Dr.
Robert L. Spitzer, considered by some to be the father of modern psychiatry,
lay awake at 4 o’clock on a recent morning knowing he had to do the one thing
that comes least naturally to him.
He
pushed himself up and staggered into the dark. His desk seemed impossibly far
away; Dr. Spitzer, who turns 80 next week, suffers from Parkinson’s disease and has trouble walking, sitting,
even holding his head upright.
The
word he sometimes uses to describe these limitations — pathetic — is the same
one that for decades he wielded like an ax to strike down dumb ideas, empty
theorizing and junk studies.
Now
here he was at his computer, ready to recant a study he had done himself, a
poorly conceived 2003 investigation that supported the use of so-called
reparative therapy to “cure” homosexuality for people strongly motivated to
change.
What
to say? The issue of gay marriage was rocking national politics yet again. The
California State Legislature was debating a bill to ban the therapy outright as
being dangerous. A magazine writer who had been through the therapy as a
teenager recently visited his house, to explain how miserably disorienting the
experience was.
And
he would later learn that a World Health Organization report,
released on Thursday, calls the therapy “a serious threat to the health and
well-being — even the lives — of affected people.”
Dr.
Spitzer’s fingers jerked over the keys, unreliably, as if choking on the words.
And then it was done: a short letter to be published this month, in the same
journal where the original study appeared.
“I
believe,” it concludes, “I owe the gay community an apology.”
Disturber
of the Peace
The
idea to study reparative therapy at all was pure Spitzer, say those who know
him, an effort to stick a finger in the eye of an orthodoxy that he himself had
helped establish.
In
the late 1990s as today, the psychiatric establishment considered the therapy
to be a nonstarter. Few therapists thought of homosexuality as a disorder.
It
was not always so. Up into the 1970s, the field’s diagnostic manual classified
homosexuality as an illness, calling it a “sociopathic personality disturbance.” Many
therapists offered treatment, including Freudian analysts who dominated the
field at the time.
Advocates
for gay people objected furiously, and in 1970, one year after the landmark
Stonewall protests to stop police raids at a New York bar, a team of gay rights
protesters heckled a meeting of behavioral therapists in New York to discuss
the topic. The meeting broke up, but not before a young Columbia University
professor sat down with the protesters to hear their case.
“I’ve
always been drawn to controversy, and what I was hearing made sense,” said Dr.
Spitzer, in an interview at his Princeton home last week. “And I began to
think, well, if it is a mental disorder, then what makes it one?”
He
compared homosexuality with other conditions defined as disorders, like depression and alcohol dependence, and saw immediately that the
latter caused marked distress or impairment, while homosexuality often did not.
He
also saw an opportunity to do something about it. Dr. Spitzer was then a junior
member of on an American Psychiatric Association committee helping to rewrite
the field’s diagnostic manual, and he promptly organized a symposium to discuss
the place of homosexuality.
That
kicked off a series of bitter debates, pitting Dr. Spitzer against a pair of
influential senior psychiatrists who would not budge. In the end, the
psychiatric association in 1973 sided with Dr. Spitzer, deciding to drop
homosexuality from its manual and replace it with his alternative, “sexual
orientation disturbance,” to identify people whose sexual orientation, gay or
straight, caused them distress.
The
arcane language notwithstanding, homosexuality was no longer a “disorder.” Dr.
Spitzer achieved a civil rights breakthrough in record time.
“I
wouldn’t say that Robert Spitzer became a household name among the broader gay
movement, but the declassification of homosexuality was widely celebrated as a
victory,” said Ronald Bayer of the Center for the History and Ethics of Public
Health at Columbia. “ ‘Sick No More’ was a headline in some gay
newspapers.”
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