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Absorbing Disorder in American Psychiatry: From 'Homosexuality' as Pathology to 'LGBT' as Risk Factors

Gender
Social Movements
Social Policy
USA
Knowledge
Power
Technology
Institutions

Abstract

Focusing on the case study of how 'Homosexuality' was formally designated no longer a mental disorder in the US in 1974, this paper advances a theory of how classification and standardization can be used to absorb and lessen the impact of struggles for sexual equality. While dominant histories of psychiatry see the removal of ‘homosexuality’ as resulting from professional research-based debate, in fact it was the result of a sustained campaign of protest and negotiation by activists in alliance with insiders within the American Psychiatric Association (APA). Depathologization turned out to be crucial to the subsequent complete overhaul of US psychiatry. Faced with a crisis of legitimacy and state and market pressure, the APA carved out a distinct domain of specialization by standardizing diagnosis to impose equivalence across disparate frames of understanding. The DSM-III, released in 1980, gained enormous authority almost overnight in America's welfare system, insurance industry, legal adjudications of ability and incarcerability, and public imagination. I argue that the taxonomy and its bureaucratic structure functioned to render diagnosis liquid, forestall alliances across lines of race, class, and disability, and create new stereotypes of sexuality that now appear in American state mental health manuals. Building upon the analysis by Bowker & Star (1999) of how classification and standards simultaneously valorize some points of view while silencing others, this paper aims to contribute to the discussion of opposition/resistance by raising the question of how to make sense of the troubled, conflictual, often invisible and depoliticized everyday processes of institutional maintenance and legitimization that allow these valorizations and silences to endure.