The lasting legacy of Dr Anonymous

In 1973 the American Psychiatric Association removed homosexuality from the Diagnostic and Statistical Manual. In doing so it rid those gay men and women living in America and the western world (and wherever else the DSM found itself as the authority on mental health) from 'illness'. Or as a headline from the Chicago Gay Crusader put it, '20,000,000 Gay People cured!'. The path to the de-medicalisation of homosexuality was a long and winding one, so this article will focus on one story in particular. The story of the 1972 APA convention, or the story of how a man in an oversized tuxedo can change the world.         

Psychiatry and homosexuality

Before the formation of the DSM-I in 1952, homosexuality was already considered by many experts as an illness. In the 1940s psychoanalysts such as Sandor Rado argued that homosexuality was a phobic condition. By the time of the DSM-I homosexuality was sufficiently pathologised to be included as a 'Sociopathic Personality Disorder'. 

Despite what we might see as apparent hostility from the psychiatric community towards homosexuals, many gay men and women welcomed this diagnostic label. Psychiatry had the ability to shift the perspective of homosexuality from a criminal and unnatural perversion to a genuine illness. Many reasoned it was better to be viewed as ill than as a criminal, a position took by many early 'homophile' groups. Formed in 1950, the male-centric Mattachine Society hosted talks from eminent psychiatrists such as Albert Ellis, who supported the notion of homosexuality as a phobic condition. The Mattachines also frequently welcomed articles by those with such views in their journal The Mattachine Review. Additionally, the mission statement of The Daughters of Bilitis, a pro-lesbian group founded in 1955, stated the group's commitment to sponsoring discussions with psychiatrists and other professionals.

For many gay men and women, the presence of a diagnostic label was important for reasons other than just the shift it brought to society's perspective on homosexuality. If their orientation was an illness, then there could be a 'cure'. Conversion therapies were popular among many psychiatrists and homosexuals distressed by their orientation. Psychiatrists such as Charles W. Socarides, an ardent critic of the removal of homosexuality from the DSM, claimed to have 'cured' homosexuality in numerous individuals. These 'conversion' therapies included aversion therapies and more traditional talking therapies.    

'We are the true authorities on homosexuality'  

This congeniality began to change, however, as the 1950's wore on. For both the Daughters of Bilitis and The Mattachine Society the publication of psychoanalyst Edmund Bergler's book Homosexuality: A disease or a way of life in 1957 proved a step too far. Both organisations roundly criticised Bergler's views on homosexuality as an illness. This was in part due to the more extreme slant of the views, but also due to the changing attitudes among many activists. By the time the DSM-II was published in 1968, recategorising homosexuality as a 'paraphilia', psychiatry had become a key target of many gay activists, such as Frank Kameny and Barbra Gittings.

Kameny began his career in activism after he was fired by the US Army Map Service for his sexuality in 1957. Kameny, unlike early homophile groups, was not content to gain equality through dialogue alone and instead encouraged protests, pickets and the leafleting of those organisations and institutions which worked to oppress the gay community. For Kameny, this meant psychiatry and the APA. In his mind the whole success of the gay rights movement rested upon removing the diagnostic label from homosexuality and wrestling the authority of homosexuality away from psychiatrists and placing it back within the gay community. Kameny summed his opinion thus: 'We are the true authorities on homosexuality whether we are accepted as it or not'.

Gittings, the editor of Daughters of Bilitis' journal The Ladder and founder of its New York branch, also believed that strong activism was needed. Unlike Kameny, however, she was less oppositional to the psychiatric movement. Until, that was, she attended a convention hosted by the East Coast Homophile Organization in 1963. Dr Ellis was invited to speak, as he often was by such organisations, about his belief in curing homosexuality. After him, Kameny was set to speak. Kameny used this opportunity to deliver a rebuttal of Ellis's views and instead suggested there was no valid evidence for homosexuality as an illness. In fact, research by Evelyn Hooker and Alfred Kinsey supported the opposite conclusion. Hooker's work suggested homosexual men were clinically indistinguishable from heterosexual men whilst Kinsey's extensive interviews with American men and women suggested that homosexual acts were far more common than once believed. Gittings later recalled: 'My thinking didn't change until Frank Kameny came along and said plainly… homosexuality is no sickness'. This represented an important ideological shift for an activist with strong influence within the gay rights movement.  

Kameny and Gittings helped place psychiatry clearly within the crosshairs of the new, more active gay rights organisations. As the 1960's progressed psychiatrists found themselves facing a more and more hostile environment. Psychiatrists now found the people, who only years before were happy to listen to them discuss the pathology of same-sex attraction, picketing outside their offices, disrupting their conferences and leafletting their lectures. The Stonewall riots in 1969 furthered this activism.

Then in 1970 the American Psychiatric Association made the decision to host its annual convention in San Francisco, a hub of gay rights activism. Naturally, for gay activists, the opportunity could not be passed up, and the decision was made to protest the convention.  Activists picketed outside whilst others disrupted expert panels on homosexuality and confronted those psychiatrists who propagated the notion of homosexuality as an illness. Despite the APA allowing Kameny and Gittings to host a limited panel at the 1971 APA convention, protests still occurred, this time with activists storming the podium of its opening ceremony. By the time of the 1972 convention, the APA realised that the only way to avoid more disruptions would be to allow gay activists a more prominent voice within proceedings. The activists were given a booth in the conventions scientific hall and another panel, one that was to include activists and psychiatrists.

Psychiatry: Friend or foe to the homosexual? A dialogue

The task of organising the panel, named 'Psychiatry: Friend or Foe to the Homosexual? A Dialogue', was left to Gittings, who had no hesitation in inviting Kameny back once again to speak. Gittings also asked several psychiatrists who supported the removal of homosexuality from the DSM to speak. Once the panel was arranged and its members secured, Gittings partner noted one major flaw with the line-up; it did not contain a gay psychiatrist. After searching, Gittings happened upon Dr John Fryer. 

