Illustration by Austin Hughes
Jack Drescher was not yet a doctor, just finishing up medical school and beginning interviews for training in psychiatry when he understood what would become his life's work. It was 1980 and the American Psychiatric Association had only seven years earlier reversed a long-standing opinion that people like him were mentally ill.
That reversal was hardly an apology, but Drescher knew it was the beginning of something important—a change for gay people and their mental health treatment. So when an interviewer for a residency at Cornell-affiliated New York Hospital said as part of the selection process, “Tell me about your intimate life,” Drescher saw no reason to lie. He was gay.
“He looked like I hit him between the eyes with a slingshot,” Drescher said. “Literally.” Why would he be so bold? “I thought it wasn't a problem. I had read like everybody else that homosexuality was no longer considered a disorder. There had been nothing in my medical school training other than it was clear people didn't want to talk about it. I didn't know it was the wrong thing to say at the time.”
While Cornell did not accept him, Drescher went on to train in psychoanalysis at the William Alanson White Institute, and he has since committed more than forty years to advancing a scientific understanding of human sexuality in the face of growing cultural forces waging a vicious attack on the social acceptance of LGBTQ+ people.
Things in the field have changed. Late last year, Drescher was among five recipients of the 2022 Sigourney Award for major advances in psychoanalysis. Special attention went to studies into the nature of human sexuality and gender, explorations of identity as determined by the physical self, and efforts to unpack racial bias institutionalized in the field of psychoanalysis.
“The Sigourney Award Trust received work from an
exceptional pool of global applicants representing sea changes in the understanding of psychoanalytic theory and its clinical application,” the committee said, noting the research affected people's lives in “education, health care delivery, race, equity, gender, and sexuality issues, and community.”
“THIS IS CULTURE WAR WORK?
Sea changes. The phrase appears again announcing the award for Drescher, a professor at Columbia University and New York University: “His work has managed to shift psychoanalytic thinking about LGBTQ+ people and brought psychoanalytic sensibilities into conversations outside of psychoanalysis, fostering a sea change in psychoanalytic organizations' perspectives on gender and sexuality,” the committee said.
This strong praise has a sound basis: since entering psychiatry, Drescher has worked to rethink faulty psychoanalytic ideas about homosexuality based on solid scientific evidence rather than past understandings. Drescher's work comes as human sexuality rises to the center of historic cultural challenges. In recent years, laws have been passed around the country both enshrining protections for LGBTQ+ people and tearing them down. The overall climate has sparked morally outraged rhetoric and inspired violence, most tragically in 2015 when a gunman killed forty-nine people at the Pulse nightclub in Orlando. Meanwhile, divisions linger internally in psychoanalysis, and the debate continues.
“This is definitely culture work,” Drescher said. “This is culture war work.”
That work seems more important now, especially as new horizons in psychology emerge. “We're at the beginning of the conversation having to do with trans people, and it's gotten ugly because politicians on the right and also people on the left have a very common view of gender, so they fall back on bedrocks that they think shouldn't be transgressed,” Drescher said.
Drescher's notable accomplishments include editing the section for Gender Dysphoria—formerly called Gender Identity Disorder—in the 2022 revision of the DSM-V and taking part in the World Health Organization's working group that revised sex and gender diagnoses for the organization's International Classification of Diseases. But perhaps most notable has been Drescher's longstanding opposition to reparative therapy.
In his 1998 paper “I'm Your Handyman: A History of Reparative Therapies,” Drescher called attention to misguided and antiquated understandings perpetuated through the dangerous practice.
“The evolution of one branch of psychoanalytic theory into an anti-homosexual political movement illustrates the permeability of boundaries between clinical issues and political ones,” Drescher wrote presciently then. “In their open support of antigay legislation, reparative therapists have moved from the traditional psychoanalytic center and have been embraced by conservative religious and political forces opposed to homosexuality.”
It's hard to imagine in 2023, nearly a decade after the US Supreme Court legalized same-sex marriage, as wider acceptance of LGBTQ+ identities becomes normalized in many parts of the world, just how powerful and important those words were as they called out a branch of psychoanalytic theory for its “mythic status as an implacable foe of lesbian and
gay identities.” Drescher said it has taken many years for the field of psychoanalysis to come to terms with itself.
“I think psychoanalysis has lagged behind culture in terms of gay rights.”
“I do think that psychoanalysis has good things to offer to the culture—the very notion of the unconsciousness that may be in operation, that [we] may not be fully considering everything we're doing, that everything is not immediately accessible to our thinking—is an idea that is very helpful in a variety of settings,” Drescher said. “But I think psychoanalysis has lagged behind culture in terms of gay rights. Psychoanalysis is behind the culture.”
Ryan Lenz is an award-winning journalist and writer who spent eight years documenting the rise of extremist ideas for the Southern Poverty Law Center. From 2005 to 2008, he covered the Iraq War for the Associated Press. He lives in Atlanta.