Editors' Note: Guest blogger Jack Drescher, M.D. is a psychiatrist and psychoanalyst in private practice in New York City. He is a Distinguished Fellow of the American Psychiatric Association, and presently serves as a Consultant to APA's Committee on Public Affairs. He is a member of the DSM-V Workgroup on Sexual and Gender Identity Disorders. He is the author of Psychoanalytic Therapy and the Gay Man (The Analytic Press) and has edited twenty books dealing with gender, sexuality and the health and mental health of LGBT communities.
A recent New York Times op-ed by David Blankenhorn and Jonathan Rauch, usually on opposing sides of the marriage equality debate, suggests a compromise solution to one of the most contentious social issues of our time:
They write, "Congress would bestow the status of federal civil unions on same-sex marriages and civil unions granted at the state level, thereby conferring upon them most or all of the federal benefits and rights of marriage. But there would be a condition: Washington would recognize only those unions licensed in states with robust religious-conscience exceptions, which provide that religious organizations need not recognize same-sex unions against their will. The federal government would also enact religious-conscience protections of its own. All of these changes would be enacted in the same bill."
The LGBT community's mixed reactions to this "modest proposal" brings to mind a story of King Solomon, once asked to resolve the issue of maternity between two women claiming the same child. "Cut the baby in two and give each woman a half," was his solution. The real mother objected and asked to spare the child and give it to the other woman. Solomon acknowledged her as the true mother and gave her custody of the child.
It is not clear today who in the LGBT community is the "true mother" of the marriage equality movement. Those who advocate for full equality and insist on going without any protections at all until they get all its benefits, or those who think half a baby is better than none?
I favor an incremental approach based on events following a historical watershed in gay civil rights: the 1973 removal of homosexuality from the American Psychiatric Association's diagnostic manual, the DSM.
At the time, the APA decision was highly contentious, pitting psychiatrists of different theoretical persuasions against each other. When the dust cleared, homosexuality was out, although not entirely. In its place stood a diagnosis first called "sexual orientation disturbance" and later renamed as "ego-dystonic homosexuality" (EDH).
EDH was APA's Solomonic compromise to keep the organization intact. It meant that only homosexuals unhappy about their sexuality were mentally ill and provided cover (and insurance reimbursement) to psychiatrists who would still "treat" their gay patients for "homosexuality. " The rest of us gay folks were perfectly fine, thank you very much.
Frank Kameny, a gay activist who played a pivotal role in the APA decision of 1973, had no objection to the new category. He thought anyone distressed at being homosexual was "clearly crazy and in need of treatment by a gay counselor to get rid of societally induced homophobia."
Yet, by 1987, with little resistance from within APA, ego dystonic homosexuality was also taken out of a revised DSM. Why was there no battle this time around?
The EDH compromise made it possible for LGB psychiatrists to come out and openly participate in the APA. Their straight colleagues got to know them and to hear, understand and respect their points of view. The political conditions necessitating a compromise in 1973 no longer existed and in a gay-friendlier APA, no one objected when it was pointed out that unhappiness about one's homosexuality is hardly grounds for calling someone mentally ill.
Despite its imperfections, a federal compromise on marriage along the lines suggested by Blankenhorn and Rauch could go a long way in changing the straight public's perception of gay people. It would make it safer for more gay people to come out. Although it would not change attitudes overnight, it would inevitably lead to change. Perhaps not fast enough for some people, but soon enough for me.