Sexuality, Therapeutic Culture, and Family Ties in the United States After 1973

In 1973, the American Psychiatric Association voted to remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (2nd ed.; DSM-II; American Psychiatric Association, 1968). Clinicians subsequently began conducting psychotherapy with gays and lesbians not in order to change their sexuality but to address the psychological effects of homophobia and associated problems. Family-related issues such as the impact of coming out to relatives became an important dimension of psychotherapy that normalized same-sex desire, identity, and relationships, even amid contemporary invocations of family values as grounds for opposing gays and lesbians' political claims. This article examines family therapy's gradual recognition of gay and lesbian families as emblematic of the historically changing relationship among psychotherapy, sexuality, and family during the 1970s to 1990s. Although early family therapists of the 1950s and 1960s were largely unconcerned with treating homosexuality as a psychiatric problem, they also generally did not recognize same-sex relationships as a possible configuration of family life because their models presumed a heterosexual nuclear family. By the 1980s and 1990s, many family therapists came to see sexuality as a dimension of family life that might shape the issues for which couples and families sought treatment but that did not warrant treatment itself. Homosexuality's depathologization in 1973 thus signaled the opening, not the closing, of lesbian and gay issues in family therapy because the cultural trends and social movements that led to homosexuality's removal from the DSM-II would, by the 1990s, also contribute to expanding family therapists' notion of "family."