DRESCHER

HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS

A History of Homosexuality and Organized

Psychoanalysis
Jack Drescher
Abstract: Today the Academy of Psychoanalysis and Dynamic Psychiatry welcomes its gay and lesbian members. Yet at the time of its 1956 founding, organized psychoanalytic attitudes toward homosexuality could be reasonably
characterized as hostile. First there was a transition from Freuds early views
of homosexuality as immature to later neofreudian theories that pathologized
same-sex attractions and behavior. Following the 1973 decision of the American
Psychiatric Association to remove homosexuality from the DSM, homosexuality is now more commonly regarded as a normal variant of human sexuality.
The history of psychoanalytic attitudes toward homosexuality reinforces the
impression that psychoanalytic theories cannot be divorced from the political,
cultural, and personal contexts in which they are formulated. This history also
shows that analysts can take positions that either facilitate or obstruct tolerance
and acceptance.

In 2006, the American Academy of Psychoanalysis and Dynamic

Psychiatry celebrated its 50th anniversary. While today the Academy
welcomes its gay and lesbian members, at the time of its 1956 founding, organized psychoanalytic attitudes toward homosexuality could
be reasonably characterized as hostile. For example, one noted psychoanalyst writing for the general public of his time was Edmund Bergler
(1956). In a book intended for a general audience, Homosexuality: Disease or Way of Life, he wrote:
I have no bias against homosexuals; for me they are sick people requiring
medical help . . . Still, though I have no bias, I would say: Homosexuals

Jack Drescher, M.D., Training and Supervising Analyst, William Alanson White
Institute; Adjunct Clinical Assistant Professor, New York University Postdoctoral
Program in Psychotherapy and Psychoanalysis; Clinical Assistant Professor of
Psychiatry, New York Medical College.
This paper is modified from the Presidential Lecture presented at the 50th Annual
Meeting of the American Academy of Psychoanalysis and Dynamic Psychiatry, Toronto,
Ontario, CA, May 19, 2006.
Journal of The American Academy of Psychoanalysis and Dynamic Psychiatry, 36(3) 443460, 2008
2008 The American Academy of Psychoanalysis and Dynamic Psychiatry

444

DRESCHER

are essentially disagreeable people, regardless of their pleasant or unpleasant outward manner . . . [their] shell is a mixture of superciliousness, fake
aggression, and whimpering. Like all psychic masochists, they are subservient when confronted with a stronger person, merciless when in power,
unscrupulous about trampling on a weaker person. (pp. 28-29)

While Berglers harsh comments may have a dissonant ring to contemporary analysts ears, they were rather typical of mid-20th century psychoanalytic conversations about homosexuality. And as Lewes
(1988) has noted, organized psychoanalysis neither rebuked nor repudiated such public pronouncements. How did that happen and how
have things changed? One aim of this article is to provide a chronicle
of evolving attitudes toward homosexuality within organized psychoanalysis, beginning with a discussion of Freuds views on homosexuality in historical context and concluding with the current state of affairs.
THEORIES OF ETIOLOGY
Any history of psychoanalytic attitudes toward homosexuality is intimately associated with how one theorizes homosexualitys etiology.
Whether biological, environmental, or psychological, etiological theories generally fall into three broad categories (Drescher, 1998, 2002),
Theories of normal variation treat homosexuality as a phenomenon
that occurs naturally; that homosexual individuals are born different, but natural, like left-handed people; in contemporary culture,
this theory underlies the belief that people are born gay.
Theories of pathology treat adult homosexuality as a disease, a condition that deviates from normal, heterosexual development; atypical gender behavior or feelings are symptoms of the disease; these
theories hold that an external, pathogenic agent causes homosexuality and that such agents can act pre- or postnatally (intrauterine
hormonal exposure, excessive mothering, inadequate or hostile fathering, sexual abuse, gender identity disorder).
Theories of immaturity regard aspects of homosexuality at a young
age as a normal step toward adult heterosexuality; ideally, homosexuality is a passing phase to be outgrown; as a developmental
arrest, adult homosexuality is stunted growth.

HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS

445

Freud in Historical Context

For many historians, the modern chronicle of homosexuality begins
with Karl Heinrich Ulrichs, who today might be called a gay political
activist. In an 1864 treatise, one of the first published normal variant
theories of the modern era, he criticized Prussias criminalization of
homosexuality. He believed that men who were attracted to men were
born with a womans spirit trapped in their bodies. Ulrichs (1864/1994)
designated the condition uranism and individuals who practiced uranian love were called urnings.1 He believed urnings constituted a third
sex that was neither male nor female.2
Karl Maria Kertbeny would echo Ulrichs normalizing approach in an
1869 political treatise that also argued against criminalizing homosexuality. Kertbeny, a Hungarian writer, coined the terms homosexual and
homosexuality (Bullough, 1979). Both he and Ulrichs argued that as a
normal variation of human sexuality, homosexual behaviors are not immoral and should not be criminalized. In 1886, neurologist Richard von
Krafft-Ebing (1886/1965) adopted Kertbenys term homosexual and
his Psychopathia Sexualis, popularized the usage in medical and scientific communities. However, unlike Kertbeny, Krafft-Ebing considered
homosexuality a degenerative neurological disorder.
Third-sex and degeneracy theories were among the major scientific
arguments of Freuds time and he would take issue with both. In Three
Essays on the Theory of Sexuality (1905/1953). arguing against degeneracy, he noted that inversion was found in people with no other mental
problems and in people distinguished by especially high intellectual
development and ethical culture (p. 138). He took direct aim at thirdsex theory in a 1915 footnote: Psychoanalytic research is most decidedly opposed to any attempt at separating off homosexuals from the
rest of mankind as a group of special character . . . all human beings are
capable of making a homosexual object-choice and have in fact made
one in their unconscious (p. 145n).
Freud would instead lay out a developmental model of bisexual instincts traversing psychosexual stages before attaining mature expres1. Ulrichs defined a woman who we would today call a lesbian as urningin.
2. Ulrichs, like Freud, turned to Greek mythology for his etymological sources.
His terminology derived from a speech in Platos Symposium that told of the elder
Aphrodite, a daughter of slain Uranus, who was born out of the remains of her fathers
dismembered body. Because she had no mother and her birth involved no female
participation, the Uranian Aphrodite, according to Plato, inspired the love of men
for men, and women for women. Heterosexuals in this nosology were dionings
descendants of Zeus and the mortal woman Dione.

