In 1973, after several years of bitter dispute, the board of trustees of the American Psychiatric Association (APA) decided to remove homosexuality from the Diagnostic and Statistical Manual of Psychiatric Disorders, its official list of mental diseases.

Infuriated by that action, dissident psychiatrists charged the leadership of their association with an unseemly capitulation to the threats and pressures of gay liberation groups and forced the board to submit its decision to a referendum of the full APA membership. And so America's psychiatrists were called to vote upon the question of whether homosexuality ought to be considered a mental disease. The entire process, from the first confrontations organized by gay demonstrators at psychiatric conventions to the referendum demanded by orthodox psychiatrists, seemed to violate the most basic expectations about how questions of science should be resolved. Instead of being engaged in a sober consideration of data, psychiatrists were swept up in a political controversy. The APA, according to its critics, had fallen victim to the disorder of a tumultuous era in which disruptive conflicts threatened to politicize every aspect of American social life. A furious egalitarianism, which challenged every form of authority, had compelled psychiatric experts to negotiate the pathological status of homosexuality with homosexuals themselves. The result was not a conclusion based on an approximation of the scientific truth as dictated by reason but an action demanded by the ideological temper of the times.

To those who viewed the 1973 decision sympathetically, psychiatry had displayed a remarkable capacity to acknowledge the significance of new research findings and to rethink its approach to sexuality.