In 1973 homosexuality was replaced in the DSM, not deleted, and the chair called the dispute a value judgment
Spitzer, who chaired the process, wrote in 1981 that the 1973 removal was a compromise: homosexuality was "replaced by the category Sexual Orientation Disturbance", and what was at issue was "a value judgment about heterosexuality".
Weak or heavily disputed. Treat as a question, not an answer. how we score evidence
Caveat on this rating: A participant's account of a process he chaired. The paper reports no data and takes a position; the opposing position was argued in the same journal in the May 1973 symposium (PMID 4784866, record only, not read). The DSM-III category the paper discusses stayed in the manual until 1987.
The person who ran the 1973 process wrote down, eight years later, what he thought had actually been decided. It is shorter and less triumphant than the story usually told.
Significant findings
Robert Spitzer chaired the nomenclature work that took homosexuality out of DSM-II. His 1981 paper in the American Journal of Psychiatry opens with the record: "In 1973 homosexuality per se was removed from the DSM-II classification of mental disorders and replaced by the category Sexual Orientation Disturbance."
Replaced, not deleted. He calls the new category what it was: "This represented a compromise between the view that preferential homosexuality is invariably a mental disorder and the view that it is merely a normal sexual variant."
The paper then turns to the quieter second fight, over the DSM-III category of Ego-dystonic Homosexuality, a diagnosis for people distressed by their own orientation. Spitzer's conclusion about both disputes is the sentence the page is built on: "He argues that what is at issue is a value judgment about heterosexuality, rather than a factual dispute about homosexuality."
The other direction
A chair saying the question was values, not facts, can be read two ways. One reading is that the diagnosis never had evidence behind it and the profession finally admitted it. The other is that the removal was itself a values decision, made under pressure, and that a vote does not settle a scientific question. Spitzer's paper supports the first reading, but the sentence is honest enough to be quoted by the second.
What this does not show
This is a commentary by a participant, not a study. It reports no data. It does not say what causes sexual orientation and does not claim to. The compromise category it describes survived until 1987; the paper was written while it was still in the manual.
Worth asking
When a diagnosis is put to a vote, what was the evidence that put it in the manual in the first place?
Source
The diagnostic status of homosexuality in DSM-III: a reformulation of the issues — Spitzer RL (1981)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1176/ajp.138.2.210
DOI: 10.1176/ajp.138.2.210
How this was scored
- Study design
- Expert opinion or commentary
- Funding
- Funding not disclosed
- Published in
- Top-tier peer-reviewed journal
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 29, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "contested". Weak or heavily disputed. Treat as a question, not an answer. It scores 35 out of 100 on our published rubric. One caveat travels with that badge: A participant's account of a process he chaired. The paper reports no data and takes a position; the opposing position was argued in the same journal in the May 1973 symposium (PMID 4784866, record only, not read). The DSM-III category the paper discusses stayed in the manual until 1987. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
The diagnostic status of homosexuality in DSM-III: a reformulation of the issues — Spitzer RL (1981). Published in: Top-tier peer-reviewed journal. DOI: 10.1176/ajp.138.2.210. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Expert opinion or commentary. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.