LGBT+ History and ‘Mental Illness’


For LGBT+ history month, our colleague, LV Penman, wanted to reflect on the histories of LGBT+ identities and ‘mental illness’.

I work part-time in the Campaigns and Communications team at Rethink Mental Illness, alongside which I am also a counsellor specialising in working with LGBT+ people. My professional experience combines with my experiences both as someone who is bisexual and non-binary, and with a personal history of diagnoses of anxiety and depression.

Often conversations about LGBT+ identities mental illness centre on how prejudice and stigma experienced by people in relation to being LGBT+ impacts their mental health. That’s a really important topic. But what I want to focus on in this blog is the ways in which psychiatry and ‘mental illness’ have been weaponised as ways of attacking and suppressing LGBT+ people.

Indeed, the World Health Organisation only completely declassified same-sex attraction as a pathology or disease in the 90s. And only stopped classifying transgender people as mentally ill last year – 2022.

The WHO maintains the International Classification of Diseases (ICD), which is one of the main psychiatric handbooks and diagnostic tools. The other is the often better-known DSM, or Diagnostic and Statistical Manual of Mental Disorders, which was created by the American Psychiatric Association. Both publications have historically classified same-sex attraction and non-normative gender identities as disorders or pathologies.

  • The World Health Organisation only stopped classifying transgender people as mentally ill last year.

Unsurprisingly, framing same-sex attraction or trans identities as ‘mental illnesses’ has always gone hand-in-hand with attacks on LGBT+ rights. There are sadly countless examples, but some prominent ones in the UK include the introduction of Section 28 in 1988, and the ongoing battle over banning conversion therapy.

Section 28

Section 28 of the local government act banned local authorities and schools from "promoting homosexuality", calling same sex relationships “pretended family”. For those of us who went to school in the years between its introduction and its eventual repeal in 2003, it has cast a long shadow; growing up in a society which casts you as deviant can lead to isolation, shame and fear. However, Section 28 also mobilised activists and brought LGBT groups together to push for change. For me, taking part in anti-Section 28 protests as a teenager was an early experience of connecting to my community.

Conversion therapy

'Conversion therapy' is an attempt to change someone’s sexual orientation or gender identity.

In the UK we have what’s called a Memorandum of Understanding on Conversion Therapy. Signatories to the MOU include over 25 health, counselling and psychotherapy organisations, who agree that the practice of conversion therapy, whether in relation to sexual orientation or gender identity, is unethical and potentially harmful.

It can be shocking to realise that conversion practices still take place today. But we can also see how the history of pathologising certain identities leads to this happening – when same sex attraction or trans identity is cast as an ‘illness’, there are those who will seek to offer a ‘cure’.

And despite the position adopted in the MOU by the largest health, counselling and psychotherapy bodies in the country, the UK government has been dragging its heels on the banning of ‘conversion therapy’ for years. Boris Johnson pledged in 2018 to ban the practice. Three years later, the government ran a public consultation on the issue between October 2021 and February 2022 before announcing on 31 March last year that they would be scrapping the ban on ‘conversion therapy’. There was immediate uproar, and then hours later, the government made a u-turn and announced that a ban would be brought into place but only for lesbian, gay and bisexual people - not trans, asexual or intersex people.

This news devastated many people in LGBT+ communities and there was once again a huge upswell in activism to campaign against this decision, with over 145,000 people signing a petition in favour of an inclusive ban. This eventually led to the government committing last month to a full ban on conversion therapy – although full details on when and how this will be implemented have yet to be announced.

  • It can be shocking to realise that conversion practices still take place today.

The value of knowing our history

When I think about histories of ‘mental illness’ and of LGBT+ communities, I feel that there is a lot to learn about how we all understand and make sense of differing experiences: what is seen as ‘normal’, and why? I’m also interested in which stories get told, and which are forgotten or have been suppressed. I want to share stories of resistance and activism in response to violence, to celebrate and recognise the people who made or make life better for LGBT+ people, and show that change is possible when we mobilise.

In thinking about how narratives and normalities are created, I also want to acknowledge that I’m writing from my white/western perspective here – there is a lot more to say and consider about the links between the histories of gender and sexual classification, racism, and colonialism. As well as about the interlocking histories of civil rights, anti-racist and gay rights movements.

I’d like to finish by sharing a powerful example of how stories can be suppressed. When I speak to people about LGBT+ history, they are often surprised to learn that there was a pioneering institute in Germany in the 1920s offering support to people of all genders and sexualities. The Institut für Sexualwissenschaft provided sexual education and championed research on sexuality and gender. It supported people to transition, and housed a huge library of resources. In 1933 it was sacked, destroyed and burned by the Nazis.

This loss of history feeds into a story that others and patholgises sexual and gender variance, treating them as something ‘new’ rather than a natural part of human diversity, and our current experiences a continuation of a cultural conversation which has been going on for thousands of years. What might things look like today had the institute flourished?