Collective Action against Non-Governmental

Institutions: A Case Study from the Lesbian and Gay

Movement, 1970-1973

Rowan Hildebrand-Chupp
5/8/09
Soc 280
Introduction

The American Psychiatric Association (APA) had considered

homosexuality a mental disorder since the first edition of the

Diagnostic and Statistical Manual of Mental Disorders was published in

1952. In the early 70s, gay liberation movement chose to attack the

APA's stance on homosexuality. This case is a clear example of a social

movement that specifically targeted the cultural status of

homosexuality, instead of its political status. In order to engage in

collective action and achieve successes against the political system,

activists needed to attack the institutions that exercised heavy control

over the stigmatization of their identity. During the 1940s and 50s the

medical model of homosexuality replaced the religious one as the

primary justification for the government’s discriminatory policies

toward homosexuality. By painting gay men and lesbians as

“pathological,” the APA enabled and provided part of the symbolic

basis for oppression based on sexual orientation. But the medical

model also planted the seeds of revolt: homosexuality was no longer a

passing sin, but rather a problem rooted deeply within the individual. In

this way, sexual orientation became an identity that individuals could

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gather around, work through, and, ultimately, defend (D'Emilio

1998:15-19).

In the midst of their own "tripartite system of domination"

maintained by medical, religious, and legal authorities, gay activists

realized that in order to achieve political victories they would need to

win some cultural ones (D'Emilo 1998:129; Morris 1986:1-4). The APA’s

classification of homosexuality as a disorder was on the top of that list.

But activism against the APA also satisfied the gay power activists’

desire to attack society’s institutions, and it fit within the multi-faceted

project of the New Left (Armstrong 2002:56-61). Activists understood

that cultural and political institutions work together to enforce systems

of oppression, and that all institutions have both material and symbolic

impacts. But if this discrimination was so institutionalized, then why did

it only take a few years for the American Psychiatric Association to

reverse its position on homosexuality?

The removal of homosexuality from the DSM provided important

benefits to gay activists, and it also brings up interesting theoretical

questions about how collective action works. Although in this case

there were certainly some mechanisms in place that are described in

the standard models for collective action, activism against a

professional organization like the APA might not necessarily display the

same mechanisms as collective action against the state. The period

from the late 60s to the early 70s was a transformative one, during

2
which the organizational logics of both the lesbian and gay

organizations and the APA were changing. This case study will show

that the multiple political logics of the gay liberation movement were

particularly suited to exploit the conflicting institutional logics within

the APA.

Literature Review

Political process theory states that broad socioeconomic

processes lead to mobilizing structures, political opportunities, and

cognitive liberation and that these three factors are required for the

emergence of a social movement (McAdam 1999). Mobilizing

structures are comprised of organizations and "organizations of

organizations" (Morris 1986:24) that can rally the mass base,

disseminate information about tactics and successes, and coordinate

collective action. Political opportunities are elements present within the

political system that make the government susceptible to change or

influence. These elements can range from a division within the elite to

the presence of successful challengers to the political system (Tarrow

1998:77-80). Mobilizing structures and political opportunities are

created by gradual, widespread socioeconomic processes, such as

migration or industrialization. The combination of political opportunities

and the mobilizing structures leads to cognitive liberation, wherein

actors come to believe both that the current system is illegitimate and

that they have the ability to change it. These three factors, in turn,

3
lead to the emergence of a social movement. This model is valuable in

that it combines analyses that focus on indigenous organizational

strength and those that focus on the influence of political elites.

On the other hand, this model works on some basic assumptions

that limit its analytic usefulness when studying cases such as the

removal of homosexuality from the DSM. Political process theory (PPT)

privileges collective action against the state, and it focuses on

struggles that address economic and political inequality and that

attempt to change state policy (Armstrong 2002:6). According to PPT,

cultural change only arises out of political and economic change, and

so it cannot fully account for collective action that is directed against

non-governmental institutions. Those struggles are labeled as

"cultural" and "expressive" rather than "political" and "instrumental"

(Bernstein 1997:533). PPT accounts for the cultural factors within social

movements by framing them as "solidary incentives" that attempt to

solve the free rider problem instead of weighing them equally

alongside the political factors (Friedman and McAdam 1992). Solidary

incentives provide actors with motivation to engage in activism and be

a part of social movement organizations, even though it is easier to let

other people do the work. According to this model, identity serves as a

solidary incentive, because it encourages individuals who match that

identity to engage in activism when they normally would not.

The multi-institutional political approach (MIP) sees society as a

4
collection of institutions that each operate within their own

organizational field and have their own institutional logics (Armstrong

and Bernstein 2008). Instead of viewing the state as the only worthy

target of collective action, this approach focuses on the patchwork of

institutions that collectively determine how actors will be categorized

and how those categorizations will influence the allocation of

resources. An analysis using this model does not look for broad social

processes, but rather looks at how mechanisms within each institution

influence its responsiveness to collective action. Instead of classifying

movements as either cultural or political, the MIP examines how

symbolic and material goals are inextricably intertwined (Friedland and

Alford 1991). Instead of focusing on how social movements achieve

change, this perspective tends to focus on why social movements

achieve change – why activists choose certain tactics or goals over

others and why institutions maintain or lose control over symbolic and

material resources.

MIP is particularly useful in this case, because it can be used to

analyze struggles that are against non-governmental institutions and

because MIP works from the assumption that cultural and political

change are linked. An analysis using this model will focus on how the

organizational logic of the lesbian and gay movement in the early 70s

interacted with the organizational logic of the American Psychiatric

Association at that time. However, MIP does not see institutions as

5
solitary, vulnerable entities; instead, all institutions interact with each

other and maintain specific material and symbolic orders that social

movements struggle against. Therefore, one possible problem with this

approach is that the same processes that work within governmental

institutions will also work within other institutions. If political

opportunities and mobilizing structures play the same role in struggles

with the APA as with the state, then the different institutional fields are

ultimately unimportant for predicting movement outcomes.

