Current anti-LGBT legislation and medical practices are focused on religious refusal, First Amendment refusal, and conversion therapy. This is considerable progress. Being Lesbian, Gay, Bisexual, or Transgender was illegal in California as late as 1975 and New York 1980; for many people in their lifetime.
For twenty years homosexuality was listed as an official mental illness by the American Psychological Association (APA). The American Psychological Association (APA) removed homosexuality from the Diagnostic and Statistical Manual (DSM) in 1973. In the first edition of the DSM in 1953, homosexuality was included as a “sociopathic personality disturbance.” In the second edition of the DSM in 1968, the severity of illness was downgraded to “sexual deviation (Dailykos.com).” Decriminalization quickly followed the American Psychological Association’s decision in California and New York. Especially considering the time to implement significant statewide legal change.
Because homosexuality was categorized as a mental illness, before 1973 sexual orientation was most commonly treated with conversion therapy. Not only minors, but adults of any age could be subjected to destructive, unwanted conversion therapy. Today conversion therapy attempts are only elective for adults and there has been great progress in having conversion of minors made illegal in every state and federally.
While stated policy changed it was much different than acceptance and full equality. The silence, treatment, and lack of action during the HIV/AIDS epidemic was evidence. Ronald Regan was and the Center for Disease control were accused of doing nothing and never mentioning AIDS while thousands of Gay men died. The media openly attached names like “Gay cancer” and “Gay related immune disease – GRID” to the epidemic (NY Times, 1982).
In 1981 a group called the American Association of Physicians for Human Rights formed during the beginning of the AIDS epidemic because of the vast inequality. In 1994 they acknowledged that their focus was Gay and Lesbian health and medical treatment and changed their name to the Gay and Lesbian Medical Association (Wiki, GLMA). In 2012 they increased inclusion becoming the Health Professionals Advancing LGBT Equality.Advocacy has focused on a reversal of an AMA policy supporting programs that encourage sex preference reversal in selected cases and publishing the “Journal of the Gay and Lesbian Medical Association (Wiki, GLMA).”
Much of the current discrimination is focused on religious refusal. Many hospital officials want to reserve the right to refuse LGBT people medical treatment or allow partners to make medical decision, provide necessary medical information, or see their partner in the emergency room. Marriage Equality establishes the legal framework for some rights, but people strongly opposed are attacking civil rights. States that do not have LGBT non-discrimination policies can still refuse services by discriminating against people for being LGBT. Many people are fighting for explicit rights through religious exemption. LGBT people can be married, but many people are fighting for the right to show their opposition and refuse to accept LGBT couples as equal.
Paul Hard of Alabama was represented by Southern Poverty Law Center. His partner died in the hospital room while he was forced to wait outside. He had crucial medical information that the hospital ignored (SPLC.org). Marriage equality is still not a reality in Alabama because of Chief Justice Roy Moore’s obstruction. People like Paul Hard will likely face the same situation even after the United States Supreme Court Ruling that same-sex marriage bans were unconstitutional because Justice Moore is upholding the right of Alabaman’s to use religious refusal. People like Paul Hard will be listed as spouse on their partner’s death certificate but can still be denied the equal rights that could prevent his partner’s death.
Currently, the APA and AMA publish many documents supporting LGBT equality (APA, 2016). The American Psychiatric Association:
“affirms that same-sex sexual and romantic attractions, feelings, and behaviors are normal and positive variations of human sexuality regardless of sexual orientation identity; reaffirms its position that homosexuality per se is not a mental disorder and opposes portrayals of sexual minority youths and adults as mentally ill due to their sexual orientation; concludes that there is insufficient evidence to support the use of psychological interventions to change sexual orientation; encourages mental health professionals to avoid misrepresenting the efficacy of sexual orientation change efforts by promoting or promising change in sexual orientation when providing assistance to individuals distressed by their own or others’ sexual orientation (AMA, 2016)”
Today, transsexualism is still listed as a mental illness in DSM (DSM-IV-TR 302.85 “Gender Identity Disorder” or GID). This is an issue because it is still not covered by most health insurance plans. This means Transgender people are forced to be labeled mentally ill but offered no treatment for the illness. Ultimately, this categorization stigmatizes transgender people with no attempt to offer medical treatment. While the AMA and APA agree that being transgender is not elective, most people who do receive surgery pay for it themselves. In addition, an estimate from the Williams Institute reported that the cost of transgender medical services including transition surgery will only cost each health insurance policy members twenty cents per month (HRC, the Look Forward).