TIME’s article celebrated Hadden’s ability to help men work through their “symptoms” of “illness”—whether that was wearing inappropriately feminine clothing or being sexually interested in men instead of women. Hadden was only one of many esteemed psychiatrists and psychologists to consider — and treat — homosexuality as a sickness during the 1960s. In fact, homosexuality was not removed from the “Diagnostic and Statistical Manual of Mental Disorders” [DSM] until 1973.

The pathologizing of homosexuality was not, however, contextually specific to 20th century America. Many of the earliest writings condemning homosexual acts as “unnatural” caught on in 12th century Europe, when religious leaders like Saint Thomas Aquinas denounced homosexuality as a sin in their early writings. Popular disdain against homosexuality, began in the realm of religion, but it quickly moved into the legal arena in centuries to come.

Mental illness as an umbrella term was still highly stigmatized at the time —and continues to be today, to a lesser extent. It’s only throughpeople sharing their storiesthat there is more visibility— and less stigma —around mental health issues and corresponding treatments. Though in culturally hostile contexts (whether that means 20 years ago or in parts of the world where social stigma related to historically abject identities pervades), sharing is not an option.

But let’s rewind for a second: not all experts in the 1950s and 60s drank the homosexuality-as-illness kool aid. As early as 1905, Sigmund Freud had actually proposed a foundational theory about human sexuality that is now referred to as “inherent bisexuality.” Despite what his predecessors said and did to those they perceived as “sick” with homosexuality, Freud believed all humans were born bisexual, and that their later preferences were simply results of life experiences and conditioning from parents and other loved ones.

In a 1935 letter he wrote to a distraught mother, Freud explicitly discouraged psychiatrists from diagnosing homosexuality as an illness worthy of treatment: “Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation, it cannot be classified as an illness.”

Furthermore, when Zoology-trained Alfred Kinsey entered the conversation in 1948, he destabilized the status quo from the vantage point of another discipline, gathering empirical findings about human sexuality. Homosexuality is, if not common in animals, at least present. By developing a groundbreaking study of sexual behavior among American adults (men and women), Kinsey was ultimately able to prove that homosexual behavior was far more common and complex than was previously assumed.

Change was still happening, though. Kinsey’s empirical studies had prompted other social scientists to research homosexuality in a variety of ways: reviewing published studies and archival data, examining patterns of sexual behavior among non-human species, and comparatively analyzing the social mores around homosexuality across different cultures and societies.

It was in 1957 that psychologist Evelyn Hooker published one of the first and most famous studies that refuted the notion that homosexuality was a psychopathology. It was in the aftermath of Hooker’s findings — and the efficient and powerful political organizing of thegay community— that the American Psychiatric Association voted to remove homosexuality from the DSM in 1973. It’s been 44 years since that decision, and certainly, progress has been made to destigmatize homosexuality, and of other mental health diagnoses, too, for that matter. (For clarity, we don’t mean to imply that homosexuality is a mental health diagnosis.)

Nonetheless, let us take note of the fact that there is extreme variation in the acceptance of gay rights across America. Conversion therapy is still happening, though it has been recently banned for minors in California, New Jersey, Oregon and Washington D.C. Critics of conversion therapy highlight that it often relies on abusive practices,both physical and psychological.

In his 2000 congressional campaign,Vice President Mike Pence famously voiced his desire for the government to defund organizations that “celebrate and encourage” activities that spread HIV. Many gay and transgender folks interpreted this as an affront to their communities. And during President Trump’s campaign, the Republican Party expressed their commitment to the “right of parents to determine the proper medical treatment and therapy for their minor children,” which many believed to be an indirect endorsement of conversion therapy.

Regardless of what government spokespeople say, it is clear that our country’s leadership is seeking to reformulate its social values publicly, through gestures such asrescinding rules on bathrooms for transgender students. As citizens, it’s up to us to continue normalizing all forms of self-expression and markers of identity. As Audre Lorde said, “Your silence will not protect you,” and so it is up to each and every one of us to speak.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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