Queer History, Mad History, and the Politics of Health

Among the central themes of the eclectic field of mad studies is a critique of psychiatric authority. Activists and academics, from a range of positions and perspectives, have questioned psychiatry's normalizing impulses and have privileged mad-identified knowledges over expert ones. One of the most successful assaults on psychiatric authority was launched by gay activists in the 1960s and early 1970s, resulting in the removal of homosexuality from the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1973. But if that event marked an inspirational victory against psychiatric power, it was also, as Robert McRuer notes, "a distancing from disability."¹ Revisiting this history through analytic lenses offered by disability and mad studies defamiliarizes familiar historical narratives and unsettles the critique of psychiatric authority, especially when countered by claims to health.

Psychiatry's reign over sexual and gender variance was pervasive throughout much of the twentieth-century United States. Jonathan Katz denounced psychiatric treatment as "one of the more lethal forms of homosexual oppression" and documents the use of lobotomy, electroconvulsive shock, aversion therapy, and psychotherapy to treat homosexuality.² Beginning in the 1950s, and with increasing assertiveness in the 1960s and 1970s, gay activists and some dissident psychiatrists worked to sever the association between mental illness and homosexuality. The psychologist Evelyn Hooker set out to study what she termed "normal" homosexuals" and in 1957 demonstrated that the psychological profile of gay men not in psychiatric treatment was indistinguishable from that of a comparable group of heterosexual men.³

A decade after Hooker began to debunk the notion of homosexuality as a mental disorder, the effort to distance homosexuality from the stigma of mental illness became the defining project of the emerging gay rights movement. The person most closely associated with that position was the homophile activist Frank Kameny. To Kameny, the claim to health was a grounding political move, necessary to the political intelligibility of gay people. "The entire homophile movement is going to stand or fall upon the question of whether homosexuality is a sickness," Kameny wrote, "and upon our taking a firm stand on it.'"⁴

By 1970 gay activists were engaged in an intense battle with the APA. Activists boldly disrupted the group's annual meetings, "zapping" sessions on aversion therapy and psychoanalysis. A 1971 petition to the APA titled "We Are the Experts on Homosexuality" echoed the disability principle of "nothing about us without us" in its authors' insistence on claiming expertise over their own lives.⁵ "We cannot play the role of a passive battlefield across which the 'authorities' fight out the question of our sickness," activists proclaimed. "In the last analysis, WE are the authorities, and it is up to us to take an active role in determining our own status and our own fate."⁶ Increasingly, that fate seemed to hang on insisting that gay men and lesbians were healthy.

It is clear what was gained by such claims. Kameny did not underestimate the extent to which the "sickness theory" undergirded larger structures of stigma, discrimination, and criminalization. The removal of homosexuality from the DSM in 1973 was celebrated as an activist victory and has been since claimed by historians as a social justice milestone. But the insights of disability and mad studies invite us to reconsider such claims. Among those insights is that health is not just a desired state or a self-evident good but an ideology that mobilizes a set of norms, prescriptions, and hierarchies of worth.⁷

Returning to some key moments in the story of activist efforts to align homosexuality with health illuminates those unspoken norms and exclusions. Hooker explicitly distanced her research subjects from criminalized populations and from people in psychiatric treatment, identifying (and valorizing) her subjects as "non-patient, non-prisoner homosexuals" (a formulation repeated, with admiration, by historians). Employment and lack of an arrest record were also criteria for participation in Hooker's studies.⁸ Gender normativity, too, was part of Hooker's understanding of "normal" homosexuality: she emphasized that many such men were involved in long-term relationships not organized around...