosexuals with a group of heterosexuals of comparable age, IQ and education.

Evelyn then put both groups through a battery of psychological tests including a Rorschach Test, the famous ink-blot test. After disguising her subjects, Evelyn gave the results to three experienced psychiatrists and asked them to identify the homosexuals. She figured that if homosexuals were inherently pathological, the psychiatrists would be able to pick them out easily. But the judges were completely unable to distinguish the homos from the hets.

Equally important was the fact that the judges categorized two thirds of the homosexuals and the heterosexuals as perfectly well-adjusted normally functioning human beings.

Hooker’s study challenged the idea that homosexuality was a pathology in the first place, and in doing this it not only called into question an entire generation of research on homosexuality, it also challenged psychiatry’s basic concept of disease. If you believed Hooker’s data the only conclusion you could come to was that psychiatry was deciding that certain behaviors were diseases, not out of any sort of scientific proof, but based on their own prejudices.

Beside Evelyn Hooker, psychiatrists who wanted to change the DSM really had only one other scientific study on their side: Alfred Kinsey’s famous 1948 sex survey which found that a whopping 37% of all men had had physical contact to the point of orgasm with other men, a finding which – besides shocking the hell out of 63% of the American public – seemed to suggest that homosexual acts were too common to be considered a disease.

In spite of all this work, psychiatry continued to maintain that the homos were sick and steadfastly refused to reevaluate the DSM. And then luck, or maybe fate, intervened.

It’s an incredible episode. I urge you to listen.

NPR has run the second part of its 2 part series on parents coping with gender identity issues in their children. I will have more to say on that story in a later post (and I promise it’s not predictable). For now my message is both that I do see a parallel between the (ongoing) struggle for gay acceptance and the gender identity issue. And I would ask that we all have empathy for the human struggles that each of us face.