I agree with Ralph Roughton that the Association needs a task force to address the educational and administrative effects of the anti-homosexuality bias within The American and its institutes (TAP 26/3). I disagree that the statements on homosexuality of May 9, 1991, and April 30, 1992, were the product of pressure “beginning about twenty years” ago within the Association and that it came from our members and the Committee on Social Issues.
In 1973, after thorough study and deliberation, the APAs Task Force on Nomenclature decided not to include homosexuality per se in DSM–III. At its annual meeting the American Psychoanalytic Association voted to urge the APA to delay deleting homosexuality, and a letter to this effect was sent to APA President Walter Barton on May 5, 1973 (Ronald Bayer, Homosexuality and American Psychiatry, Princeton University Press, 1987, Chapter 4).
A Position Statement on Homosexuality and Civil Rights was prepared by Robert Spitzer, M.D., and the Task Force on Nomenclature and approved by APA on November 2–4, 1973. It stated: “Whereas homosexuality per se implies no impairment in judgment, stability, reliability, or general social or vocational capabilities, therefore, be it resolved that the APA deplores all public and private discrimination against homosexuals … and declares that no burden of proof of such judgement, capability, or reliability shall be placed upon homosexuals greater than that imposed on any other persons.…”
I know of no pressure within The American to support or adopt a similar statement until I wrote to Dick Simons on June 8, 1987, asking the Association to endorse it. I said: “At a time when the AIDS epidemic is contributing to increased discrimination and anti-gay violence, an endorsement might be of some help.… The continuing view of homosexuality as an illness, the ascription of psychopathology to all homosexuals with total disregard of contrary evidence, and the prevalent and pernicious labeling of homosexuals as ‘perverts’ all contribute to prejudice.”
The Executive Committee narrowed my request, and in November 1987 Ray Raskin and his Committee on Social Issues were asked to consider recommending a statement on discrimination and prejudice against homosexuals because of the AIDS epidemic. They did prepare such a statement for the fall 1988 meeting, but there was then a new president, and Homer Curtis asked the committee not to bring it up. He was concerned about the Association's taking positions on issues not directly related to psychoanalysis.
On July 14, 1989, I formulated a statement of more direct relevance to psychoanalysis and asked Dr. Curtis to take the following to the Executive Committee and the Board on Professional Standards for discussion: “The American Psychoanalytic Association deplores all discrimination against persons because of sexual orientation in its affiliated institutes and societies with regard to admission and progression of candidates and to the appointment and progression of these persons to any position or office.”
The Executive Committee and Board felt it was unnecessary to make such a statement “since The American had been following a non discriminating (sic) policy.” At its May 3, 1989, meeting, the Board simply reaffirmed its traditional principle that admission to and progression in our training program “be based on careful evaluation of personal integrity, analyzability, and educability, not on presumption based on diagnosis, symptoms, or manifest behavior.”
An exchange with Homer Curtis at that meeting made me believe that there would be no chance of getting the Association to make an explicit statement on nondiscrimination related to homosexuals. On May 27, therefore, I wrote to the Psychiatric News, detailing my efforts. They published an article on the matter July 21, and on October 15 the Executive Committee endorsed in full the APA's 1973 Position Statement on Homosexuality and Civil Rights.
Following the publication of the article in Psychiatric News, the Academy of Psychoanalysis issued a statement that “sexual orientation in and of itself should never be a reason for the rejection of an applicant from any educational or vocational institution.” The Boston Psychoanalytic Institute incorporated into its bylaws a nondiscrimination statement that specifically included sexual orientation.
Knowing that Mike Allison, who was then president, was sympathetic to my efforts, I wrote him informally on November 2, 1990, that, aside from the inherent cruelty and unfairness of discrimination, many institutes are in communities that have ordinances that make discrimination on the basis of sexual orientation illegal. I enclosed a draft of a statement for the Executive Committee to consider. It stated: “No affiliate institute shall exclude or discriminate against persons seeking admission to or advancement in such institutes.… or deny advancement to or the benefits of faculty status or training or supervising analyst status on the basis of a person's sexual orientation.”
At its March 1991 meeting the Executive Committee drafted a statement specifically including sexual orientation, along with presumptions of diagnosis, symptoms, and manifest behavior in items not to be considered in evaluating candidates for admission. The question of advancement to training and supervising analyst status, however, was not addressed.
In a letter to Dr. Allison on March 18 I objected to this omission. In a forthright response, he noted that there were “organizational difficulties in having it elaborated in the direction and specific details you would like to see.” A revised and improved statement was adopted by the Executive Council on May 9, but again no mention was made of training and supervising analysts. Since I understood that the major opposition to including them in the statement had come from the Board, I spoke to Marvin Margolis. He asked that I write him a formal letter, which I did on August 13. When I received no response to the letter or to a follow-up request that he call me, I asked the ACLU to write to Drs. Allison, Pacella, and Margolis, reminding them of various ordinances that make it illegal to discriminate on the basis of sexual orientation. The ACLU sent its letter on April 23, 1992, and on April 30 the Executive Council approved an amended statement that included training and supervising analysts.
Dr. Roughton implies that all that should be needed to eliminate bias and revise our theory is a group of our members dedicated to doing so; he adds that “we shouldn't need a gay caucus or political action committee.” I do not underestimate the contributions of Dick Simons, Mike Allison, Ray Raskin, and others in these endeavors. I am certain, however, that only an openly gay person who did not fear exposure would have the motivation and means to provide the outside pressure that was unfortunately necessary for The American to begin to change a policy that had generally excluded from our institutes men and women who were comfortable with their sexual orientation.
Richard A. Isay, M.D.
New York, NY