Alternatively, political process theory may more adequately explain

how social movements emerge, maintain themselves, and decline,

while a multi-institutional political approach might be more useful

when analyzing how social movements interact with a variety of

institutions in order to gain symbolic and material concessions.

Karen Armstrong uses organizational field theory in her book,

Forging Gay Identities, in order to explain how the political logics of the

lesbian and gay movement shifted over time (2002). She argues that

the interest group logic of the homophile movement was combined

with the redistributive and identity politics of the New Left within the

gay liberation movement. When the New Left collapsed, the lesbian

and gay movement’s organizational field crystallized around the

political logic of identity, which encourages each activist to express

their gay identity in whatever way they desire. Through this self-

expression, identity politics build a diverse coalition of interests unified

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around one identity but comprised of many different ways of

approaching that identity. In this case, the resulting stance supported

both cultural and political goals and tactics by allowing the gay rights

activists to pursue rights within the political system while gay pride

activists sought to build and maintain their collective identity in the

face of cultural discrimination.

Armstrong’s theory provides a framework for looking at how the

internal logics – “the rules of the game” – (2002:9) changed within the

gay movement during the same time that activists were targeting the

American Psychiatric Association’s stance on homosexuality. According

to Armstrong, from 1968 to 1971 there were several different political

logics competing within the lesbian and gay movement. This period of

instability and the crystallization that followed it may help explain the

changes in the tactics used by activists against the APA. The main

limitation of Armstrong’s analysis is her overgeneralization of the

influence of these political logics. She is unable to account for why

some gay activists occasionally rebuked the importance of identity well

after the field had crystallized. Fortunately, this case study involves the

very historical periods where her analysis is most useful.

Mary Bernstein’s work on identity looks at how the factors

described by political process theory influence the way that actors

tactically use identity depending on their goals (1997, 2003). Bernstein

tries to avoid the essentialist categorization of movements as either

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“expressive” (as described by new social movement theory) or

“instrumental” (as described by political process theory). In order to do

this, she breaks down the tactics and goals of movements. She divides

the strategic use of identity into two categories: identity for education

and identity for critique (Bernstein 1997:538). The former refers to

efforts to place an identity within the mainstream, to accommodate the

viewpoints of others, and to educate them about that identity. The

latter refers to tactics that place an identity outside of the mainstream,

to criticize the dominant norms and point to that identity as the ideal.

Generally, identity for education is used when actors have more

mobilizing structures and access to the polity, and identity for critique

is used when actors have little organizational strength or political

opportunity. However, the influence of the political system is mediated

by the varying importance actors place on political, cultural, or

mobilization goals. Goals, tactics, and political factors do not relate on

a one-to-one basis: one set of political factors will not necessarily force

activists to adopt one set of goals and tactics, and the goals of activists

do not necessarily determine their tactics or vice versa. In the

presence of political opportunities, activists may nevertheless seek

other goals and refuse to deploy identity tactically. Alternatively, a

moral shock that highlights the lack of political opportunities can lead

to mobilization and a focus on cultural goals and tactics that are less

politically successful (Bernstein 2003).

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 Bernstein’s loose framework provides a useful way to look at how

political and organizational factors influence the goals and tactics of

social movement actors. It bridges the gap between the political logics

that Armstrong specifies and the mechanisms in political process

theory. The interest group logic of the homophile movement can be

roughly thought of as a combination of identity for education and

political goals. The political logic of the gay liberation movement is the

combination of identity for critique and a variety of cultural, political,

and mobilization goals. MIP takes this framework and adds another

dimension to it: namely, the idea that in non-governmental struggles

there may be other sets of opportunities at work. However,

cultural/symbolic institutions and political/material institutions

influence each other, and so these distinctions may depend on the

perceptions of movement actors themselves. Any use of Bernstein’s

framework must keep in mind that she simultaneously differentiates

goals and tactics along political and cultural lines while acknowledging

that the political order and the cultural order are ultimately inseparable

(1997:559).

My analysis will investigate the relative usefulness of political

process theory and a multi-institutional political approach. In order to

do this, I use Bernstein’s concept of identity deployment in order to

look at how the activists' tactics adapted based on their relationship to

the APA. I will also use Armstrong’s organizational field approach to

9
study the importance of the contrasting political logics within the

lesbian and gay movement. My case study will assess whether the

factors described by political process theory or an analysis of the

institutional and organizational logics within the case will be more

useful in explaining the outcome. In order for political process theory to

still be useful in cases of activism against non-governmental

institutions, factors analogous to the ones that are delineated by

political process theory (political opportunity, etc.) must be present. If

a multi-institutional political approach is more useful, then the factors

that differentiate institutions (i.e. institutional logics) will more fully

explain the end result.

Case Study

Background: the lesbian and gay movement, 1950s-1960s

The psychiatric establishment had been the focus of members of

the lesbian and gay movement since the 1950s, but their relationship

shifted as the goals and tactics of the movement changed. In the 50s,

the homophile organizations tried to distance themselves from any sort

of gay identity by choosing cryptic names like “The Mattachine

Society” and “The Daughters of Bilitis,” and they refused to lobby

directly. Instead they focused on persuading influential professionals

(psychiatrists, lawyers, etc.) to be more accepting in hopes that the

professionals would, in turn, spread their message of tolerance towards

homosexuals. They did not engage in collective action; instead, they

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held meetings and published periodicals. They used their identity for

education, as they encouraged homosexuals to dress and act

conservatively and tried to present themselves as typical members of

society. Activists downplayed the sexual aspect of their identity with

the word “homophile" instead of "homosexual," and some activists

even claimed that being homosexual did not necessarily involve having

sex with other members of the same sex. Ultimately, the homophile

movement in the 1950s refused to take strong stances and merely

pleaded for tolerance (D'Emilio 1998).

