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Historical Background
In the beginning of the 19th century, people began studying homosexuality scientifically. At this time, most theories regarded homosexuality as a disease, which had a great influence on how it was viewed culturally. There was a paradigm shift in the mid 20th century in psychiatric science in regards to theories of homosexuality. Psychiatrists began to believe homosexuality could be cured through therapy, and other theories about the genetic and hormonal origin of homosexuality were becoming accepted. There were variations of how homosexuality was viewed and it was not universally viewed as pathological. Some early psychiatrists such as Sigmund Freud and Havelock Ellis adopted more accepting stances on homosexuality. Freud and Ellis believed that homosexuality was a normal outcome of development for some people. Alfred Kinsey's research and publications about homosexuality began the social and cultural shift away from viewing homosexuality as an abnormal condition. These shifting viewpoints in the psychological studies of homosexuality are evident in its placement in the first version of the Diagnostic Statistical Manual (DSM) in 1952, and subsequent removal in 1973.

Freud and Psychoanalysis
Sigmund Freud's views on homosexuality were complex. In his attempts to understand the causes and development of homosexuality, he first explained bisexuality as a normal part of the “original libido endowment”, by which he meant that all humans are born bisexual. He believed that the libido has a homosexual portion and a heterosexual portion, and through the course of development one wins out over the other. He also believed in a basic biological explanation for natural bisexuality in which humans are all biologically capable of being aroused by either sex. Because of this he described homosexuality as one of many sexual options available to people. Freud proposed that humans’ inherent bisexuality leads individuals to eventually choose which expression of sexuality is more gratifying, but because of cultural taboos homosexuality is repressed in many people. According to Freud, if there were no taboos people would choose whichever was more gratifying to them- and this could remain fluid throughout life- sometimes a person would be homosexual, sometimes heterosexual.

Some other causes of homosexuality for which he advocated included an inverted Oedipus complex where individuals begin to identify with their mother and take themselves as a love object. This love of ones self is defined as narcissism, and Freud thought that people who were high in the trait of narcissism would be more likely to develop homosexuality because loving the same sex is like an extension of loving oneself.

Freud believed treatment of homosexuality was not successful because the individual does not want to give up their homosexual identity because it brings them pleasure.He used analysis and hypnotic suggestion as treatments, but showed little success. It was through this that Freud arrived at the conclusion that homosexuality was “noting to be ashamed of, no vice, no degradation, it cannot be classified as an illness, but a variation of sexual function”. He further stated that psychoanalysts “should not promise to abolish homosexuality and make normal heterosexuality take its place” as he had concluded in his own practice that attempts to change homosexual orientations were likely to be unsuccessful. While Freud himself may have come to a more accepting view of homosexuality, his legacy in the field of psychoanalysis, especially in the united states viewed homosexuality as negative, abnormal and caused by family and developmental issues. It was these views that significantly impacted the rationale for putting homosexuality in the first and second publications of the American Psychiatric Association’s DSM, conceptualizing it as a mental disorder and further stigmatizing homosexuality in society

Havelock Ellis
Havelock Ellis (1859-1939) was working as a teacher in Austria, when he had a revelation that he wanted to dedicate his life to exploring the issue of sexuality. He returned to London in 1879 and enrolled in St. Thomas’s Hospital Medical School. He began to write, and in 1896 he co-authored Sexual Inversion with John Addington Symonds, which was first published in German, and a year later it was translated into English. Their book explored homosexual relationships, and in a progressive approach for their time they refused to criminalize or pathologize the acts and emotions that were present in homosexual relationships.

Ellis disagreed with Freud on a few points regarding homosexuality, especially regarding its development. He argued that homosexuals do not have a clear cut Oedipus complex but they do have strong feelings of inadequacy, born of fears of failure and may also be afraid of relations with women. Ellis argued that the restrictions of society contributed to the development of same-sex love. He believed that homosexuality is not something people are born with, but that at some point humans are all sexually indiscriminant, and then narrow down and choose which sex acts to stick with. According to Ellis, some people choose to engage in homosexuality, while others will choose heterosexuality. He proposed that being “exclusively homosexual” is to be deviant because the person is a member of a minority and therefore statistically unusual, but that society should accept that deviations from the “normal” were harmless, and maybe even valuable. Ellis believed that psychological problems arose not from homosexual acts alone, but from when someone “psychologically harms himself by fearfully limiting his own sex behavior”.

Ellis is often attributed with coining the term “homosexuality” but in reality he despised the word because it conflated Latin and Greek roots and instead used the term “invert” in his published works. Soon after Sexual Inversion was published in England it was banned as lewd and scandalous. Ellis argued that homosexuality was a characteristic of a minority, and was not acquired or a vice and was not curable. He advocated changing the laws to leave those who chose to practice homosexuality at peace, because at the time it was a punishable crime. He believed societal reform could occur, but only after the public was educated. HIs book book became a landmark in the understanding of homosexuality.

Alfred Kinsey
Alfred Charles Kinsey (1984- 1956) was a sexologist who founded the Institute for Sex Research, which is now known as the Kinsey Institute for Research in Sex, Gender and Reproduction. His explorations into different sexual practices originated from his study of the variations in mating practices among wasps. He developed a the Kinsey Scale, which measures sexual orientation in ranges from 0 to 6 with 0 being exclusively heterosexual and 6 being exclusively homosexual. His findings indicated that there was great variability in sexual orientations. Kinsey published books titled Sexual Behavior in the Human Male, and Sexual Behavior in the Human Female, which brought him a lot of fame and controversy. The prevailing approach to homosexuality at the time was to pathologize and attempt to change homosexuals. Kinsey’s book demonstrated that homosexuality was more common than was assumed, suggesting that these behaviors are normal and part of a continuum of sexual behaviors.

The Diagnostic and Statistical Manual
The social, medical and legal approach to homosexuality ultimately led for its inclusion in the first and second publications of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). This served to conceptualize homosexuality as a mental disorder and further stigmatize homosexuality in society. However, the evolution in scientific study and empirical data from Kinsey, Evelyn Hooker and others confronted these beliefs, and by the 1970’s psychiatrists and psychologists were radically altering their views on homosexuality. Tests such as the Rorschach, Thematic Apperception Test (TAT) and the Minnesota Multiphasic Personality Inventory (MMPI) indicated that homosexual men and women were not distinguishable from heterosexual men and women in functioning. These studies failed to support the previous assumptions that family dynamics, trauma and gender identity were factors in the development of sexual orientation. In light of the overwhelming data, as well as changing social norms, the Board of Directors for the American Psychiatric Association removed homosexuality as a mental disorder from the DSM in 1973.