Attitudes to homosexuality have undergone nothing short of a revolution in the past five decades.
First published in 1968, DSM-II (the American classification of mental disorders) listed homosexuality as a mental disorder. In this, the DSM followed in a long tradition in medicine and psychiatry, which in the 19th century appropriated homosexuality from the Church and, in an élan of enlightenment, transformed it from sin to mental disorder.
In those days, some therapists employed aversion therapy of the kind featured in A Clockwork Orange to ‘cure’ male homosexuality. This typically involved showing ‘patients’ pictures of naked men while giving them electric shocks or emetics (drugs to make them vomit), and, once they could no longer bear it, showing them pictures of naked women or sending them out on a ‘date’ with a young female nurse.
In 1973, the American Psychiatric Association (APA) asked all members attending its convention to vote on whether they believed homosexuality to be a mental disorder. 5,854 psychiatrists voted to remove homosexuality from the DSM, and 3,810 to retain it. The APA then compromised, removing homosexuality from the DSM but replacing it, in effect, with ‘sexual orientation disturbance’ for people ‘in conflict with’ their sexual orientation. Not until 1987 did homosexuality completely fall out of the DSM.
Meanwhile, the World Health Organization only removed homosexuality from its ICD classification with the publication of ICD-10 in 1992, although ICD-10 still carries the construct of ‘ego-dystonic sexual orientation’. In this ‘condition’, the person is not in doubt about his or her sexual preference, but ‘wishes it were different because of associated psychological and behavioural disorders’.
As I discuss in The Meaning of Madness, the evolution of the status of homosexuality in the classifications of mental disorder highlights that concepts of mental disorder can be rapidly evolving social constructs that change as society changes. In 1989, Denmark became the first country to offer legal recognition for same-sex couples, and in 2001 the Netherlands became the first country to legalize same-sex marriage. On March 12, 2015, the European Parliament passed a resolution (by 472 to 115 votes) encouraging E.U. institutions and Member States to ‘further contribute to reflection on the recognition of same-sex marriage or same-sex civil union as a political, social and human and civil rights issue.’
In most of the U.K. civil partnerships have been available to same-sex couples since 2005, and marriage since 13 March 2014. In the U.S. Vermont became the first state to legalize civil unions in 2000, and in 2004 Massachusetts became the first state to legalize same-sex marriage. On June 26, 2013, the U.S. Supreme Court ruled against the Defence of Marriage Act, which barred federal recognition of same-sex marriage. Two years later on the same day, it ruled against state level bans on same-sex marriage, thereby legalizing same-sex marriage throughout the country. According to Pew Research Center polling, in 2001, 57% of Americans opposed gay marriage and 35% supported it; by 2017, 63% supported it and only 32% opposed it.
As I write, same-sex marriage is legal in the United States, Canada, the United Kingdom (with the exception of Northern Ireland), many European countries, many Latin American countries, New Zealand, and South Africa. Many other territories including Australia, Israel, and Japan offer an alternative form of recognition such as a civil union, registered partnership, or other similar construct.
But same-sex sexual relations, let alone marriage, remain illegal in many parts of Africa, the Middle East, the Caribbean, and Central, South, and Southeast Asia, in some cases punishable with life imprisonment or even death. In 2015, President Yahya Jammeh of Gambia declared: “If you do it [in Gambia] I will slit your throat—if you are a man and want to marry another man in this country and we catch you, no one will ever set eyes on you again, and no white person can do anything about it.” In some countries, most notably Russia and China, same-sex sexual relations are legal, but lesbian, gay, bisexual, and transgender people face substantial legal and social challenges.
Many people still think of same-sex marriage as a historical first, but this is far from being the case. Same-sex marriage was practised and accepted among precolonial peoples such as the Two-spirits, the Fa’afafine, and more than 30 African cultures; in Ancient Mesopotamia and perhaps also Ancient Egypt; and in Fujian province during the Ming dynasty.
In Ancient Rome, same-sex marriage, after three centuries on the run, was explicitly outlawed in 342 AD by the Christian co-emperors Constantius II and Constans—and it is worth noting that its return in our age corresponds with an ebbing of Christianity from the West.
In Ancient Athens, aristocratic men such as Agathon and Pausanias, who feature in Plato’s Symposium, went beyond the pederastic tradition of mentoring young males by forming lifelong partnerships. The ancient epigram Lovers’ Lips had for a long time been ascribed to Plato himself: 'Kissing Agathon, I had my soul upon my lips; for it rose, poor wretch, as though to cross over.'
But if there was just one thing missing from Athens and Rome, then that thing was gender parity.
Neel Burton is author of For Better For Worse: Should I Get Married and other books.
Voting numbers at the 1973 APA convention are from Davies J (2013): Cracked: Why Psychiatry is Doing More Harm Than Good. Icon Books.
Love R (2015): European parliament votes in favour of report declaring marriage equality a human right. Attitude.co.uk, 14 March 2015.
Masci D et al. (2017): 5 facts about same-sex marriage. Pewresearch.org, 26 June 2017.
Bolton D (2015): Gambian President Yahya Jammeh threatens to ‘slit the throats’ of gay people. Independent.co.uk, 12 May 2015.
Lovers’ Lips attributed to Plato by Diogenes Laertes, Lives of Eminent Philosophers III.
Lovers’ Lips in Mackail JW (1906): Select Epigrams from the Greek.