The attitude of homophile activists about the psychiatric

establishment at this time was mixed and agnostic. On the one hand,

some activists wanted psychiatrists to speak more tolerantly about

homosexuals, but on the other hand, many activists actually agreed

with the medical model and thought that homosexuality was an illness

that needed to be cured, or at least prevented (Minton 2002:246-250).

Psychiatrists on both sides gave lectures at meetings of various

homophile organizations and published papers in homophile

periodicals. The periodicals generally took an impartial stance and

believed that the scientific process would play itself out in their favor.

Most homophile activists at this time believed that psychiatrists knew

more about homosexuality than they did, and they deferred to the

knowledge of the experts. Of course, they were always eager to help

those who were interested in publishing studies that went against the

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psychiatric orthodoxy at this time. Evelyn Hooker’s groundbreaking

research used the Mattachine Society in order to recruit gay

participants, and in 1957 the Mattachine Review published her article:

the first to study a group of homosexuals who were not in therapy,

prison, or institutionalized. She found that there was no difference

between homosexuals and heterosexuals on various projective tests

that measure pathology, and when she submitted the results to

experts in assessing those tests, the experts were no better than

chance at determining which of the participants were gay (Minton

2002:247-249).

In the first half of the 1960s, the homophile organizations

became more militant, as the political opportunity represented by the

civil rights movement proved that direct action could be effective. One

of the leaders of this transition was Franklin Kameny, who started a

chapter of the Mattachine Society in Washington D.C. in 1961. He had

lost his government job because he was gay, and he had fought his

firing in court for several years with no success (D'Emilio 1998:150-

151). The Washington Mattachine Society wrote letters to

congressmen, had meetings with public officials about the

government’s discriminatory policies, and fought legally for

homosexual rights. In 1963, the Washington Mattachine Society joined

with other homophile groups on the east coast to form ECHO, the

militant wing of the homophile movement. In 1965, Kameny and his

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small group of activists even picketed in front of the White House,

something that would have been unthinkable ten years before because

of the homophile movement's secrecy and its refusal to engage in

direct politics (D'Emilio 1998:164-165).

The homophile movement not only shifted to NAACP-style

tactics, but they also shifted their goals. Talking to many governmental

officials made Frank Kameny realize that the labeling of homosexuality

as a disorder impaired his group's ability to achieve political victories.

In a speech to the New York Mattachine Society in 1964, he said, "The

entire homophile movement... is going to stand or fall upon the

question of whether homosexuality is a sickness, and upon our taking a

firm stand on it" (Minton 2002:245). He saw that classification as “the

major supportive factor currently behind the negative attitude of

society at large" (Minton 2002:244). The conflict within the movement

over the medical model came to a head in 1965, when the New York

Mattachine Society’s elections favored the militant activists. Now, the

homophile activists saw themselves as the experts on homosexuality,

and they believed that the burden of proof was on the psychiatrists to

show that homosexuality was actually a disorder. The tide had turned

against those who still embraced the medical model, and in 1965

Kameny’s chapter of the Mattachine Society officially declared a

resolution against the “sickness model" (Clendinen and Nagourney

1999:202).

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 However, direct action was not taken against the psychiatric

establishment until the rise of gay liberation. As the homophile

movement was overtaken by the politics of the New Left, the activists

became more confrontational, and the movement was quickly

radicalized. In 1968, NACHO, the North American Conference of

Homophile Organizations, adopted the slogan of “Gay is Good" and

sought to take pride in their identity. This slogan was intentionally

modeled off of the black power slogan "Black is Beautiful" (Minton

2002:253). That year activists at Columbia University picketed a panel

discussion on homosexuality, and, as the American Medical Association

held a conference in San Francisco, activists held a press conference

protesting the stigmatizing views of one psychoanalyst, Charles

Socarides. The Gay Liberation Front formed a few weeks after the

Stonewall riots on June 27th, 1969, and it had a revolutionary agenda

centered on the abolishment of existing social institutions in order to

achieve sexual liberation. The Gay Activists Alliance formed in fall 1969

out of the Gay Liberation Front due to disagreements about whether or

not the movement should ally with the Black Panthers. The members of

the GAA wanted to focus their energies on gay liberation and did not

want a revolution by any means necessary, but they still used some of

the confrontational tactics of the GLF (Armstrong 2002:87-88).

Gay liberationists, particularly the gay pride activists, pioneered

the use of "zaps," a confrontational tactic where activists approach

14
officials and question them loudly and directly about their stances on

homosexuality. This tactic was used heavily in the struggle to remove

homosexuality from the DSM, because it was particularly useful when

activists wanted to increase their visibility and make themselves heard.

According to Elizabeth Armstrong, "The GAA staged highly successful

cultural zaps. The GAA, tailored to the 'hip homosexual mainstream,'

was 'activist but nonviolent, imaginative, cool, and very successful'"

(Armstrong 2002:92). Zaps represented a compromise between the

more radical sectors of the gay liberation movement and those who

wished to remain nonviolent and focus on gay identity specifically. This

tactic was popular because it was immediately gratifying and it yielded

results (Armstrong 2002:74).

The transitions that occurred from the homophile movement in

the 1950s to the gay liberation movement in the late 1960s had a

crucial impact on the stance of gay activists against the psychiatric

establishment. This transformation led to organizations that were more

inclusive and more suited to mobilizing activists. The dominant form of

identity deployment shifted from educating the psychiatrists about

homosexuality and apologizing for their homosexuality to critiquing

psychiatry and presenting homosexuality as "moral, in a positive and

real sense, and... right, good, and desirable" (D'Emilio 1998:153). The

goal also changed – while some gay power activists wanted revolution

and a complete restructuring of society, gay pride activists wanted to

15
develop a positive gay identity, and gay rights activists still wanted to

achieve political successes in this new phase of the lesbian and gay

movement. At least at first, the actions that gay activists took against

the American Psychiatric Association fit within each of these political

logics. The tactics of the gay liberationists were more direct and

confrontational and used public displays of anger and identity.

