A History of LGBTQ+ Mental Health: 1776 to Today

The history of LGBTQ+ mental health in the United States is a checkered, often unsavory, and frequently hurtful one. However, it's also a story characterized by wins - at least eventually.

Let's a take a moment to explore the history of LGBTQ+ mental health and therapy, so we can understand better the importance of continued progress.

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1776 to 1870: Puritanism and Its Consequences

1880s to 1960s: A changing world makes room for queerness.

1970 to 1987: Two steps forward, one step back.

1987 to Today: Modernizing, at least on the surface.

Why LGBTQ+ Affirmative Therapy Is So Important

1776 to 1870: Puritanism and Its Consequences

Prior to the 1870s, if you had mentioned LGBTQ+ mental health, the response would not be malicious grunts. It wouldn't even be laughter. The only response you would get would be blank, confused stares.

The term homosexuality was not coined until 1868. The acronym "LGBT" was developed in the 1990s. "LGBTQ+" has really only been around for a few years.

If you wanted to refer to homosexuals, the closest term you had was "sodomy". A biblical term, "sodomy" has negative, sinful connotations; its common use in early nationhood was the result of baby America's early inhabitants.

Despite how we like to think of ourselves as a nation - secular; antithetical to Eastern theocracies - the United States has a history of incorporating religion into law and society. Having been settled initially and primarily by Puritan Christians, the prevailing attitude towards homosexuality in early America was similar in flavor and intensity to the disdain people felt for adulterers or murderers.

Homosexuality, to the communities of the day, was something to be feared, hated, and cleansed from the population.

It was only in the 1870s that gay rights became something that anyone cared about publicly.

Of course, being publicly gay back then was like painting a target on your back, so most homosexuals and transpeople understandably continued to hide their identities.

But at least the wheels had started moving.

People started writing about gay rights. Secret drag balls became a facet of life for many subcommunities. Gay activism emerged after the Civil War from the literary ether of a newly reunited country.

1880s to 1960s: A changing world makes room for queerness.

While gay activism came to life and began to grow during the period between the Civil War and World War II, it was still mostly conducted behind closed doors, under pseudonyms, or by cover of night.

Post-war, as households became wealthier, technological advancement quickened, and telecommunications developed further, the civil rights movement began in earnest.

Suddenly, those with measurable amounts of power began to care about historically disenfranchised and oppressed people: Minority races, women, and homosexuals finally had at least a few defenders in the institutions that had kept them down and excluded them for so long.

Finally, in 1967, same-sex sexual activity was federally decriminalized. While this was certainly not the end of restricted rights for gay people - nor of violence against them - it did at least mean that homosexuals could not go to prison explicitly for their sexuality.

It was around this time that LGBTQ+ mental health was brought into the fold within the psychiatric establishment. Of course, as you'll read below, that wasn't necessarily all good.

1970 to 1987: Two steps forward, one step back.

While it was no longer illegal to be gay in the United States by 1967, it was still heavily frowned upon. This is, unfortunately, reflected in the literature and publications of the psychiatric community at the time.

Homosexuality, until 1973, was labeled a mental disorder. Prior to that, coming out as gay often meant being institutionalized - which, particularly in those days, was pretty much a guarantee of being abused.

In 1973, homosexuality was removed from official psychiatric literature and was no longer considered a mental illness. This is perhaps one of the most important moves for LGBTQ+ people in the 20th century - but again, it wasn't like everything was sunshine and rainbows after that.

Other classifications of homosexuality still present in the literature led to many of the same problems as before, as well as some new ones.

Through these classifications, the concept of conversion therapy was popularized and often applied within medicine.

1987 to Today: Modernizing, at least on the surface.

In 1987, when LGBTQ+ acceptance was still in its trying-but-altogether-failing infancy, the mental healthcare industry had a problem.

Try as they might, the existing establishment of psychiatric publishing in that day simply could not reconcile their internal biases against LGBTQ+ people with the accelerating inflow of research proving that being gay - in any form of function - is not a mental illness.

Starting in 1980, the DSM-III (that is, the industry-standard catalog of mental health disorders used by mental health professionals) defined and categorized a disorder called ego-dystonic homosexuality. In essence, this diagnosis was pushed on anyone who was homosexual, but told a clinician that they wished they weren't.

It should come as no surprise that, in an era where coming out as gay often meant sacrificing one's social life and safety, ego-dystonic homosexuality was a common diagnosis in the LGBTQ+ community.

It didn't stop at horrifically offensive but overall physically harmless diagnoses, either. The model of ego-dystonic homosexuality was used as further justification for one of the most insidious institutions to ever mar the history of The United States: homosexual conversion therapy.

Utilizing a startling array of equipment - startling both in their cruelty as well as in the obviously nonscientific theories behind them - clinicians and religious leaders have been trying their hardest for centuries to turn gay people straight.

The people in charge of these facilities used everything from lobotomization to electrocution to "treat" (see: torture) those in the LGBTQ+ community.

Did it work? It depends on what the true definition of "success" was for those who invented these laughably illogical nightmares.

If they truly intended to turn people straight, then no, it didn't work. Most people left conversion therapy just as gay, lesbian, bisexual, or trans as they were when they went in.

And we should note here that, while some LGBTQ+ people reported reductions in their homosexual behavior and identity, it's extremely likely they were either saying whatever they needed to say to get the hell out of there, or that they truly felt less gay upon exiting, but then very quickly realized that, actually, there was no real change.

If their goal was purely to torture and maim those who underwent their so-called "procedures", then they succeeded to great effect. LGBTQ+ people emerging from conversion therapy often found themselves permanently scarred, usually physically and always, always psychologically.

Conversion therapy survivors are twice as likely to commit suicide than LGBTQ+ people who haven't been to conversion therapy.

By 1987, it was clear to most scientists that conversion therapy was bogus. While the practice has continued for decades under new justifications, ego-dystonic sexual orientation was removed from the DSM-III and all subsequent iterations.

Queerness, it was beginning to be understood, was not some malfunction of the brain that must be corrected. It was as much a part of a person as their hair or skin color.

After that, the sociologists took over. The right questions started being asked, if not immediately answered: How can society treat these people better? What are the social pain points that lead to people wanting not to be gay? How do we start to change the forgone conclusions of the past that have hurt so many?

These days, conversion therapy is no longer accepted in scientific or medical communities in the United States. While it can still legally be facilitated by religious institutions, those basing treatment plans on medical fact will never again send a queer child into that horrific - not to mention ultimately pointless - practice.

Instead, modern therapists and psychologists work with patients to affirm their identities and orientations, helping them to find internal peace and self-love through the use of scientifically-rooted and evidence-backed talk therapy.

Why LGBTQ+ Affirmative Therapy Is So Important

It's clear from the exploration above that only in the last few years has LGBTQ+ mental health been anywhere close to where it should have always been.

That's why LGBTQ+ affirmative therapy is so important. It separates us from the foul hatred of the past, and sets us up for a brighter future.