part0013

A ttitudes to homosexuality, in the West and elsewhere, have undergone nothing short of a revolution in the past few decades.

First published in 1968, the second revision of the American classification of mental disorders (DSM-II), still listed homosexuality as a mental disorder. In this, the DSM followed in a long tradition in medicine and psychiatry, which in the nineteenth century appropriated homosexuality from the Church and, in what must then have seemed like an élan of enlightenment, transformed it from sin to mental disorder.

In the 1950s and 60s, some therapists employed aversion therapy of the kind depicted in A Clockwork Orange (1971) to ‘cure’ male homosexuality. This typically involved showing ‘patients’ pictures of naked men while giving them electric shocks or emetics (drugs to make them vomit), and, once they could no longer bear it, showing them pictures of naked women or sending them out on a ‘date’ with a nubile nurse. Needless to say, these cruel and degrading methods proved entirely ineffective .

In 1973, the American Psychiatric Association (APA) asked all members attending its annual convention to vote on whether they believed homosexuality to be a mental disorder. 5,854 psychiatrists voted to remove homosexuality from the DSM, and 3,810 to retain it. The APA then compromised, removing homosexuality from the DSM but replacing it, in effect, with ‘sexual orientation disturbance’ for people ‘in conflict with’ their sexual orientation. Not until 1987 did homosexuality completely fall out of the DSM.

Meanwhile, the World Health Organization in Geneva only removed homosexuality from its International Classification of Diseases (ICD) with the publication of ICD-10 in 1992, although ICD-10 still carried the construct of ‘ego-dystonic sexual orientation’. In this ‘condition’, the person is not in doubt about his or her sexual preference, however ‘wishes it were different because of associated psychological and behavioural disorders’.

The evolution of the status of homosexuality in the classifications of mental disorders highlights that concepts of mental disorder can be rapidly evolving social constructs that change as society changes—an idea that I develop in The Meaning of Madness .

In 1989, Denmark became the first country to offer legal recognition for same-sex couples; then in 2001 the Netherlands became the first country to legalize same-sex marriage. In most of the UK, civil partnerships have been available to same-sex couples since 2005, and marriage since 2014. In 2015, the European Parliament passed a resolution, by 472 to 115 votes, calling upon Member States to ‘further contribute to reflection on the recognition of same-sex marriage or same-sex civil union as a political, social and human and civil rights issue. ’

Over in the US, in 2000, Vermont became the first state to legalize civil unions; then in 2004, just four years later, Massachusetts became the first state to legalize same-sex marriage. On June 26, 2013, the US Supreme Court ruled against the Defence of Marriage Act, which barred federal recognition of same-sex marriage. Two years later on the same day, it ruled against state level bans on same-sex marriage, legalizing same-sex marriage across the country. According to Pew Research Center polling, in 2001, 57% of Americans opposed gay marriage and 35% supported it; by 2019, 61% supported it and only 31% opposed it.

As I write, same-sex marriage is legal in the United States, Canada, the United Kingdom (including since 2020 Northern Ireland), many European countries, many Latin American countries, Australia, New Zealand, and South Africa. Many other territories including Israel, Italy, and Japan offer an alternative form of recognition such as a civil union, registered partnership, or other similar construct.

But same-sex sexual relations, let alone marriage, remain illegal in many parts of Africa, the Middle East, the Caribbean, and Central, South, and Southeast Asia, in some cases punishable with life imprisonment or even death. In recent years, several African countries have been softening their stance, but a few have hardened it and even, in the case of Chad and Gabon, gone so far as to criminalize ‘sodomy’ (anal intercourse). In countries like China and Russia, same-sex sexual relations are legal, but LGBT people face substantial legal and social challenges.

Many people think of same-sex marriage as a historical first—except, of course, that it isn’t. Same-sex marriage was practised and accepted among many precolonial peoples (Chapter 5); in Ancient Mesopotamia and perhaps also Ancient Egypt (Chapter 8); and in Fujian province during the Ming dynasty.

In Ancient Rome, same-sex marriage, after three centuries on the trot, was, in 342 CE, explicitly outlawed by the co-emperors Constantius II and Constans—although, according to the historian Aurelius Victor (d. 390 CE), Constans himself had a reputation for ‘scandalous behaviour with handsome barbarian hostages’. The father of the co-emperors, Constantine the Great, had converted to Christianity on his deathbed, and it is worth noting that the return of same-sex marriage in our age, after an absence of almost 1,700 years, corresponds with an ebbing of Christianity from the West.

In Ancient Athens, aristocratic men such as Agathon and Pausanias, who both feature in Plato’s Symposium , went beyond the pederastic tradition of mentoring young males by forming lifelong same-sex partnerships.