However, there was also an older set of militant homophile activists

who saw psychiatry as an important target, and they would prove

useful for negotiating with the APA.

Background: the American Psychiatric Association, 1950s-

1960s

At the same time, the American Psychiatric Association had been

going through its own shifts; it was changing "from a private-practice-

centered, psychoanalytically based profession to a research-oriented,

university-dominated discipline" (Kutchins and Kirk 1997:64). When

insurance companies and Medicaid began to cover psychotherapy in

the mid 1960s, they became frustrated with the lack of accountability

within the psychiatric establishment. Most psychotherapy at this time

was based in the psychoanalytic tradition, and its effects were not

backed empirically. The federal government and the insurance

companies pushed for the APA to establish more stringent restrictions

on diagnostic categories and on empirically valid treatments. In

addition, deinstitutionalization – the trend towards releasing psychiatric

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patients from long-term care within mental health hospitals –

highlighted the inefficacy and limited usefulness of psychoanalytic

therapy. Psychoanalysts were often unwilling or unable to help patients

who were severely disordered (Mayes and Horwitz 2003). “Research-

oriented psychiatrists insisted that the discipline needed to expand

scientific research on mental disorders, increase diagnostic reliability

among clinicians, and more clearly demarcate different mental

disorders" (Mayes and Horwitz 2003:256), but a psychiatric

establishment that was governed by the practical experience of

psychoanalysts could not pursue those goals. Finally, psychiatrists

were under attack from psychologists, social workers, and other mental

health professionals because they charged more for the same

therapies that not been proven useful. Insurance companies and the

federal government supported the expansion of psychotherapy's

domain to include other, non-medical mental health professionals.

The medical model of homosexuality was a locus for this conflict.

Psychoanalytic thinkers such as Irving Bieber and Charles Socarides

were the primary proponents of the medical model at this time. They

staked their careers on research that studied the pathology of

homosexuals. More generally, the presence of homosexuality in the

DSM was one sign of psychoanalysis’ influence within the APA, and

psychoanalysts were the strongest defenders of its status as a

disorder. At the same time, the liberal climate of the 60s had placed

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liberal psychiatrists in many of the positions of power within the APA.

Judd Marmor, a psychoanalyst who went against the medical model,

saw that psychoanalysis was not very effective in treating his

homosexual patients, and he began to encourage them to accept their

homosexuality (Kutchins and Kirk 1997:63-64). He would later lead the

charge within the APA against homosexuality's classification as a

disorder. Although previous studies – such as Hooker’s 1957 study and

Alfred Kinsey’s earlier research on the prevalence of homosexuality –

had undermined the medical model, defenders brushed aside those

studies in the face of the large number of studies they had produced

that assumed homosexuality was a disorder.

Although these shifts had created cracks within the APA, the idea

of homosexuality as a disorder was still thoroughly institutionalized.

Clinicians saw themselves as acting rationally and morally to help cure

their intrinsically sick homosexual patients. This institutionalized view

of pathology was self-sustaining because its believers saw themselves

as "logical and right" when they treated homosexuals (Berger and

Luckmann 1966). Before the gay activists targeted the APA, over 90-95

percent of its members agreed with the medical model (Glass 2002).

After all, many of the people who worked as clinicians at this time were

psychoanalysts, and the psychologists who used other perspectives

were often focused on research and teaching in other areas. The stage

was set for activists to claim a dramatic victory, but in many ways

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neither the members of the APA themselves nor the activists realized

the full extent of the struggle between the institutional logics of

research and treatment, empiricism and psychoanalysis.

A divided elite is a classic example of a political opportunity,

according to political process theory. But in this case, the division was

more than an academic division. Two political elites that have different

policy approaches may disagree about how things should be done, but

divided elites in countries with relatively open political systems

generally still agree on basic institutional logics (i.e. that the

government should be elected by people, that each political official has

special interests they are accountable to, etc.). In this case, however,

the divisions within the APA were not only about academic divisions on

the status of homosexuality – they were institutional divisions about

the implicit framework organizing and giving meaning to the members

of the APA.

Though gay activists knew that there was not a total consensus

about homosexuality within the APA, they did not realize that the

conflicts within the APA went far deeper than some academic

disagreement about diagnostic classification. An institution divided by

opposing logics, therefore, may not appear to be weak, because the

conflict is based on implicit rules that actors outside of the institution

are unaware of. But when an event triggers that division and forces a

decision in favor of one logic or the other, the opposition of

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institutional logics can further the aims of activists seeking to make

change within an organization. “Institutional opportunities” (if they

exist) differ from political opportunities in that they do not necessarily

signal to potential activists that they will achieve success.

The struggle to remove homosexuality from the DSM: 1970-

1973

In May 1970, the American Psychiatric Association held its annual

conference in San Francisco, where the Gay Liberation Front swelled

with radical activists who were also involved in antiwar demonstrations

and the black power movement. They seized the opportunity to make

some noise. At a lecture given by one of the most infamous

psychoanalysts, Irving Bieber, activists yelled, insulted, and cursed at

him, preventing him from giving his lecture. When one researcher

attempted to present his paper on using aversive conditioning to treat

homosexuality, activists yelled at him and asked him, “Where did you

take your residency? Auschwitz?” (Clendinen and Nagourney

1999:201). They forced the meeting to be adjourned, much to the ire

of the psychiatrists present. After this disruption, one psychiatrist

sympathetic to their cause, Kent Robinson, talked to one of the

organizers of the protest, Larry Littlejohn. Littlejohn told him that that

they wanted to present a panel at the next APA convention. Kent

Robinson told John Ewing, the chair of the Program Committee, that the

activists would disrupt the entire convention next time if they did not

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receive a panel. John Ewing agreed to give them a panel in order to

prevent further disruptions (Bayer 1981:103-104).

