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The truth on how homosexuality was removed from the DSM by APA – Commentary on Dr Yik’s response to Lawrence Khong

Pastor Lawrence Khong of Faith Community Baptist Church recently gave an interview with Elgin Toh, which was reported in the Straits Times “I told the minister to send me to jail” (7 September 2013). In it, he made comments about whether homosexuals are born that way and talked about ex-homosexuals. Excerpt:

Q: But a lot of homosexuals would tell you it is normal because they were born this way.

There is no proof at all. Zero proof, according to the researchers who have gone into this.

Q: I think they are divided about this, but I don’t think there is zero proof.

Well, I challenge the nation to do a study and lay out all the evidence. And I’m confident that the research as a whole will show you that that isn’t true. Every ex-homosexual is proof that people are not born this way. There are no ex-blacks, no ex-Chinese, but there are ex-homosexuals.

Q: There are such people in your church?

There are. I can have them come and tell you their stories.

Yik Keng Yeong (Dr) in his response to ST Forum “Conversion therapy for homosexuals not mainstream medicine”, makes the following argument:

PASTOR Lawrence Khong says “there are no ex-blacks, no ex-Chinese, but there are ex-homosexuals” (“‘I told the minister to send me to jail'”; last Saturday).

It is a moot point.

In 1973, homosexuality was removed from the American psychiatric profession’s diagnostic manual of mental disorders. Conversion reparative counselling to convert homosexual leanings to become heterosexual was no longer considered mainstream medicine.

This discredited therapy was again repudiated in a United States court last month.

While Mr Khong is willing to have some of his church members share their stories of being successfully “converted”, the US court ruled that such therapy has not been clearly demonstrated to be efficacious or even desirable. It cited anecdotal reports of its harm, including depression, suicidal thoughts or actions, and substance abuse.

Dr Yik may sound informed in highlighting how homosexuality has been removed from the American psychiatric profession’s diagnostic manual of mental disorders (DSM), but is he really informed of the cultural issues surrounding America then and the questionable process leading to the removal of homosexuality from the DSM?

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In Destructive Trends in mental health, respected veterans of the mental health industry Rogers H.Wright and Nicholas A.Cummings sought to educate consumers, practitioners, and policy makers about a variety of recent issues and trends that have significantly changed the mental health fields in America. They got established and revered practitioners to write chapters which explore these important issues. The following regarding the removal of homosexuality from the DSM in 1973 was written as a matter of verifiable fact:

“The Diagnostic and Statistical Manual of the American Psychiatric Association yielded suddenly and completely to political pressure when in 1973 it removed homosexuality as a treatable aberrant condition. A political firestorm had been created by gay activists within psychiatry, with intense opposition to normalizing homosexuality coming from a few outspoken psychiatrists who were demonized and even threatened, rather than scientifically refuted. Psychiatry’s House of Delegates sidestepped the conflict by putting the matter to a vote of the membership, marking for the first time in the history of healthcare that a diagnosis or lack of diagnosis was decided by popular vote than by scientific evidence…”(page 9)

The stonewall riots: To understand why the APA was under tremendous political pressure to remove homosexuality from the DSM, you have to understand the history of the homosexual rights movement. The stonewall riots probably marked the outward beginnings of the movement. It was a series of spontaneous, violent demonstrations and riots by the gay community against a police raid on a gay pub in 1969. The speed at which the activists groups form and organized immediately after the stonewall incident was breathtaking. Within six months, two gay activist organizations were formed in New York, concentrating on confrontational tactics, and three newspapers were established to promote rights for gays and lesbians. Within a few years, gay rights organizations were founded across the U.S. and the world. On June 28, 1970, the first Gay Pride marches took place in Los Angeles, Chicago, and New York commemorating the anniversary of the riots.

Against a backdrop where homosexuals were gaining public sympathy and growing louder in voice and bolder in pressure lobbying, Destructive Trends in mental health reports:

“Bayer describes one instance in 1972 in which the New York Gay Activist Alliance organized a protest during a conference of the Association for the Advancement of Behaviour Therapy. The protesters called for “an end to the use of aversion techniques to change the natural sexual orientation of human beings”… the activists gained access to one of the conference rooms during a presentation in front of a large audience that included Dr Robert Spitzer, then a member of the APA’s Nomenclature Committee. This was the first time Spitzer had been confronted with homosexuals demanding changes in psychiatry’s conceptualization of homosexuality. Apparently, impressed by the passion and arguments of the protesters, Spitzer arranged for a formal presentation of their views to the Nomenclature Committee.”

