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Aren’t you behind the times with your belief that homosexuality is pathology?

This question can’t be answered comprehensively unless we take a look at the history of how the medical and psychological communities have regarded homosexuality.

  • The original Diagnostic and Statistical Manual of Mental Disorders (DSM) — the official reference manual used to diagnose mental disorders by professionals in America and throughout the world, published in 1952 — categorized homosexuality as one of the “sociopathic personality disturbances.”
  • The DSM became the DSM II in 1968 and relocated homosexuality from the list of sociopathic disorders and instead included it with other sexual deviations.
  • The 1973 version of this manual, the DSM III, made the most salient change of all when homosexuality was considered psychologically problematic only when an individual was dissatisfied with it — a state referred to as “ego-dystonic.”
  • The DSM III R, an even later revision, completely omits any reference to homosexuality at all.

The 1973 revision made the biggest headlines, The December 16, 1973, edition of the Washington Post proclaimed, “Doctors Rule Homosexuals Not Abnormal.” And on December 16, 1999, 26 years later, this same paper reran this very article with a new title — “Sick No More.”

So, how did this come about? Is homosexuality psychologically normal? A look at the truth surrounding these changes in the DSM is quite illuminating. In their book, Homosexuality: The Use of Scientific Research in the Church’s Moral Debate, Stanton Jones and Mark Yarhouse bring much needed clarification to these questions.

The removal of homosexuality from the DSM was in response to a majority vote of the APA (American Psychiatric Association). The original APA vote was called at a time of significant social change and was taken with unconventional speed that circumvented the normal channels from consideration of the issues because of explicit threats from gay rights groups to disrupt APA conventions and research.

But the task force set up to review the status of homosexuality was extremely biased. Not one single psychiatrist assigned to this panel believed homosexuality to be abnormal. It is no surprise, then, that this group arrived at a decision that supported homosexuality as psychologically normal. Jones and Yarhouse continue:

However, it appears that in contrast to the results of the vote, the majority of the APA membership continued to view homosexuality as a pathology. A survey four years after the vote found that 69% of psychiatrists regarded homosexuality as a “pathological adaptation.” A much more recent survey suggests that the majority of psychiatrists around the world continue to view same-sex behavior as signalling mental illness.

“The removal of homosexuality from the DSM does not conclusively decide the issue of the pathological status of homosexuality,” the authors add. “There is no absolute standard of judging normality or abnormality.” Furthermore, they suggest that there are “four empirical (or at least partially empirical) criteria… commonly used to define behavior patterns as abnormal:”

  • statistical infrequency
  • personal distress
  • maladaptiveness
  • deviation from social norms

Let’s take a closer look at each of these.

Statistical Infrequency

The percentage of homosexuals in the world’s population is as low as 1 to 3 percent. Stanton and Yarhouse write,

Compare this percentage to the estimated lifetime incidence rates of some other major psychopathological disorders. In comparison, the prevalence of homosexuality is much less frequent than such common disorders as phobias (14.3%) and alcohol abuse and dependence (13.8%), about as frequent as some disorders that are less common, as is the case with panic (1.6%) and schizophrenia (1.5%), and much more frequent than somatization disorders (0.1%)… In comparison to these prevalence rates, homosexuality is not so common as to be eliminated as a possible pathology on frequency alone.

Personal Distress

Stanton and Yarhouse note,

Psychopathology is often accompanied by personal distress as is the case with depressive disorders and sexual dysfunctions. However, personal distress is not a necessary aspect of psychopathology. Some problems that we all recognize as pathological are also characterized by patterns of denial and minimization of distress, as is the case with some experiences of alcoholism and drug addiction.

In fact, they add, as is the case with some alcoholics,

with homosexuality the claim is often made that “there is no evidence of higher rates of emotional instability or psychiatric illness among homosexuals than among heterosexuals.” This claim has been made so often that it has taken on the status of truth that “everybody knows”; however, the factual basis for this assertion is debatable.

Maladaptiveness

“A behavior pattern or characteristic is ‘adaptive’ when it is constructive, helpful, healthy and contributes to the person moving in a valued direction,” Stanton and Yarhouse write. Can homosexuality ever be seen as constructive, helpful, healthy, or the attainment of a desirable goal?

Psychologist Elizabeth Moberly answers that question this way:

God did not create homosexuals as homosexuals, but as men and women who are intended to attain psychological maturity in their gender identity… The mistake of some homosexuals is to assume that the goal has already been reached, when in fact development has been checked and still requires completion.

Deviation from Social Norms

Homosexuality does indeed violate societal norms, Stanton and Yarhouse argue. The problem is that the psychological community refuses to acknowledge this fact. Most mental health organizations and associations have instead suggested that societal norms must be altered toward full acceptance of homosexuality as a normal variant, as some of them have done in 2002, trying to convince themselves and the American public that sexual abuse perpetuated on children is not always harmful to them.

For Christians seeking to defend their beliefs in the marketplace of ideas, though, it doesn’t much matter how the American Psychiatric Association or any other professional association views or classifies homosexuality. God’s truth, that homosexuality is a deviation from His intent for mankind, always must have the final say.

MIKE HALEY
101 Frequently Asked Questions About Homosexuality (2004) Harvest House: Eugene, Oregon

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