This confrontation has two important theoretical implications: the

mobilizing structures present in San Francisco were vital for this event

to occur, but the effectiveness of this mobilization partially depended

on the type of institution that they confronted. In some ways, this was

an instance of collective action out of convenience – the GLF might not

have chosen to fight the APA if the APA had not landed on the GLF's

doorstep. The GLF used its preferred style of tactics: disruptive,

theatrical, and angry. The impact of these tactics was greater because

the APA did not have the same power to deal with confrontational

tactics as a governmental institution would. They were successful

because the APA could not react with force. Instead, the APA had to

concede to the protestors in hopes that order could be restored. If the

GLF stormed the U.S. Congress and tried to out-yell congressmen, the

activists would have been forcibly removed. Therefore, the type of

institution that is targeted has important consequences for what kinds

of tactics will be successful in fighting it.

In 1971, the APA held their conference in Washington D.C., home

of Frank Kameny and his chapter of the Mattachine Society, which had

taken a stance against psychiatry several years before gay liberation

had started. As expected, there was a panel called “Lifestyles of Non-

Patient Homosexuals" with Frank Kameny, Larry Littlejohn (a militant

21
homophile activist), Del Martin (one of the founders of the Daughters

of Bilitis), Lilli Vincenz, and Jack Baker (Bayer 1981:106). This panel

used identity for critique when they rejected psychiatry’s involvement

in the lives of homosexuals and, in Littlejohn’s words, stated that "the

homosexual lifestyle for those people who live it, is beautiful and I

think it should be appreciated" (Bayer 1981:107). The confrontational

tactics of the gay liberationists were still in effect, and members of the

GLF and the GAA took over the highly symbolic Convocation of Fellows

during the convention. Frank Kameny himself seized the microphone in

the chaos and declared war on psychiatry, subverting an event that

was both well attended by psychiatrists and which had ritualistic

importance within the APA (Clendinen and Nagourney 1999:203-204).

The conflicting political logics of the gay liberation movement in this case

provided the activists with flexibility and a two-pronged strategy. The disruptive,

confrontational tactics of the gay liberationist activists satisfied the political logic of

identity and the conflicting goals of gay power and gay pride activists. By seizing the

microphone at the Convocation of Fellows, they displayed and took pride in their identity

in a public way that could not be ignored. For gay power activists, the lure of disrupting a

central ritual of the APA’s convention must have been irresistible, because it enabled

them to attack the APA at its symbolic core. Gay pride activists were able to build

themselves up and come face to face with the psychiatrists that had stigmatized gay

identity for decades. At the same time, the panel discussions expressed the more

reformist, interest-group logic of the past homophile movement, albeit in a more “out and

22
proud” tone. Gay pride and gay rights activists could lobby the psychiatrists in a calmer

tone according to their own political logics.

Although the mixed political logics of the gay liberation movement explain this

strange confluence of tactics, the different institutional logics within the APA point to

why those tactics worked. The fact that the activists were not completely locked out of

the conference is alone impressive, considering that the activists did not stop engaging in

the very tactics that the APA had sought to avoid by giving them a panel. The lack of a

coherent negative response to this two-pronged strategy hints at the lack of cohesion

between the institutional logics of the APA. It was so conflicted about how to deal with

these activists that it could not effectively rebuke them. Alternatively, this combination of

tactics may have been effective because it appealed to both sides: the sympathetic

psychiatrists were swayed by the views presented on the panels, while they psychiatrists

who were not sympathetic still wanted to end the chaos and have the APA’s order

restored. Another possibility is that the presence of this panel alone points to the division

with the APA. After all, to a psychoanalytic clinician there seems to be very little point in

talking to “non-patient homosexuals.” However, an institutional logic of empiricism and

science might support the proliferation of opposing points of view and the airing of

disagreements. Regardless of the reason, it is clear that the APA was somehow conflicted

about how to deal with the activists' strategies.

There was another constituency within the APA that activists had

not even been aware of: the Gay-PA, an informal, underground group of

homosexual psychiatrists (Bayer 1981:110). For these psychiatrists,

homosexuality’s status as a mental disorder was deeply troubling,

23
because it was a constant threat to the future of their careers. To come

out of the closet publicly would be professional suicide for them.

However, their place as insiders within the APA meant that they had a

particular type of potential leverage that the activist outsiders did not

have. In a reversal of the typical resource mobilization paradigm, the

insiders had less ability to create change than the outsiders because

the insiders were afraid of revealing their identity. This reversal can be

explained by MIP because it accounts for the institutional logics that

determine how insiders and outsiders actually function within each

institution. After the 1971 convention, members of the Gay-PA

contacted the gay activists, and the connection between these groups

became vital for the 1972 convention.

At the 1972 APA convention in Dallas, Kent Robinson had

successfully negotiated with the gay activists and, instead of a

disruptive confrontation, there was a panel that included two

sympathetic psychiatrists, two gay activists, and “Dr. H. Anonymous.”

Dr. Anonymous was a gay psychiatrist who came on stage wearing a

mask, a robe, and a voice-altering device in order to cover his identity.

The man behind the mask, John Fryer, was a part of the Gay-PA, and he

had been the only person the activists could find in the Gay-PA who

was willing to sit on a panel (Minton 2002:258). Frank Kameny had at

first rejected the idea of him coming on stage disguised, because it

went against the prevailing political logic of identity. But Fryer was

24
constrained by the institution within which he worked, and to come on

stage at all was already a serious risk for him. This panel shattered the

illusion that opposition to homosexuality’s classification as a mental

illness was only coming from external, political sources. Outspoken

psychiatrists like Judd Marmor had already been poking holes in the

psychiatric consensus about homosexuality for some time, but Dr.

