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Jack Drescher
I have no bias against homosexuals; for me they are sick people requiring
medical help . . . Still, though I have no bias, I would say: Homosexuals
Jack Drescher, M.D., Training and Supervising Analyst, William Alanson White
Institute; Adjunct Clinical Assistant Professor, New York University Postdoctoral
Program in Psychotherapy and Psychoanalysis; Clinical Assistant Professor of
Psychiatry, New York Medical College.
This paper is modified from the Presidential Lecture presented at the 50th Annual
Meeting of the American Academy of Psychoanalysis and Dynamic Psychiatry, Toronto,
Ontario, CA, May 19, 2006.
Journal of The American Academy of Psychoanalysis and Dynamic Psychiatry, 36(3) 443–460, 2008
© 2008 The American Academy of Psychoanalysis and Dynamic Psychiatry
444 DRESCHER
THEORIES OF ETIOLOGY
Freud was tolerant for his time. He signed a 1930 petition to decrimi-
nalize homosexuality (Abelove, 1985/1993). Yet, although he did not
consider homosexuality an illness, his theory did not quite constitute a
clean bill of health—calling someone immature, rather than sick, is not
as offensive, but neither appellation is particularly respectful. Nor did
Freud hide his contempt for the normalizing, third sex theories of his
era’s German homophile (gay rights) movement:
PSYCHOANALYTIC DISSENTERS
THE SEXOLOGISTS
In the wake of the 1973 APA decision, cultural attitudes about homo-
sexuality began to shift. In the U.S. and elsewhere, those who accepted
scientific authority on such matters gradually came to accept the nor-
malizing view. Similar shifts gradually took place in the international
mental health community as well. In 1992, the World Health Organiza-
tion accepted the U.S. view and removed homosexuality per se from
the International Classification of Diseases (ICD-10; Nakajima, 2003).
Gradually, a new perspective emerged in many Western societies: if
homosexuality is not an illness, and if one does not literally accept bib-
HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS 451
lical prohibitions against it, and if gay people are able and prepared to
function as productive citizens, then what is wrong with being gay?4
The psychoanalytic community, however, would take longer than
others to adopt this perspective. Following the 1973 decision, and as
their influence gradually declined in the mental health professions,
psychoanalysts circled their wagons. As normalization was taking
place in the rest of the culture, analysts, in their journals and at their
meetings, continued to write and speak about homosexuality in patho-
logical terms. More troubling, they continued to deny openly gay men
and lesbians training in their institutes.
However, after 1973, there were stirrings of change within main-
stream psychoanalysis. Richard C. Friedman (a member of the Ameri-
can and later of the Academy) wrote an early critique, but published
it in Contemporary Psychoanalysis (a journal of a non-APsaA institute—
William Alanson White). Stephen A. Mitchell (a White-trained psychol-
ogist) wrote two seminal papers (1978, 1981) that criticized the theories
and techniques of mainstream analysts who pathologized homosexual-
ity, including one published in the International Review of Psycho-analy-
sis (1981). At a 1983 Fall Meeting of the APsaA, a panel (with Stanley
Leavy, Richard Isay, Robert Stoller, and Richard C. Friedman) aired crit-
ical views of the then-dominant analytic perspective (Isay & Friedman,
1986). Both Isay (1985, 1989) and Friedman (1988) would later offer his-
torically significant criticisms of mainstream psychoanalytic attitudes
and theories of that time.
By the 1980s, most institutes were still not accepting gay and lesbian
candidates (Domenici & Lesser, 1995; Magee & Miller, 1997). There were
exceptions, as in the case of the White Institute (which had accepted
gay candidates since the 1950s, but did not want it publicly known)
or in the American, as in the case of Sidney H. Phillips (personal com-
munication) who was openly gay and accepted for training at Western
New England Psychoanalytic Institute in 1980.
Things would change. In 1989, the American Academy of Psycho-
analysis adopted a sexual orientation non-discrimination policy in re-
gard to membership—a first for any psychoanalytic organization. In
1991, in response to a threatened discrimination lawsuit (Isay, 1996; So-
carides, 1995). the APsaA adopted a sexual orientation non-discrimina-
tion policy regarding the selection of candidates and revised it in 1992
to include selection of faculty and training analysts as well. In 1992, the
American would also create a Committee on Issues of Homosexual-
ity (later the Committee on Gay and Lesbian Issues). The Committees
would identify areas of antihomosexual bias and work with institutes
and the APsaA toward opening up its institutes, changing attitudes,
policies, and curriculum (Hoffman et al., 2000; Roughton, 1995).
With the new millennium came new books (Cohler & Galatzer-
Levy, 2000; Cole, 2002; Dean & Lane, 2001; D’Ercole & Drescher, 2004;
Drescher, D’Ercole, & Schoenberg, 2003 Lingiardi, 2002; Sherman, 2005).
The Journal of Gay and Lesbian Psychotherapy, relaunched in 1999, had a
senior editorial board of gay and lesbian analysts. Many of the papers
the journal published were by gay and lesbian analysts as well. In ad-
dition, inspired by Roy Schafer’s (1995) paper in which he updated his
views on homosexuality, the JGLP solicited and published articles by
prominent senior analysts whose earlier writings had pathologized ho-
mosexuality. Both Otto Kernberg (2002) and Joyce McDougall (2001)
provided new formulations of their theoretical and clinical perspec-
tives.
In 2001, the Journal of the American Psychoanalytic Association devoted
an entire issue (Volume 49, Number 4) to non-pathologizing papers on
homosexuality. In 2002, Volume 30 of The Annual of Psychoanalysis fo-
cused on, “Rethinking Psychoanalysis and the Homosexualities,” with
contributions from Schafer, Martin Bergmann, and Ethel Person. That
same year, Sidney Phillips (2001, 2002). of the Western New England
Institute, became the APsaA’s first Training Analyst promoted as an
openly gay man. Also in 2001, due to efforts by Ralph Roughton and
“straight allies” in the American, the International Psychoanalytic As-
sociation (IPA) approved a position statement opposing “discrimina-
tion of any kind. This includes, but is not limited to, any discrimination
on the basis of age, race, gender, ethnic origin, religious belief or homo-
sexual orientation” (Roughton, 2003, p. 195). In 2004, Joseph P. Merlino,
M.D., an openly gay analyst, became President of the American Acad-
emy of Psychoanalysis and Dynamic Psychiatry.
CONCLUSION
ment. The patient and the analyst were both motivated to answer the
question of how the family got the patient off the track toward normal
heterosexuality. For as Schafer (1995) notes:
. . . many moral judgments have been taken for granted as factual state-
ments, while many other moral judgments have been presented as rea-
soned conclusions based on careful exercises of curiosity in the form of
purportedly scientific investigation or, even more simply, uncontroversial
reality testing. (p. 189)
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460 DRESCHER