446

DRESCHER

sions of sexuality. Adults who achieved sexual excitement by means

other than penile-vaginal intercoursefellatio or receptive anal sex,
for examplesuffered from either fixations or regressions. Freud saw
these latter activities, heterosexual or homosexual, as expressions of
immature sexuality (1908). and contrasted them with what he believed
to be mature forms of genital, (hetero)sexual expression.3
In Freuds model of the mind, hysteria was contrasted with perversion. In hysteria, repressive mechanisms malfunctioned and unacceptable instincts were transformed, through displacement and conversion,
into physical symptoms. In perversion there was no conflict, leading
to Freuds claim that neuroses are the negative of perversions (1905,
p. 165). This theory informed his longstanding positions that inversion
was not a neurotic illness and his pessimism about converting homosexuality:
[T]he removal of genital inversion or homosexualityis in my experience
never an easy matter . . . In general, to undertake to convert a fully developed homosexual into a heterosexual does not offer much more prospect
of success than the reverse, except that for good practical reasons the latter
is never attempted. (Freud, 1920, p. 151)

He echoed these sentiments late in life in his now-famous Letter to an

American Mother:
Homosexuality is assuredly no advantage, but it is nothing to be ashamed
of, no vice, no degradation; it cannot be classified as an illness; we consider
it to be a variation of the sexual function, produced by a certain arrest of
sexual development . . . By asking me if I can help, you mean, I suppose,
if I can abolish homosexuality and make normal heterosexuality take its
place. The answer is, in a general way, we cannot promise to achieve it.
In a certain number of cases we succeed in developing the blighted germs
of heterosexual tendencies which are present in every homosexual, in the
majority of cases it is no more possible. (Freud, 1935, pp. 423-424)

Freud was tolerant for his time. He signed a 1930 petition to decriminalize homosexuality (Abelove, 1985/1993). Yet, although he did not
consider homosexuality an illness, his theory did not quite constitute a
clean bill of healthcalling someone immature, rather than sick, is not
as offensive, but neither appellation is particularly respectful. Nor did
3. Since same-sex activities preclude penile-vaginal intercourse, in Freuds nosology,
homosexual acts could only be regarded as immature forms of sexual expression.

HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS

447

Freud hide his contempt for the normalizing, third sex theories of his
eras German homophile (gay rights) movement:
The mystery of homosexuality is therefore by no means so simple as it
is commonly depicted in popular expositions a feminine mind, bound
therefore to love a man, but unhappily attached to a masculine body; a
masculine mind, irresistibly attracted by women, but, alas! imprisoned in
a feminine body. . . . Tendentious literature has obscured our view of this
interrelationship by putting into the foreground, for practical reasons [the
kind of object choice], which is the only one that strikes the layman, and
in addition by exaggerating the closeness of the association between this
and [physical hermaphroditism] . . . If [psychoanalytic] findings are taken
into account, then, clearly, the supposition that nature in a freakish mood
created a third sex falls to the ground. (Freud, 1920, pp. 170-171)

The Neofreudian pathologizers

Freuds contempt for normalizing theories of homosexualitywould
be taken up by the organized movement he founded. However psychoanalytic practitioners of the mid-20th century based their clinical
approaches to homosexuality on the work of Sandor Rado (1940). Rado
held that Freuds theory of innate bisexuality was in error, that there
was no such thing as normal homosexuality, and that heterosexuality
was the biological norm.
In Rados theory, adult homosexuality is a phobic avoidance of heterosexuality caused by inadequate, early parenting. His theorys adherents included Bieber et al. (1962). who considered homosexuality to
be a pathologic biosocial, psychosexual adaptation consequent to pervasive fears surrounding the expression of heterosexual impulses (p.
220). Socarides (1968) took issue with Freud and theorized an unconscious neurotic mechanism leading to homosexuality. Ovesey (1969)
claimed homosexuality was a deviant form of sexual adaptation into
which the patient is forced by the injection of fear into the normal sexual function (pp. 20-21). These post-Freudian theories had a significant
impact on psychiatric thought in the mid-20th century and were part
of the rationale for including a diagnosis of homosexuality in both
the 1st (1952) and 2nd (1968) editions of the Diagnostic and Statistical
Manual (DSM; Drescher, Stein, & Byne, 2005). The adoption of these
theories also meant that openly gay men and women were considered
ineligible to train as psychoanalysts or in any of the mental health professions that were dominated by psychoanalytic thinking (Domenici &
Lesser, 1995; Isay, 1996; Lewes, 1988; Magee & Miller, 1997).