Spitzer was to become the one to spearhead APA’s 1973 decision to remove homosexuality from its list of mental disorders. (Yet interestingly, he undo his “hero” status among the homosexual community when some 28 years later, he argued in a paper that it is possible for highly motivated individuals to successfully change their sexual orientation from homosexual to heterosexual.)

Here are the chain of events:

  • ž1973 – Board of Trustees of The American Psychiatric Association (APA) approves the deletion of homosexuality from the DSM-II and substitutes a diagnosis of “sexual orientation disturbance.” Intense discussion and debate followed.
  • On Dec 15 1973, the Board of Trustees of the APA voted to delete homosexuality altogether from the DSM. Opposition from several psychiatrists immediately followed. A referendum on the Board’s decision was called.
  • ž1974 – the entire membership of the APA was polled for their support or rejection of the Board’s decision. žOf the 10,000 voting members, nearly 40% opposed the Board’s decision to normalize homosexuality. Decision was hardly unanimous. (Controversially, a survey conducted in 1979 asked 10,000 psychiatrists if they felt homosexuality “usually represented a pathological adaptation.” ž69% of respondents said “yes,” and ž60% said homosexual men were less capable of “mature, loving relationships” than heterosexual men.)

The author of Destructive Trends in mental health was right to conclude:

“Diagnosis today in psychology and psychiatry is cluttered with politically correct verbiage, which seemingly has taken precedence over sound professional experience and scientific validation.”

Explaining how it is possible that intellectual openness, scientific inquiry, aspiration towards diversity, and freedom from political pressure that once flourished in the American Psychological Association has been eclipsed by an “ultra-liberal agenda,” the author describes:

“žThe field of psychology is severely fractionated into almost sixty formal divisions and fifty state associations, which compete for seats on the organization’s governing body, the Council of Representatives. Originally intended as units organized around special interests and concerns within psychology, they have become power bases and self-interest groups that fiercely vie against one another for the limited number of seats on the Council of Representatives in order to influence the course and commitments of the APA.”

Ok, so homosexuality’s removal from the DSM is not scientifically sound. What about conversion therapy? Page 17 of Destructive Trends in mental health writes:

“Although the APA is reluctant or unable to evaluate the questionable practices and has thus avoided addressing the issue of best practices, this did not prevent its Council of Representatives in 2002 from stampeding into a motion to declare the treatment of homosexuality unethical. This was done with the intent of perpetuating homosexuality, even when the homosexual patient willingly and even eagerly seeks treatment. The argument was that because homosexuality is not an illness, its treatment is unnecessary and unethical… Vigorously pushed by the gay lobby, it was eventually seen by a sufficient number of Council members as runaway political correctness and was defeated by the narrowest of margins.”

Perhaps this excerpt from the preface of the book best describes the lack of Americans’ trust in the APA; their absurdity; and their own undermining of reputation and integrity due to a lost of scientific credibility.

“Political diversity is so absent in mental health circles that most psychologists and social workers live in a bubble. So seldom does anyone express ideological disagreement with colleagues that they believe all intelligent people think as they do. They are aware that conservatives exist but regard the term intelligent conservative as an oxymoron… This bubble is so encapsulating that psychologists were shocked when the House of Representatives and the Senate of the United States censured the APA for publishing in one of its journals a meta-analysis and interview study of college students who had been molested as children. The publication challenged the notion that these experiences had been deleterious, setting off a firestorm led by radio talk show host “Dr. Laura” Schlessinger, which culminated in the APA being the only professional society in the history of America to be censured by the Congress… They blame Dr. Laura and her powerful allies in the Congress, but the finger pointing fails to note that the condemnation was unanimous in both the House and the Senate. It further fails to note that not one of psychology’s traditional friends voted against the resolution, and even the two psychologist members of the House abstained rather than vote nay. The humiliation was complete.”

The facts clearly showed that homosexuality’s removal from the DSM is unsupported by scientific evidences but is the result of incessant lobbying, pressure tactics and threats – something our Singapore’s society faces today as well. Dr Yik’s seemingly informed contribution in fact, lacks understanding and awareness of America’s cultural reality, and his assertion only adds on to the deception and confusion that the Singapore public currently faces.

At least Lawrence Khong began his argument regarding whether homosexuals are born that way with a challenge for “the nation to do a study and lay out all the evidence.” There’s nothing much you can fault Khong here if his basis is to convince the mass public through comprehensive research – fairly – for both sides.

If Dr Yik is after political correctness, popular opinion or unscientific notions, he should be good with where his current understanding is at. But if he is after truth, scientific literacy and public good, he should accept this constructive criticism, do more unbiased research himself and reconsider his stand.

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