Since their emergence in the modern era, the fields of medicine and psychiatry have been fraught with controversy surrounding the categorization of various human characteristics, behaviors, and experiences. From race to gender to mental illness, these disciplines have played a significant role in shaping how society understands and treats different identities and conditions. One such identity that has faced significant stigmatization is that of the LGBTQ community. While the medical field's treatment of queer individuals has undergone considerable change in recent years, its history reveals a long-standing pathologization of non-heteronormative sexualities and genders. This essay explores how medicine and psychiatry have historically treated homosexuality and transgenderism and examines some of the lasting impacts this has had on those communities.
Historical context
The earliest known mention of homosexuality as a medical diagnosis dates back to the late nineteenth century when it was included in the International Classification of Diseases, which was compiled by the World Health Organization in 1893. Under "mental diseases," homosexuality was listed alongside other disorders like hysteria, epilepsy, and alcoholism. Despite being removed from the ICD in 1968, the legacy of this classification remains, having contributed to widespread public fear and misunderstanding about non-heteronormative sexualities. Similarly, transgender individuals were often classified as suffering from "gender dysphoria" or "gender identity disorder," further contributing to their marginalization and exclusion from mainstream society.
Pathologizing sexuality
One of the most damaging ways in which psychiatric and medical discourses have pathologized LGBTQ identities is through their categorization of homosexuality as a mental illness. In addition to listing homosexuality as a disease, the American Psychiatric Association (APA) also endorsed conversion therapy as a legitimate treatment for "curing" homosexuals until 1973. Such treatments involved everything from electric shock therapy to psychoanalysis and typically focused on reprogramming individuals to be more heteronormative. While many countries have since outlawed such practices, the damage done to those who underwent them cannot be undone.
The APA's decision to list homosexuality as a mental illness only reinforced societal prejudices against queer people and created an atmosphere where they felt ashamed and isolated.
Long-term effects
The long-term impacts of these pathologies are far-reaching, affecting not just individual LGBTQ individuals but entire communities.
The stigma surrounding homosexuality has led to high rates of suicide among LGBTQ youth, particularly those who come from religious or conservative backgrounds where homophobia runs rampant. Similarly, transgender individuals face significant challenges when it comes to accessing healthcare, education, employment, and other social services due to the perception that their gender identity is inherently disordered. As a result, many struggle with depression, anxiety, substance abuse, and other mental health issues.
While medicine and psychiatry have made some progress in recognizing and validating LGBTQ identities, their historical discourses have had lasting consequences that continue to shape society's attitudes towards non-heteronormative sexualities and genders. By recognizing this history and acknowledging the harm caused by pathologization, we can work towards creating a more inclusive and supportive environment for all people, regardless of their sexual orientation or gender expression.
In what ways have psychiatric and medical discourses historically pathologized LGBTQ identities, and what are the long-term effects?
Psychiatry and medicine have historically pathologized LGBTQ identities by diagnosing them as mental illnesses, such as homosexuality and transgenderism. This has led to numerous long-term effects on LGBTQ individuals.