By Paul Theerman, Associate Director, Center for the History of Medicine and Public Health

In the late 19^th century, new legal, criminal, and scientific frameworks emerged seeking to understand, define, and in some cases control, human sexuality. In particular, homosexual activity between men became illegal in many countries, which opened up discussion about what counted as “normal” or “deviant” sexual expression. A significant body of research work began to be generated, such as Richard von Krafft-Ebing’s Psychopathia Sexualis (1886), seeking to understand the range of human sexuality and arguing that “deviancy” should be treated as a medical rather than criminal issue.¹

Evelyn Hooker. Courtesy of UC Davis.

By the 20^th century, pioneering researchers like Evelyn Hooker (1907–1989) had begun to question whether homosexuality should be considered in medical terms. Hooker administered standard psychological tests to carefully selected groups of gay and straight men, who performed virtually identically. Her work was one in a series of investigations that eventually led to the removal of homosexuality from the list of mental disorders in the major official categorization of mental illness in the United States, the Diagnostic and Statistical Manual of Mental Disorders.

Born in Nebraska in 1907, Hooker went to the University of Colorado for her bachelor’s and master’s degrees in psychology. She undertook her Ph.D. work at Johns Hopkins, graduating in 1932. For the next eight years, she worked in a number of colleges, including Whittier College, was laid up with tuberculosis for two years, and had a fellowship year in Berlin. In 1940, she took up a research associate position at UCLA, where she remained for the next 30 years.²

Teaching was part of her purview. As the story goes, a friendship with a student who was gay, struck up in the mid-1940s, led to the student’s request that she research the gay community in Los Angeles. By 1953 she felt ready to do a controlled study, aided by a grant from the National Institute of Mental Health (NIMH). She assembled a group of 60 men, equal numbers of gay and straight, and matched for age, IQ, and education. In addition, the subjects had to be otherwise mentally healthy, that is, not in therapy nor showing any obvious mental disturbance. Finally, all were supposed to be “pure” in their orientation: purely heterosexual or purely homosexual. To this group, Hooker administered the Rorschach test, the Thematic Apperception Test (TAT), and the Make-A-Picture Story (MAPS) test, designed to measure personality, emotional stability, and coherence of thought. Recognized psychological experts evaluated the tests. After reviewing the results, Hooker found that they could not distinguish the tests completed by gay men from those by straight men. Any mental illness in this group was as likely to be found among heterosexual men as among homosexual ones.³

“Table II—Ratings on Overall Adjustment—Rorschach.” In Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques 21 (1958): 18-31. Click to enlarge.

Hooker presented her results at the 1956 meeting of the American Psychological Association. The editors of the Journal of Projective Techniques persuaded her to publish the results despite her wish to continue work until they were “incontrovertible.”⁴ In the following years, she continued to work and publish on the topic of gay men’s mental health—women were very little studied, the researchers themselves noted—with continued support from the NIMH. In 1967, the director of the NIMH, Dr. Stanley F. Yolles, appointed her the chair of the Institute’s Task Force on Homosexuality. Two years later, the task force finished its work. Its report concluded that “Homosexuality represents a major problem for our society largely because of the amount of injustice and suffering entailed in it, not only for the homosexual but also for those concerned about him.”⁵ It recommended establishing a Center for Study of Sexual Behavior within NIMH, to support research and training especially for mental health professionals, law enforcement personnel, and guidance and caretaking personnel.

Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques 21 (1958): 18.

And yet . . . if gay people didn’t track differently than straight people on a whole range of mental disorders, they definitely did in one instance, according to the diagnostic standards of the times. Homosexuality itself was considered to be a mental disorder. And as jarring as it is to see, the same task force report from 1969 included as its final working paper “Treatment of Homosexuals,” detailing psychoanalytic, group, and drug- and electric shock–based aversion therapies, all intended to redirect sexual orientation.⁶ At the same time, though, countervailing political and cultural forces pushed towards acceptance of homosexuality, its normalization and de-medicalization. A recent New York Times article captures some of that flavor, expressed in the pre-Stonewall 1960s. As is well known, the Diagnostic and Statistical Manual included homosexuality as a mental disorder as late as its second edition in 1968; the American Psychiatric Association removed this designation in 1973, and the third edition of the DSM, published in 1980, included only the disorder “ego-dystonic homosexuality,” for those gay people uncomfortable with their orientation.⁷ By the 1987 revision of DSM, this condition was further downgraded to a “disorder not otherwise specified.”⁸

“Other Psychosexual Disorders. 302.00 Ego-dystonic Homosexuality,” American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (Third Edition) (Washington, DC: American Psychiatric Association, 1980), p. 281.

Evelyn Hooker went on to be a beloved mentor, especially for psychiatrists and psychologists interested in gay studies.⁹ She was the subject of a 1991 documentary, Changing our Minds: The Story of Dr. Evelyn Hooker,¹⁰ and the recipient of many awards, including the Distinguished Contribution in the Public Interest Award of the American Psychological Association. She passed away in 1996.

References

1. A brief introduction to the history of sexology can be found at The Kinsey Institute, which continues to explore sexual health and knowledge worldwide: www.kinseyinstitute.org/resources/sexology.html. See also APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation, Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation (Washington, DC: American Psychological Association, 2009), especially chapter 2, “A Brief History of Sexual Orientation Change Efforts,” pp. 21–25; Jonathan Katz’s Gay American History: Lesbians and Gay Men in the U.S.A. (1976; reprint ed., New York: New American Library, 1992) and The Invention of Heterosexuality (New York: Dutton, 1995); and Jennifer Terry, An American Obsession: Science, Medicine, and Homosexuality in Modern Society (Chicago: The University of Chicago Press, 1999).

2. Biographical material on Evelyn Hooker, here and below, comes from “Psychology’s Feminist Voices: Evelyn Gentry Hooker,” http://www.feministvoices.com/evelyn-gentry-hooker/, accessed June 10, 2015.

3. Evelyn Hooker, “The Adjustment of the Male Overt Homosexual,” Journal of Projective Techniques 21 (1958): 18-31.

4. Ibid., quotation from footnote on page 18.

5. National Institute of Mental Health Task Force on Homosexuality, Final Report and Background Papers, edited by John M. Livingood (Rockville, MD: U.S. Dept. of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, 1972), quotation from page 2.

6. NIMH Task Force on Homosexuality, Final Report: Task Force Working Papers, “Treatment of Homosexuals,” by Jerome D. Frank, pp. 63–68.

7. APA Task Force, Report, p., 23; American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (Third Edition) (Washington, DC: American Psychiatric Association, 1980), pp. 281–83.

8. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (Third Edition–Revised) (Washington, DC: American Psychiatric Association, 1987), p. 296.

9. See in particular, Linda D. Garnets and Douglas C. Kimmel, eds., Psychological Perspectives on Lesbian, Gay, and Bisexual Experiences, 2^nd ed. (New York: Columbia University Press, 2003), especially the chapter “What a Light It Shed: The Life of Evelyn Hooker,” by Garnets and Kimmel.

10. Changing Our Minds: The Story of Dr. Evelyn Hooker, directed by Richard Schmiechen, DVD, 75 mins. (San Francisco: Frameline, 1991).