Dr Fryer was a gifted psychiatrist with a keen interest in end of life care. Prior to Gittings call, he had been fired from two separate institutions due to his sexuality. One boss who had discovered his sexuality had reasoned that whilst it might have been acceptable to employ someone who was camp (which they believed Fryer to be) and it might even have been acceptable to hire someone who was gay, it was not acceptable to hire someone who was both. Keen not to lose another position Fryer originally turned Gittings down. It was only after months of subsequent rejections that Gittings once again contacted Fryer, begging for his help. Fryer agreed on the condition he could be disguised.   

In crafting his disguise Fryer turned to a friend of his, a drama major. He recommended an oversized tuxedo to hide Fryer's frame (Fryer, it has been noted, was an imposing man). To disguise his face, it was decided that a latex mask, disfigured beyond all recognition and topped with a curly wig, would be used. For that honour, a mask of Richard Nixon was chosen. On the day of the panel, Fryer used a voice-distorting microphone to deliver his speech. All these precautions ensured that it would not be Fryer who addressed the filled hall, but 'Dr Henry Anonymous'. His disguise also served another purpose – by hiding Fryer it allowed him to speak on behalf of all gay psychiatrists not just himself.  

At the panel, each member spoke about the need to remove homosexuality from the DSM. The psychiatrists on the panel argued that the evidence for homosexuality as a pathology was limited and biased. Kamney asked the psychiatrists to ally themselves with the gay activists, and Gittings, foreshadowing Dr Anonymous, spoke of the gay psychiatrists operating within the profession. Then Dr Anonymous spoke.

'I am homosexual, I am a psychiatrist', Dr Anonymous began. 'I, like most of you in this room, am a member of the APA and am proud of that membership'. He explained how, for the hundreds of gay psychiatrists present at the convention (the self-styled 'Gay PA'), only by ensuring that 'no one in a position of power is aware of our sexual preference or gender identity' could they hope to thrive in their profession.

Dr Anonymous continued by highlighting the difficulties involved in trying to keep a coherent sense of health when by being gay you were technically ill. He pointed to the irony that many gay psychiatrists 'work 20 hours daily to protect institutions who would literally chew us up and spit us out'.

Then Dr Anonymous addressed the members of the 'Gay PA'. He tasked them with showing 'creative ingenuity' in challenging the status quo and implored them to 'pull your courage up by your bootstraps…for we all have something to lose'.

Finally, Dr Anonymous noted the loss to humanity that was being inflicted by forcing gay psychiatrists to hide their identity. 'We are taking…a risk, however, in not living full our humanity, with all of the lessons it has to teach all other humans around us'.  He finished his speech by declaring that gay psychiatrists must 'use our skills and wisdom to help them [Heterosexuals] and us grow to be comfortable with that little piece of humanity called homosexuality.'

After his speech, Dr Anonymous received a standing ovation. Later Fryer noted that just a few rows from the front, amongst the psychiatrists applauding Dr Anonymous' bravery and candid wisdom, was that official who had fired him for being both gay and flamboyant.  

The 1973 decision

Homosexuality was removed from the DSM in 1973 and replaced with 'ego-dystonic homosexuality'. The APA reasoned that whilst being gay was not inherently pathological, it did bring with it the possibility of unique mental health issues caused by the distress of same-sex attraction.

The actual practical process of its removal was aided heavily by an encounter between gay activist Ron Gold and Charles Spitzer, a junior member of the APA's nomenclature committee (the committee tasked with determining what conditions made the DSM) in 1972.  Whilst this is another story for another time, Fryer's speech is cited as a key factor behind the momentum and attitude change within the APA that facilitated its removal of homosexuality from the DSM. All mentions of homosexuality were eventually removed from the DSM in 1987.

The removal of the sickness label was a watershed moment for the LGBTQ community and a key victory in their struggle against prejudice. Not only did it aid in the integration of gay individuals into healthy society it also shifted the psychological focus of homosexuality away from an exclusively clinical setting and into the everyday – something that the emergent field of LGBTQ psychology has built upon.  

Fryer was officially recognised as Dr Anonymous at 1994 APA convention. Fryer died in 2003. In his honour the APA now grants the 'Fryer Award' to individuals who significantly contribute to improving the health of sexual minorities. The award doesn't specify if these individuals need to do so whilst wearing the distorted mask of a former US president. 

- Cade Anderson-Smith is a first-year undergraduate at Goldsmiths, University of London, studying for a BSc in Psychology with Clinical Psychology. E-mail: [email protected]

Photo: Barbara Gittings, Frank Kameny, and John Fryer in disguise as "Dr. H. Anonymous" in a photo taken by Kay Tobin Lahusen.

Key sources

Bayer, R. (1981). Homosexuality and American psychiatry: the politics of diagnosis (1st ed.). New York: Basic Books.

Clarke, V., Ellis, S. J., Peel, E., & Riggs, D. W. (2014). Lesbian, Gay, Bisexual Trans & Queer Psychology (3rd ed.). Cambridge: Cambridge University Press.

LGBT Issues Committee (n.d.). The History of Psychiatry & Homosexuality. Retrieved from http://www.aglp.org/gap/1_history/

Soares, M. (1998). The Purloined Ladder. Journal of Homosexuality, 34(3-4), 27-49.

Speech of Dr. Henry Anonymous (John Fryer). (n.d.). Retrieved from https://217boxes.com/speech/

Spiegel, A (Writer and Narrator). (2002, January). 81 Words [Radio Program]. In I. Glass (Host), This American Life. Chicago, IL: Chicago Public Radio.