Anonymous’ opening words, “I am a homosexual. I am a psychiatrist"

(Bayer 1981:109), showed without a doubt that psychiatrists

themselves were not “immune” to homosexuality and that

homosexuals could lead successful careers just like anyone else. Dr.

Anonymous talked about the fear that gay psychiatrists felt, and he

said that there were hundreds of gay psychiatrists attending that very

conference.

The power of Dr. Anonymous’ words comes from the intrinsic

institutional logic within the psychiatric establishment at that time that

those who treat are fundamentally different from those who are

treated. Psychiatrists worked under an assumption that pathological

people could not treat pathology, and so if there were many

psychiatrists who were homosexual, then homosexuality must not be

pathological. More generally, by breaking down the distinction between

patient and clinician, Dr. Anonymous used a fundamental institutional

logic of psychiatry to force psychiatrists to admit that homosexuality

was not a disorder. Furthermore, the presence of well-respected

25
psychiatrists on the panel prevented opponents from claiming that the

pressure was entirely political and external. The debate could be

framed as scientific, even though the main reason for the debate was

due to the external pressure from gay activists.

There were several other events in 1972 that signaled that the

consensus had shifted against the medical model of homosexuality and

away from the psychoanalytic institutional logic. In 1970, soon after

gay liberationists had disrupted the convention that year, Charles

Socarides approached the New York District Branch of the APA and

asked them if he could set up a task force on sexual deviation. They

agreed, but when the report was submitted to the council in May 1972,

they rejected it because they said that it was too psychoanalytic

(Bayer 1981:113-114). That year in the International Journal of

Psychiatry position papers on both sides were published. These papers

show that the debate had shifted from primarily an external struggle

against disruptive activists to an internal struggle about what factors

should govern the classification of mental disorders (Bayer 1981:112).

However, the disruptive tactics had not disappeared entirely. At a

meeting of the Association for the Advancement of Behavior Therapy,

the New York GAA chapter staged a protest where they demonstrated

outside the hotel while other protestors shouted down the speakers

inside. The activists were protesting the aversive techniques

researchers had been using in their attempt to "cure" gay men of their

26
homosexuality. At this meeting, one of the leaders of the protest,

Ronald Gold, happened to meet with Robert Spitzer, a member of the

APA's Committee on Nomenclature.

Spitzer was not sympathetic to their cause (and had been

meaning to scold Gold for his group's actions), but after talking to him

Spitzer agreed to arrange a meeting between the activists and the

Committee on Nomenclature. He also agreed to sponsor a panel at the

next convention of the APA to debate whether or not homosexuality

should be classified as a mental disorder (Bayer 1981:116). He had

been trained as a psychoanalyst but had spent most of his career as a

professor at a university dealing with issues of diagnosis.

At that meeting on February 9th, 1973, a gay psychologist

appointed by the GAA, Charles Silverstein, gave a formal presentation

to the Committee on Nomenclature, citing past research, including the

older work of Kinsey and Hooker, and newer studies, like one by Marvin

Siegelman that replicated Hooker's findings using more objective

measures (Minton 2002:235). This was an example of identity being

used for education, because instead of declaring war on psychiatry or

decrying it from afar, the activists were using scientific studies in order

to make their case. They chose a person with psychological training in

order to appear more legitimate in the eyes of the committee.

According to Ronald Bayer:

Nothing impressed the members of the Committee on Nomenclature more

than the sober and professional manner in which the homosexual case was

27
 presented to them. After several years of impassioned denunciations and
disruptions, here, at last, was a statement that could be assimilated,
analyzed, and discussed in a scientific context. (1981:120)

As the APA internalized the debate, activists knew that they needed to

use their identity for education in order to sway that debate.

Silverstein's presentation capitalized on the clash between institutional

logics within the APA by depicting psychoanalytic theory as "a series of

'adult fairy tales'" and telling the committee that "You must choose

between the undocumented theories that have unjustly harmed a

great number of people and... controlled scientific studies" (Bayer

1981:119). By couching the debate as science against psychoanalysis,

Silverstein made it clear to the committee (or at least to Robert

Spitzer) that a victory for the gay activists would be a defeat for

psychoanalysis.

Silverstein also knew that the labeling of homosexuals as

pathology enabled the government's discriminatory practices. He

cited:

the Defense Department's refusal to grant security clearance to avowed

homosexuals because they suffered from a mental illness; a demand on the
part of the New York Taxi Commission that a homosexual receive a psychiatric
evaluation twice a year in order to assure his "fitness" to drive; the refusal of a
university to grant a charter to a Gay Liberation group because the presence
of such an organization on campus would not be "beneficial to the normal
development of our students"; and the denial of a license to a homosexual to
practice law. (Bayer 1981:118-119)

These examples made it clear to the Nomenclature Committee that their actions enabled

the state to discriminate against homosexuals in many different ways. They were forced

to confront the fact that they were responsible for the harsh treatment of homosexuals. In

addition, Silverstein's knowledge of these cases highlights the fact that gay activists knew

28
that the legal and medical stance on homosexuality were inextricably linked. Because

these institutions supported each other, the activists needed to find some way to break

through this system of oppression. The psychiatric establishment was the most responsive

among these interconnected institutions, and the Nomenclature Committee responded

very positively to this meeting.

When the New York Times reported on this meeting and declared

that homosexuality would probably not stay in the DSM for much

longer, psychoanalytic societies and outspoken psychoanalysts rallied

against any such change. Irving Bieber and Charles Socarides

organized an Ad Hoc Committee Against the Deletion of Homosexuality

from DSM-II, and they tried unsuccessfully to influence leaders within

the APA to "appoint a special committee, 'balanced in its composition,'"

(Bayer 1981:121) to review any decision before it became official.