448

DRESCHER

Psychoanalytic Dissenters
While most American psychoanalysts and all of their professional
organizations maintained that homosexuality was a pathological condition, there were prominent dissenters. Foremost was Judd Marmor,
whose early contribution to the early psychiatric debate on homosexuality was Sexual Inversion (1965). There he tried to assemble relevant
information in every sector of the complexity of [homosexuality]history, comparative zoology, genetics, endocrinology, sociology, anthropology, law, psychology, and psychoanalytic psychiatry (p. 1). Marmor
was not averse to airing views with which he disagreed; the volume
included contributions from Rado, Bieber, and Ovesey. He asserted that
the fundamental issue raised by the diagnostic status of homosexuality
was neither medical nor semantic, but moral (Marmor, 1972).
Another psychoanalytic dissenter was Thomas Szasz. In The Myth of
Mental Illness (1960). he criticized mental health professionals in general for labeling many unconventional behaviors as signs of illness. He
argued that mental illness was a metaphor, rather than an actual illness like a viral infection or a broken leg. Rather than practicing medicine, Szasz accused his fellow psychiatrists of using diagnoses as a way
to increase their own power and influence. As a spokesperson of the
anti-psychiatry movement, he would take psychiatrists to task for
diagnosing not only homosexuality, (1965) but other diagnoses like
substance abuse (1974) as well.
Robert Stoller (1968), a psychoanalyst whose clinical work and writings included the study of transsexual and intersex patients, introduced
sexology concepts into the analytic literature. Most important was his
importation of John Moneys (Money, Hampson, & Hampson, 1957)
concept of a gender identity distinct from a sexual orientation. Stollers
theoretical contributions would further undermine traditional analytic
theories of homosexuality that typically conflated gender identity and
sexual orientation.
The Sexologists
While a psychoanalytically dominated psychiatry was trying to
cure homosexuality, sexology researchers of the mid-20th century
tried to make sense of human sexual behavior in the general population. Analysts drew conclusions from a self-selected group (patients
seeking treatment for their homosexuality) and wrote up findings as
case reports. Sexologists, on the other hand, went into the field and

HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS

449

recruited large numbers of nonpatient subjects for studies. Eventually,

their research lent support to a view that homosexuality, like heterosexuality, might be considered a normal variation of human sexual expression.
Most prominent among sexological studies were Alfred Kinseys
Sexual Behavior in the Human Male (Kinsey, Pomeroy, & Martin, 1948)
and Sexual Behavior in the Human Female (Kinsey, Pomeroy, Martin, &
Gebhard, 1953). Kinsey surveyed thousands of people and found homosexuality to be more common in the general population than was
generally believed, although his now-famous 10% statistic is today
believed to be closer to 1 to 4% (Laumann, Gagnon, Michael, & Michaels, 1994). Kinseys findings were sharply at odds with prevailing
psychiatric views that claimed homosexuality to be rare. In 1951, Ford
and Beachs Patterns of Sexual Behavior, a cross-cultural and ethological
study, supported Kinseys view that homosexuality was not rare and
that it occurred in nature. Psychologist Evelyn Hooker (1957) demonstrated, through impartially interpreted projective tests, that contrary
to prevailing psychoanalytic theory of the time, a group of nonpatient
homosexual men showed no more psychopathology than heterosexual
controls.
1973: Psychoanalysis and Sexology clash
American psychiatry, influenced at the time by ego psychology, mostly ignored sexology research and its normalizing conclusions about
homosexuality. However, in 1970, this research was brought forcefully
to the attention of the American Psychiatric Association (APA). After
1969s Stonewall riots in New York Citys Greenwich Village (Duberman, 1994), organized gay activists, convinced that psychiatrys pathologizing attitudes about homosexuality were a major contributor to social stigma, disrupted first the 1970 and then again the 1971 annual APA
meetings.
In response to protests, two panels at the 1971 and 1972 APA meetings featured nonpatient gay activists explaining to a psychiatric audience the stigma caused by psychiatric diagnosis. At the 1972 meeting,
activists were joined by a psychiatrist, John Fryer, M.D., who appeared
as Dr. H Anonymous, wearing a rubber mask, a fright wig, and an
oversized tuxedo. Fryer, using a voice-disguising microphone, told his
audience what it was like to be a closeted gay psychiatrist.
During this period, APA also embarked upon an internal process of
studying the scientific question of whether homosexuality should be
considered a psychiatric disorder. APAs Board of Trustees charged its

450

DRESCHER

Nomenclature Committee as the scientific body best suited to address

this issue. The Committee interviewed proponents of normalizing and
pathologizing views and did their own review of the psychiatric, psychoanalytic, and sexology literature. The latter, a subject not usually
taught in psychiatric training programs at that time, was unfamiliar to
most practicing psychiatrists (Drescher, 2007).
After a review lasting more than a year, the Nomenclature Committee recommended to the Board of Trustees that APA remove homosexuality per se from the diagnostic manual. After review and approval
by other APA committees and deliberative bodies, in December 1973,
APAs Board of Trustees voted to remove homosexuality from the DSMII. Within two years, other major mental health professional organizations, including the American Psychological Association, the National
Association of Social Workers, and the Association for Advancement of
Behavior Therapy, endorsed the APA decision.
However before the removal could be formally implemented, analysts who had argued against change wrote and submitted a petition to
the APA. They demanded a referendum of the entire APA membership
to challenge the Boards decision. The petition included 200 signatures
of APAs psychoanalytic members who were gathered at the December 1973 meeting of the American Psychoanalytic Association (APsaA;
Bayer, 1981; Drescher & Merlino, 2007). In 1974, the Boards decision
to remove was upheld by a 58% majority of voting APA members. Following the referendum, APA also issued a groundbreaking position
statement supporting civil rights protection for gay people in employment, housing, public accommodation and licensing, and the repeal of
all sodomy laws (APA, 1974).
PSYCHOANALYSIS AND HOMOSEXUALITY: 1973-1992
In the wake of the 1973 APA decision, cultural attitudes about homosexuality began to shift. In the U.S. and elsewhere, those who accepted
scientific authority on such matters gradually came to accept the normalizing view. Similar shifts gradually took place in the international
mental health community as well. In 1992, the World Health Organization accepted the U.S. view and removed homosexuality per se from
the International Classification of Diseases (ICD-10; Nakajima, 2003).
Gradually, a new perspective emerged in many Western societies: if
homosexuality is not an illness, and if one does not literally accept bib-

HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS

451

lical prohibitions against it, and if gay people are able and prepared to
function as productive citizens, then what is wrong with being gay?4
The psychoanalytic community, however, would take longer than
others to adopt this perspective. Following the 1973 decision, and as
their influence gradually declined in the mental health professions,
psychoanalysts circled their wagons. As normalization was taking
place in the rest of the culture, analysts, in their journals and at their
meetings, continued to write and speak about homosexuality in pathological terms. More troubling, they continued to deny openly gay men
and lesbians training in their institutes.
However, after 1973, there were stirrings of change within mainstream psychoanalysis. Richard C. Friedman (a member of the American and later of the Academy) wrote an early critique, but published
it in Contemporary Psychoanalysis (a journal of a non-APsaA institute
William Alanson White). Stephen A. Mitchell (a White-trained psychologist) wrote two seminal papers (1978, 1981) that criticized the theories
and techniques of mainstream analysts who pathologized homosexuality, including one published in the International Review of Psycho-analysis (1981). At a 1983 Fall Meeting of the APsaA, a panel (with Stanley
Leavy, Richard Isay, Robert Stoller, and Richard C. Friedman) aired critical views of the then-dominant analytic perspective (Isay & Friedman,
1986). Both Isay (1985, 1989) and Friedman (1988) would later offer historically significant criticisms of mainstream psychoanalytic attitudes
and theories of that time.
By the 1980s, most institutes were still not accepting gay and lesbian
candidates (Domenici & Lesser, 1995; Magee & Miller, 1997). There were
exceptions, as in the case of the White Institute (which had accepted
gay candidates since the 1950s, but did not want it publicly known)
or in the American, as in the case of Sidney H. Phillips (personal com-

4. This perspective gradually gathered momentum. In 1973, homosexual behavior

was illegal in most of the United States. In 2003, when three quarters of the states had
already repealed their sodomy laws, the U.S. Supreme Court ruled (6-3) in Lawrence and
Garner v. Texas to overturn the remaining ones. Same-sex marriage is now an option
for gay people in Belgium, Canada, The Netherlands, Norway, South Africa, Spain, and
in the U.S. States, California and Massachusetts. New York State will recognize gay
marriages legally performed in other countries and states. Same-sex civil unions are
available in Argentina (Buenos Aires). the Czech Republic, Denmark, Finland, France,
Germany, Great Britain, Greenland, Hungary, Iceland, Mexico (Mexico City), Sweden,
Switzerland, Uruguay, and in the U.S. states of Connecticut, New Hampshire, New
Jersey, and Vermont (http://www.marriageequality.org/meusa/index.shtml). Maine,
Hawaii, Oregon, and Washington State offer domestic partner benefits. New Jersey,
Vermont and Sweden are presently considering upgrading their civil union laws to
marriage.

452

DRESCHER

munication) who was openly gay and accepted for training at Western
New England Psychoanalytic Institute in 1980.
Things would change. In 1989, the American Academy of Psychoanalysis adopted a sexual orientation non-discrimination policy in regard to membershipa first for any psychoanalytic organization. In
1991, in response to a threatened discrimination lawsuit (Isay, 1996; Socarides, 1995). the APsaA adopted a sexual orientation non-discrimination policy regarding the selection of candidates and revised it in 1992
to include selection of faculty and training analysts as well. In 1992, the
American would also create a Committee on Issues of Homosexuality (later the Committee on Gay and Lesbian Issues). The Committees
would identify areas of antihomosexual bias and work with institutes
and the APsaA toward opening up its institutes, changing attitudes,
policies, and curriculum (Hoffman et al., 2000; Roughton, 1995).
THE QUEERING OF PSYCHOANALYSIS
Prior to the 1990s, when most psychoanalytic institutes would not
train openly gay candidates, those analysts who did come out in the late
1980s and early 90s were, with a few exceptions, mostly psychologists
and mostly trained outside the APsaA. Many of their intellectual and
theoretical influences derive from sources outside traditional, medical
psychoanalytic circles. Included in this group are analysts from Great
Britain (OConnor & Ryan, 1993) and from the American interpersonal
and relational traditions (Blechner, 1993; Corbett, 1993; Drescher, 1996a,
b 1996; Lesser, 1993; Schwartz, 1993).
Many of these analysts found themselves either influenced by or
resonating with queer theory, a postmodern academic discipline. Queer
theorists challenge implicit assumptions that underlie conventional,
binary categories like masculinity/femininity, or homosexuality/
heterosexuality. They criticize cultural (and analytic) norms by deconstructing the implicit assumptions upon which those norms are
based. Queer theorists writings draw attention to the ways in which
identities (including but not limited to sexual identities) can be socially
constructed through history (Foucault, 1978/1980), language and custom, and most do not believe that these identities arise from biological
(essentialist) factors.
The earlier critics of pathologizing theories addressed nonanalytic attitudes (Marmor, 1980; Mitchell, 1978, 1981); or offered alternative normative developmental theories using oedipal models (Isay, 1989; Lewes,

HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS

453

1988; Morgenthaler, 1984/1988); or sidestepped dynamic causes altogether and attributed or hypothesized a biological basis for same-sex
desire (Friedman, 1988; Isay, 1989). In contrast, the literature of postmodern gay and lesbian analysts would shift the clinical and theoretical focus from questions about what causes homosexuality to, among
other things, inquiring why people ask questions about etiology in
the first place. As Corbett (1997) puts it, the goal of analysis should not
be why homosexuality but how homosexuality (p. 500).
A major showcase for this emerging perspective took place in December 1993, at a conference of the New York University Postdoctoral
Program in Psychotherapy and Psychoanalysis. Entitled, Perspectives on Homosexuality: An Open Dialogue, it was an unprecedented
gathering of heterosexual and gay analysts. In the published proceedings, Disorienting Sexuality (Domenici & Lesser, 1995). Adrienne Harris
foreword noted: To characterize the appearance of a group practicing
identity politics in psychoanalysis in 1993 as courageous is to immediately mark the uniqueness and the entrenched difficulties in considering homosexuality within psychoanalysis. What is commonplace
in most institutional settings is and has still been radical and resisted
within psychoanalysis (p. xi).
The 90s saw a growth in publications by gay and lesbian analysts
raising new issues and asking previously unexplored questions. They
wrote of psychoanalytic history and technique, of gay therapists treating gay and straight patients, posited normal developmental models
for children who grow up gay, questioned traditional analytic concepts
of masculinity and femininity, modified psychoanalysis to treat patients
with HIV, and cast light on the previously invisible but historic contributions to the early psychoanalytic movement of lesbians like Bryher
(Annie Winifred Ellerman) and H.D. (Hilda Doolittle; Blechner, 1997;
Corbett, 1996; DErcole, 1996; Frommer, 1994; Glazer, 1998; Lewes, 1999;
Magee & Miller, 1996; Phillips, 1998; Schaffner, 1996; Schwartz, 1996;
Vaughan, 1999). They also wrote and edited psychoanalytic texts for
the next generation of analysts (Drescher, 1998; Glassgold & Iasenza,
1995; Lesser & Schoenberg, 1999; Magee & Miller, 1997; OConnor &
Ryan, 1993; Schwartz, 1998; Young-Bruehl, 1996).
Changes were taking place in the psychoanalytic mainstream as well.
In 1997, the APsaA became the first mainstream mental health organization to endorse gay marriage (Hausman, 1998). a position the American Psychological and American Psychiatric Associations would adopt
only later, in 2003 and 2005, respectively.

454

DRESCHER

HOMOSEXUALITY AND PSYCHOANALYSIS:

THE SECOND CENTURY
With the new millennium came new books (Cohler & GalatzerLevy, 2000; Cole, 2002; Dean & Lane, 2001; DErcole & Drescher, 2004;
Drescher, DErcole, & Schoenberg, 2003 Lingiardi, 2002; Sherman, 2005).
The Journal of Gay and Lesbian Psychotherapy, relaunched in 1999, had a
senior editorial board of gay and lesbian analysts. Many of the papers
the journal published were by gay and lesbian analysts as well. In addition, inspired by Roy Schafers (1995) paper in which he updated his
views on homosexuality, the JGLP solicited and published articles by
prominent senior analysts whose earlier writings had pathologized homosexuality. Both Otto Kernberg (2002) and Joyce McDougall (2001)
provided new formulations of their theoretical and clinical perspectives.
In 2001, the Journal of the American Psychoanalytic Association devoted
an entire issue (Volume 49, Number 4) to non-pathologizing papers on
homosexuality. In 2002, Volume 30 of The Annual of Psychoanalysis focused on, Rethinking Psychoanalysis and the Homosexualities, with
contributions from Schafer, Martin Bergmann, and Ethel Person. That
same year, Sidney Phillips (2001, 2002). of the Western New England
Institute, became the APsaAs first Training Analyst promoted as an
openly gay man. Also in 2001, due to efforts by Ralph Roughton and
straight allies in the American, the International Psychoanalytic Association (IPA) approved a position statement opposing discrimination of any kind. This includes, but is not limited to, any discrimination
on the basis of age, race, gender, ethnic origin, religious belief or homosexual orientation (Roughton, 2003, p. 195). In 2004, Joseph P. Merlino,
M.D., an openly gay analyst, became President of the American Academy of Psychoanalysis and Dynamic Psychiatry.
CONCLUSION
Psychoanalytic attitudes and theoriesand the organizations in
which these theories and attitudes are developedreflect the cultures
in which they are formulated (Drescher, 1996b, 1997). American culture vigorously persecuted homosexuality from the 1940s through the
1960s, at a time when the theories of analysts like Rado, Bieber, and
Socarides predominated in psychoanalytic organizations. Not surprisingly, in those years, patients and analysts usually began treatment
with a shared view that homosexuality was a problem requiring treat-

HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS

455

ment. The patient and the analyst were both motivated to answer the
question of how the family got the patient off the track toward normal
heterosexuality. For as Schafer (1995) notes:
. . . it seems like a straightforward technical principle that in doing character analysis one must render what is ego-syntonic ego-alien, thereby making it possible to analyze pathological character traits. . . . one realizes how
much space this technical principle leaves for the analysts personal values
to be imposed on the patient. Here we need think only of the ego-syntonic
homosexual orientation in whatever way that is structured in character,
and of how so many analysts tried to make these orientations ego-alien or
else resignedly thought it was hopeless even to try. (p. 200)

Given the role that subjectivity plays in psychoanalytic theorizing, it

is no surprise that the Bieber et al. (1962) study, grounded in the values
of the 1950s, found the best interparental relationships where father
dominates but does not minimize mother (p. 158). As Schafer (1995)
goes on to say:
. . . many moral judgments have been taken for granted as factual statements, while many other moral judgments have been presented as reasoned conclusions based on careful exercises of curiosity in the form of
purportedly scientific investigation or, even more simply, uncontroversial
reality testing. (p. 189)

Changing cultural values would again play a role in the analytic

narratives that portray homosexuality as a normal variant of human
sexuality. As sexual attitudes became more tolerant in the late 1960s
through the 1980s, nonpathological theoretical models emerged. In one
variation of that model, analyst and patient simply assume that homosexuality is intrinsic and normal for the patient. As the origins of
homosexuality are attributed to factors beyond the patients conscious
or unconscious control, they are no longer considered a subject of analytic inquiry. Even in cases where the analyst and patient believe that
homosexuality is constructed or a product of conflict (Chodorow, 1992;
Lewes, 1988). such an outcome is not presumed to be inferior to a heterosexual orientation. From these perspectives, the analyst and patient
spare themselves the task of figuring out what prevented the patients
heterosexual development. The narrative that instead emerges flows
from the question of how the patient deals with a world that is hostile
to homosexuality or it may explore a patients difficulties in accepting
his own sexuality.

