A proposal About Homosexuality and the APA Nomenclature: Homosexuality as One Form of Sexual Behavior and Sexual Orientation Disturbance as a Psychiatric Disorder

by Robert L. Spitzer, M.D

Controversy rages as to whether homosexuality should be regarded as a pathological deviation of normal sexual development or as a normal variant of the human potential for sexual response. Recently, this controversy has focused on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders DSM-II) where homosexuality is listed as an official diagnosis in the section on Sexual deviations.

The proponents of the view that homosexuality is a normal variant of human sexuality argue for the elimination of any reference to homosexuality in a manual of psychiatric disorders because it is scientifically incorrect, encourages an adversary relationship between psychiatry and the homosexual community, and is misused by some people outside of our profession who wish to deny civil rights to homosexuals. Those who argue that homosexuality is a pathological disturbance in sexual development assert that to remove homosexuality from the nomenclature would be to give official sanction to this form of deviant sexual development, would be a cowardly act of succumbing to the pressure of a small but vocal band of activist homosexuals who defensively attempt to prove that they are not sick, and would tend to discourage homosexuals from seeking much-needed treatment.

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If homosexuality per se does not meet the criteria for a psychiatric disorder, what is it? Descriptively, it is one form of sexual behavior. Our profession need not now agree on its origin, significance, and value for human happiness when we acknowledge that by itself it does not meet the requirements for a psychiatric disorder. Similarly, by no longer listing it as a psychiatric disorder we are not saying that it is "normal" or as valuable as heterosexuality.

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