Psychoanalytic societies passed resolutions against changing the DSM,

realizing that their primacy within the APA was being threatened by

this decision. When the psychoanalytic institutional logic was

challenged, those who most benefited from it swiftly moved to cry foul.

In the midst of this rising conflict, the 1973 Honolulu convention

of the APA had no disruptive activists; instead, there was a panel

entitled "Should Homosexuality Be in the APA Nomenclature?" with

psychiatrists on both sides of the debate, as well as the activist Ronald

Gold. Instead of activists or sympathetic psychiatrists trying to raise

awareness of the problems with the diagnosis of homosexuality, this

29
panel was a debate within the APA about what course of action it

should take. Ronald Gold provided the voice of the activists, saying,

"I'm fighting the psychiatric profession now, but I know that a false

adversary situation has been drawn between psychiatry and gay

liberation" (Clendinen and Nagourney 1999:214). He talked about his

own mental health struggles and how the "worst thing about a

psychiatric diagnosis... is that gay people believe it" (Clendinen and

Nagourney 1999:213). Hundreds of psychiatrists attending applauded

his speech, and the responses of the approximately one thousand

psychiatrists present showed that many psychiatrists no longer

supported the medical model.

The transition from disruptive confrontations to reasoned debate

might have been caused by the institutionalization of outsiders or by

as a side effect of the field crystallization described by Elizabeth

Armstrong. One explanation for this transition is that as time went on,

the activists' dissent became incorporated into acceptable channels

that fit in with the institutional logic of science and the scientific

process. Alternatively, Armstrong believes around 1972 that the

organizational field of gay activism crystallized around a political logic

of identity when gay power no longer seemed realistic or relevant

(Armstrong 2002:103-106). The movement as a whole became more

moderate as a result, and so there was less desire among activists for

overt clashes with society's institutions. Ronald Gold still stood up for

30
gay identity when he said during the panel, "There are advantages to

being gay. I learned that in the gay movement" (Clendinen and

Nagourney 1999:214), but he was no longer screaming it from the

audience like in 1970 or 1971.

Later that night, Ronald Gold took Robert Spitzer to a meeting of

the Gay-PA at a gay bar in Honolulu in hopes of showing him all the

high-functioning homosexuals who were a part of the APA. When they

realized that Spitzer was straight, they were enraged at Gold for outing

all of them to a high-ranking psychiatrist. At that moment, an army

psychiatrist in full uniform ran into the bar and started crying as he

talked about how moved he had been by Gold's speech. Spitzer stayed

and talked to the psychiatrists of the Gay-PA about their experiences

and about the panel. According to some sources, it was this event that

completely converted him and eventually led him to put forth a

proposal that would attempt to heal the rift within the institutional

logics of the APA (Glass 2002; Clendinen and Nagourney 1999:215).

Other sources have focused on the influence that the past studies on

homosexuality had on Spitzer’s stance (Minton 2002:260), while still

others have said that Spitzer saw the rift coming and put himself into a

position where he could work to heal that rift and gain power and

influence within the APA (Kutchins and Kirk 1997:72). In keeping with

this, Spitzer might have been trying to foster the shift from a clinician-

based, psychoanalytic institutional logic to a university-based,

31
empirical institutional logic because he thought he stood to gain from

such a shift.

Spitzer's solution was a proposal that would remove

homosexuality from the DSM and replace it with a new diagnostic

category: sexual orientation disturbance. This label would be given to

homosexuals who experienced distress with their sexual orientation

and who wanted to be heterosexual. The logic of this proposal came

from Spitzer's ideas about the definition of a mental disorder. He

thought that mental disorders needed to cause subjective distress and

impair general social functioning. Homosexuality could not be an

illness because there were so many high-functioning homosexuals who

did not find their sexual orientation to be distressing. This proposal

satisfied the research-oriented institutional logic because it lent itself

to a more generalizable view of mental disorders that could be

investigated empirically. It also appealed to the psychoanalytic,

therapy-centered institutional logic because homosexuality was still a

disorder to those who wanted to treat it (Kutchins and Kirk 1997:67-

70).

This proposal was adopted by the board of trustees on December

15th, 1973, along with a proposal that supported the end of "all public

and private discrimination against homosexuals in such areas as

employment, housing, public accommodation and licensing"

(Clendinen and Nagourney 1999:216). Although the Committee on

32
Nomenclature never actually formally accepted Spitzer's proposal, by

claiming to represent that committee Spitzer was able to convince the

Council on Research and Development to accept the proposal. As

Spitzer moved the proposal higher and higher within the APA's

bureaucracy, each group refused to go against the word of the

previous one because each committee did not want to differ from the

"expert advice" of the previous one. The institutional logic of the APA

helped Spitzer navigate his proposal through the organization even

though he did not have his own committee's approval. For his part,

Franklin Kameny accepted the compromise because "Any homosexual

who would rather be heterosexual would have to be crazy" (Clendinen

and Nagourney 1999:215). Although some activists disliked the fact

that some form of mental disorder relating to homosexuality was still in

the DSM, they realized that the media coverage of the event tended to

overlook this fact. For all intents and purposes, the public saw that

homosexuality was no longer considered pathological. Eventually, the

remaining mention of homosexuality was taken out of the DSM quietly

in 1987 (Kutchins and Kirk 1997:88).

Conclusion

The lesbian and gay activists in this case study succeeded

because of the implicit organizational and institutional logics of the gay

liberation organizations and the American Psychiatric Association. The

challengers used their diverse political logics and tactics to create a

33
two-pronged strategy. While the confrontational gay liberationists

disrupted conventions and forced the APA to listen, the previous

generation of homophile activists spoke on panels and triggered a

debate within the APA. By coupling identity for critique and identity for

education, activists were able to swiftly bring down one of the most

important pillars holding up the system of discrimination against

homosexuality. Some activists appealed to psychiatrists using the new

interest-group logic of equal rights, while other activists focused on the

political logic of identity by being loud and proud, standing up for their

identity and denouncing anyone who looked down on that expression.