456

DRESCHER

This history of psychoanalytic attitudes toward homosexuality reinforces the impression that psychoanalytic theories cannot be divorced
from the political, cultural, and personal contexts in which they are formulated. This history also shows that analysts can take positions that
either facilitate or obstruct tolerance and acceptance. In 1921, Ernest
Jones asked whether a homosexual candidate should be accepted for
analytic training. In a circular letter to Freuds inner circle, he and
Rank (1921) replied that homosexuality alone should not be an exclusionary criterion and that an individuals other qualities should be taken into account. After a somewhat rocky start, in the second century of
psychoanalysis, that now seems to be the case. Today, gay and lesbian
analysts speak as respected subjects within their analytic communities,
no longer regarded as derided objects. As a result, they can now advocate for and focus psychoanalytic attention on the psychological needs
of their gay and lesbian patients.

REFERENCES
Abelove, H. (1993). Freud, male homosexuality, and the Americans. In H. Abelove, M.A. Barale, & D. Halperin. (Eds.), The lesbian and gay studies reader (pp.
381-393). New York: Routledge. (Original work published in 1985)
American Psychiatric Association. (1974). Position statement on homosexuality and
civil rights. American Journal of Psychiatry, 131(4), 497. Retrieved from http: //
www.psych.org/Departments/EDU/Library/APAOfficialDocumentsand Related/ PositionStatements/197310.aspx, on July 31, 2008.
American Psychiatric Association. (1952). Diagnostic and statistical manual of mental
disorders. Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1968). Diagnostic and statistical manual of mental
disorders, 2nd edition. Washington, DC: American Psychiatric Press.
Bayer, R. (1981). Homosexuality and American psychiatry: The politics of diagnosis. New
York: Basic Books.
Bergler, E. (1956). Homosexuality: Disease or way of life. New York: Hill & Wang.
Bieber, I., Dain, H.J., Dince, P.R., Drellich, M.G., Grand, H.G., Gundlach, R.H., et al.
(1962). Homosexuality: A psychoanalytic study. New York: Basic Books.
Blechner, M.J. (1993). Homophobia in psychoanalytic writing and practice. Psychoanalytic Dialogues, 3, 627-637.
Blechner, M.J. (Ed.). (1997). Hope and mortality: Psychodynamic approaches to AIDS and
HIV. Hillsdale, NJ: Analytic.
Breuer, J., & Freud, S. (1955). Studies on hysteria. In J. Strachey (Ed. & Trans.), The
Standard Edition of the Complete Psychological Works of Sigmund Freud (Vol. 2).
London: Hogarth Press. (Original work published in 1985)
Bullough, V. (1979). Homosexuality: A history. New York: Meridian.
Chodorow, N.J. (1992). Heterosexuality as a compromise formation: Reflections on
the psychoanalytic theory of sexual development. Psychoanalysis and Contemporary Thought, 15, 267-304.

HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS

457

Cohler, B. J., & Galatzer-Levy, R. M. (2000). The course of gay and lesbian lives. Chicago:
University of Chicago Press.
Cole, G. (2002). Infecting the treatment: The experience of an HIV-positive psychoanalyst.
Hillsdale, NJ: Analytic.
Corbett, K. (1993). The mystery of homosexuality. Psychoanalytic Psychology, 10,
345-357.
Corbett, K. (1996). Homosexual boyhood: Notes on girlyboys. Gender and Psychoanalysis, 1, 429-461.
Corbett, K. (1997). Speaking queer: A reply to Richard C. Friedman. Gender and Psychoanalysis, 2, 495-514.
Dean, T., & Lane, C. (2001). Homosexuality & psychoanalysis. Chicago: University of
Chicago Press.
DErcole, A. (1996). Postmodern ideas about gender and sexuality: The lesbian
woman redundancy. Psychoanalysis and Psychotherapy, 13(2), 142-152.
DErcole, A., & Drescher, J. (Eds.). (2004). Uncoupling convention: Psychoanalytic approaches to same-sex couples and families. Hillsdale, NJ: Analytic.
Domenici, T., & Lesser, R.C. (Eds.). (1995). Disorienting sexuality: Psychoanalytic reappraisals of sexual identities. New York: Routledge.
Drescher, J. (1996a). A discussion across sexual orientation and gender boundaries:
Reflections of a gay male analyst to a heterosexual female analyst. Gender and
Psychoanalysis, 1(2), 223-237.
Drescher, J. (1996b). Psychoanalytic subjectivity and male homosexuality. In R.P. Cabaj & T.S. Stein (Eds.), Textbook of homosexuality and mental health (pp. 173-189).
Washington, DC: American Psychiatric Press.
Drescher, J. (1997). From preoedipal to postmodern: Changing psychoanalytic attitudes toward homosexuality. Gender & Psychoanalysis, 2(2), 203-216.
Drescher, J. (1998). Psychoanalytic therapy and the gay man. Hillsdale, NJ: Analytic.
Drescher, J. (2002). Causes and becauses: On etiological theories of homosexuality.
In Rethinking Psychoanalysis and the Homosexualities (The annual of psychoanalysis, vol. 30) (pp. 57-68). Hillsdale, NJ: Analytic.
Drescher, J. (2007). An interview with Robert L. Spitzer, MD. In J. Drescher & J.P.
Merlino (Eds.), American psychiatry and homosexuality: An oral history (pp.
95-111). New York: Harrington Park Press.
Drescher, J., & Merlino, J. P. (Eds.) (2007). American psychiatry and homosexuality: An
oral history. New York: Harrington Park Press.
Drescher, J., DErcole, A., & Schoenberg, E. (Eds.). (2003). Psychotherapy with gay men
and lesbians: Contemporary dynamic approaches. New York: Harrington Park
Press.
Drescher, J., Stein, T.S., & Byne, W. (2005). Homosexuality, gay and lesbian identities, and homosexual behavior. In B. Sadock & V. Sadock (Eds.), Kaplan and
Sadocks comprehensive textbook of psychiatry, 8th edition (pp. 1936-1965). Baltimore, MD: Williams and Wilkins.
Duberman, M. (1994). Stonewall. New York: Plume.
Ford, C.S., & Beach, F.A. (1951). Patterns of sexual behavior. New York: Harper &
Row.
Foucault, M. (1978). The history of sexuality, volume I, an introduction. Originally published as Histoire de la sexualit 1: La volont de savoir (Paris: Gallimard, 1978).
New York: Vintage.
Freud, S. (1905). Three essays on the theory of sexuality. In J. Strachey (Ed. & Trans.),

