ADHD Homosexuality and the DSM
The case of homosexuality shows clearly how much cultural bias plays a role in psychiatric diagnoses. Psychiatry uses a guide to classifying mental disorders called the DSM (Diagnostic and Statistical Manual of Mental Disorders). The current one is the fourth edition and is called the DSM-IV.
The clinical classification of homosexuality evolved in line with the changes in attitude to homosexuality within society. Homosexuality was defined until 1974, by the American Psychiatric Association in the DSM (Diagnostic and Statistical Manual of Mental Disorders) as a mental health disorder. Homosexuality was then, in 1974, officially downgraded to Sexual Orientation Disturbance.
In 1973, the American Psychiatric Association (APA) asked all the members attending its convention to vote on whether they considered homosexuality to be a mental disorder. The vote to remove homosexuality from the list of mental disorders was not unanimous. 5,854 psychiatrists voted for removal , while 3,810 voted to keep it listed as a mental disorder.
Since it was clearly not a unanimous decision, the Psychiatric Association found a compromise, Homosexuality was conveniently renamed to Sexual Orientation Disturbance. Now everybody was happy. This evolved into Ego-Dystonic Homosexuality in 1980 when the DSM-III was published. In 1986, when the DSM-III was revised, homosexuality as Ego-Dystonic Homosexuality was finally removed from the DSM system. .
In the DSM-III there was a “mental disorder” called Ego-Dystonic Homosexuality. The reason for this was that psychologists and psychiatrists said that some gays and lesbians came to them for treatment. The explanation went like this: “This revision in the nomenclature provides the possibility of finding a homosexual to be free of psychiatric disorder, and provides a means to diagnose a mental disorder whose central feature is conflict about homosexual behavior.” Ego-Dystonic Homosexuality disappeared from the DSM in 1986, but was replaced by sexual disorder not otherwise specified. That term covers all bases.
The World Health Organization (WHO) has a parallel diagnostic system, the ICD-10 (International Statistical Classification of Diseases and Related Health Problems 10th Edition). They also considered homosexuality to be a mental health disorder. The WHO were slower at removing homosexuality from their mental health disorders list. They removed it in 1992, but are still keeping a form of homosexuality in their diagnostic criteria, Ego-dystonic Sexual Orientation.
Although the ADHD diagnosis is defined in the DSM-IV making it appear scientific, it is not purely scientific as the criteria used are subjective. What is perceived as different or unusual, but still in the “normal” range in one culture can be perceived as a “disorder” in another culture
Homosexuality didn’t suddenly change in 1974. There was no medical scientific breakthrough. The changing social attitude, not science said that same-sex attraction was a normal variant of sexuality among well-adjusted people. Science is about studying the material world, not about making theories to fit moral attitudes in society
Still the idea of homosexuality as a “mental disorder” continued. In the DSM-IV, there was a “mental disorder” called Gender Identity Disorder. Gender Identity Disorder, or GID, is when a person feels that their physical gender does not match their true gender
And the issue will continue on into the future. The next version of the DSM, the DSM-V, changed Gender Identity Disorder to Gender Incongruence
Homosexuality can be called a sin, an inclination, a preference, an orientation, or a lifestyle, but never a mental disorder.
The attitudes driven by the pharmaceutical industry, schools and other authorities are confusing what ADHD is, and how society can and should understand ADHD.