A review of award-winning documentary Cured.

Cured premiered on PBS on 11 October to coincide with National Coming Out Day. The documentary chronicles the years-long campaign which led the American Psychiatric Association (APA) to remove homosexuality from its manual of mental disorders.

Featuring rich, newly unearthed archival footage and incisive interviews with key players, Cured has already won an award from the American Historical Association. The British Film Institute called it “one of the best documentaries of this or any year.”

The first part made me sick to my stomach. In one scene, shot in 1966, an assembly of children are warned, “If we catch you with a homosexual… the rest of your life will be a living hell.” In another scene, a psychiatrist publicly opines that homosexuals cannot “remain happy for long.”

Homosexuality had once been in the purview of the Church, but people no longer believed so much in sin, and homosexuality came to be rebranded as something more credible for the times. In the first edition of its manual of mental disorders (DSM-I), published in 1952, the APA included homosexuality as a “sociopathic personality disturbance.” In the second edition (DSM-II), published in 1968, it reclassified it as a “sexual deviation.”

By the 1960s, a large majority of Americans believed homosexuality to be a mental illness, and many looked upon gays with varying mixtures of disgust, discomfort, and fear. People who were denounced as homosexual were unable to work as a teacher or judge or civil servant, or even to retain the custody of their children. Most gays had little choice but to remain closeted. Many bought into the narrative that they were mentally defective: some hoped that marriage might cure them; others sought treatment or were coerced into it.

The most common “treatment” at the time was talk therapy, but many gay men and women were subjected to more aggressive interventions such as aversion therapy and electroconvulsive therapy—even, in extremis, castration or lobotomy.

One, now elderly, victim described it as “like a horror movie.”

The fight-back

Small, isolated protests began to take place from 1965, with activists putting their livelihoods and families and friendships on the line. This gay liberation movement began to snowball after the 1969 Stonewall Uprising, in response to an arbitrary police raid in Greenwich Village, New York.

In 1970, activists infiltrated and disrupted the National Convention of the APA. At the 1971 convention, astronomer Frank Kameny demanded that psychiatrists provide scientific evidence for their claim that homosexuality is a mental disorder. In 1972, Dr John Fryer—who, like Kameny, had lost his job after being outed—addressed the convention under strict anonymity, complete with mask and wig and voice-distorting microphone. He began: “I am a homosexual. I am a psychiatrist… What is it like?” Hearts were warming, and minds shifting on the meltwater. In 1973, activist Ronald Gold received a standing ovation for his talk entitled, “Stop it, you’re making me sick!”

In December 1973, the APA board voted unanimously (with two abstentions) to remove homosexuality from the DSM. But psychoanalysts who objected to that move forced the APA to hold a referendum. In 1974, the APA asked its membership to vote on whether to affirm the board’s vote: 5,854 psychiatrists voted in favour, 3,810 against. The APA then compromised, removing homosexuality but replacing it, in effect, with “sexual orientation disturbance” for people “in conflict with” their sexual orientation. Not until 1987 did homosexuality completely drop 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 orientation, however, “wishes it were different because of associated psychological and behavioural disorders.”

As I discuss in The Meaning of Madness, 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. Today, the standard of psychotherapy in the US and Europe is gay affirmative psychotherapy, which encourages gay people to accept their sexual orientation—although some licensed professionals still conduct so-called “conversion therapy.”

Further thoughts

The early successes of the gay liberation movement are not ancient history but well within living memory. Gay marriage has been legal for some years now, but the old notions of sin and mental illness, of guilt and inadequacy, live on in the collective consciousness, including the substance of gay people born long after the 1970s. While the documentary is All-American, there are many countries in which homosexuality remains illegal, in some cases punishable with life imprisonment or even death. In many parts of Africa, conditions for gay people are in fact getting worse. Some important battles have been won but the war is far from over, and this documentary is good ammunition.

I think it’s also worth asking why attitudes to homosexuality, at least in America and Europe, have shifted so far and so fast after centuries of stasis. We flatter ourselves that we are more enlightened and tolerant than our forebears, but progress in one area is often tied to progress in other areas, and it must have helped that gender roles are now less defined and childbearing no longer the imperative it used to be.

But that is not to diminish the achievements of heroic activists like Frank Kameny and John Fryer, who carried the hand of history.

In the U.S., Cured is available to stream for free through November 30 at pbs.org and on the PBS video app. The film is streaming in the UK on Sky and NOW through 2024.

Loyalty is a broader concept than trust. Loyalty can be based on trust, typically long-standing trust, but can also be based on other things. Thus, loyalty to one’s country or football team, or to a tyrant, is based on something quite other than trust. Certain pets may offer the illusion of trust, but more properly offer loyalty.

The word ‘loyal’ is related to the word ‘legal’ and has, or had, feudal connotations, akin to ‘allegiance’ but with more feeling or personal involvement. Still today, loyalty is often to something that is greater than or beyond us. To call someone loyal can be slightly demeaning, whereas to call someone trustworthy is invariably ennobling.

Trust may be associated with love, and, especially with romantic love, can be a prerequisite for love. But it is entirely possible to love someone, and even to rely on his love, without also trusting him—as we often do, for example, with children. Conversely, we often trust people, such as doctors and judges, who do not love or even sympathize with us.

We can rely on someone to be a certain way or do certain things, such as turn up on time, get angry, or lose our keys. But trust is more than mere reliability, or, as we have seen, mere loyalty. Instead, trust is established when I ask or allow a suitable candidate to take at least some responsibility for something that I value, thereby making myself vulnerable to her, and she agrees to take that responsibility, or, in the circumstances, can reasonably be expected to do so.

I trust my doctor with my health because, by virtue of being a doctor, and my doctor, she has taken some responsibility for my health—and, of course, I have asked or allowed her to do so. But even then, my trust in my doctor is not all-embracing: given the kind of person that she is, and the nature of our compact, I can trust her with my health, but not, say, with my housekeeping or my finances.

My doctor may well one day decide, for one reason or another, to stop caring for my health, but I would expect her to regretfully make me aware of this fact, and maybe to make transitional arrangements so as to protect the thing that I value and entrusted her with, in this case, my health. If she withdrew herself in this measured and considerate manner, I would feel sad, disappointed, and perhaps annoyed, but I would not feel betrayed or let down, or, at least, not nearly as much as I would otherwise have.

The French for trust is confiance, which, like the English ‘confidence’, literally means ‘with faith’. Perhaps we cannot trust people not to let us down, other than by a leap of faith similar to belief in God, with the length of the leap determined by such factors as fear, habit, nature, reason, and love. But we can just about trust them—or some of them—not to mislead us, and to let us down lightly.