458

DRESCHER

The standard edition of the complete psychological works of Sigmund Freud (Vol. 7,
pp. 123-246). London: Hogarth Press.
Freud, S. (1920). The psychogenesis of a case of homosexuality in a woman. In J.
Strachey (Ed. & Trans.), The standard edition of the complete psychological works
of Sigmund Freud (Vol. 18, pp. 145-172). London: Hogarth Press.
Freud, S. (1908). Civilized sexual morality and modern mental illness. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of
Sigmund Freud (Vol. 9, pp. 177-204). London: Hogarth Press.
Freud, S. (1935). Anonymous (Letter to an American mother). In E. Freud (Ed.), The
Letters of Sigmund Freud (pp. 423-424). New York: Basic Books.
Freud, S., & Rank, O. (1921). Circular letter. Body Politic. Toronto, May 1977, p. 9.
Friedman, R.C. (1976). Psychodynamics and sexual object choice. Contemporary Psychoanalysis, 12, 94-108.
Friedman, R.C. (1988). Male homosexuality: A contemporary psychoanalytic perspective.
New Haven, CT: Yale University Press.
Frommer, M.S. (1994). Homosexuality and psychoanalysis: Technical considerations
revisited. Psychoanalytic Dialogues, 4, 215-233.
Frommer, M.S. (1999). Reflections on self-disclosure, desire, shame and emotional
engagement in the gay male psychoanalytic dyad. Journal of Gay and Lesbian
Psychotherapy, 3(1), 53-65.
Glassgold, J., & Iasenza, S. (Eds.). (1995). Lesbians and psychoanalysis: Revolutions in
theory and practice. New York: Free.
Glazer, D.F. (1998). Homosexuality and the analytic stance: Implications for treatment and supervision. Gender and Psychoanalysis, 3(4), 397-412.
Hausman, K. (1998). American Psychoanalytic Association asks states to legalize
marriage of same-sex partners. Psychiatric News, 33(3), 1, 29.
Hirschfeld, M. (2000). The homosexuality of men and women. M. Lombardi-Nash
(Trans.). Buffalo, NY: Prometheus Books. (Original work published in 1914)
Hoffman, L. G., Hevesi, A.G., Lynch, P.E., Gomes, P.J., Chodorow, N.J., Roughton,
R.E., et al. (2000). Homophobia: Analysis of a permissible prejudice: A public forum of the American Psychoanalytic Association and the American Psychoanalytic Foundation. Journal of Gay & Lesbian Psychotherapy, 4(1), 5-53.
Hooker, E.A. (1957). The adjustment of the male overt homosexual. Journal of Projective Techniques, 21, 18-31.
Isay, R.A. (1985). On the analytic therapy of homosexual men. Psychoanalytic Study
of the Child, 40, 235-255.
Isay, R.A. (1989). Being homosexual: Gay men and their development. New York: Farrar,
Straus and Giroux.
Isay, R.A. (1996). Becoming gay: The journey to self-acceptance. New York: Pantheon.
Isay, R.A., & Friedman, R.C. (1986). Toward a further understanding of homosexual
men. Journal of the American Psychoanalytic Association, 4, 193-208.
Kernberg, O. F. (2002). Unresolved issues in the psychoanalytic theory of homosexuality and bisexuality. Journal of Gay and Lesbian Psychotherapy, 6(1), 9-27.
Kinsey, A.C., Pomeroy, W.B., & Martin, C.E. (1948). Sexual Behavior in the Human
Male. Philadelphia: Saunders.
Kinsey, A., Pomeroy, W., Martin, C., & Gebhard, P. (1953). Sexual behavior in the human female. Philadelphia: Saunders.
Krafft-Ebing, R. (1965). Psychopathia sexualis. H. Wedeck (Trans.). New York: Putnam.