The success of gay activism was much more than pure numbers; in

fact, many of the most successful actions were carried out by only

handfuls of activists. The activists' success was determined less by

their level of mobilization than by the tactical decisions of those who

had been mobilized.

On the other hand, the American Psychiatric Association had

some traditional political opportunities: sympathetic members and a

division within the elite. But those divisions were determined by

conflicting institutional logics that were competing to determine

whether the APA would remain a clinician-centered, theory-based

organization or shift into a university-centered, research-based

organization. These contradictory institutional logics were not obvious

to the challengers, but they were crucial to the compromise that was

34
reached and to the motivations of people like Robert Spitzer. The

academic debate within the research literature was just a sign of the

deeper conflict within the APA. Furthermore, the lesbian and gay

activists' radical, confrontational tactics would not have been as

effective if they had been directed against a different kind of institution

that could respond to the disruptions with force. The institutional logics

of the APA also explain why the insiders within the APA, the members

of the Gay-PA, only contributed minimally to the struggle.

The struggle over homosexuality in the DSM may have been the

beginning of the end for the psychoanalytic, private-practice based

institutional logic. Influenced by some of the same people who were

involved in this debate, including Robert Spitzer, the DSM-III came out

in 1980 and ended psychoanalysis’ reign over the APA. DSM-III defined

disorders in a way that was designed to avoid any theoretical bias,

instead focusing on lists of diagnostic symptoms. The APA now used

empirical data in order to ensure the reliability of all the diagnostic

categories, eliminating the vague definitions based on psychoanalytic

theory in previous versions. Finally, the DSM-III became a tool that

insurance companies could use to determine how treatment would be

covered. The APA ceded its focus on psychotherapy as its main sphere

of influence and instead focused on its role in diagnosing and

prescribing medication (Mayes and Horwitz 2003).

Without a doubt, the political opportunities presented by the

35
tumultuous period of the late 60s and early 70s contributed to the

success of gay liberationists in a general way. They had cognitive

liberation in spades, and the organizational shift away from

accomodationist politics provided mobilizing structures that could

actually rally people together and provide a more coherent face to gay

activism. But ultimately these are broad strokes that may have limited

usefulness when analyzing the specific successes and failures of social

movements, because they neglect the relationships between specific

institutions and specific social movement organizations. In addition to

expanding the range of conflict that can be studied, a multi-

institutional political approach provides a more fine-grained account of

what motivates activists to seek some goals over others or use some

tactics over others. In turn, this approach can study the way those

goals and tactics influence and are influenced by the targeted

institution.

References

Armstrong, Elizabeth A. 2002. Forging Gay Identities: Organizing Sexuality in San

Francisco, 1950-1994. Chicago: University of Chicago Press.
Armstrong, Elizabeth A. and Bernstein, Mary. 2008. "Culture, Power, and Institutions: A
Multi-Institutional Politics Approach to Social Movements." Sociological Theory
26: 74-99.
Bayer, Ronald. 1981. Homosexuality and American Psychiatry: The Politics of
Diagnosis. New York: Basic Books.
Berger, Peter L. and Luckmann, Thomas. 1966. The Social Construction of Reality: A
Treatise in the Sociology of Knowledge. New York: Doubleday.
Bernstein, Mary. 1997. "Celebration and Suppression: The Strategic Uses of Identity by
the Lesbian and Gay Movement." The American Journal of Sociology 103: 531-
565.
Bernstein, Mary. 2003. "Nothing Ventured, Nothing Gained? Conceptualizing Social
Movement "Success" in the Lesbian and Gay Movement." Sociological

36
 Perspectives, 46: 353-379.
Clendinen, Dudley and Nagourney, Adam. 1999. Out for Good: The Struggle to Build a
Gay Rights Movement in America. New York: Simon & Schuster.
D'Emilio, John. 1998. Sexual Politics, Sexual Communities: The Making of a
Homosexual Minority in the United States, 1940-1970. Chicago: University of
Chicago Press.
Friedland, Roger and Alford, Robert R. 1991. "Bringing Society Back In: Symbols,
Practices, and Institutional Contradictions." Pp. 232-263 in The New
Institutionalism in Organizational Analysis, edited by W.W. Powell and P.J.
DiMaggio. Chicago: University of Chicago Press.
Friedman, Debra and McAdam, Doug. 1992. "Collective Identity and Activism:
Networks, Choices, and the Life of a Social Movement" in Frontiers in Social
Movement Theory, edited by A.D. Morris and C.M. Mueller. New Haven: Yale
University Press.
Glass, Ira. 2002. "81 Words." This American Life, radio program. Originally aired 1/18.
http://www.thisamericanlife.org/Radio_Episode.aspx?episode=204.
Kutchins, Herb and Kirk, Stuart A. 1997. Making Us Crazy: DSM: The Psychiatric Bible
and the Creation of Mental Disorders. New York: Free Press.
Mayes, Rick and Horwitz, Allan V. 2003. "DSM-III and the Revolution in the
Classification of Mental Illness." Journal of the History of the Behavioral
Sciences 41: 249-267.
McAdam, Doug. 1999. Political Process and the Development of Black Insurgency,
1930-1970. Chicago: University of Chicago Press.
Minton, Henry L. 2002. Departing from Deviance: A History of Homosexual Rights and
Emancipatory Science in America. Chicago: University of Chicago Press.
Morris, Aldon. 1986. The Origins of the Civil Rights Movement: Black Communities
Organizing for Change. New York: Free Press.
Tarrow, Sidney G. 1998. Power in Movement: Social Movements and Contentious
Politics. New York: Cambridge University Press.

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