Cf. Obituary, Judd Marmor, Psychiatrist who changed the view of homosexuality as a mental disorder, BMJ 2004;328:466 (21 February), doi:10.1136/bmj.328.7437.466
and
"Treating homosexuality as a sickness: Summary of responses. BMJ 2004;328:956 (17 April), doi:10.1136/bmj.328.7445.956-a

Giving Marmor Credit for the Idea that Homosexuality is Not an Illness is Undeserved 21 February 2004

Jeffrey A. Schaler, Ph.D.,
Assistant Professor, Department of Justice, Law and Society, School of Public Affairs
American University, 4400 Massachusetts Avenue, N.W., Washington, D.C. 20016-8043 U.S.A.
Email Jeffrey A. Schaler, Ph.D.

Sir:

Re: Obituary. Judd Marmor: Psychiatrist who changed the view of homosexuality as a mental disorder. BMJ 2004;328:466 (21 February).

Although the Latin proverb, "De mortuis nil nisi bonum," enjoins us that "Of the dead, we should speak kindly or not at all," giving Marmor credit for the idea that homosexuality is not an illness is undeserved. In fact, he deserves blame for knowingly borrowing this idea from Thomas Szasz, and claiming it as his own.

In the first edition of the book on homosexuality that he edited, Sexual Inversion: The Multiple Roots of Homosexuality, (New York: Basic Books, 1965), Marmor included a chapter by Szasz. In that chapter, published 5 years after his paper titled "The myth of mental illness" (later the title of his book), Szasz set forth his case against viewing homosexuality as a mental illness. Revealingly, Marmor, in his Introduction to the volume, wrote: "Is homosexuality an ’illness,’ or is it merely a different ‘way of life'? Most of the psychoanalysts in this volume (except Szasz) are of the opinion that homosexuality is definitely an illness to be treated and corrected" (p. 15).

Marmor's parenthetical phrase, "except Szasz," clearly indicates that Marmor, also a psychoanalyst, did not then share this view. (He never ceased his bitter opposition to Szasz's views.) In that book, Marmor never asserted that homosexuals are not mentally ill and regularly referred to them as "patients."

Ronald Bayer, in his definitive Homosexuality and American Psychiatry: The Politics of Diagnosis (New York: Basic Books, 1981), wrote: "It was Thomas Szasz who attempted to shift the terms of discussion to a conceptual level, focusing his attack on both the underlying ideological assumptions of psychiatry and the power of the profession in contemporary society. ... For Szasz the fundamental self-serving error of psychiatry was its effort to claim that deviations from behavioral norms were illnesses..." (Pp. 54-55).

Moreover, Szasz did not simply assert that homosexuality is not an illness, he asserted, and showed why, none of the (mis)behaviors psychiatrists classify as mental illnesses are illnesses. This, as Bayer recognized, was too much for psychiatry to stomach: Szasz's "far-reaching critique could not serve as the basis for the transformation of psychiatric thinking on homosexuality. To follow Szasz would have required a radical rupture with the deepest commitments of contemporary psychiatry" (p. 60).

Bayer noted that Marmor's 1965 views on homosexuality were "seen by contemporary homosexual critics as supportive of the dominant pathological view [of mental illness]" (p. 61). Unlike Szasz, Marmor was a loyal psychiatrist, always ready to defend the profession from its critics.

In short, Marmor rescued psychiatry from its commitment to labeling and persecuting homosexuals as sick, while at the same time he carefully preserved the profession's privilege to label and persecute as mentally ill other deviants, such as drug abusers and transsexuals. For this, organized psychiatry was duly grateful to him.

References

Szasz, T. The myth of mental illness. American Psychologist 1960 Feb; 15: 113-118

Szasz, T. The myth of mental illness: foundations of a theory of personal conduct. New York: Paul B. Hoeber, 1961.

Szasz, T. Legal and moral aspects of homosexuality. In, Judd Marmor, ed., Sexual inversion: the multiple roots of homosexuality. New York: Basic Books, pp. 124-139, 1965.

Bayer R. Homosexuality and American psychiatry: the politics of diagnosis. New York: Basic Books, Inc., 1981.

Competing interests: None declared