HOMOSEXUALITY AND ORGANIZED PSYCHOANALYSIS

459

Laumann, E.O., Gagnon, J.H., Michael, R.T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of
Chicago Press.
Lesser, R.C. (1993). A reconsideration of homosexual themes. Psychoanalytic Dialogues, 3, 639-641.
Lesser, R.C., & Schoenberg, E. (Eds.). (1999). That obscure subject of desire: Freuds female homosexual revisited. New York: Routledge.
Lewes, K. (1988). The psychoanalytic theory of male homosexuality. New York: Simon
and Schuster.
Lewes, K. (1999). Unspoken questions: Unsayable answers. Journal of Gay and Lesbian Psychotherapy, 3(1), 33-44.
Lingiardi, V. (2002). Men in love: Male homosexualities from Ganymede to Batman. Chicago and Lasalle, IL: Open Court.
Magee, M., & Miller, D. (1996). What sex is an amaryllis? What gender is lesbian?
Looking for something to hold it all. Gender and Psychoanalysis, 1(2), 139-170.
Magee, M., & Miller, D. (1997). Lesbian lives: Psychoanalytic narratives old and new.
Hillsdale, NJ: Analytic.
Marmor, J. (Ed.). (1965). Sexual inversion: The multiple roots of homosexuality. New
York: Basic Books.
Marmor, J. (1972). Homosexualitymental illnessor moral dilemma? International
Journal of Psychiatry. 10, 114-117.
Marmor, J. (Ed.). (1980). Homosexual behavior: A modern reappraisal. New York: Basic
Books.
McDougall, J. (2001). Gender identity and creativity. Journal of Gay and Lesbian Psychotherapy, 5(1), 5-28.
Mitchell, S.A. (1978). Psychodynamics, homosexuality, and the question of pathology. Psychiatry, 41, 254-263.
Mitchell, S.A. (1981). The psychoanalytic treatment of homosexuality: Some technical considerations. International Review Psycho-Analysis, 8, 63-80.
Money, J., Hampson, J.G., & Hampson, J.L. (1957). Imprinting and the establishment
of gender roles. Archives of Neurology and Psychiatry, 77, 333-336.
Morgenthaler, F. (1988). Homosexuality heterosexuality perversion A. Aebi (Trans.). P.
Moor (Ed.). Hillsdale, NJ: Analytic. (Original work published in 1984)
Nakajima, G.A. (2003). The emergence of an international lesbian, gay, and bisexual psychiatric movement. Journal of Gay and Lesbian Psychotherapy, 7(1/2),
165-188.
OConnor, N., & Ryan, J. (1993). Wild desires and mistaken identities: Lesbianism and
psychoanalysis. New York: Columbia University.
Ovesey, L. (1969). Homosexuality and pseudohomosexuality. New York: Science House.
Phillips, S.H. (1998). A new analytic dyad: Homosexual analyst, heterosexual patient. Journal of the American Psychoanalytic Association, 46, 1195-1219.
Phillips, S.H. (2001). The overstimulation of everyday life: I: New aspects of male homosexuality. Journal of the American Psychoanalytic Association, 49, 1235-1267.
Phillips, S.H. (2002). The overstimulation of everyday life: II. Male homosexuality,
countertransference, and psychoanalytic treatment. Annual of Psychoanalysis,
30, 131-145.
Rado, S. (1940). A critical examination of the concept of bisexuality. Psychosomatic
Medicine, 2, 459-467.
Roughton, R. (1995). Overcoming antihomosexual bias: A progress report. The Amer-

460

DRESCHER

ican Psychoanalyst, 29(4), 15-16.

Roughton, R. (2002). Rethinking homosexuality: What it teaches us about psychoanalysis. Plenary Address. Journal of the American Psychoanalytic Association,
50, 733-763.
Roughton, R. (2003). The International Psychoanalytical Association and homosexuality. Journal of Gay and Lesbian Psychotherapy, 7(1/2), 189-196.
Scasta, D.L. (2002). John E. Fryer, MD, and the Dr. H. Anonymous episode. Journal of
Gay and Lesbian Psychotherapy, 6(4), 73-84.
Schafer, R. (1995). The evolution of my views on nonnormative sexual practice. In T.
Domenici & R.C. Lesser (Eds.). Disorienting sexuality: Psychoanalytic reappraisals of sexual identities (pp. 187-202). New York: Routledge.
Schaffner, B. (1996). Modifying psychoanalytic methods when treating HIV-positive
patients. Journal of the American Academy Psychoanalysis, 25(1), 123-141.
Schwartz, A.E. (1998). Sexual subjects: Lesbians, gender, and psychoanalysis. New York:
Routledge.
Schwartz, D. (1993). HeterophiliaThe love that dare not speak its aim. Psychoanalytic Dialogues, 3, 643-652.
Schwartz, D. (1996). Questioning the social construction of gender and sexual orientation. Gender and Psychoanalysis, 1, 249-260.
Sherman, E. (2005). Notes from the margins: The gay analysts subjectivity in the treatment setting. Hillsdale, NJ: Analytic.
Socarides, C.W. (1968). The overt homosexual. New York: Grune & Stratton.
Socarides, C.W. (1995). Homosexuality: A freedom too far. Phoenix, AZ: Adam Margrave Books.
Stoller, R. (1968). Sex and gender. New York: Science House.
Szasz, T.S. (1960). The myth of mental illness. American Psychologist, 15, 113-118.
Szasz, T.S. (1965). Legal and moral aspects of homosexuality. In J. Marmor (Ed.),
Sexual inversion: The multiple roots of homosexuality (pp. 124-139). New York:
Basic Books.
Szasz, T.S. (1974). Ceremonial chemistry. New York: Anchor Books.
Ulrichs, K. (1864). The riddle of man-manly love. M. Lombardi-Nash (Trans.). Buffalo, NY: Prometheus Books. (Original work published in 1864)
Vaughan, S. (1999). The hiding and revelation of lesbian desire in lesbians: The lasting legacy of developmental traumas. Journal of Gay and Lesbian Psychotherapy,
3(2), 81-90.
Young-Bruehl, E. (1996). The anatomy of prejudices. Cambridge, MA: Harvard University Press.

420 West 23 Street, #7D

New York, NY 10011
jadres@psychoanalysis.net